scholarly journals A Case Report of Severe Delirium after Amantadine Withdrawal

2017 ◽  
Vol 9 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Franz Marxreiter ◽  
Jürgen Winkler ◽  
Martin Uhl ◽  
Dominik Madžar
Keyword(s):  
Cognitive Impairment ◽  
Case Report ◽  
Withdrawal Syndrome ◽  
Dopamine Agonists ◽  
Psychotic Symptoms ◽  
Drug Induced ◽  
Comt Inhibitors ◽  
Mao B ◽  
Psychotropic Substance

Amantadine is frequently used in addition to dopaminergic substances like dopamine agonists or L-Dopa in advanced Parkinson disease (PD). However, adverse effects like hallucinations limit its use. PD patients developing severe psychotic symptoms upon treatment with either dopaminergic substances and/or amantadine need to stop intake of any psychotropic substance. Here, we report the case of a 71-year-old PD patient without previously known cognitive impairment. He presented with drug-induced psychotic symptoms due to changes in his therapeutic regimen (increase in COMT inhibitors, newly introduced MAO B inhibitors). Also, amantadine had been part of his long-term medication for more than 2 years. The severity of his psychotic symptoms required a L-Dopa monotherapy. After changing his medication, the patient developed severe delirium that resolved rapidly after i.v. amantadine infusion, suggesting an amantadine withdrawal syndrome. Amantadine withdrawal syndrome is a rare adverse event that may present even in PD patients without cognitive impairment. This case report highlights the need for a gradual withdrawal of amantadine even if acute and severe psychotic symptoms are present. Moreover, this is the first report of a cognitively unimpaired patient developing an amantadine withdrawal syndrome.

Lithium-Induced Parathyroid Dysfunction: A Case Report and Review of the Literature

1993 ◽  
Vol 27 (9) ◽  
pp. 1040-1043 ◽  
Author(s):  
Jerry W. Taylor ◽  
Angela J. Bell
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
Lithium Carbonate ◽  
Suspected Drug ◽  
Current Management ◽  
Therapy Discontinuation ◽  
Drug Induced ◽  
Parathyroid Dysfunction ◽  
Management Recommendations

OBJECTIVE: Twenty-six cases of lithium-induced hyperparathyroidism have been reported in the literature. This article describes an additional case that illustrates current management recommendations. DESIGN: Case report. Clinical presentation and proposed mechanisms of the suspected drug-induced effect are discussed. CONCLUSIONS: Serum calcium concentrations should be determined before and periodically during long-term lithium carbonate therapy. Discontinuation of therapy in patients who develop lithium-induced parathyroid dysfunction generally corrects calcium and parathyroid hormone concentrations. Surgery is indicated in patients with complications of hyperparathyroidism.

Prevalence of Obesity in Patients Receiving Depot Antipsychotics

1988 ◽  
Vol 153 (2) ◽  
pp. 214-217 ◽  
Author(s):  
T. Silverstone ◽  
Glenyss Smith ◽  
Elizabeth Goodall
Keyword(s):  
Antipsychotic Drugs ◽  
Clinical Importance ◽  
Chronic Schizophrenia ◽  
Psychotic Symptoms ◽  
Drug Induced ◽  
London Borough ◽  
Prevalence Of Obesity ◽  
Depot Neuroleptic ◽  
Depot Antipsychotics

Antipsychotic drugs have long been noted to cause pronounced weight gain, and drug-induced obesity can assume major clinical importance in long-term medication in the management of chronic schizophrenia. Obesity is associated with increased morbidity and may reduce compliance, leading to a return of psychotic symptoms. In a survey of 226 patients attending depot neuroleptic clinics in one inner London borough, it was found that the prevalence of clinically relevant obesity was four times that in the general population.

scholarly journals Long-lasting rescue of schizophrenia-relevant cognitive impairments via risperidone-loaded microPlates

2022 ◽  
Author(s):  
Elena Bellotti ◽  
Gabriella Contarini ◽  
Federica Geraci ◽  
Sebastiano Alfio Torrisi ◽  
Cateno Piazza ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mouse Model ◽  
Sustained Release ◽  
Temporal Order ◽  
Single Injection ◽  
Chronic Administration ◽  
Psychotic Symptoms ◽  
Residual Rate ◽  
Long Acting

AbstractSchizophrenia is a disorder characterized by cognitive impairment and psychotic symptoms that fluctuate over time and can only be mitigated with the chronic administration of antipsychotics. Here, we propose biodegradable microPlates made of PLGA for the sustained release of risperidone over several weeks. Two microPlate configurations – short: 20 × 20 × 10 μm; tall: 20 × 20 × 20 μm – are engineered and compared to conventional ~ 10 μm PLGA microspheres in terms of risperidone loading and release. Tall microPlates realize the slowest release documenting a 35% risperidone delivery at 100 days with a residual rate of 30 ng/ml. Short microPlates and microspheres present similar release profiles with over 50% of the loaded risperidone delivered within the first 40 days. Then, the therapeutic efficacy of one single intraperitoneal injection of risperidone microPlates is compared to the daily administration of free risperidone in heterozygous knockout mice for dysbindin-1, a clinically relevant mouse model of cognitive and psychiatric liability. In temporal order object recognition tasks, mice treated with risperidone microPlates outperform those receiving free risperidone up to 2, 4, 8, and 12 weeks of observation. This suggests that the sustained release of antipsychotics from one-time microPlate deposition can rescue cognitive impairment in dysbindin mice for up to several weeks. Overall, these results demonstrate that risperidone-loaded microPlates are a promising platform for improving cognitive symptoms associated to schizophrenia. Moreover, the long-term efficacy with one single administration could be of clinical relevance in terms of patient’s compliance and adherence to the treatment regimen. Graphical abstract Single injection of long-acting risperidone-loaded µPL ameliorates the dysbindin-induced deficit in a clinically relevant mouse model of cognitive and psychiatric liability for up to 12 weeks

scholarly journals The effectiveness of long-term aripiprazole injections to a patient with paranoid schizophrenia: a case report

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Anna Maria Szota ◽  
Aleksander Araszkiewicz
Keyword(s):  
Case Report ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Paranoid Schizophrenia ◽  
Psychotic Symptoms ◽  
Suicidal Thoughts ◽  
Duration Of Hospitalization ◽  
History Of ◽  
Long Acting

AbstractParanoid schizophrenia is a chronic, psychotic disorder which can be treated with long-acting injectable (LAI) antipsychotic drugs. There are risperidone (Risperdal Consta®), olanzapine (Zypadhera®), paliperidone (Xepilon®) and aripiprazole (Abilify Maintena®) currently available.The aim of this study was to present a case history of the patient to whom monthly injections of aripiprazole effectively prevented both relapses of psychotic symptoms and hospitalizations.Case report: A 55-year-old male patient with a 13-year history of paranoid schizophrenia has been effectively treated with aripiprazole (LAI) (400mg, every 4 weeks). During the last 8 years of treatment his mental state has been stabilized, without any acute psychotic symptoms and without any anxiety, or violent behaviours. Moreover, there have been no psychotic symptoms, or suicidal thoughts, or tendencies recordered. Therefore, no hospitalization has been required. However, despite the treatment, negative symptoms such as blunted affect, cognitive dysfunction and social withdrawal have been sustained.Discussion: The available articles on aripiprazole (LAI) treatment indicate that it was effective in reducing the positive and negative symptoms of schizophrenia, as well as reducing the frequency and duration of hospitalization. However, the case report of a patient who has not had relapses of psychotic symptoms and suicidal thoughts and has not been hospitalized during 8 years of treatment with aripiprazole (LAI) has not yet been reported.Conclusions: Regular, long-term injections of aripiprazole (LAI) are very effective at preventing positive symptoms of schizophrenia development and preventing both suicidal thoughts and hospitalizations. Therefore, treatment with this drug in everyday practice should be increased.

scholarly journals Psychotic Symptoms after Long Term Using Diazepam and Alprazolam Medication; Depend Syndrome of Alprazolam

2019 ◽  
Vol 4 (10) ◽  
Keyword(s):  
Adverse Effects ◽  
Brain Tissue ◽  
Half Life ◽  
Withdrawal Syndrome ◽  
Psychotic Symptoms ◽  
Negative Consequences ◽  
Experimental Conditions ◽  
Alprazolam Withdrawal ◽  
The Brain

Alprazolam and Diazepam two most prescribed benzodiazepine in the Kosovo have been potential for addictive use. Both drugs are rapidly absorbed and enter the brain tissue rapidly, leading to reinforcement. Alprazolam has a short half – life that may lead to more withdrawal symptoms than Diazepam. In experimental conditions, they are among the most reinforcing benzodiazepines. Each causes a withdrawal syndrome, but Alprazolam withdrawal may be more severe and may occur after a shorter period of use. Adverse effects from their use are rare, yet negative consequences may be seen with some regularly. Alprazolam deserves special caution, because of its relative newness great popularity-reinforcing capabilities relatively sense withdrawal syndrome, and reports of addiction and negative consequences of use.

scholarly journals The use of tetrabenazine for the treatment of drug-induced tardive dyskinesia – report of four cases

2016 ◽  
Vol 16 (4) ◽  
pp. 194-200
Author(s):  
Ewa Szczepocka ◽  
◽  
Radosław Magierski ◽  
Tomasz Sobów ◽  
Adam Wysokiński ◽  
...  
Keyword(s):  
Movement Disorders ◽  
Mental Condition ◽  
Psychotic Symptoms ◽  
Drug Induced ◽  
Symptoms Of Depression ◽  
The Face ◽  
History Of ◽  
Chronic Neuroleptic ◽  
Written Informed Consent

Tardive dyskinesias are defined as a syndrome of involuntary, irregular, hyperkinetic movement disorders, including mixed movement disorders of the face and the mouth as well as choreoathetoid movements of the trunk and limbs. They are a serious and usually irreversible side effect of chronic neuroleptic treatment and affect approximately 15–20% of patients. Treatment attempts using amantadine, levetiracetam, piracetam, clonazepam, propranolol, vitamin B6, vitamin E, ondansetron, botulinum toxin and Ginkgo biloba were made. However, in many cases the treatment efficacy has not been confirmed in long-term studies in larger groups of patients. Tetrabenazine, registered in Poland for the treatment of hyperkinetic motor disorders in the Huntington’s disease, is one of the available therapeutic options. We present the course and the effects of tetrabenazine therapy in four patients with antipsychotic-induced tardive dyskinesias. Based on the experience gained during the research program using tetrabenazine, we believe that the use of this agent should be limited to patients in a stable mental condition, with no current symptoms of depression or active psychotic symptoms. In our opinion, suicidal tendencies or thoughts and a history of neuroleptic malignant syndrome are absolute contraindications. The off-label use of tetrabenazine requires a written informed consent of the patient and careful monitoring of their mental and neurological condition.

Tramadol-induced parkinsonism: a case report of a 75-year-old woman

2018 ◽  
Vol 30 (2) ◽  
pp. 275-278 ◽  
Author(s):  
Ranbir Singh
Keyword(s):  
Case Report ◽  
Female Gender ◽  
Acute Onset ◽  
Negative Consequences ◽  
Probability Scale ◽  
Main Risk Factor ◽  
Drug Induced ◽  
Old Patients ◽  
Medical Practitioners

Abstract Adverse drug reaction (ADR) is a form of unwanted reaction and is the crucial reason for illness and death. Tramadol-induced parkinsonism is a kind of ADR that occurs after the repeated intake of tramadol. Long-term exposure to tramadol has been known to induce tremor and alter the functioning of dopamine. This case report introduces a 75-year-old woman diagnosed with tramadol-induced parkinsonism due to the administration of tramadol for the treatment of post-operated (breast cancer) acute onset of severe pain on the left side of the chest. The assessment of the offending drug was carried out via Naranjo probability scale. A score of 6 was reported for this patient, defining tramadol as a probable cause of this reaction. For the management of the drug-induced parkinsonism, levodopa/carbidopa was prescribed and the symptoms related to parkinsonism resolved within a week. The age of the patient and the female gender is considered to be the main risk factor for the occurrence of such reaction. This case report is an attempt to spread awareness about the negative consequences of long-term use of tramadol in old patients. Thus, the medical practitioners must be very careful while administering tramadol to the old aged population.

Prevalence of paranoid symptomatology in the elderly and relationship to organic brain factors

2011 ◽  
Vol 26 (S2) ◽  
pp. 853-853
Author(s):  
M. Serrano Díaz de Otálora ◽  
J. Gómez-Arnau Ramírez ◽  
R. Martínez de Velasco ◽  
P. Artieda Urrutia
Keyword(s):  
Cognitive Impairment ◽  
Black People ◽  
The Elderly ◽  
Delusional Disorder ◽  
Psychotic Symptoms ◽  
Medical Conditions ◽  
Paranoid Symptoms ◽  
Organic Brain ◽  
The Many

IntroductionPsychotic diseases in the elderly are underdiagnosed due to the limited use of medical resources. Advanced age makes psychoses of any cause less pure and differentiated, since old age adds a cognitive-impairment component to the basal psychotic defect.ObjectivesWe intend to estimate the prevalence of paranoid symptoms in older patients, and to study the many medical conditions associated with psychosis.MethodsWe conducted a literature review and we have performed a review of several clinical trials.ResultsWe found 12.1% of paranoid symptoms in the elderly with cognitive impairment. In absence of this factor, we found a prevalence of 14.1% for suspicion tendencies, 6.9% for paranoid thoughts and 5.5% for evident delusions. These figures were significantly higher in old black people.We present a table of the main medical conditions that can produce psychotic symptoms. Some cases of apparently typical delusional disorder can appear as a long-term complication of some of these diseases. If organic factors are subtle and long lasting, the clinical may reproduce a fairly typical delusional disorder and may respond to treatment with neuroleptic drugs.ConclusionsIt seems possible that organic brain factors are more common that we believe, becoming essential a comprehensive study of the old psychotic patient. We should pay more attention to psychotic symptoms in elderly patients and avoid conclusions based on cross-evaluations. Diagnosis will be defined by evolution in most of the cases.

New Pharmacotherapy for Parkinson's Disease

1997 ◽  
Vol 31 (10) ◽  
pp. 1205-1217 ◽  
Author(s):  
Mildred D Gottwald ◽  
Jacquelyn L Bainbridge ◽  
Glenna A Dowling ◽  
Michael J Aminoff ◽  
Brian K Alldredge
Keyword(s):  
Parkinson’S Disease ◽  
Clinical Trial ◽  
Parkinson's Disease ◽  
Clinical Studies ◽  
Dopamine Agonists ◽  
Motor Fluctuations ◽  
Phase Iii ◽  
Pharmacokinetic Data ◽  
Comt Inhibitors

OBJECTIVE: To summarize the development, pharmacology, pharmacokinetics, efficacy, and safety of five investigational antiparkinsonian drugs that are in or have recently completed Phase III trials: three dopamine agonists, pramipexole, ropinirole, and cabergoline; and two catechol- O-methyltransferase (COMT) inhibitors, entacapone and tolcapone. The pathophysiology and the role of dopamine in Parkinson's disease are also reviewed. DATA SOURCES: A MEDLINE search of relevant English-language literature, clinical studies, abstracts, and review articles pertaining to Parkinson's disease was conducted. Manual searches of 1996/1997 meeting abstracts published by the American Academy of Neurology and the Movement Disorders Society were also performed. Manufacturers provided unpublished Phase III trial efficacy and pharmacokinetic data. STUDY SELECTION AND DATA EXTRACTION: Clinical trial investigations selected for inclusion were limited to human subjects. Interim analyses after 6 months for long-term clinical trial studies in progress were included. Pharmacokinetic data from animals were cited if human data were unavailable. Statistical analyses for all studies were evaluated. DATA SYNTHESIS: By selectively targeting D2 receptors, the newer dopamine agonists (i.e., cabergoline, pramipexole, ropinirole) may delay the introduction of levodopa and thus the occurrence of levodopa-induced dyskinesias. In addition, they are efficacious as adjunctive therapies in patients with advanced Parkinson's disease. Unlike the currently available dopamine agonists, pramipexole and ropinirole are non-ergot derivatives and do not cause skin inflammation, paresthesias, pulmonary infiltrates, or pleural effusion. The COMT inhibitors, tolcapone and entacapone, improve the pharmacokinetics of levodopa by preventing its peripheral catabolism and increasing the concentration of brain dopamine; thus, these agents may reduce the incidence of “wearing-off ' effects associated with the short half-life of levodopa and the progression of Parkinson's disease. CONCLUSIONS: Interim 6-month analyses of pramipexole, ropinirole, and cabergoline for symptomatic treatment of early Parkinson's disease have shown these drugs to be efficacious and relatively well-tolerated when used as monotherapy. Their role in delaying the development of motor fluctuations and delaying the addition of levodopa is the subject of long-term clinical studies. In advanced stages of Parkinson's disease, these medications were also efficacious; however, the main adverse effects included dyskinesias, somnolence, and hallucinations. The COMT inhibitors, entacapone and tolcapone, have also demonstrated efficacy in improving on-time in patients with stable disease. Tolcapone has also demonstrated efficacy in patients with motor fluctuations. Both drugs are relatively well-tolerated, with the exception of dyskinesias that require reduction of the levodopa dosage and occasional diarrhea.

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