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Schizoaffective Disorders Case Summary

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We present a case of 44-year-old Haitian-American male suffering from Schizoaffective disorder since 2005. The patient was born and raised by a single parent, immigrated to the USA. Since 2012, he has been getting admitted to the Kings County Hospital, inpatient psychiatric unit almost two to three times a year and generally remains on the unit for a period of three to four weeks every time.

In 2012, the patient was brought to the emergency department after reportedly agitated behavior in a restaurant and threatening customers where he had florid disorganization and psychosis. Baselines including Toxicology Screen, Urine Detailed Report, and Liver function test (LFT) was all normal. He was held on a legal status and treated with Risperidone and Valproate. …show more content…
Valproate level was 50.0 (target level 80-100). After one month, the patient noted to have abnormal twitching movements of his head and appeared drowsy. Electrocardiography (ECG) and Computed Tomography of Brain (CT brain) were ordered and Neurology consult was taken. Shortly after, the patient became unresponsive and immediately help was called and the patient was transferred to Intensive Care Unit for further management as his ammonia level was found to be 383 but with no hepatotoxicity (normal LFTs) and normal EKG, the Valproic Acid level was found to be 110 as he received the injection in the morning leading to discontinuation of Valproic Acid and we started

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