THIN AT WHAT COST? CASE REPORTS OF SIBUTRAMINE-INDUCED PSYCHOTIC DISORDERS

Objective: the objective of these 4 case reports is to highlight that psychotic symptom can occur due to the consumption of sibutramine. the psychosis is usually self-remitting, once its consumption is stopped. methods: all cases with first episode psychosis presenting to a tertiary mental health institute in singapore were screened and 4 consecutive sibutramine-induced psychoses cases are reported. results: all the 4 cases that were diagnosed with sibutramine induced psychoses, had history of consumption of the substance in the tablet form or in substances like slimming tea or slimming powders. in 2 out of the 4 cases, no antipsychotics were started. in the 2 cases that received antipsychotics, they were for short duration. there was a temporal association between the consumption of sibutramine containing substances and the onset of psychotic symptoms. all patients were on follow up for two years and in 2 patients, there were no recurrence of psychotic symptoms. in 2 patient recurrent psychotic symptoms were temporally related with consumption of sibutramine and symptoms remitted when the consumption was stopped. conclusions: despite sibutramine being banned in several countries, it can still be purchased from countries allowing its sale and from online stores. labeling a patient having schizophrenia can be avoided if detailed history, specifically enquiring about the consumption of sibutramine is obtained