scholarly journals Psychomotor Agitation Non-responsive to Treatment: A Case Report of Phenibut Withdrawal Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Cecilia Maria Esposito ◽  
Gian Mario Mandolini ◽  
Giuseppe Delvecchio ◽  
Alessio Fiorentini ◽  
Paolo Brambilla
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Outcome Data ◽  
Psychotic Symptoms ◽  
Psychoactive Substances ◽  
Psychomotor Agitation ◽  
Present Case Report ◽  
The Face ◽  
Withdrawal Syndromes ◽  
Restitutio Ad Integrum

Background and Objectives: Phenibut (4-amino-3-phenyl-butyric acid), acting as a GABA-B receptor agonist, has a beneficial effect on anxiety. Although its medical use is not approved in western countries, it can be easily obtained worldwide via the Internet, so it spread as a substance of abuse. In recent years, some case reports have, therefore, highlighted episodes of acute toxicity or withdrawal, but it is still a largely unknown phenomenon.Methods: In this case report, a 50-year-old woman was admitted to the emergency room with psychomotor agitation, psychotic symptoms, and insomnia, and was non-responsive to treatment. She was hospitalized at the psychiatry ward for 25 days and gave her consent for the publication of the present case report.Results: The suspicion of phenibut withdrawal allowed to establish the appropriate management, leading to the restitutio ad integrum of the psychopathological case.Conclusions: In the face of an incoercible psychomotor agitation case, the knowledge of the so-called novel psychoactive substances allows for more appropriate clinical management of intoxication and withdrawal syndromes. This is a scientifically significant report as it provides therapeutic and outcome data concerning a syndrome that is still quite unfamiliar.

scholarly journals Persistent delusional theme over 13 episodes of psychotic depression

2013 ◽  
Vol 25 (6) ◽  
pp. 370-373 ◽  
Author(s):  
Søren Dinesen Østergaard ◽  
Anne Katrine K. Leadholm ◽  
Anthony J. Rothschild
Keyword(s):  
Case Report ◽  
Electroconvulsive Therapy ◽  
Case Reports ◽  
Psychotic Symptoms ◽  
Psychotic Depression ◽  
Medical File ◽  
Course Of Illness ◽  
Clinical Phenomenon ◽  
Initial Episode ◽  
Multiple Episodes

ObjectiveUnipolar psychotic depression (PD) is a highly debilitating condition, which needs intense monitoring and treatment. Among patients with recurrent PD, delusions tend to be very similar or identical over several separate episodes during the course of illness, but case reports illustrating this clinical phenomenon in detail are lacking from the literature.MethodsCase report describing the 45-year-old Ms. J, who has experienced multiple episodes of PD. The report is based on a review of her medical file.ResultsThe delusional theme of Ms. J's initial episode of PD reappeared at several subsequent episodes. During the majority of admissions, Ms. J was treated with electroconvulsive therapy, which resulted in significant improvement in the depressive, psychotic and catatonic features.ConclusionMs. J's case illustrates that PD can be a stable phenotype over many episodes and that it is important to recognise psychotic symptoms in order to prescribe the best possible treatment.

scholarly journals Non-surgical management of periapical lesions with triple antibiotic paste: A case reports

2020 ◽  
Vol 2 ◽  
pp. 120-123
Author(s):  
Munish Singla ◽  
Iyana Garg ◽  
Vandana Goyal ◽  
Harleen Kaur ◽  
Litik Mittal
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Root Canal ◽  
Case Reports ◽  
Endodontic Treatment ◽  
Root Canal Treatment ◽  
Periapical Lesion ◽  
Present Case Report ◽  
Periapical Lesions ◽  
Triple Antibiotic Paste

Sterilization of root canal space is foremost for the success of the endodontic treatment which is usually carried out with intracanal irrigants and medicaments. Triple antibiotic paste (metronidazole, ciprofloxacin, and minocycline) is used to achieve sterilization and healing of periradicular area. In the present case report, the triple antibiotic paste was used for non-surgical management of periapical lesion for 3 weeks. After 3 weeks, the tooth became asymptomatic that was then obturated. Hence, it is confirmed that conventional root canal treatment, along with intracanal medicaments (triple antibiotic paste), can non-surgically manage the periapical lesions and further promotes healing.

scholarly journals Case report of hidradenitis suppurativa localized to the face in an HIV patient

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110579
Author(s):  
Brian D Rankin ◽  
Richard M Haber
Keyword(s):  
Case Report ◽  
Skin Disease ◽  
Hidradenitis Suppurativa ◽  
Case Reports ◽  
Hiv Positive ◽  
Inflammatory Skin Disease ◽  
Hiv Patients ◽  
Disease Case ◽  
The Face ◽  
Inflammatory Skin

Hidradenitis suppurativa is a chronic, debilitating inflammatory skin disease. Case reports of individuals with hidradenitis suppurativa presenting exclusively on the face, as well as reports of individuals with HIV and hidradenitis suppurativa, are rare. Here, we present the case of an HIV-positive man who presented with hidradenitis suppurativa localized only on his face. We also review facial hidradenitis suppurativa and hidradenitis suppurativa in HIV patients.

scholarly journals Juvenile sterile granulomatous dermatitis (puppy strangle) in Pekingese and German shepherd puppies

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Mohammad Abbaszadeh Hasiri ◽  
Efat Baghaei Moghaddam
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Bacterial Culture ◽  
Skin Lesions ◽  
Response To Therapy ◽  
Skin Scraping ◽  
German Shepherd ◽  
Present Case Report ◽  
The Face ◽  
Granulomatous Dermatitis

Juvenile sterile granulomatous dermatitis is an uncommon granulomatous and pustular disorder of the face, pinnae, and submandibular lymph nodes of puppies. A 10-week-old male Pekingese and a 8-week-old female German shepherd presented with submandibular lymphadenomegaly, skin lesions on muzzle and periocular area (Papules, crusts and pustules). The case did not respond to antibiotic therapy. Results of a hemogram, biochemical panel, and urinalysis were normal. Due to skin scraping, cytology examination (impression smear), fungal and bacterial culture and response to therapy puppy strangle (juvenile cellulitis) was diagnosed. The puppies made a full recovery on glucocorticoid therapy. The present case report describes the first report of juvenile sterile granulomatous dermatitis in Iran.

FC02-04 - Assessment of schizophrenia in adults with intellectual disability and autism - an empirical study

2011 ◽  
Vol 26 (S2) ◽  
pp. 1818-1818 ◽  
Author(s):  
T.L. Bakken ◽  
H. Martinsen ◽  
S. Friis ◽  
S. Lovoll ◽  
D.E. Eilertsen
Keyword(s):  
Case Report ◽  
Intellectual Disability ◽  
Statistical Analysis ◽  
Empirical Study ◽  
Negative Symptoms ◽  
Case Reports ◽  
Psychotic Symptoms ◽  
Global Functioning ◽  
Adequate Treatment ◽  
Report Data

IntroductionIn adults with intellectual disability and autism, psychosis is rarely detected due to misinterpretation of psychotic symptoms being autism or idiosyncratic communication. The patients can poorly communicate the delusions and hallucinations they experience. Observable indicators are therefore necessary.ObjectivesTo establish reliable and valid behavioural indicators of psychosis in adults with intellectual disability and autism.AimsThe aim was to investigate behavioural indicators of psychosis in adults with intellectual disability and autism.MethodsForty-three patients with intellectual disability and autism from a hospital-based study were recruited. Eight of these patients were assessed as having schizophrenia-like psychosis. They were further examined through a case-report study. Both statistical analysis and data from the case reports were included. Case report data were compared with scores from a validation study of the Psychopathology in Autism Checklist, PAC.ResultsBehavioural disorganisation, severe decreased global functioning, suspected hallucinations and decreased sociability were observed in the eight psychotic patients. The level of disorganisation was significantly higher in the psychotic patients than in the non-psychotic patients - this included patients with “plain” autism. Adequate treatment significantly decreased the level of disorganised behaviour.ConclusionsDisorganised behaviour, occurring concurrent with disorganised speech, severe decreased global functioning, suspected hallucinations and negative symptoms, were found to be reliable and valid indicators of psychosis.

scholarly journals Olanzapine-induced leucopaenia and thrombocytopaenia in an elderly patient: a case report and review of the evidence

2018 ◽  
Vol 31 (2) ◽  
pp. e000013 ◽  
Author(s):  
Yogender Kumar Malik ◽  
Swapnajeet Sahoo ◽  
Ajit Avasthi
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
Side Effects ◽  
Case Reports ◽  
The Elderly ◽  
Elderly Individual ◽  
Psychotic Symptoms ◽  
Elderly Individuals ◽  
Second Generation Antipsychotics ◽  
Life Threatening

Haematological adverse effects of antipsychotics are rare but life threatening. Existing literature is limited to case reports, which are mostly reported on second generation antipsychotics (clozapine, olanzapine, risperidone, quetiapine). Elderly individuals are at risk of developing side effects with any psychotropics. Olanzapine is commonly used for the management of psychotic symptoms as well as for the management of behavioural and psychological problems with dementia in the elderly. In this case report, we report thrombocytopaenia and leucopaenia in an elderly individual with schizophrenia which developed after initiation of olanzapine and reverted back after stoppage of the drug. This case report highlights that the elderly are susceptible to develop haematological side effects with olanzapine and hence monitoring may be essential.

scholarly journals Psychosis associated with methimazole-induced hypothyroidism: a case report

2013 ◽  
Vol 62 (2) ◽  
pp. 171-173 ◽  
Author(s):  
Priscila C. F. Lazaro ◽  
Julia C. Loureiro ◽  
Claudio E. M. Banzato
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Psychotic Symptoms ◽  
Antithyroid Drugs ◽  
Psychotic Episode ◽  
Thyroid Status ◽  
Free T4 ◽  
Acute Change ◽  
Thyroid Goiter ◽  
Psychiatric Manifestations

INTRODUCTION: Thyroid dysfunction has often been associated with several psychiatric manifestations. Previous case reports/series suggest the possible role played by acute alteration of thyroid status in the onset of psychotic symptoms. METHODS: Case report and literature review. RESULTS: A 45-year-old woman with no psychiatric antecedents was brought to the ER with a full-blown psychotic episode, marked by paranoid delusions, which developed gradually over two months. She had been treated elsewhere for hyperthyroidism for five years with methimazole 40 mg/d, with poor compliance. One month before the beginning of the psychotic symptoms, methimazole was raised to 60 mg/d and she started taking it correctly. Five months earlier she had TSH: 0.074 uUI/ml and free T4: 1.3 ng/dl. At admission we found a diffuse thyroid goiter, TSH: 70.9 uUI/ml and free T4: 0.03 ng/dl. Brain CT was normal. We hospitalized her with the diagnosis of a psychosis secondary to hypothyroidism, suspended methimazole, and gave her levothyroxine (up to 75 µg/d) and risperidone (2 mg/d). The patient had a quick remission and was discharged after 15 days. Within one month she had TSH: 0.7 uUI/ml and was completely recovered psychiatrically. She has been well since then, with risperidone in the first 8 months, and without it for 10 months now. CONCLUSION: This case report is a reminder of the necessity of checking thyroid status as part of clinical assessment of psychoses. It also supports the hypothesis that antithyroid drugs may have severe psychiatric consequences, especially when they lead to an acute change of thyroid status.

scholarly journals Pharmacotherapy of Patients Taking New Psychoactive Substances: A Systematic Review and Analysis of Case Reports

2021 ◽  
Vol 12 ◽  
Author(s):  
Michal Ordak ◽  
Aleksandra Zmysłowska ◽  
Miłosz Bielski ◽  
Daniel Rybak ◽  
Maja Tomaszewska ◽  
...  
Keyword(s):  
Case Reports ◽  
Synthetic Cannabinoids ◽  
Muscle Relaxants ◽  
New Psychoactive Substances ◽  
Psychoactive Substances ◽  
Psychomotor Agitation ◽  
Time Period ◽  
The World ◽  
Research Chemicals ◽  
Herbal Highs

Background: In recent years, an increase in the frequency of hospitalizations of patients taking newer and newer psychoactive substances has been observed around the world. Each year, authors publish case reports of patients who consumed previously unknown NPS. Most publications of this type concern the period between 2014 and 2016. However, no publication systematically reviews the pharmacotherapy used in these cases. This study aims to review the case reports of patients taking NPS published between 2010 and 2019, as well as analyzing the pharmacotherapy used.Methods: We searched the Thomson (Web of Knowledge), PubMed/Medline, Science Direct, Scopus and Google Scholar databases. The search was performed using all possible combinations of the term “case report” describing the use of NPS, also referred to as designer medications, internet medications, research chemicals and herbal highs.Results: We analyzed 51 case reports on the intake of various types of NPS. Most of them (p < 0.001) concerned the use of synthetic cannabinoids (41.2%) and cathinones (31.4%). The pharmacotherapy applied primarily (p < 0.001) consisted of administering benzodiazepines to patients (62.7%), most of whom took only this group of medications (25.5%), followed by groups receiving benzodiazepines combined with neuroleptics (15.7%) and muscle relaxants (11.8%). Opioids were administered primarily to patients taking synthetic opioids (p < 0.001). Of the 5 cases of deaths from NPS reported in the literature, three relate specifically to the synthetic opioid MT-45. The later the time period, the more medications patients were administered (p = 0.02).Conclusion: In the pharmacotherapy for NPS poisoning, one should focus primarily on combating psychomotor agitation.

scholarly journals Successful management of mandibular first molars with endodontic-periodontal lesions – Two case reports

2021 ◽  
Vol 62 (2) ◽  
Author(s):  
Shirin Behdad ◽  
◽  
Gonçalo Caramês ◽  
Beatriz Pereira ◽  
Mariana Pires ◽  
...  
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Interdisciplinary Approach ◽  
Regenerative Therapy ◽  
Successful Management ◽  
Present Case Report ◽  
Natural Dentition ◽  
Vascular Connections ◽  
Periodontal Healing

The interrelationship between pulpal and periodontal disease primarily occurs through the intimate anatomic and vascular connections between the pulp and the periodontium. The purpose of this case report is to present the treatment of two cases of mandibular first molars displaying endodontic-periodontal lesions with and without the use of regenerative bone techniques. The endodontic treatments were performed under an operating microscope in two appointments. Later, periodontal therapy was performed with a non-surgical approach in one case and with guided bone regeneration in the other. A 12-month radiographic and clinical follow-up showed periapical and periodontal healing in both cases. The present case report demonstrates that an interdisciplinary approach can help improve the prognosis and maintain natural dentition. Moreover, periodontal regenerative therapy can be performed to guide the wound healing towards the regeneration of lost periodontal structures.

scholarly journals Psychogenic polydipsia and hyponatremia – A side effect of psychosis: a review with a case report

2016 ◽  
Vol 65 (3) ◽  
pp. 300-303 ◽  
Author(s):  
João Perestrelo ◽  
Bruno Teixeira
Keyword(s):  
Mental Illness ◽  
Case Report ◽  
Case Reports ◽  
Relevant Literature ◽  
Hormone Secretion ◽  
Free Water ◽  
Psychotic Symptoms ◽  
Chronic Mental Illness ◽  
Psychogenic Polydipsia ◽  
Primary Polydipsia

ABSTRACT Primary polydipsia, or psychogenic polydipsia, is a condition that results in considerable morbidity and mortality. In psychiatric patients, psychogenic polydipsia and the syndrome of inappropriate antidiuretic hormone secretion may cause hyponatremia. In the 1970s, it was recognized that antipsychotics such as tiotixene and haloperidol could impair the excretion of a free water load. There are also several case reports of drug-induced hyponatremia in patients using atypical drugs suggesting that these probably can also impair water balance and induce hyponatremia. Case report and review of relevant literature are reported in this article. Psychogenic polydipsia is a common cause of hyponatremia among individuals with chronic mental illness. A case of severe hyponatremia caused by psychogenic polydipsia is described involving a female patient with an adult lifelong history of chronic mental illness diagnosed as schizoaffective disorder. After switching her antipsychotic medication to clozapine water ingestion was normalized as well as sodium levels and her psychotic symptoms improved. Primary polydipsia occurs commonly with schizophrenia and other mental diseases and can cause hyponatremia. PPD may present as an acute psychotic state or as inexplicable emergence of seizures. Appropriate, timely clinical assessment with special attention to thirst, fluid intake, and urine output is essential. Proper treatment may include drug withdrawal and fluid and saline restriction. Once corrected, some pharmacological agents can be tried. The article illustrates the importance of the diagnosis of psychogenic polydipsia given its electrolyte disturbances and life threatening situations.

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