Psychotropic Management in Cotard Syndrome: Case Reports Supporting Dual Medication Management

Cotard syndrome is a rare presentation where patients present with nihilistic thoughts of dying or already being dead. These delusions manifest from either a medical or psychiatric etiology and can be difficult to treat. Recently Couto and Gonçalves purposed that treatment should include an atypical...

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Main Authors: Adam J. Fusick, Chemar Davis, Steven Gunther, Cory Klippel, Gregory Sullivan
Format: Article
Language:English
Published: Hindawi Limited 2024-01-01
Series:Case Reports in Psychiatry
Online Access:http://dx.doi.org/10.1155/2024/7630713
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author Adam J. Fusick
Chemar Davis
Steven Gunther
Cory Klippel
Gregory Sullivan
author_facet Adam J. Fusick
Chemar Davis
Steven Gunther
Cory Klippel
Gregory Sullivan
author_sort Adam J. Fusick
collection DOAJ
description Cotard syndrome is a rare presentation where patients present with nihilistic thoughts of dying or already being dead. These delusions manifest from either a medical or psychiatric etiology and can be difficult to treat. Recently Couto and Gonçalves purposed that treatment should include an atypical antipsychotic alone or in combination with either a mood stabilizer or antidepressant. Here the authors advocate for a more specific but well-known psychotropic regimen, namely the combination of olanzapine and fluoxetine. We conducted a literature review and of 246 papers identified, only three reported using a combination of fluoxetine and olanzapine with many of them having limited or confounding information that make it difficult for us to comment on the historically efficacy of this medication combination. Therefore, the authors provide two case examples of patients being treated successfully with olanzapine and fluoxetine. One, a 66-year-old male veteran and another 76-year-old male veteran. Both of these cases hold significance as the patient’s psychotic depression was so severe as to warrant ECT as a possible treatment. In both cases, this medication combination was able to avoid the procedure. Overall, with the addition of our cases and the sparse information available in the literature, we propose the combination of fluoxetine and olanzapine as an effective Cotard syndrome treatment.
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spelling doaj.art-e9381a8e83de41cb8ca7eb3016b3c6372024-04-17T00:00:03ZengHindawi LimitedCase Reports in Psychiatry2090-68382024-01-01202410.1155/2024/7630713Psychotropic Management in Cotard Syndrome: Case Reports Supporting Dual Medication ManagementAdam J. Fusick0Chemar Davis1Steven Gunther2Cory Klippel3Gregory Sullivan4Mental Health and Behavioral Sciences ServiceCollege of MedicineMental Health and Behavioral Sciences ServiceMental Health and Behavioral Sciences ServiceMental Health and Behavioral Sciences ServiceCotard syndrome is a rare presentation where patients present with nihilistic thoughts of dying or already being dead. These delusions manifest from either a medical or psychiatric etiology and can be difficult to treat. Recently Couto and Gonçalves purposed that treatment should include an atypical antipsychotic alone or in combination with either a mood stabilizer or antidepressant. Here the authors advocate for a more specific but well-known psychotropic regimen, namely the combination of olanzapine and fluoxetine. We conducted a literature review and of 246 papers identified, only three reported using a combination of fluoxetine and olanzapine with many of them having limited or confounding information that make it difficult for us to comment on the historically efficacy of this medication combination. Therefore, the authors provide two case examples of patients being treated successfully with olanzapine and fluoxetine. One, a 66-year-old male veteran and another 76-year-old male veteran. Both of these cases hold significance as the patient’s psychotic depression was so severe as to warrant ECT as a possible treatment. In both cases, this medication combination was able to avoid the procedure. Overall, with the addition of our cases and the sparse information available in the literature, we propose the combination of fluoxetine and olanzapine as an effective Cotard syndrome treatment.http://dx.doi.org/10.1155/2024/7630713
spellingShingle Adam J. Fusick
Chemar Davis
Steven Gunther
Cory Klippel
Gregory Sullivan
Psychotropic Management in Cotard Syndrome: Case Reports Supporting Dual Medication Management
Case Reports in Psychiatry
title Psychotropic Management in Cotard Syndrome: Case Reports Supporting Dual Medication Management
title_full Psychotropic Management in Cotard Syndrome: Case Reports Supporting Dual Medication Management
title_fullStr Psychotropic Management in Cotard Syndrome: Case Reports Supporting Dual Medication Management
title_full_unstemmed Psychotropic Management in Cotard Syndrome: Case Reports Supporting Dual Medication Management
title_short Psychotropic Management in Cotard Syndrome: Case Reports Supporting Dual Medication Management
title_sort psychotropic management in cotard syndrome case reports supporting dual medication management
url http://dx.doi.org/10.1155/2024/7630713
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