Role of pattern identification, electroencephalography and antiepileptic medication in a patient with schizophrenia on Clozapine - a case report

Schizophrenia and epilepsy co-occur at rates more than that by chance occurrence. Psychotic symptom by itself can be an ictal phenomenon. Seizure-potential of most antipsychotics further complicates the scenario. The clinical presentation, use of diagnostic tools and choice of antiepileptic medication pose challenge to the psychiatrist. We report a case where an individual presents with a typical pattern of auditory hallucination while taking Clozapine. We highlight the following - the importance of pattern identification in clinical diagnosis, judicious use of diagnostic test like electroencephalography and the choice of Sodium valproate as antiepileptic in Clozapine-treated individual.