Anti-NMDA receptor autoimmune encephalitis: a case report

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Pharmacology

Background:

• A 42-year-old female presented with insomnia, concentration difficulties, and short-term memory impairment.
• The patient denied any history of illicit drug use.

Observation:

• Treatment with fluoxetine and temazepam was initiated for presumed anxiety.
• Following medication initiation, the patient experienced acute confusion and paranoid delusions.
• The patient developed a delusion that her partner intended to harm her.

Findings:

• The clinical presentation suggests a potential adverse reaction to fluoxetine and/or temazepam.
• The neurological and psychiatric symptoms evolved after the introduction of these medications.
• Differential diagnosis should consider medication side effects in patients with new-onset cognitive and psychotic symptoms.

Implications:

• This case highlights the importance of considering medication side effects in the differential diagnosis of new-onset neurological and psychiatric symptoms.
• Further investigation is warranted to determine the specific agent responsible and the underlying mechanism.
• Clinicians should maintain a high index of suspicion for drug-induced psychosis and cognitive impairment.