Insomnia is a prodromal symptom for psychosis

Abstract EN

A 23-year-old male patient, complaining of insomnia for the last two years, has been unresponsive to several trials of sedatives and hypnotics.

Moreover, he has experienced multiple fluctuating symptoms of dysphoric mood, isolation, anhedonia, and easy provocation; accordingly, he was prescribed a dosage of escitalopram (20 mg/day per day) and quetiapine (50 mg/day), at night.

Later, the symptoms were resolved, except for insomnia.

Consequently, other trials of psychotropic medication were received, without any improvement till he presented with delusion of persecution, auditory hallucinations (second person with ordering type), television broadcasting, and depersonalization.

At that time, olanzapine 20 md/day, in addition to depakine chrono (500 mg, BID) and risperidone (2 mg/day), were prescribed; but, he showed minimal improvement.

This case indicates that a possibility of insomnia, to be the prodromal symptom for psychosis, should be given considerable attention in young patients, with resistant insomnia.