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Olanzapine as an Adjunct in the Management of Refractory Psychogenic Excoriation With Comorbid Schizophrenia: A Case Report
Neurotic or psychogenic excoriation (PE) is one of the most commonly diagnosed skin disorders associated with a primary psychiatric condition. PE is characterized by excessive picking and scratching of normal-appearing skin, and is often comorbid or is an inherent manifestation of affective disturba...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Cureus
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384453/ https://www.ncbi.nlm.nih.gov/pubmed/32742822 http://dx.doi.org/10.7759/cureus.8772 |
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author | Yeager, Violet Bogoyas, Matthew Goubran, Bishoy Gonzalez, Lisandra Ferrer, Gerardo F |
author_facet | Yeager, Violet Bogoyas, Matthew Goubran, Bishoy Gonzalez, Lisandra Ferrer, Gerardo F |
author_sort | Yeager, Violet |
collection | PubMed |
description | Neurotic or psychogenic excoriation (PE) is one of the most commonly diagnosed skin disorders associated with a primary psychiatric condition. PE is characterized by excessive picking and scratching of normal-appearing skin, and is often comorbid or is an inherent manifestation of affective disturbance and psychosis itself in schizophrenia. Evidence in the literature has demonstrated the therapeutic efficacy of selective serotonin reuptake inhibitors (SSRI) in treating PE. Other pharmacological treatments that have shown therapeutic benefits in case reports include doxepin, clomipramine, naltrexone, pimozide, and olanzapine. However, using adjunct therapeutic methods or augmentation in the treatment of neurogenic excoriation in the setting of schizophrenia is still not well explored. In this study, we discuss the case of a 59-year-old medically complex paraplegic male with schizophrenia comorbid with severe refractory PE. The patient had poor adherence to psychopharmacological treatment. Consequently, the patient was repeatedly hospitalized due to acute exacerbations of schizophrenic episodes and self-mutilation due to PE. After several failed treatment approaches, olanzapine 10 mg PO BID was added as an adjunct therapy to the Haldol® Decanoate (Janssen Pharmaceutica, Beerse, Belgium) at a dosage of 100 mg/month intramuscularly to control the acute PE symptoms. This treatment modality proved successful in this case, and the patient has been free from PE relapse for over one year of close follow-up. Olanzapine along with Haldol Decanoate long-acting injectable (LAI), might, therefore, be a useful adjunct therapeutic modality for patients with refractory PE with a comorbid diagnosis of schizophrenia and warrants further research. |
format | Online Article Text |
id | pubmed-7384453 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-73844532020-07-30 Olanzapine as an Adjunct in the Management of Refractory Psychogenic Excoriation With Comorbid Schizophrenia: A Case Report Yeager, Violet Bogoyas, Matthew Goubran, Bishoy Gonzalez, Lisandra Ferrer, Gerardo F Cureus Dermatology Neurotic or psychogenic excoriation (PE) is one of the most commonly diagnosed skin disorders associated with a primary psychiatric condition. PE is characterized by excessive picking and scratching of normal-appearing skin, and is often comorbid or is an inherent manifestation of affective disturbance and psychosis itself in schizophrenia. Evidence in the literature has demonstrated the therapeutic efficacy of selective serotonin reuptake inhibitors (SSRI) in treating PE. Other pharmacological treatments that have shown therapeutic benefits in case reports include doxepin, clomipramine, naltrexone, pimozide, and olanzapine. However, using adjunct therapeutic methods or augmentation in the treatment of neurogenic excoriation in the setting of schizophrenia is still not well explored. In this study, we discuss the case of a 59-year-old medically complex paraplegic male with schizophrenia comorbid with severe refractory PE. The patient had poor adherence to psychopharmacological treatment. Consequently, the patient was repeatedly hospitalized due to acute exacerbations of schizophrenic episodes and self-mutilation due to PE. After several failed treatment approaches, olanzapine 10 mg PO BID was added as an adjunct therapy to the Haldol® Decanoate (Janssen Pharmaceutica, Beerse, Belgium) at a dosage of 100 mg/month intramuscularly to control the acute PE symptoms. This treatment modality proved successful in this case, and the patient has been free from PE relapse for over one year of close follow-up. Olanzapine along with Haldol Decanoate long-acting injectable (LAI), might, therefore, be a useful adjunct therapeutic modality for patients with refractory PE with a comorbid diagnosis of schizophrenia and warrants further research. Cureus 2020-06-22 /pmc/articles/PMC7384453/ /pubmed/32742822 http://dx.doi.org/10.7759/cureus.8772 Text en Copyright © 2020, Yeager et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Dermatology Yeager, Violet Bogoyas, Matthew Goubran, Bishoy Gonzalez, Lisandra Ferrer, Gerardo F Olanzapine as an Adjunct in the Management of Refractory Psychogenic Excoriation With Comorbid Schizophrenia: A Case Report |
title | Olanzapine as an Adjunct in the Management of Refractory Psychogenic Excoriation With Comorbid Schizophrenia: A Case Report |
title_full | Olanzapine as an Adjunct in the Management of Refractory Psychogenic Excoriation With Comorbid Schizophrenia: A Case Report |
title_fullStr | Olanzapine as an Adjunct in the Management of Refractory Psychogenic Excoriation With Comorbid Schizophrenia: A Case Report |
title_full_unstemmed | Olanzapine as an Adjunct in the Management of Refractory Psychogenic Excoriation With Comorbid Schizophrenia: A Case Report |
title_short | Olanzapine as an Adjunct in the Management of Refractory Psychogenic Excoriation With Comorbid Schizophrenia: A Case Report |
title_sort | olanzapine as an adjunct in the management of refractory psychogenic excoriation with comorbid schizophrenia: a case report |
topic | Dermatology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384453/ https://www.ncbi.nlm.nih.gov/pubmed/32742822 http://dx.doi.org/10.7759/cureus.8772 |
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