Case report: Recovery of hallucinations and cognitive impairment after administration of donepezil in a patient with schizophrenia and carbon monoxide poisoning

Seon-Hwa Baek; Ju-Wan Kim; Yun Young Lee; Ju-Yong Kim; Sung-Wan Kim; Jae-Min Kim

doi:10.3389/fpsyt.2022.1071417

Case report: Recovery of hallucinations and cognitive impairment after administration of donepezil in a patient with schizophrenia and carbon monoxide poisoning

Front Psychiatry. 2022 Nov 18:13:1071417. doi: 10.3389/fpsyt.2022.1071417. eCollection 2022.

Authors

Seon-Hwa Baek¹, Ju-Wan Kim¹, Yun Young Lee², Ju-Yong Kim¹, Sung-Wan Kim¹, Jae-Min Kim¹

Affiliations

¹ Departments of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea.
² Departments of Radiology, Chonnam National University Medical School, Gwangju, South Korea.

Abstract

Objectives: This report aims to introduce a rare case of a dramatic recovery by donepezil with a patient with schizophrenia who suffered from remaining psychotic symptoms despite proper treatment and had a cognitive impairment by carbon monoxide (CO) poisoning sequelae.

Case report: A 38-year-old male who developed schizophrenia 2 years ago had attempted suicide via CO inhalation due to his uncontrolled symptoms. He was hospitalized with delayed neurological sequelae (DNS). Though hyperbaric oxygen therapy (HBOT) was applied 10 times, his cognitive impairment did not recover. Surprisingly, with 5-10 mg donepezil, both cognitive function and the psychotic symptoms of the patient remarkably improved.

Conclusion: This case showed a good response of donepezil for a patient with schizophrenia and CO-induced DNS after ineffective HBOT. Although the mechanism of the phenomenon is unclear, it can be possible reasons that the neuroprotective effect of donepezil and white matter insult by CO poisoning.

Keywords: carbon monoxide; delayed neurological sequelae; donepezil; schizophrenia; suicide.

Publication types

Case Reports