New onset multimodal hallucinations associated with mirtazapine: a case report

2010 ◽  
Vol 22 (5) ◽  
pp. 837-839 ◽  
Author(s):  
Kalpana P. Padala ◽  
Prasad R. Padala ◽  
Timothy Malloy ◽  
William J. Burke
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Side Effect ◽  
The Elderly ◽  
Side Effect Profile ◽  
Visual Hallucinations ◽  
Care Needs ◽  
Treatment Of Depression ◽  
Safe Side ◽  
New Onset

ABSTRACTMirtazapine, a commonly used antidepressant, has a relatively safe side effect profile and is commonly used in the elderly for treatment of depression. It has been proposed as being particularly suitable for patients with depression associated with insomnia and weight loss. Although mental status changes and perceptual abnormalities secondary to its use are rare, special care needs to be taken, especially while starting treatment or while increasing the dose. We report three cases of auditory, musical and visual hallucinations associated with the use of mirtazapine.

Long-term efficacy and safety of imiquimod 5% and fluorouracil 1% creams in medical monotherapy of complex eyelid basal cell carcinomas

2021 ◽  
pp. 112067212110356
Author(s):  
Manpreet Singh ◽  
Aditi Mehta Grewal ◽  
Himanshi Singh ◽  
Manjula Sharma ◽  
Manpreet Kaur ◽  
...  
Keyword(s):  
Basal Cell ◽  
Side Effect ◽  
The Elderly ◽  
Fixed Dose ◽  
Side Effect Profile ◽  
Efficacy And Safety ◽  
Term Efficacy ◽  
Basal Cell Carcinomas ◽  
Double Blinded

Purpose: To study the long-term efficacy and safety of local application of imiquimod 5% and fluorouracil 1% creams in complex eyelid basal cell carcinomas (BCCs). Methods: A retrospective, non-comparative study in biopsy-proven, complex (involving canthi or >50% of eyelid length) eyelid BCC patients who were medically unfit for surgical procedures. All patients were medically treated with either of the creams using fixed-dose regimens for a minimum of 3 months. All received oral vitamin C 500 mg QID for 3 months as an adjunct for collagen healing. A minimum of “post-treatment” follow-up of 12 months was observed. Results: Of total 30 patients, imiquimod 5% and fluorouracil 1% were used in 16 and 14 patients, respectively. The mean age of our patients was 70.5 years. The co-morbidities included – severe coronary artery disease using blood-thinners ( n = 19), poorly controlled diabetes ( n = 12), poorly controlled hypertension ( n = 6), on nebulization ( n = 3), and tuberculosis with pulmonary fibrosis ( n = 2). Complete clinical tumor resolution was noted in 10 and 8 patients over 12 and 16.5 weeks, respectively, in imiquimod and fluorouracil groups. Periocular skin erythema, chemical conjunctivitis, and skin depigmentation were seen in all the patients of imiquimod group. On the other hand, the local side-effect profile in fluorouracil patients was limited. Conclusion: The medical treatment of complex eyelid BCC is a useful alternative to surgery in the elderly with significant co-morbidities. It provides a promising long-term relief with a tolerable side-effect profile. A prospective, randomized, double-blinded trial would provide stronger evidence for the efficacy of these drugs.

Chronic Subdural Hematoma in the Elderly: A Case Report

1996 ◽  
Vol 9 (2) ◽  
pp. 100-101 ◽  
Author(s):  
Michel Elie ◽  
Francois Primeau ◽  
Martin G. Cole
Keyword(s):  
Elderly Patient ◽  
Weight Loss ◽  
Case Report ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Poor Response ◽  
The Elderly ◽  
Response To Treatment ◽  
Pharmacologic Treatment ◽  
Paranoid Symptoms

A previously healthy 82-year-old male presented with depressive and paranoid symptoms of 3 months' duration. Physical examination and cognitive functions were normal. Poor response to treatment and continuing weight loss lead to medical investigations that ultimately showed a large, left frontoparietal, chronic subdural hematoma. Following drainage, the patient showed some improvement in paranoid features but still required pharmacologic treatment for depression. The psychiatric features of chronic subdural hematoma as well as the management of this neurologic condition in the elderly patient are reviewed and discussed.

Esotropia in a Child Treated With a Scopolamine Patch for Drooling

PEDIATRICS ◽  
1996 ◽  
Vol 97 (1) ◽  
pp. 126-127
Author(s):  
William V. Good ◽  
Lucy S. Crain
Keyword(s):  
Case Report ◽  
Side Effect ◽  
Protein C ◽  
Side Effect Profile ◽  
Protein C Deficiency ◽  
Neurodevelopmental Disabilities ◽  
Care Givers ◽  
Substantial Problem ◽  
Spastic Quadriplegia ◽  
Clotting Disorder

Drooling in children who have neurodevelopmental disabilities can pose a substantial problem. Recent studies have indicated that, because of its anticholinergic effect, the use of a scopolamine patch may help eliminate drooling.1,2 The ease of administration of the patch, coupled with its very low side-effect Profile, adds to its desirability. However, we want to alert care givers to a problem we attribute to the scopolamine patch. Esotropia developed in one of our patients when scopolamine transdermal patching was done. The esotropia resolved shortly after cessation of patching. CASE REPORT This 4-year-old boy has spastic quadriplegia, a significant developmental delay, a well-controlled seizure disorder, and microcephaly secondary to a neonatal cerebrovascular hemorrhage associated with a protein C deficiency clotting disorder.

scholarly journals Risperidone-associated enuresis—a case report

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Ashish Sarangi ◽  
Zachary Mkhantar ◽  
Preston Weaver
Keyword(s):  
Decision Making ◽  
Case Report ◽  
Side Effect ◽  
Negative Symptoms ◽  
Informed Decision Making ◽  
Side Effect Profile ◽  
Case Presentation ◽  
Potential Side Effect ◽  
Metabolic Side Effect ◽  
Positive And Negative Symptoms

Abstract Background Risperidone has been reported to be effective in treating both the positive and negative symptoms of schizophrenia, aggression, and behavioral disorders. While the metabolic side effect profile of this medication has been broadly studied, studies related to this medication’s bladder effects are relatively rare. We present a case of risperidone-induced enuresis in an adult male with schizophrenia that resolved upon discontinuation of the offending medication. Case presentation We describe a case of a 32-year-old man with a primary psychotic disorder who developed debilitating enuresis secondary to taking risperidone. Enuresis resolved upon switching to Seroquel. Conclusion Enuresis secondary to risperidone is not commonly discussed prior to initiation by the treating psychiatrist however can be debilitating. Discussing this potential side effect is critical to informed decision making on the patient’s part.

Citalopram-Associated Alopecia: A Case Report and Brief Literature Review

2019 ◽  
Vol 14 (2) ◽  
pp. 167-170 ◽  
Author(s):  
Joshua Hekmatjah ◽  
Kinza Tareen ◽  
Ruqiya Shama Tareen
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Side Effect ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Early Recognition ◽  
Side Effect Profile ◽  
First Line ◽  
Drug Induced ◽  
Bizarre Behavior

Background: Selective Serotonin Reuptake Inhibitors (SSRIs) are the first-line treatments for various psychiatric disorders. SSRIs offer an improved side effect profile compared to older treatments, which improves patients’ adherence and quality of life. Case Report:Here we discuss a case of an uncommon, but a distressing side effect of citalopram. A 76-year old woman was referred to the psychiatry clinic for bizarre behavior. The patient was diagnosed with behavioral variant frontotemporal dementia and was started on citalopram 20 mg and aripiprazole 5 mg daily. At 3.5 months the patient complained of diffuse hair thinning on her scalp. Citalopram was considered the offending agent and was discontinued. Within a few months, the patient regained most of her hair. Although drug-induced alopecia is common among other SSRIs, it is relatively rare with citalopram. Results and Conclusion:Early recognition, withdrawal of offending agent, and reassurance to the patient that hair loss is reversible can help alleviate patient distress and avoid relapse.

scholarly journals Pravastatin-Induced Eczematous Eruption Mimicking Psoriasis

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Michael P. Salna ◽  
Hannah M. Singer ◽  
Ali N. Dana
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
The Elderly ◽  
Case Presentation ◽  
Dermatology Clinic ◽  
Systemic Treatments ◽  
Eczematous Dermatitis ◽  
Erythematous Plaques ◽  
New Onset

Background. Statins, an example of the most commonly prescribed medications to the elderly, are not without side effects. Dermatologic events are often overlooked as arising from medications, particularly those which are taken chronically. Moreover, elderly patients are prone to pharmacologic interactions due to multiple medications. In this report, we describe a case of a statin-induced eczematous dermatitis with a psoriasis-like clinical presentation and review the skin manifestations that may arise from statin therapy.Case Presentation. An 82-year-old man with gout and hypercholesterolemia presented to dermatology clinic with new onset of pruritic, scaly erythematous plaques bilaterally on the extensor surfaces of his arms. He had never had similar lesions before. Despite various topical and systemic treatments over several months, the rash continued to evolve. The patient was then advised to discontinue his long-term statin, which led to gradual resolution of his symptoms. He was subsequently diagnosed with statin-induced eczematous dermatitis.Conclusions. This case report describes an adverse cutaneous reaction to statins that is rarely reported in the literature. Medications, including longstanding therapies, should be suspected in cases of refractory dermatologic lesions.

scholarly journals Use of Antimuscarinics in the Elderly

2009 ◽  
Vol 9 ◽  
pp. 459-465 ◽  
Author(s):  
Bhavin Patel ◽  
Tamara Bavendam ◽  
Gopal Badlani
Keyword(s):  
Overactive Bladder ◽  
Side Effect ◽  
Older Persons ◽  
The Elderly ◽  
Review Article ◽  
Side Effect Profile ◽  
Treatable Condition

Overactive bladder (OAB) is a common, costly, and treatable condition in older persons. There is a wide array of available antimuscarinics for the treatment of these conditions; however, their side effect profile and the limited number of studies that evaluate their effect in the elderly curb their use. This review article focuses on OAB and its treatment, with special attention to the use of antimuscarinics in the elderly.

Safety of sublingual grass pollen immunotherapy after anaphylaxis

2008 ◽  
Vol 123 (6) ◽  
pp. 683-684 ◽  
Author(s):  
J R Nichani ◽  
J de Carpentier
Keyword(s):  
Case Report ◽  
Adverse Events ◽  
Grass Pollen ◽  
Side Effect ◽  
Sublingual Immunotherapy ◽  
Subcutaneous Immunotherapy ◽  
Side Effect Profile ◽  
Fatal Complication ◽  
Discontinuation Of Treatment ◽  
Safe Treatment Option

AbstractAim:To demonstrate that sublingual immunotherapy is a safe treatment option in patients who have previously suffered anaphylaxis when undergoing subcutaneous grass pollen immunotherapy.Case report:We report two patients who developed a systemic anaphylactic reaction following subcutaneous grass pollen immunotherapy, resulting in discontinuation of treatment. Following treatment of the acute anaphylactic episode, both patients were subsequently safely commenced on sublingual grass pollen immunotherapy.Conclusion:Injection immunotherapy has a relatively low risk of severe adverse events, although anaphylaxis is a potentially fatal complication and usually results in termination of the immunotherapy programme. Sublingual immunotherapy has a safer side effect profile than subcutaneous immunotherapy, with no reported cases of anaphylaxis.

scholarly journals Use of Phenobarbital in Delirium Tremens

2017 ◽  
Vol 5 (4) ◽  
pp. 232470961774216 ◽  
Author(s):  
Jeffrey Fujimoto ◽  
Jerry J. Lou ◽  
Antonio M. Pessegueiro
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Clinical Response ◽  
Clinical Improvement ◽  
Alcohol Withdrawal ◽  
Side Effect ◽  
Delirium Tremens ◽  
Standard Of Care ◽  
Side Effect Profile ◽  
Hispanic Male

The standard of care for alcohol withdrawal centers on the use of escalating doses of benzodiazepines until clinical improvement is achieved. However, there is no established standard in the care of patients with severe alcohol withdrawal and delirium tremens that is refractory to benzodiazepine therapy. One potential therapy that is gaining traction is the use of phenobarbital, which may be mechanistically superior to benzodiazepines in treating delirium tremens because of its effects on GABA and N-methyl-D-aspartate receptors. The dosing of phenobarbital and its subsequent taper, however, is still unclear and the side effect profile is not well characterized. In this case report, we present the case of a 37-year-old Hispanic male who presented with alcohol withdrawal and subsequent delirium tremens who was treated with phenobarbital with positive clinical response and minimal side effects.

scholarly journals Case report: Symptomatic pericarditis post covid-19 vaccination

2021 ◽  
Author(s):  
Sarah Ashaari ◽  
Hafiz Ahmed Sohaib ◽  
Kenneth Bolger
Keyword(s):  
Case Report ◽  
Disease Control ◽  
Side Effect ◽  
Rapid Development ◽  
Symptomatic Relief ◽  
Side Effect Profile ◽  
First Line ◽  
Post Vaccination ◽  
Case Summary ◽  
Control And Prevention

Abstract Background The Covid-19 pandemic has led to rapid development of Covid-19 vaccine. Centers for Disease Control and Prevention (CDC) has recently reported increase in myopericarditis incidence post Covid-19 vaccination. Post-vaccination myo-pericarditis as side effect has been reported however is infrequent. We described a case of pericarditis post- first dose of Pfizer-BioNTech vaccine. Case Summary A patient presented with typical symptoms of pericarditis and related ECG and echocardiogram changes, 7 days post receiving the first dose of Covid-19 vaccine. No other causes were identified from series of investigations. Patient had good symptomatic relief with non-steroidal anti- inflammatory medication. Conclusion The incidence of pericarditis post-vaccination is rare, with limited reporting in previous literatures. No causal relationship has yet to be established due to small number of cases. The benefits of Covid-19 vaccination currently outweigh the side effect profile and recommended as the first line approach to control the current pandemic.

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