The paranoid disorders of five patients remitted after treatment with
thymoleptic agents despite the absence of a full affective syndrome. Their
clinical symptoms at admission included suspiciousness, hypervigilance,
ideas of reference, hostility, belligerence, and delusions of persecution
or of infidelity. Some had phasic disturbances with somatic complaints or
prominent phobic anxiety symptoms, a family history of affective disorder,
or prior responses to thymoleptic drugs. These observations suggest that
some patients with paranoid psychosis who do not have a full DSM-III
affective syndrome may respond to antidepressant pharmacotherapy alone,
i.e., without neuroleptics. Systematic, prospective studies of this
phenomenon would help to ascertain diagnostic criteria for such patients
and the range of therapeutic responses.
Abstract Teaser