Long-term effectiveness and safety of endoxifen in the treatment of bipolar mania: a case report

Bipolar disorder (BD) displays abnormalities in protein kinase C (PKC) signaling, and evidence suggests that inhibiting PKC may help treat mania. Endoxifen a potent inhibitor of the PKC signaling pathway, is effective in controlling acute bipolar mania, atdoses of 8 mg OD, for a period of 3-weeks. Here we present the case of a patient with severe mania, increased alcohol consumption administered endoxifen 8 mg BID for a period of 3-months, to achieve a better response. High-dose, long-term treatment with endoxifen was efficacious in controlling manic symptoms, with no adverse effects. Additionally, the patient didn抰 consume alcohol during the course of treatment. This case showed the long-term effectiveness and safety of high-dose endoxifen to control mania in a patient with BD.

Study of Lipid Derangement in Pyschiatric Disorder.

Background: Several studies have investigated the relationships of lipid levels with psychiatric patients and their results revealed an association between lipid derangement and psychiatric disorders. The aim of our study is to evaluate the lipid profile alteration in psychiatric disorder and compare with normal control. Materials and Methods: This study was conducted at People’s College of Medical Sciences and Research Centre, Bhopal. Sixty newly diagnosed psychiatric patients were included in this study and compare with 40 normal subjects. In both the groups we have measured lipid profile which includes serum total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), very low density lipoprotein cholesterol (VLDL), and cardiovascular risk factors (R-1and R2). Results: The levels of serum TC, TG, LDL-C and VLDL-C and risk factors in psychiatric patients was significantly increased as compared to control group (p<0.05). While serum HDL-C level was significantly decreased in test group (p > 0.05). Conclusion: In our study it is clearly evident that psychiatric disorders are associated with significantly higher levels of lipids (constituents of lipid profile) and risk factors for coronary heart disease.

Association of hypertension and its treatment with dementia and cognitive functioning.

AIM: Hypertension is known to induce many pathological changes in the body, including cardiac hypertrophy, atherosclerosis, micro-aneurisms and stroke. Besides these conspicuous pathologies, it also has subtle effects on the functioning of the brain. These cognitive changes have received little attention despite the fact that they make a large impact on the daily functioning of affected persons. The present study was conducted to assess the effect of hypertension and related factors on cognitive functions in an Indian population. METHODS AND RESULTS: A cohort of young hypertensive subjects was recruited after obtaining informed consent. Subjects with confounding factors, such as substance use, neurological disorders, endocrinopathies, inflammatory conditions and psychiatric illnesses, were excluded. The average systolic and diastolic blood pressure of the subjects since the onset of illness and prescription of drugs were noted from the records. Compliance was assessed with the help of information given by the subjects and their close relatives. The mini-mental state examination and a battery of neuropsychological tests (digit span test, trail making test, Stroop test, visuospatial working memory matrix and word fluency test) were applied to all participants. Univariate regression analysis was used for the assessment of association and a one-way analysis of variance was performed on categorical variables. The mean age of the subjects was 52 years, and the average duration of hypertension 9 years. Twelve subjects had dementia which could be attributed to the subtle effects of hypertension only. Blood pressure (both systolic and diastolic) had a significant negative association with the cognitive tests. Cognitive impairment was also seen in subjects who reported poor drug compliance and those using beta blockers, while calcium channel blockers played a protective role. CONCLUSIONS: Hypertension was associated with a significant decline in cognitive functioning in younger subjects. Good compliance with drugs and the use of calcium channel blockers had a protective effect on hypertension-induced cognitive decline.