A psychiatric perspective on the therapy of psychosis in systemic lupus erythematosus.

A brief description of psychosis in the general psychiatric setting and its treatment using antipsychotic agents including 'atypical' drugs. A review of the prevalence of neuropsychiatric syndromes in lupus (using The American College of Rheumatology standardized definitions) from recent studies showing wide variation in reported rates. Underlying pathophysiologic mechanisms postulated for neuropsychiatric manifestations of lupus are reviewed with implications for treatment. The use and success of intravenous pulsed cyclophosphamide (singly and in combination with methylprednisiolone) for severe neuropsychiatric psychosis is reviewed.