After having been started on diazepam for anxiety a patients returns to clinic complaining of abdominal pain, constipation, and muscle weakness. Which of the following do you suspect?
Porphyria
Porphyria is also known as 'the little imitator' as it mimics a number of common psychiatric presentations.
Porphyria can be precipitated by psychotropics drugs. Common ones include:-
- Barbiturates
- Benzodiazepines
- Sulpiride
- Certain mood stabilizers
Porphyria presents in many different ways. Symptoms to look out for include:-
- Abdominal pain
- Mental state changes
- Constipation
- Vomiting
- Muscle weakness
Crimlisk H. The little imitator-porphyria: a neuropsychiatric disorder. Journal of Neurology, Neurosurgery, and Psychiatry 1997;62:319-328.
