scholarly journals Olanzapine-induced leucopaenia and thrombocytopaenia in an elderly patient: a case report and review of the evidence

2018 ◽  
Vol 31 (2) ◽  
pp. e000013 ◽  
Author(s):  
Yogender Kumar Malik ◽  
Swapnajeet Sahoo ◽  
Ajit Avasthi
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
Side Effects ◽  
Case Reports ◽  
The Elderly ◽  
Elderly Individual ◽  
Psychotic Symptoms ◽  
Elderly Individuals ◽  
Second Generation Antipsychotics ◽  
Life Threatening

Haematological adverse effects of antipsychotics are rare but life threatening. Existing literature is limited to case reports, which are mostly reported on second generation antipsychotics (clozapine, olanzapine, risperidone, quetiapine). Elderly individuals are at risk of developing side effects with any psychotropics. Olanzapine is commonly used for the management of psychotic symptoms as well as for the management of behavioural and psychological problems with dementia in the elderly. In this case report, we report thrombocytopaenia and leucopaenia in an elderly individual with schizophrenia which developed after initiation of olanzapine and reverted back after stoppage of the drug. This case report highlights that the elderly are susceptible to develop haematological side effects with olanzapine and hence monitoring may be essential.

Antipsychotics-induced leukopenia and neutropenia: A case report and review of literature

2016 ◽  
Vol 33 (S1) ◽  
pp. S546-S546 ◽  
Author(s):  
H. Maatallah ◽  
H. Ben Ammar ◽  
M. Said ◽  
A. Aissa
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Atypical Antipsychotics ◽  
Antipsychotic Drugs ◽  
Psychotic Symptoms ◽  
Review Of Literature ◽  
Blood Cell Count ◽  
Life Threatening ◽  
Dsm Iv ◽  
Competing Interest

IntroductionAntipsychotic drugs effectively control psychotic symptoms, but may cause important side effects, significantly increasing morbidity and mortality. Hematologic abnormalities are frequent and may be life-threatening in some patients. Many prospective investigations confirmed neutropenia as a frequent occurrence with virtually all atypical antipsychotics.Objective and methodsDefine epidemiological, clinical and therapeutic characteristics of antipsychotics – induced leukopenia and neutropenia through a case report and a review of literature.Case reportPatient 28 years old native of Tunis, with family history: brother who suffer of undifferentiated schizophrenia. Since the age of 16 years he has been followed for disorganized schizophrenia (DSM IV). He was initially put under Haldol Decanoate (2 months), fluphenazine (2 months), amisulpride (3 months), sulpride (2 months), olanzapine (3 months), Rispreridone (1 month), aripiprazole (5 months) leukopenia/neutropenia is occurring during treatment with each molecule and which promptly resolved after discontinuation. Reduced white blood cell count has also been reported after addition of lithium. Actually an ECT is proposed for this patient.ConclusionThis case report shows the importance of hematological monitoring during the course of typical or atypical treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Use of amisulpride in clozapine-resistant schizophrenic patients: Three case reports

2011 ◽  
Vol 26 (S2) ◽  
pp. 1338-1338
Author(s):  
S.E. Ahlund ◽  
I. Gosai
Keyword(s):  
Side Effects ◽  
Treatment Option ◽  
Case Reports ◽  
Clinical Results ◽  
Psychotic Symptoms ◽  
Large Numbers ◽  
Second Generation Antipsychotics ◽  
Insufficient Response ◽  
Schizophrenic Patients

IntroductionIt is generally accepted that Clozapine is the gold standard treatment in patients with treatment resistant schizophrenia. Large numbers of patients treated with Clozapine discontinue treatment for various reasons including severe side-effects and insufficient response. There is limited literature supporting the next-step treatment option following the discontinuation of Clozapine.ObjectivesThe atypical antipsychotic Amisulpride as a next-step treatment option beyond Clozapine, is hypothesised to be useful in some patients due to its first pass metabolism which differs from other second generation antipsychotics. The authors present the clinical response from using Amisulpride in three Clozapine-resistant schizophrenic patients.AimsThe authors aim to demonstrate the role of Amisulpride monotherapy in patients with schizophrenia who are resistant to, Clozapine.MethodThree cases of individuals with residual psychotic symptoms despite Clozapine use and/ or with significant side effects precipitating discontinuation, are presented. They were changed to Amisulpiride and their response was evaluated by clinical assessment.ResultsPositive clinical results were obtained in all three patients, with improvement of psychotic symptoms and of some of the more common side effects of Clozapine.ConclusionThe findings from these cases suggest that Amisulpride can be of benefit in treating Clozapine-resistant schizophrenic patients. Further, more structured trials are needed to understand these findings.

Arterial hypertension + past stroke – a case report

2021 ◽  
Vol 14 (3) ◽  
pp. 324-326
Author(s):  
Maria Łukasiewicz ◽  
Marta Swarowska-Skuza
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Chronic Disease ◽  
Side Effects ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Systolic Hypertension ◽  
The Elderly ◽  
Isolated Systolic Hypertension ◽  
Special Group

Arterial hypertension, as a very widespread chronic disease, and thus differing in both pathomechanism and course in patients, requires a significant individualization of pharmacotherapy. One such special group is the elderly. Both the low-renin pathomechanism of arterial hypertension and its phenotype (isolated systolic hypertension) imply the choice of a specific pharmacotherapy. Additionally, in this group, side effects should be observed much more vigilantly, while target blood pressure values should be treated more liberally. An example of antihypertensive therapy in a patient belonging to the group described is presented in the following case.

Delirium on clozapine: A tale of friend turned foe-A case report

2020 ◽  
pp. 009121742097282 ◽  
Author(s):  
Aparna Das ◽  
Rebecca Minner ◽  
Lewis Krain ◽  
John Spollen
Keyword(s):  
Case Report ◽  
Clinical Practice ◽  
Side Effects ◽  
Adverse Effects ◽  
Older Adult ◽  
Psychiatric Illness ◽  
Management Strategies ◽  
Treatment Resistant ◽  
Drug Of Choice ◽  
Life Threatening

Treatment resistant schizophrenia (TRS) is often encountered in clinical practice. Clozapine remains the drug of choice in the management of TRS. Several studies have shown that clozapine is the most effective antipsychotic medication to date for TRS. But it is also well known that it has multiple side effects. Some side effects are transient and relatively benign, while other adverse effects are menacing, serious and life-threatening. Delirium may occur with clozapine and is a therapeutic challenge as there is always a risk of precipitating delirium on clozapine rechallenge. Limited management strategies are available as alternatives for the management of psychiatric illness stabilized on clozapine. In this case report, we describe an older adult patient who developed delirium on clozapine. The aims of this case report are to discuss the mechanism by which clozapine leads to delirium, revisit various factors which could possibly lead to delirium, and discuss the different management strategies available for management of psychiatric illness for a patient previously stabilized on clozapine.

Risperidone in the treatment of psychoses in the elderly: a case report series

2002 ◽  
Vol 17 (2) ◽  
pp. 96-103 ◽  
Author(s):  
R. Bullock ◽  
S. Libretto
Keyword(s):  
Side Effects ◽  
Elderly Patients ◽  
Negative Symptoms ◽  
Case Reports ◽  
Antipsychotic Agents ◽  
The Elderly ◽  
The Body ◽  
Continuous Treatment ◽  
Atypical Antipsychotic Agents

SummaryRisperidone is one of the newer atypical antipsychotic agents, which combines potent serotonin and dopamine receptor antagonism. It shows efficacy against the positive and negative symptoms of schizophrenic psychoses and other psychotic conditions, and has a low propensity to cause extrapyramidal side effects. The aim of these case reports in elderly patients is to provide the benefit of personal experience with risperidone to the body of published literature and to demonstrate the types of patients that may benefit from treatment. These cases were compiled retrospectively from data collected on referral and during routine hospital appointments. This series covers four main areas of concern when treating the elderly: low-maintenance dosing minimising the likelihood of adverse events; successful treatment of patients previously uncontrolled and experiencing side effects with other antipsychotics; the possibility of intermittent rather than continuous treatment; and the benefits to patients, carers and the health services. At low doses, risperidone is an effective and well-tolerated treatment for psychoses in elderly patients that improves the quality of life for both patients and their caregivers.

Fatal hyperkalemia following succinylcholine administration in a child on oral propranolol

2015 ◽  
Vol 30 (1) ◽  
Author(s):  
Anuradha Ganigara ◽  
Chandrakala Ravishankar ◽  
Chandrika Ramavakoda ◽  
Madhavi Nishtala
Keyword(s):  
Drug Interaction ◽  
Case Report ◽  
Side Effects ◽  
Drug Combination ◽  
Neuromuscular Block ◽  
Severe Effect ◽  
Adrenergic Blocker ◽  
Life Threatening ◽  
Adrenergic Blockers ◽  
Oral Propranolol

AbstractSuccinylcholine is one of the most commonly used drugs by anesthesiologists worldwide for rapid access to airway both in emergency and elective situations. Nonetheless, the very mention of succinylcholine generates the most energetic high decibel debate between its users and nonusers. Despite its potential to produce a short-acting, ultra-intense neuromuscular block rapidly in seconds, it is surrounded by a plethora of side effects and drug interactions. This case report is about one such drug interaction of this innocent yet malicious drug, which resulted in the death of a 14-year-old girl. Both β-adrenergic blockers and succinylcholine are known to cause hyperkalemia. Life-threatening hyperkalemia in susceptible individuals who have been administered succinylcholine has the most severe effect on the myocardium and can result in asystole with minimal chances of resuscitation. Both succinylcholine and a nonselective β-adrenergic blocker, propranolol, have the propensity to affect the transcellular redistribution of potassium which can result in hyperkalemia. We advocate cautious use of this drug combination till further studies confirm the drug interaction and find the potential triggering factors involved.

Risperidone-Induced Neuroleptic Malignant Syndrome: A Case Report and Review

1996 ◽  
Vol 41 (1) ◽  
pp. 52-54 ◽  
Author(s):  
Gb Meterissian
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Neuroleptic Malignant Syndrome ◽  
Clinical Features ◽  
Prior History ◽  
Extrapyramidal Side Effects ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication ◽  
The One

Objectives: 1. To report the case of a 53-year-old patient who developed neuroleptic malignant syndrome (NMS) — a rare but potentially life-threatening complication of neuroleptic therapy — 4 days after treatment with risperidone was initiated. 2. To review previously reported cases of NMS associated with risperidone. Methods: A computerized search of several databases, including MEDLINE, was conducted to find all previously reported cases of NMS with risperidone. Results: Five reported cases of risperidone-induced NMS were found in the literature. All cases including the one reported here displayed typical clinical features of NMS and all 6 patients had a prior history of extrapyramidal side effects and/or NMS. Age and duration of exposure to risperidone did not seem to be of significance. Conclusions: These cases illustrate that clinicians should be on the lookout for risperidone-induced NMS.

Decision-Making in Old Age: Cautiousness and Rigidity

1981 ◽  
Vol 13 (2) ◽  
pp. 89-98 ◽  
Author(s):  
Richard E. Calhoun ◽  
Sam L. Hutchison
Keyword(s):  
Decision Making ◽  
Old Age ◽  
The Elderly ◽  
Elderly Individual ◽  
Elderly Individuals ◽  
Two Factors ◽  
Behavioral Rigidity ◽  
Elderly Participant ◽  
Risky Decisions

The purpose of the present study was to test the findings of Botwinick's work on cautiousness and decision-making in old age [1, 2], along with an examination of two factors not previously studied: rigidity and certainty of decision outcome. Sixty-four elderly participants of both sexes participated in filling out the Choice Dilemmas Questionnaire (CDQ) after having been classified as high or low on Schaie's Test of Behavioral Rigidity [3]. In general, Botwinick's conclusions were supported: 1. when given the opportunity to avoid making decisions on the CDQ, the elderly did so, even under conditions of no risk at all concerning the outcome of the decision; 2. elderly individuals appeared to become more conservative and cautious in their decisions when the outcome was directed at the lives of young individuals than when older individual's lifestyles were of concern. This latter phenomenon, however, was not seen when the elderly participant was required to make a decision and could not elect to abstain. In addition, rigidity was found to be related to risky decisions made by the elderly individual.

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