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A Complicated Case of Stroke, Epilepsy, and Mood Disorder: Hyperhomocysteinemia or Medication Cascade Publisher



Mohammadian F1 ; Amini H1, 2 ; Mohebbi N3 ; Jafarimehdiabad A1
Authors
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Authors Affiliations
  1. 1. Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

Source: Iranian Journal of Psychiatry and Behavioral Sciences Published:2021


Abstract

Introduction: Hyperhomocysteinemia is a risk factor for atherosclerosis and vascular disease, which is correlated with cerebral problems and various neurological disorders. Case presentation: We report a 20-year-old lady with a history of hyperhomocysteinemia affected with stroke, seizure, and mood disorder. By initiating medication for these illnesses, different complications appeared. During the hospital stay, drugs for treating a disease deteriorated the other. We encountered a complex patient and numerous ambiguities in her management. Conclusions: For patients with elevated serum homocysteine and psychiatry disorders, it is important to consider MTHFR gene mutation. Achallenge in these patients is to select the medication that does not deteriorate hyperhomocysteinemia. In this complex case, we used carbamazepine that was accompanied by clinical improvement. © 2021, Author(s).