1. Replacement of antipsychotic and antiepileptic medication by L-??-methyldopa in a woman with velocardiofacial syndrome
- Author
-
Rand C Ritchie, Edward A Smith, Rashiklal Patel, and James F O'Hanlon
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Psychosis ,medicine.medical_treatment ,Craniofacial Abnormalities ,Norepinephrine ,Seizures ,Dopamine ,medicine ,Humans ,Abnormalities, Multiple ,Pharmacology (medical) ,Methyldopa ,Antipsychotic ,Syndrome ,medicine.disease ,Psychiatry and Mental health ,Regimen ,Phenotype ,Anticonvulsant ,Psychotic Disorders ,Anesthesia ,Anticonvulsants ,Female ,medicine.symptom ,Psychology ,Adrenergic alpha-Agonists ,Mania ,Antipsychotic Agents ,medicine.drug - Abstract
We report the case of a 23-year-old woman with velocardiofacial syndrome (VCFS) and a history of psychosis and seizures. She had been treated with conventional antipsychotic and antiepileptic drugs for 10 and 3 years, respectively. However, she continued to experience occasional hallucinations and paroxysmal jerking of the extremities. L-alpha-methyldopa 500 mg b.i.d. (later reduced to 250 mg t.i.d.) was added to her regimen. Hallucinations and seizures stopped shortly. Over the course of approximately 1 year, the previous medications were discontinued without recurrence of psychotic and epileptic symptoms. Eventually, improved mental functions and behaviour enabled her transition from living in a licensed residential facility to sharing a private residence with a partner. VCFS is associated with haploinsufficiency of catecholamine-methyltransferase, leading to excessive extraneuronal catecholamine concentrations. Alpha-Methyldopa inhibits catecholamine neurotransmission in a variety of ways. It is possible that the drug compensated for genetically disturbed catecholamine transmission thus achieving beneficial effects in this case.
- Published
- 2003