Effect of Clozapine on Anti-N-Methyl-D-Aspartate Receptor Encephalitis With Psychiatric Symptoms: A Series of Three Cases
The main clinical manifestations of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis are acute or subacute seizures, cognition impairment, and psychiatric symptoms. Nowadays, the scheme of antipsychotic therapy for this disease has not been established. This study reports three cases of...
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| Format: | Article |
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Frontiers Media S.A.
2019-04-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fnins.2019.00315/full |
| _version_ | 1819142296368578560 |
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| author | Ping Yang Liang Li Shuaishuai Xia Bin Zhou Yong Zhu Gaoya Zhou Erwen Tu Tianhao Huang Huiyong Huang Feng Li Feng Li |
| author_facet | Ping Yang Liang Li Shuaishuai Xia Bin Zhou Yong Zhu Gaoya Zhou Erwen Tu Tianhao Huang Huiyong Huang Feng Li Feng Li |
| author_sort | Ping Yang |
| collection | DOAJ |
| description | The main clinical manifestations of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis are acute or subacute seizures, cognition impairment, and psychiatric symptoms. Nowadays, the scheme of antipsychotic therapy for this disease has not been established. This study reports three cases of anti-NMDAR encephalitis with psychiatric symptoms. The anti-NMDAR antibodies in cerebrospinal fluid (CSF) and serum were positive. The psychiatric symptoms still existed after intravenous immunoglobulin (IVIG) treatment; thus, clozapine was used for antipsychotic therapy. Case 1 was a 37-year-old man who suffered from bad mood and suicide behaviors for 1 month. Hallucination and delusion still existed after IVIG treatment and hormone therapy, and the symptoms were relieved when given clozapine for 12 months. Case 2 was a 28-year-old man who was admitted to our hospital due to injuring other people and destructive behaviors for 2 days. He showed irritability, bad temper, declined cognition, and severe delusion of persecution after IVIG treatment and hormone therapy, but the psychiatric symptoms disappeared when given clozapine for 3 months. Case 3 was a 23-year-old man who suffered from headache and babbing for 7 days. Symptoms such as irritability, bad temper, babbing, and injuring other people still existed after IVIG treatment and hormone therapy, but they disappeared when given clozapine for 2 months. Therefore, we suggest that during the treatment of anti-NMDAR encephalitis with psychiatric symptoms, if the anti-NMDAR antibodies in CSF and serum were positive, and psychiatric symptoms could not be controlled after IVIG and hormone therapy, clozapine may work. |
| first_indexed | 2024-12-22T12:08:05Z |
| format | Article |
| id | doaj.art-03017821526a4b838ee48ff44ba48f60 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-12-22T12:08:05Z |
| publishDate | 2019-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-03017821526a4b838ee48ff44ba48f602022-12-21T18:26:22ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2019-04-011310.3389/fnins.2019.00315440119Effect of Clozapine on Anti-N-Methyl-D-Aspartate Receptor Encephalitis With Psychiatric Symptoms: A Series of Three CasesPing Yang0Liang Li1Shuaishuai Xia2Bin Zhou3Yong Zhu4Gaoya Zhou5Erwen Tu6Tianhao Huang7Huiyong Huang8Feng Li9Feng Li10Department of Psychiatry, Hunan Brain Hospital, Clinical Medical School, Hunan University of Chinese Medicine, Changsha, ChinaProvincial Key Laboratory of TCM Diagnostics, Hunan University of Chinese Medicine, Changsha, ChinaProvincial Key Laboratory of TCM Diagnostics, Hunan University of Chinese Medicine, Changsha, ChinaDepartment of Psychiatry, Hunan Brain Hospital, Clinical Medical School, Hunan University of Chinese Medicine, Changsha, ChinaDepartment of Psychiatry, Hunan Brain Hospital, Clinical Medical School, Hunan University of Chinese Medicine, Changsha, ChinaDepartment of Psychiatry, Hunan Brain Hospital, Clinical Medical School, Hunan University of Chinese Medicine, Changsha, ChinaDepartment of Psychiatry, Hunan Brain Hospital, Clinical Medical School, Hunan University of Chinese Medicine, Changsha, ChinaShanghai Institute of Measurement and Testing Technology, Shanghai, ChinaProvincial Key Laboratory of TCM Diagnostics, Hunan University of Chinese Medicine, Changsha, ChinaProvincial Key Laboratory of TCM Diagnostics, Hunan University of Chinese Medicine, Changsha, ChinaSchool of Dentistry, University of California, Los Angeles, Los Angeles, CA, United StatesThe main clinical manifestations of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis are acute or subacute seizures, cognition impairment, and psychiatric symptoms. Nowadays, the scheme of antipsychotic therapy for this disease has not been established. This study reports three cases of anti-NMDAR encephalitis with psychiatric symptoms. The anti-NMDAR antibodies in cerebrospinal fluid (CSF) and serum were positive. The psychiatric symptoms still existed after intravenous immunoglobulin (IVIG) treatment; thus, clozapine was used for antipsychotic therapy. Case 1 was a 37-year-old man who suffered from bad mood and suicide behaviors for 1 month. Hallucination and delusion still existed after IVIG treatment and hormone therapy, and the symptoms were relieved when given clozapine for 12 months. Case 2 was a 28-year-old man who was admitted to our hospital due to injuring other people and destructive behaviors for 2 days. He showed irritability, bad temper, declined cognition, and severe delusion of persecution after IVIG treatment and hormone therapy, but the psychiatric symptoms disappeared when given clozapine for 3 months. Case 3 was a 23-year-old man who suffered from headache and babbing for 7 days. Symptoms such as irritability, bad temper, babbing, and injuring other people still existed after IVIG treatment and hormone therapy, but they disappeared when given clozapine for 2 months. Therefore, we suggest that during the treatment of anti-NMDAR encephalitis with psychiatric symptoms, if the anti-NMDAR antibodies in CSF and serum were positive, and psychiatric symptoms could not be controlled after IVIG and hormone therapy, clozapine may work.https://www.frontiersin.org/article/10.3389/fnins.2019.00315/fullclozapineanti-NMDA receptor encephalitispsychiatric symptomsantipsychotic therapyintravenous immunoglobulinhormone |
| spellingShingle | Ping Yang Liang Li Shuaishuai Xia Bin Zhou Yong Zhu Gaoya Zhou Erwen Tu Tianhao Huang Huiyong Huang Feng Li Feng Li Effect of Clozapine on Anti-N-Methyl-D-Aspartate Receptor Encephalitis With Psychiatric Symptoms: A Series of Three Cases Frontiers in Neuroscience clozapine anti-NMDA receptor encephalitis psychiatric symptoms antipsychotic therapy intravenous immunoglobulin hormone |
| title | Effect of Clozapine on Anti-N-Methyl-D-Aspartate Receptor Encephalitis With Psychiatric Symptoms: A Series of Three Cases |
| title_full | Effect of Clozapine on Anti-N-Methyl-D-Aspartate Receptor Encephalitis With Psychiatric Symptoms: A Series of Three Cases |
| title_fullStr | Effect of Clozapine on Anti-N-Methyl-D-Aspartate Receptor Encephalitis With Psychiatric Symptoms: A Series of Three Cases |
| title_full_unstemmed | Effect of Clozapine on Anti-N-Methyl-D-Aspartate Receptor Encephalitis With Psychiatric Symptoms: A Series of Three Cases |
| title_short | Effect of Clozapine on Anti-N-Methyl-D-Aspartate Receptor Encephalitis With Psychiatric Symptoms: A Series of Three Cases |
| title_sort | effect of clozapine on anti n methyl d aspartate receptor encephalitis with psychiatric symptoms a series of three cases |
| topic | clozapine anti-NMDA receptor encephalitis psychiatric symptoms antipsychotic therapy intravenous immunoglobulin hormone |
| url | https://www.frontiersin.org/article/10.3389/fnins.2019.00315/full |
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