Research Reports - A case report of mania and psychosis five months after traumatic brain injury successfully treated using olanzapine

Case Rep Psychiatry. 2017;2017:7541307. doi: 10.1155/2017/7541307. Epub 2017 Jun

Cittolin-Santos GF(1), Fredeen JC(2), Cotes RO(2).

BACKGROUND: There are few published pharmacologic trials for the treatment of
acute mania following traumatic brain injury (TBI). To our knowledge, we present
the first case report of an individual being treated and stabilized with
olanzapine monotherapy for this condition.
CASE PRESENTATION: We describe the case of a 53-year-old African American male
admitted to an inpatient psychiatric hospital with one month of behavioral
changes including irritability, decreased need for sleep, hyperverbal speech,
hypergraphia, and paranoia five months after TBI. Using Diagnostic and
Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria, he was
diagnosed with bipolar disorder due to traumatic brain injury, with manic
features. He was serially evaluated with clinical rating scales to measure
symptom severity. The Young Mania Rating Scale (YMRS) score upon admission was
31, and the Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS)
score was initially 9. After eight days of milieu treatment and gradual titration
of olanzapine to 15 mg nightly, his symptoms completely abated, with YMRS and
CRDPSS scores at zero on the day of discharge.
CONCLUSION: Olanzapine was effective and well tolerated for the treatment of
mania following TBI. 

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