[Review of cases of zoophilia in patients with Parkinson's disease]. / Revision de casos de zoofilia en pacientes con enfermedad de Parkinson.

INTRODUCTION: Parkinson's disease (PD) is characterized by motor symptoms such as bradykinesia, rigidity, alteration of postural reflexes and tremor at rest and other non-motor symptoms such as changes in sleep patterns and sexual behavior. However, little is known about paraphilic sexual behaviors. AIM: To summarize the number of cases of zoophilic behaviors in patients with PD between January 2000 and December 2017. DEVELOPMENT: A review was carried out in PubMed, Scopus and Virtual Health Library. Eleven articles were identified by title; six were excluded because they did not present cases related to zoophilic behavior. We found five cases of men, usually with PD of several years of course, taking dopamine agonists and who presented the zoophilic behaviors followed increasing of the dose. The zoophilic behaviors decreased with reducing doses of dopamine agonists and taking atypical antipsychotic such as clozapine or quetiapine. CONCLUSIONS: It is limited the case reports of zoophilic behaviors in patients with PD. The patients reported are men in whom the dose of dopamine agonists was increased. It is important that the clinical follow-up of patients with PD disease includes a careful review of sexual behaviors including those of the paraphilic spectrum.

TITLE: Revision de casos de zoofilia en pacientes con enfermedad de Parkinson.Introduccion. La enfermedad de Parkinson (EP) se caracteriza por sintomas motores, como bradicinesia, rigidez, alteracion de reflejos posturales y temblor en reposo, y otros sintomas no motores, como cambios en el patron de sueño y el comportamiento sexual. Sin embargo, se conoce poco sobre los comportamientos sexuales parafilicos. Objetivo. Resumir el numero de casos de comportamientos zoofilicos en pacientes con EP entre enero de 2000 y diciembre de 2017. Desarrollo. Se realizo una revision en PubMed, Scopus y la Biblioteca Virtual en Salud. Se identificaron por el titulo 11 articulos; se excluyeron seis porque no presentaban casos relacionados con un comportamiento zoofilico. Se encontraron cinco casos de hombres, generalmente con EP de varios años de curso, polimedicados con agonistas dopaminergicos, quienes presentaron los comportamientos parafilicos despues del incremento de la dosis. Los comportamientos zoofilicos cedieron con la reduccion de la dosis de los agonistas dopaminergicos y antipsicoticos atipicos, como clozapina o quetiapina. Conclusiones. Es limitada la notificacion de casos de comportamientos zoofilicos en pacientes con EP. Los pacientes notificados son hombres en quienes se incremento la dosis de agonistas dopaminergicos. Es importante que el seguimiento clinico de los pacientes con EP incluya una revision de los comportamientos sexuales, incluidos los del espectro parafilico.

[The prevalence of symptoms of anxiety and depression in female migraine sufferers]. / Prevalencia de síntomas de ansiedad y de depresión en mujeres con migraña.

INTRODUCTION: The comorbidity migraine and mental disorder is high, specially, anxiety and depressive disorders. Aim. To establish the prevalence of anxiety and depressive symptoms in a clinical population of women who suffered from migraine. PATIENTS AND METHODS: We included women with migraine over 18 years old, no pregnant and without psychiatric history. We quantified anxiety and depressive symptom with Zung's self-reporting scales. RESULTS: A group of 110 women was studied, mean age was 34.4 years (SD 9.4); average scholarity was 9.1 years (SD 4.5); 72.7% was married, and 46.9% was housewife. 68.2% suffered from migraine with aura and 31.6% migraine without aura. 70.0% presented anxiety and 52.7% depression clinically important. Average Zung' scores for anxiety was 53.9 (SD 7.9) and for depression was 51.0 (SD 9.5). It was significant comorbidity migraine associated with anxiety and depression. CONCLUSIONS: The prevalence of anxiety and depression is high among women with migraine. It was independent of age, scholarity, marital status, occupation and sort of migraine. It is frequent comorbidity anxiety and depressive symptoms among women with migraine.

Prevalencia de síntomas de ansiedad y de depresión en mujeres con migraña / The prevalence of symptoms of anxiety and depression in female migraine sufferers

Introducción. La comorbilidad de la migraña y los trastornos mentales es elevada, particularmente en el caso de la ansiedad y la depresión. Objetivo. Determinar la prevalencia de síntomas ansiosos y depresivos en mujeres con migraña. Pacientes y métodos. Se evaluaron pacientes con migraña mayores de 18 años, sin historia de tratamiento psiquiátrico y no embarazadas. Se cuantificaron los síntomas de ansiedad y de depresión con las escalas de autoinforme de Zung. Resultados. Se incluyeron 110 mujeres, con una edad promedio de 34,4 años (DE: 9,4), con una escolaridad promedio de 9,1 años (DE: 4,5), el 72,7 por ciento casadas y el 46,9 por ciento amas de casa. Presentaba migraña con aura el 68,2 por ciento y migraña sin aura el 31,8 por ciento. El 70,0 por ciento de las evaluadas presentaba síntomas de ansiedad, y el 52,7 por ciento, síntomas depresivos con importancia clínica. Las puntuaciones en la escala para la ansiedad y para la depresión fueron, en promedio, de 53,9 (DE: 7,9) y 51,0 (DE: 9,5), respectivamente. Se observó una comorbilidad significativa de migraña y síntomas ansiosos y depresivos con importancia clínica. Conclusiones. La prevalencia de síntomas ansiosos y depresivos es elevada en mujeres que sufren migraña, independiente de la edad, el nivel educativo, el estado civil, la ocupación y el tipo de cefalea. Es frecuente la coexistencia de síntomas ansiosos y depresivos en mujeres con migraña (AU)

Introduction. The comorbidity migraine and mental disorder is high, specially, anxiety and depressive disorders. Aim. To establish the prevalence of anxiety and depressive symptoms in a clinical population of women who suffered from migraine. Patients and methods. We included women with migraine over 18 years old, no pregnant and without psychiatric history. We quantified anxiety and depressive symptom with Zung’s self-reporting scales. Results. A group of 110 women was studied, mean age was 34.4 years (SD 9.4); average scholarity was 9.1 years (SD 4.5); 72.7% was married, and 46.9% was housewife. 68.2% suffered from migraine with aura and 31.6% migraine without aura. 70.0% presented anxiety and 52.7% depression clinically important. Average Zung’ scores for anxiety was 53.9 (SD 7.9) and for depression was 51.0 (SD 9.5). It was significant comorbidity migraine associated with anxiety and depression. Conclusions. The prevalence of anxiety and depression is high among women with migraine. It was independent of age, scholarity, marital status, occupation and sort of migraine. It is frequent comorbidity anxiety and depressive symptoms among women with migraine (AU)

[Antidepressants in migraine prophylaxis: an approximation]. / Antidepresivos en la profilaxis de la migraña: una aproximación.

INTRODUCTION: Migraine is one of the most frequently observed neurological problems in primary health care centres, while major depressive disorder (MDD) is the most prevalent mental disorder in the general population. It has been observed that emotional factors can trigger or worsen bouts of migraine and there is a high rate of comorbidity between migraine and MDD in the general population. 50% of patients formally diagnosed as suffering from migraine also meet MDD criteria. The association found between these clinical entities is complex and not casual: it is not simply a matter of an emotional response to the recurring headaches. AIM: Our aim was to report on the value of antidepressants in the prophylaxis of migraine. DEVELOPMENT: The following have all been used in migraine prophylaxis: alpha2-agonists, calcium channel antagonists, anticonvulsive drugs, antidepressants, beta blockers, magnesium and serotoninergic agents, among others. It has been reported that antidepressant drugs with an important agonistic action on 5-HT2 receptors are useful in the prophylaxis of migraine. Furthermore, some antidepressants exert a direct analgesic effect and modulate the response to pain by means of neuronal mechanisms. CONCLUSIONS: Antidepressants are undoubtedly the best alternative available for prophylaxis in patients who present migraine associated to MDD. Amitriptyline has proved itself to be effective in dosages ranging from 30 to 150 mg/day, while recent studies have also shown fluoxetin to be effective in doses of between 20 and 40 mg/day. Moreover, in general, antidepressants are drugs with a low risk of toxicity and few serious or very troublesome side effects.

Antidepresivos en la profilaxis de la migraña: una aproximación / Antidepressants in migraine prophylaxis: an approximation

Introducción. La migraña es uno de los problemas neurológicos más frecuentes en la consulta de atención primaria; por su parte, el trastorno depresivo mayor (TDM) es el trastorno mental más prevalente en la población general. Se ha observado que los factores emocionales pueden desencadenar o agravar los episodios de migraña, y se encuentra una alta comorbilidad de migraña y TDM en la población general. El 50 por ciento de los pacientes con diagnóstico formal de migraña reúnen criterios para TDM. La asociación encontrada entre estas entidades clínicas es compleja y no casual, no es simplemente una respuesta emocional ante las cefaleas recurrentes. Objetivo. Presentar la utilidad de los antidepresivos en la profilaxis de la migraña. Desarrollo. Para el tratamiento profiláctico de la migraña se han utilizado agonistas 2, antagonistas de los canales de calcio, anticonvulsionantes, antidepresivos, betabloqueadores, magnesio y agonistas serotoninérgicos, entre otros. Se ha documentado que los antidepresivos con acción agonista importante sobre los receptores de 5-HT2 son útiles en la profilaxis de la migraña. Además, algunos antidepresivos tienen una acción analgésica directa y modulan la respuesta ante el dolor mediante mecanismos neuronales. Conclusiones. Sin duda, los antidepresivos constituyen la mejor alternativa en la profilaxis de los pacientes que presentan migraña asociada a TMD. La amitriptilina tiene una eficacia comprobada con dosis entre 30 y 150 mg/día, mientras que algunos estudios recientes muestran igualmente la utilidad de la fluoxetina, que es efectiva con dosis entre 20 y 40 mg/día. Además, en general, los antidepresivos son medicamentos con bajo riesgo de toxicidad y pocos efectos secundarios graves o demasiado molestos (AU)

Introduction. Migraine is one of the most frequently observed neurological problems in primary health care centres, while major depressive disorder (MDD) is the most prevalent mental disorder in the general population. It has been observed that emotional factors can trigger or worsen bouts of migraine and there is a high rate of comorbidity between migraine and MDD in the general population. 50% of patients formally diagnosed as suffering from migraine also meet MDD criteria. The association found between these clinical entities is complex and not casual: it is not simply a matter of an emotional response to the recurring headaches. Aim. Our aim was to report on the value of antidepressants in the prophylaxis of migraine. Development. The following have all been used in migraine prophylaxis: α2-agonists, calcium channel antagonists, anticonvulsive drugs, antidepressants, beta blockers, magnesium and serotoninergic agents, among others. It has been reported that antidepressant drugs with an important agonistic action on 5-HT2 receptors are useful in the prophylaxis of migraine. Furthermore, some antidepressants exert a direct analgesic effect and modulate the response to pain by means of neuronal mechanisms. Conclusions. Antidepressants are undoubtedly the best alternative available for prophylaxis in patients who present migraine associated to MDD. Amitriptyline has proved itself to be effective in dosages ranging from 30 to 150 mg/day, while recent studies have also shown fluoxetin to be effective in doses of between 20 and 40 mg/day. Moreover, in general, antidepressants are drugs with a low risk of toxicity and few serious or very troublesome side effect (AU)