ABSTRACT
WHAT IS KNOWN AND OBJECTIVES: The occurrence of dysgraphia after sertraline intake has never been reported. The objective was to describe a case of this adverse drug reaction and present a review of similar cases held in international databases with a discussion of the possible pharmacological mechanisms. CASE SUMMARY: We observed a 60-year-old man who experienced resting tremors, dyskinesia and dysgraphia 2 months after a stepwise increase in sertraline dosing from 50 to 200 mg/day. WHAT IS NEW AND CONCLUSION: Dysgraphia is a possible adverse drug reaction to sertraline, and we suggest that inhibition of extrapyramidal dopaminergic activity might be the pharmacological mechanism.
Subject(s)
Agraphia/chemically induced , Selective Serotonin Reuptake Inhibitors/adverse effects , Sertraline/adverse effects , Adverse Drug Reaction Reporting Systems , Databases, Factual , Dopamine/metabolism , Dose-Response Relationship, Drug , Humans , Male , Middle Aged , Selective Serotonin Reuptake Inhibitors/administration & dosage , Sertraline/administration & dosageABSTRACT
OBJECTIVE: To evaluate potential differences in insight among bipolar manic, mixed and bipolar depressed inpatients and assess the role of clinical and demographic characteristics as possible predictors. METHOD: One hundred and twenty consecutive inpatients divided into three diagnostic groups were studied on admission (T0), at discharge (T1) and at 18weeks after hospitalization (T2). The young mania rating scale (YMRS), the Hamilton rating scale for depression (HAMD) and the scale to assess unawareness of mental disorder (SUMD) were used. RESULTS: Patients with mixed mania showed highest scores on the SUMD than patients with mania or bipolar depression. It was found a significant relationship between improvements in mania and in the insight. The level of insight at baseline was the only predictor of awareness in social consequences, moreover clinical and demographic characteristics were predictors of insight into mental illness. For what concerns insight about therapy benefits it was influenced by level of mania at baseline. CONCLUSION: The three general dimensions of insight revealed significant differences among the three groups. Regression models suggest that insight is a multidimensional concept in which some aspects are state-related, associated with psychopathology, whereas others are trait-like qualities, not directly associated with symptoms and predicted only by level at baseline.
