[Preventive role of lithium in self-injurious behavior: a case report]. / Rôle du lithium dans la prévention des passages à l'acte auto-agressifs. A propos d'un cas.

The authors report a case of 48 years old woman with mental retardation, followed for 30 years. She has conduct disorder and during this period we note a large number of self-injuries. She swallowed broken glasses, safety pins and once jumped from a bridge. The impulsiveness of these self-injuries is the main factor; they are not planned self-attempts. Lots of different treatments have been prescribed (neuroleptics, antidepressant serotonin uptake blockers and others) and it is only with the lithium that we could observe a period of 2 years without self-injuries. This case questions about the way of action of the lithium and about a possible specificity in the preventive action on conduct disorder with self-injurious behavior, on this type of patient.

[Anticonvulsants in agitation and behavior disorders in demented subjects. Report of 8 cases]. / Thymorégulateurs dans l'agitation et les troubles du comportement chez le sujet dément. A propos de huit cas.

Aggressive agitation, agitation and insomnia with generalized anxiety are commonly observed in Alzheimer's disease. These symptoms remain a principal problem in the clinical management of elderly patients. Neuroleptics are commonly the selected medication for controlling severe aggression, especially the violent out bursts often seen in demented patients. Their use is frequently complicated by side effects, particularly somnolence and confusion. Valpromide and Carbamazepine have been efficacy alternatives and very well tolerated. We report eight cases of demented patients who presented an agitation and aggressive behaviors and had been treated with Valpromide or Carbamazepine. The patients agitation was well controlled at that point and had no apparent side effects. A combination Valpromide or Carbamazepine with neuroleptics permitted a reduction doses of neuroleptics and their side effects. We think that these behaviors disorders belong to the mood disorders. The symptomatology is modified because an alteration of cognitive faculty.

[Secondary dermatologic effects of serotonin reuptake inhibitor antidepressants: hypothesis of cross-reacting allergy. Apropos of 2 cases]. / Effets secondaires dermatologiques des antidépresseurs inhibiteurs de la recapture de la sérotonine: hypothèse d'une allergie croisée. A propos de deux cas.

Toxidermia is a well-known complication of antidepressant therapy. The authors report two cases of adverse cutaneous reactions after treatment by several serotonin uptake blockers. The first case concerns a 38-year-old woman, who suffered from depressive disorder. She has been treated with fluoxetine. After eight days, a cutaneous reaction appeared. This reaction subsided when fluoxetine was stopped. Two months later, she had a prescription of paroxetine, and the same skin adverse effect appeared. The cutaneous lesion decreased with the suppression of paroxetine. The chronology of the eruption suggests that it was caused by an adverse reaction to the both serotonin uptake blockers. The second case concerns a 40-year-old man who had several prescriptions of antidepressant treatment in a period of one year: fluoxetine, fluvoxamine, paroxetine and sertraline. Each time a cutaneous reaction appeared. It is advisable to substitute after an adverse effect a medication from one of the other classes of antidepressants. But what we saw in these cases is that the serotonin uptake blockers could be involved in the same allergic reaction while these drugs have different chemistry structures. Only three of them have the same excipient. These cases ask the question of cross-reactivity between the serotonin uptake blockers.