ABSTRACT
Background: Majority of the antipsychotics including some of the atypical antipsychotics are associated with adverseeffects related to blockade of dopamine (D2) receptors. Of them, galactorrhoea can be a very distressing andembarrassing symptom. A constant search is therefore on for antipsychotics with lesser adverse effects.Case description: A thirty year old married lady suffering from Unspecified Nonorganic Psychosis of three yearsduration had developed troublesome galactorrhoea while on treatment with trifluperazine. It was changed over torisperidone in an effort to reverse galactorrhoea but without benefit. She was then switched over to aripiprazole whiletapering off the previous medication. Her mental condition improved while her galactorrhoea too stopped within threeweeks.Discussion: Unlike other antipsychotic drugs, aripiprazole as a partial D2 agonist, may not result in the severehypodopaminergic state in the tubero-infundibular pathways and thus does not increase prolactin levels. This mode ofaction is unique to aripiprazole and explains how it can ameliorate the galactorrhoea induced by other antipsychoticdrugs.Conclusion: Aripiprazole is an effective and a safer atypical antipsychotic more so for its low propensity forgalactorrhoea. It may also reverse the galactorrhoea induced by other antipsychotics such as risperidone.
ABSTRACT
In the pharmacological management of depression, antidepressant drugs take about two weeks for the onsetof their therapeutic action while electroconvulsive therapy though faster, is a cumbersome procedure requiringan anesthetist and many gadgets. Recent studies have shown that ketamine when given to severely depressedpatients in the dose of 0.5mg/ kg body weight as a slow intravenous infusion over 40 minutes brought aboutrapid and significant relief within a few hours to within a day. It was however a transitor y improvement whichlasted for up to a week. As the dose of ketamine administered was very small, it was now tried in theintramuscular route with similar rapid improvement of depressive symptoms in a 25 year old man. His case isreported here as it promises to be an easy tool for providing quick relief to severely depressed patients.