History repeats itself: pharmacodynamic trends in the treatment of anxiety disorders.

The original treatment indicated for those suffering from neurotic anxiety was to employ psychotherapy to facilitate changes in behavior and coping with stressful events. A spectrum of somatic treatments "from cathartics and emetics to opium and "strengthening tonics", from atropine and digitalis to potassium bromide and chloral hydrate, from barbiturates to benzodiazepines", to serotonergics, came to be used as well [1]. The Food and Drug Administration originally approved many gamma-aminobutyric acid (GABA) facilitating drugs since the 1960s for anxiety treatment. The 1980s evidenced the approval of a few serotonergic treatments that cornered the prescribing market and the front line of most treatment protocols. More recently, GABAergic drugs are making a return in the treatment of anxiety disorders. The following paper details the pharmacodynamic history of treating anxiety and also updates the reader as to the newer GABA-based approaches mentioned above.

Psychiatric medication-induced obesity: treatment options.

A majority of psychiatric medications are known to generate weight gain and ultimately obesity in some patients. The authors undertook a comprehensive literature review in order to provide a better understanding of novel treatment options in regards to alleviating weight gained by use of antidepressants, antipsychotics, and mood stabilizers. There are no agents for management of this weight gain approved by the Food and Drug Administration (FDA), and existing studies on options are mainly uncontrolled, small-scale projects with limited power to produce coherent conclusions. There is a clear need for larger studies on existing options, and future psychotropics without these side-effects are currently in the pipeline.

Psychiatric medication induced obesity: an aetiologic review.

A majority of psychiatric medications are known to generate weight gain and ultimately obesity in some patients. There is much speculation about the prevalence of weight gain and the degree of weight gain during acute and longitudinal treatment, but consensus shows that weight gain is prominent. The present review looked at the aetiology and cause of weight gain associated with psychotropic use and presents hypotheses as to why patients gain weight on antipsychotics, mood stabilizers and antidepressants. It is found that most psychotropic medications induce some weight gain, and clinicians are encouraged to utilize active interventions to alleviate the weight gain in order to prevent more serious obesity related comorbidities.

Psychiatric medication-induced obesity: a review.

A majority of psychiatric medications are known to generate weight gain and ultimately obesity in some patients. There is much speculation about the prevalence of weight gain and the degree of weight gain during acute and longitudinal treatment with these agents. There is newer literature looking at the aetiology of this weight gain and the potential treatments being used to alleviate this side-effect. We found solid evidence that weight gain is often associated with the mood stabilizers, and antipsychotics and antidepressants. Only few weight neutral or weight loss producing psychotropics are available, and weight gain, outside of an immediate side-effect, may generate secondary side-effects and medical comorbidity. Weight gain may cause hypertension, diabetes, osteoarthritis, sedentary lifestyle, coronary artery disease, etc. Given the likelihood of inducing weight gain with psychotropic medications and the longitudinal impact on physical health, a thorough literature review is warranted to determine the epidemiology, aetiology and treatment options of psychotropic-induced weight gain.

Postpartum psychosis in a case of sheehan's syndrome.

This case report describes a case of a 23 years old female who presented with clinical features of postpartum psychosis (Psychotic disorder not otherwise specified, DSM-IV). On investigation she was found to be suffering from Sheehan's syndrome (postpartum pituitary infarction). It was interesting to note that all the clinical features of Sheehan's syndrome and psychosis improved with hormone replacement therapy and she did not require treatment with antipsychotic medications.

Reemergence of positive symptoms of schizophrenia during the course of treatment with risperidone.

Thirty patients suffering from schizophrenia (diagnosed as per DSM-IV criteria), for more than 2 years and having predominant negative symptoms were started on risperidone (2-10 mg/day) and were followed up over a period of 16 weeks. The improvement was assessed using PANSS (Positive and Negative Syndrome Scale).During this 16 weeks follow up, it was interestingly noted that though there was a significant improvement in negative symptoms in all the patients, in 7 patients there was a reemergence of positive symptoms. Four patients had increase in rating on suspiciousness and hostility and two patients reported auditory hallucinations. One patient developed delusions and conceptual disorganization along with suspiciousness and hostility.

Gender identity disorder : a report of three cases.

Gender Identity Disorder (GID) is a complex problem. This report describes three cases of GID with more or less similar clinical presentation. It was interesting to note that inspite of the similarity in their early clinical features, their own approach towards their illness, the reaction of the family members and the outcome were different. The report also highlights the need for different therapeutic approaches required in the individual cases.