alexa Psychiatric Comorbidity In Patients With Prader Willi Syndrome- A Case Series
ISSN: 2378-5756

Journal of Psychiatry
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19th Global Congress on Pediatricians & Child Psychiatry
July 12-13, 2017 Chicago, USA

Michael Nevid and Katherine Callaghan
Stony Brook University School of Medicine, USA
Posters & Accepted Abstracts: J Psychiatry
DOI: 10.4172/2378-5756-C1-021
Abstract
Prader Willi syndrome (PWS) is a genetic disorder of physical and developmental consequence caused by loss of function on chromosome 15 (q11-q13). Patients with PWS often have concurrent behavioral disturbances such as preoccupation with food, skin picking or aggression. Psychosis has also been described in the adult PWS population. Obsessive-compulsive tendencies, and aggression are seen in younger PWS populations. Yet, little has been reported on the PWS population with bipolar disorder. In regards to treatment, SSRIs lessen obsessive compulsive and aggressive symptoms in some patients. However, there are case reports of increased aggression, food-seeking behavior or mania after starting an SSRI which may suggest underlying bipolar illness. Here we present five cases of Prader Willi syndrome patients exhibiting episodic manic symptoms indicative of bipolar mood disorder. We subsequently discuss individual treatment regimens. This case series demonstrates bipolar disorder which can be seen in adolescent as well as adult patients with PWS. SSRIs are the current mainstay psychiatric treatment for behavioral disturbances. However, this trend must be re-evaluated for the PWS population. We note the antipsychotics ziprasidone and risperidone prevented further manic episodes, guanfacine decreased aggression and NAC lessened skin picking. Ziprasidone, a weight neutral atypical, may be a better option than other atypicals when considering hyperphagia in PWS. Given the added burden of aggression in PWS, the common decade delay from symptom to diagnosis could lead to more morbidity in the PWS population compared to those without this syndrome.
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