Serum sodium changes in fluoxetine users at different age groups

Fluoxetine, a widely used antidepressant, can affect the serum sodium level. The aim of this study was to evaluate and compare changes in the serum sodium level of depressive patients taking fluoxetine according to age. This quasi-experimental study was conducted on 126 patients with depression, dividing the patients into two age groups of 15 to 35 years, and above 55 years, who referred to psychiatric clinics of the Isfahan University of Medical Sciences. Serum sodium level was measured prior to fluoxetine therapy and at the first and third week after; adverse symptoms were recorded. Serum sodium level, hyponatremia, and other adverse effects were compared between the two age groups. There was a significant decrease in serum sodium levels in the older patients at the first and third week after the therapy; but the serum sodium levels decreased only after the third week of therapy in the younger patients [p < 0.05]. Serum sodium level was significantly lower in older than in younger patients at the third week of the therapy [140.8 +/- 2.26 vs. 135.2 +/- 2.06; p < 0.05], and hyponatremia was detected only in the older patients after the first and third week of therapy, 4.7% and 15.8%, respectively. Using fluoxetine can decrease serum sodium level, which is more frequent, more severe, and more clinically manifested in older than younger patients. Monitoring serum sodium level is recommended in early weeks of fluoxetine therapy especially for patients older than 55 years of age

effect of family training on salivary cortisol in children with disruptive behavior disorder

Antisocial, aggressive and delinquent behaviors in adults often begin early in life. Basal cortisol is a valuable biological marker in children with disruptive behavior disorder [DBD]. To investigate the association between biological factor [cortisol] and disruptive behaviors, we studied the effect of family training on salivary cortisol level in children with DBD. Basal salivary cortisol levels were studied in 19 children with DBD, [aged 8 -13 years old] prior and 2 months after the treatment. The disruptive behavior of the child was also assessed by Child Behavior Checklist [CBCL], before and 2 months after treatment. Children with lower basal cortisol level had more sever behavioral problems. Surprisingly, this group had a better response to family therapy. Parental training is an effective method for behavioral modification of children with DBD. Salivary cortisol can be considered as a biological marker for the severity of disruptive behavior and response to therapy

Effect of trazodone on sleep bruxism in children and adolescents 6-18 years of age, a pilot study

Sleep bruxism is a common sleep disorder with unclear etiology and no definitive treatment. Recent suggested medications are not often practically used due to their numerous limitations. Based on the fact that sleep bruxism occurs most often in the second stage of non-REM sleep, this study aimed to assess the effect of trazodone on sleep bruxism. This pilot study was conducted as a before-after design on 28 children and adolescents with 6-18 years of age suffering from sleep bruxism referring by children and adolescents mental health clinic, children dental specialists and pediatricians. The treatment started with 0.5mg/kg/day. In non-responders, it was weekly added by 0.5 mg/kg/day [with optimum of 2 mg/kg/day]. Frequency of bruxism and related morning face/jaw pain were assessed daily from two weeks before [baseline] to four weeks after starting the intervention by the parents/roommate. Findings showed a significant reduction in the frequency of both bruxism and related morning pain from baseline to the 2nd and the 4th weeks of the intervention [P<0.001]. Minor side effects such as drowsiness, nausea and dry mouth were seen among approximately one-third of the patients. These side effects were self-limited and tolerable. Trazodone could be effective in reducing the frequency of sleep bruxism and its related morning face/jaw pain. Well-designed placebo-controlled trials are needed to confirm the results

Effects of parent training on salivary cortisol in children and adolescents with disruptive behavior disorder

Since adulthood antisocial, aggressive and delinquent behaviors often have their onset early in life, investigating the association between biological factors and disruptive behaviors in children and adolescents are important and are emphasized on in the recent years. Baseline cortisol level seems to be a valuable biological marker of individuals with Disruptive Behavior Disorder [DBD]. This study examined the effect of parent training on salivary cortisol levels of children with DBD. Saliva samples were assayed to determine cortisol levels in nineteen clinic-referred children with DBD [aged 8 through 13 years] before and after an eight-session parent training program. Children's disruptive behaviors were assessed by Child Behavior Check List before and after the intervention. Children's salivary cortisol increased significantly after parent training sessions. Children with DBD who had lower basal cortisol levels had more severe disruptive behaviors and a better response to intervention by parent training as assessed by changes in cortisol levels and disruptive behaviour scores. However, post-interventional reduction of disruptive behaviors and increase in cortisol level was significant for all levels of baseline cortisol. Parent training is an effective method for behavioral modification in DBD. Salivary cortisol may be considered a predictive factor for severity of the child or adolescent's disruptive behaviors and also for response of those behaviors to parent training