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Faces and shadows: cabergoline-induced acute psychosis in a woman with no previous psychiatric history - 面孔与阴影:卡麦角碱诱发的无精神病史女性急性精神病
Q Medicine Pub Date : 2016-06-01 DOI: 10.5455/BCP.20151203010237
Z. Ozturk
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引用次数: 0
The Frequency of Benzodiazepine Use in the Isparta Province 伊斯帕塔省苯二氮卓类药物的使用频率
Q Medicine Pub Date : 2016-06-01 DOI: 10.5455/BCP.20150707103818
A. Akpınar, A. Yaman, K. Karakuş, I. Atay, K. Demi̇rci̇
ABSTRACTObjective: In the present study, we aimed to determine the frequency of benzodiazepine prescriptions to patients with psychiatric disorders in Isparta Province, Turkey.Methods: The data was collected retrospectively from records of controlled drugs of Isparta Province in 2011. A total of 11,317 benzodiazepine prescriptions for any kind of psychiatric disorder, written for patients from January 2011 through December 2011 were included. Prescriptions for diagnoses other than psychiatric disorders were excluded.Results: In Isparta Province, one year frequency of benzodiazepine use at least one time was 2.06% (2.58% for females and 1.53% for males). The number for patients aged 65 years or older was found to be 3.92%. Benzodiazepines were prescribed mostly by general practitioners (39.2%), psychiatrists (33.4%), and neurologists (19.2%). The most frequently prescribed benzodiazepines were alprazolam (76.4%), clonazepam (11.4%), and diazepam (6.8%).Conclusion: The frequency of benzodiazepine use in Isp...
摘要目的:本研究旨在了解土耳其伊斯帕塔省精神障碍患者使用苯二氮卓类药物的频率。方法:回顾性收集2011年伊斯帕塔省管制药品记录资料。从2011年1月到2011年12月,总共有11317张苯二氮卓类药物处方用于治疗各种精神疾病。除精神障碍以外的诊断处方被排除在外。结果:伊斯帕塔省一年内至少使用一次苯二氮卓类药物的频率为2.06%(女性为2.58%,男性为1.53%)。65岁及以上患者占3.92%。苯二氮卓类药物主要由全科医生(39.2%)、精神科医生(33.4%)和神经科医生(19.2%)开具。最常用的苯二氮卓类药物是阿普唑仑(76.4%)、氯硝西泮(11.4%)和地西泮(6.8%)。结论:苯二氮卓类药物在Isp患者中的使用频率。
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引用次数: 4
Missing the diagnosis in a young woman with repeated hospital admissions: a case report - 反复住院的年轻女性误诊:一例报告
Q Medicine Pub Date : 2016-06-01 DOI: 10.5455/BCP.20160105112215
Z. Li, Zhenzhen Xiong, Xiehe Liu, Xiangdong Tang, Taomei Li
Kleine-Levin syndrome (KLS) is a rare sleep disorder characterized by various symptoms, such as recurrent episodes of hypersomnia, cognitive abnormalities, psychiatric symptoms, hyperphagia, and behavioral disturbances, and is often confused with other diseases. To date, a number of classic cases of KLS have been identified worldwide; however, incomplete forms of KLS without hyperphagia have rarely been reported. Here, we report a case of a repeatedly hospitalized 24-year-old woman who suffered from psychiatric symptoms, abnormal behaviors, cognitive abnormalities, and recurrent episodes of hypersomnia for eight years. During this period, she was admitted three times, and different diagnoses were considered because the symptoms differed each time. In view of the recurrent episodes of hypersomnia, we monitored the patient using polysomnography (PSG). Carbamazepine and methylphenidate extended-release tablets were used to treat the patient, and beneficial effects were observed. Therefore, when a patient presents with recurrent episodes of hypersomnia, particularly those lasting approximately 20 hours per day, we suggest that psychiatrists should the possibility of KLS.
Kleine-Levin综合征(KLS)是一种罕见的睡眠障碍,其特征是反复发作的嗜睡、认知异常、精神症状、嗜食和行为障碍,并且经常与其他疾病混淆。迄今为止,在世界范围内已经发现了许多典型的KLS病例;然而,没有贪食的不完全型KLS很少有报道。在此,我们报告一例24岁的女性反复住院,她患有精神症状、异常行为、认知异常和反复发作的嗜睡症长达8年。在此期间,她住院三次,由于每次症状不同,考虑了不同的诊断。鉴于反复发作的嗜睡,我们使用多导睡眠图(PSG)监测患者。采用卡马西平、哌甲酯缓释片治疗,效果良好。因此,当患者出现反复发作的嗜睡,特别是每天持续约20小时,我们建议精神科医生应该考虑KLS的可能性。
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引用次数: 0
Insignificant Effects of Atomoxetine on Thyroid Functions in Children and Adolescents with Attention Deficit and Hyperactivity Disorder in Short Term 托莫西汀对儿童和青少年注意缺陷和多动障碍患者甲状腺功能的短期影响不显著
Q Medicine Pub Date : 2016-03-01 DOI: 10.5455/BCP.20150505104526
C. Tanıdır, I. Tanıdır, K. Bahali, H. Gunes, H. Adaletli, E. Öztürk, Tolga Ünüvar, O. Uneri
ABS TRACT: Insignificant effects of atomoxetine on thyroid functions in children and adolescents with attention deficit and hyperactivity disorder in short term Objective: In this study, we aimed to explore the effects of atomoxetine on thyroid functions in children and adolescents with attention deficit hyperactivity disorder. Methods: A retrospective chart review was done to evaluate the thyroid function tests of patients diagnosed with attention deficit hyperactivity disorder and treated with only atomoxetine. The thyroid function tests of 38 subjects, from both before atomoxetine was started and during an effective dose of atomoxetine treatment, were found from the patient charts and compared statistically. Results: There were no statistically significant differences between the baselines levels of thyroidstimulating hormone (TSH), free T4, and free T3 values and those during an effective dose of atomoxetine treatment. In one subject, four weeks after atomoxetine was started and titrated to the effective dose, an insignificant increase in TSH was observed, which decreased to the normal range after the discontinuation of the atomoxetine treatment. Conclusion: Therapeutic doses of atomoxetine do not seem to change thyroid functions in children and adolescents with attention deficit hyperactivity disorder.
摘要:托莫西汀对儿童青少年注意缺陷多动障碍患者甲状腺功能的短期影响不显著目的:本研究旨在探讨托莫西汀对儿童青少年注意缺陷多动障碍患者甲状腺功能的影响。方法:回顾性分析诊断为注意缺陷多动障碍且仅使用阿托西汀治疗的患者的甲状腺功能。38名受试者的甲状腺功能测试,从阿托西汀开始治疗前和阿托西汀有效剂量治疗期间,从患者图表中找到并进行统计比较。结果:促甲状腺激素(TSH)基线水平、游离T4和游离T3值与托莫西汀有效剂量期间的基线水平无统计学差异。在一名受试者中,在托莫西汀开始并滴定到有效剂量四周后,观察到TSH的不显著增加,在托莫西汀治疗停止后,TSH降至正常范围。结论:治疗剂量的托莫西汀似乎不能改变儿童和青少年注意缺陷多动障碍患者的甲状腺功能。
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引用次数: 0
Effect of Methylphenidate on Impulsivity in a Child with Pica and Attention Deficit Hyperactivity Disorder 哌醋甲酯对异食癖和注意缺陷多动障碍儿童冲动的影响
Q Medicine Pub Date : 2016-03-01 DOI: 10.5455/BCP.20151013010546
H. Gunes, C. Tanıdır, H. Adaletli, O. Uneri
Pica is defined as persistent eating of substances that have no nutritive value for at least one month in a developmentally inappropriate manner and the behavior should not be part of a culturally appropriate action. Although the etiological factors have not been clearly described, several psychiatric conditions including mental retardation, developmental disorders, dementia, schizophrenia, autism spectrum disorder, major depressive disorder, obsessive compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD) have been reported in association with pica 1-3 . In this report, we present a
异食癖被定义为持续进食没有营养价值的物质至少一个月,而且这种行为不应该是文化上适当的行为的一部分。虽然病因尚不清楚,但一些精神疾病,包括智力迟钝、发育障碍、痴呆、精神分裂症、自闭症谱系障碍、重度抑郁症、强迫症(OCD)和注意缺陷多动障碍(ADHD),已被报道与异食癖有关1-3。在本报告中,我们提出了一个
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引用次数: 4
Polydipsia Secondary to Quetiapine Use: A Case Report 喹硫平引起的烦渴1例报告
Q Medicine Pub Date : 2016-03-01 DOI: 10.5455/BCP.20151019014403
A. Trevizol, I. Sato, Q. Cordeiro, P. Shiozawa
Polydipsia is characterized by excessive water drinking. It has been related to psychiatric conditions such as schizophrenia, cognitive impairments, and neurological disorders such as brain tumors. Excessive drinking may lead to hyponatremia, nausea, vomiting, delirium, ataxia, seizures, coma, and even death. Here, we present a case of polydipsia secondary to quetiapine use in a patient with schizophrenia. JVO, 20 years old, male, single, diagnosed with schizophrenia according to the DSM-IV criteria for about six years ago. The patient was under pharmacological treatment with quetiapine in increasing doses, reaching 800 mg/day. One week later, he presented at the psychiatric emergency room with nausea, vomiting, confusion, and disorientation. Psychiatric symptoms included blunt affect, auditory hallucinations (voices commenting on patient’s actions and conversing with one another), and persecutory delusions. In fact, the patient was persecutory with near relatives and daily activit ies were l imited by his psychotic behaviors. Increased water intake was observed and diuresis reached approximately 12 liters/ day. Complementary tests showed hyponatrenia with a serum sodium level of 105 mmol/L (135145 mmol/L). All other laboratory tests and neuroimaging studies were within normal range. Other possible etiologies of polydipsia, such as diabetes mellitus, diabetes insipidus, syndrome of inappropriate antidiuretic hormone secretion (SIADH), and thyroid or adrenal dysfunctions were excluded. Psychogenic polydipsia was a possible differential diagnosis, however we could observe a strong temporal association between polydipsia symptoms intensity and quetiapine u s e . F u r t h e r m o r e , w i t h q u e t i a p i n e discontinuation, clinical remission of polydipsia symptoms with normalization of complementary laboratory tests were obtained. The patient has never manifested such behavior before quetiapine use. Initial treatment was 1,000 ml intravenous infusion of sodium chloride 0.9% and water intake restriction to one liter per 24 hours. Quetiapine was replaced by risperidone. Patient showed improvement with normalization of serum sodium levels and presented with clinical improvement during the next three days. In polydipsia the excessive drinking of water reduces plasma osmolarity. Considering the use of antipsychotic drugs inducing polydipsia, it has been previously hypothesized that the use of neuroleptics may increase vasopressin (ADH) secretion, therefore inducing water retention. Another theoretical mechanism could be based on possible anticolinergic effects inherent to antipsychotics that would induce sensation of thirst. Regarding the specific use of quetiapine, there has been only one case in medical literature reporting quetiapine inducing hyponatremia. However, the metabolic imbalance was due to syndrome of inappropriate secretion of antidiuretic hormone rather than secondary to polydipsia. In this present case, we report and highlight DOI:
烦渴的特点是饮水过量。它与精神疾病如精神分裂症、认知障碍和神经系统疾病如脑肿瘤有关。过量饮酒可导致低钠血症、恶心、呕吐、谵妄、共济失调、癫痫发作、昏迷,甚至死亡。在这里,我们提出一个病例多饮继发奎硫平使用精神分裂症患者。JVO, 20岁,男性,单身,六年前根据DSM-IV诊断为精神分裂症。患者正在接受喹硫平的药物治疗,剂量逐渐增加,达到800mg /天。一周后,他出现在精神科急诊室,表现为恶心、呕吐、精神错乱和定向障碍。精神症状包括钝感、幻听(对患者行为的评论和彼此交谈的声音)和受迫害妄想。事实上,患者受到近亲属的迫害,日常活动受到精神病行为的限制。观察到饮水量增加,利尿达到约12升/天。补充试验显示低钠血症,血清钠水平为105 mmol/L (135145 mmol/L)。所有其他实验室检查和神经影像学检查均在正常范围内。排除其他可能的多饮原因,如糖尿病、尿崩症、抗利尿激素分泌不当综合征(SIADH)、甲状腺或肾上腺功能障碍。心因性烦渴是一种可能的鉴别诊断,但我们可以观察到烦渴症状强度与喹硫平剂量之间存在较强的时间相关性。经停药治疗后,多饮症状临床缓解,辅助实验室检查正常化。患者在使用喹硫平前从未出现过此类行为。初始治疗为静脉输注0.9%氯化钠1000毫升,饮水限制为每24小时1升。用利培酮代替喹硫平。患者血清钠水平恢复正常,并在随后3天出现临床改善。在烦渴时,过量饮水会降低血浆渗透压。考虑到抗精神病药物的使用会导致烦渴,以前的假设是,使用抗精神病药物可能会增加抗利尿激素(ADH)的分泌,从而导致水潴留。另一种理论机制可能是基于抗精神病药物固有的抗共碱能作用,这种作用会引起口渴的感觉。关于喹硫平的具体使用,医学文献中仅有一例报道喹硫平诱发低钠血症。然而,代谢失衡是由于抗利尿激素分泌不当综合征,而不是继发于烦渴。在本例中,我们报告并突出显示DOI: 10.5455/bcp.20151019014403
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引用次数: 0
Does Combined Antipsychotic Treatment Provide Better Control on Symptoms in Patients with Schizophrenia than the Monotherapy 联合抗精神病药物治疗比单一治疗能更好地控制精神分裂症患者的症状
Q Medicine Pub Date : 2016-03-01 DOI: 10.5455/BCP.20150629110950
E. Karslioğlu, E. Özalp, İsmail Volkan Şahi̇ner, M. Ozturk, Melike Nur Albayrak, Serap Aydin, Sadik Aydin, O. Yuncu, A. Çayköylü
Objective: Combined antipsychotic treatment is frequently used in clinical practice either to improve the symptom control or to reduce the severity of side effects. The expected benefits by combining different antipsychotics include active cross-titration and co-utilization of different administration routes of the therapeutic agents. However, except the add-on therapies to clozapine, there is no objective evidence implying the superiority of combined therapy over monotherapy. Furthermore, there are a number of published case reports of significant side effects accompanying combined antipsychotic usage such as extrapyramidal and metabolic symptoms, seizures, and electrocardiographic abnormalities. It is also argued that switching into a new therapeutic agent might be more beneficial than augmenting the ongoing medication by polypharmacy. Here, we studied on a group of hospitalized schizophrenia patients in a training and research hospital in Turkey whether the Positive and Negative Symptom Scale (PANSS) scores differ between the patients under monotherapy and combined therapy. Methods: Hospital records belonging patients with schizophrenia who were followed up between the years of 2003 and 2013 were retrieved. Schizophrenia diagnoses were re-evaluated and confirmed according to the DSM-IV-TR criteria. All the patients who met the diagnostic criteria and having PANSS subscale scores (n=158) were included in the study. PANSS scores at the time of hospitalization are represented by adding “-before” suffixes, while the ones at the time of discharge by adding “-after”. Results: Our series composed of 158 schizophrenia patients (54 women and 104 men). When the medications were reviewed, we found that 66 patients (41.8%) were treated with a single drug and the atypical antipsychotics were the most commonly used group. Multiple drugs were combined on 92 patients (58.2%) and the most common combination was the “atypical + typical” antipsychotics. PANSS subscales and their comparisons among the groups of monotherapy and combined therapy revealed a slight statistical difference in PANSS negative scores at the time of hospitalization, although we found no significant changes in terms of PANSS scales, in general. Conclusion: In this study, we presented the overall frequency and patterns of our combined antipsychotic therapy in our daily routine work. We only used severity of symptoms in our study, and observed no differences between mono and combined therapy groups in terms of the PANSS evaluation. Further clinical studies with clinical, metabolic, and laboratory data as well as the long follow-ups are needed to uncover if combined therapy proves to be beneficial over monotherapy.
目的:临床常用联合抗精神病药物治疗以改善症状控制或减轻不良反应的严重程度。不同抗精神病药物联合使用的预期益处包括药物的主动交叉滴定和不同给药途径的共同利用。然而,除了氯氮平的附加治疗外,没有客观证据表明联合治疗优于单一治疗。此外,有一些已发表的病例报告显示,联合使用抗精神病药物会产生严重的副作用,如锥体外系和代谢症状、癫痫发作和心电图异常。也有人认为,转换到一种新的治疗药物可能比增加正在进行的药物多药更有益。在这里,我们研究了土耳其一家培训和研究医院的一组住院精神分裂症患者,在接受单一治疗和联合治疗的患者中,阳性和阴性症状量表(PANSS)评分是否存在差异。方法:检索2003 - 2013年随访的精神分裂症患者的住院记录。根据DSM-IV-TR标准重新评估和确认精神分裂症诊断。所有符合诊断标准且具有PANSS亚量表评分的患者(n=158)均纳入研究。住院时的PANSS评分用“-前”后缀表示,出院时的PANSS评分用“-后”后缀表示。结果:本研究共纳入158例精神分裂症患者(女性54例,男性104例)。在用药回顾中,我们发现66例(41.8%)患者使用单一药物治疗,非典型抗精神病药物是最常用的药物组。92例(58.2%)患者合并多种药物,以“非典型+典型”抗精神病药物组合最为常见。单药组和联合治疗组的PANSS亚量表及其比较显示,住院时PANSS负评分有轻微的统计学差异,但我们总体上没有发现PANSS量表的显著变化。结论:在本研究中,我们展示了我们在日常工作中联合抗精神病药物治疗的总体频率和模式。在我们的研究中,我们只使用症状的严重程度,在PANSS评估方面,单药组和联合治疗组之间没有差异。需要进一步的临床研究,包括临床、代谢和实验室数据以及长期随访,以发现联合治疗是否比单一治疗有益。
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引用次数: 3
Ziprasidone use Associated with Sexual Hyperarousal 齐拉西酮与性亢奋有关
Q Medicine Pub Date : 2016-03-01 DOI: 10.5455/BCP.20150714054535
H. Kocakaya, Z. Çelikbaş, M. Yıldız, E. Songur, S. Batmaz
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引用次数: 0
Effects of maternal symptom ratings and other clinical features on short-term treatment response to OROS methylphenidate in children and adolescents with ADHD in a naturalistic clinical setting. 在一个自然的临床环境中,母亲症状评分和其他临床特征对儿童和青少年多动症儿童和青少年哌甲酯OROS短期治疗反应的影响
Q Medicine Pub Date : 2016-01-01 DOI: 10.5455/BCP.20150703013708
E. Tasgin, O. Oner, P. Yurtbaşı, K. Munir
OBJECTIVE To investigate the effect of Attention Deficit Hyperactivity Disorder (ADHD), antisocial behavior and anxiety/depression ratings of mothers, and child and adolescents' age, gender, ADHD subtype, and comorbidity on one-month drug treatment response to OROS methylphenidate in ADHD in a naturalistic setting. METHODS The analyses included 223 subjects (191 boys, 32 girls; age 6-15 years, mean: 9.4) treated with OROS methylphenidate (18-72 mg/day, mean: 31 mg/d; 0.4-1.4 mg/kg/d) for one-month. Treatment response was defined as larger than 25% or more decrease in pre-treatment the Conners Parent Rating Scale (CPRS) or the Conners Teacher Rating Scale (CTRS) total scores and the Clinical Global Impression improvement with drug treatment 3 (minimally improved) or higher. Maternal ADHD, antisocial behavior and anxiety/depression ratings were obtained by the Adult Self Rating (ASR). Logistic regression analyses were computed in order to calculate the effects of gender; age; ADHD subtype; comorbid anxiety disorder, learning disorder, oppositional defiant/conduct disorder; maternal ASR Anxiety/Depression, ADHD and Antisocial scores. RESULTS 35.2% of subjects had statistically significant 25% or more decrease in pretreatment CPRS total scores and 38.6% of subjects had statistically significant 25% or more decrease in pretreatment CTRS total scores. The subjects with comorbid anxiety disorder had the poorest drug response. Maternal self-reported antisocial and anxiety/depressive symptomatology were statistically significantly associated with worse response to treatment in terms of CPRS (respectively, OR=0.83, 95% CI: 0.75-0.92, p<0.01; OR=0.95, 95% CI: 0.9-0.99, p<0.05) and CTRS total scores (OR=0.9, 95% CI: 0.82-0.99, OR=0.95, 95% CI: 0.91-1, p<0.05). Baseline rating scores were also important predictors of drug treatment response. Effects of age, gender and maternal ADHD were not statistically significant. CONCLUSION ADHD children and adolescents with comorbid anxiety disorders and those whose mothers have more self-reports of antisocial and depressive symptoms showed less favorable short-term response to OROS-MPH. These subjects may require further attention and additional interventions to augment treatment with OROS methylphenidate.
目的在自然环境下,探讨注意缺陷多动障碍(ADHD)、母亲的反社会行为和焦虑/抑郁评分,以及儿童和青少年的年龄、性别、ADHD亚型和合并症对ADHD患者服用哌甲酯OROS 1个月药物治疗反应的影响。方法共纳入223例受试者(男童191例,女童32例;年龄6-15岁,平均:9.4岁)使用哌甲酯OROS治疗(18-72 mg/天,平均:31 mg/天;0.4 ~ 1.4 mg/kg/d),一个月。治疗反应定义为治疗前康纳斯家长评定量表(CPRS)或康纳斯教师评定量表(CTRS)总分和药物治疗3(最低改善)或更高的临床总体印象改善大于25%或更多。采用成人自评(ASR)获得母亲ADHD、反社会行为和焦虑/抑郁评分。进行Logistic回归分析,计算性别的影响;年龄;多动症亚型;共病焦虑症、学习障碍、对立违抗/行为障碍;结果35.2%的受试者前处理CPRS总分下降25%及以上,38.6%的受试者前处理CTRS总分下降25%及以上。合并焦虑障碍的受试者对药物的反应最差。在CPRS方面,母亲自我报告的反社会和焦虑/抑郁症状与治疗反应较差有统计学显著相关(分别OR=0.83, 95% CI: 0.75 ~ 0.92, p<0.01;OR=0.95, 95% CI: 0.9 ~ 0.99, p<0.05)和CTRS总分(OR=0.9, 95% CI: 0.82 ~ 0.99, OR=0.95, 95% CI: 0.91 ~ 1, p<0.05)。基线评分也是药物治疗反应的重要预测指标。年龄、性别和母亲ADHD的影响无统计学意义。结论伴有焦虑障碍的adhd儿童和青少年以及母亲自我报告有更多反社会和抑郁症状的儿童和青少年对OROS-MPH的短期反应较差。这些受试者可能需要进一步的关注和额外的干预,以加强OROS哌甲酯治疗。
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引用次数: 2
Neuroinflammation in Schizophrenia: A Critical Review and The Future 精神分裂症中的神经炎症:一个重要的回顾和未来
Q Medicine Pub Date : 2016-01-01 DOI: 10.5455/BCP.20161123044657
F. Aricioglu, C. Ozkartal, G. Unal, S. Dursun, M. Cetin, N. Müller
Schizophrenia is a serious mental illness that affects approximately 1% of the population worldwide, with positive, negative and cognitive dysfunctions and a significant deterioration in psychosoci...
精神分裂症是一种严重的精神疾病,影响全球约1%的人口,具有积极、消极和认知功能障碍,心理社会显著恶化。
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引用次数: 25
期刊
Klinik Psikofarmakoloji Bulteni-bulletin of Clinical Psychopharmacology
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