RESUMO
Here, authors report on an interesting case of an adolescent with a diagnosis of schizo-affective disorder, maintained on LAI paliperidone palmitate that developed an unusual dystonic reaction in form of anismus that masquerade as constipation and faecal impaction. To our knowledge, this is one of the earliest reports of antipsychotic-induced anismus notably in adolescent population. Clinicians should be mindful of unusual forms of dyskinesias that might be associated with high-potency antipsychotic use.
Assuntos
Antipsicóticos , Palmitato de Paliperidona , Humanos , Palmitato de Paliperidona/efeitos adversos , Palmitato de Paliperidona/administração & dosagem , Antipsicóticos/efeitos adversos , Antipsicóticos/administração & dosagem , Adolescente , Transtornos Psicóticos/tratamento farmacológico , Masculino , Discinesia Induzida por Medicamentos , Feminino , Distonia/induzido quimicamenteRESUMO
NTX is FDA-approved for opiate and alcohol use disorders as anti-craving agent. It has been used successfully off-label in other psychiatric indications. Here, we shed some light on these while examining the extant evidence.
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Naltrexona , Antagonistas de Entorpecentes , Animais , Humanos , Alcoolismo/tratamento farmacológico , Fissura/efeitos dos fármacos , Naltrexona/administração & dosagem , Naltrexona/farmacologia , Naltrexona/uso terapêutico , Antagonistas de Entorpecentes/administração & dosagem , Antagonistas de Entorpecentes/farmacologia , Uso Off-Label , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , PsicofarmacologiaAssuntos
Inibidores Seletivos de Recaptação de Serotonina , Disfunções Sexuais Fisiológicas , Humanos , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Disfunções Sexuais Fisiológicas/induzido quimicamente , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Masculino , Feminino , Disfunções Sexuais Psicogênicas/induzido quimicamente , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Adulto , Pessoa de Meia-IdadeRESUMO
Clozapine, amongst antipsychotics, has a unique composite mode of action that might translate into an expanded therapeutic potential on clinical grounds. Sorely, clozapine remains underutilized.
Assuntos
Antipsicóticos , Clozapina , Discinesia Induzida por Medicamentos , Esquizofrenia , Humanos , Clozapina/efeitos adversos , Esquizofrenia/tratamento farmacológico , Discinesia Induzida por Medicamentos/tratamento farmacológico , Antipsicóticos/farmacologiaRESUMO
Here, authors report on an interesting case of early-onset of schizophrenia where adjunctive pregabalin alleviated risperidone-induced pseudoparkinsonism, helped with insomnia and agitation and boosted antipsychotic response with great tolerability. We wager that gabapentenoids can be a viable option in the niche of psychopharmacotherapy of schizophrenia in CAP population.
Assuntos
Antipsicóticos , Esquizofrenia , Adolescente , Humanos , Risperidona/efeitos adversos , Antipsicóticos/efeitos adversos , Esquizofrenia/tratamento farmacológico , Pregabalina/uso terapêuticoRESUMO
Gepirone was recently launched and FDA-approved for MDD. It belongs to azapirones group of psychotropics that is in popular use in Japan and China. Here, author wraps up current knowledge on gepirone contrasted with the older and cheaper anxiolytic buspirone.
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Ansiolíticos , Pirimidinas , Humanos , Buspirona , Ansiolíticos/farmacologia , Ansiolíticos/uso terapêutico , Antidepressivos/farmacologia , Antidepressivos/uso terapêuticoRESUMO
Introduction: Investigating the epidemiology of mental health disorders resulting from COVID-19 intervention measures, primary school closures, and social isolation in children and adolescents needs to be prioritized over adults at the post-pandemic stage. Most preliminary psychosocial studies conducted during the pandemic have demonstrated that younger age groups are the most vulnerable to such implications. Thus, this study aims to estimate the probable prevalence of specific anxiety disorders in children and quantify their relationships with relevant demographic risk factors. Methods: We used a cross-sectional study comprising 430 children aged between 8- and 18 years old living in Kuwait during the period of school closures as well as full and partial lockdowns. The survey included questions about participants' characteristics, children's anxiety using the Screen for Child Anxiety Related Emotional Disorders Questionnaire (SCARED) scale, and children's emotions and behaviours using the Strengths and Difficulties Questionnaire (SDQ). Univariate and multivariate logistic regression analyses were used to summarize the demographic and characteristics of the participants and their association with general, social, and generalized anxieties, as well as behavioural and emotional difficulties. Results: We inferred that 24.83% of our participants had at least one anxiety disorder, while 20.19% were classified as abnormal on the SDQ scale. Our multivariate analysis revealed that lockdown duration and sex of the child were consistently significant predictors (p-values < 0.05) of the broad spectrum of selected mental disorders. Additionally, we inferred notable increases in the likelihood of mental disorders associated with the increased duration of lockdowns. Conclusions: Our findings revealed preliminary insights into the vulnerability of young populations to the indirect negative impacts of strict public health measures during pandemic emergencies. Thus, authorities should consider such implications when planning and implementing similar interventions in future pandemics.
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Though research in juvenile depression is advancing, evidence examining effective treatments for Treatment-resistant juvenile depression remains at large limited. There is a dire need for more studies to help guide clinicians navigating these challenging cases.
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Depressão , Transtorno Depressivo Resistente a Tratamento , Humanos , Depressão/tratamento farmacológico , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Resultado do TratamentoRESUMO
A renewed interest in the use of ß-blockers for neurodevelopmental disorders has recently resurfaced, notably as an addition to the limited psychopharmacological armamentarium of autism spectrum disorders (ASD). In this clinical perspective, authors decently argue this use could be advantageous and multi-folded for this population.
Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Humanos , Transtorno Autístico/tratamento farmacológico , Transtorno do Espectro Autista/tratamento farmacológicoAssuntos
Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Humanos , Psicotrópicos/efeitos adversos , Disfunções Sexuais Fisiológicas/induzido quimicamente , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Disfunções Sexuais Psicogênicas/induzido quimicamente , Disfunções Sexuais Psicogênicas/tratamento farmacológicoRESUMO
Authors report on an interesting case of a teenager with attention-deficit/hyperactivity disorder and comorbid generalized anxiety disorder, who developed takotsubo cardiomyopathy subsequent to pharmacokinetic and pharmacodynamic interactions between atomoxetine, a selective norepinephrine reuptake inhibitor, and the antidepressant duloxetine. Clinicians should be mindful of the potential for cardiovascular adverse effects when prescribing agents that target noradrenergic receptors.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Cardiomiopatia de Takotsubo , Adolescente , Humanos , Cloridrato de Atomoxetina/efeitos adversos , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Cloridrato de Duloxetina/efeitos adversos , Cardiomiopatia de Takotsubo/induzido quimicamente , ComorbidadeRESUMO
Background: Transcranial magnetic stimulation (TMS) is effective in the management of treatment resistant major depressive disorder (MDD) and has recently become widely available. Our aim was to explore the literature for evidence of the mechanism of action. Method: We examined our own accumulating TMS library, the reference lists of all available papers and used a search engine to collect information. We collated and examined this information under relevant heading. Results: TMS produces a large number of physiological changes including site of stimulation neurochemical, brain wave and blood flow effects, and distant structure effects including neurotransmitter effects and volume increase. TMS also corrects generalized and local functional connectivity (FC) abnormalities which are a feature of MDD. Conclusion: TMS produces a range of physiological changes. It is unclear which of these underpin its antidepressant. It is likely more than one work synergistically to this end-almost certainly the capacity to correct MDD induced FC abnormalities makes a strong antidepressant contribution.
Assuntos
Transtorno Depressivo Maior , Transtorno Depressivo Resistente a Tratamento , Humanos , Transtorno Depressivo Maior/terapia , Estimulação Magnética Transcraniana , Transtorno Depressivo Resistente a Tratamento/terapiaRESUMO
Pseudotumor cerebri or idiopathic intracranial hypertension (IIH) secondary to psychotropic drugs is a very rare occurrence. Lithium is typically the culprit agent. Here, authors report on an interesting case of an adolescent with early-onset schizophrenia that develops a reversible IIH putatively related to olanzapine-induced weight gain. This is followed by discussion of purported pharmacodynamic mechanisms and brief review of literature. Clinicians should be cognizant to this serious complication given the propensity of the majority of atypical antipsychotics to induce significant weight gain especially in younger population.