ABSTRACT
Objective: The objective of this case report is to highlight the challenges faced in managing a patient with treatment resistant bipolar mania. Methods: We report a case of a young Chinese lady who was in the manic phase of bipolar mood disorder and though compliant, was found to be resistant to standard anti-manic medications that were given for a duration of 3 months. Clozapine was used as augmentation therapy. Results: Marked clinical improvement was shown after augmentation with clozapine. Conclusions: Clozapine appears to be effective augmentation therapy when dealing with cases of resistant bipolar mania. However, further in-depth studies are needed to substantiate its indication, safety and effectiveness in such cases.
ABSTRACT
Objective: The objective of this case report is to highlight a rare case of delusion of parasitosis induced by heroin abuse. Methods: We report a case of a 44-yearold heroin addict who had the false and unshakeable belief of being infested by the African botfly. As a result of his belief, he resorted to various methods to rid himself of the insect such as picking his skin with a knife and burning his skin with a lighter. Result: He was diagnosed to be suffering from heroin induced psychotic disorder and was successfully treated with the atypical antipsychotic olanzapine. Conclusions: Heroin; an opiate which is not commonly known to cause psychosis was seen to have been the cause of the delusion of parasitosis suffered by our patient.