Drug-drug Interaction between Psychotropic Medications and Medications Used in COVID-19: Comparison of Online Databases

Objective@#COVID-19 has gravely affected patients with psychiatric conditions. Potential interactions may occur between psychotropic medications and medications used in treatment of COVID-19. This study aimed to compare the online databases in terms of the quality of drug-drug interaction related information available on them. @*Methods@#216 drug interactions which included fifty-four psychotropic medication interactions with four COVID-19 drugs across six databases were analyzed by four authors independently. The overall grading of the databases was done on Likert scale independently by the authors using the parameters of ease of understanding for consumers and professionals, level of completeness, discussion on level of evidence and the number of available drugs, congruity with other databases and the mean score was tabulated. @*Results@#Drugbank and Lexicomp had maximum discrepancy. The safety profile of Hydroxychloroquine was the best (eighteen moderate/severe psychotropic medication reactions) while Ritonavir has worst profile with thirty-nine medications. Drugbank had the highest SCOPE score (1.00) for completeness and covid19druginteractions.com had least (0.81). Overall, Liverpool© Drug Interaction Group and Lexicomp scored the highest (23/30 each) and were the best interaction checker software closely followed by Drugs.com (22/30). Medscape and WebMD were the poorest interaction checker databases. @*Conclusion@#There is significant variability in the available online databases. Liverpool © Drug Interaction Group and Lexicomp were the most reliable sources for healthcare workers whereas for patients, Drugs.com was the easiest to understand (as it segregates the needs of general consumers and professionals distinctly to explain the interaction).

Management Dilemma in Olanzapine Induced Restlessness and Cramps in Legs

No abstract available.

Early Augmentation Response with Low-frequency Repetitive Transcranial Magnetic Stimulation in Treatment Resistant Depression

No abstract available.

How Electroconvulsive Therapy Works?: Understanding the Neurobiological Mechanisms

Electroconvulsive therapy (ECT) is a time tested treatment modality for the management of various psychiatric disorders. There have been a lot of modifications in the techniques of delivering ECT over decades. Despite lots of criticisms encountered, ECT has still been used commonly in clinical practice due to its safety and efficacy. Research evidences found multiple neuro-biological mechanisms for the therapeutic effect of ECT. ECT brings about various neuro-physiological as well as neuro-chemical changes in the macro- and micro-environment of the brain. Diverse changes involving expression of genes, functional connectivity, neurochemicals, permeability of blood-brain-barrier, alteration in immune system has been suggested to be responsible for the therapeutic effects of ECT. This article reviews different neurobiological mechanisms responsible for the therapeutic efficacy of ECT.

The Phenomenon Of Dissociation, Depression And Borderline Personality In A Young Woman

Early life adversities like parental loss during childhood, physical abuse, sexual abuse and emotional harassment may have deleterious consequences in an individual’s life, which can manifest under the form of various externalizing or internalizing behaviors. This case study aimed to highlight the impact of unusual early life adversities in a young woman’s mental health and related management issues. Methods: We reported a case of a young lady presenting with anxiety, low mood, disturbed sleep and appetite for more than six months. She also had episodes of dissociative stupor following any stressful event for approximately 13 years. She was hospitalized, evaluated clinically as well as by psychometric assessment. Relevant pharmacological and psychological interventions were performed. Results: She was diagnosed with Major depressive disorder with dissociative disorder and borderline personality disorder. The patient had multiple stressors during childhood like - loss of parents, emotional & physical abuse, which had an impact on her mental wellbeing. Conclusion: Early life adversities are detrimental to the mental health of an individual. The clinical outcome depended upon on the nature of trauma to the mental well-being, mode of intervention done and available psychosocial supports. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.

An Unusual, Paradoxical Arousal with Alprazolam in a Dependant User

No abstract available.

Impact of High Dose Lorazepam on Seizure Threshold in Catatonia: Experience from a Case Study

No abstract available.

Neuro-stimulation Techniques for the Management of Anxiety Disorders: An Update

Neuro-stimulation techniques have gradually evolved over the decades and have emerged potential therapeutic modalities for the treatment of psychiatric disorders, especially treatment refractory cases. The neuro-stimulation techniques involves modalities like electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), vagus nerve stimulation (VNS) and others. This review discusses the role of neuro-stimulation techniques in the treatment of anxiety disorders. The various modalities of neuro-stimulation techniques are briefly discussed. The evidence base relating to use of these techniques in the treatment of anxiety disorders is discussed further. The review then highlights the challenges in conducting research in relation to the use of neuro-stimulation techniques with reference to patients with anxiety disorders. The review provides the future directions of research and aimed at expanding the evidence base of treatment of anxiety disorders and providing neuro-stimulation techniques as promising effective and acceptable alternative in select cases.

Evolving Concept Of Abnormal Illness Behavior & Clinical Implications

Objectives: The concept of “Abnormal illness behavior (AIB)” has been evolved to a greater extent in the last century. Henry Sigerist introduced the concept of “illness behavior” in 1929. Mechanic & Volkart defined and further conceptualized the impression on illness behavior. Talcott Parson had given the concept of “Sick role,” and Issy Pilosky had familiarized the notion of “abnormal illness behavior.” The main objective of this article is to review the conceptual evolution on “abnormal illness behavior” and to analyze its current clinical implications. Methods: Extensive search of literature was performed regarding abnormal illness behavior, illness behavior and sick role in online web searching sites like – Google Scholar, PubMed and individual journal sites as well as google books. The literature was critically reviewed with personal inputs from authors. Results: Abnormal illness behavior ranges from denial of illness in one extreme to conscious amplification of symptoms on the other. Abnormal illness behavior is noticed in various clinical conditions like stress-related disorder, stress-related disorders, factitious disorder and malingering. Conclusions: Identifying abnormal illness behavior can prevent unnecessary and excessive utilization of medical aids for the same.

Factors Affecting Executive Functions In Patients Recovered From Acute And Transient Psychotic Disorder

Objectives: Executive function is an important cognitive function affected in many psychiatric disorders but limited data is available regarding its course in patients recovered from acute and transient psychotic disorder. The aim of this study was to assess the executive function of recovered patients of acute and transient psychotic disorder and to evaluate different factors affecting the executive function of patients recovered from acute and transient psychotic disorder. Method: This was a non-invasive, one point, comparative study where the executive function was assessed after clinical recovery from acute and transient psychotic disorder. The patients were divided into two groups (poor and fair) on the basis of their executive performance. Retrograde analyses of different factors affecting executive performance were carried out. Results: A total of 28 patients had undergone assessment on Wisconsin Card Sorting Test (WCST) out of which 13 patients had poor and 15 patients had fair executive performance. The fair executive performance group had shorter duration of psychosis, male preponderance and more years of education. Conclusion: Average duration of psychosis seems to be a reliable predictor of better or poor executive functioning.