Neurobeachin gene disruption is a rare genetic mutation, which causes the development of autism and long-term potentiation of the CA1 region of the hippocampus. It causes an increase in fear response and impairs fear extinction. Prazosin is an alpha 1 receptor antagonist. It mitigates the alpha-1 activity, which causes fear and startles response in PTSD patients.
This case is about a 27-year-old White male who showed marked improvement in paranoid behaviour after taking prazosin. The condition improved within a few days.
He presented in the emergency with a complaint of weight loss because of eating pre-packaged food and worsening functional status. The patient hadn’t showered and was wearing the same clothes for several months. He was in the hospital for two months before starting prazosin. While he was in the in-patient department, he demonstrated paranoia and sensitivity to opening doors. Moreover, he was guarding his interactions, barely communicating with the other patients and providers. His grooming habits were poor, and he hardly showered or changed his clothes.
Prazosin Prognosis
Since the initiation of prazosin, the White male demonstrated a change in his behaviour. He was initiating and maintaining conversations. He was also showering and changing his clothes regularly. Moreover, his eating habits also got better and he was eating a variety of foods.
After seven months of hospitalization, he was discharged to live in an apartment with a caregiver.
Conclusion
The potential treatment was prazosin because of its effects on alpha-1 adrenergic antagonism. Although the patient did not have any triggering events leading to the diagnosis of post-traumatic stress disorder, his rare deletion of the gene could have been involved in the diminished fear response.
The low dosage of prazosin shows rapid improvement in paranoia in patients with Neurobeachin gene deletion. Moreover, its side effects are relatively favourable when used in low dosage, once daily.
