Psychopharmacology bulletin最新文献

High rates of both suicidality and NSSI in individuals with BPD indicate the severity of the distress experienced by many of those diagnosed. It behoves clinicians to delve into the many disparate determinants these behaviours might subserve, in order to inform tailored and effective treatment decisions.

Objective: Hallucinogen-persisting Perception Disorder (HPPD) is a rare condition characterized by the re-experiencing of one or more perceptual symptoms that an individual experienced while intoxicated with a hallucinogenic substance when the individual is sober. While there are several case reports of HPPD in adult patients, there is a scarcity of documented cases in children and adolescents. The purpose of this article is to highlight the presentation, diagnosis, and treatment of HPPD in a 16-year-old male patient.

Methods: In this case report, the patient is a 16-year-old male with a history of major depressive disorder (MDD) and polysubstance use using Lysergic acid diethylamide (LSD), 3,4-Methylenedioxymethamphetamine (MDMA), psilocybin, cannabis, and benzodiazepines. He endorsed having auditory hallucinations and a heightened sense of hearing in between usage of MDMA for the past eight months and described auditory and visual hallucinations during his 5-day admission at the inpatient child psychiatric unit. Aripiprazole 5 mg was used as treatment for HPPD.

Results: On review of literature, the first-line treatment for HPPD with clonidine and benzodiazepine has been documented by few case reports. Second generation antipsychotics are documented to be less effective with the exception of aripiprazole. The authors witnessed gradual improvement in the patient's symptoms with the use of aripiprazole, although it was not completely resolved during his hospital course.

Conclusions: This case demonstrates the presentation of HPPD and efficacy of aripiprazole in an adolescent patient. The diagnosis was further complicated by the patient's history of polysubstance use, and determining a distinction from non-substance-induced psychotic disorders was paramount.

Introduction: Although adolescent use of combustible cigarettes (CC) has decreased, the rise of nicotine electronic vaping products (EVPs) presents new public health concerns. Nicotine vaping devices, with appealing packaging and flavors, are now the most commonly used nicotine delivery method among adolescents. While the long-term effects remain unclear, short-term effects include tachycardia, coughing, and wheezing. This review explores the relationship between nicotine vaping and sleep disturbances in adolescents.

Methods: A PubMed search (2006-2024) using keywords "nicotine sleep adolescents," "vaping sleep adolescents," and "e-cigarette sleep adolescents" identified 159 articles. Filters for "Humans," "English," and "Age-Birth-18 years" narrowed the list to 124. Abstracts were independently screened for cross-sectional studies describing sleep disturbances, yielding nine articles. Outcome measures included insufficient sleep (< 7-8 hours/night) and sleep latency, assessed through self-reported hours and the Pittsburgh Sleep Quality Index (PSQI).

Results: Data from 106,628 adolescents (12-18 years; males = females) revealed e-cigarette (most common vaping device used) and dual users (e-cigs + CC) reported significantly more insufficient sleep on school nights than non-users. Dual users exhibited increased sleep latency, particularly in males. Two studies suggested chronic insufficient sleep might lead to initiation or increased use of vaping devices, highlighting a bidirectional relationship.

Conclusions: Many survey studies indicate vaping nicotine is associated with sleep disturbances in adolescents. Other studies determined sleep disturbances were associated with an initiation or increase in vaping nicotine indicating a cause-and-effect conundrum. Further investigation through longitudinal studies are needed to determine factors such as the causal relationship, dose-response and product-specific effects.

Fixed-dose combinations were, and still, quite in vogue in medical practice but for better or worse, did not gain a foothold in psychiatric prescriptions. Whilst briefing the merits and demerits of these formulations, authors herein provide a list of common psychotropic drug combinations on market, explaining the underneath psychopharmacological rationale.

The relationship between antipsychotic medications and thyroid dysfunction has been highlighted in various studies and case reports, particularly concerning subclinical hypothyroidism. This report presents the case of a 31-year-old male patient diagnosed with schizophrenia who received short-term treatment with paliperidone. Routine follow-up assessments revealed significant changes in thyroid function, including marked elevation in thyroid-stimulating hormone (TSH) levels and a slight decrease in free thyroxine (FT4) levels. These alterations were associated with ongoing paliperidone use, suggesting a potential link to hypothyroidism. The findings underscore the importance of continuous thyroid function monitoring in patients prescribed paliperidone to identify potential side effects and ensure comprehensive management of both psychiatric and endocrine health. This case emphasizes the need for increased awareness among healthcare providers regarding the endocrine effects of antipsychotic medications, particularly second-generation agents like paliperidone, to facilitate early detection and timely intervention, ultimately improving patient outcomes.

There is much uncertainty on continuing antipsychotics where a patient has an asymptomatic rise in creatine kinase. This case report describes a patient in his late 20s and early 30s with an established diagnosis of schizophrenia. He experienced multiple asymptomatic rises in creatine kinase (CK) when treated with numerous antipsychotics, which led to them being discontinued. Eventually, successful treatment was undertaken when clozapine was trialled. This led to improved quality of life scores when objectively measured, as well as good tolerance with no physical health sequelae. In conclusion, we recommend that clozapine is considered when other antipsychotic medications lead to elevated CK levels or neuroleptic malignant syndrome.

Schizophrenia is a serious mental illness that is a leading cause of disability worldwide. While antipsychotic agents are the most effective medications, up to one-third of patients experience treatment resistance, and approximately one-sixth of patients experience ultra-resistant illness. There is a growing body of evidence that inflammation, oxidative stress, and neurodegeneration may be contributing to pathophysiology and treatment response. Several agents with potential to improve inflammation and oxidative stress have been investigated, with some showing statistically significant benefits, though robust improvement in symptomatology has not been consistently demonstrated. Hericium erinaceus (HE) is an edible mushroom that has been used as a medicinal food for centuries. In pre-clinical studies, it has demonstrated anti-inflammatory, antioxidant, neuroprotective, and neurogenesis-promoting effects. The specific inflammatory markers that are impacted by HE align well with biomarkers shown to be altered in chronic and treatment resistant schizophrenia. Most clinical studies to date have assessed HE for the treatment of mild cognitive impairment, depression, and anxiety. In clinical studies, HE has been well tolerated, with the most common adverse effect of gastrointestinal disturbance. Given potential for HE to improve inflammation, reduce oxidative stress, and promote adult neurogenesis in the hippocampus, it is theorized that HE may have beneficial effects on symptomatology when used as an add-on to antipsychotic therapy in those with residual symptoms or treatment resistance. The goal of this review is to describe theoretical benefits and potential dosing strategies based on pre-clinical and clinical data.

Objective: A patient with major depressive disorder (MDD) was receiving transcranial magnetic stimulation (TMS). A little over halfway through the course the patient was bereaved and experienced normal sadness. Our objective is to describe the tracking and outcome of this common emotionally distressing event.

Method: Routine assessments conducted at the centre include the six-item Hamiton depression rating (HAMD6) scale, the Clinical Global Impression-Severity (CGI-S) scale, and the Subjective Depression Scale (SDS6). In addition, the Daily Sadness Scale (DSS) is applied at each treatment day; this is a single question asking how much sadness/depression is being experienced.

Results: On the 19th treatment day, the patient was bereaved and experienced appropriate sadness. The pathological state (MDD) resolved, as reflected by changes in the psychometric tools. Following the death, normal sadness emerged and lessened over a few weeks.

Conclusion: This case illustrates that while TMS can effectively treat MDD, it does not prevent the emergence of sadness in uncomplicated bereavement.

Since its first inception by Kahlbaum in relation to schizophrenia, Catatonia syndrome is currently believed to cut across many neuropsychiatric diagnoses. In this focussed review, authors touch briefly on prevalence of catatonia in psychiatric presentations, discuss clinical diagnosis, neurobiology, typology, and conclude with a psychopharmacological algorithm to treatment.