PMC5942176_01
Schematic drawing of the course of treatment. The day the patient received a brain injury due to a fall down a flight of stairs is set at Day 0. Administered doses of CBZ, CPZ, VPA, quetiapine, and mianserin are presented in mg/day. Aside from these drugs, haloperidol (<3 mg/day) or risperidone (<3 mg/day) were used to treat psychomotor excitement with delusional thoughts during the entire course of treatment. Serum concentrations of CBZ and VPA at the indicated time points (arrows) are given in microg/mL. The ratio of eosinophils in the white blood cells is presented as a percentage, and the levels of gamma-GTP and ALP are presented in U/L. The normal ranges for each parameter and the therapeutic effective serum concentrations of the drugs are indicated in parentheses.. Abbreviations: CBZ, carbamazepine; CPZ, chlorpromazine; VPA, valproic acid; gamma-GTP, gamma-glutamyl transpeptidase; ALP, alkaline phosphatase.
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To treat the symptoms of psychomotor excitement with delusion and aggression, the psychotropic drugs CPZ and VPA were administered, with CBZ added later (Figure 1). After his recovery from the allergic reaction to CBZ, CPZ, and VPA, the patient again exhibited milder cutaneous eruptions, possibly induced by mianserin (Figure 1).