ABSTRACT
Antipsychotics are considered a gold standard treatment for schizophrenia. However, there is considerable variation in antipsychotic medication choice. Factors considered involved include symptomatology, prior response, and adverse reactions. This case report presents a 38-year-old male patient with schizophrenia in acute psychosis refractory to several antipsychotics. Hypotheses for the mechanism of action of antipsychotics and psychopharmacology are discussed, and treatment resistance is defined. The patient's psychiatric, medical, and social history and past antipsychotic medications are reviewed. Afterward, the rationale for initiating perphenazine is discussed, and the patient's improvement with this medication is examined. Current literature on perphenazine's efficacy is also reviewed and discussed alongside its limitations.
ABSTRACT
Headache is a common adverse effect of electroconvulsive therapy. The analgesic medications acetaminophen, nonsteroidal anti-inflammatory agents, muscle relaxants, or narcotics usually produce only short-term benefit. Topiramate was an effective therapy for a post-electroconvulsive therapy headache that did not respond to typical pain medicines.
