RESUMO
Newer atypical antipsychotics have many benefits compared with conventional antipsychotics. However it has been known that atypical antipsychotics are associated with drug-induced weight gain and dibetes mellitus. Obesity and diabetes mellitus may be problematic side effects to patients with schizophrenia because they can cause many medical problems and also drug compliance which is important to prognosis can be reduced by those adverse effects. We present here a male patient, aged 26 years old, who was treated with risperidone, olanzapine, quetiapine subsequently and gained weight by 32 kilograms (almost 50% increase) during four years long treatment and diagnosed as having diabetes mellitus. We switched the antipsychotics to amisulpride at the day of admission and increased the dosage to 800 mg. At discharge after 34 days after admission, his psychotic symptoms were considerably improved and blood glucose level at fasting time was stabilized within acceptable range. And he also lost weight by 5 kilograms after admission. Amisulpride would be a relatively appropriate choice of drug in patient with atypical antipsychotics induced weight gain and/or diabetes mellitus.
Assuntos
Adulto , Humanos , Masculino , Antipsicóticos , Glicemia , Peso Corporal , Complacência (Medida de Distensibilidade) , Diabetes Mellitus , Jejum , Obesidade , Prognóstico , Risperidona , Esquizofrenia , Aumento de PesoRESUMO
OBJECTIVES: Repetitive transcranial magnetic stimulation (rTMS) is a novel, noninvasive method of brain stimulation. Since conventional rTMS does not cause seizure, marked advantage over electroconvulsive therapy (ECT), rTMS can be used easily and widely. Once the effects of rTMS on cognitive function are elucidated, its application will be further extended. However, the effects of rTMS on cognitive function have not been well examined. This study aimed to evaluate the effect of low frequency rTMS on visual short term memory. METHODS: Forty normal healthy volunteers were randomly assigned to rTMS (n=20) or sham (n=20) groups. The rTMS group were again randomly divided into left prefrontal (n=10) and right prefrontal (n=10) groups. For each group rTMS was given at 1 Hz for 20 minutes with 100% of motor threshold. As a cognitive task, Corsi Block Tapping Test (CORSI) in the computerized Vienna Test System, which can assess visual short term memory, was performed before, during, and after the rTMS. RESULTS: No significant difference was found in the visual short term memories between the rTMS and the sham groups before, during, or after 1 Hz rTMS, nor between the left and right prefrontal rTMS groups. CONCLUSION: This study demonstrates that rTMS, contrary to ECT, has no adverse visual short term memory effect when used as the standard treatment paradigm. Therefore, rTMS could be a new and safe treatment method in various neuropsychiatric fields without any interference of cognitive function.
Assuntos
Encéfalo , Cognição , Eletroconvulsoterapia , Voluntários Saudáveis , Memória , Convulsões , Estimulação Magnética TranscranianaRESUMO
OBJECTIVES: Repetitive transcranial magnetic stimulation (rTMS) is a novel, noninvasive method of brain stimulation. Since conventional rTMS does not cause seizure, marked advantage over electroconvulsive therapy (ECT), rTMS can be used easily and widely. Once the effects of rTMS on cognitive function are elucidated, its application will be further extended. However, the effects of rTMS on cognitive function have not been well examined. This study aimed to evaluate the effect of low frequency rTMS on visual short term memory. METHODS: Forty normal healthy volunteers were randomly assigned to rTMS (n=20) or sham (n=20) groups. The rTMS group were again randomly divided into left prefrontal (n=10) and right prefrontal (n=10) groups. For each group rTMS was given at 1 Hz for 20 minutes with 100% of motor threshold. As a cognitive task, Corsi Block Tapping Test (CORSI) in the computerized Vienna Test System, which can assess visual short term memory, was performed before, during, and after the rTMS. RESULTS: No significant difference was found in the visual short term memories between the rTMS and the sham groups before, during, or after 1 Hz rTMS, nor between the left and right prefrontal rTMS groups. CONCLUSION: This study demonstrates that rTMS, contrary to ECT, has no adverse visual short term memory effect when used as the standard treatment paradigm. Therefore, rTMS could be a new and safe treatment method in various neuropsychiatric fields without any interference of cognitive function.