Psychiatric Manifestations of Multiple Sclerosis: A Review

1996 ◽  
Vol 41 (7) ◽  
pp. 441-445 ◽  
Author(s):  
Jennifer Rodgers ◽  
Roger Bland
Keyword(s):  
Multiple Sclerosis ◽  
Side Effects ◽  
Psychiatric Disorder ◽  
Psychiatric Illness ◽  
Tricyclic Antidepressants ◽  
Relevant Literature ◽  
Standard Methods ◽  
Occurrence Type ◽  
Psychiatric Manifestations

Objective: To report the occurrence, type, causes, and management of psychiatric manifestations in multiple sclerosis (MS). Method: Review of recent, relevant literature. Results: Psychiatric illness, especially depression, occurs much more frequently than expected inpatients with MS, is frequently unrecognized or ignored, and is treatable using standard methods, although patients with MS may be unusually sensitive to side effects of tricyclic antidepressants. Conclusions: Research is needed to better define the causes of psychiatric syndromes inpatients with MS. Those treating MS should increase their awareness of and sensitivity to the likelihood of psychiatric disorder in these patients.

scholarly journals Characterizing the features and course of psychiatric symptoms in children and adolescents with autoimmune encephalitis

2021 ◽  
Author(s):  
R Rosello ◽  
B Girela-Serrano ◽  
S Gómez ◽  
B Baig ◽  
M Lim ◽  
...  
Keyword(s):  
Side Effects ◽  
Psychiatric Disorder ◽  
Children And Adolescents ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Autoimmune Encephalitis ◽  
Emotional Lability ◽  
Liaison Psychiatry ◽  
Paediatric Cohort ◽  
Psychiatric Manifestations

AbstractAutoimmune encephalitis (AE) can present like a psychiatric disorder. We aimed to illustrate the psychiatric manifestations, course and management of AE in a paediatric cohort. Neuropsychiatric symptoms, investigations and treatment were retrospectively retrieved in 16 patients (mean age 11.31, SD 2.98) with an AE diagnosis at the liaison psychiatry services in two UK tertiary paediatric centres. Psychiatric presentation was characterised by an acute polysymptomatic (predominantly agitation, anger outbursts/aggressiveness, hallucinations, and emotional lability) onset. Antipsychotics produced side effects and significant worsening of symptoms in four cases, and benzodiazepines were commonly used. This psychiatric phenotype should make clinicians suspect the diagnosis of AE and carefully consider use of treatments.

Modified Frontal Leucotomy: A Review of 106 Cases

1964 ◽  
Vol 110 (465) ◽  
pp. 211-221 ◽  
Author(s):  
J. L. T. Birley
Keyword(s):  
Side Effects ◽  
Critical Review ◽  
Psychiatric Illness ◽  
Empirical Therapy ◽  
Psychological Literature ◽  
Standard Operation ◽  
Functional Psychoses

Frontal leucotomy has been used in the treatment of psychiatric illness for over twenty years. Its popularity has undergone the usual fluctuations of a newly-introduced form of empirical therapy, and at present there are many different opinions about its value (Lancet, 1962; Pippard, 1962). For a critical review of the clinical and psychological literature, see Willett (1960). The standard operation has fallen out of favour, not because it was thought to be ineffective, but because it had undesirable side-effects on the personality. Various “modified” operations have, therefore, been introduced. Using one of these—the “orbital undercutting” technique—Knight (1960) has reported excellent results in 129 cases of long-standing depression. Robin (1958, 1959), however, has reported no difference between the outcome for 198 patients who had a standard leucotomy for functional psychoses, fifty-two of them affective, and an equal number of carefully but retrospectively matched controls.

Fluoxetine Efficacy vs Comparative Drugs: An Overview

1988 ◽  
Vol 153 (S3) ◽  
pp. 51-58 ◽  
Author(s):  
Malcolm Lader
Keyword(s):  
Side Effects ◽  
Tricyclic Antidepressants ◽  
Antipsychotic Agents ◽  
Synaptic Cleft ◽  
Endogenous Depression ◽  
Acute Effects ◽  
Anticholinergic Effects ◽  
The Past ◽  
Chronic Effects ◽  
Clinical Action

The tricyclic antidepressants (TCAs) were discovered accidentally by pharmaceutical chemists seeking first, better antihistamines and then antipsychotic agents. Careful clinical assessment revealed the antidepressant properties and suggested that the closer the patient resembled the classical textbook description of ‘endogenous’ depression, the more likely was an adequate clinical response to occur (Kuhn, 1958). However, it was quickly realised that the TCAs possess a plethora of side-effects, particularly sedation and symptoms related to their anticholinergic effects.Despite much research over the past 25 years, it is unclear how TCAs effect clinical improvement. The two main neurotransmitters involved in some way are noradrenaline (Schildkraut, 1965) and 5-hydroxytryptamine (5-HT; serotonin; Van Praag, 1977). It was proposed that TCAs acted by blocking the reuptake of one or other or both of these neurotransmitters, thereby increasing their concentration in the synaptic cleft. However, as well as these acute effects, chronic effects, such as a decrease in the number of central beta-adrenoceptors (‘down-regulation’) occur, and these are probably more relevant to the clinical action.

scholarly journals Central Neuropathic Pain in a Patient with Multiple Sclerosis Treated Successfully with Topical Amitriptyline

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
David J. Kopsky ◽  
Remko Liebregts ◽  
Jan M. Keppel Hesselink
Keyword(s):  
Multiple Sclerosis ◽  
Neuropathic Pain ◽  
Adverse Events ◽  
Active Compound ◽  
Analgesic Effect ◽  
Tricyclic Antidepressants ◽  
Double Blind ◽  
Carryover Effect ◽  
Double Blind Placebo ◽  
Central Neuropathic Pain

Central neuropathic pain in patients with multiple sclerosis (MS) is a common debilitating symptom, which is mostly treated with tricyclic antidepressants or antiepileptics. Unfortunately, the use of these drugs is often limited due to adverse events. We investigated the analgesic effect of topical amitriptyline 5% and 10% cream in a patient with central neuropathic pain due to MS. The analgesic effect of topical amitriptyline cream on neuropathic pain was dose related. To evaluate whether this analgesic effect is due to the active compound or placebo, we conducted a double-blind placebo-controlled n-of-1 study with amitriptyline 5% cream and placebo. The instruction was to alternate the creams every week following the pattern ABAB, with an escape possibility of amitriptyline 10% cream. The result was a complete pain reduction after application of cream B, while most of the time cream A did not reduce the pain. The patient could correctly unblind both creams, determining B as active. She noted that in the week of using the active cream no allodynia was present, with a carryover effect of one day.

scholarly journals Psychiatric disorders in multiple sclerosis patients

2009 ◽  
Vol 67 (3a) ◽  
pp. 664-667 ◽  
Author(s):  
Mirella Martins Fazzito ◽  
Sérgio Semeraro Jordy ◽  
Charles Peter Tilbery
Keyword(s):  
Multiple Sclerosis ◽  
Psychiatric Disorder ◽  
Optic Neuritis ◽  
Psychiatric Disorders ◽  
Clinical Presentation ◽  
Demyelinating Disease ◽  
Common Symptom ◽  
Multiple Sclerosis Patients ◽  
Variable Clinical Presentation

Multiple sclerosis (MS) is a demyelinating disease showing variable clinical presentation. Optic neuritis is the most common symptom, followed by motor and sensitive manifestations. It is known that this disease may be related to several psychiatric disorders, especially depression. In this study we will discribe 5 cases of MS patients harboring psychiatric disorder related or unchained by the disease itself.

Psychiatric Disorder in the General Hospital

1986 ◽  
Vol 149 (2) ◽  
pp. 172-190 ◽  
Author(s):  
Richard Mayou ◽  
Keith Hawton
Keyword(s):  
Psychiatric Disorder ◽  
General Hospital ◽  
Psychiatric Morbidity ◽  
Routine Clinical Practice ◽  
Standard Methods ◽  
Different Types ◽  
Patient Groups ◽  
Hospital Doctors ◽  
The Many

There have been many reports of psychiatric disorder in medical populations, but few have used standard methods on representative patient groups. Even so, there is consistent evidence for considerable psychiatric morbidity in in-patient, out-patient and casualty department populations, much of which is unrecognised by hospital doctors. We require a better classification of psychiatric disorder in the general hospital, improved research measures, and more evidence about the nature and course of the many different types of problem so that we can provide precise advice for their management of routine clinical practice.

Treatment options in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

2021 ◽  
Vol 27 ◽  
Author(s):  
Paulus Rommer ◽  
Uwe K Zettl
Keyword(s):  
Multiple Sclerosis ◽  
Side Effects ◽  
Neuromyelitis Optica ◽  
Treatment Options ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorders ◽  
The Past ◽  
Drug Classes ◽  
Spectrum Disorders

: There are few diseases with as many therapeutic advances in recent years as in multiple sclerosis. Nine different drug classes with more than a dozen approved therapies are now available. Similarly, there have been unimaginable advances in understanding neuromyelitis optica (now neuromyelitis optica spectrum disorder [NMOSD]) over the past 15 years. Building on the knowledge gained, the first therapies have been approved in recent years. In this review, we aim to present all therapies approved for the treatment of MS or NMOSD. The different forms of application, different approval criteria and most important side effects will be presented. This work is intended for physicians who are interested in MS and NMOSD therapies and want to get a first overview and does not replace the respective guidelines of the regulatory authorities.

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