[Initiation of treatment with olanzapine in a patient hospitalized at UMD].

Miss R is a 28-year-old patient presenting with paranoid schizophrenia. During a second acute psychotic episode involving attempted murder of her son, she was forcibly hospitalized in a Difficult Patients Unit. Following failure of treatment with a standard antipsychotic, therapy with olanzapine was rapidly initiated. Symptomatic improvement occurred quite rapidly, and the patient re-entered into contact with others and was once again able to relate normally with her son. By means of an admittedly heavy management regimen, this patient, considered as dangerous, was able to follow a programme resulting in independence and renewed social integration. After two years of follow-up, improvement persisted and the patient now lives alone in an apartment. Analysis of this "exemplary" case and of current data in the literature suggests that more extensive use of new antipsychotics may be envisaged in the management of acute psychotic episodes.