After reading “Is she being abused or ‘acting out’” (Cases That Test Your Skills, Current Psychiatry, December 2007), I wonder if oxcarbazepine might have been the culprit behind Ms. L’s delusions that her caretaker was abusing her. There is some evidence that oxcarbazepine can contribute to delirium, and the timing of her allegations shortly after starting oxcarbazepine makes me think that perhaps the drug contributed to her delusions. Clearly the patient improved when taking risperidone, but I wonder what would happen if she had been switched to a different mood stabilizer.
Susan Rose, PhD
Portland, OR