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Letters   |    
Control of Mania With Chelation-Only in a Case of Wilson’s Disease
Saikat Mitra, M.B.B.S.; Anindya Kumar Ray, M.D.; Sanchari Roy, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E06. doi:10.1176/appi.neuropsych.12110271
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Dept. of Psychiatry
R. G. Kar Medical College
Kolkata, India

Copyright © 2014 by the American Psychiatric Association

Extract

To the Editor: Psychiatric symptoms are not uncommon in Wilson’s disease (WD). Some patients may present only with psychiatric symptoms in the initial phase of disease, but, in the majority, they develop in the course of WD along with neurological signs. The common psychiatric symptoms are incongruous behavior, irritability, depression, and cognitive impairment.1 There are also case reports of manic-like presentation in patients with WD.2,3 Management of manic symptoms in the previous case reports was done by mood stabilizers (mostly lithium or valproate), atypical antipsychotics, or ECT.3 We have not found any report of treatment of psychiatric symptoms only by optimization of copper chelation.

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References

Dening  TR;  Berrios  GE:  Wilson’s disease: a longitudinal study of psychiatric symptoms.  Biol Psychiatry 1990; 28:255–265
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Machado  AC;  Deguti  MM;  Caixeta  L  et al:  Mania as the first manifestation of Wilson’s disease.  Bipolar Disord 2008; 10:447–450
[CrossRef] | [PubMed]
 
Loganathan  S;  Nayak  R;  Sinha  S  et al:  Treating mania in Wilson’s disease with lithium.  J Neuropsychiatry Clin Neurosci 2008; 20:487–489
[CrossRef] | [PubMed]
 
WHO:  International Classification of Diseases 10th Revision Clinical Description and Diagnostic Guidelines .  Geneva,  World Health Organization, 1992
 
Chroni  E;  Lekka  NP;  Tsibri  E  et al:  Acute, progressive akinetic-rigid syndrome induced by neuroleptics in a case of Wilson’s disease.  J Neuropsychiatry Clin Neurosci 2001; 13:531–532
[CrossRef] | [PubMed]
 
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