Atomoxetine treatment may decrease striatal dopaminergic transporter availability after 8 weeks: pilot SPECT report of three cases

Attention deficit/hyperactivity disorder is one of the most common neurodevelopmental disorders. The pathophysiology is thought to involve noradrenaline and dopamine. The role of dopamine transporter (DAT) was evaluated in imaging studies using mostly dopamine reuptake inhibitors. Atomoxetine is a selective noradrenaline reuptake inhibitor. Here we report the results of a pilot study conducted to evaluate changes in striatal DAT after 8 weeks of atomoxetine treatment. Our results suggest that 8 weeks of atomoxetine treatment may change striatal DAT bioavailability as measured via SPECT but that change was not correlated with genotype or clinical improvement

Current developments in the psychopharmacological treatment of childhood and adolescent bipolar disorder

Bipolar disorder (BD) of childhood and adolescence is not rare but difficult to diagnose because of its atypical presentation compared with that of adults. Similar to treatment for adults with BD, pharmacotherapy is considered as the first-line treatment for pediatric BD and usually involve the use of mood stabilizing agents such as lithium, carbamazepine, and valproate and antipsychotic agents, such as risperidone, olanzapine, and quetiapine. Sufficient data was not obtained about pharmacotherapy of BD and most of the studies to date do not have standard assessment protocols and placebo control groups. In this article we aimed to review all controlled, open, and special designed studies and to inform about their findings. According to results from published studies: 1- There are few well-designed clinical trials and systematic treatment with prospective follow-up is essential for methodology, 2- lithium and divalproex sodium appear to have comparable efficacy at the end of the trials, 3- some controlled data were obtained for safety and efficacy of quetiapine, 4- stimulants should be used cautiously but are not contraindicated

Pediatric Bipolar Disorders: From the Perspective of Turkey

Introduction: In Turkey, there is much controversy and skepticism about the existence of mania in children and adolescents, and a paucity of rigorous data. Despite ongoing controversy, the view that pediatric Bipolar Disorder(BD) is rare or non-existent has been increasingly challenged not only by case reports but also by systematic research. Methods: Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria are usually employed in these research studies and case reports and it was strongly suggested that pediatric BD may not be rare but that it may be difficult to diagnose. Results: In concordance with the current literature, euphoric mood and episodic course is rare in Turkish children and adolescents and the affective phenomenology is often mixed and dysphoric, with affective storms and temper outbursts. Comorbidity (especially with ADHD) is a big issue in accurate diagnosis and treatment. Conclusion: There are promising treatment studies, but we need more studies in both prepubertal children and adolescents about phenomenology, etiology, and treatment of this important condition

A hypothermia case with early onset schizophrenia treated with clozapine

The usage of antipsychotics in children and adolescents increase in the general of the world and it was reported that 90% of these antipsychotics were atypical antipsychotic by researchers. Clozapine is considered to be the prototype of the atypical antipsychotics, as it was the first to be recognized as having less extrapyramidal side effects, not causing tardive dyskinesia, and not elevating prolactin. Clozapine is not a first choice antipsychotic but it can be used when other antipsychotics cannot be effective. Atypical antipsychotics, also clozapine, alter ability of body to regulate response to changes in temperature and humidity, patients may become hypothermic or hyperthermic; more likely in temperature changes due to inhibition of the hypothalamic control area. Transient temperature alteration can occur with clozapine in up to 50% of patients, usually within the first three weeks of treatment. In this article we present a 17 years old male adolescent with early onset schizophrenia. Although three different atypical antipsychotics were used and there was no treatment response in that case. After clozapine was administered, transient thermoregulation alteration was seen at the beginning of the treatment

Adjunctive olanzapine treatment in bipolar adolescents responding insufficiently to mood stabilizers - Four case reports

This report was aimed to evaluate the efficacy of olanzapine treatment as an adjunct therapy to mood stabilizers in the treatment of four adolescents responding insufficiently to mood stabilizers. All patients were diagnosed with bipolar I disorder according to DSM IV criteria. YMRS (Young mania rating scale) and CGI (Clinical global impression, improvement and therapeutic effectiveness scales) were used to evaluate overall response of the episode to the drugs. All patients with no adequate response to mood stabilizers did respond to adjunctive olanzapine treatment (10-30 mg/per day). It has been suggested that antipsychotics may be useful as an adjunct to mood stabilisers in bipolar disorder. However, further research is warranted regarding the use of atypical antipsychotics in children and adolescents