Panic Attacks and Major Depression after Discontinuation of Long-Term Diazepam Abuse

DICP ◽  
1989 ◽  
Vol 23 (12) ◽  
pp. 989-990 ◽  
Author(s):  
Fabrizio Schifano ◽  
Guido Magni

A case is described of a patient with a history of several years of diazepam abuse (in the last 24 months at dosages of 120 mg/d). A tapering schedule was carried out during a 12-day stay in the hospital in which the diazepam dosage was reduced by a fixed quantity every day, corresponding to about ten percent of the initial dosage. Five days after discharge from the hospital the patient experienced panic attacks, for the first time, which continued until 13 days after discharge. By the 40th day, the patient was experiencing a major depressive episode, which improved after administration of clomipramine therapy. We suggest that a relatively quick withdrawal schedule (ten percent per day) is probably inadequate in preventing withdrawal reactions to long-acting benzodiazepines taken in high doses for an extended period of time.

2021 ◽  
pp. 227853372110083
Author(s):  
Smita Mukherjee ◽  
Zubin R. Mulla

We examine the cost of leaders changing between empowering and directive leadership styles on team outcomes. In a laboratory experiment, we collected data from 240 participants in 80 teams. Confederates enacted different leadership styles and led teams of participants in performing a series of tasks. When leaders changed their style from directive to empowering, teams took time to respond in terms of higher satisfaction with leader and affective commitment. However, when leaders changed their style from empowering to directive, the deterioration of satisfaction with leader and reduction in affective commitment were immediate. Moreover, teams of leaders who had been consistently directive showed higher affective commitment as compared to teams of leaders who had a history of being empowering but later shifted to being directive. First time managers can get inputs on how they should enact their leadership style and be aware that switching between styles may impose long-term costs on the team’s affective commitment and satisfaction with the leader.


2010 ◽  
Vol 16 (4) ◽  
pp. 587-600 ◽  
Author(s):  
Harald Dolles ◽  
Sten Söderman

AbstractFor the first time in the history of FIFA (Fédération Internationale de Football Association), the football (soccer) World Cup held in Germany 2006 specifically addressed environmental concerns. By doing so, the German Organizing Committee did not have the objective of creating a short-term vision, but rather of making a long-term and lasting contribution to the improvement of environmental protection in hosting a mega-sporting event. By taking the football world cup in Germany as a case study, we will provide insights into the so-called ‘Green Goal’ programme and its four main areas: water, waste, energy, and transportation. From a global point of view, climate protection was added by the Organizing Committee as the fifth area of action and was recognised as a cross-sectorial task. Finally, questions are addressed on how to apply those measurements in the planning and organisation of other mega (-sporting) events.


ARTMargins ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 112-118
Author(s):  
Terry Smith

Change in the history of art has many causes, but one often overlooked by art historical institutions is the complex, unequal set of relationships that subsist between art centers and peripheries. These take many forms, from powerful penetration of peripheral art by the subjects, styles and modes of the relevant center, through accommodation to this penetration to various degrees and kinds of resistance to it. Mapping these relationships should be a major task for art historians, especially those committed to tracing the reception of works of art and the dissemination of ideas about art. This lecture, delivered by Nicos Hadjinicolaou in 1982, outlines a “political art geography” approach to these challenges, and demonstrates it by exploring four settings: the commissioning of paintings commemorating key battles during the Greek War of Independence; the changes in Diego Rivera's style on his return to Mexico from Paris in the 1920s; the impact on certain Mexican artists in the 1960s of “hard edge” painting from the United States; and the differences between Socialist Realism in Moscow and in the Soviet Republics of Asia during the mid-twentieth century. The lecture is here translated into English for the first time and is introduced by Terry Smith, who relates it to its author's long-term art historical quest, as previously pursued in his book Art History and Class Struggle (1973).


2012 ◽  
Vol 26 (1) ◽  
pp. 59-61 ◽  
Author(s):  
Livia R. Macedo ◽  
Jehan Marino ◽  
Brady Bradshaw ◽  
Joseph Henry

Graves’ disease is an autoimmune syndrome with symptoms such as tachycardia, atrial fibrillation, and psychiatric symptoms. Limited evidence exists for the treatment of Graves’ hyperthyroidism-induced psychosis with atypical antipsychotics. A 47-year-old female with a psychiatric history of bipolar disorder presented for the first time to the psychiatric hospital. She was agitated and grossly psychotic with delusions. Electrocardiogram showed atrial fibrillation and tachycardia. Drug screen urinalysis was negative. Endocrine workup resulted in a diagnosis of Graves’ disease (thyroid-stimulating hormone [TSH]: 0.005 μIU/mL, triiodothyronine [T3]: 537 ng/dL, thyroxine [T4]: 24 mcg/dL, free T4: 4.5 ng/dL, positive antithyroid peroxidase antibody, and antinuclear antibody). Aripiprazole 10 mg daily was initiated and titrated to 15 mg daily on day 4. On day 16, her suspicious behavior, judgment, and insight improved. Other medications given included aspirin 325 mg daily, metoprolol 25 mg twice daily, titrated to 12.5 mg twice daily, and methimazole 30 mg daily, titrated to 20 mg twice daily, and discontinued on day 29. The patient received radioiodine I-131 treatment 1 week later. We report the first known case on the use of aripriprazole to treat Graves’ hyperthyroidism-induced psychosis. Further studies examining the long-term effects and appropriate dose and duration of aripiprazole in this patient population are needed.


2008 ◽  
Vol 24 (5) ◽  
pp. E7 ◽  
Author(s):  
Felix Umansky ◽  
Yigal Shoshan ◽  
Guy Rosenthal ◽  
Shifra Fraifeld ◽  
Sergey Spektor

✓ The long-term or delayed side effects of irradiation on neural tissue are now known to include the induction of new central nervous system neoplasms. However, during the first half of the 20th century, human neural tissue was generally considered relatively resistant to the carcinogenic and other ill effects of ionizing radiation. As a result, exposure to relatively high doses of x-rays from diagnostic examinations and therapeutic treatment was common. In the present article the authors review the literature relating to radiation-induced meningiomas (RIMs). Emphasis is placed on meningiomas resulting from childhood treatment for primary brain tumor or tinea capitis, exposure to dental x-rays, and exposure to atomic explosions in Hiroshima and Nagasaki. The incidence and natural history of RIMs following exposure to high- and low-dose radiation is presented, including latency, multiplicity, histopathological features, and recurrence rates. The authors review the typical presentation of patients with RIMs and discuss unique aspects of the surgical management of these tumors compared with sporadic meningioma, based on their clinical experience in treating these lesions.


2020 ◽  
Vol 11 ◽  
pp. 41
Author(s):  
Ramsis F. Ghaly ◽  
Ana Plesca ◽  
Kenneth D. Candido ◽  
Nebojsa Nick Knezevic

Background: Suicide cases are the end product of a combination of biological, clinical, psychological, social, and cultural risk/protective factors, and attempts to remain unpredictable. Case Description: A 43-year-old male presented to the hospital with jaundiced skin/eyes of 7 days’ duration. He had a history of a major depressive disorder and chronic alcohol consumption (e.g., 3–5 alcoholic drinks/day for the past 15 years). Studies documented acute hepatic disease (e.g., biopsy-documented hepatocellular alcoholic hepatitis), accompanied by a cholestatic disease. The patient was discharged on clonidine, iron multivitamin, folic acid, gabapentin, and prednisone. Eight days postdischarge from the hospital, he committed suicide (e.g., self- inflicted gunshot wound to the head). Conclusion: Concomitant administration of gabapentin, prednisone, and clonidine, especially if used for the first time, may play a synergistic effect in increasing a patient’s suicide risk.


2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Anna Maria Szota ◽  
Aleksander Araszkiewicz

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.


2019 ◽  
Vol 12 (1) ◽  
pp. e223365
Author(s):  
Kiran Dhaliwal ◽  
Colin Thomas Brewster ◽  
Sivarajasingham Pakeerathan

Acute blue finger syndrome is a rare benign condition that mimics digital ischaemia. We discuss the case of a 32-year-old woman who presented with a 6hour history of blue discolouration of the middle finger of the right hand, associated with pain and swelling. There was no history of trauma and this was the first time that the patient had experienced these symptoms. Examination found blue discolouration of the digit primarily on the volar aspect with associated swelling. All investigations, including blood tests, X-rays and Doppler scanning, were normal. The symptoms resolved spontaneously within 48 hours. There were no recurrent episodes or long-term sequelae. Patients presenting with an acutely blue finger need rapid assessment to exclude digit ischaemia. Knowledge of this rare benign condition may prevent unnecessary distress, invasive investigations and potentially harmful treatment of a healthy patient.


2021 ◽  
Author(s):  
Alexander Yu. Galushkin

The collection of the most significant scientific papers by Alexander Yu. Galushkin (1960–2014), the last of Viktor Shklovsky’s literary secretaries, the creator of one of the first independent philological journals in Russia “De Visu”, the long-term employee of the IWL RAS, and the head of the Literary Heritage Department, reflects the main areas of his research interests. In addition to articles and publications, the section “From the History of Russian Formalism” includes the extensive work “From Conversations with Viktor Shklovsky”. The section “From the History of Literary Life” contains articles and notes from periodicals that have become inaccessible (the old “Literaturnoe Obozrenie”, the Parisian newspaper “Russkaia Mysl”). The section “From the Documentary Biography of E.I. Zamyatin” presents materials for the book of the same name prepared by A.Yu. Galushkin on the basis of his works on Zamyatin; as an appendix, his PhD thesis “Discussion on B. Pilnyak and E. Zamyatin in the Context of Literary Policy of the Late 1920s — Early 1930s” with author’s corrections and additions is published for the first time. The collection is concluded with the bibliography of A.Yu. Galushkin’s works.


2020 ◽  
Author(s):  
А.А. Логунова

Статья продолжает тему, начатую документальной публикацией автора в журнале Opera musicologica № 4 (42) / 2019, и освещает малоизвестные факты из истории взаимоотношений Россини с подданными Российской империи в период с 1817 по 1865 год. Источниками информации послужили материалы из следующих хранилищ: Российский государственный исторический архив, Российская национальная библиотека, Государственный архив Российской Федерации, Российский национальный музей музыки, Санкт-Петербургский государственный музей театрального и музыкального искусства, Российский государственный архив литературы и искусства. В статье подробно комментируются два письма Россини к И. М. Толстому, придворному из окружения Александра II, свидетельствующие о продолжительных дружеских отношениях композитора с влиятельным российским чиновником. Среди рекомендательных писем Россини особенно интересны послания 1860 года — к Т. Рикорди и Дж. Боноле, в которых идет речь о молодом русском певце, будущем режиссере А. Д. Гарфильд-Дмитриеве. Представленные в настоящей статье документы — шесть писем и музыкальный автограф для альбома М. Я. Раппапорта — не только открывают новую страницу в истории русских контактов Россини, но содержат малоизученные факты, касающиеся биографии композитора и его итальянских связей. Большинство автографов публикуются впервые. The article continues the documentary publication in the Opera musicologica, no. 4 (2019) and deals with unknown facts from the history of relations between Rossini and subjects of the Russian Empire on the basis of the materials from the Russian State Historical Archive, the State Archive of the Russian Federation, the Russian National Museum of Music, the National Library of Russia, the St. Petersburg State Museum of Theatre and Music, the Russian State Literature and Arts Archive. The main attention is paid to letters by Rossini to Ivan M. Tolstoy, testifying to the composer’s long-term friendly relations with the influential Russian official from the entourage of Alexander II. Among Rossini’s letters of recommendation, messages to Tito Ricordi and Giovanni Bonola about a Russian singer Aleksandr Dmitriev are of particular interest. Six letters and a musical autograph presented in this article not only open a new page in the history of Rossini’s Russian contacts, but also contain little-studied facts concerning the composer’s biography and his Italian connections. Most autographs are published for the first time.


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