Pub Date : 2019-11-01DOI: 10.9758/cpn.2019.17.4.556
A. Uzun, Ş. Y. Sapmaz, Masum Öztürk, H. Kandemir
Atypical antipsychotics in children and adolescents are widely used for aggression, emotional variability and psychosis treatment. Aripiprazole is also an atypical antipsychotic that increasingly used in children and adolescents with schizophrenia, autism and bipolar disorder. In this case report, a medically healthy patient with autism associated with behavioral problems is presented with the development of hypertension after the onset of aripiprazole and the return of blood pressure to normal levels after withdrawal of the drug. The purpose of this case study is to discuss and report the emergence of aripiprazole-induced hypertension as a side effect of drugs in children and adolescents.
{"title":"Hypertension Induced by Aripiprazole Use in an Autistic Child Patient","authors":"A. Uzun, Ş. Y. Sapmaz, Masum Öztürk, H. Kandemir","doi":"10.9758/cpn.2019.17.4.556","DOIUrl":"https://doi.org/10.9758/cpn.2019.17.4.556","url":null,"abstract":"Atypical antipsychotics in children and adolescents are widely used for aggression, emotional variability and psychosis treatment. Aripiprazole is also an atypical antipsychotic that increasingly used in children and adolescents with schizophrenia, autism and bipolar disorder. In this case report, a medically healthy patient with autism associated with behavioral problems is presented with the development of hypertension after the onset of aripiprazole and the return of blood pressure to normal levels after withdrawal of the drug. The purpose of this case study is to discuss and report the emergence of aripiprazole-induced hypertension as a side effect of drugs in children and adolescents.","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"17 1","pages":"556 - 558"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42174548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.9758/cpn.2019.17.4.564
Ahmed Naguy
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. A Comment on “Successful Management of Clozapine-induced Akathisia with Gabapentin Enacarbil: A Case Report”
{"title":"A Comment on “Successful Management of Clozapine-induced Akathisia with Gabapentin Enacarbil: A Case Report”","authors":"Ahmed Naguy","doi":"10.9758/cpn.2019.17.4.564","DOIUrl":"https://doi.org/10.9758/cpn.2019.17.4.564","url":null,"abstract":"This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. A Comment on “Successful Management of Clozapine-induced Akathisia with Gabapentin Enacarbil: A Case Report”","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"17 1","pages":"564 - 565"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44763568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.9758/cpn.2019.17.4.547
Tomoki Hanazawa, Y. Kamijo
Suvorexant, an orexin receptor antagonist used for insomnia, has been shown to have a preventive effect on delirium in a randomized placebo-controlled trial. However, its effectiveness in the management of nocturnal delirium has not yet been determined. Here we report four cases in which elderly patients with moderate to severe Alzheimer’s disease who developed nocturnal delirium were treated with suvorexant. In case 1, 15 mg suvorexant was initiated to manage nocturnal delirium refractory to antipsychotics, antidepressants, and a Japanese herbal medicine, resulting in immediate sleep improvement. However, treatment discontinuation led to recurrence of symptoms, which were reversed by recommencing suvorexant. In case 2, as antipsychotics used for the treatment of nocturnal delirium were ineffective, 15 mg suvorexant was administered. The patient achieved rapid improvement in sleep. In case 3, the use of atypical antipsychotics for the treatment of nocturnal delirium was contraindicated, as the patient had diabetes. Therefore, 15 mg suvorexant was administered following good outcomes in cases 1 and 2, resulting in immediate sleep improvement. Finally, in case 4, 15 mg suvorexant was used as an initial medication for nocturnal delirium, and the patient showed sleep improvement immediately. Elevated orexin levels in the cerebrospinal fluid are reportedly linked to sleep deterioration in patients with moderate to severe Alzheimer’s disease. The immediate and reproducible action and effectiveness of suvorexant observed in our patients suggest that enhanced cerebral orexin activity might be associated with sleep-wake cycle disturbances due to delirium in elderly patients with Alzheimer’s disease.
{"title":"Effect of Suvorexant on Nocturnal Delirium in Elderly Patients with Alzheimer’s Disease: A Case-series Study","authors":"Tomoki Hanazawa, Y. Kamijo","doi":"10.9758/cpn.2019.17.4.547","DOIUrl":"https://doi.org/10.9758/cpn.2019.17.4.547","url":null,"abstract":"Suvorexant, an orexin receptor antagonist used for insomnia, has been shown to have a preventive effect on delirium in a randomized placebo-controlled trial. However, its effectiveness in the management of nocturnal delirium has not yet been determined. Here we report four cases in which elderly patients with moderate to severe Alzheimer’s disease who developed nocturnal delirium were treated with suvorexant. In case 1, 15 mg suvorexant was initiated to manage nocturnal delirium refractory to antipsychotics, antidepressants, and a Japanese herbal medicine, resulting in immediate sleep improvement. However, treatment discontinuation led to recurrence of symptoms, which were reversed by recommencing suvorexant. In case 2, as antipsychotics used for the treatment of nocturnal delirium were ineffective, 15 mg suvorexant was administered. The patient achieved rapid improvement in sleep. In case 3, the use of atypical antipsychotics for the treatment of nocturnal delirium was contraindicated, as the patient had diabetes. Therefore, 15 mg suvorexant was administered following good outcomes in cases 1 and 2, resulting in immediate sleep improvement. Finally, in case 4, 15 mg suvorexant was used as an initial medication for nocturnal delirium, and the patient showed sleep improvement immediately. Elevated orexin levels in the cerebrospinal fluid are reportedly linked to sleep deterioration in patients with moderate to severe Alzheimer’s disease. The immediate and reproducible action and effectiveness of suvorexant observed in our patients suggest that enhanced cerebral orexin activity might be associated with sleep-wake cycle disturbances due to delirium in elderly patients with Alzheimer’s disease.","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"17 1","pages":"547 - 550"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43642479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.9758/cpn.2019.17.4.503
E. Min, Sung-Gon Kim, Jin-Seong Lee, Bi-A Seo, Woo-Young Jung, S. Huh, Ji-Hun Park, C. Hong, Hee Jung Yu
Objective Alcohol-induced blackout (blackout) is a typical early symptom of cognitive impairment caused by drinking. However, the first onset age of blackout or the duration after onset of blackout has not been directly compared in previous studies. The purpose of this study was to investigate the differences in cognitive function to the first start age of blackouts and their duration. Methods Thirty-one male subjects were included in this study. Their age at the first blackout and the duration after the onset of blackout were investigated. Neuropsychological tests were conducted to determine their attention, memory, and executive function. Subjects were divided into three groups according to their age of the first onset blackout (group O1, < 20 years; group O2, 21–39 years; and group O3, > 40 years). Subjects were also divided into three groups by duration after the onset of blackout (P1, < 10 years; P2, 10–29 years; and P3, > 30 years). We then examined differences in neurocognitive function among these groups. Results O1 tended to have a lower memory score than O2 (F = 3.28, p = 0.053). Significant differences were observed in attention and executive function between groups P1 and P3 (Digit Span_backward: F = 6.07, p < 0.05; visual span_forward: F = 4.19, p < 0.05; executive intelligence quotient: F = 3.55, p < 0.05). Conclusion Greater memory impairment was detected in subjects having an earlier age of the first blackout. The longer the duration after the onset of blackout, the more impaired their attention and executive function skills.
{"title":"Difference in Cognitive Function by First Onset Age of Alcohol Induced Blackout and Its Duration","authors":"E. Min, Sung-Gon Kim, Jin-Seong Lee, Bi-A Seo, Woo-Young Jung, S. Huh, Ji-Hun Park, C. Hong, Hee Jung Yu","doi":"10.9758/cpn.2019.17.4.503","DOIUrl":"https://doi.org/10.9758/cpn.2019.17.4.503","url":null,"abstract":"Objective Alcohol-induced blackout (blackout) is a typical early symptom of cognitive impairment caused by drinking. However, the first onset age of blackout or the duration after onset of blackout has not been directly compared in previous studies. The purpose of this study was to investigate the differences in cognitive function to the first start age of blackouts and their duration. Methods Thirty-one male subjects were included in this study. Their age at the first blackout and the duration after the onset of blackout were investigated. Neuropsychological tests were conducted to determine their attention, memory, and executive function. Subjects were divided into three groups according to their age of the first onset blackout (group O1, < 20 years; group O2, 21–39 years; and group O3, > 40 years). Subjects were also divided into three groups by duration after the onset of blackout (P1, < 10 years; P2, 10–29 years; and P3, > 30 years). We then examined differences in neurocognitive function among these groups. Results O1 tended to have a lower memory score than O2 (F = 3.28, p = 0.053). Significant differences were observed in attention and executive function between groups P1 and P3 (Digit Span_backward: F = 6.07, p < 0.05; visual span_forward: F = 4.19, p < 0.05; executive intelligence quotient: F = 3.55, p < 0.05). Conclusion Greater memory impairment was detected in subjects having an earlier age of the first blackout. The longer the duration after the onset of blackout, the more impaired their attention and executive function skills.","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"17 1","pages":"503 - 508"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44999078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.9758/cpn.2019.17.4.566
Ö. Uygur, H. Uygur
TO THE EDITOR Yasemin [1] reported that curly hair due to valproate in a patient with bipolar disorder for the first time. To the best of our knowledge, there is no bipolar disorder patient whose hair loss and curly hair due to valproate at the same time, in the literature. We aimed to present a case of hair loss and curly hair due to valproate at the same time in bipolar disorder and we want to contribute to the letter of Yasemin. Written informed consent for publication was obtained from the patient. Valproate is one of the mood stabilizers commonly used in the treatment of bipolar affective disorders. Well known side effects reported on valproate administration are tremor, weight gain, gastrointestinal disorders, liver dysfunction, metabolic acidosis, and thrombocytopenia. In addition, cosmetic side effects such as hair loss, color changes, thinning and curling of hair have also been reported in valproate-treated patients [2]. Alopecia or hair loss was found more frequently as a result of literature search with keywords “alproate” and “hair” on Google Search and PubMed for articles related to the topic. On the other hand, curly hair is a very rare side effect of valproate [3]. A study on a group who used valproate indicated that 5 out of 295 patients who were using valproate experienced curling of hair [4]. The patient is 50 years old and has had a diagnosis of bipolar disorder for 26 years. She has experienced four manic and three depressive episodes. She had used valproate or valproate plus quetiapin or valproate plus olanzapine at different periods until the last two years. She discontinued her treatment in 2017 for a period of two years, resulting in hypomanic episode. We started valproate and titrated 1,250 mg/day. She noticed that her hair lossed and then it was curly growed at the ninth month of valproate usage. There were no other medical illness or drugs that could explain this condition. She has never had any perming of the hair performed. Her hair has remained curly during follow up the patient. The mechanism of valproate effects on hair is not completely clear. Hair loss with valproate is dose-dependent and there is a decrease in biotinidase activity during valproate treatment and can be prevented by applying biotin to experimental rats [5]. It is the other most frequently proposed hypothesis that the inhibitory effect of the metals chelating and metal enzymes can lead to this [3]. Surprisingly, despite oral valproate administration that cause hair loss, hair regeneration was detected in experiments with topical valproate [6]. Hair loss and curly hair is not well known side effect of valproate. Psychiatrists should recognize the cosmetic side effects of valproate on hair and informed to patient.
{"title":"Valproate Induced Hair Loss and Curly Hair in Bipolar Disorder","authors":"Ö. Uygur, H. Uygur","doi":"10.9758/cpn.2019.17.4.566","DOIUrl":"https://doi.org/10.9758/cpn.2019.17.4.566","url":null,"abstract":"TO THE EDITOR Yasemin [1] reported that curly hair due to valproate in a patient with bipolar disorder for the first time. To the best of our knowledge, there is no bipolar disorder patient whose hair loss and curly hair due to valproate at the same time, in the literature. We aimed to present a case of hair loss and curly hair due to valproate at the same time in bipolar disorder and we want to contribute to the letter of Yasemin. Written informed consent for publication was obtained from the patient. Valproate is one of the mood stabilizers commonly used in the treatment of bipolar affective disorders. Well known side effects reported on valproate administration are tremor, weight gain, gastrointestinal disorders, liver dysfunction, metabolic acidosis, and thrombocytopenia. In addition, cosmetic side effects such as hair loss, color changes, thinning and curling of hair have also been reported in valproate-treated patients [2]. Alopecia or hair loss was found more frequently as a result of literature search with keywords “alproate” and “hair” on Google Search and PubMed for articles related to the topic. On the other hand, curly hair is a very rare side effect of valproate [3]. A study on a group who used valproate indicated that 5 out of 295 patients who were using valproate experienced curling of hair [4]. The patient is 50 years old and has had a diagnosis of bipolar disorder for 26 years. She has experienced four manic and three depressive episodes. She had used valproate or valproate plus quetiapin or valproate plus olanzapine at different periods until the last two years. She discontinued her treatment in 2017 for a period of two years, resulting in hypomanic episode. We started valproate and titrated 1,250 mg/day. She noticed that her hair lossed and then it was curly growed at the ninth month of valproate usage. There were no other medical illness or drugs that could explain this condition. She has never had any perming of the hair performed. Her hair has remained curly during follow up the patient. The mechanism of valproate effects on hair is not completely clear. Hair loss with valproate is dose-dependent and there is a decrease in biotinidase activity during valproate treatment and can be prevented by applying biotin to experimental rats [5]. It is the other most frequently proposed hypothesis that the inhibitory effect of the metals chelating and metal enzymes can lead to this [3]. Surprisingly, despite oral valproate administration that cause hair loss, hair regeneration was detected in experiments with topical valproate [6]. Hair loss and curly hair is not well known side effect of valproate. Psychiatrists should recognize the cosmetic side effects of valproate on hair and informed to patient.","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"51 s30","pages":"566 - 567"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41257500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.9758/cpn.2019.17.4.487
Tsung-Yu Tsai, Huai-Hsuan Tseng, M. Chi, H. Chang, Cheng-Kuan Wu, Yen Kuang Yang, P. Chen
Objective Loneliness is a specific risk factor for depressive symptoms and suicidal behavior. The present study examined whether the serum oxytocin level would interact with social support and buffers loneliness and hypothalamic-pituitary-adrenal (HPA)-axis activity in drug-naïve patients with major depressive disorder (MDD). Methods Twenty-six patients with MDD (male:female = 3:23; mean age, 45.54 ± 12.97 years) were recruited. The 17-item Hamilton Depression Rating Scale, UCLA Loneliness Scale and self-reported Measurement of Support Function Questionnaire were administered. Serum oxytocin and cortisol levels were assessed using a commercial immunoassay kits. Results In MDD patients, a negative association was found between degrees of social support and loneliness (β = −0.39, p = 0.04). The interaction between social support and serum oxytocin level was negatively associated with loneliness (β = −0.50, p = 0.017) and serum cortisol level (β = −0.55, p = 0.020) after adjusting for age. Follow-up analyses showed that the association between higher social support and lower loneliness was observed only in the higher-oxytocin group (r = −0.75, p = 0.003) but not in the lower group (r = −0.19, p = 0.53). The significance remained after further adjusting for sex and depression severity. Conclusion Low oxytocin level is a vulnerability factor for the buffering effect of social support for loneliness and aberrant HPA-axis activity in MDD patients.
目的孤独是抑郁症状和自杀行为的特定危险因素。本研究旨在探讨drug-naïve重度抑郁障碍(MDD)患者血清催产素水平是否与社会支持相互作用，并缓冲孤独感和下丘脑-垂体-肾上腺(HPA)轴活动。方法26例重度抑郁症患者(男:女= 3:23;平均年龄(45.54±12.97岁)。采用17项汉密尔顿抑郁评定量表、UCLA孤独感量表和支持功能自评量表。使用商业免疫测定试剂盒评估血清催产素和皮质醇水平。结果MDD患者的社会支持程度与孤独感呈负相关(β = - 0.39, p = 0.04)。调整年龄后，社会支持与血清催产素水平的交互作用与孤独感(β = - 0.50, p = 0.017)和血清皮质醇水平(β = - 0.55, p = 0.020)呈负相关。随访分析显示，较高的社会支持与较低的孤独感之间的关联仅在催产素水平较高的组中存在(r = - 0.75, p = 0.003)，而在催产素水平较低的组中没有(r = - 0.19, p = 0.53)。在进一步调整性别和抑郁严重程度后，这一意义仍然存在。结论低催产素水平是社会支持对MDD患者孤独感和hpa轴异常活动的缓冲作用的易损因素。
{"title":"The Interaction of Oxytocin and Social Support, Loneliness, and Cortisol Level in Major Depression","authors":"Tsung-Yu Tsai, Huai-Hsuan Tseng, M. Chi, H. Chang, Cheng-Kuan Wu, Yen Kuang Yang, P. Chen","doi":"10.9758/cpn.2019.17.4.487","DOIUrl":"https://doi.org/10.9758/cpn.2019.17.4.487","url":null,"abstract":"Objective Loneliness is a specific risk factor for depressive symptoms and suicidal behavior. The present study examined whether the serum oxytocin level would interact with social support and buffers loneliness and hypothalamic-pituitary-adrenal (HPA)-axis activity in drug-naïve patients with major depressive disorder (MDD). Methods Twenty-six patients with MDD (male:female = 3:23; mean age, 45.54 ± 12.97 years) were recruited. The 17-item Hamilton Depression Rating Scale, UCLA Loneliness Scale and self-reported Measurement of Support Function Questionnaire were administered. Serum oxytocin and cortisol levels were assessed using a commercial immunoassay kits. Results In MDD patients, a negative association was found between degrees of social support and loneliness (β = −0.39, p = 0.04). The interaction between social support and serum oxytocin level was negatively associated with loneliness (β = −0.50, p = 0.017) and serum cortisol level (β = −0.55, p = 0.020) after adjusting for age. Follow-up analyses showed that the association between higher social support and lower loneliness was observed only in the higher-oxytocin group (r = −0.75, p = 0.003) but not in the lower group (r = −0.19, p = 0.53). The significance remained after further adjusting for sex and depression severity. Conclusion Low oxytocin level is a vulnerability factor for the buffering effect of social support for loneliness and aberrant HPA-axis activity in MDD patients.","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"17 1","pages":"487 - 494"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41845159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.9758/cpn.2019.17.4.517
Y. Torun, E. Güney, Arzu Aral, Dicle Büyüktaşkin, Huseyin Tunca, Y. Taner, E. Işeri
Objective The effect of vascular endothelial growth factor (VEGF) on neuronal development is known, but its relationship with attention deficit hyperactivity disorder (ADHD), a neurodevelopmental disorder, has not yet been fully elucidated. To our knowledge, this is the first human study investigating serum VEGF levels in ADHD patients. In this study, it has been aimed to compare serum VEGF levels between a healthy control group and in ADHD patients to help determine the association between serum VEGF levels and ADHD. Methods This study sample included forty-four patients diagnosed with ADHD and 43 healthy volunteer controls between 7 to 14 years old. Blood samples were taken from patients and the healthy control group to assess their serum VEGF levels. VEGF levels were calculated by subjecting the optical densities of the samples to concentrations of known standards as provided in the ELISA kit and then performing a regression correlation analysis. Results The mean VEGF level of the children was 333.6 ± 209.8 in the ADHD group and 341.3 ± 201.8 in the control group. There were no statistically significant differences in serum VEGF levels between the ADHD and control groups (U = 926.000, z = −0.170, p = 0.865). Conclusion There was no significant difference in serum VEGF levels for untreated ADHD cases and a healthy control group. This is the first human study investigating serum VEGF levels in ADHD patients, so there is a need to replicate these findings.
{"title":"Determination of Serum Vascular Endothelial Growth Factor Levels in Attention Deficit Hyperactivity Disorder: A Case Control Study","authors":"Y. Torun, E. Güney, Arzu Aral, Dicle Büyüktaşkin, Huseyin Tunca, Y. Taner, E. Işeri","doi":"10.9758/cpn.2019.17.4.517","DOIUrl":"https://doi.org/10.9758/cpn.2019.17.4.517","url":null,"abstract":"Objective The effect of vascular endothelial growth factor (VEGF) on neuronal development is known, but its relationship with attention deficit hyperactivity disorder (ADHD), a neurodevelopmental disorder, has not yet been fully elucidated. To our knowledge, this is the first human study investigating serum VEGF levels in ADHD patients. In this study, it has been aimed to compare serum VEGF levels between a healthy control group and in ADHD patients to help determine the association between serum VEGF levels and ADHD. Methods This study sample included forty-four patients diagnosed with ADHD and 43 healthy volunteer controls between 7 to 14 years old. Blood samples were taken from patients and the healthy control group to assess their serum VEGF levels. VEGF levels were calculated by subjecting the optical densities of the samples to concentrations of known standards as provided in the ELISA kit and then performing a regression correlation analysis. Results The mean VEGF level of the children was 333.6 ± 209.8 in the ADHD group and 341.3 ± 201.8 in the control group. There were no statistically significant differences in serum VEGF levels between the ADHD and control groups (U = 926.000, z = −0.170, p = 0.865). Conclusion There was no significant difference in serum VEGF levels for untreated ADHD cases and a healthy control group. This is the first human study investigating serum VEGF levels in ADHD patients, so there is a need to replicate these findings.","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"17 1","pages":"517 - 522"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49192972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.9758/cpn.2019.17.4.537
K. Kweon, Hyo-Won Kim
Objective This study aimed to investigate the effectiveness and safety of bupropion extended-release for the treatment of depressive disorder in children and adolescents. Methods This was a 12-week, retrospective chart review of bupropion, which included 127 youth (age, 15.3 ± 2.3 years; 66 boys) with depressive disorders (105 with major depressive disorder, 14 with dysthymia, 11 with adjustment disorder with depressed mood, and seven with depressive disorder not otherwise specified). Illness severity at baseline and at the 4th, 8th, and 12th weeks was retrospectively scored using the Clinical Global Impressions-Depression-Severity (CGI-Depression-S) and/or Clinical Global Impressions-Depression-Improvement (CGI-Depression-I). Results The mean dose of bupropion was 180.0 ± 52.6 (range, 75–300) mg/day and the mean duration 33.9 ± 53.1 (range, 7–295) weeks. The CGI-Depression-S scores were significantly decreased over 12 weeks (F = 132.125, p < 0.001, partial η2 = 0.508). Fifty-eight subjects (45.7%) were determined to be responders at 12 weeks (defined by a CGI-Depression-I score ≤ 2). Forty-six patients (36.2%) discontinued bupropion before the 12 weeks (19 due to adverse events, 15 due to poor effectiveness, three due to referral to other clinics, and nine due to follow-up loss for unknown reasons). Overall, bupropion was well tolerated. The most common adverse event was irritability (n = 12, 9.4%), which resolved spontaneously in eight subjects or after drug discontinuation in four subjects. Conclusion Our results provide preliminary evidence of the effectiveness and safety of bupropion in children and adolescents with depressive episodes. Large, prospective, placebo-controlled studies are needed to confirm these findings.
{"title":"Effectiveness and Safety of Bupropion in Children and Adolescents with Depressive Disorders: A Retrospective Chart Review","authors":"K. Kweon, Hyo-Won Kim","doi":"10.9758/cpn.2019.17.4.537","DOIUrl":"https://doi.org/10.9758/cpn.2019.17.4.537","url":null,"abstract":"Objective This study aimed to investigate the effectiveness and safety of bupropion extended-release for the treatment of depressive disorder in children and adolescents. Methods This was a 12-week, retrospective chart review of bupropion, which included 127 youth (age, 15.3 ± 2.3 years; 66 boys) with depressive disorders (105 with major depressive disorder, 14 with dysthymia, 11 with adjustment disorder with depressed mood, and seven with depressive disorder not otherwise specified). Illness severity at baseline and at the 4th, 8th, and 12th weeks was retrospectively scored using the Clinical Global Impressions-Depression-Severity (CGI-Depression-S) and/or Clinical Global Impressions-Depression-Improvement (CGI-Depression-I). Results The mean dose of bupropion was 180.0 ± 52.6 (range, 75–300) mg/day and the mean duration 33.9 ± 53.1 (range, 7–295) weeks. The CGI-Depression-S scores were significantly decreased over 12 weeks (F = 132.125, p < 0.001, partial η2 = 0.508). Fifty-eight subjects (45.7%) were determined to be responders at 12 weeks (defined by a CGI-Depression-I score ≤ 2). Forty-six patients (36.2%) discontinued bupropion before the 12 weeks (19 due to adverse events, 15 due to poor effectiveness, three due to referral to other clinics, and nine due to follow-up loss for unknown reasons). Overall, bupropion was well tolerated. The most common adverse event was irritability (n = 12, 9.4%), which resolved spontaneously in eight subjects or after drug discontinuation in four subjects. Conclusion Our results provide preliminary evidence of the effectiveness and safety of bupropion in children and adolescents with depressive episodes. Large, prospective, placebo-controlled studies are needed to confirm these findings.","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"17 1","pages":"537 - 541"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41454228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.9758/cpn.2019.17.4.523
H. Aytuluk, Tahsin Simsek, Mehmet Yılmaz, A. Turan, K. Saraçoğlu
Objective To evaluate the effects of 2 different dose regimens of propofol (low dose: < 1 mg/kg, high dose: ≥ 1 mg/kg) on the duration of the seizures, the required energy for the seizures, and the seizure threshold over the course of electroconvulsive therapy (ECT). Methods The electronic medical records of 165 patients receiving 971 sessions of ECT were analyzed retrospectively. Patients were evaluated in two groups according to the according to propofol doses that they had received for ECT. Group LP (n = 91): patients who received low dose propofol (< 1 mg/kg). Group HP (n = 74): patients who received high dose propofol (≥1 mg/kg). Results The required energy for seizures in Group HP were significantly higher than the Group LP in the 3rd, 4th, 5th, 6th, 7th, 8th, and 9th sessions (p < 0.05). The duration of seizures in the Group HP were significantly lower than the Group LP in the 1st, 2nd, 4th, 5th, 7th, and 8th sessions (p < 0.05). Higher electrical stimulus was needed to acquire a minimum length of seizure (> 25 sn) during the course of ECT in higher propofol doses. Although there was an increase in the seizure threshold over the course of ECT in both groups, this increase was found to be much more pronounced in the high-dose propofol group according to the low-dose propofol group. Longer duration of seizures was observed in the low-dose propofol group. Conclusion Higher doses of propofol in induction of anesthesia can lead to a more progressive rise in seizure threshold than lower doses of propofol.
{"title":"Can Propofol Lead to an Increase in Seizure Threshold Over the Course of Electroconvulsive Therapy?","authors":"H. Aytuluk, Tahsin Simsek, Mehmet Yılmaz, A. Turan, K. Saraçoğlu","doi":"10.9758/cpn.2019.17.4.523","DOIUrl":"https://doi.org/10.9758/cpn.2019.17.4.523","url":null,"abstract":"Objective To evaluate the effects of 2 different dose regimens of propofol (low dose: < 1 mg/kg, high dose: ≥ 1 mg/kg) on the duration of the seizures, the required energy for the seizures, and the seizure threshold over the course of electroconvulsive therapy (ECT). Methods The electronic medical records of 165 patients receiving 971 sessions of ECT were analyzed retrospectively. Patients were evaluated in two groups according to the according to propofol doses that they had received for ECT. Group LP (n = 91): patients who received low dose propofol (< 1 mg/kg). Group HP (n = 74): patients who received high dose propofol (≥1 mg/kg). Results The required energy for seizures in Group HP were significantly higher than the Group LP in the 3rd, 4th, 5th, 6th, 7th, 8th, and 9th sessions (p < 0.05). The duration of seizures in the Group HP were significantly lower than the Group LP in the 1st, 2nd, 4th, 5th, 7th, and 8th sessions (p < 0.05). Higher electrical stimulus was needed to acquire a minimum length of seizure (> 25 sn) during the course of ECT in higher propofol doses. Although there was an increase in the seizure threshold over the course of ECT in both groups, this increase was found to be much more pronounced in the high-dose propofol group according to the low-dose propofol group. Longer duration of seizures was observed in the low-dose propofol group. Conclusion Higher doses of propofol in induction of anesthesia can lead to a more progressive rise in seizure threshold than lower doses of propofol.","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"17 1","pages":"523 - 530"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43732340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.9758/cpn.2019.17.4.542
S. Youn, Suyeon Lee, Changnam Kim, Seockhoon Chung
Objective We aimed to investigate whether the sleep education and hypnotics reduction program (the i-sleep program), developed for all hospitalized patients and medical personnel, help reducing the hypnotics prescriptions rate among hospitalized cancer patients in a general hospital. Methods Patient data such as hypnotics prescribed at the time of admission and discharge during prior to (year of 2014) and after (year of 2015) initiation of the i-sleep program were collected and compared. Also, hypnotics prescription rate at the first day of each month of 2014 and 2015 were estimated and compared. Results All of 12,382 patients in 2014 and 12,313 patients in 2015 were admitted to the Department of Oncology of the hospital. In 2014, 782 (6.3%) of 12,382 inpatients were already taking hypnotics at the time of admission, and 594 (76.0%) of the 782 patients were still taking sleeping pills at the time of discharge. Following initiation of the i-sleep program (2015), 792 (6.4%) of 12,313 inpatients were already taking hypnotics at the time of admission, and 553 (69.8%) of the 792 inpatients were still taking them at the time of discharge (relative risk, 0.92; 95% confidence interval, 0.87–0.98). On the first day of each month of 2014, 7.3% to 12.6% (mean, 10.0%) of inpatients had prescriptions for hypnotics. Following initiation of the program, the rate of hypnotic prescription was significantly reduced (3.2–10.8%; mean, 8.0%; p = 0.03). Conclusion Our date showed that the i-sleep program may help to reduce the hypnotic prescription rate in hospitalized cancer patients.
{"title":"The Effect of a Sleep Education and Hypnotics Reduction Program on Hypnotics Prescription Rate for the Hospitalized Patients with Cancer at a General Hospital","authors":"S. Youn, Suyeon Lee, Changnam Kim, Seockhoon Chung","doi":"10.9758/cpn.2019.17.4.542","DOIUrl":"https://doi.org/10.9758/cpn.2019.17.4.542","url":null,"abstract":"Objective We aimed to investigate whether the sleep education and hypnotics reduction program (the i-sleep program), developed for all hospitalized patients and medical personnel, help reducing the hypnotics prescriptions rate among hospitalized cancer patients in a general hospital. Methods Patient data such as hypnotics prescribed at the time of admission and discharge during prior to (year of 2014) and after (year of 2015) initiation of the i-sleep program were collected and compared. Also, hypnotics prescription rate at the first day of each month of 2014 and 2015 were estimated and compared. Results All of 12,382 patients in 2014 and 12,313 patients in 2015 were admitted to the Department of Oncology of the hospital. In 2014, 782 (6.3%) of 12,382 inpatients were already taking hypnotics at the time of admission, and 594 (76.0%) of the 782 patients were still taking sleeping pills at the time of discharge. Following initiation of the i-sleep program (2015), 792 (6.4%) of 12,313 inpatients were already taking hypnotics at the time of admission, and 553 (69.8%) of the 792 inpatients were still taking them at the time of discharge (relative risk, 0.92; 95% confidence interval, 0.87–0.98). On the first day of each month of 2014, 7.3% to 12.6% (mean, 10.0%) of inpatients had prescriptions for hypnotics. Following initiation of the program, the rate of hypnotic prescription was significantly reduced (3.2–10.8%; mean, 8.0%; p = 0.03). Conclusion Our date showed that the i-sleep program may help to reduce the hypnotic prescription rate in hospitalized cancer patients.","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"17 1","pages":"542 - 546"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44863622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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