scholarly journals Antipsychotic-induced hyperprolactinemia in Tourette syndrome

2017 ◽  
Vol 7 (6-7) ◽  
pp. 201-205 ◽  
Author(s):  
Judith J. G. Rath ◽  
Marlies E. J. Deen ◽  
Hessel van Houten ◽  
Sebastiaan F. T. M. de Bruijn ◽  
Joop van Gerven ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Tourette Syndrome ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Atypical Antipsychotics ◽  
Psychotic Disorders ◽  
Treatment Options ◽  
Therapeutic Interventions ◽  
Childhood Onset ◽  
Choice Of Treatment ◽  
Age And Sex

For many years, Tourette syndrome (TS) was considered to be a rare disorder, but tics and TS are now recognized as fairly common childhood-onset conditions. Children and adolescents with TS are frequently treated with antipsychotics, either as monotherapy or in combination with psychostimulants, melatonin and selective serotonin reuptake inhibitors (SSRIs). Antipsychotics are most often used in schizophrenia and related psychotic disorders, and in these conditions hyperprolactinemia is one of the most common adverse effects associated with antipsychotics, occurring in 40–50% of patients. We describe two patients with TS who experienced antipsychotic-induced hyperprolactinemia. Treatment options generally consist of dose reduction or switching from typical to atypical antipsychotics. However, diminishing dosages can lead to exacerbations of tics. Also, not all atypical antipsychotics have the same pharmacologic properties required to normalize prolactin levels. The choice of treatment may also be affected by the patient’s age and sex. These factors are discussed in relation to these cases, and illustrated by the results of therapeutic interventions over the years.

Functional psychoses

2017 ◽  
pp. 1057-1064
Author(s):  
Luis Agüera-Ortiz
Keyword(s):  
Adverse Effects ◽  
Older People ◽  
Atypical Antipsychotics ◽  
Psychotic Disorders ◽  
Late Onset ◽  
Psychotic Symptoms ◽  
Younger Adults ◽  
Psychological Management ◽  
Concomitant Medications

Psychotic symptoms are more common in older people than in any other age. The most frequent psychotic disorders in older people are juvenile-onset schizophrenia in ageing patients, psychosis in Alzheimer’s disease, and the late- and very late-onset schizophrenia-like psychosis. Drug treatment of all types of psychosis is essential and often achieves similar levels of efficacy than in younger adults. The treatment of choice for any psychotic condition is atypical antipsychotics. Rather than being based on specific diagnosis, the choice of drug must be highly personalized, depending on the efficacy for the particular patient, drug’s profile of adverse effects, medical comorbidities, and concomitant medications. Attention should be paid to the emergence of adverse effects that are in general more frequently found with conventional than with atypical antipsychotics. Clinical and psychological management includes the need to establish a therapeutic alliance with the patient and ensure adherence to treatment in the long term.

Involuntary Emotional Expression Disorder: Treating the Untreated

CNS Spectrums ◽  
2007 ◽  
Vol 12 (S5) ◽  
pp. 23-27 ◽  
Author(s):  
Benjamin Rix Brooks
Keyword(s):  
Emotional Expression ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
Treatment Options ◽  
Multicenter Studies ◽  
Choice Of Treatment ◽  
Sexual Disturbances ◽  
Assessment Measures ◽  
Lateral Sclerosis

AbstractPatients with involuntary emotional expression disorder (IEED) have impaired social and occupational functioning and there is currently no Food and Drug Administration-approved treatment. Treatment options include tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), dopaminergic agents, and a combination of dextromethorphan and quinidine. Studies of monaminergic agents have typically been small and executed in single-center settings. Assessment measures generally show significant symptomatic improvements, including a reduction in the number of laughing or crying episodes and improvements in patients' clinical condition. The tolerability profiles of these agents are well defined, and include dizziness, tachycardia, and QTc prolongation (TCAs), and sleep and sexual disturbances (SSRIs). The combination of dextromethorphan and quinidine has also been assessed in two large multicenter studies in patients with amyotrophic lateral sclerosis and multiple sclerosis. Compared with placebo and either agent alone, there were significant improvements in symptoms, quality of life, and relationships. The most common side effects were dizziness and nausea, and potential drug interactions with quinidine should also be considered. Choice of treatment should be evidence-based, taking into account both efficacy and tolerability.

Ayurvedic management of Ischemic Gangrene due to Diabetes Mellitus - A Case Report

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Vikram S. ◽  
Saraswathi Devi H.N.
Keyword(s):  
Diabetes Mellitus ◽  
Upper Limb ◽  
Medical Science ◽  
Limb Ischemia ◽  
Interesting Case ◽  
Therapeutic Interventions ◽  
Acute Ischemia ◽  
Arterial Circulation ◽  
Ct Angiogram ◽  
Choice Of Treatment

Medical science says that ischemia is a common complication in Diabetes, especially in the lower limb but this is a case presenting ischemic changes in upper limb which is unique and also in such type of acute ischemia amputation is the only choice of treatment to save the life of patient from septicaemia. Such a rare and interesting case was taken at Sri Sri Ayurveda Hospital and handled by proper Ayurvedic line of treatment by which circulation is re-established which saved both limb and life of patient. A patient by name Sundaramma, 62yr Female, visited Sri Sri Ayurveda Hospital on 29/2/2016 with a diagnosis of Right upper limb Ischemia with Diabetes Mellitus and Active TB. The main symptoms were severe pain and burning sensation in Right hand and forearm, discolouration of fingers with ulcers, Bluish black discolouration over right thumb, necrosis, pus dischargeand stiffness, associated with difficulty in movement of right arm, shoulder joint, elbow joint, palm and fingers. Diagnosed as Right Upper Limb Ischemia with Diabetes Mellitus and active TB. Therapeutic interventions like Right upper limb Doppler and CT angiogram were done. Such a complicated case was taken at Sri Sri Ayurveda Hospital, and carefully handled by Ayurvedic methods of management, which was ended up by preventing amputation of the limb and also achieving the re-establishment of arterial circulation.

scholarly journals B Cells and Antibodies as Targets of Therapeutic Intervention in Neuromyelitis Optica Spectrum Disorders

2021 ◽  
Vol 14 (1) ◽  
pp. 37
Author(s):  
Jan Traub ◽  
Leila Husseini ◽  
Martin S. Weber
Keyword(s):  
B Cells ◽  
Neuromyelitis Optica ◽  
Plasma Cells ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Therapeutic Interventions ◽  
Complement Factor ◽  
Major Subset ◽  
Spectrum Disorders

The first description of neuromyelitis optica by Eugène Devic and Fernand Gault dates back to the 19th century, but only the discovery of aquaporin-4 autoantibodies in a major subset of affected patients in 2004 led to a fundamentally revised disease concept: Neuromyelits optica spectrum disorders (NMOSD) are now considered autoantibody-mediated autoimmune diseases, bringing the pivotal pathogenetic role of B cells and plasma cells into focus. Not long ago, there was no approved medication for this deleterious disease and off-label therapies were the only treatment options for affected patients. Within the last years, there has been a tremendous development of novel therapies with diverse treatment strategies: immunosuppression, B cell depletion, complement factor antagonism and interleukin-6 receptor blockage were shown to be effective and promising therapeutic interventions. This has led to the long-expected official approval of eculizumab in 2019 and inebilizumab in 2020. In this article, we review current pathogenetic concepts in NMOSD with a focus on the role of B cells and autoantibodies as major contributors to the propagation of these diseases. Lastly, by highlighting promising experimental and future treatment options, we aim to round up the current state of knowledge on the therapeutic arsenal in NMOSD.

scholarly journals Extended adverse effects of cyclophosphamide on mouse ovarian function

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jihyun Kim ◽  
Sooseong You
Keyword(s):  
Adverse Effects ◽  
Cancer Survivors ◽  
Cancer Survival ◽  
Ovarian Function ◽  
Treatment Options ◽  
Bioinformatics Analyses ◽  
Hormonal Stimulation ◽  
Patients With Cancer ◽  
Multiple Exposures

Abstract Purpose Most patients with cancer undergo multiple administrations of anticancer drugs during treatment, resulting in chronic impairment of their reproductive health. As improved treatment options increase cancer survival, it has become increasingly important to address fertility issues in cancer survivors. In this study, we examined the pathophysiological effects of multiple exposures to cyclophosphamide (Cy) on the ovaries of mice and their underlying molecular mechanism. Methods Female C57BL/6 mice were intraperitoneally injected with 100 mg/kg Cy six times over 2 weeks; 4 weeks later, the mice were sacrificed and their ovaries, sera, and oocytes were collected for histological observation, measurement of anti-Müllerian hormone levels, and assessment of oocyte quantity and quality in response to hormonal stimulation. Gene expression changes in Cy-treated ovaries were examined by microarray and bioinformatics analyses. Results After repeated Cy exposure, the anti-Müllerian hormone level was decreased, and follicle loss and impairments in the quality of oocyte were irreversible. The expression levels of genes involved in folliculogenesis, oogenesis, and zona pellucida glycoprotein transcription displayed sustained alterations in Cy-exposed ovaries even after 4 weeks. Conclusion The adverse effects of Cy on ovarian function and oocytes remained even after chemotherapy was complete. Therefore, strategies to prevent ovarian damage or restore ovarian function after treatment are required to safeguard the fertility of young cancer survivors.

scholarly journals Mitochondrial Dysfunction in Atrial Fibrillation—Mechanisms and Pharmacological Interventions

2021 ◽  
Vol 10 (11) ◽  
pp. 2385
Author(s):  
Paweł Muszyński ◽  
Tomasz A. Bonda
Keyword(s):  
Atrial Fibrillation ◽  
Mitochondrial Dysfunction ◽  
Treatment Options ◽  
Therapeutic Interventions ◽  
Energy Deficit ◽  
Functional Changes ◽  
Electrical Instability ◽  
Ionic Fluxes ◽  
Prevention Methods ◽  
Invasive Techniques

Despite the enormous progress in the treatment of atrial fibrillation, mainly with the use of invasive techniques, many questions remain unanswered regarding the pathomechanism of the arrhythmia and its prevention methods. The development of atrial fibrillation requires functional changes in the myocardium that result from disturbed ionic fluxes and altered electrophysiology of the cardiomyocyte. Electrical instability and electrical remodeling underlying the arrhythmia may result from a cellular energy deficit and oxidative stress, which are caused by mitochondrial dysfunction. The significance of mitochondrial dysfunction in the pathogenesis of atrial fibrillation remains not fully elucidated; however, it is emphasized by the reduction of atrial fibrillation burden after therapeutic interventions improving the mitochondrial welfare. This review summarizes the mechanisms of mitochondrial dysfunction related to atrial fibrillation and current pharmacological treatment options targeting mitochondria to prevent or improve the outcome of atrial fibrillation.

scholarly journals Patients’ attitudes toward conventional and herbal treatments for depression and anxiety: A cross-sectional Israeli survey

2021 ◽  
pp. 002076402199238
Author(s):  
Or Burstein ◽  
Alon Shamir ◽  
Nurit Abramovitz ◽  
Ravid Doron
Keyword(s):  
Adverse Effects ◽  
Large Scale ◽  
Prescription Medications ◽  
Depression And Anxiety ◽  
Cultural Backgrounds ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Cultural Aspects ◽  
Final Sample ◽  
Choice Of Treatment

Background: As many patients view conventional antidepressants and anxiolytics negatively, it is not surprising that the willingness to apply these treatments is far from ideal, thus posing a critical barrier in promoting an effective and durable treatment. Aim: The present study aimed to explore patients’ attitudes toward conventional and herbal treatments for depression and anxiety, while considering cultural and demographic factors, to further elucidate the antecedes that putatively determine the treatment’s outcome. Methods: During June 2017, a cross-sectional survey was conducted using stratified sampling from a large-scale Israeli volunteer online panel. The final sample included 591 Jewish Israeli adults that reported they were suffering from depression or anxiety. Results: A heterogeneous range of attitudes toward treatment was found: for example, a large group of patients did not utilize prescription medications (39%), a professional consultation (12.9%), or any form of treatment (17.4%). Interestingly, these patients were significantly more likely to support naturally-derived treatments and were less concerned with scientific proof. Further, adverse effects were demonstrated as a prominent factor in the choice of treatment. A higher incidence of adverse effects was associated with an increased willingness to consider an alternative herbal treatment. Noteworthy attitudes were found in orthodox-Jewish individuals, who showed similar consultation rates, but utilized more psychological, rather than pharmacological treatments. Conclusions: It is proposed that patients’ perspectives and cultural backgrounds are needed to be taken into consideration during the clinical assessment and choice of treatment. The findings imply that a particular emphasis should be placed on patients that discard conventional pharmacological options and on distinct cultural aspects. Several recommendations for revising the current policy are advocated to promote more culturally-informed and patient-oriented care.

Rheumatic Diseases of Childhood

1988 ◽  
Vol 10 (6) ◽  
pp. 183-190
Author(s):  
Robert M. Rennebohm
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Effects ◽  
Juvenile Rheumatoid Arthritis ◽  
Chief Complaint ◽  
Musculoskeletal Complaints ◽  
Joint Symptoms ◽  
Rheumatic Conditions ◽  
Inflammatory Drugs ◽  
Systematic Collection ◽  
Age And Sex

The pediatrician frequently encounters children and adolescents with musculoskeletal complaints that raise the possibility of rheumatic disease. The purposes of this article are: to review an approach to the evaluation of "joint" symptoms and to review the pharmacology, use, and adverse effects of nonsteroidal anti-inflammatory drugs. RHEUMATOLOGIC HISTORY Systematic collection of the historical details is fundamental in the evaluation of "joint" complaints (Table 1). Age and Sex The child's age and sex provide initial clues. For example, suspicion that a young girl (less than 5 years of age) with knee swelling might have monoarticular juvenile rheumatoid arthritis is heightened simply because of her age and sex. (At onset of their disease, almost 20% of all patients with juvenile rheumatoid arthritis are young girls with pauciarthritis, most commonly involving the knee.) Suspicion that an older boy (10 years of age or older) with axioskeletal complaints might have an enthesopathy syndrome is increased, in part, because of his age and sex. of the age and sex predilections of various rheumatic conditions is, therefore, helpful. Chief Complaint The chief complaint is often directive. For example, the complaint "his knees hurt every night" or "his legs hurt at night" is not characteristic of children who have juvenile rheumatoid arthritis or other well-defined inflammatory arthritides.

scholarly journals CURRENT PHARMACOLOGICAL STATUS OF CARDIOPROTECTIVE PLANTS AGAINST ISOPROTERENOL INDUCED MYOCARDIAL INFARCTION

2018 ◽  
Vol 11 (4) ◽  
pp. 17
Author(s):  
Syeda Nishat Fathima ◽  
Vasudeva Murthy S
Keyword(s):  
Myocardial Infarction ◽  
Lifestyle Modification ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Cardiac Biomarkers ◽  
Therapeutic Interventions ◽  
Current Status ◽  
Plant Parts ◽  
Heart Muscle Cells ◽  
Modern Era

 Objective: Cardiovascular diseases are the major cause of morbidity and mortality in the modern era. Myocardial infarction is a condition where there is a significant decrease or block in the blood (oxygen) supply to the part of heart, leading to degeneration of a portion of the myocardium which triggers a cascade of cellular, inflammatory and biochemical events, leading eventually to the irreversible death (necrosis) of heart muscle cells. Various therapeutic interventions, including lifestyle modification, pharmacological treatment options, and surgical techniques are available. The present review focus on the plants that have been evaluated for cardioprotective activity against isoproterenol-induced myocardial infarction.Method: The current status of Cardioprotective plants was obtained from a literature search of electronic databases such as Google Scholar, Pubmed and Scopus up to 2017 for publications on medicinal plants used against isoproterenol-induced myocardial infarction. Isoproterenol, Isoprenaline, myocardial infarction, cardioprotective were used as keywords for the searching.Result: A total of 117 different plant parts and their extracts have till now been published to possess cardioprotection against isoproterenol-induced myocardial infarction. Isoproterenol a beta-adrenergic receptors agonist causes severe stress in myocardium resulting in the infarct-like lesion and produced cardiotoxic effects by elevating the levels of cardiac biomarkers and causing changes in ECG. Plant-based medicines with their antioxidant, antiapoptotic, antihyperlipidemic, platelet antiaggregatory, anti-lipid peroxidation property provide substantial evidence for the management of Ischemia.Conclusion: This review, therefore, provides a useful resource to enable a thorough assessment of the profile of plants that have cardioprotective activity against isoproterenol-induced myocardial infarction.

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