RE-EXAMINATION OF PSYCHIATRIC DISORDERS FROM THE VIEWPOINT OF ANTIPSYCHOTIC-INDUCED ENCEPHALOPATHY

Abstract Background There is inadequate understanding of chronic encephalopathy as one of the irreversible side effects of antipsychotics. Aims & Objectives The objective of this study was to identify clinical picture and to re-examining psychiatric disorders. Method Inquiries were sent to patients and lawyers, researchers were interviewed, and information was used from the literature. Results 15 years-old male, diagnosed wrongly as schizotypal personality. Haloperidol 10mg/day or levomepromazine, sulpiride, imipramine had taken for two years. After starting the medicine, insomnia worsened, Parkinsonism, catalepsy, prodromal stage of Neuroleptic malignant syndrome(NMS) appeared. MRI revealed cortical atrophy scattered each cerebral lobes toward the periphery(fig). Cerebral fissure and sulcus enlarged. Cerebral ventricle did not enlarge. Electroencephalography has revealed brain waves in the second stage of sleep during arousal. The 2nd case 48 years-old female. After the hysteromyoma operation, anxiety and hysteria appeared. The doctor gave haloperidol, 2.4mg [ /day ] 100 days, Chlorpromazine and diazepam were used together. Extrapyramidal syndrome, including Parkinson’ s syndrome appeared. Hypermyotonia and WAIS decreases from standard levels to 60. She had confined to bed for 3 years because of her tiredness of the brain after withdrawal of haloperidol. In acute stage, marked extrapyramidal symptom, anxiety, and mild dementia. In the chronic stage, they could only perform work for a short period of time due to mental exhaustion accompanied by heavy-headedness and became bedridden because of cerebral exhaustion, similar to chronic fatigue syndrome. Discussion & Conclusion It is the important viewpoint for re-examining the schizophrenic brain why antipsychotics heal the schizophrenic brain but destroy the normal brain. A normal brain is characterized by the orderly execution of neuronal activity, which is comprised of gene expression, impulse transmission, and neural circuits. Schizophrenia occurs when this orderly process disintegrates, resulting in the disruption of normal neural activity. Malignant neoplasm neural circuits are associated with the pathogenesis of schizophrenia. They occur independently of native neural circuits to generate the false self. Although the neurons located on the brain surface are already at the sleep level, the neurons located in the deep layers of the cerebral cortex are still active about EEG. The possibility that a reduction in continuity between neural circuits leads to insomnia is discussed. References Chandran. M and El-Shazy. M (2009), “Catatonia, neuroleptics and brain damage-a case report”, J Psychophamacol, Vol.23 No.2, pp.223-226