"May I have your attention please?"- A case report

The patient is a 21-year old male, whose developmental history served as a fertile ground of predisposing factors for yielding a psychiatric diagnosis. He grew up without a mother in a dysfunctional home, without rules to follow or consequences for his disobedience. He did not receive clear instructions on what was right or wrong and did not have any good role models for an orderly life and stable relationship. Instead, he was given undeserved freedom at a very young age, and then at 21 years old, he became detached, anxious, distracted, and purposeless.

The clinical profile inpatients with psychoactive substance-induced mental disorder and comorbidity in a tertiary hospital from January 1995 to September 2000

Substance abuse as well as its psychiatric consequences is prevalent in the Philippines. This causes an increase in admission rates in mental health institutions that describe these cases are rate. Objective: This study aims to determine the clinical profile of patients with psychoactive substance induced mental disorder and substance abuse co-morbidity. Methods: The medical records of patients admitted at the Community Center of Santo Tomas University Hospital from January 1995-September 2000 with the above diagnosis were reviewed. The data was analyzed using descriptive statistics. Results: Most patients were single, male, college undergraduate, unemployed and Roman Catholic. The mean age was 30 years old, living predominantly in Metro Manila. Most of them were smokers and occasional alcoholic beverage drinkers. More than 30% were diagnosed with substance induced psychotic disorder followed closely by co-morbidity with antisocial personality disorder and schizophrenia, respectively. The most common substance abused was methamphetamine "shabu" and the interval between the onset of symptoms and the psychiatric manifestations was 4-5 years. The presenting symptoms were restlessness, agitation and violent behavior. They also had paranoid delusions, auditory and visual hallucinations. The most common medication given was typical anti psychotics, specifically haloperidol, with a mean length of hospitalization of one month. Conclusion: Drug abuse was associated with a high risk for psychiatric co-morbidity, especially methamphetamine use, which is known to induce psychosis, responsible for agitation, violence and paranoia that would the require anti psychotic medication, and hospitalization.

Post marketing surveillance on the use of zonisamide for epilepsy in the Philippines: A preliminary report

The objective of the study is to monitor on a wide population base the safety and efficacy of zonisamide in patients with partial, generalized, and combined seizures. This is an open label, descriptive, post-marketing surveillance preliminary report that includes the data obtained from October 2008 to May 2010 of a four-year study. The study included 516 patients allocated to either zonisamide monotherapy or zonisamide add-on therapy, with efficacy and safety assessed monthly for three months. For adult patients, a maximum oral dose of 600 mg per day was allowed while a maximum dose of 12 mg/kg/day of zonisamide was allowed for pediatric patients. Efficacy measures were the proportion of responders and percentage change in seizure frequency from baseline. 321 of the 516 patients were included in the efficacy analysis. The responder rates were 53.27%, 80.37%, and 92.52% after the 1st month, 2nd month, and 3rd month of treatment respectively. The use of zonisamide led to seizure-reduction rates of 45.74%, 68.43%, & 82.85% during the 1st, 2nd, & 3rd month of use respectively. Safety analysis was done on all the 516 subjects. Adverse events were mostly mild and observed in 6.78% of patients. No serious adverse events were encountered. 7 subjects (1.4%) discontinued taking zonisamide because of increased seizure frequency in 4 patients, and 1 patient each due to absence of effect on seizure-control, rashes, and thrombocytopenia. All the rest continued taking zonisamide.