Acute Psychosis Related to Baclofen in a Patient Treated for Binge Eating Disorder Highlights the Urgent Need to Regulate Off-Label Prescriptions.

about 5 to 6 years ago, but discontinuing the medication secondary to excessive sedation. In addition, he reported taking fluoxetine 25 years ago transiently for a few weeks; he reported discontinuing the psychotropic medication secondary to adverse sexual effects. The veteran reported drinking alcohol and indulging in marijuana recreationally during his time in Vietnam. He denies any recreational drug use since 1977. He reported drinking 1 to 2 alcohol beverages yearly. Veteran denies any alcohol usage over the past 18 months. His Mini Mental Status Exam score prior to his disinhibition episode was 27. The patient and his family could establish a temporal relationship with the disinhibition symptoms and administration of 0.5 mg of clonazepam. Subsequently, the patient was tapered off clonazepam over 2 weeks, and disinhibition symptoms subsided. The veteran scored 7 on the Naranjo algorithm, indicating a probable adverse drug reaction. The sleep medicine physician prescribed olanzapine 10 mg by mouth, which led to resolution of his RBD. Olanzapine was started during the benzodiazepine taper to obtain consolidated sleep and mood stability and potentially improve CPAP adherence due to its soporific effect. Olanzapine was deemed to be a safe alternative given the veteran showed no evidence of cognitive impairment. Based on his Mini Mental Status Exam score and clinical evaluation, he demonstrated no significant problems with memory, language, thinking, or judgment that were greater than normal age-related changes.

• Publication year

  2019

• Venue

  Journal of Clinical Psychopharmacology

• Publication date

  2019-04-01

• Fields of study

  Medicine, Psychology

• Identifiers
  DOI 10.1097/JCP.0000000000001044PMID 30939595
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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