Rhabdomyolysis secondary to severe tic fits

Tourette syndrome (TS) is a condition wherein motor and vocal tics occur, provoked by an urge, but often not able to be completely voluntarily controlled. Tics are known to cause physical and emotional risks to quality of life, and in rare extreme cases, may have permanent consequences. We report the first cases, to our knowledge, of rhabdomyolysis due to extreme tic fits in two distinct patients with TS. Both patients presented with severe tics, leading to elevated creatine kinase and a diagnosis of rhabdomyolysis requiring hospitalisation and intravenous fluids. Neither had neuroleptic malignant syndrome. One patient was on concurrent neuroleptic therapy, but his laboratory parameters improved when tics subsided despite continued neuroleptic use. Our cases highlight the potential complication of rhabdomyolysis secondary to severe tic fits independent of neuroleptic use.

Dynamics of Quality of Life Indices in Case of Metabolic Syndrome in Patients with Paranoid Schizophrenia on the Background of Atypical Neuroleptic Agents Application and Improvement of Comorbidity

The objective of the research was to study the features of quality of life dynamics depending on clinical and psychopathological symptoms in patients with paranoid schizophrenia asso ciated with metabolic syndrome on the background of long-term neuroleptic therapy and to study the eff ectiveness of concomitant corrective therapy. 140 patients with paranoid schizophrenia (F20.0) were examined and divided into three groups. Group I included 40 patients who received haloperidol at an ave rage daily dose of 4.6 ± 1.3 mg/day, Group II consisted of 40 patients who received risperidone (3.7 ± 1.8 mg/day), Group III included 40 patients who received quetiapine (413 ± 116 mg/day). Half of the patients in each of the presented groups continued to receive neuroleptic therapy according to the above mentioned regimen, and the other half of the patients received metformin hydro chloride at a dose of 500 mg/day in addition to the standard therapy. The cont rol group consisted of 20 patients diag nosed with "paranoid schizophrenia, remission", without metabolic syndrome signs, who had not received neuroleptics for the past six months. The Positive and Negative Syndrome Scale (PANSS) and the Medical Outcomes Study 36-Item Short-Form Health Status Questionnaire (SF-36) were used to study the patients’ mental health in detail. In this research, we monitored the impact of comorbidity on quality of life indices in the patients with long-lasting treatment of schizophrenia by neuroleptic agents, and noted that concomitant corrective therapy was appropriate in terms of compliance increase and quality of life indices improvement in the studied category of patients. Keywords: paranoid schizophrenia, metabolic syndrome, atypical neuroleptic agents, quality of life

“I Am Not Sure If I Should Do DaT”

Nuclear medicine-based imaging techniques can provide an estimation of nigrostriatal tract denervation based on radionucleotide uptake in the distal presynaptic terminals of dopaminergic neurons. Although unhelpful in differentiating between differing etiologies of denervation in varied neurodegenerative disorders associated with parkinsonism, this imaging is justified in situations in which parkinsonism is believed to be drug-induced or functional or in cases in which subclinical parkinsonism is suspected. The most common clinical situation in which dopamine transporter imaging is helpful is in the patient on neuroleptic therapy that cannot be stopped who has developed parkinsonism. Dopamine transporter imaging should be normal in drug-induced tremor.

Functional morphology of gonads under conditions of antipsychotic therapy

Gonadotoxic side effects of antipsychotic agents are known to cause serious disturbances in both germinative and endocrine testicular functions. The hormonal activity of the testes undergo undulating changes whereas the germinative function progressively decreases from the onset of neuroleptic therapy. The morphological and functional disturbances in the testicles are especially well pronounced after 10 years of antipsychotic treatment. The morphofunctional changes in the ovaries become apparent from the very beginning of antipsychotropic therapy; they are indicative of the progressive impairment of reproductive and endocrine functions of the female gonads.