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Reconsidering delusions

Vol. 9, No. 12 / December 2010

I appreciate Dr. Henry A. Nasrallah’s refreshing, mind-bending thoughts about delusions in, “Are some nonpsychotic psychiatric disorders actually psychotic?” (From the Editor, Current Psychiatry, November 2010, p. 16-19). I am moved to contemplate delusions in a new way and to try an antipsychotic in select cases. If delusional thinking were like a closed circuit with its associated neurotransmitter pathway and no access to cortical modification, it would make sense to use a “circuit breaker” (such as dopamine inhibitors and anxiolytics) to open up a pathway to cortical modification. Cognitive-behavioral therapy would help with the transition to cortical control.

Justine Forbes, MD
Private Practice
Los Gatos, CA

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