scholarly journals Possibility of a New Indication for Amantadine in the Treatment of Bipolar Depression—Case Series Study

2020 ◽  
Vol 13 (10) ◽  
pp. 326
Author(s):  
Marek Krzystanek ◽  
Artur Pałasz
Keyword(s):  
Depressive Symptoms ◽  
Side Effects ◽  
Bipolar Depression ◽  
Therapeutic Option ◽  
Case Series ◽  
Mood Stabilizer ◽  
New Drugs ◽  
Case Series Study ◽  
Antidepressant Efficacy

Bipolar disorder is a chronic and remitting mental illness. Antidepressants are not effective in treating acute bipolar depression, and antipsychotic drugs used in the treatment of bipolar depression cause frequent side effects. This situation justifies the search for new drugs as well as the repurposing of drugs used in other indications. In an open and naturalistic serious case study, 4 patients diagnosed with bipolar I disorder, chronically treated with a mood stabilizer, in whom at least two antidepressants were ineffective in the depressive phase, were treated with amantadine. The woman received 100 mg/day and 3 men received the target dose of 200 mg/day. All patients treated with amantadine improved their depressive symptoms after 1 week of treatment. None of them experienced side effects or manic switch. To reduce the risk of a manic switch, the treatment with amantadine was discontinued 2 weeks after the improvement of depressive symptoms, and no recurrence of depressive symptoms was observed. Amantadine may be a further therapeutic option for the treatment of acute bipolar depression. The drug in this indication may act quickly and be well tolerated. Confirmation of the antidepressant efficacy of amantadine in this indication requires replication of the results and conducting clinical trials.

scholarly journals Opioid-free anesthesia for patients with joint hypermobility syndrome undergoing craneo-cervical fixation: a case-series study focused on anti-hyperalgesic approach

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Carlos Ramírez-Paesano ◽  
Albert Juanola Galceran ◽  
Claudia Rodiera Clarens ◽  
Vicenҫ Gilete García ◽  
Bartolomé Oliver Abadal ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Hospital Discharge ◽  
Case Series ◽  
Ehlers Danlos Syndrome ◽  
Painful Condition ◽  
Discharge Data ◽  
Gastrointestinal Complications ◽  
Case Series Study ◽  
Series Study

Abstract Background Patients with Ehlers-Danlos Syndrome/Hypermobility Type (EDS-HT/JHS) and Craneo-Cervical Instability frequently suffer from severe widespread pain which is difficult to control. Chronic neuroinflammation, opioid-induced hyperalgesia, and central sensitization may explain this painful condition. The aim of this study was to determine if opioid-free anesthesia plus the postoperative administration of lidocaine, ketamine and dexmedetomidine can reduce postoperative pain and the need of methadone rescues in comparison with opioid-based management in these patients undergoing Craneo-Cervical Fixation (CCF). The secondary aim was to assess the needs of opioids at hospital-discharge, incidence of gastrointestinal complications and the requirement of anxiolytic. Methods A retrospective, consecutive case series study was designed. 42 patients with EDS-HT/JHS undergoing CCF were enrolled in two groups: an OFA-plus Group that received opioid-free anesthesia with propofol, lidocaine, ketamine and dexmedetomidine, and OP Group, opioid-based anesthesia-analgesia. The main variables: Preoperative Visual Analogue Score (VAS), postoperative VAS on the 1st, 2nd, 4th and 6th days, sufentanil or morphine requirements, need for methadone rescue, and VAS at hospital-discharge. Data was presented by mean ± SD, percentage, median or interquartile range. Chi-squared or Fisher’s test. 95% C.I and P values < 0.05. Results Nineteen patients in OFA-plus, and 23 patients in OP group. VAS was lower in OFA-plus on the postoperative days evaluated (p < 0.001).VAS at hospital-discharge was lower in OFA-plus: 4.96 (4.54–5.37) vs. OP 6.39 (6.07–6.71) (p < 0.001). Methadone requirement was lower in the OFA-plus (p < 0.001). 78% of patients in OFA-plus didn’t need methadone rescue. 95% in OP group needed methadone rescues at high doses(> 15 mg/day). No differences regarding equivalent doses of sufentanil or morphine consumption on the 2nd, 4th, and 6th postoperative days were found. OFA-plus decreased ileus, nausea and vomiting (p < 0.001). 60.9% in OFA-plus group decreased opioid requirements at hospital-discharge compared with preoperative values. A 77% reduction of anxiolytics requirements was shown. Conclusion OFA-plus management for patients undergoing CCF with EDS-HT/JHS shows significant reduction in postoperative pain and at hospital-discharge compared with opioid-based anesthesia. OFA-plus management decreases the total doses of methadone rescues, reduces anxiolytic requirements and gastrointestinal side-effects, except for constipation. OFA-plus management is a feasible option to improve postoperative pain control, reducing the opioids’ use and their postoperative side-effects in patients undergoing CCF with EDS-HT/JHS.

Efficacy of ultra-low-dose (0.1 mg) ranibizumab intravitreal injection for treatment of prethreshold type 1 retinopathy of prematurity: A case series

2018 ◽  
Vol 30 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Islam SH Ahmed ◽  
Ahmed MA Hadi ◽  
Hassan H Hassan
Keyword(s):  
Side Effects ◽  
Intravitreal Injection ◽  
Retinopathy Of Prematurity ◽  
Large Scale ◽  
Low Dose ◽  
Case Series ◽  
Results Of Treatment ◽  
Case Series Study ◽  
Systemic Side Effects

Aim: To report the results of treatment of type 1 prethreshold retinopathy of prematurity using intravitreal injection of ultra-low dose of ranibizumab (0.1 mg in 0.01 mL). Design: A retrospective observational case series study. Methods: Review of files of eligible infants who received this form of treatment to determine the outcome of treatment and any associated ocular or systemic side effects. Results: The study included 24 eyes of 12 preterm infants with mean gestational age of 29.75 ± 1.54 weeks and mean birth weight of 1074.58 ± 320.59 g. A total of 22 eyes (91.67%) had zone II disease while 2 eyes of one infant (8.33%) had zone I disease. All cases showed regression of the signs of the active retinopathy of prematurity with complete retinal vascularization. None of the cases required retreatment. Three eyes developed ocular complications. Apart from mild feeding intolerance that lasted for 24 h after injection in one infant, none of the cases developed systemic side effects. Conclusion: Intravitreal injection of ultra-low-dose ranibizumab showed promising efficacy and good ocular safety. However, further large-scale studies are required to give stronger evidence about the efficacy and safety of ultra-low-dose ranibizumab.

scholarly journals Literature based discovery of alternative TCM medicine for adverse reactions to depression drugs

2020 ◽  
Vol 21 (S5) ◽  
Author(s):  
Qing Xie ◽  
Kyoung Min Yang ◽  
Go Eun Heo ◽  
Min Song
Keyword(s):  
Side Effects ◽  
Herbal Medicines ◽  
Interaction Network ◽  
Enrichment Analysis ◽  
New Drugs ◽  
Protein Protein Interaction ◽  
Target Drug ◽  
Target Disease ◽  
Literature Based Discovery

Abstract Background In recent years, Traditional Chinese Medicine (TCM) and alternative medicine have been widely used along with western drugs as a complementary form of treatment. In this study, we first use the scientific literature to identify western drugs with obvious side effects. Then, we find TCM alternatives for these western drugs to ameliorate their side effects. Results We used depression as a case study. To evaluate our method, we showed the relation between herb-ingredients-target-disease for representative alternative herbs of western drugs. Further, a protein-protein interaction network of western drugs and alternative herbs was produced, and we performed enrichment analysis of the targets of the active ingredients of the herbs and examined the enrichment of Gene Ontology terms for Biological Process, Cellular Component, and Molecular Function and KEGG Pathway levels, to show how these targets affect different levels of gene expression. Conclusion Our proposed method is able to select herbs that are highly relevant to the target indication (depression) and are able to treat the side effects caused by the target drug. The compounds from our selected alternative herbal medicines can therefore be complementary to the western drugs and ameliorate their side effects, which may help in the development of new drugs.

Pramipexole: Augmentation in the Treatment of Depressive Symptoms

CNS Spectrums ◽  
2006 ◽  
Vol 11 (3) ◽  
pp. 172-175 ◽  
Author(s):  
Sanjay Gupta ◽  
Jennifer L. Vincent ◽  
Bradford Frank
Keyword(s):  
Depressive Symptoms ◽  
Treatment Regimen ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Case Series ◽  
Unipolar Depression ◽  
Off Label Use ◽  
Retrospective Case ◽  
Off Label ◽  
Hamilton Rating Scale

ABSTRACTWe describe a retrospective case series of three patients, two with bipolar depression and one with unipolar depression. Pramipexole is a Food and Drug Administration-approved antiparkinsonian agent, which, when used to augment antidepressants, would be considered an off-label use and should be discussed with the patient. These patients had robust responses to pramipexole augmentation of their treatment regimen. All three patients had been taking an atypical antipsychotic. The depressive symptoms were evaluated using the Hamilton Rating Scale for Depression.

scholarly journals Use of remdesivir in the treatment of coronavirus disease 2019 (COVID-19) infection among Sudanese patients: a case series

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 512
Author(s):  
Maysoun Yousif ◽  
Ghada Abd El-Raheem ◽  
Doaa Mohamed
Keyword(s):  
Side Effects ◽  
Liver Enzymes ◽  
Case Series ◽  
Supportive Therapy ◽  
First Case ◽  
Case Series Study ◽  
New Treatment ◽  
Series Study

Introduction: The coronavirus disease 2019 (COVID-19) pandemic is affecting populations worldwide. Remdesivir is an anti-retroviral agent, with a broad spectrum of usage. Remdesivir usage against COVID-19 had been studied both in vitro and in vivo but is still considered a new treatment for COVID-19 and is not available in all countries. The aim of our study was to report several cases of the use of remdesivir in Sudanese patients and report the adverse events related to the course of treatment. Methods: A case series study was conducted in Imperial Hospital, Khartoum, Sudan reporting two cases who received remdesivir for treating COVID-19 besides other treatments such as steroids and supportive therapy in December 2020. Cases were males aged over 65 years. Cases presentation: Both patients were severe cases of COVID-19 admitted to the intensive care unit (ICU), who received remdesivir for treating COVID-19 infection. Several side effects were reported: the first case had increased liver enzymes and then unexpectedly died from severe resistant hypotension; and hypoalbuminemia was noticed in the second case. Conclusions: Remdesivir use among patients in Sudan must be studied extensively in order to determine the unexpected fatal event and assess the association of this event to remdesivir use, as well as to report the frequency of the side effects.

scholarly journals Chemical cauterization of peristomal granulomas with 50% trichloroacetic acid

2019 ◽  
Author(s):  
Rosaura Paczek ◽  
Luisa Passberg
Keyword(s):  
Trichloroacetic Acid ◽  
Therapeutic Option ◽  
Case Series ◽  
Clinical Results ◽  
Focal Lesions ◽  
Regular Treatment ◽  
Case Series Study ◽  
Chemical Cauterization ◽  
The Individual

Objetive: This study deals with the treatment of granulomas, one of the possible complications of the stomies, which are characterized as focal lesions, whose formation occurs due to the presence of aggressive agents to the tissues from the increase of the degree of cellularity and other tissue elements, generating annoyance and anxiety to patients. This study aims to describe the clinical results of the treatment of peristomal granulomas with the use of 50% trichloroacetic acid (TCA). Methods: This is a case series study, carried out by professionals in a referral center for the treatment of individuals with an ostomy in the city of Porto Alegre, state of Rio Grande do Sul. Results: The study sample consisted of 13 patients who underwent follow-up for treatment of peristomal granulomas with TCA. Data collection was performed during nursing consultations, based on the observation and photographic record of the granulomas, with subsequent evolution in the individual charts. Conclusion: It was concluded from this study that the regular treatment with TCA resulted in regression of the granulomas until their total disappearance, being this acid able to be considered, therefore, a potential therapeutic option; however, it is recommended to carry out further studies on its use in stomatherapy, seeking the use of more robust clinical research methodologies and with bias control.

scholarly journals Opioid-free Anesthesia for Patients With Joint Hypermobility Syndrome Undergoing Craneo-cervical Fixation: a Case-series Study Focused on Anti-hyperalgesic Approach

2020 ◽  
Author(s):  
Carlos R Ramirez-Paesano ◽  
Albert Juanola Galcerán ◽  
Claudia Rodiera Clarens ◽  
Vicenç Gilete García ◽  
Bartolomé Oliver Abadal ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Hospital Discharge ◽  
Case Series ◽  
Joint Hypermobility Syndrome ◽  
Ehlers Danlos Syndrome ◽  
Discharge Data ◽  
Gastrointestinal Complications ◽  
Case Series Study ◽  
Series Study

Abstract Background. Patients with Ehlers-Danlos Syndrome/Hypermobility Type (EDS-HT/JHS) and Craneo-Cervical Instability frequently suffer from severe widespread pain which is difficult to control. Chronic neuroinflammation, opioid-induced hyperalgesia, and central sensitization may explain this painful condition.The aim of this study was to determine if opioid-free anesthesia plus the postoperative administration of lidocaine, ketamine and dexmedetomidine can reduce postoperative pain and the need of methadone rescues in comparison with opioid-based management in these patients undergoing Craneo-Cervical Fixation(CCF). The secondary aim was to assess the needs of opioids at hospital-discharge, incidence of gastrointestinal complications and the requirement of anxiolytic.Methods. A retrospective, consecutive case series study was designed. 42 patients with EDS-HT/JHS undergoing CCF were enrolled in two groups: an OFA-plus Group that received opioid-free anesthesia with propofol, lidocaine, ketamine and dexmedetomidine, and OP Group, opioid-based anesthesia-analgesia. The main variables: Preoperative Visual Analogue Score (VAS), postoperative VAS on the 1st, 2nd, 4th and 6th days, sufentanil or morphine requirements, need for methadone rescue, and VAS at hospital-discharge. Data was presented by mean ± SD, percentage, median or interquartile range. Chi-squared or Fisher’s test. 95% C.I and P values <0.05 . Results. Nineteen patients in OFA-plus, and 23 patients in OP group. VAS was lower in OFA-plus on the postoperative days evaluated (p<0.001).VAS at hospital-discharge was lower in OFA-plus: 4.96 (4.54-5.37) vs. OP 6.39 (6.07-6.71) (p<0.001). Methadone requirement was lower in the OFA-plus (p<0.001). 78% of patients in OFA-plus didn’t need methadone rescue. 95% in OP group needed methadone rescues at high doses(>15mg/day). No differences regarding equivalent doses of sufentanil or morphine consumption on the 2nd, 4th, and 6th postoperative days were found. OFA-plus decreased ileus, nausea and vomiting (p<0.001). 60.9% in OFA-plus group decreased opioid requirements at hospital-discharge compared with preoperative values. A 77% reduction of anxiolytics requirements was shown. Conclusion: OFA-plus management for patients undergoing CCF with EDS-HT/JHS shows significant reduction in postoperative pain and at hospital-discharge compared with opioid-based anesthesia. OFA-plus management decreases the total doses of methadone rescues, reduces anxiolytic requirements and gastrointestinal side-effects, except for constipation. OFA-plus management is a feasible option to improve postoperative pain control, reducing the opioids’ use and their postoperative side-effects in patients undergoing CCF with EDS-HT/JHS.

scholarly journals Office Hysteroscopic Laser Enucleation of Submucous Myomas without Mass Extraction: A Case Series Study

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Sergio Haimovich ◽  
Maite López-Yarto ◽  
Julio Urresta Ávila ◽  
Alejandro Saavedra Tascón ◽  
José L. Hernández ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Case Series ◽  
Uterine Cavity ◽  
Hysteroscopic Myomectomy ◽  
Submucous Myoma ◽  
Case Series Study ◽  
Laser Enucleation ◽  
A Prospective Study ◽  
Series Study

Background and Objectives. A new two-step hysteroscopic myomectomy carried out in the office setting and without anesthesia was feasible for the excision of submucous myomas. The objective of this study was to assess whether removal of submucous myomas from the uterine cavity after hysteroscopic laser enucleation is necessary.Methods. Between June 2009 and April 2013, all outpatients with symptomatic myomatosis (bleeding, pelvic pain, and infertility) assessed ultrasonographically were eligible to participate in a prospective study. All patients underwent office hysteroscopic enucleation of submucous myomas. Enucleated myomas were left in the uterine cavity. Neither anesthesia nor antibiotic prophylaxis was used.Results. Sixty-one women (mean age: 47.3 years) were included. Regardless of hysteroscopic localization and grading, all myomas were enucleated. The mean (standard deviation, SD) diameter of the myoma as measured by the ultrasound scan was 22.6 (8.5) mm. In 29 cases (47.5%), the diameter of the resected myoma was >20 mm and in 10 cases (16.4%) >30 mm. After a mean follow-up of 68.2 (16.5) days, none of the patients showed a residual myoma inside the uterine cavity.Conclusions. The present results indicate that leaving laser-enucleated submucous myoma in the uterine cavity is a feasible and safe therapeutic option.

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