Antipsychotic pitfalls: idiopathic intracranial hypertension and antipsychotic-induced weight gain

2020 ◽  
Vol 13 (6) ◽  
pp. e236161 ◽  
Author(s):  
Hirofumi Namiki
Keyword(s):  
Quality Of Life ◽  
Weight Gain ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
First Generation ◽  
Vision Loss ◽  
Blurred Vision ◽  
Poor Vision ◽  
Second Generation Antipsychotics

Idiopathic intracranial hypertension (IIH) is a condition associated with poor vision and headaches that can cause disability and reduced quality of life. The onset of IIH is typically associated with sudden weight gain and obesity, which may be due to first-generation or second-generation antipsychotics. This case involved the use of quetiapine in an obese, 28-year-old woman; she gained significant weight after starting the antipsychotic and later developed headaches and blurred vision. Reducing quetiapine and administering acetazolamide significantly improved her symptoms within 4 weeks. This case reminds physicians to consider IIH as a cause of headache and vision loss in patients who have gained weight after starting or increasing quetiapine.

Profiles of Obesity, Weight Gain, and Quality of Life in Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)

2007 ◽  
Vol 143 (4) ◽  
pp. 635-641.e1 ◽  
Author(s):  
Anthony B. Daniels ◽  
Grant T. Liu ◽  
Nicholas J. Volpe ◽  
Steven L. Galetta ◽  
Mark L. Moster ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Gain ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Pseudotumor Cerebri

Health-related quality of life in patients with uveitis

2018 ◽  
Vol 103 (9) ◽  
pp. 1284-1288 ◽  
Author(s):  
Mohith Shamdas ◽  
Kerolos Bassilious ◽  
Philip Ian Murray
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Vision Loss ◽  
Glaucomatous Optic Neuropathy ◽  
Health Related Quality ◽  
Poor Vision ◽  
Five Dimensions ◽  
Related Quality ◽  
Health Related

Background/aimsTo measure health-related quality of life (HRQOL) in patients with uveitis using time trade-off (TTO) and standard gamble (SG) methods of direct utility analysis.MethodsConsecutive patients attending a tertiary referral uveitis clinic were administered standardised, interview-delivered TTO and SG questionnaires and completed the European Quality of Life Five Dimensions Five Level (EQ5D-5L) questionnaire. Clinical data recorded included best-corrected visual acuity, uveitis anatomical and clinical classifications, duration since diagnosis, disease activity, current medication and any ocular or systemic comorbidities.ResultsTwo hundred patients with uveitis (124 female, 76 male, median age 54 years) were included. Overall mean TTO utility was 0.831 (95% CI 0.802 to 0.860); mean SG utility was 0.868 (95% CI 0.840 to 0.896) and mean EQ5D-5L utility was 0.742 (95% CI 0.702 to 0.782). There was a negative correlation between visual acuity and mean HRQOL (6/12 or better: TTO 0.86, SG 0.893; 6/15–6/60: TTO 0.662, SG 0.742; worse than 6/60: TTO 0.608, SG 0.712). Poor vision in the better- seeing eye (p=0.004), bilateral disease (p=0.047) and concurrent glaucomatous optic neuropathy (p=0.005) were predictors of poor TTO HRQOL. No correlation was found between HRQOL and duration of diagnosis, a flare of uveitis or being on systemic therapy. Patients with uveitis with poor vision have a TTO value worse than patients with end-stage renal failure on haemodialysis or those with AIDS.ConclusionLoss of vision resulting from uveitis is associated with reduced HRQOL. The TTO and SG utility values appear directly dependent on the degree of vision loss and not on the duration of disease or systemic medications.

scholarly journals Intracranial Pressure Directly Predicts Headache Morbidity in Idiopathic Intracranial Hypertension

2021 ◽  
Author(s):  
Susan Mollan ◽  
Benjamin Wakerley ◽  
Zerin Alimajstorovic ◽  
James Mitchell ◽  
Ryan Ottridge ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Body Mass ◽  
Idiopathic Intracranial Hypertension ◽  
Positive Association ◽  
Headache Severity ◽  
Cutaneous Allodynia

Abstract Objective: Headache is the predominant disabler in idiopathic intracranial hypertension (IIH). The aim was to characterise headache and investigate the association with intracranial pressure.Methods: IIH:WT was a randomised controlled parallel group multicentre trial in the United Kingdom investigating weight management methods in IIH. Participants with active IIH (evidenced by papilloedema) and a body mass index (BMI) ≥35kg/m2 were recruited. At baseline, 12 months and 24 months headache characteristics and quality of life outcome measures were collected and lumbar puncture measurements were performed.Results: Sixty-six women with active IIH were included with a mean age of 32.0 years (SD ± 7.8), and mean body mass index of 43.9 ± 7.0 kg/m2. The headache phenotype was migraine-like in 86%. Headache severity correlated with ICP at baseline (r=0.285; p=0.024); change in headache severity and monthly headache days correlated with change in ICP at 12 months (r=0.454, p=0.001 and r=0.419, p=0.002 respectively). Cutaneous allodynia was significantly correlated with ICP at 12 months. (r=0.479, p<0.001). Boot strap analysis noted a positive association between ICP at 12 and 24 months and enabled prediction of both change in headache severity and monthly headache days. ICP was associated with significant improvements in quality of life (SF-36).Conclusions: We demonstrate a positive relationship between ICP and headache and cutaneous allodynia, which has not been previously reported in IIH. Those with the greatest reduction in ICP over 12 months had the greatest reduction in headache frequency and severity; this was associated with improvement of quality of life measures.Classification of evidence: This work provides Class IIa evidence of the association of raised intracranial pressure and headache. ClinicalTrials.gov number, NCT02124486.

scholarly journals Emergency department utilization among individuals with idiopathic intracranial hypertension

2019 ◽  
Vol 32 (1) ◽  
pp. 152-163
Author(s):  
Sean Murphy ◽  
Daniel L. Friesner ◽  
Robert Rosenman ◽  
Carin S. Waslo ◽  
Johnathan Au ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Private Insurance ◽  
Symptom Relief ◽  
Emergency Department Utilization ◽  
Life Questionnaire ◽  
Content Type ◽  
Shunt Procedure

Purpose Idiopathic intracranial hypertension (IIH) can be a debilitating disorder that is difficult to identify and treat. Failure to adequately manage IIH symptoms may force patients to present at emergency departments (EDs) seeking symptom relief. The purpose of this paper is to empirically characterize ED use by previously diagnosed IIH patients. Design/methodology/approach Patients diagnosed with IIH, and who registered with the Intracranial Hypertension Registry by 2014, were solicited for study inclusion. A survey was designed to elicit ED use during the period 2010–2012. Information on demographic and socioeconomic characteristics, IIH signs and symptoms, time since diagnosis, perspectives of ED use and quality of life was collected. Quality of life was assessed using an adaptation of the Migraine-Specific Quality of Life Questionnaire. Data were analyzed using descriptive statistics and nonparametric hypothesis tests. Findings In total, 39 percent of IIH patients used emergency services over the study period; those that did used the services intensely. These patients were more likely to be non-white, live in households making less than $25,000 annually, have public insurance and have received a diversional shunt procedure. Patients who used the ED were less likely to live in households making $100,000, or more, annually and have private insurance. Participants who used the ED had significantly lower quality-of-life scores, were younger and had been diagnosed with IIH for less time. Originality/value ED staff and outside physicians can utilize the information contained in this study to more effectively recognize the unique circumstances of IIH patients who present at EDs.

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