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Sir: In the literature we found only a few cases of severe cutaneous reactions to the antipsychotic drug risperidone [2, 4], either as monotherapy or in combination with other psychotropic drugs, above all with valproate [1, 3]. Our report describes three occurrences of facial and periorbital oedema with risperidone therapy in one patient that faded away every time the treatment with risperidone was discontinued. Mrs. R, a 63-year-old patient with chronic paranoid schizophrenia, has been hospitalised in our psychiatric hospital for 36 years. Most of the time her behaviour has been disorganised, with imperative auditory hallucinations, outbursts of severe agitation and physical and verbal aggression. During her long-term hospitalisation, she has been receiving practically all the known antipsychotics as well as clozapine and olanzapine. In 1998, risperidone 2 mg daily, titrated to 6 mg daily in 2 weeks, was added to fluphenazine, biperiden and bromazepam which, at the time, she had been receiving for many months. Periorbital oedema occurred after 1 month and it faded away in 1 week's time after the cessation of treatment with risperidone. All other drugs remained. Biochemical, haematological and thyroid laboratory values were within normal. Because her psychical status deteriorated and because she did not respond to treatment, 1 year later risperidone titrated to 6 mg daily in 2 weeks was once again introduced into treatment with promethazine, biperiden, clonazepam and nitrazepam. After a 45-day treatment together with

Chloroquine, an anti-malarial drug, is also used in the treatment of rheumatoid arthritis. It has been known for decades that chloroquine could cause psychiatric side effects; however, reports are scarce. This report concerns a rare case of 2 challenge and re-challenge episodes of mania during chloroquine treatment of rheumatoid arthritis. Some hypothetical pathophysiological mechanisms that may lead to these adverse effects are discussed.

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