All patients recruited to the study were receiving treatment with antipsychotic treatment, thus it is not possible to distinguish between effects due to primary neurodysfunction associated with schizophrenia and effects of antipsychotic treatments. This technique shows potential for quick and easy objective investigation of neurodysfunction in a variety of clinical conditions,

potentially including screening for psychosis risk and monitoring for medication side-effects. Acknowledgments We thank Stephen Sparrow at Insight Inhibitors,research,lifescience,medical Sports for his technical support. Footnotes Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Conflict of interest statement: The authors declare that there are no conflicts of interest.

Contributor AZD2281 Information Stuart John Leask, Division of Psychiatry, University Inhibitors,research,lifescience,medical of Nottingham, Institute of Mental Health, Triumph Road, Nottingham NG7 2TU, UK. Bert Park, Nottinghamshire Healthcare Trust, Institute of Mental Health, Nottingham, UK. Priya Khana, Nottinghamshire Healthcare Trust, Institute of Mental Health, Nottingham, UK. Ben DiMambro, Nottinghamshire Healthcare Trust, Institute of Mental Health, Nottingham, UK.
A 36-year-old man with a history of opioid dependence and depression presented to the emergency department Inhibitors,research,lifescience,medical (ED) in late 2009 with acute onset of confusion and paranoid ideation. His partner had noticed its development over a 24-hour period, during which he had believed there was an intruder in his home and been at times incoherent. He had complained Inhibitors,research,lifescience,medical of headache and she had observed facial grimacing and unusual limb movements. On assessment in the ED he was acutely confused, agitated and intermittently aggressive. There was a marked diaphoresis, with rigidity and choreoathetoid movements noted. The patient’s blood pressure was fluctuant and pulse elevated, Inhibitors,research,lifescience,medical with mild pyrexia of 37.5°C recorded. There were no focal neurological deficits. The patient appeared to be responding to perceptual abnormalities and reported auditory and visual hallucinations. The patient’s partner revealed a history others of opioid dependence and hepatitis C infection. He had

been engaged with the substitute prescribing programme since 1997 and was receiving methadone 90 mg daily. He had developed depression after being treated for hepatitis C in 2007 with pegylated interferon. At the time of presentation to the ED his antidepressant treatment regime involved venlafaxine 375 mg daily (since February 2009), quetiapine 50 mg nocte (since May 2009) and levothyroxine 50 µg daily (since December 2008). He was not receiving any additional medications. There was no prior history of confusion or psychosis. He was admitted medically and initially treated empirically with acyclovir and chloramphenicol until an encephalitis could be excluded. Intravenous lorazepam was administered on two occasions for severe agitation.