Combination therapy of modified electroconvulsive therapy and long-acting injectable aripiprazole for dopamine supersensitivity psychosis: a case report.

In the treatment of schizophrenia, long-term pharmacotherapy with D2-receptor antagonists can induce dopamine supersensitivity psychosis (DSP). We report a male patient with schizophrenia with suspected DSP due to excessive polypharmacy. He was hospitalized for several years. Most psychotropic drugs were reduced and subsequently stopped without the exacerbation of symptoms by administering modified electroconvulsive therapy (mECT). Aripiprazole was then selected as the main drug for treatment, which was subsequently changed to the long-acting injection formulation. He was eventually discharged and returned home. Combination therapy with mECT and aripiprazole, especially the long-acting injectable formulation, may help improve and prevent DSP.

Post-prandial portal hemodynamics after upper gastrointestinal tract abscission.

BACKGROUND/AIMS: The purpose of this study is to analyze the changes in post-prandial portal hemodynamics after upper gastrointestinal tract abscission, using pulsed Doppler ultrasonography. METHODOLOGY: The study group consisted of normal volunteers and patients who had undergone total gastrectomy (TG), distal partial gastrectomy (PG), transthoracic esophagectomy and reconstruction with a gastric tube (TE), pancreatoduodenectomy (PD), or pylorus-preserving pancreatoduodenectomy (PPPD). The maximal portal blood flow velocity (Vmax) was measured by the pulsed Doppler method before and after nutrient intake. Ratio of each postprandial mean Vmax to pre-prandial mean Vmax was described as ratio of flow velocity (RFV). RESULTS: In the TG group, the RFV curve shifted markedly to the left in comparison to that in the control and PG groups. The pattern in the TE group was similar to that in the control group. In the PD group, the curve shifted to the left in comparison to that in the control group. In the PPPD group, the RFV was low throughout the examination. The pattern in the PPPD Billroth-I reconstruction group was similar to that in the control group, but not to the PPPD Billroth-II reconstruction group. CONCLUSIONS: The pattern of RFV reflectedfood transport dynamics after upper gastrointestinal surgery.