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Development of forced normalisation psychosis with ethosuximide
  1. Sean Apap Mangion1,
  2. Fergus Rugg-Gunn2
  1. 1Department of Telemetry, University College London, Institute of Neurology, London, UK
  2. 2Deparment of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
  1. Correspondence to Dr Sean Apap Mangion, seanapapmangion{at}


A 50-year-old man with known multidrug resistant coexistent focal and generalised epilepsy was commenced on ethosuximide, with normalisation of his electroencephalogram and cessation of absence seizures. Within 3 weeks, he developed a rapidly worsening paranoid psychosis with visual and olfactory hallucinations. A month after the cessation of ethosuximide and concurrent treatment with olanzapine, his psychosis resolved and permitted reinitiation of ethosuximide at a lower dose without recurrence of psychotic symptoms.

  • epilepsy and seizures
  • drugs: cns (not psychiatric)
  • delusional disorder
  • clinical neurophysiology

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  • Contributors SAM collected the patient data, performed the data review and composed the primary case report. FR-G provided the case, oversaw the case report write-up, and subsequently updated and corrected the drafts presented and offered expert advice.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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