Hepatic comorbidity in psychiatry. A case report

2017 ◽  
Vol 41 (S1) ◽  
pp. S483-S483
Author(s):  
G. Pardo de Santayana ◽  
R. Landera ◽  
M. Juncal ◽  
O. Porta ◽  
L. Sánchez ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Antipsychotic Drugs ◽  
Therapeutic Option ◽  
Blood Levels ◽  
Good Tolerance ◽  
Iatrogenic Complications ◽  
Competing Interest ◽  
Long Term Prognosis ◽  
Long Acting

IntroductionComorbidity between mental and physical illnesses is very common and their possible interactions must always be taken into account. Hepatic disorders in particular, can affect the blood levels of antipsychotic drugs altering their effects on patients. Therefore, it is very important to assess in each case which treatment might be the most beneficial for the patient to avoid iatrogenic complications.AimTo review articles in Pub-Med and UpToDate about the possible iatrogenic complications that can arise using antipsychotic drugs in patients with hepatic disorders.MethodsWe describe the case of a 52-year-old male with Schizophrenia who was diagnosed of HCV infection ten years ago, for which he rejected any kind of treatment due to delirious ideation. In the past he was treated with oral Paliperidone with good tolerance, which he discontinued because of pour insight and stopped attending Psychiatric consultation. In April 2016 the patient was hospitalised suspecting a hepatocellular carcinoma.ResultsDuring hospitalization he began treatment with long-acting injectable formulation of Paliperidone Palmitate that improved his insight. The patient agreed to perform the necessary tests to verify the suspected diagnosis, which was sadly confirmed. He achieved psychopathological stability, but unfortunately the patient died 6 months later because of his hepatocellular carcinoma.ConclusionsPaliperidone is a good therapeutic option in patients with hepatic disorders because it is not metabolised by the liver. It also has a depot formulation that improves adherence in patients with low insight, reducing the danger of future psychotic decompensation and improving the long-term prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Aripiprazole once-monthly efficacy in patients with schizophrenia. Review

2016 ◽  
Vol 33 (S1) ◽  
pp. S582-S582
Author(s):  
M.F. Molina López ◽  
M.C. Cancino Botello ◽  
A. Peña Serrano ◽  
M.D.L.A. Canseco Navarro
Keyword(s):  
Quality Of Life ◽  
Negative Symptoms ◽  
Partial Agonist ◽  
Emotional Interaction ◽  
Medication Delivery ◽  
Pubmed Database ◽  
Competing Interest ◽  
Long Acting

Introductionlong acting injectable formulations of antipsychotics are a valuable option for patients with schizophrenia, offering continuous medication delivery and stable dosage levels. Aripiprazole once-monthly is the first dopamine partial agonist available in long acting formulation approved in Europe for Schizophrenia with excellent results so far.Aimsto conduct a current review of articles related to the use and efficacy of Aripiprazole once monthly in patients with Schizophrenia.Methodssystematic review of the literature in English using the following keywords: “aripiprazole once-monthly”, “aripiprazole long acting formulation”, “schizophrenia”. PubMed database.ResultsAripiprazole once-monthly (AOM) formulation efficacy has been proven in many studies. The importance of maintaining an oral overlap during 14 days is highlighted in all studies that have been reviewed in order to reach therapeutic level; therefore, it can be used in patients with acute decompensations. Recent studies comparing AOM versus Paliperidone Palmitate once monthly (PP) have shown that patients with AOM had greater clinical improvement and, even though both drugs were well tolerated, when Quality of Life Style Scale was analyzed an important improvement in empathy, sense of purpose, emotional interaction and curiosity in the AOM group was observed.Conclusionslong acting injectable antipsychotics increase long-term adherence treatment and reduce risk of relapse. Because of its unique mechanism of action, Aripiprazole once-monthly improves positive and negative symptoms, giving the patient an opportunity to have a better quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Recompensation of Decompensated Hepatitis B Cirrhosis: Current Status and Challenges

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hong Zhao ◽  
Qi Wang ◽  
Changling Luo ◽  
Ligai Liu ◽  
Wen Xie
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Antiviral Treatment ◽  
Research Data ◽  
Current Status ◽  
Evaluation Time ◽  
Long Term Prognosis ◽  
Time Evaluation

Liver-function decompensation or hepatocellular carcinoma (HCC) gradually appears after chronic hepatitis B progresses to cirrhosis. Effective antiviral treatment can significantly improve the long-term prognosis of decompensated patients, and some patients present recompensation of decompensated hepatitis B cirrhosis. At present, there are limited research data on the recompensation of decompensated hepatitis B cirrhosis. There is still controversy regarding the evaluation time, evaluation indicators, influencing factors, and long-term prognosis of recompensation.

Validation of the Conventional Resection Criteria in Patients with Hepatocellular Carcinoma in Terms of the Incidence of Posthepatectomy Liver Failure and Long-Term Prognosis

2015 ◽  
Vol 32 (5) ◽  
pp. 344-351 ◽  
Author(s):  
Kohta Iguchi ◽  
Etsuro Hatano ◽  
Kenya Yamanaka ◽  
Shiro Tanaka ◽  
Kojiro Taura ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Failure ◽  
Disease Free Survival ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
Free Survival ◽  
Posthepatectomy Liver Failure ◽  
Long Term Prognosis ◽  
Patient Prognosis

Background/Aims: Resection criteria in hepatocellular carcinoma (HCC) should be established based on the risk of posthepatectomy liver failure (PHLF) and the survival benefit from hepatectomy. This study aimed at verifying the validity of the conventional criteria regarding the incidence of PHLF and the long-term prognosis of HCC patients. Methods: A retrospective study was performed on 265 patients who underwent major hepatectomy. Makuuchi's criteria and the future liver remnant plasma clearance rate of indocyanine green (ICGK-rem) ≥0.05 criterion were evaluated. Results: A total of 107 and 158 patients were within and beyond Makuuchi's criteria, respectively. Makuuchi's criteria were associated with the incidence of PHLF (p = 0.03) but not with its severity (p = 0.12). No differences in disease-free survival (DFS) or overall survival (OS) were observed between the groups (p = 0.75 and p = 0.94, respectively). Using the ICGK-rem ≥0.05 criterion, 223 and 42 patients were within and beyond the criterion, respectively. ICGK-rem was correlated with both the incidence of PHLF (p = 0.002) and its severity (p = 0.03). No differences in DFS or OS were observed between the groups (p = 0.75 and p = 0.29, respectively). Conclusions: Strict criteria are likely to preclude some patients from obtaining the greater survival benefits of hepatectomy. New criteria that consider patient prognosis are needed.

The Role of Long Acting Antipsychotics in Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S15-S15
Author(s):  
E. Vieta
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Term Treatment ◽  
Patient Profile ◽  
Long Term Treatment ◽  
Short And Long Term ◽  
Competing Interest ◽  
Long Acting

Antipsychotics are widely used for the short and long-term treatment of bipolar disorder. Depot and long-acting injectable formulations (LAIs) can be particularly useful for certain subgroups of patients. This lecture will discuss the available data from randomized controlled trials of LAIs in bipolar disorder. A recently published meta-analysis and individual studies assessing depot medications, as well as modern LAIs such as risperidone, paliperidone and aripiprazole, will be reviewed, looking carefully into the prevention of either pole of illness and tolerability. Potential indications and patient profile, based on data and clinical experience, will be discussed.Disclosure of interestThe author has not supplied his declaration of competing interest.

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