EpistemisDelusions of grandeur
Specialty: Psychiatry.
Why it occurs
- Manic or mixed episode of bipolar disorder
- Schizophrenia (paranoid or disorganized subtype)
- Narcissistic personality disorder in decompensated phase
- Progressive general paralysis (tertiary syphilis or neurosyphilis)
- Frontotemporal or Alzheimer's dementia with psychotic symptoms
- Intoxication by stimulants or anabolic steroids
Initial workup
Young Mania Scale (YMRS); serology for syphilis (RPR/VDRL) in blood and cerebrospinal fluid if there is clinical suspicion; lumbar puncture if neuroinfection is suspected; Brain MRI to rule out frontal atrophy.
red flags
Involvement in large-scale ruinous businesses, disproportionate expenses that ruin family assets, or extreme physical risk behaviors based on the belief of invulnerability.
Standard management
- Lithium carbonate — mood stabilizer of choice in bipolar disorder
- Aripiprazole — dopaminergic modulating antipsychotic that reduces expansiveness without excessive sedation
- Valproic acid — alternative or adjuvant for the control of dysphoric mania
- Quetiapine — atypical antipsychotic with sedative and stabilizing properties
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Psychiatry
- Listed causes
- 6
- Treatment options
- 4