Mirtazapine augmentation for selective serotonin reuptake inhibitor-induced sexual dysfunction: a retropective investigation.

The aim of the present study was to retrospectively identify sexual dysfunction changes in the patients under mirtazapine-augmented serotonin reuptake inhibito (SSRI) treatment. The study comprised medical records of 20 outpatients, under mirtazapine-augmented SSRI treatment for their major depressive disorder, who had been selected among the patients that had developed sexual dysfunction to previous treatment as monotherapy, with SSRI for at least six weeks. These drugs were maintained and mirtazapine were added (15-45 mg/day). There was a significant difference in scores between baseline and week 4 or week 8 on the both Hamilton Depression Rating and Arizona Sexual Experience Scale. According to Clinical Global Impression-Improvement, 68.4% of the patients were responders. The use of low-dose mirtazapine as an add-on treatment to SSRIs appears to be an effective and well-tolerated augmenttaion for sexual dysfunction caused by SSRIs.

Attention deficit hyperactivity disorder erroneously diagnosed and treated as bipolar disorder.

OBJECTIVE: There is a dearth of literature on patients erroneously diagnosed and treated for bipolar disorder. METHOD: The authors report a case of an adult with attention deficit hyperactivity disorder erroneously diagnosed and treated for bipolar disorder for 6 years. At that point, methylphenidate was initiated. The patient was judged to be a good treatment responder with improvements noted in the clinical global impressions severity scale. It was seen that the improvement was maintained at a 6-month follow-up. CONCLUSION: The present case reflects the importance of careful differential diagnosis when evaluating for bipolar disorder.

Low plasma adiponectin levels in obsessive-compulsive disorder.

This study was designed to examine plasma adiponectin levels in patients with obsessive-compulsive disorder (OCD). The plasma adiponectin and glucose concentrations were determined in 23 patients (13 females, 10 males) and age and sex-matched 23 healthy controls (14 females and 9 males). In measuring adiponectin levels, ELISA method was used. The mean adiponectin levels were 11.1+/-2.2 ng/ml for the patient group and 17.6+/-2.9 ng/ml for control group (P=0.00078). By using ANCOVA, significant difference in the mean adiponectin values continued after controlling for BMI or sex (F=6.04, P<0.013 adjusted for BMI; F=5.67, P<0.021 adjusted for sex). Despite some limitations, the present study suggests that there may be an interaction between OCD and plasma adiponectin. In this interaction, one should keep into mind both pathophysiologic dimension and cardiovascular vulnerability. But it is clear that although the present findings are of considerable significance they should be supported by the studies with larger sample.

Effect of sertindole on QTc interval in patients with schizophrenia.

Sertindole has been marketed and offered daily clinical practice only for 9 months in our country, so no data has been its QTc prolongation potential. In the present study, we performed a clinical trial to investigate the effects of sertindole on QTc in patients with schizophrenia. The study comprised 21 patients with schizophrenia. Sertindole was administered in the following dosing regime: treatment was initiated with 4 mg/day sertindole. From day 3 to day 6, the dose was increased to 8 mg/day, and up to day 9, it was raised to 12 mg/day. The protocol allowed up to dose of 20mg/day according to effectiveness and tolerability. QTc values were determined at beginning, months 3 and 6. In addition, Positive and Negative Syndrome Scale (PANSS) were scored concomitantly. At the beginning of 6-month period, the mean QTc interval of patients was 391.7+/-19.2 ms. At the end of this period, it was 402.8+/-23.8 ms. Although the mean QTc interval changing was significant throughout 6-month period, of the patients, at any evaluation point, only 1 female (451 ms) and 1 male (433 ms) had borderline prolongation at month 3 for both, without any exceeding the dangerous limits. In summary, our results suggest that sertindole is tolerable and despite dose-related QT prolongation, sertindole had not the proarrhythmic profile. Future studies with larger sample evaluating the effects of treatment are required.