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Rapid resolution of acute and transient psychotic disorder with the homoeopathic medicine: A case report
*Corresponding author: Dr. Vivek G. Vasoya, Dr. Vasoya’s Healing Homeopathy - Neuropsychiatry and De Addiction Centre, Rajkot, Gujarat, India. drvasoyashealinghomoeopathy@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Vasoya VG, Umaretiya NJ. Rapid resolution of acute and transient psychotic disorder with the homoeopathic medicine: A case report. J Intgr Stand Homoeopathy. 2025;8:44-7. doi: 10.25259/JISH_10_2024
Abstract
Acute and transient psychotic disorder includes highly variable symptoms including delusions, hallucinations and disorganised thinking without warning, reaching peak severity within 2 weeks. Episodes most often resolve within days to a month. Unrelated to other medical conditions, substance use or withdrawal, this disorder presents a unique challenge in terms of management. In the present case, Kali Bromatum, a homoeopathic medicine, was effectively used for treatment. The patient showed significant improvement from initial severity scores to complete recovery, as measured using two tools: The Clinician-Rated Dimensions of Psychosis Symptom Severity and Modified Naranjo Criteria. This approach contrasts with traditional methods that may require antipsychotics or hospitalisation, illustrating the potential of homoeopathy in managing such disorders within a home setting.
Keywords
Homoeopathy
Kali Bromatum
Mental health
Psychotic disorders
INTRODUCTION
Acute and transient psychotic disorders (ATPD) abruptly manifest with severe symptoms such as delusions and hallucinations, peaking rapidly without warning signs. This psychiatric condition is noted for its variability in symptoms, which can shift dramatically within hours; the disorder typically resolves within 3 months. The distinct nature of ATPD, not linked to other medical conditions or substance withdrawal, presents unique treatment challenges. Traditional management often relies on antipsychotics and hospitalisation,[1] which may not always be the most individualised or gentle approach for patients. In this context, the use of Kali Bromatum, a homoeopathic similimum, introduces an alternative therapeutic option. A detailed case study showcases its effectiveness in treating ATPD, marked by a significant improvement in symptom severity and a return to baseline functioning, validated by clinical assessments. This approach contrasts with conventional methods,[1] highlighting the potential of homoeopaths in providing a personalised and less invasive treatment method for acute psychotic episodes.
CASE REPORT
Patient information
Onset: Sudden.
Duration: One day – there were no mental symptoms before the onset of current symptoms.
Progress: A 26-year-old man with a background in electrical engineering, employed as a repair technician in the industry, consulted us on October 27, 2023, accompanied by his father. From the afternoon of 26th October, the patient started experiencing intense suspicions, believing that his family was conspiring against him and that he was the subject of their conversations. He also feared that his mobile phone had been compromised. Presenting as detached and preoccupied, his demeanour suggested a disconnect from his surroundings as he was not maintaining eye contact. In addition, he was grappling with guilt over a past incident where he had taken a small electronic item from his workplace; though he had not received any complaints from the workplace, he was repeatedly seeking forgiveness for this action. There had been no occurrence of guilt before this episode. He was experiencing episodes of involuntary crying during the night, running here and there inside the home, coupled with a strong desire for the presence and reassurance of his father and wife, driven by feelings of anxiety and fear. The patient had complete insomnia, with his symptoms intensifying between 3 and 4 am. This abrupt change in behaviour, contrasting with his previous state of normal work and family engagement, had been ongoing for a day.
Stressors: None. No history of substance use.
Medical history: Complaints of migraine for 8 years, often triggered by emotional disturbances. He was taking painkillers as and when required.
Family history: No significant illness in the family.
Mental state examination at the time of first consultation
Appearance and behaviour
Appears age-appropriate, with no distinctive physical characteristics. His demeanour is preoccupied and he seems detached from his surroundings. No abnormal or involuntary movements were noted. Running here and there is possibly linked to anxiety. Poor eye contact with the physician.
Speech and language
Speech rate and volume are within normal limits but may vary with emotional topics. Speech flow is generally coherent but occasionally disrupted due to emotional distress.
Mood and affect
The patient reports feelings of anxiety and fear. Affect is congruent with the reported mood, showing signs of distress, worry, and intermittent tearfulness.
Thought process and content
Thought processes appear linear but are heavily influenced by the current emotional state. Prominent themes include intense suspicion towards his family, the delusion of privacy invasion (mobile phone hacking) and overwhelming guilt about a past minor theft.
Perceptions
No hallucinations were reported or observed.
Cognition
The patient is oriented to time, place and person.
Concentration and Attention: Potential impairment due to emotional distress and lack of sleep. No overt signs of memory impairment, but his current mental state is affecting his recall abilities.
Insight and judgement
Partial insight into his condition; recognises the change in his behaviour but may not fully understand its nature or severity. Judgement appears to be affected by his current mental state, as he was unable to handle past events of minor theft rationally due to paranoid thoughts and intense emotional responses.
Diagnostic process
The clinical diagnosis guided by a detailed mental state examination suggests ATPD, characterised by acute onset of paranoia, losing touch with reality and emotional distress without a prior psychiatric history. Differential diagnosis is crucial, ruling out chronic conditions and substance-induced psychosis due to the absence of hallucinations and substance use.[2,3]
Physical examination: No significant findings; the patient’s vitals were stable.
Diagnosis: ATPD (6A23.0).[3]
Therapeutic intervention: The patient was managed on an outpatient department basis.
Available totality
Thinks he has committed a crime – A small theft in the past from the workplace.
Suspicious – The family is planning something against him, and he is the topic of their conversation.
His mobile is being hacked.
Fearful and anxious – desires family’s company.
Fits of weeping.
Total sleeplessness due to fear and anxiety.
| No | Rubrics |
|---|---|
| 1 | MIND -DELUSIONS -conspiracies -against him; there are conspiracies |
| 2 | MIND -DELUSIONS -watched, she/he is being |
| 3 | MIND -DELUSIONS -crime -committed a crime; he had |
| 4 | MIND -COMPANY -desire for -alone agg.; when |
| 5 | MIND - WEEPING – involuntary |
| 6 | SLEEP -SLEEPLESSNESS -insane people, in |
| 7 | GENERALS -NIGHT -midnight -after -3 h-3–4 h |
Medicines/coverage
Kali Brom 6/9
Arsenic alb 5/9
Pulsatilla 4/6
Lachesis 6/7
Rhus tox 4/7
Causticum 4/5
The susceptibility in this case was judged to be moderate to high, considering the psychotic affection of the mind, good vitality and intensity of complaints. Therefore, following the materia medica reference and remedy differentiation [Table 2], we deemed the Kali Bromatum 200C potency sufficient to initiate the reaction.
| Lachesis | Kali Bromatum |
|---|---|
| Often indicated in cases where there is intense jealousy, suspicion and a tendency towards loquacity. Patients may show marked sensitivity to touch and an aversion to tight clothing, particularly around the neck. The mental symptoms can exacerbate during sleep, with patients waking in a state of agitation. Lachesis patients are typically more loquacious, jumping from topic to topic and their symptoms improve with the onset of discharge. The presence of intense suspicions, in this case, aligns with the symptoms of Lachesis, but the absence of loquacity and the lack of specific modality make its application less straightforward.[5-7] | It is characterised by its efficacy in treating cases with marked paranoia, fears of being harmed and guilt over imagined wrongs. Patients may experience profound insomnia, restlessness and nightmares, often worsening in the early hours of the morning. The profile of Kali Bromatum includes mental dullness and confusion, which can manifest as detachment and preoccupation, closely mirroring the patient’s state. The guilt over a minor theft, intense suspicion towards his family and specific aggravation of symptoms between 3 and 4 am strongly suggest the suitability of Kali Bromatum.[5-7] |
Follow-up and outcomes
We used the Clinician-Rated Dimensions of Psychosis Symptom Severity Criteria[8] to assess the severity of symptoms throughout treatment. It shows a score of 16 on 1st consultation, followed by 21 during a brief period of homoeopathic aggravation and eventually to 0 in subsequent follow-ups, indicating a quick and gentle improvement.
To assess the effectiveness of homoeopathic intervention, we used the Modified Naranjo Criteria.[9] The result we got after following this scale is 11/13. The patient was followed up for 4 months; he was in remission at the last follow-up [Table 3].
| Time | Details | Interpretation | Action |
|---|---|---|---|
| Day 1 | |||
| 10:30 am | As mentioned in case details | 1st prescription | Kali Bromatum 200 C 1 dose |
| 4:30 pm | No change after 1stdose | Status queue | Kali Bromatum 200 C 1 dose |
| 06:00 pm | Distress and restlessness increased, development of suicidal ideation+, suspicion and delusions present, guilt -present, not slept. Aggravation lasted for 1 h | Homoeopathic aggravation | Placebo 4 hourly |
| 10:00 pm | All complaints are much better, with no suicidal ideation and no guilt complex, the patient has been sleeping since 9:30 pm | Sure signs of improvement. | Placebo 4 hourly |
| Day 2 | |||
| 9:00 am | Slept well at night, had breakfast, no delusions/suspicion, calm and at ease, no guilt complex, no complaints/abnormal behaviour at present. | Sure signs of improvement. | Placebo 6 hourly |
| 6:00 pm | No complaints, no guilt complex, generally normal | Case in remission | Placebo |
DISCUSSION
The presented case report demonstrates that an appropriate acute homoeopathic remedy can effectively and gently address ATPD. In this instance, Kali Bromatum 200 C, selected based on the patient’s distinctive mental state, facilitated a swift recovery. The Clinician-Rated Dimensions of Psychosis Symptom Severity criteria were employed for assessment, revealing a progression from a score of 16 at the initial consultation to 21 during a brief period of homoeopathic aggravation and eventually to 0 in subsequent follow-ups, indicating a quick and gentle improvement. While standard treatment guidelines for ATPD typically involve antipsychotics, antidepressants, psychotherapy and potentially hospitalisation for supervision and restraint, this case achieved resolution in a home setting using the indicated acute homoeopathic remedy.[10] An initial short-lived aggravation was observed, followed by a rapid and gentle recuperation. The patient has been in remission for 4 months. This case underscores the potential of homoeopathy in the treatment of acute psychotic disorders.
The notable strength of this case report lies in the diagnostic confirmation by a qualified psychiatrist and the utilisation of the Clinician-Rated Dimensions of Psychosis Symptom Severity criteria, a globally recognised assessment tool.
CONCLUSION
This report highlights the potential effectiveness of homoeopathy in managing acute psychotic disorders such as ATPD. To further validate the efficacy of homoeopathic treatments in acute psychotic disorders, well-structured research studies with suitable methodologies are essential. The case study encourages further exploration into homoeopathic treatments, suggesting a promising avenue for managing such complex psychiatric disorders in a more holistic and patient-centred manner.
Ethical approval:
Institutional Review Board approval is not required.
Declaration of patient consent:
The authors certify that they have obtained all appropriate patient consent.
Conflicts of interest:
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation:
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Supplementary material available on:
https://dx.doi.org/10.25259/JISH_10_2024
Financial support and sponsorship: Nil.
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