Worsening of Myasthenia Gravis After Administration of Antipsychotics for Treatment of Schizophrenia

She, Shenglin; Yi, Wenying; Zhang, Bei; Zheng, Yingjun

doi:10.1097/jcp.0000000000000741

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…The use of olanzapine for this patient was justifi ed by the known sedative properties of this drug (along with antipsychotic activity) and this drugi is concidered as fi rst-choice medication for aggresive psychotic patients. The classic antipsychotics such as haloperidol, amisulpride or paliperidone were described as safer [11] which is confi rmed by our case report.…”

Section: Discussionsupporting

confidence: 81%

The case of acute psychotic episode treatment in patient with myasthenia gravis

Pajor¹,

Jankowska²,

Jarema³

2021

Glob J Medical Clin Case Rep

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A seventy-one old male patient with no previous Hx of mental disorders including alcohol use and with no family Hx of mental disorders was admitted to psychiatric ward due to acute aggression, agitation, excessive irritability and lack olf sleep. He suferred from myasthenia gravis for years and was treated chronically with ambenonium 20 mg daily. Because of comorbidity of uveitis with macular edema he received treatment with prednisolone 70mg daily. Because of acute psychotic symptoms the treatment with olanzapine up to 20mg/d was introduced without effect. The treatment was switched to haloperidol 10mg/d with gradual improvement of patient's behaviour. He was discharged from the hospital with indication to continue psychiatric, ohpthalomogic, and neurological outpatient care.

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Section: Discussionsupporting

confidence: 81%

The case of acute psychotic episode treatment in patient with myasthenia gravis

Pajor¹,

Jankowska²,

Jarema³

2021

Glob J Medical Clin Case Rep

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“…The lifetime prevalence of one or more autoimmune diseases is increased by 50% in schizophrenia [5], hence schizophrenia poses a possible risk factor of developing myasthenia gravis [6]. Till present day, the comorbidity of both disorders has been reported in around 10 cases that had varying degrees of myasthenic exacerbations [7].…”

Section: Discussionmentioning

confidence: 99%

Unmasking of Myasthenia Gravis After Introduction of Oral Risperidone in a Schizophrenic Saudi Male: A Case Report

Abualkhair¹,

Almaghrabi²,

Edrees³

et al. 2021

Cureus

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Myasthenia gravis is an autoimmune disease that affects the neuromuscular junction. It causes generalized muscle weakness that may include the respiratory muscles, potentially leading to a medical emergency known as a myasthenic crisis. This is a case report of a rare incident of a myasthenia gravis exacerbation after administration of the oral antipsychotic risperidone to a schizophrenic patient. Few similar cases have been reported. Although rare, such incidents are dangerous as physicians could easily confuse myasthenia gravis symptoms with extrapyramidal side effects of antipsychotics. This concern should be addressed not just with risperidone but rather with any other antipsychotics that exhibit anticholinergic side effects.

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“…Myasthenic patients are included in this group, given their increased risk for respiratory muscle weakness and resulting distress. A recent case report described a patient with myasthenia gravis who developed ptosis and respiratory distress after receiving a dose of a benzodiazepine for insomnia (11). Benzodiazepines are generally considered to be contraindicated in patients with the disease; they would not have been an appropriate choice for our patient, given her resolving episode of myasthenic crisis (and history of substance abuse) (12).…”

Section: Pharmacologic Considerations In Myasthenia Gravis and Overvimentioning

confidence: 99%

“…Quetiapine is an atypical antipsychotic that can be used at a low dose as an off-label treatment for insomnia; however, the complete list of adverse effects is quite extensive (28). There have been a number of case reports in which quetiapine, as well as other antipsychotics (to include olanzapine and risperidone), have led to an aggravation of myasthenic symptoms, pointing to their anticholinergic properties as a potential mechanism (11). Quetiapine also has the potential to cause orthostatic hypotension; the implications for myasthenia gravis have been discussed previously.…”

Section: Pharmacologic Considerations In Myasthenia Gravis and Overvimentioning

confidence: 99%

Management of Insomnia and Anxiety in Myasthenia Gravis

Jordan

Ortiz

2019

JNP

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Myasthenia gravis is a neuroimmunological disorder leading to skeletal muscle weakness. Common symptoms of the disease, such as anxiety, depression, and insomnia, can cause significant distress in patients. Unfortunately, selecting an appropriate medication for treatment of psychiatric comorbidities can prove to be challenging for providers given the unique pharmacologic constraints that myasthenia gravis presents. The authors present the following clinical vignette and accompanying discussion in an attempt to highlight the special considerations that must be taken into account when treating anxiety and insomnia in patients with myasthenia gravis, as well as to provide an overview of available medication options through the lens of existing constraints.

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Worsening of Myasthenia Gravis After Administration of Antipsychotics for Treatment of Schizophrenia

Cited by 10 publications

References 13 publications

The case of acute psychotic episode treatment in patient with myasthenia gravis

The case of acute psychotic episode treatment in patient with myasthenia gravis

Unmasking of Myasthenia Gravis After Introduction of Oral Risperidone in a Schizophrenic Saudi Male: A Case Report

Management of Insomnia and Anxiety in Myasthenia Gravis

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