Adjunctive low-dose amisulpride in motor conversion disorder.
Extant pharmacological options for motor conversion disorder include mainly antidepressants and benzodiazepines. We report on the case of a 42-year-old female patient with frequent daily episodes of almost complete paralysis for the last 6 months resistant to an escitalopram-lorazepam combination at adequate doses. By contrast, the adjunctive administration of low-dose amisulpride at 200 mg/d to the patient's regimen resulted in her substantial and durable improvement. We hypothesize that low-dose amisulpride, acting as a selective antagonist of D2 and D3 dopamine autoreceptors, might reverse the decreased activity of frontal and subcortical dopaminergic circuits presumably involved in motor control during hysterical paralysis.
Oulis
Panagiotis
P
1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, 74 Vas. Sofias Ave., Athens, Greece. oulisp@med.uoa.gr
Kokras
Nikolaos
N
Papadimitriou
George N
GN
Masdrakis
Vasilios G
VG
D000328:Adult; D000077582:Amisulpride; D015283:Citalopram / Q000627:therapeutic use; D003291:Conversion Disorder / Q000188:drug therapy* / Q000503:physiopathology; D018492:Dopamine Antagonists / Q000627:therapeutic use*; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008140:Lorazepam / Q000627:therapeutic use; D009044:Motor Cortex / Q000187:drug effects* / Q000503:physiopathology; D010264:Paraplegia / Q000188:drug therapy / Q000523:psychology; D011596:Psychomotor Disorders / Q000188:drug therapy* / Q000503:physiopathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013469:Sulpiride / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
D000077582:Amisulpride; D015283:Citalopram; D018492:Dopamine Antagonists; D004338:Drug Combinations; D008140:Lorazepam; D017367:Selective Serotonin Reuptake Inhibitors; D013469:Sulpiride