| Abstrakt: |
INTRODUCTION/OBJECTIVES: Empty sella is the neuroradiological or pathological finding of an empty sella turcica containing no pituitary tissue. Even though empty sella syndrome (ESS) and schizophrenia are both relatively common in the general population, to the best of our knowledge, there is only one similar case report regarding the co-occurrence of those two conditions. CASE PRESENTATION: We present two patients with empty sella findings on brain magnetic resonance imaging and with the diagnosis of treatment-resistant schizophrenia (TRS). A 50-year-old female who has had schizophrenia for 37 years was treated with olanzapine 20 mg, carbamazepine 800 mg and clozapine 500 mg daily, while a 33-year-old male with schizophrenia for 12 years was taking olanzapine 25 mg, promazine 300 mg, diazepam 30 mg, fluphenazine 4,5 mg and carbamazepine 600 mg daily. They both had severe psychopathology, including physical aggression, grossly disorganized behavior, hostility, overwhelming delusions and hallucinations, which required constant supervision. While all treatment options were ineffective for many months, electroconvulsive therapy (ECT) was indicated and the patients’ symptoms subsided significantly after 12 treatments of ECT. CONCLUSION: The relationship between TRS and ESS is completely unknown, given scarce literature reports so far. Our cases showed that the presence of empty sella was associated with the lack of response, but with unusually good tolerance to many antipsychotics in very high doses. This is also the second report on the use of ECT in those patients. According to this, ECT might be a safe and effective option in patients with TRS who have radiological findings of ESS. [ABSTRACT FROM AUTHOR] |
