Drug-induced akathisia: subjective experience and objective findings.

Drug-induced akathisia, especially antidepressant-induced akathisia, is a concern for mental health professionals of all disciplines, especially since the introduction of the so-called third-generation antidepressants such as fluoxetine. Failure to identify and treat this disorder can result in extraordinary suffering for the patient, which can in turn lead to preoccupation with the idea of suicide, specifically by jumping. The goal of this paper is to provide clinicians with an understanding of the protean presentations of this disorder along with a discussion of the current theories of etiology and pathophysiology as well as a strategy for identification and treatment.

Neurosarcoidosis presenting as schizophreniform disorder.

A patient whose clinical presentation met criteria for schizophreniform disorder was ultimately found to have neurosarcoidosis, and the psychiatric symptoms responded to steroid treatment. The ongoing search for organic etiology was prompted by the presence of cognitive decline, perseveration and rare bizarre automatisms. This is virtually the first reported association between schizophreniform disorder and sarcoidosis. We reviewed the literature on neurologic involvement and psychiatric manifestations in sarcoidosis as well as the concurrence between organicity and schizophrenic psychosis. The importance of attending to all elements of the mental status examination in a patient with complex atypical findings is underscored.

Isosafrole and schizophrenia-like psychosis.

A 19-year-old man developed a schizophrenia-like psychosis after ingesting isosafrole. His use of amphetamines and LSD failed to produce a similar syndrome. Isosafrole may provide another biochemical model for schizophrenia.