Childhood and adult attention deficit hyperactivity disorder symptoms in fibromyalgia: associations with depression, anxiety and disease impact.

Objective: The first aim of this study was to determine the prevalence of childhood and current attention deficit hyperactivity disorder (ADHD) symptoms in patients with fibromyalgia. The second aim is to assess the role of depression and anxiety on the relationship between childhood and adult ADHD symptoms with disease impact in this population.Methods: Sixty-four patients with fibromyalgia were compared to matched 58 healthy controls. All participants completed the Wender Utah Rating Scale (WURS), Adult ADHD Self-Report Scale (ASRS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Fibromyalgia Impact Questionnaire (FIQ).Results: Patients with fibromyalgia had significantly higher mean scores of depression (BDI), anxiety (BAI), childhood ADHD symptoms (WURS) and adult ADHD symptoms (ASRS total, ASRS hyperactivity/impulsivity subscale and ASRS attention deficit subscale) than the control group. Fibromyalgia impact (FIQ) was significantly correlated with depression (BDI; r = 0.57, p < .001), anxiety (BAI; r = 0.56, p < .001) and childhood ADHD symptoms (WURS; r = 0.41, p < .001) in fibromyalgia group. There was no significant correlation between fibromyalgia impact (FIQ) and adult ADHD symptoms (ASRS total or sub-scale scores). Hierarchical multiple regression indicated that childhood ADHD symptoms (WURS), anxiety (BAI) and depression (BDI) predicted fibromyalgia impact. Both anxiety (BAI) and depression (BDI) mediated the relationship between childhood ADHD symptoms (WURS) and fibromyalgia impact (FIQ).Conclusion: Childhood ADHD symptoms may be a contributory factor to poorer functioning in the patients with fibromyalgia. The relationship was more pronounced in the presence of depression and anxiety symptoms. Evaluation of childhood and adult ADHD symptoms in patients with fibromyalgia is important for recognition and treatment of ADHD comorbidity and also for attenuating the severity of the disease

Withdrawal-emergent dyskinesia and supersensitivity psychosis due to olanzapine use

PubMed ID: 28360793Tardive dyskinesia (TD) usually appears after years of antipsychotic drug use and appears to be related to the total lifetime medication dose. In withdrawal-emergent dyskinesia (WE-D), which is considered to be a subtype of TD, dyskinetic symptoms often appear shortly after a rapid reduction in antipsychotic drug dose or sudden discontinuation of the drug. Supersensitivity psychosis, which is frequently observed along with TD and is considered to have a similar etiology as TD, is a psychotic relapse phenomenon that occurs after the withdrawal of an antipsychotic drug or a rapid reduction in the drug dosage. In general, atypical antipsychotics tend to be associated with less propensity to cause TD when compared with typical antipsychotics. Furthermore, olanzapine and clozapine may have a therapeutic potential in improving or totally curing TD. In this study, a case of WE-D because of discontinuing olanzapine use and supersensitivity psychosis is discussed.Tardiv diskinezi sıklıkla yıllar boyu antipsikotik ilaç kullanımından sonra ortaya çıkmaktadır ve yaşam boyu tedavi dozu ile ilişkili görünmektedir. Tardiv diskinezinin bir alt tipi olarak kabul edilen çekilme diskinezisi tablosunda diskinezi belirtileri ilaç dozunun hızlı azaltılması veya ani kesilmesinden kısa bir süre sonra ortaya çıkar. Sıklıkla tardiv diskineziyle birlikte görülen ve oluşumunda tardiv diskineziyle benzer mekanizmaların rol oynadığı öne sürülen bir durum olan süpersensitivite psikozu, kullanılan antipsikotiğin hızlı azaltılması veya ani kesilmesine bağlı olarak oluşan psikotik relaps durumudur. Genel olarak atipik antipsikotikler tipik olanlarla kıyaslandığında tardiv diskineziye daha az yatkınlık oluş- turma ile ilişkilendirilir. Bunun da ötesinde klozapinin ve olanzapinin tardiv diskinezi bulgularında düzelme veya tamamen iyileşme sağlama potansiyeli olduğu bildirilmiştir. Bu yazıda olanzapin tedavisinin kesilmesine bağlı olarak çekilme diskinezisi ve supersensitivite psikozu olgusu tartışılmıştır.Publisher's Versio

Fluoxetine-related ecchymosis treated with venlafaxine: a case report

Selective serotonin reuptake inhibitors (SSRIs) are known to have a relatively favourable side effect profile. In recent years, there has been an emphasis on the risk of upper gastrointestinal bleeding in patients taking SSRI antidepressants. Although they may have some effects on coagulation profile, ecchymosis is a rare clinical manifestation of these effects. Here, we report a 25-year-old female patient who was diagnosed with major depressive disorder and manifested spontaneous ecchymoses on her legs rapidly following fluoxetine use. Her complete blood cell count, prothrombin time, partial thromboplastin time, bleeding time, and other hematological screening tests were within normal limits. After discontinuation of fluoxetine, her ecchymoses were resolved in two weeks. Ecchymosis did not recur after fluoxetine was discontinued, and the patient was switched to venlafaxine

[Use of Modafinil in Co-existing Major Depression and ErectileDysfunction: A Case Report].

Erectile dysfunction is a sexual dysfunction which is commonlycomorbid with major depression. Antidepressant treatment does notalways improve comorbid sexual dysfunctions in major depression. Infact, sexual dysfunction may worsen or get complicated following theintroduction of antidepressants. Modafinil is a drug with stimulanteffect on the central nervous system by binding to norepinephrineand dopamine transporters and consequently increasing synapticnorepinephrine and dopamine levels. Modafinil is primarily used inthe treatment of narcolepsy and chronic fatigue syndrome. In addition,it is known for its effectiveness in attention deficit hyperactivitydisorder and as an add-on option for major depression. In this paper,we report the case of a 39-year-old man with major depression whosecomorbid erectile dysfunction improved after addition of modafinilto antidepressant treatment. Fluoxetine 20 mg/day was initiatedand despite the improvement of most of the depressive symptomsand the sexual desire, his complaints of fatigue, weakness and erectiledysfunction continued. With the addition of modafinil (200 mg /day),improvement was observed not only in psychomotor symptoms but alsoin erectile dysfunction of the patient

Withdrawal-Emergent Dyskinesia and Supersensitivity Psychosis Due to Olanzapine Use

Tardiv diskinezi sıklıkla yıllar boyu antipsikotik ilaç kullanımından sonra ortaya çıkmaktadır ve yaşam boyu tedavi dozu ile ilişkili görünmektedir. Tardiv diskinezinin bir alt tipi olarak kabul edilen çekilme diskinezisi tablosunda diskinezi belirtileri ilaç dozunun hızlı azaltılması veya ani kesilmesinden kısa bir süre sonra ortaya çıkar. Sıklıkla tardiv diskineziyle birlikte görülen ve oluşumunda tardiv diskineziyle benzer mekanizmaların rol oynadığı öne sürülen bir durum olan süpersensitivite psikozu, kullanılan antipsikotiğin hızlı azaltılması veya ani kesilmesine bağlı olarak oluşan psikotik relaps durumudur. Genel olarak atipik antipsikotikler tipik olanlarla kıyaslandığında tardiv diskineziye daha az yatkınlık oluş- turma ile ilişkilendirilir. Bunun da ötesinde klozapinin ve olanzapinin tardiv diskinezi bulgularında düzelme veya tamamen iyileşme sağlama potansiyeli olduğu bildirilmiştir. Bu yazıda olanzapin tedavisinin kesilmesine bağlı olarak çekilme diskinezisi ve supersensitivite psikozu olgusu tartışılmıştır.Tardive dyskinesia (TD) usually appears after years of antipsychotic drug use and appears to be related to the total lifetime medication dose. In withdrawal-emergent dyskinesia (WE-D), which is considered to be a subtype of TD, dyskinetic symptoms often appear shortly after a rapid reduction in antipsychotic drug dose or sudden discontinuation of the drug. Supersensitivity psychosis, which is frequently observed along with TD and is considered to have a similar etiology as TD, is a psychotic relapse phenomenon that occurs after the withdrawal of an antipsychotic drug or a rapid reduction in the drug dosage. In general, atypical antipsychotics tend to be associated with less propensity to cause TD when compared with typical antipsychotics. Furthermore, olanzapine and clozapine may have a therapeutic potential in improving or totally curing TD. In this study, a case of WE-D because of discontinuing olanzapine use and supersensitivity psychosis is discussed