Parkinson Psychosis: A Complex Interaction of Disease and Medication Related Factors

2017 ◽  
Vol 41 (S1) ◽  
pp. S662-S662
Author(s):  
S. Petrykiv ◽  
L. de Jonge ◽  
M. Arts
Keyword(s):  
English Language ◽  
Case Reports ◽  
Pharmacological Therapy ◽  
Complex Interaction ◽  
Psychotic Symptoms ◽  
Psychiatric Ward ◽  
Related Factors ◽  
Appropriate Therapy ◽  
Competing Interest ◽  
Paranoid Psychosis

IntroductionPsychotic symptoms are the most important non-motoric symptoms of the Parkinson disease (PD). The quality of life of those patients can be significantly improved with an appropriate therapy. In this article we provide evidence about the etiology, differential diagnosis and therapeutic possibilities with a work-up for the clinics.Objectives & aimsTo provide a case report of patient with PD who developed a paranoid psychosis after administration of levodopa/carbidopa, followed by a literature review on psychotic symptoms evoked by psychotropic medication by patients with PD.MethodsAn English-language literature search was conducted using Pubmed, EMBASE searching for case reports and observational studies reporting iatrogenic psychotic symptoms by patients with PD.ResultsMs. C. was a 65-year old woman with PD who was observed in a polyclinic setting and who used a levodopa/carbidopa combination. She developed paranoid psychosis with a following admission to the psychiatric ward. We have gradually lowered the dose of anti-Parkinson medication. Subsequently, treatment with clozapine was initiated and the psychotic symptoms resolved within five months.ConclusionParkinson psychosis is due to a complex interaction of neurodegenerative changes and pharmacological therapy. Therefore, the role of iatrogenic factors must be always carefully assessed. Psychosis inducting agents should be lowered or stopped before the treatment with antipsychotic medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Burning Mouth Syndrome: Problem in the Mouth?

2017 ◽  
Vol 41 (S1) ◽  
pp. S254-S254
Author(s):  
S. Petrykiv ◽  
L. de Jonge ◽  
M. Arts
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Antidepressant Medication ◽  
Burning Mouth Syndrome ◽  
Psychiatric Ward ◽  
Drug Induced ◽  
First Case ◽  
Painful Sensation ◽  
Burning Mouth ◽  
Competing Interest

IntroductionBurning mouth syndrome (BMS) is characterized by an intraoral burning sensation for which no medical or dental cause can be found. Sporadic evidence suggests that drug induced conditions may evoke BMS. Intriguingly, we observed a patient who developed BMS after induction of citalopram.Objectives & aimsA case report of patient with BMS from our psychiatric ward will be presented here, followed by a literature review on drugs induced BMS.MethodsBased on a recent literature search, we present a first case report of BMS that was apparently induced in patient shortly after beginning of citalopram. We performed a systematic search through PubMed, EMBASE and Cochrane's Library to find more cases of psychotropic induced BMS.ResultsMs. A. was a 72-year old woman meeting DSM-IV diagnostic criteria for melancholic depression, who was observed in a clinical setting. We started citalopram 10 mg. 1dd1, with 10 mg. 1dd1 increase over 7 days to 20 mg, 1dd1. The following day, she displayed a persistent burning painful sensation in the mouth. Other than BMS oropharyngological syndromes were excluded after consultation with qualified medical specialists. Citalopram therapy was discontinued, and nortrilen treatment was initiated. BMS symptoms resolved over four days. Twelve case reports have linked BMS to the use antidepressants and anxiolytics.ConclusionContrasting the statement that no medical cause can be found for BMS, we found that psychotropics may evoke the syndrome. Compared to other psychotropic drugs, antidepressant medication has the strongest association with BMS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Predictors of aggressive behavior among acute psychiatric patients: 5 years clinical study

2016 ◽  
Vol 33 (S1) ◽  
pp. S626-S627
Author(s):  
T. Aparicio Reinoso ◽  
S. Gonzalez Parra
Keyword(s):  
Psychiatric Patients ◽  
Therapeutic Option ◽  
Violent Behavior ◽  
Nursing Assistants ◽  
Psychotic Symptoms ◽  
Admission Diagnosis ◽  
Psychiatric Ward ◽  
Competing Interest ◽  
In The Beginning

IntroductionThe problem of violence and aggressive behaviour among patients with psychiatric disorders need careful assessment to improve the quality of psychiatric care.ObjectiveThe aim of this paper is to describe the characteristics of repeated episodes of violence among patients admitted to a Psychiatric Ward, which is a total of 66 beds at Doctor Rodriguez Lafora Hospital from January 2009 to December 2014.MethodsWe designed a retrospective, longitudinal and observational study over a 5-year period in two brief hospitalization units of Doctor Rodriguez Lafora Hospital in Madrid. The main variables studied were: type of admission, diagnosis, age, trigger and shift.ResultsIn our study, we analyzed the prototypical person who carries out these episodes of aggression: a male between 31–40 years, diagnosed with psychotic disorder or personality disorder, involuntary admitted. This episode is associated as a main trigger to mood disturbances, lack of acceptance of standards and psychotic symptoms. These episodes occur more frequently in the afternoon shift one business day and often processed without injuries or minor bruises to other patients and/or nursing assistants. In our practice, we have observed that in most cases adequate verbal restraint in the beginning is sufficient to prevent the episode of aggression.ConclusionsUnderstand the aggressive factors can influence the production of violent behavior and the use of appropriate containment techniques may be considered a therapeutic option to prevent and address violent behavior in psychiatric patients hospitalized in brief hospitalization units.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Evidence and the main adverse effects regarding drug therapies in the war against COVID-19

2020 ◽  
Vol 27 ◽  
Author(s):  
Mauricio Mora-Ramírez ◽  
Paulina Melgoza-Hernández ◽  
Sebastian Eduardo Toledo-Ramírez ◽  
Juan Manuel Mejía Aranguré
Keyword(s):  
Adverse Effects ◽  
Drug Targets ◽  
English Language ◽  
Randomized Clinical Trials ◽  
Case Reports ◽  
Case Series ◽  
Pharmacological Therapy ◽  
Rapid Review ◽  
Definitive Therapy ◽  
Potential Drug Targets

Background: Nowadays, the breakthrough of COVID-19 pandemic around the world is the biggest health challenge for the clinicians, and it represents an unexpected effort to identify effective treatment for those patients. No proven definitive therapies for this infection currently exist. Unfortunately, the infected patients increased in an alarming way every day, faster than medical evidence. At present, the expanding knowledge regarding SARS-COV-2 virology provides several potential drug targets. Objective: Therefore, clinicians need a rapid review and guideline about the main adverse effects regarding the most prescribed drugs and, specifically, the efficacy and potential risk of each pharmacological therapy, during hospital care. Methods: The articles review was performed using PubMed to identify relevant papers in English language reported through July 20th, 2020; a second review was performed using Web of Science until August 28th. Due to the lack of randomized clinical trials, we included case reports, case series, and reviews. We found 1606 total articles related. The authors independently reviewed the titles and abstracts for inclusion. Conclusion: At present, despite the enormous medical effort for publishing several trials or case reports, we have not yet discovered a definitive therapy against the COVID-19 infection. This brief review aims to prompt identification of risk factors and main adverse effects in a systematic view related to therapy with partial evidence proposed to date.

Meditation-induced psychosis: a narrative review and individual patient data analysis

2019 ◽  
pp. 1-7 ◽  
Author(s):  
Pawan Sharma ◽  
Ananya Mahapatra ◽  
Rishab Gupta
Keyword(s):  
English Language ◽  
Psychotic Disorders ◽  
Case Reports ◽  
Psychotic Symptoms ◽  
Clinical Settings ◽  
Equal Distribution ◽  
Meditative Practice ◽  
History Of ◽  
Age Range ◽  
The Relationship

Background: Meditation is associated with health benefits; however, there are reports that it may trigger or exacerbate psychotic states. In this review, we aim to collate case reports of psychotic disorders occurring in association with meditative practice and to discuss the relationship between psychosis and meditation. Methodology: We performed case-based analysis of all the existing studies published in English language using PubMed, PsycINFO, Cochrane, Scopus, EMBASE, CINAHL and Google Scholar with the search terms; ‘Psychosis’ OR ‘Psychotic Symptoms’ OR ‘Schizophrenia’ AND ‘Meditation.’ Results: A total of 19 studies and 28 cases were included in the review. The patients described had an age range of 18–57 years; there was equal distribution of males and females. The diagnoses included acute psychosis in 14 cases, schizophrenia in 7 cases, mania with psychotic symptoms in 3 cases, and schizoaffective disorder in 1 case. The types of meditation described were Transcendent, Mindfulness, Buddhist Meditation like Qigong, Zen, and Theraveda, and others like Bikram yoga, Pranic Healing, and Hindustan Type meditation. Of the 28 cases reported, 14 patients had certain precipitating factors like insomnia, lack of food intake, history of mental illness, stress, and psychoactive substance use. Conclusion: There are case reports of psychotic disorder arising in association with meditative practice; however, it is difficult to attribute a causal relationship between the two. At the same time, there is a body of research describing the beneficial effect of meditative practice in clinical settings for patients with psychotic disorders. Appropriately designed studies are needed to further investigate the relationship between meditative practice and psychosis.

Corticosteroid-induced psychosis: Case report and review of the literature

2017 ◽  
Vol 41 (S1) ◽  
pp. s840-s840
Author(s):  
M. Tenorio Guadalupe ◽  
I. Alberdi Páramo
Keyword(s):  
Psychotic Disorder ◽  
Clinical Presentation ◽  
Scientific Literature ◽  
Case Reports ◽  
Corticosteroid Treatment ◽  
Psychotic Symptoms ◽  
Clinical Aspects ◽  
Psychotic State ◽  
Competing Interest ◽  
Improved Methods

IntroductionSteroid psychosis still presents many unsettled clinical aspects. Despite several reviews and case reports are available, modes of onset and recovery need a more accurate description. We will focus on a 53-year-old woman who was hospitalized against her will because of her agitated psychotic state. Her symptoms were indicative of an acute psychotic disorder resulting from the use of corticosteroids. We considered it important to report this case because corticosteroids have been widely prescribed since about 1950 to treat a broad spectrum of somatic illnesses and to emphasize the relevance of the dose of steroids in this case.ObjectivesWe describe a case of substance-induced psychotic disorder resulting from corticosteroids administration and we review the scientific literature about this topic.AimsTo obtain more information about the incidence of steroid-induced psychotic symptoms, the relation between the type of steroids, its dose and the clinical presentation, the most important risk factors and how to prevent psychotic episodes during steroids-treatment.MethodsAfter discussing the case, we studied the literature systematically using official medical browsers.ResultsVery little reliable evidence has been available relating to steroid-induced psychosis.ConclusionsThere is much to learn about adverse psychiatric reactions to corticosteroid treatment. It should be improved awareness of the limited available knowledge and to stimulate research aimed at improved methods of prevention, recognition and treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

“Bouffée Délirante” Induced by Meditation

2016 ◽  
Vol 33 (S1) ◽  
pp. S533-S533 ◽  
Author(s):  
R.A. Baena Mures ◽  
L. Niell Galmes ◽  
Y. Lázaro Pascual ◽  
M.D. Saiz Gonzalez
Keyword(s):  
Adverse Events ◽  
Female Patient ◽  
Literature Search ◽  
Case Reports ◽  
Psychotic Symptoms ◽  
Cultural Syndromes ◽  
Vulnerable Patients ◽  
Psychotic Reaction ◽  
Dsm Iv ◽  
Competing Interest

IntroductionMeditation is frequently applied in Western as well as non-Western countries for different purposes; we know little about adverse events. The symptomatology of a meditation-related psychosis appears to show similarities with that we call “bouffée delirante”.MethodsA female patient is described who developed an acute and transient psychosis with polymorphic symptomatology after meditating (Bikram-yoga). We made a literature search for psychotic states related to meditation.ResultsThere are some case reports of psychosis disorder induced by meditation. Some cultural syndromes like Qi-gong appear on DSM-IV as psychotic reaction. In this case, the syndrome is not culture bound.ConclusionsMeditation can act as a stressor in vulnerable patients who may develop a transient psychosis with polymorphic symptomatology (confusion, pananxiety, mood swings and mood dystonic psychotic symptoms) with a short duration.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Agenesis of the Corpus Callosum in A Patient With Bipolar Disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S493-S493
Author(s):  
J. Nogueira ◽  
R. Ribeiro ◽  
J. Vieira ◽  
R. Sousa ◽  
S. Mendes ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Corpus Callosum ◽  
Past History ◽  
Case Reports ◽  
Manic Episode ◽  
Psychotic Symptoms ◽  
Major Depressive ◽  
Mixed Features ◽  
Competing Interest ◽  
The Brain

BackgroundThe corpus callosum (CC) is the largest white matter structure in the brain, which plays a crucial role in interhemispheric communication. Agenesis of the CC is a rare development anomaly, with unknown cause. It could be asymptomatic or associated with mental retardation and neurologic symptoms. Some case reports, post-mortem studies and image studies have linked thickness reduction and agenesis of CC with psychotic symptoms, mainly in schizophrenia patients. Lately, anatomical abnormalities in the CC have been reported in patients with Bipolar Disorder (BD).Case reportA 52-year-old woman was brought to the emergency room by the authorities after being physically aggressive to her 13-year-old daughter and inappropriate behavior in public. At the emergency department her mood was elevated with emotional lability, dispersible attention, slight increase of motor activity, pressured and difficult to interrupt speech, grandious and self-referent delusional ideas.Her past history revealed hippomaniac episodes characterized by periods of excessive shopping and hyperphagia. In 2008, she had a major depressive episode.Head CT-SCAN revealed agenesia of CC. She received the diagnosis of Manic Episode with mixed features and was treated with valproic acid, flurazepam and olanzapine.ConclusionThis case reinforces the fact that changes in CC, probably due to deficiency in myelination, could have a crucial importance in the pathophysiology of Bipolar Disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Vitamin B12 deficiency induced psychosis – a case report

2017 ◽  
Vol 41 (S1) ◽  
pp. s805-s805 ◽  
Author(s):  
A.R. Carvalho ◽  
S. Vacas ◽  
C. Klut
Keyword(s):  
Vitamin B12 ◽  
Case Reports ◽  
Vitamin B12 Deficiency ◽  
The Body ◽  
Psychotic Symptoms ◽  
Concurrent Administration ◽  
Persecutory Delusions ◽  
B12 Deficiency ◽  
Competing Interest ◽  
Psychotic Features

Vitamin B12 is one of the most essential vitamins affecting various systems of the body. Cases of neuropsychiatry disorders due to its deficiency are more common in elderly patients with prevalence of 10–20%. The most common psychiatry symptoms reported in the literature associated with vitamin B12 deficiency was depression, mania, psychotic symptoms, cognitive impairment and delirium. Here, we report a case of vitamin B12 deficiency in a 52-year-old male who presented with psychotic features: persecutory delusions, tactile and auditory hallucinations. Patient had neither recorded psychiatry history nor any drug abuse. Medical history includes hypertension, diabetes mellitus and glaucoma. The patient was not a vegetarian. All relevant laboratory evaluations and head CT were normal except vitamin B12. The patient was treated with antipsychotics (risperidone 3 mg/day) and intramuscular vitamin B12. One week after, there was total remission of psychotic symptoms. In the follow-up during the next four months, psychiatry symptoms did not recur at any time. This case reports a rare case of vitamin B12 deficiency induced psychosis. Although there was concurrent administration of an antipsychotic along with vitamin B12, it underlines the importation of evaluation of vitamin B12 and other potential reversible causes of psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Neurosyphilis and early-onset major neurocognitive disorder – Case reports

2016 ◽  
Vol 33 (S1) ◽  
pp. S630-S630
Author(s):  
A.M. Exergian ◽  
M. Ladea ◽  
R. Hagiu
Keyword(s):  
Early Onset ◽  
Case Reports ◽  
Venereal Disease ◽  
Psychiatric Ward ◽  
Neurocognitive Disorder ◽  
Test Results ◽  
Adequate Treatment ◽  
Atypical Clinical Presentation ◽  
Competing Interest ◽  
Acute Psychiatric Ward

IntroductionNeurosyphilis has been called “the great imitator” because of its atypical clinical presentation ranging from motor dysfunctions to psychotic episodes to dementia. This, and the fact that it has become a rare disease, makes diagnosis challenging.ObjectiveThis work will present three early onset Major Neurocognitive Disorder cases for which neurosyphilis was considered as a possible cause.AimsIn this presentation, we underline clinical characteristics that should raise the suspicion of neurosyphilis and the importance of an adequate diagnosis.MethodsThe three patients presented as case-reports were admitted to an acute psychiatric ward, presenting with psychomotor agitation and aggression. The initial clinical evaluation (including the patient's medical history) did not suggest the presence of syphilis. Subsequent blood-tests were performed, including RPR (Rapid Plasma Reagin) or VDRL (Venereal Disease Research Laboratory) which were positive in all three cases. Other tests were performed in order to confirm the presence of neurosyphilis.ResultsAll three patients had positive treponemal and nontreponemal test results. For only one of the three patients, imagistic abnormalities of the brain were present. For two of the patients, a positive diagnosis of Major Neurocognitive Disorder due to neurosyphilis was established.ConclusionsNeurosyphilis can be a cause for Major Neurocognitive Disorder. The diagnosis of this pathology is important because cognitive function can be improved by adequate treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Congenital Zika Virus Infection Paradigm: What is in the Wardrobe? A Narrative Review

2019 ◽  
Vol 1 (1) ◽  
pp. 49-56
Author(s):  
Mariam M. Mirambo ◽  
Lucas Matemba ◽  
Mtebe Majigo ◽  
Stephen E. Mshana
Keyword(s):  
Virus Infection ◽  
Neural Tube ◽  
Zika Virus ◽  
English Language ◽  
Case Reports ◽  
Case Series ◽  
Epidemiological Studies ◽  
Ocular Manifestations ◽  
Zika Virus Infection ◽  
N 93

Background: Zika virus infection during pregnancy has been recently associated with congenital microcephaly and other severe neural tube defects. However, the magnitude of confirmed cases and the scope of these anomalies have not been extensively documented. This review focuses on the magnitude of laboratory-confirmed congenital Zika virus cases among probable cases and describing the patterns of congenital anomalies allegedly caused by the Zika virus, information which will inform further research in this area. Methods: We conducted a literature search for English-language articles about congenital Zika virus infection using online electronic databases (PubMed/MEDLINE, POPLINE, Embase, Google Scholar, and Web of Knowledge). The search terms used were, “zika”, “pregnancy”, [year], “microcephaly”, “infants”, “children”, “neonates”, “foetuses”, “neural tube defect”, and “CNS manifestations” in different combinations. All articles reporting cases or case series between January 2015 and December 2016 were included. Data were entered into a Microsoft Excel database and analysed to obtain proportions of the confirmed cases and patterns of anomalies. Results: A total of 24 articles (11 case series, 9 case reports, and 4 others) were found to be eligible and included in this review. These articles reported 919 cases, with or without microcephaly, presumed to have congenital Zika virus infection. Of these cases, 884 (96.2%) had microcephaly. Of the 884 cases of microcephaly, 783 (88.6%) were tested for Zika virus infection, and 216 (27.6%; 95% confidence interval, 24.5% to 30.8%) were confirmed to be Zika virus-positive. In addition to microcephaly, other common abnormalities reported – out of 442 cases investigated – were calcifications of brain tissue (n=240, 54.3%), ventriculomegaly (n=93, 20.8%), cerebellar hypoplasia (n=52, 11.7%), and ocular manifestations (n=46, 10.4%). Conclusion: Based on the available literature, Zika virus infection during pregnancy might lead to a wide array of outcomes other than microcephaly. There is a need for more epidemiological studies in Zika-endemic areas, particularly in Africa, to ascertain the role of Zika virus in causing congenital neurological defects.

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