The purpose of this paper is to report a case of a 19 year old woman who presented with prominent hyperactive delirium and Systemic Lupus Erythematosus (SLE). The psychiatric drug treatment and rational for its usage are discussed. This case illustrates the importance of differentiating between the psychiatric manifestations of chronic high dose steroid use and a psychosis secondary to brain involvement of SLE. Lupus cerebritis should be included in the provisional diagnosis of the young woman with acute onset of psychosis and should be carefully differentiated from a psychotic disorder especially if the patient has no clear period of premorbid psychiatric pathology or a genetic predisposition for a primary psychotic disorder.
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