scholarly journals Maintenance Electroconvulsive Therapy Meeting Unmet Needs of Antipsychotics in Older Patients: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Sharmilla Kanagasundram ◽  
Ishwary Damodaran ◽  
Lee Wen Pei ◽  
Sharmilla Kanagasundram ◽  
Tan Chow Hock
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Older Patients ◽  
Unmet Needs ◽  
First Episode ◽  
Low Doses ◽  
Extrapyramidal Side Effects ◽  
Anticholinergic Side Effect ◽  
Maintenance Ect

This case report highlights problems encountered by psychiatrists when treating a 68-year-old female patient who presented with a first episode of psychosis. She suffered from constipation, an anticholinergic side effect of quetiapine and both anticholinergic and extrapyramidal side effects of olanzapine. Finally, she was able to tolerate a combination of two pharmacologically different antipsychotics namely olanzapine and aripiprazole combined with a course of ECT followed by maintenance ECT. The authors would like to highlight maintenance ECT as part of the solution to patients who find it difficult to tolerate antipsychotics. Especially when only low doses of antipsychotics can be tolerated by the patient.

OLANZAPINE INDUCED AMENORRHEA REVERSED BY SWITCHING TO ARIPIPRAZOLE- A RARE CASE REPORT

2021 ◽  
pp. 50-51
Author(s):  
Ankit Halder ◽  
Navna Panchami ◽  
Abhishek Das
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Rare Case ◽  
Atypical Antipsychotics ◽  
Extrapyramidal Side Effects ◽  
Rare Case Report

Due to less extrapyramidal side-effects ,atypical antipsychotics use in psychiatry has increased a lot. But it is associated with other metabolic and endocrine side effects. Olanzapine is one such antipsychotic that less likely to cause hyperprolactinemia which can present as amenorrhea in patients.Here we present a rare case of olanzapine induced amenorrhoea reversed by switching to Aripiprazole.

scholarly journals Extrapyramidal side effects and suicidal ideation under fluoxetine treatment: a case report

2010 ◽  
Vol 9 (1) ◽  
Author(s):  
Christos Christodoulou ◽  
Athanasia Papadopoulou ◽  
Emmanouil Rizos ◽  
Kalliopi Tournikioti ◽  
Xenia Gonda ◽  
...  
Keyword(s):  
Case Report ◽  
Suicidal Ideation ◽  
Side Effects ◽  
Extrapyramidal Side Effects ◽  
Fluoxetine Treatment

Risperidone-Induced Neuroleptic Malignant Syndrome: A Case Report and Review

1996 ◽  
Vol 41 (1) ◽  
pp. 52-54 ◽  
Author(s):  
Gb Meterissian
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Neuroleptic Malignant Syndrome ◽  
Clinical Features ◽  
Prior History ◽  
Extrapyramidal Side Effects ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication ◽  
The One

Objectives: 1. To report the case of a 53-year-old patient who developed neuroleptic malignant syndrome (NMS) — a rare but potentially life-threatening complication of neuroleptic therapy — 4 days after treatment with risperidone was initiated. 2. To review previously reported cases of NMS associated with risperidone. Methods: A computerized search of several databases, including MEDLINE, was conducted to find all previously reported cases of NMS with risperidone. Results: Five reported cases of risperidone-induced NMS were found in the literature. All cases including the one reported here displayed typical clinical features of NMS and all 6 patients had a prior history of extrapyramidal side effects and/or NMS. Age and duration of exposure to risperidone did not seem to be of significance. Conclusions: These cases illustrate that clinicians should be on the lookout for risperidone-induced NMS.

scholarly journals Efficacy of atypical v. typical antipsychotics in the treatment of early psychosis: meta-analysis

2010 ◽  
Vol 196 (6) ◽  
pp. 434-439 ◽  
Author(s):  
Nicolas A. Crossley ◽  
Miguel Constante ◽  
Philip McGuire ◽  
Paddy Power
Keyword(s):  
Side Effects ◽  
Randomised Controlled Trials ◽  
Atypical Antipsychotics ◽  
Meta Analysis ◽  
Evidence Base ◽  
First Episode ◽  
Controlled Trials ◽  
Extrapyramidal Side Effects ◽  
Randomised Controlled ◽  
Typical Antipsychotics

BackgroundThere is an ongoing debate about the use of atypical antipsychotics as a first-line treatment for first-episode psychosis.AimsTo examine the evidence base for this recommendation.MethodMeta-analyses of randomised controlled trials in the early phase of psychosis, looking at long-term discontinuation rates, short-term symptom changes, weight gain and extrapyramidal side-effects. Trials were identified using a combination of electronic (Cochrane Central, EMBASE, MEDLINE and PsycINFO) and manual searches.ResultsFifteen randomised controlled trials with a total of 2522 participants were included. No significant differences between atypical and typical drugs were found for discontinuation rates (odds ratio (OR) = 0.7, 95% CI 0.4 to 1.2) or effect on symptoms (standardised mean difference (SMD) = –0.1, 95% CI –0.2 to 0.02). Participants on atypical antipsychotics gained 2.1 kg (95% CI 0.1 to 4.1) more weight than those on typicals, whereas those on typicals experienced more extrapyramidal side-effects (SMD = –0.4, 95% CI –0.5 to –0.2).ConclusionsThere was no evidence for differences in efficacy between atypical and typical antipsychotics, but there was a clear difference in the side-effect profile.

Fatal Overdose with Amantadine

1986 ◽  
Vol 31 (8) ◽  
pp. 757-758 ◽  
Author(s):  
P.E. Cook ◽  
Stanley W. Dermer ◽  
Terry Mcgurk
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Adverse Reactions ◽  
Extrapyramidal Side Effects ◽  
Fatal Overdose ◽  
First Case

The authors describe the first case report in the psychiatric literature of death from an overdose of amantadine hydrochloride used to treat neuroleptic induced extrapyramidal side effects. The pharmacology, adverse reactions and risks of using amantadine are briefly reviewed.

scholarly journals Drug-Drug-Induced Akathisia: Two Case Reports

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Grace Owusu Aboagye ◽  
Daniel Ankrah
Keyword(s):  
Side Effects ◽  
Rating Scale ◽  
Beta Blockers ◽  
Case Reports ◽  
First Episode ◽  
Extrapyramidal Side Effects ◽  
Drug Induced ◽  
Fluphenazine Decanoate ◽  
Probable Case ◽  
Psychotropic Medicines

Extrapyramidal side effects of psychotropic medicines are usually experienced by patients in the first few weeks of initiating therapy. Patients stabilized on these medications who present with distressing complaints akin to akathisia may be triggered by other factors. This report presents two cases of drug-drug-induced akathisia. Case A is a patient with schizophrenia who was being managed with risperidone 2 mg tablet daily for the past 3 years. She fell ill and reported to a nearby clinic where she was prescribed ciprofloxacin and artemether/lumefantrine tablets for the treatment of an infection and malaria. She presented 7 days later to her psychiatrist with complaints of restlessness, tremor, palpitations, insomnia, and resurgence of obsessive thoughts. Case B is a patient who was diagnosed with first-episode psychotic depression and admitted for 10 days. Her medications on admission were fluphenazine decanoate 25 mg depot injection once, olanzapine 10 mg tablet daily, and fluoxetine 20 mg capsule daily. On discharge, ciprofloxacin 500 mg tablet every 12 hours for 5 days and fluconazole 150 mg capsule once were added to her medications for the treatment of a urinary tract infection. She reported back to the hospital a day after discharge with complaints of restlessness, “seizures,” tremor, abdominal discomfort, and weight gain. Both patients were diagnosed with akathisia using ICD-10 classification and the Barnes akathisia rating scale and managed with anticholinergics, benzodiazepines, and beta blockers. Other measures employed in managing the akathisia included reducing the dose of the antipsychotic and/or switching antipsychotics. Despite these management measures, the symptoms of akathisia persisted and only resolved after 4weeks. Upon the resolution of symptoms, Case A continued treatment on olanzapine 5 mg tablet daily and fluoxetine 20 mg capsule daily while Case B continued treatment on risperidone 2 mg tablet daily and fluoxetine 20 mg capsule daily. Using Naranjo’s adverse drug reaction causality assessment scale, Medscape drug interaction checker, and literature review, a possible and probable case of drug-drug-induced akathisia was made for Case A and Case B. This report is to create more awareness about psychotropic-antimicrobial-induced akathisia. The information underpins the need for health professionals to consider adverse drug-drug interactions as the probable cause of extrapyramidal side effects experienced by patients on antipsychotics.

scholarly journals Extrapyramidal side effects with low doses of amisulpride

2014 ◽  
Vol 56 (2) ◽  
pp. 197 ◽  
Author(s):  
Nikhiles Mandal ◽  
Subrata Sen ◽  
OmP Singh
Keyword(s):  
Side Effects ◽  
Low Doses ◽  
Extrapyramidal Side Effects

scholarly journals Agitated Depression; The Challenges in Management and the Role of Maintenance Electroconvulsive Therapy

2020 ◽  
Vol 18 (3) ◽  
Author(s):  
V. Janaki ◽  
W. Suzaily
Keyword(s):  
Case Report ◽  
Depressed Patient ◽  
Electroconvulsive Therapy ◽  
Maintenance Ect ◽  
Adequate Dosage

This case report highlights the challenges encountered and the role of maintenance electroconvulsive therapy (ECT) in the management of a depressed patient who presented with symptoms of agitation. Despite on an adequate dosage and duration of medications, the patient showed poor improvement and persistent agitation. Upon commencing maintenance ECT in addition to the pharmacotherapy, the patient’s condition markedly improved. As conclusion, maintenance ECT may be another option in managing agitated depression.

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