Mesh : Adolescent Age of Onset Aggression Amino Acid Metabolism, Inborn Errors / epidemiology genetics psychology therapy Anticonvulsants / therapeutic use Anxiety Disorders / genetics Child Contraindications, Drug Developmental Disabilities / epidemiology genetics psychology therapy Electroencephalography Epilepsy / genetics Hallucinations / genetics Humans Neuroimaging Phenotype Psychotic Disorders / genetics Psychotropic Drugs / therapeutic use Sleep Disorders, Intrinsic / genetics Succinate-Semialdehyde Dehydrogenase / antagonists & inhibitors deficiency genetics Symptom Assessment Valproic Acid / adverse effects pharmacology gamma-Aminobutyric Acid / metabolism

来  源:   DOI:10.1097/YPG.0000000000000264

Abstract:
Succinic semialdehyde dehydrogenase (SSADH) deficiency is an ultra-rare inborn error of metabolism that results in disrupted gamma-amino butyric acid (GABA) catabolism. In addition to developmental delay, intellectual disability, hypotonia, ataxia, and seizures, a variety of neuropsychiatric symptoms may occur, including psychosis. By highlighting all available and relevant case reports/series, this qualitative review seeks to characterize the prevalence, clinical manifestation, pathophysiology, and treatment of psychotic symptoms in this population. Psychosis occurs in a minority of SSADH-deficient individuals, and most commonly presents as auditory or visual hallucinations with an onset in adolescence or young adulthood. Although the pathophysiology underlying the development of psychosis in this context is not fully understood, it likely in part relates to increased GABA and/or gamma hydroxybutyric acid activity. Although antipsychotic medications should be used cautiously in SSADH deficiency, they may be effective at treating emergent psychotic symptoms.
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