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• W4308358803 abstract "A 35 year old Caucasian female with a history of hypothyroidism, vitamin D deficiency, bipolar disorder, and anxiety disorder presented to a large psychiatric facility on a voluntary basis due to worsening mood lability, obsessive thoughts, repetitive mannerisms, and dangerous behavior despite adequate psychiatric follow up in an outpatient setting. Her symptoms began 4 months prior after an upper respiratory infection treated with antibiotics. Her outpatient psychiatric medication regimen included citalopram 20 mg daily, risperidone 2 mg daily, and mirtazapine 15 mg daily. Since the upper respiratory infection, the patient reported recurrent obsessive thoughts (e.g. I need to go on a drive with my Mom.) and associated compulsive rituals such as grabbing the steering wheel while her mother was driving. The patient denied having current or past tics. She denied persistent depressed mood except in association with her distressing obsessive-compulsive symptoms. Standard medical workup and MRI brain with and without contrast were noncontributory. The patient was started on escitalopram 20 mg daily for obsessive and compulsive symptoms along with N-acetyl cysteine 600 mg po qAM and qHS for augmentation. Risperidone 1mg po qAM and qHS was continued for mood stability and as augmentation for comorbid Tourette's spectrum and symmetry-related symptoms. Her symptoms improved with this regimen and she was discharged after five days in the hospital. This case demonstrates the potential for adult-onset obsessive-compulsive disorder following infection and the value of a complete medical history during psychiatric hospitalization. With the relative rarity of adult-onset obsessive-compulsive disorder, further studies are warranted to determine the treatment and mechanism of pathology. Further neuroimaging research and characterization of this patient and others may help to elicit the answers towards the mechanism of pathology and the optimal medication and treatment regimen for late-onset obsessive-compulsive disorder." @default.
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• W4308358803 date "2022-12-01" @default.
• W4308358803 modified "2023-09-30" @default.
• W4308358803 title "A case of late onset obsessive-compulsive disorder following an upper respiratory infection" @default.
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