Carbamazepine-induced delayed-onset agranulocytosis in a case of bipolar disorder with Kikuchi’s disease

2021 ◽  
Vol 14 (6) ◽  
pp. e241973
Author(s):  
Cebasta Irudayaraj ◽  
Raviteja Innamuri ◽  
Dheeraj Kattula
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Symptoms ◽  
Drug Effects ◽  
Significant Loss ◽  
Drug Induced ◽  
Kikuchi’S Disease ◽  
Delayed Onset ◽  
Loss Of Weight ◽  
Kikuchi's Disease

A 48-year-old man who is a known case of bipolar disorder was maintaining well on a combination of carbamazepine and quetiapine for 3 years until he developed fever, severe leucopenia and lymphadenopathy, along with significant loss of weight and appetite. A thorough investigation revealed Kikuchi’s disease as a likely histological diagnosis. Carbamazepine was discontinued and quetiapine was titrated for the management of psychiatric symptoms. The patient gradually made good recovery following discontinuation of carbamazepine and the diagnosis of drug-induced myelosuppression was retained. Clinicians need to be aware of the adverse effects of medications being used for long-term prophylaxis and other possible conditions that may change the course of drug effects.

scholarly journals Affective Temperaments and Illness Severity in Patients with Bipolar Disorder

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 54
Author(s):  
Mario Luciano ◽  
Luca Steardo ◽  
Gaia Sampogna ◽  
Vito Caivano ◽  
Carmen Ciampi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Protective Factor ◽  
Psychiatric Symptoms ◽  
Control Group ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Affective Temperaments

Background and objectives: Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and the highest suicide rate. Although affective temperaments can impact on BD long-term outcome, their role remains poorly investigated. The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to assess the relation between affective temperaments and severity of clinical picture in a sample of patients with BD. Materials and Methods: A total of 199 patients have been recruited in the outpatients units of two university sites. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments. Results: Predominant cyclothymic and irritable temperaments are associated to higher number of relapses, poorer quality of life, higher rates of aggressive behaviors, and suicide attempts. Conversely, the predominant hyperthymic disposition was a protective factor for several outcome measures, including relapse rate, severity of anxiety, depressive and manic symptoms, suicidality, and earlier age at onset. One limitationo of the present study is that the recruitment took place in two university sites; therefore, our findings cannot be fully generalized to the whole community of BD patients. Other limitations are the lack of a control group and the cross-sectional design of the study. Conclusions: The early identification of affective temperaments can help clinicians to identify those BD patients who are more likely to show a poor long-term outcome. An early screening of affective temperaments can be useful to develop targeted integrated pharmacological and psychosocial interventions.

scholarly journals Drug induced psychiatric disorder-A mini review

2019 ◽  
Vol 10 (4) ◽  
pp. 3263-3268
Author(s):  
Nivetha S. R ◽  
Divya M ◽  
Arul B ◽  
Kothai R
Keyword(s):  
Drug Abuse ◽  
Psychiatric Disorder ◽  
Drug Dependence ◽  
Psychiatric Symptoms ◽  
Patient Counseling ◽  
Drug Induced ◽  
General Management

This article reviews the agents that are responsible for producing psychiatric symptoms in an individual as a result of drug abuse, which may lead to delusions and hallucinations. There are several categories of drug that are responsible for producing psychiatric syndromes such as benzodiazepines, cannabis, amphetamines, alcohol, inhalants and hallucinogens. Long term use of these drugs may lead to drug dependence, intoxication and may even worsen the condition. The general management of drug-induced psychiatric disorder is to minimize the use of the drug, gradual withdrawal of the drug and patient counseling.

scholarly journals Sodium valproate induced acute pancreatitis in a bipolar disorder patient: a case report

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Wanli Huang ◽  
Xin Ren ◽  
Fang Shen ◽  
Baoping Xing
Keyword(s):  
Bipolar Disorder ◽  
Acute Pancreatitis ◽  
Sodium Valproate ◽  
Pediatric Patients ◽  
Drug Effects ◽  
Mood Stabilizers ◽  
Amylase Level ◽  
Drug Induced ◽  
First Onset ◽  
High Level

Abstract Background Sodium valproate is one of the most widely used antiepileptics and mood stabilizers. However, this drug may induce acute pancreatitis. Few cases have been reported so far, mainly on the pediatric patients who underwent antiepileptic treatment. Hereby, we present a case of bipolar disorder with sodium valproate-induced acute pancreatitis. Case presentation The patient is a 54-year-old Chinese male. He was diagnosed with bipolar disorder for more than 39 years. Since the first onset of the disease, he had several relapses. The patient had had sodium valproate to stabilize mood swings for a year before the occurrence of acute pancreatitis. But he did vomit once during the inpatient care period. Then he was referred to another hospital following a notably high level of amylase. The results of computed tomography demonstrated an increased pancreatic volume and swollen peripancreatic fat tissue. As a result, the patient was diagnosed with acute pancreatitis. Unlike other cases reported in literatures, the high amylase level did not revert to normal after the withdrawal of medications. The patient was discharged from hospital with a high level of amylase, and was placed under follow-up observations. Conclusion Acute pancreatitis is considered as one of the idiosyncratic adverse reactions to antiepileptic drugs. Previous reports were mainly on the pediatric patients with increased propensity to idiosyncratic drug effects, or the adult chronic renal failure patients with sodium valproate-induced pancreatitis due to the retention of intermediate metabolites in their bodies. In this study, even though our patient exhibited no high risk of developing pancreatitis, he was treated for drug-induced acute pancreatitis in three hospitals. As rare as drug-induced acute pancreatitis can be, it should not be overlooked, Moreover, the mechanism of how sodium valproate induces acute pancreatitis remains unknown. Therefore, physicians need to consider the medical history of patients before prescribing this medication.

Does provider adherence to a treatment guideline change clinical outcomes for patients with bipolar disorder? Results from the Texas Medication Algorithm Project

2005 ◽  
Vol 35 (12) ◽  
pp. 1695-1706 ◽  
Author(s):  
ELLEN B. DENNEHY ◽  
TRISHA SUPPES ◽  
A. JOHN RUSH ◽  
ALEXANDER L. MILLER ◽  
MADHUKAR H. TRIVEDI ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Clinical Outcomes ◽  
Psychiatric Symptoms ◽  
Treatment Guideline ◽  
Patient Characteristics ◽  
Manic Symptoms ◽  
Provider Adherence ◽  
Over Time

Background. Despite increasing adoption of clinical practice guidelines in psychiatry, there is little measurement of provider implementation of these recommendations, and the resulting impact on clinical outcomes. The current study describes one effort to measure these relationships in a cohort of public sector out-patients with bipolar disorder.Method. Participants were enrolled in the algorithm intervention of the Texas Medication Algorithm Project (TMAP). Study methods and the adherence scoring algorithm have been described elsewhere. The current paper addresses the relationships between patient characteristics, provider experience with the algorithm, provider adherence, and clinical outcomes. Measurement of provider adherence includes evaluation of visit frequency, medication choice and dosing, and response to patient symptoms. An exploratory composite ‘adherence by visit’ score was developed for these analyses.Results. A total of 1948 visits from 141 subjects were evaluated, and utilized a two-stage declining effects model. Providers with more experience using the algorithm tended to adhere less to treatment recommendations. Few patient factors significantly impacted provider adherence. Increased adherence to algorithm recommendations was associated with larger decreases in overall psychiatric symptoms and depressive symptoms over time, but did not impact either immediate or long-term reductions in manic symptoms.Conclusions. Greater provider adherence to treatment guideline recommendations was associated with greater reductions in depressive symptoms and overall psychiatric symptoms over time. Additional research is needed to refine measurement and to further clarify these relationships.

What is the optimal serum lithium level in the long-term treatment of bipolar disorder? A review

2007 ◽  
Vol 40 (06) ◽  
Author(s):  
E Severus ◽  
N Kleindienst ◽  
F Seemüller ◽  
S Frangou ◽  
HJ Möller ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Term Treatment ◽  
Lithium Level ◽  
Serum Lithium Level ◽  
Long Term Treatment

A Case of Kikuchi's Disease Associated with Hemophagocytic Syndrome

2011 ◽  
Vol 54 (12) ◽  
pp. 859
Author(s):  
Hyun Ji Kim ◽  
Jin Young Park ◽  
Sung Min Chung ◽  
Han Su Kim
Keyword(s):  
Hemophagocytic Syndrome ◽  
Kikuchi’S Disease ◽  
Kikuchi's Disease

Hashimoto encephalopathy

2013 ◽  
Vol 154 (33) ◽  
pp. 1312-1316 ◽  
Author(s):  
Gábor Pocsay ◽  
Andrea Gazdag ◽  
József Engelhardt ◽  
István Szaniszló ◽  
Zoltán Szolnoki ◽  
...  
Keyword(s):  
Psychiatric Symptoms ◽  
Immunosuppressive Treatment ◽  
Unknown Origin ◽  
Corticosteroid Treatment ◽  
Thyroid Peroxidase ◽  
Thyroid Autoantibodies ◽  
Thyroglobulin Antibodies ◽  
Hashimoto Encephalopathy ◽  
Generalized Seizures

The authors present a case report and review the literature on Hashimoto encephalopathy. The onset of the disease may be marked by focal and then progressively generalized seizures or other neurological symptoms, but a cognitive decline or various psychiatric symptoms may also emerge. High levels of anti-thyroid peroxidase antibodies and/or anti-thyroglobulin antibodies are present in the serum. Corticosteroid treatment usually results in an improvement of symptoms. The syndrome is frequently overlooked and, therefore, the authors strongly recommend testing serum thyroid autoantibodies in cases with encephalopathy of unknown origin independently on the presence of thyroid disease in the patient or family history. The importance of long-term immunosuppressive treatment should also be stressed. Orv. Hetil., 2013, 154, 1312–1316.

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