Drushti Birwatkar, Shweta Kalita, Nikita Mehdiratta* and Alan Hirsch
Introduction: A misperception of intensified gravitational forces as a psychotropic effect has not heretofore been described.
Case presentation: A 37-year-old right-handed female with a history of hypertension, diabetes mellitus type 2, and schizoaffective disorder with bipolar subtype presented with presence hallucinations. For an epoch of 2 days, she experienced the sensation that something was "pressing down on her" and that gravity was too strong. She argued that gravity was too strong rather than feeling weak. The patient received carbamazepine 200 mg QHS, haloperidol 5 mg BID, baclofen 5 mg QHS, and chlorpromazine 50 mg PO BID at during the episode.
Results: Physical Examination: Diffuse thyroid enlargement. Neurological Examination: Mental Status Examination: The patient is awake with poor hygiene and eye contact. Hyperverbal, grandiose with expansive affect, poor insight, and judgment. Cranial Nerve (CN) examination: CN I: Alcohol Sniff Test: 8. CN II: Visual acuity with correction 20/20 OD, 20/25 OS. Motor Examination: Mild left pronator drift. Cerebellar Examination: Finger-to-nose dysmetria bilaterally. Reflexes: 3+ bilateral brachioradialis and biceps, 1+ left triceps, and absent reflexes in both lower extremities. Bilateral positive Hoffman's reflexes. The Patient Health Questionnaire 9: 7.
Discussion: The psychic slowing of schizoaffective disorder may lead to a more significant effort to contract muscles, thus reducing muscle contraction and strength, with an overwhelmingly pronounced perception of weight and gravity. Psychotropic medications may have acted to cause dysfunction in muscle initiation and preparation of muscle firing, causing a reduction of contraction of muscle spindles and reduced muscle tension, thus reducing weight perception. Peradventure, psychotropics may induce muscle stiffness, increasing weight perception.
Conclusion: Moreover, drug-induced Parkinson's symptoms have not induced weakness but rather a lag or delay between the motor command and muscle contraction, which was perceived as weakness and thus increased perception of gravitational force. Psychotropic drug evaluation would benefit those with a distorted perception of external objects and forces, especially those who do not complain of weakness or exhaus tion.
