“The delirious substance abuser” (Cases That Test Your Skills, Current Psychiatry, January 2012, p. 58-67) was an excellent review of the complex presentations when patients use multiple substances. Recently, we admitted a patient presenting with delirium with psychosis. She presented with similar symptoms as Ms. K in your article, with the addition of severe tactile hallucinosis that led our patient to jump out of a moving vehicle because she thought bugs were crawling over her. She eventually admitted to using “bath salts” (methylenedioxypyrovalerone) orally and her psychotic symptoms remitted in 3 days.
Vineet Mehta, MD
Consulting Psychiatrist
Health First
Melbourne, FL
Private Practice
Indialantic, FL