Hidden Cardiac Lesions and Psychotropic Drugs as a Possible Cause of Sudden Death in Psychiatric Patients: A Report of 14 Cases and Review of the Literature

A limited number of studies worldwide have investigated the prevalence of HIV, syphilis, and hepatitis B and C infection among psychiatric patients. However, prevalence of these infections in the population with chronic mental illness has not been clearly established. Most of the published papers are from developed countries and have derived from relatively small and non-representative samples. We performed a systematic review of the published literature to identify studies on these infectious diseases within psychiatric populations in Brazil and other developing countries. Overall, prevalence rates varied from 0% to 29% for HIV; 1.6% to 66% for HBV; 0.4% to 38% for HCV; and 1.1% to 7.6% for syphilis. Several risk factors were identified and discussed, although sampling limitations restrict the generalization of study findings. This review highlights the lack of information on the prevalence of sexually transmitted diseases and their associated factors among persons with chronic mental illness and identifies gaps in the knowledge base in both developing and developed countries.

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Pitfalls in arrhythmogenic left ventricular cardiomyopathy (ALVC). A review of the literature with considerations on a single case of sudden death in a juvenile athlete

Journal of Forensic and Legal Medicine ◽

10.1016/j.jflm.2021.102208 ◽

2021 ◽

pp. 102208

Author(s):

Francesco Simonit ◽

Daniele Muser ◽

Giorgio Morocutti ◽

Lorenzo Desinan

Keyword(s):

Sudden Death ◽

Single Case ◽

Left Ventricular ◽

Review Of The Literature ◽

Ventricular Cardiomyopathy

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Outpatient Psychotropic Drug Interactions in a Public Psychiatry Hospital in Bahrain: An Audit Study

Current Psychopharmacologye ◽

10.2174/2211556010666210701164436 ◽

2021 ◽

Vol 10 ◽

Author(s):

Yasin Tayem ◽

Saeed Aljaberi ◽

Ali Alfehaid ◽

Abdulaziz Almekhyal ◽

Haitham Jahrami ◽

...

Keyword(s):

Drug Interactions ◽

Psychotropic Drugs ◽

Psychiatric Patients ◽

Psychotropic Medications ◽

Outpatient Psychiatry ◽

High Prevalence ◽

Public Psychiatry ◽

And Gender ◽

Potential Interactions ◽

Outpatient Prescriptions

Background: Psychotropic polypharmacy is particularly common which puts psychiatric patients at high risk for developing drug-drug interactions. Objective: We aimed to study potential interactions between psychotropic medications prescribed within the outpatient psychiatry setting. Method: This was an audit study, which targeted a sample of outpatient prescriptions ordered within the outpatient clinics of the main psychiatry hospital in Bahrain over 2017. We studied the degree and correlation between psychotropic drugs. Results: The total number of prescriptions in our sample was 992 (56.1% males, 43.9% females). Psychotropic polypharmacy was detected in 842 prescriptions (84.9%). Potential interactions between psychotropic drugs were observed in 550 prescriptions (56.4%). The degree of interaction was minor in 43 prescriptions (7.8%), significant in 419 prescriptions (76.2%), and serious in 88 prescriptions (16%). Schizoaffective disorder subjects were the most likely to suffer from interactions (64.6%), whereas prescriptions issued for those who had schizophrenia contained the least number of interactions (51.6%). The total number of interactions was strongly associated with polypharmacy (p < .001), and gender (p < .01), but not with age (p > .05) or diagnosis (p > .05). Conclusion: High prevalence of polypharmacy and interactions between psychotropic medications were observed in our sample, particularly of the significant grade.

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Psychotropic drug-induced genetic-epigenetic modulation of CRTC1 gene is associated with early weight gain in a prospective study of psychiatric patients

Clinical Epigenetics ◽

10.1186/s13148-019-0792-0 ◽

2019 ◽

Vol 11 (1) ◽

Cited By ~ 1

Author(s):

Aurélie Delacrétaz ◽

Anaïs Glatard ◽

Céline Dubath ◽

Mehdi Gholam-Rezaee ◽

Jose Vicente Sanchez-Mut ◽

...

Keyword(s):

Weight Gain ◽

Side Effects ◽

Prospective Study ◽

Psychotropic Drugs ◽

Energy Homeostasis ◽

Psychiatric Patients ◽

Metabolic Disturbances ◽

Drug Induced ◽

Metabolic Side Effects ◽

Early Weight Gain

Abstract Background Metabolic side effects induced by psychotropic drugs represent a major health issue in psychiatry. CREB-regulated transcription coactivator 1 (CRTC1) gene plays a major role in the regulation of energy homeostasis and epigenetic mechanisms may explain its association with obesity features previously described in psychiatric patients. This prospective study included 78 patients receiving psychotropic drugs that induce metabolic disturbances, with weight and other metabolic parameters monitored regularly. Methylation levels in 76 CRTC1 probes were assessed before and after 1 month of psychotropic treatment in blood samples. Results Significant methylation changes were observed in three CRTC1 CpG sites (i.e., cg07015183, cg12034943, and cg 17006757) in patients with early and important weight gain (i.e., equal or higher than 5% after 1 month; FDR p value = 0.02). Multivariable models showed that methylation decrease in cg12034943 was more important in patients with early weight gain (≥ 5%) than in those who did not gain weight (p = 0.01). Further analyses combining genetic and methylation data showed that cg12034943 was significantly associated with early weight gain in patients carrying the G allele of rs4808844A>G (p = 0.03), a SNP associated with this methylation site (p = 0.03). Conclusions These findings give new insights on psychotropic-induced weight gain and underline the need of future larger prospective epigenetic studies to better understand the complex pathways involved in psychotropic-induced metabolic side effects.

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