Bupropion induced hyponatremia: A review of literature

2017 ◽  
Vol 41 (S1) ◽  
pp. S749-S749
Author(s):  
M. Arts ◽  
S. Petrykiv ◽  
J. Fennema ◽  
L. De Jonge
Keyword(s):  
Case Studies ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Rare Condition ◽  
The Elderly ◽  
Vasopressin Release ◽  
Increased Risk ◽  
Competing Interest ◽  
Underlying Mechanisms

IntroductionFor over 20 years, bupropion has been used as an antidepressant by inhibiting the norepinephrine-dopamine reuptake. Hyponatremia is a relatively rare condition that has been associated with the use of antidepressants including selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). However, a few case studies have reported that bupropion was associated with hyponatremia.Objectives and aimsTo review available literature on bupropion-induced hyponatremia and its possible underlying mechanisms.MethodsCase studies are presented and discussed followed by a literature review.ResultsHyponatremia has been reported with the use of many antidepressants, however, studies on bupropion induced hyponatremia has been limited. In literature only four case reports have been presented. Typically, this condition is only seen in frail or elderly patients. Possible mechanism is that bupropion may cause hyponatremia by the noradrenergic stimulation of vasopressin release.ConclusionClinicians should be aware of increased risk of hyponatremia associated with antidepressants, including bupropion. Especially in the elderly, clinical symptoms of hyponatremia can be misinterpreted and may lead to a life-threatening condition.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A case of share psychotic disorder induced by mephedrone

2016 ◽  
Vol 33 (S1) ◽  
pp. S309-S309
Author(s):  
R.A. Baena ◽  
Y. Lázaro ◽  
J. Rodriguez ◽  
L. Olivares ◽  
A. Matas ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Scientific Literature ◽  
Case Reports ◽  
Rare Condition ◽  
Psychiatric History ◽  
Psychiatric Disturbance ◽  
Medical Treatments ◽  
Novel Drugs ◽  
Close Relationship ◽  
Competing Interest

IntroductionShare psychotic disorder “folie à deux” is a rare condition characterized by the transmission of delusional aspects from a patient to another linked by a close relationship. We report the case of two Spanish men who have experienced a combined delusional episode induced by mephedrone.ObjectivesDescribe a case of share psychotic disorder induced by mephedrone. Make a review on scientific literature about the use of mephedrone (little is known about the psychiatric consequences of the use of these compounds). The patients had no psychiatric history.AimsShow the danger of these novel drugs that are often bought as apparently safe and legal.ConclusionsShare psychotic disorder was first introduced by Lasegue and Falret who hypothesized that transmission of psychiatric disturbance from one person to another was possible under certain circumstances. The correlation of symptoms with the intake of these substances is supposed in the light of a negative psychiatric history and no other concomitant medical treatments. An important number of case reports documented deaths related to the ingestion of mephedrone. Another problem is that these substances are not detected by standard blood and urine test so that the diagnosis of intoxication is often delayed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Citalopram–induced delusions in an older adult

2017 ◽  
Vol 41 (S1) ◽  
pp. S751-S752
Author(s):  
J. Fennema ◽  
S. Petrykiv ◽  
L. De Jonge ◽  
M. Arts
Keyword(s):  
Case Report ◽  
Older Adult ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Case Reports ◽  
Dose Range ◽  
Early Morning ◽  
Medical Evidence ◽  
First Case ◽  
Therapeutic Dose Range ◽  
Competing Interest

IntroductionSelective serotonin reuptake inhibitors (SSRIs) are the most prescribed antidepressants worldwide. In older adults, citalopram is generally well tolerated and safe in the therapeutic dose range of 20 to 40 mg/day. In literature, there are cases of SSRI-induced psychosis, but mainly with fluoxetine. There are only three reported cases of citalopram-induced delusions, however, these case-reports did not involve an older adult.Objectives and aimsTo provide a case of citalopram–induced psychosis in an older adult, followed by the review of available literature.MethodsA case report is presented and discussed followed by a literature review.ResultsA 64-year-old woman without somatic illnesses was referred by a general practitioner with depressive symptoms. One week after initiation of citalopram 10 mg/day she suddenly developed delusions, predominantly in the early morning. No other medical evidence was found that could explain her delusions. After discontinuation of citalopram her delusions quickly resolved.ConclusionThis is the first case report of a SSRI-induced delusion in an older adult. Citalopram has been reported to be one of the safest SSRIs. Although most SSRI's have a mild side-effect profile, care should be taken when initiating SSRIs since unpredictable adverse effects may occur.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The Value of Anlotinib in the Treatment of Intractable Brain Edema: Two Case Reports

2021 ◽  
Vol 11 ◽  
Author(s):  
Song Yang ◽  
Jian Sun ◽  
Mingna Xu ◽  
Yuru Wang ◽  
Guihong Liu ◽  
...  
Keyword(s):  
Growth Factor ◽  
Intracranial Pressure ◽  
Brain Edema ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Growth Factor Receptor ◽  
Growth Factor Receptors ◽  
Peritumoral Edema ◽  
Fibroblast Growth Factor Receptors ◽  
Increased Risk

About 20-30 percent of patients with cancer, such as non-small cell lung cancer, breast cancer, melanoma and renal cell carcinoma, will develop brain metastases (BM). Primary and secondary brain tumors are often accompanied by peritumoral edema. Due to the limited intracranial space, peritumoral edema will further increase the intracranial pressure and aggravate clinical symptoms. Radiotherapy, as a basic component of the treatment of intracranial tumors, induces blood vessel damage and aggravates brain edema. The combination of edema caused by the tumor itself and radiotherapy is collectively referred to as intractable brain edema. Edema can increase intracranial pressure and cause associated neurologic symptoms, which seriously affects the quality of life of patients. Steroids, specifically dexamethasone, have become the gold standard for the management of tumor-associated edema. However, steroids can lead to variety of adverse effects, including moon face, high blood pressure, high blood sugar, increased risk of infection, bone thinning (osteoporosis), and fractures, especially with prolonged use. The investigation of other types of drugs is urgently needed to address this problem.Compared to other anti-angiogenic agents, anlotinib acts on vascular endothelial growth factor receptors (VEGFR1, VEGFR2/KDR, and VEGFR3), fibroblast growth factor receptors (FGFR1, FGFR2, FGFR3 and FGFR4), platelet derived growth factor receptor (PDGFR) and stem cell factor receptor (c-kit) simultaneously. However, according to the literature retrieval, there are no studies on anlotinib for the treatment of intractable brain edema. We describe here two cases of brain edema and review the literature available and hope to discover new agents that are safer and more effective.

Depression and Huntington's Disease: Prevalence, Clinical Manifestations, Etiology, and Treatment

CNS Spectrums ◽  
2001 ◽  
Vol 6 (4) ◽  
pp. 306-308,325-326 ◽  
Author(s):  
James R. Slaughter ◽  
Matthew P. Martens ◽  
Kathleen A. Slaughter
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Case Series ◽  
Convulsive Therapy ◽  
Number Of Factors ◽  
Literature Searches ◽  
Increased Risk

ABSTRACTIn order to determine the extent to which depression complicates Huntington's disease (HD), we have analyzed the existing literature on depression in HD in order to report the prevalence, clinical manifestations, and treatment of HD depression. By means of MEDLINE literature searches and reviews of HD articles' bibliographies, we identified for our analysis 16 HD depression studies. Our results indicate that the prevalence of depression is 30% for all HD patients. Clinical manifestations of HD depression include a marked increased risk for suicide. The etiology of HD depression is unclear, but may be due to a number of factors, such as dysfunction in the caudate nucleus, dysfunction in the ventral striatum, and various genetic factors that are discussed in this review. Case reports and case series support the efficacy of standard antidepressant interventions in resolving symptoms of depression. Efficacious treatments reported in the literature include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and electro-convulsive therapy. In this study, the successful anecdotal treatment of seven consecutive HD depressed patients with sertraline suggests that sertraline may be a safe and efficacious treatment of HD depression.

Differential Diagnosis Based on Age. Diagnostic Difficulties

2016 ◽  
Vol 33 (S1) ◽  
pp. S473-S473
Author(s):  
S. Rodrígue Vargas
Keyword(s):  
Differential Diagnosis ◽  
Literature Review ◽  
Clinical Symptoms ◽  
Psychiatric Symptoms ◽  
The Elderly ◽  
Psychotic Symptoms ◽  
Review Of The Literature ◽  
Diagnostic Difficulties ◽  
Diagnostic Hypothesis ◽  
Competing Interest

IntroductionFollowing a case presented in our inpatient unit as well as various interdepartmental from internal medicine and other emergencies, we decided to conduct a literature review on the different organic causes that can trigger the onset of psychotic symptoms in elderly.ObjectivesA correct differential diagnosis of psychiatric symptoms in elderly.AimsLiterature review of the literature on the presentation of psychotic symptoms in the elderly.MethodsDescription of a clinical case and development of diagnostic hypotheses.Results and conclusionsFor several decades are experiencing a gradual aging of the population, which means that we are at the onset of clinical symptoms not described by classical authors. Furthermore, scientific advances make infectious causes (such as neurosyphilis was our first diagnostic hypothesis) are increasingly rare. The elderly usually has multiple comorbidities, which are receiving various treatments that must be ruled out possible adverse effects.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Hypoprothrombinemia Associated with Cefmetazole

1997 ◽  
Vol 31 (2) ◽  
pp. 180-184 ◽  
Author(s):  
Gail A Breen ◽  
Wendy L St Peter
Keyword(s):  
At Risk ◽  
Vitamin K ◽  
Clinical Symptoms ◽  
The Elderly ◽  
International Normalized Ratio ◽  
Fresh Frozen Plasma ◽  
Endstage Renal Disease ◽  
Populations At Risk ◽  
Increased Risk ◽  
Patients At Risk

Objective To report a case of hypoprothrombinemia associated with the use of cefmetazole sodium, define patients at risk for this adverse effect, and identify options to prevent this problem. Case Summary A malnourished patient with endstage renal disease received cefmetazole following a below-the-knee amputation of the right leg. Three days later, a prothrombin time (FT) and an international normalized ratio (INR) were obtained and were markedly elevated from baseline; however, the patient had no clinical symptoms of bleeding. Cefmetazole was discontinued. Vitamin K and fresh frozen plasma were administered. The PT and INR normalized within 24 hours and remained normal throughout the remainder of hospitalization. Discussion The incidence of hypoprothrombinemia associated with cefmetazole reported in the literature is conflicting and not consistent. There are three proposed mechanisms of cephalosporin-associated hypoprothrombinemia, two of which involve the N-methylthiotetrazole (NMTT) chain. The most plausible mechanism is NMTT inhibition of vitamin K epoxide reductase in the liver. Patients at an increased risk for this adverse event include those with low vitamin K stores, specifically patients who are malnourished, with low albumin concentrations and poor food intake. The elderly and patients with liver or renal dysfunction are examples of populations at risk. Conclusions Hypoprothrombinemia may occur with cephalosporins and is especially problematic with those containing an NMTT side chain. Clinicians need to identify patients at risk for developing antibiotic-associated hypoprothrombinemia, monitor them closely, and give vitamin K as prophylaxis accordingly.

Delusional of Parasitosis in Geriatric Patients

2016 ◽  
Vol 33 (S1) ◽  
pp. S470-S470
Author(s):  
M. Gutierrez Rodriguez ◽  
C. Moreno Menguiano ◽  
F. Garcia Sanchez ◽  
R. Martin Aragon
Keyword(s):  
Geriatric Patients ◽  
Current Knowledge ◽  
Case Reports ◽  
Antipsychotic Agents ◽  
The Elderly ◽  
The Body ◽  
Delusional Parasitosis ◽  
Pubmed Database ◽  
Primary Disorder ◽  
Competing Interest

IntroductionDelusional of parasitosis or Ekbom's syndrome (ES) is a psychiatric disorder in which the patient has a fixed and false belief that small organisms infest the body. The belief is often accompanied by hallucinations. It is an uncommon condition that was initially studied by dermatologists, more prevalent in the elderly and typically observed in women older than 50 years although isolated cases among men have been reported.ObjectiveTo review current knowledge about delusional of parasitosis in elderly patients through literature systematic review and the analysis of a case report.MethodologyWe performed a literature search using electronic manuscripts available in PubMed database published during the last five years, following the description and discussion of a clinical case. We report a case of an 85-year-old man who presented a delusional parasitosis as a primary disorder.ResultsThe literature on ES consists mostly of case reports and limited series. In this paper, we analyze the etiology, demographic characteristics, clinical features and treatment in geriatric patients with delusional parasitosis.ConclusionInternational classifications have included this syndrome in non-schizophrenic delusions. However, it has also been reported in schizophrenia, affective disorders, and organic or induced psychosis. Treatment is based on antipsychotic agents, psychotherapy and cooperation between dermatologists and psychiatrists.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Immunosenescence in Childhood Cancer Survivors and in Elderly: A Comparison and Implication for Risk Stratification

2021 ◽  
Vol 2 ◽  
Author(s):  
Petra Lázničková ◽  
Kamila Bendíčková ◽  
Tomáš Kepák ◽  
Jan Frič
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Immune Cell ◽  
The Elderly ◽  
Childhood Cancer Survivors ◽  
Future Research ◽  
Low Grade ◽  
Increased Risk ◽  
Underlying Mechanisms ◽  
Health Complications

The population of childhood cancer survivors (CCS) has grown rapidly in recent decades. Although cured of their original malignancy, these individuals are at increased risk of serious late effects, including age-associated complications. An impaired immune system has been linked to the emergence of these conditions in the elderly and CCS, likely due to senescent immune cell phenotypes accompanied by low-grade inflammation, which in the elderly is known as “inflammaging.” Whether these observations in the elderly and CCS are underpinned by similar mechanisms is unclear. If so, existing knowledge on immunosenescent phenotypes and inflammaging might potentially serve to benefit CCS. We summarize recent findings on the immune changes in CCS and the elderly, and highlight the similarities and identify areas for future research. Improving our understanding of the underlying mechanisms and immunosenescent markers of accelerated immune aging might help us to identify individuals at increased risk of serious health complications.

Serotonin syndrome during treatment with low dose of escitalopram associated with miconazole mucoadhesive tablet: a suspected drug interaction

2012 ◽  
Vol 24 (5) ◽  
pp. 845-847 ◽  
Author(s):  
Grégory Baptista ◽  
Céline Eiden ◽  
Paul Monguillot ◽  
Christelle Philibert ◽  
Claude Jeandel
Keyword(s):  
Drug Interaction ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Syndrome ◽  
Low Dose ◽  
Present Report ◽  
Cytochromes P450 ◽  
The Elderly ◽  
Multiple Drug ◽  
Pharmacokinetic Data ◽  
Increased Risk

ABSTRACTAntidepressant treatments, including selective serotonin reuptake inhibitors, are associated in older adults with an increased risk of adverse effects compared to younger adults. This is partly explained by multiple drug use causing drug–drug interactions. In the present report, we describe a case of serotonin syndrome in an 88-year-old woman receiving a low dose of escitalopram. The onset of this episode could have been induced by a drug–drug interaction with an acute treatment by miconazole gingival adhesive tablets. The lack of pharmacokinetic data in the elderly population should prompt us to be especially cautious about prescription of this new formulation of miconazole in association with drugs metabolized by cytochromes P450 isoenzymes.

scholarly journals Association Between Obstructive Sleep Apnea, Its Treatment, and Alzheimer's Disease: Systematic Mini-Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Chih-Yun Kuo ◽  
Hung-Ta Hsiao ◽  
Ing-Hsien Lo ◽  
Tomas Nikolai
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
The Elderly ◽  
Protein Levels ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Osa Treatment ◽  
Underlying Mechanisms

Obstructive sleep apnea (OSA) and Alzheimer's disease (AD) are common in the elderly population. Obstructive sleep apnea that may cause significant changes in the cerebrospinal fluid β-amyloid and T-tau and/or P-tau protein levels is often identified as a risk factor for development of AD. Although the underlying mechanisms of AD are still not fully understood, a hypothesis associating OSA with AD has been already proposed. In this systematic mini-review, we first discuss the recent findings supporting the association of OSA with an increased risk of AD and then provide evidence suggesting the positive effect of OSA treatment on a reduced risk of AD.

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