New-Onset Seizure Associated with Quetiapine and Olanzapine

2002 ◽  
Vol 36 (3) ◽  
pp. 437-439 ◽  
Author(s):  
Dawson W Hedges ◽  
Kreg G Jeppson
Keyword(s):  
Risk Factors ◽  
White Woman ◽  
Atypical Antipsychotics ◽  
Low Dose ◽  
Case Reports ◽  
Seizure Threshold ◽  
Onset Seizure ◽  
Case Summary ◽  
New Onset

OBJECTIVE: To report a case involving a witnessed seizure in a patient receiving concurrent olanzapine and quetiapine. CASE SUMMARY: A 27-year-old white woman was observed to have a seizure while receiving a stable dosage of olanzapine 15 mg/d, with the addition of quetiapine 100 mg in the evening 1 day before the occurrence of the seizure. There were no known risk factors for epilepsy. DISCUSSION: This case reports a new-onset seizure in the context of concurrent olanzapine and quetiapine use. Interpretation is complicated by recent discontinuation of low-dose clonazepam. CONCLUSIONS: While uncommon, seizures can occur with non-clozapine atypical antipsychotics. Caution is indicated when using these drugs with other agents that may lower the seizure threshold.

scholarly journals Delayed-Onset Seizure in a Mild Quetiapine Overdose: Report of a Case and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Jason A. Chen ◽  
Katherine M. Unverferth ◽  
Erick H. Cheung
Keyword(s):  
Atypical Antipsychotics ◽  
Low Dose ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Review Of The Literature ◽  
Potential Complication ◽  
Onset Seizure ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Delayed Onset ◽  
Unusual Phenomenon

Among atypical antipsychotics, quetiapine is commonly prescribed and considered to have a favorable side effect and safety profile. Here, we report the case of a patient who developed a generalized tonic-clonic seizure 28 hours following ingestion of 1,400 mg of quetiapine. Review of the literature identifies delayed-onset seizure as a potential complication of quetiapine overdose. Unique to this case, delayed-onset seizures occurred in a patient with a relatively low dose of quetiapine and no obvious toxidrome, suggesting that this reaction may be an important consideration in the management of quetiapine overdose. The pharmacokinetics and pharmacodynamics of quetiapine may explain this unusual phenomenon.

scholarly journals New-onset seizure in HIV-infected adult Zambians

Neurology ◽  
2016 ◽  
Vol 88 (5) ◽  
pp. 477-482 ◽  
Author(s):  
Omar K. Siddiqi ◽  
Melissa A. Elafros ◽  
Christopher M. Bositis ◽  
Igor J. Koralnik ◽  
William H. Theodore ◽  
...  
Keyword(s):  
Risk Factors ◽  
Opportunistic Infections ◽  
Clinical Laboratory ◽  
Jc Virus ◽  
Seizure Recurrence ◽  
Onset Seizure ◽  
Karnofsky Score ◽  
Varicella Zoster ◽  
Identifiable Risk Factor ◽  
New Onset

Objective:To identify the etiology of new-onset seizure in HIV-infected Zambian adults and identify risk factors for seizure recurrence.Methods:A prospective cohort study enrolling HIV-infected adults with new-onset seizure within 2 weeks of index seizure obtained clinical, laboratory, and neuroimaging data to determine seizure etiology. Participants were followed to identify risk factors for seizure recurrence. Risk factors for mortality were examined as mortality rates were unexpectedly high.Results:Eighty-one patients with CSF for analysis were enrolled and followed for a median of 306 days (interquartile range 61–636). Most (91%) were at WHO stage III/IV and 66 (81%) had a pre-seizure Karnofsky score ≥50. Prolonged or multiple seizures occurred in 46 (57%), including 12 (15%) with status epilepticus. Seizure etiologies included CNS opportunistic infections (OI) in 21 (26%), hyponatremia in 23 (28%), and other infections in 8 (10%). OIs included Cryptococcus (17%), JC virus (7%) and 5% each for tuberculosis, cytomegalovirus, and varicella-zoster virus. No etiology could be identified in 16 (20%). Thirty (37%) patients died during follow-up and 20 (25%) had recurrent seizures with survival being the only identifiable risk factor.Conclusions:HIV-infected adults with new-onset seizure in Zambia often have advanced HIV disease with OI being the most frequent seizure etiology. Seizure recurrence is common but no risk factors for recurrence other than survival were identified. These findings suggest an urgent need for immune reconstitution in this population. Initiating treatment for seizure prophylaxis where only enzyme-inducing antiepileptic medications are available could threaten antiretroviral efficacy.

scholarly journals New-Onset Diabetes Mellitus in Patients with Idiopathic Membranous Nephropathy Undergoing Tacrolimus and Low-Dose Corticosteroid Therapy

2019 ◽  
Vol 44 (6) ◽  
pp. 1352-1362 ◽  
Author(s):  
Lina Shao ◽  
Juan Jin ◽  
Binxian Ye ◽  
Baihui Xu ◽  
Yiwen Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Risk Factor ◽  
Corticosteroid Therapy ◽  
Low Dose ◽  
Significant Difference ◽  
Dose Corticosteroid ◽  
New Onset Diabetes Mellitus ◽  
New Onset

Background: Idiopathic membranous nephropathy (IMN) is the most common cause of nephrotic syndrome in adults. Although various studies have demonstrated the efficacy of tacrolimus combined with corticosteroids for treating IMN, both tacrolimus and corticosteroids have been shown to be diabetogenic, particularly following organ transplantation. Furthermore, the frequency and risk factors for new-onset diabetes mellitus (NODM) in IMN patients treated with tacrolimus plus low-dose corticosteroids remain unclear. Objectives: To evaluate the incidence of NODM in IMN patients undergoing tacrolimus plus low-dose corticosteroid therapy and to confirm the risk factors for NODM development. Methods: This retrospective study recruited 72 eligible patients with biopsy-proven IMN from our center, between September 2013 and June 2018. All subjects were treated with tacrolimus plus low-dose corticosteroids for a minimum of 3 months. The primary outcome was NODM development during the follow-up period. The secondary outcome was complete or partial remission. Patients were divided into 2 groups: patients with NODM (NODM group) and those without NODM (No-NODM group). Demographic and clinical data at baseline and follow-up were assessed. Results: During follow-up, 31 of the 72 patients developed NODM (43.0%). The median time to occurrence was 3 months after treatment initiation. NODM patients were significantly older (median age 59 vs. 40 years) than No-NODM patients. Baseline fasting blood glucose levels were slightly higher in the NODM group; however, the difference was not significant (p = 0.07). Older age was an independent risk factor for NODM (OR 1.73 and 95% CI 1.20–2.47, p = 0.003). Overall kidney remission rates were 80.6%. There was no significant difference in remission rate between groups. There was a significant difference in development of pulmonary infection, which occurred in 7 NODM patients and only in 1 No-NODM patient (p = 0.018). IMN reoccurred in 5 NODM patients but only 1 No-NODM patient. Conclusions: Tacrolimus plus low-dose corticosteroid therapy was an efficient treatment for IMN; however, it was accompanied by increased NODM morbidity, which should be considered serious, due to the increased risk of life-threatening complications. Increasing age was a major risk factor for NODM in IMN patients treated with tacrolimus plus low-dose corticosteroid therapy.

scholarly journals Risk factors of recurrent seizure, co-morbidities, and mortality in new onset seizure in elderly

Seizure ◽  
2013 ◽  
Vol 22 (7) ◽  
pp. 577-580 ◽  
Author(s):  
Kanitpong Phabphal ◽  
Alan Geater ◽  
Kitti Limapichat ◽  
Pornchai Sathirapanya ◽  
Suwanna Setthawatcharawanich
Keyword(s):  
Risk Factors ◽  
Onset Seizure ◽  
Recurrent Seizure ◽  
New Onset

scholarly journals Association between Risk Factors and New-Onse Seizures in Old Age Population

2021 ◽  
pp. 47-58
Author(s):  
Samee Jatoi ◽  
Dayo Abdullah ◽  
M. Z. Jilani ◽  
Soomro Fatima
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Disease ◽  
Brain Tumor ◽  
Old Age ◽  
Cns Infection ◽  
Control Group ◽  
Onset Seizure ◽  
And Control ◽  
New Onset

Objective: To determine the association between risk factors and new-onset seizures in old age population at a tertiary care hospital, Karachi. Methods: A case control study on old age patients of > 60 years visited emergency department (ED) either with new onset seizure or without seizure were conducted at ED of Ziauddin University Hospital Karachi. 154 consecutive old age patients were distributed into two groups i.e., case group (77 old age patients of new onset seizure) and control group (77 old age patients without seizure). Risk factors including stroke, dementia, head trauma, metabolic causes, brain tumor, infection of central nervous system (CNS), depression and anxiety were evaluated. Results: Out of 154 old age patients, male was 32 (41.6%) and 40 (51.9%) and female was 45 (58.4%) and 37 (48.1%) in case and control group respectively. Type of seizure in control group was generalized tonic–clonic seizure (GTCS) in 51 (66.2%) patients and focal seizure in 26 (33.8%) patients. Comorbidities were diabetes mellitus (DM) in 76 (98.7%) and 59 (76.6%) patients, hypertension (HTN) in 72 (93.5%) and 63 (81.8%) patients and ischemic heart disease (IHD) in 39 (50.6%) and 25 (32.5%) patients. Risk factors were stroke in 23 (29.9%) and 16 (20.8%) patients, dementia in 3 (3.9%) and 0 (0.0%) patients, head trauma in 0 (0.0%) and 33 (42.9%) patients, metabolic causes in 27 (35.1%) and 27 (35.1%) patients, brain tumor in 6 (7.8%) and 0 (0.0%) patients, CNS infection in 17 (22.1%) and 1 (1.3%) patients and depression in 2 (2.6%) and 0 (0.0%) patients. Conclusion: New-onset seizures are significantly associated with age, diabetes mellitus, hypertension, ischemic heart disease, brain tumor and CNS infection.

Citalopram-Related SIADH

2003 ◽  
Vol 19 (2) ◽  
pp. 91-93 ◽  
Author(s):  
Ginger J Ertel ◽  
Todd W Nesbit
Keyword(s):  
Mechanism Of Action ◽  
Older Patients ◽  
White Woman ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Case Reports ◽  
Lower Number ◽  
Medline Search ◽  
Case Summary ◽  
Number Of Patients ◽  
Increased Risk

Objective: To report a case of syndrome of inappropriate antidiuretic hormone (SIADH) after the initiation of citalopram and trazodone therapy. Case Summary: A 75-year-old white woman developed SIADH after the initiation of citalopram and trazodone therapy. Discussion: Selective serotonin-reuptake inhibitors (SSRIs) and trazodone have been associated with hyponatremia in the literature. There are numerous reports of SSRIs, primarily fluoxetine, associated with SIADH. There are 8 case reports of SIADH reported with citalopram in the literature, which were identified through a MEDLINE search that included all languages and bibliographic review of those cases. The number of citalopram cases may not be associated with a reduced incidence but with the infrequency of citalopram use compared with the widespread use of fluoxetine. The mechanism of action of citalopram is enhancement of serotoninergic neurotransmission, which is similar to other serotonin (5-HT) reuptake inhibitors. To date, there are only 2 reports of trazodone associated with hyponatremia in the literature, both as a result of an overdose. Conclusions: SIADH has been reported with several SSRIs, but to a lesser degree with citalopram, which may be attributed to the lower number of patients using it compared with other SSRIs. Increased awareness and monitoring of SIADH is important, especially in older patients who may be at an increased risk of SIADH.

Deep vein thrombosis on the fourth day of risperidone therapy

2021 ◽  
Vol 14 (3) ◽  
pp. e239569
Author(s):  
Kavitha Konnakkaparambil Ramakrishnan ◽  
Mithila George
Keyword(s):  
Adverse Effect ◽  
Deep Vein Thrombosis ◽  
Atypical Antipsychotics ◽  
Low Dose ◽  
Case Reports ◽  
Paranoid Schizophrenia ◽  
Antipsychotic Treatment ◽  
Vein Thrombosis ◽  
Initiation Of Therapy ◽  
Deep Vein

Deep vein thrombosis has been recognised as a complication of antipsychotic treatment and is reported to be more common with atypical antipsychotics. Risperidone is a second-generation atypical antipsychotic and there have been case reports of risperidone-associated deep vein thrombosis, most of them reporting the complication from 2 weeks to a few months of initiation of therapy. Here, we are reporting a case of deep vein thrombosis in a male patient in his early forties with paranoid schizophrenia, which presented on the fourth day of starting risperidone therapy. This case is being reported to highlight the fact that deep vein thrombosis can occur as early as fourth day of initiation of risperidone therapy, that too at a low dose (2 mg/day). The case also emphasises the importance of monitoring these patients for this rare but potentially serious adverse effect from the first day itself after initiation of a new antipsychotic.

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