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Post-stroke psychosis: how long should we treat?
Maria do Céu Ferreira1, Célia Machado2, Beatriz Santos1
1Serviço de Psiquiatria, Hospital de Braga, Braga, Portugal.
Trends in Psychiatry and Psychotherapy
|June 15, 2017
Summary
This case study highlights a rare instance of post-stroke psychosis requiring long-term, low-dose antipsychotic therapy. Continuous treatment may be necessary for select patients experiencing these neurological and psychiatric symptoms.
Area of Science:
- Neurology
- Psychiatry
- Neuroscience
Background:
- Post-stroke psychosis is an uncommon but significant complication following cerebrovascular events.
- Early identification and management of psychosis after stroke are crucial for patient outcomes.
Observation:
- A 65-year-old male developed psychotic symptoms, including delusional jealousy and agitation, one month after a right posterior cerebral artery ischemic stroke.
- Symptoms resolved with therapeutic doses of risperidone but recurred upon discontinuation.
- The patient achieved remission with a low-dose maintenance regimen of risperidone (0.25 mg/day).
Findings:
- This case demonstrates the potential need for sustained, low-dose antipsychotic treatment in managing persistent post-stroke psychosis.
- Continuous low-dose therapy effectively controlled psychotic symptoms in this patient over a one-year follow-up period.
Implications:
- The findings suggest that prolonged antipsychotic maintenance may be beneficial for specific post-stroke psychosis cases, particularly those with non-acute onset and identifiable risk factors.
- This case expands the understanding of treatment strategies for rare neurological and psychiatric sequelae of stroke.
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