Past Issues

A 43-year-old male patient was hospitalized with complaints of manic and psychotic symp-toms. He had no history of systemic diseases and brain injury. He had two previous psychiatric vis-its, suspecting substance-induced disorder. His family stated his mental condition had been nor-mal without taking any medication in recent five years. This time, he presented himself with manic symptoms of decreased need of sleep, increased sexual drive, and hazardous driving five days be-fore he was hospitalized. He subsequently devel-oped psychotic symptoms as persecutory delu-sion, delusion of being possessed, and visual hallucinations. At the emergency department, his mental status examination showed elated mood, labile affect, and loosed associations. He denied illegal substance use, and his urine drug screen was negative in finding. After admission, he re-ceived olanzapine 15 mg daily and his symptoms were resolved one week afterwards.