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1.
J Affect Disord ; 200: 89-96, 2016 Aug.
Article in English | MEDLINE | ID: mdl-27130958

ABSTRACT

BACKGROUND: Specific treatment of obsessive compulsive disorder (OCD) is based on cognitive-behavioral therapy, serotonin reuptake inhibitors (SRIs) or their combination. Treatment strategies do not always follow evidence-based guidelines in outpatient settings. Data on pharmacotherapy in inpatient settings are lacking. METHODS: Prescription data for inpatients suffering from OCD in the time period 1994-2012 were obtained from the database of the Drug Safety Program in Psychiatry (AMSP). Data were collected on two index dates per year; the prescription patterns and changes over time were analysed. RESULTS: Of 842 patients 89.9% received at least one psychotropic drug and 67.6% a combination of at least two psychotropic drugs. The drug groups prescribed most often were antidepressants (78.0%), antipsychotics (46.7%), and tranquilizers (19.7%). In 58.0% of all cases selective serotonin reuptake inhibitors (SSRIs) were used as antidepressants, followed by tricyclic antidepressants (TCAs, 17.8%), mainly clomipramine (10.9%). Second-generation antipsychotics (SGAs) were administered in 37.8% of all cases, first-generation antipsychotics (FGAs) in 13.7%. While the use over time significantly increased for psychotropic drugs, antidepressants, antipsychotics, tranquilizers, SSRIs and SGAs, it remained stable for FGAs and decreased for TCAs. LIMITATIONS: Observational cross-sectional study without follow-up or additional information. CONCLUSIONS: In clinical practice, most OCD patients received pharmacological treatment. The high prescription rate of SSRIs and their preference over clomipramine as well as the augmentation of this therapy with SGAs comply with the guidelines. Administration of tranquilizers as well as sedative FGAs and the choice of single SGAs are not in line with expert recommendations.


Subject(s)
Antidepressive Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Obsessive-Compulsive Disorder/drug therapy , Selective Serotonin Reuptake Inhibitors/therapeutic use , Tranquilizing Agents/therapeutic use , Adult , Clomipramine/therapeutic use , Cognitive Behavioral Therapy , Cross-Sectional Studies , Female , Humans , Inpatients , Male , Middle Aged , Young Adult
2.
Acta Medica (Hradec Kralove) ; 52(1): 15-8, 2009.
Article in English | MEDLINE | ID: mdl-19754002

ABSTRACT

We report on a serious side effect in a severely depressed 55-year-old woman, who presented an erythematous pigmented skin rash on the whole body under combination treatment with antidepressants, atypical antipsychotic drugs, the mood stabilizer lithium and the lipid-lowering drug pravastatin. The skin rash effect was most probably due, in first line, to olanzapine, but the cutaneous skin condition was triggered and aggravated by pravastatin, a 3-hydoxy-3-methylglutaryl-coenzyme A-(HMG-CoA)-reductase inhibitor, and lithium medication. The allergic reaction started to develop after co-administration of pravastatin. Therefore, the combination of atypical antipsychotics with statins should be carefully monitored and the benefits and disadvantages should be balanced.


Subject(s)
Anticholesteremic Agents/adverse effects , Antipsychotic Agents/adverse effects , Benzodiazepines/adverse effects , Drug Eruptions/etiology , Pravastatin/adverse effects , Antipsychotic Agents/therapeutic use , Benzodiazepines/therapeutic use , Drug Eruptions/pathology , Drug Interactions , Female , Humans , Middle Aged , Olanzapine , Pravastatin/therapeutic use , Risk Factors
4.
Int J Eat Disord ; 41(8): 766-7, 2008 Dec.
Article in English | MEDLINE | ID: mdl-18521917

ABSTRACT

OBJECTIVE: A male adolescent with an anorexia nervosa-restricting type reported about his habit to carry out severe exercises to hold his weight. Seven weeks after admission to hospital, laboratory findings showed an extremely high level of serum creatinine kinase (CK) (>20,000 U/L) without clinical signs for rhabdomyolysis or renal depression. METHOD: Clinical observation and routine laboratory controls in the patient, who participated in our special program for patients with eating disorder. RESULTS: To minimize the risk for renal failure, a treatment with bicarbonate for volume repletion, forced diuresis and urinary alkalinisation over 24 hr were initiated. After 12 hr, CK decreased to almost 50% and it normalized then within 10 days. CONCLUSION: This is the first reported case of anorexia nervosa with this extremely high level of serum CK, induced by excessive physical activity.


Subject(s)
Anorexia Nervosa/blood , Anorexia Nervosa/complications , Creatine Kinase/blood , Rhabdomyolysis/blood , Anorexia Nervosa/diagnosis , Humans , Male , Renal Insufficiency/blood , Renal Insufficiency/complications , Renal Insufficiency/diagnosis , Severity of Illness Index , Young Adult
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