title: Not a usual suspect; rabeprazole therapy presenting as a severe neuropsychiatric illness: case report.
abstract: We report the case of a patient who, as a result of exposure to the proton pump inhibitor rabeprazole, developed a severe and disabling admixture of neuropsychiatric symptoms. Because of its widely appreciated placebo-like side effect profile, rabeprazole was never suspected as being the cause of his symptoms. Instead, a somatoform spectrum disorder was assigned based on the patient's atypical symptom presentation, progressive course, subjective psychological distress, intemperate consumption of healthcare resources over a relatively brief period of time and lack of any medical explanation for his symptoms at that time, despite exhaustive laboratory and radiologic work-ups. This case report reinforces the notion that even a medication such as rabeprazole, with an established safety and tolerability profile, may be associated with side effects severe enough to mimic disabling neuropsychiatric illness.
authors.affiliation: Branch Medical Clinic, Naval Air Station, Jacksonville, Florida, USA. caamdusn@wmconnect.com
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Alfonzo
authors.forename: William V
authors.initials: WV
authors.lastname: Bobo
authors.forename: Myron D
authors.initials: MD
authors.lastname: Almond
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D001562:Benzimidazoles / Q000009:adverse effects*; D001921:Brain / Q000503:physiopathology*; D003937:Diagnosis, Differential; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology*; D009853:Omeprazole / Q000031:analogs & derivatives; D006180:Proton-Translocating ATPases / Q000009:adverse effects*; D064750:Rabeprazole; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D001562:Benzimidazoles; D064750:Rabeprazole; D006180:Proton-Translocating ATPases; D009853:Omeprazole