Subject(s)
Anti-Anxiety Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Buspirone/therapeutic use , Schizophrenia/drug therapy , Adult , Anti-Anxiety Agents/adverse effects , Antipsychotic Agents/adverse effects , Buspirone/adverse effects , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Schizophrenic PsychologyABSTRACT
A high frequency of sexual dysfunction occurs in treated and untreated patients with schizophrenia. Unfortunately, no effective therapy for this problem is currently available. We present a case of a 26-year-old patient with paranoid schizophrenia, who suffered from lack of desire and erection, and was successfully treated with sildenafil citrate (Viagra). This case illustrates the complex character of sexual dysfunction in male schizophrenia patients.
Subject(s)
Erectile Dysfunction/complications , Erectile Dysfunction/drug therapy , Phosphodiesterase Inhibitors/therapeutic use , Piperazines/therapeutic use , Schizophrenia, Paranoid/complications , Adult , Humans , Male , Prolactin/blood , Purines , Sildenafil Citrate , SulfonesABSTRACT
Three adolescent and two adult patients suffering from chronic excited psychoses (either schizophrenia or schizoaffective disorder) resistant to traditional neuroleptics and clozapine were treated with combined clozapine-lithium. Improvement was assessed with the Positive and Negative Symptoms Scale, the Brief Psychiatric Rating Scale and the Clinical Global Impressions, administered before and during combined clozapine-lithium treatment. All patients demonstrated a significant improvement with this combination. There was no occurrence of agranulocytosis, neuroleptic malignant syndrome or other clinically significant adverse effects.
ABSTRACT
Polysomnography was performed in 20 depressed patients and 8 normal controls for 2 consecutive nights. A subset of patients had 3 consecutive nights. Patients were assigned to groups according to the presence (group I) or absence (group II) of a first night effect (REM sleep latency on the first night in the laboratory was at least 30 min longer than on the second night). The groups were equivalent with regard to gender distribution, age, and severity of depression. In group I, REM sleep latency on nights 2 and 3 was significantly shorter than in group II. REM sleep percentage on the second night in group I was increased compared to the first night. A shift of REM sleep to the first cycle was prominent on the first night only in patients with a first night effect. On average, delta sleep was preserved in group I compared to group II. We suggest that the first night effect reflects a physiological system with greater capacity to respond adaptively and to preserve homeostasis when confronted with environmental stressors.
Subject(s)
Depressive Disorder/psychology , Polysomnography/standards , Sleep/physiology , Adult , Aged , Electroencephalography , Electrooculography , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Research Design , Sleep, REM/physiologyABSTRACT
Despite advancement in psychopharmacology, treatment-resistant schizophrenia still poses a challenge to modern psychiatry. We present four patients with schizophrenia treated with clozapine and ECT. One patient who developed neuroleptic malignant syndrome (NMS) on conventional neuroleptics experienced no complications with this combination.
Subject(s)
Antipsychotic Agents/therapeutic use , Clozapine/therapeutic use , Electroconvulsive Therapy , Schizophrenia/drug therapy , Adult , Anesthesia, Intravenous , Combined Modality Therapy , Drug Resistance , Female , Humans , Male , Middle Aged , Schizophrenic PsychologyABSTRACT
Refractoriness to treatment is a common problem in management of schizophrenics. Conventional pharmacotherapy is usually effective in controlling positive symptoms of the disease, such as delusions and hallucinations. However, they have restricted ability to affect negative symptoms (flat affect, social withdrawal) and to reverse functional disability and behavioral deviance. Furthermore, typical neuroleptics produce adverse effects, such as extrapyramidal symptoms and tardive dyskinesia. A new generation of antipsychotic agents with a low profile of side-effects and good tolerance has recently been developed and actively investigated. Seroquel (ICI 204-636), a dibenzoth azepine derivative, is a novel, putative, potential, atypical neuroleptic; it is a combined dopamine/ serotonin receptor antagonist. We report a 54-year-old man suffering from chronic therapy-resistant schizophrenia, with both positive and negative symptoms, who was successfully treated with Seroquel during 1 year.
Subject(s)
Antipsychotic Agents/therapeutic use , Dibenzothiazepines/therapeutic use , Schizophrenia/drug therapy , Drug Resistance , Follow-Up Studies , Humans , Male , Middle Aged , Quetiapine Fumarate , Schizophrenic PsychologyABSTRACT
Self-castration has been described in different eras and societies. It usually occurs in transsexualism, serious personality disorders and psychosis. It is not impulsive, but the result of long-standing conflicts, usually involving difficulties with male identity and inability to cope with sexual drives. Schizophrenics usually act under the influence of delusions and hallucinations. The medical and social attitudes to self-castration are never unequivocal. There are 60 case reports in the psychiatric literature. We describe a 35-year-old schizophrenic who castrated himself.
