scholarly journals Zolpidem dependence in an adult with bipolar affective disorder and epilepsy: A case report

2019 ◽  
Vol 32 (5) ◽  
pp. e100102
Author(s):  
Sujita Kumar Kar ◽  
Suyash Dwivedi

Zolpidem is a short-acting non-benzodiazepine hypnotic agent, commonly recommended for short-term treatment of insomnia. Zolpidem has less dependence potential than benzodiazepines. Patients with mental illnesses often have disturbed sleep, for which zolpidem is often prescribed. Long-term use and self-medication (in more than recommended doses) are more likely to cause dependence. We report here a case of bipolar affective disorder with epilepsy, who developed dependence to zolpidem and had severe withdrawal symptoms. The management issues are also discussed with review of the literature.

Author(s):  
سعيد مزعل موازي ◽  
يحيى فائق حسين ◽  
عبد المنعم دولاني ◽  
سيف يوسف عبدالله السويدي

Recently, many studies have been conducted to discover or improve cancers treatment. The current study aims to investigate the anticancer effect of thymoquinone, cordyceps, spirulina, ganoderma lucidium, poria cocos, and lion’s mane in four different concentrations 4, 8, 16, and 32 ug (equivalent to 1 mg/mL) in two different time treatments (48 and 96 hours) on human nasal epithelial cell line RPMI 2650. By using cell culture cytotoxicity techniques and assay, the highest anticancer effect on RPMI 2650 was obtained by thymoquinone. The lowest anticancer effect was demonstrated by poria cocos and cordyceps. However, these two medications showed higher anticancer effect when given in short-term treatment (48 hours) compared to long-term treatment (96 hours). Ganoderma lucidium and spirulina showed better impact than poria cocos, cordyceps, and lion’s mane in term of cells cytotoxicity. Mild to moderate antineoplastic effect was seen by utilizing lion’s mane treatment compared other drugs. Therefore, adopting a long-term treatment of high concentrations and doses of thymoquinone, cordyceps, spirulina, ganoderma lucidium, poria cocos, and lion’s mane can be more effective in the treatment of nasal cancer. In conclusion, these drugs were found to be a promising cancer remedy; therefore, they can be utilized as alternative treatment for nasal cancer or any other type of cancer therapy.


CNS Spectrums ◽  
1998 ◽  
Vol 3 (9) ◽  
pp. 64-71 ◽  
Author(s):  
Gary A. Christenson ◽  
Scott J. Crow ◽  
James E. Mitchell ◽  
Thomas B. Mackenzie ◽  
Ross D. Crosby ◽  
...  

AbstractThis short-term, open-label study investigates short- and long-term effects of the selective serotonin reuptake inhibitor (SSRI) fluvoxamine for the treatment of trichotillomania (TTM). Additionally, this study aimed to test the hypothesis that the presence of hair pulling compulsiveness is predictive of SSRI response. Nineteen subjects meeting the Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised, (DSM-III-R) criteria for TTM were treated with fluvoxamine at doses up to 300 mg/day. Random regression analysis of change across time for patients who completed the study (n=14) and those who dropped out (n=5) revealed statistically significant improvements in Physician Rating Scale, hair-pulling episodes, Trichotillomania Impairment Scale, and Trichotillomania Symptom Severity Scale, but not in estimated amount of hair pulled. In addition, the percentage of patients' focused or compulsive hair-pulling symptoms was predictive of treatment response. Unfortunately, all three subjects who entered long-term treatment displayed substantial movement back toward baseline by the end of 6 months. We concluded that fluvoxamine produces moderate reductions in symptoms during the short-term treatment of TTM and that the presence of focused or compulsive hair pulling may be predictive of treatment response. However, responses may be short lived when treatment is extended.


Author(s):  
N. N. Stenyaeva ◽  
D. F. Chritinin

In recent years, ideas about the regulation of the autonomic functions of the human body and the psychosomatic effects of sex hormones have expanded significantly. Dysregulation of the HPG-axis is involved in the pathogenesis of a number of stressassociated mental illnesses. Infertility and its long-term treatment is characterized by a long-term impact on patients of various stressful factors. Reproductive medicine has now made impressive advances in biotechnology. Reproductive medicine has now achieved impressive success due to the revolutionary development of biotechnologies. Nevertheless, a significant number of couples have to struggle unsuccessfully with infertility for many years, and the social consequences of this are extremely significant for the family and society as a whole. Taking into account the relationship between the mental and somatic health of infertile women, greater attention of clinicians to the mental sphere of patients, providing forced childless couples with the necessary psychological and psychiatric care will reduce stress during infertility treatment and increase patient satisfaction.


2020 ◽  
Vol 15 (2) ◽  
pp. 110-124
Author(s):  
Joy E. Ikekpeazu ◽  
Oliver C. Orji ◽  
Ikenna K. Uchendu ◽  
Lawrence U.S. Ezeanyika

Background and Objective: There may be a possible link between the use of HAART and oxidative stress-related mitochondrial dysfunction in HIV patients. We evaluated the mitochondrial and oxidative impacts of short and long-term administration of HAART on HIV patients attending the Enugu State University Teaching (ESUT) Hospital, Enugu, Nigeria following short and long-term therapy. Methods: 96 patients categorized into four groups of 24 individuals were recruited for the study. Group 1 comprised of age-matched, apparently healthy, sero-negative individuals (the No HIV group); group 2 consisted of HIV sero-positive individuals who had not started any form of treatment (the Treatment naïve group). Individuals in group 3 were known HIV patients on HAART for less than one year (Short-term treatment group), while group 4 comprised of HIV patients on HAART for more than one year (Long-term treatment group). All patients were aged between 18 to 60 years and attended the HIV clinic at the time of the study. Determination of total antioxidant status (TAS in nmol/l), malondialdehyde (MDA in mmol/l), CD4+ count in cells/μl, and genomic studies were all done using standard operative procedures. Results: We found that the long-term treatment group had significantly raised the levels of MDA, as well as significantly diminished TAS compared to the Short-term treatment and No HIV groups (P<0.05). In addition, there was significantly elevated variation in the copy number of mitochondrial genes (mtDNA: D-loop, ATPase 8, TRNALEU uur) in the long-term treatment group. Interpretation and Conclusion: Long-term treatment with HAART increases oxidative stress and causes mitochondrial alterations in HIV patients.


2017 ◽  
Vol 22 (6) ◽  
pp. 518-524 ◽  
Author(s):  
Marco P Donadini ◽  
Francesco Dentali ◽  
Samuela Pegoraro ◽  
Fulvio Pomero ◽  
Chiara Brignone ◽  
...  

Isolated distal deep vein thrombosis (IDDVT) is a common clinical manifestation of venous thromboembolism (VTE). However, there are only scant and heterogeneous data available on the long-term risk of recurrent VTE after IDDVT, and the optimal therapeutic management remains uncertain. We carried out a retrospective cohort study of consecutive patients diagnosed with symptomatic IDDVT between 2004 and 2011, according to a predefined short-term treatment protocol (low molecular weight heparin (LMWH) for 4–6 weeks). The primary outcome was the occurrence of recurrent VTE. A total of 321 patients were enrolled. IDDVT was associated with a transient risk factor or cancer in 165 (51.4%) and 56 (17.4%) patients, respectively. LMWH was administered for 4–6 weeks to 280 patients (87.2%), who were included in the primary analysis. Overall, during a mean follow-up of 42.3 months, 42 patients (15%) developed recurrent VTE, which occurred as proximal DVT or PE in 21 cases. The recurrence rate of VTE per 100 patient-years was 3.5 in patients with transient risk factors, 7.2 in patients with unprovoked IDDVT, and 5.9 in patients with cancer ( p=0.018). At multivariable analysis, unprovoked IDDVT and previous VTE were significantly associated with recurrent VTE (HR 2.16, 95% CI 1.12–4.16 and HR 1.97, 95% CI 1.01–3.86, respectively). In conclusion, the long-term risk of recurrent VTE after IDDVT treated for 4–6 weeks is not negligible, in particular in patients with unprovoked IDDVT or cancer. Further studies are needed to clarify whether a longer, but definite treatment duration effectively prevents these recurrences.


Author(s):  
Tom Burns ◽  
Mike Firn

This chapter deals with the other major psychotic illness, bipolar affective disorder. Bipolar disorder poses a difficult question for outreach workers, as patients are often well recovered between episodes—so should persisting outreach be provided? We report very good results in severe bipolar disorder where continuity of care has paid off. The chapter also deals with theories of causation and classification. The section on treatment identifies the importance of early admission in hypomania, the use of mood stabilizers, and the value of identifying and agreeing on relapse signatures. It also confirms the value of working hard to strengthen the therapeutic relationship and of psychosocial interventions such as psycho-education. Long-term work with these patients brings home just how persistent and disabling the depressive phases can be.


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