Case
Published · Updated · 2 min read
Paroxysmal perceptual alterations during paliperidone treatment: a case report
What it means for practice
Brief visual disturbances during paliperidone treatment should be distinguished from psychotic relapse. This case suggests that dose reduction may decrease episode frequency.
Summary
This case report describes a 32-year-old man with bipolar I disorder who experienced paroxysmal perceptual alterations during paliperidone treatment. The patient also had alcohol and benzodiazepine use disorders.
Presentation and changes after treatment adjustment
Episodes involved brief visual disturbances, including intensified perception of light and colors, and resolved after sleep. Reducing the paliperidone dose was followed by a decrease in episode frequency. Propranolol reduced their duration and intensity.
Clinical relevance and limits of the evidence
The authors emphasize the importance of recognizing these disturbances to avoid misinterpreting them as psychotic relapse. Dose adjustment is considered a potential treatment strategy. However, this is a report of one patient, not a comparative study of intervention effectiveness.
The supplied abstract does not provide paliperidone or propranolol doses, the precise timing of symptom onset, or follow-up duration. It therefore does not establish a specific treatment-adjustment regimen or a causal relationship with paliperidone.
Case analysis
- Likely mechanism
- The supplied abstract does not describe the mechanism of paroxysmal perceptual alterations during paliperidone treatment; the available information is insufficient to determine it.
- Causality assessment
- Editorial WHO-UMC assessment: possible causal relationship. Symptoms occurred during paliperidone treatment, and their frequency decreased after dose reduction. However, the precise temporal relationship is not provided, and alternative causes, including those related to the coexisting alcohol and benzodiazepine use disorders, have not been excluded.
- Take-home lesson
- Paroxysmal visual disturbances during paliperidone treatment should not automatically be interpreted as psychotic relapse. In this patient, dose reduction was accompanied by fewer episodes, while propranolol reduced their duration and intensity.
Source
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Paroxismale perceptuele alteraties bij paliperidongebruik: een casusbespreking. tvgg.be.
Reviewed by: DrugCard editorial team ·
This article does not replace clinical judgement. Disclaimer