Quetiapine vs. risperidone in treating psychosis in neurosyphilis: a case report.
OBJECTIVE
A 44-year-old male patient presented with agitation, auditory hallucinations, and delusions of persecution was diagnosed as having neurosyphilis.


METHODS
He was treated with penicillin G 24 million units/day, risperidone 6 mg/day, and memantine 20 mg/day with partial response to psychotic symptoms and significant extrapyramidal symptoms.


RESULTS
On his follow-up, after 5 months, his cognitive status and serological tests remained the same, and his cell count was increased. A second therapy of penicillin was administered without any clinical improvement. On his second hospitalization for severe psychotic agitation after approximately 1 year, quetiapine 1200 mg/day was introduced and the psychiatric state improved immediately without significant side effect.


CONCLUSIONS
Quetiapine, which has a low potential for producing extrapyramidal side effects, should be considered in the treatment of psychotic symptoms of neurosyphilis.
Taycan
Okan
O
Department of Psychiatry, Cerrahpasa Medical Faculty, Istanbul University, 34098 Istanbul, Turkey. okantaycan@yahoo.com
Ugur
Mufit
M
Ozmen
Mine
M
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D003987:Dibenzothiazepines / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D009494:Neurosyphilis / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D010406:Penicillins / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000209:etiology*; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000627:therapeutic use*
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D010406:Penicillins; D000069348:Quetiapine Fumarate; D018967:Risperidone