Idiopathic Recurrent Catatonia Needs Maintenance Lorazepam: Case Report and Review

2007 ◽  
Vol 41 (7) ◽  
pp. 625-627 ◽  
Author(s):  
Narayana Manjunatha ◽  
Sahoo Saddichha ◽  
Christoday R.-J. Khess

Objectives: Catatonia as a phenomenon has been well described with either a schizophrenic illness, severe mood disorders or periodic catatonia disorder. We aim to report a patient who had recurrent catatonia that responded to and required lorazepam for maintenance. Methods: We describe the case of a 28 year old woman who had a history of recurrent catatonia that was unresponsive to most anti-psychotics, but who responded to high doses of lorazepam and needed long-term lorazepam for maintenance. Results and Conclusion: Our patient met the criteria for a diagnosis of idiopathic catatonic disorder. Response to lorazepam suggests that a certain group of patients may require long-term treatment with lorazepam, especially those who may have down-regulation of GABA-A receptors.

Author(s):  
Jacob Maier ◽  
Daniel Rapport ◽  
Alex McCormick ◽  
Chandani Lewis

Alternative therapies are necessary to treat catatonia in patients with comorbidities that are not amenable to therapy with benzodiazepines or ECT. This is a patient with schizophrenia with catatonic features and a history of polysubstance abuse. Consequently, he was not a candidate for treatment with benzodiazepines, so an alternative needed to be found. GABAergic medications have been used previously as alternatives to benzodiazepines and ECT. In this case we chose sodium valproate, due to its cross-reaction with GABAergic systems. There are five reported cases using sodium valproate. Three of which were treated with intravenous valproate, while the remaining two do not specify the route of administration. We present a case where oral sodium valproate was used successfully for both acute and long-term catatonic treatment. To our knowledge, no other report has looked at both acute and long-term treatment with sodium valproate. Oral sodium valproate can be considered for patients with substance use disorders like COPD, sleep apnea or myasthenia gravis in which benzodiazepines are contraindicated and where ECT is not an option for treatment.


2021 ◽  
Vol 27 (4) ◽  
pp. 322-325
Author(s):  
Gerasimos Konstantinou ◽  
Charalabos C. Papageorgiou ◽  
Elias Angelopoulos

2004 ◽  
Vol 171 (4S) ◽  
pp. 424-424 ◽  
Author(s):  
Monica G. Ferrini ◽  
Eliane G. Valente ◽  
Jacob Rajfer ◽  
Nestor F. Gonzalez-Cadavid

Author(s):  
Park Benjamin J ◽  
Camoriano David ◽  
Vital Mark C ◽  
Chévez-Barrios Patricia ◽  
Goosey John D ◽  
...  

Purpose: To describe management of a patient with ligneous conjunctivitis secondary to plasminogen deficiency and review the literature on treatment with plasminogen. Design: Interventional case report. Methods: A 6-year-old Caucasian girl developed ligneous conjunctivitis recalcitrant to debridement and treatment with topical cyclosporin A and steroids. The literature was reviewed regarding treatment of ligneous conjunctivitis with plasminogen. Results: The patient was treated with plasminogen containing drops derived from her father’s fresh frozen plasma. The ligneous conjunctivitis resolved, and the patient was managed on these drops for the following 8 years, initiating treatment for flares and tapering according to clinical response. Conclusions: Plasminogen drops concentrated from fresh frozen plasma are a safe and effective option for long-term treatment of ligneous conjunctivitis.


Author(s):  
Gennaro Ratti ◽  
Antonio Maglione ◽  
Emilia Biglietto ◽  
Cinzia Monda ◽  
Ciro Elettrico ◽  
...  

Long term treatment with ticagrelor 60 mg and low-dose aspirin are indicated after acute coronary syndrome (ACS). We retrospectively reviewed aggregate data of 187 patients (155 M and 38 F) (mean age 63.8±9 years) in follow up after ACS with at least one high risk condition (Multivessel disease, diabetes, GFR<60 mL/min, history of prior myocardial infarction, age >65 years) treated with ticagrelor 60 mg twice daily (after 90 mg twice daily for 12 months). The results were compared with findings (characteristics of the patients at baseline, outcomes, bleeding) of PEGASUS-TIMI 54 trial and Eu Label. The highrisk groups were represented as follows: multivessel disease 105 pts (82%), diabetes 63 pts (33%), GFR< 60 mL/min 27 pts (14%), history of prior MI 33 pts (17%), >65 year aged 85 pts (45%). Treatment was withdrawn in 7 patients: 3 cases showed atrial fibrillation and were placed on oral anticoagulant drugs, one developed intracranial bleeding, in three patients a temporary withdrawal was due to surgery (1 colon polyposis and 2 cases of bladder papilloma). Chest pain without myocardial infarction occurred in 16 patients (revascularization was required in 9 patients). Dyspnea was present in 15 patients, but was not a cause for discontinuation of therapy. Long term treatment with ticagrelor 60 mg twice daily plus aspirin 100 mg/day showed a favourable benefit/risk profile after ACS.  In this study all patients had been given ticagrelor 90 mg twice daily for 12 months and the 60 mg twice daily dosage was started immediately thereafter, unlike PEGASUS-TIMI 54 trial in which it was prescribed within a period ranging from 1 day to 1 year after discontinuation of the 90 mg dose. This makes our results more consistent with current clinical practice. However, a careful outpatient follow-up and constant counseling are mandatory to check out compliance to therapy and adverse side effects.


1992 ◽  
Vol 6 (2_suppl) ◽  
pp. 334-339
Author(s):  
Malcolm Peet

Recurrent mood disorder carries a risk of suicide of ~ 15%. Patients who do commit suicide have often received inadequate antidepressant or prophylactic lithium treatment. Long-term treatment with lithium normalizes the excess mortality associated with recurrent mood disorders, including that from suicide. A reduced availability of the most lethal methods of suicide may contribute epidemiologically to a reduced rate of suicide, and therefore the differences in overdose toxicity between antidepressants may be pertinent. Education of mental health workers regarding the effective treatment of mood disorders can help to reduce the rate of suicide. Patient education and psychological support can lead to improved compliance with prophylactic medication and early detection of relapse, but more formal psychotherapy does not appear to be helpful. Specialized mood disorder clinics lead to better patient care than is possible in a routine psychiatric out-patient clinic.


2015 ◽  
Vol 15 (2) ◽  
pp. 30-34
Author(s):  
K. Pecova

Abstract The author is presenting the case of a 23-year-old female patient with a severe form of acne conglobata, with the first symptoms of the disease occurring as far back as the prepubertal age. In the past year the disease has combined with hidradenitis suppurativa (to be referred to henceforth as “HS”), Hurley stage I, in the axillae and both sides of the inguinal region, with a family history of acne conglobata (both her mother and brother were affected). Further examinations ruled out inflammatory bowel disease because of a lack of further associated symptoms, except for sideropenic anaemia (lesser form) and lower serum values of vitamin D. Up until now the disease has been resistant to treatment, including the long-term treatment of methylprednisolone in combination with isotretinoid as well as dapsone and antibiotics.


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