Pregabalin dependence: A case report

PubMed ID: 26364177Pregabalin is a new generation antiepileptic that exerts its effect by decreasing the release of such neurotransmitters as glutamate, noradrenaline, and substance P. Pregabalin can be prescribed in Turkey at 150-600 mg to treat neuropathic pain, generalized anxiety disorder, fibromyalgia, and as concomitant therapy in adult patients with partial epilepsy. Experimental studies have shown that pregabalin could be beneficial in the treatment of benzodiazepine dependence and withdrawal, as well as for relapse prevention in patients with alcohol dependence. Nonetheless, the number of case reports on the abuse potential of pregabalin has increased. Herein we present a patient with pregabalin dependence. The patient's underlying alcohol and polysubstance dependence, and symptoms of generalized anxiety were thought to contribute to the development of pregabalin dependence. The patient reported that he had experienced severe withdrawal symptoms when he tried to stop using pregabalin. Bupropion and low-dose quetiapine were added to his paroxetine treatment, and pregabalin was discontinued gradually. Following this treatment the patient had not exhibited any signs of pregabalin dependence for one month. Although pregabalin is a promising drug for various psychiatric disorders, it should be used carefully in patients with a history of substance dependence

Antidepressant-discontinuation induced mania: A case report and review of the literature [Antidepresan kesilmesinin neden oldugu mani: Bir olgu ve literatürün gözden geçirilmesi]

Antidepressants have been used successfully in the treatment of depression for a long time. In the literature there are various studies and case reports about manic shift occured during antidepressant treatment. Although, it is well known that sudden discontinuation of an antidepressant drug may elicit a withdrawal reaction, mania or hypomania which can occur during sudden withdrawal of an antidepressant drug is rarely known. Recognizing this rarely known phenomenon and increasing number of in case reports will help the clinicians to predict patients who are inclined to manic shift and to understand probable etiological mechanisms. In this paper this interesting phenomenon was discussed in a case report and the literature was reviewed

The effects of the addiction programme of probation on treatment motivation, abstinence and quality of life: A comparative study with motivational interviewing and individual intervention

Introduction: The aim of this study is to evaluate the effectiveness of Addiction Programme of Probation (APP) created by the Substance Abuse Treatment Commission of Ministry of Health. Methods: The sample was consisted of probationers who were referred to Ege University by probation offices in February 2010. Literate probationers aged above 18, who fulfilled the SCID-I criteria for substance dependence, or had positive urine sample for illegal drugs were included. The probationers were allocated respectively to three treatment groups: APP (n=28); Motivational Interviewing (MI; n=30); Individual Intervention (II; n=30). The effectiveness of the treatment modalities was assessed by the State Anxiety Inventory; the WHO Quality of Life-Brief form; the Treatment Motivation Questionnaire. Visual analogue and Likert-type scales were used to assess the sense of the importance and the readiness of quitting drugs also the levels of craving. Urine toxicological analyses were performed fortnightly. Results: The APP increased the readiness of quitting drugs. The MI increased both the sense of importance and readiness of quitting drugs, decreased the frequency and severity of craving. The II improved the mental and physical health, increased the confidence in treatment also readiness of quitting drugs. Additionally, II decreased the level of anxiety, the severity, frequency and duration of craving. There was a significant decrease in positive urine samples of all groups. Conclusion: Because of changing only “the level of being ready to quit substance abuse”, APP is considered as an inadequate program compared with MI and II. © 2017 by Turkish Association of Neuropsychiatry.NationwideWithin the direction of the abovementioned necessity, aiming to offer a standard treatment programme to probation convicts nationwide, a 6-week treatment programme that comprises psychoeducation, cognitive-behavioral approaches as well as motivational interview techniques prepared by the Substance Abuse Treatment Modalities Commission of Ministry of Health, under the name of Addiction Programme of Probation was formed. The programme was decided to be utilized with the perspective that it might provide grounds to practice with its general outlines as accepted in 26th Meeting of the Substance Abuse Treatment Modalities Commission that was held on 01.07.2009. -

DSM-IV and the South Oaks Gambling Screen: Diagnosing and Assessing Pathological Gambling in Turkey

The main purpose of this study was to investigate the effectiveness of the DSM-IV diagnostic criteria and the South Oaks Gambling Screen (SOGS) in identifying Turkish pathological gamblers. Fifty-nine subjects participated in the study. The subjects were diagnosed as either pathological gamblers or not (comparison group) through the use of the DSM-IV criteria and were given the Turkish version of the SOGS. Four of the ten DSM-FV criteria were found to be problematic in the diagnosis of Turkish pathological gamblers. The data concerning reliability and validity of the Turkish version of the SOGS suggested that the SOGS can be used as a reliable and valid instrument in identifying Turkish pathological gamblers. Most (16 out of 20) of the items of the SOGS appear to work well in discriminating pathological gamblers from the subjects in the comparison group. In the case of the two DSM-IV criteria and the four SOGS items that failed to discriminate, cultural factors seemed to be responsible for the failure

Does quetiapine have an addiction potential? [Ketiyapin bagimlilik mi yapiyor?]

Quetiapine is one of the atypical antipsychotics that were approved to be used in the treatment of schizophrenia and bipolar disorder. Apart from these disorders, it is also used for the treatment of alcohol and drug addiction. But nowadays it is interesting to note the speculations on the misuse of quetiapine. In this study, the phenomenon on the misuse/addiction of quetiapine was overviewed by considering two cases in which misuse of quetiapine was noticed

Reliability and validity study of the Turkish version of the clinical opiate clinical scale [Klinik opiyat yoksunluk ölçeği (clinical opiate withdrawal scale-cows) Türkçe sürümünün güvenilirliği ve geçerliliği]

Introduction: The aim of the present study was to perform reliability and validity analyses of the Turkish version of the Clinical Opiate Withdrawal Scale which is used to determine the severity of opiate withdrawal. Methods: Initially, the Clinical Opiate Withdrawal Scale (COWS) was translated into Turkish and subsequently back-translated into English. The originality of the back-translated version was approved by the author who developed the scale. After the translation was completed, the scale was used to assess the withdrawal symptoms of 100 patients with opiate withdrawal and 41 patients with alcohol withdrawal. Cronbach’s alpha was used in the reliability assessment; explanatory and confirmatory factor analyses were used in structural validity assessment; and in scale validity, ROC analysis was used among diagnosis groups. Results: The Cronbach’s alpha internal consistency coefficient was calculated as 0.74 in reliability analyses. The correlation coefficient was found to be 0.975 (p<0.001) for inter-rater reliability. Factor analysis was conducted for the structural validity of the scale and findings that support the unidimensional structure of the scale were observed. In the confirmatory factor analysis, CFI, GFI and RMSEA values were found to be 0.905, 0.905 and 0.079, respectively. It was detected that COWS was successful in distinguishing between opiate and alcohol withdrawal symptoms and the area under the ROC curve was 0.878. Conclusion: This study showed that the Turkish version of COWS can be used reliably and validly for assessing opiate withdrawal. © 2015 by Turkish Association of Neuropsychiatry