ABSTRACT
OBJECTIVE: Nightmares and insomnia in combat-related post-traumatic stress disorder (PTSD) might be resistant to treatment with selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines. METHOD: We describe five case reports of patients suffering from long-lasting and intractable nightmares and insomnia. They were given different psychotropic agents in past few years, with no improvement in their sleep disturbance. Olanzapine was added to the current treatment regimen. RESULTS: Both nightmares and insomnia improved rapidly after olanzapine institution in all of five patients. No adverse events of olanzapine were reported. CONCLUSION: Olanzapine augmentation might be useful in alleviating treatment-resistant nightmares and insomnia in patients with combat-related PTSD.
Subject(s)
Antipsychotic Agents/administration & dosage , Dreams/drug effects , Pirenzepine/analogs & derivatives , Pirenzepine/administration & dosage , Selective Serotonin Reuptake Inhibitors/administration & dosage , Sleep Initiation and Maintenance Disorders/drug therapy , Stress Disorders, Post-Traumatic/complications , Stress Disorders, Post-Traumatic/drug therapy , Adult , Benzodiazepines , Combat Disorders/complications , Combat Disorders/drug therapy , Dose-Response Relationship, Drug , Drug Administration Schedule , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Olanzapine , Sleep Initiation and Maintenance Disorders/etiology , Stress Disorders, Post-Traumatic/etiology , Time Factors , Treatment Outcome , WarfareABSTRACT
Depression is twice as common in women as in men, although some concern has been raised in terms of misdiagnosing depression in men. The incidence of depression in women varies during the life span. The peak incidence during childbearing years appears to be associated with cyclic hormonal changes. Women also present with reproductive -specific mood disorders: pre-menstrual dysphoric disorder (PMDD), depression in pregnancy, postpartal mood disorder (PDD) and perimenopausal depressive disorder. Gender differences were repeatedly observed in response to antidepressant medication. Premenopausal women appear to respond poorly and to show low tolerability to TCAs, but they tend to show greater responsiveness to the SSRIs. In contrast, men and postmenopausal women can respond equally to the TCAs and SSRIs. These differences are contributed to gender differences in pharmacokinetics of antidepressants and to the influence of menstrual cycle. These findings suggest the need for a gender-specific approach to the evaluation and management of depression.
Subject(s)
Depression , Sex Characteristics , Antidepressive Agents/pharmacokinetics , Antidepressive Agents/therapeutic use , Depression/diagnosis , Depression/drug therapy , Depression/etiology , Depression, Postpartum/diagnosis , Depression, Postpartum/drug therapy , Depression, Postpartum/psychology , Female , Humans , Male , Menopause/psychology , Pregnancy , Pregnancy Complications , Premenstrual Syndrome/diagnosis , Premenstrual Syndrome/drug therapy , Premenstrual Syndrome/psychology , Sex FactorsABSTRACT
INTRODUCTION: While efficacy in treatment of the acute phase of schizophrenia is well established for so-called atypical antipsychotics, more data regarding long-term treatment are needed. METHOD: In a naturalistic, open-label study, 32 patients were included in order to investigate the efficacy and safety of risperidone over 3 years of treatment; 26 of them were treatment-resistant to the previously used antipsychotic drugs (except clozapine). RESULTS: At the end of the first year, 20 of these 26 patients showed at least partial improvement. At the end of the third year, 17 patients were still being treated with risperidone. While eight patients were lost to follow-up, six relapsed in spite of good compliance. All the adverse events which occurred during treatment were strictly dose-dependent and disappeared when the dose was lowered to 4 mg daily. CONCLUSIONS: Within the limits of naturalistic studies, it can be concluded that risperidone seemed to be an effective and safe drug for long-term treatment in the majority of our patients. (Int J Psych Clin Pract 2002; 6: 193-197 ).
ABSTRACT
The subject of this study was to determine the frequency of drug use and attitudes toward drug use in Croatian high school students. The study was carried out in a middle-class high school in Zagreb. Out of 273 students who participated in an anonymous, self-report, 23-item questionnaire, 69 reported that they had at least once used drugs. The most frequently used drug was cannabis. While one third of students have been offered drugs, even 41% of the students would have take the drug if it becomes available. It can be concluded that the drugs appear to be highly available among Croatian students. According to our results, even more stronger increase in the number of drug users in Croatia could be expected.
