Selective serotonin reuptake inhibitor discontinuation syndrome: A review

PubMedID: 12008858Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed in the treatment of depression and anxiety, as well as obsessive-compulsive, eating, and impulse-control disorders. Paralleling their widespread use has been an increase in adverse-effect reports not noted during short-term efficacy studies. Significant among these adverse effects is SSRI discontinuation syndrome, which follows the interruption of extended treatment or a reduction in drug dosage and entails somatic and psychological symptoms. These self-limiting symptoms resolve on reintroduction of the drug and cannot be explained as a remanifestation of the original disorder. To facilitate proper diagnosis and avoid unnecessary therapeutic or diagnostic interventions, all physicians who prescribe SSRIs should become familiar with these symptoms. The most appropriate approach to therapy for discontinuation syndrome involves educating patients and reassuring them that this is a reversible condition, reinstating the original SSRI, and further slowing the rate of tapering. © 2002 Springer Science and Business Media and LLC

Comorbidity of anxiety disorders in patient with bipolar-I disorder

WOS: 000165731700469

Discontinuation symptoms associated with nefazodone

PubMedID: 14870958We present a patient who developed discontinuation symptoms following abrupt cessation of nefazodone. Three days after the first appearance of the discontinuation symptoms (i.e. 5 days after cessation of the drug), all symptoms resolved spontaneously without a need for intervention. This case report emphasizes the importance of gradual discontinuation of serotonergic drugs to avoid any consequent unpleasant discontinuation symptoms

Comorbidity of adult attention-deficit hyperactivity disorder and bipolar disorder: Prevalence and clinical correlates

PubMedID: 18437277The aim of this study was to determine the frequency of adult attention deficit hyperactivity disorder (ADHD) comorbidity with lifetime bipolar disorder, and the influence of this comorbidity on various demographic and clinical variables in patients. Patients (n = 159) with a previous diagnosis of bipolar disorder (79 female, 80 male) were included in this study. All patients were interviewed for the presence of current adult and childhood ADHD diagnosis and other axis I psychiatric disorder comorbidities using the structured clinical interview for DSM-IV (SCID) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL). The subjects also completed a Wender Utah rating scale (WURS-25) and a Current Symptoms Scale for ADHD symptoms. In particular, patients' clinical characteristics, the age of onset of bipolar disorder, and the number of episodes were noted. Twenty-six of the 159 bipolar patients (16.3%) were diagnosed with adult ADHD, while another subgroup of patients (n = 17, 10.7%) received a diagnosis of childhood ADHD but did not fulfill criteria for adult ADHD. Both of these two subgroups (patients with adult ADHD, and patients with only childhood ADHD) had an earlier age of onset of the disease and a higher number of previous total affective or depressive episodes than those without any lifetime ADHD comorbidity. However only bipolar patients with adult ADHD comorbidity had higher lifetime comorbidity rates for axis I psychiatric disorders, such as panic disorder and alcohol abuse/dependence, compared to patients without lifetime ADHD. Bipolar patients with comorbid adult ADHD did not differ from bipolar patients with comorbid childhood ADHD in terms of any demographic or clinical variables except for adult ADHD scale scores. In conclusion, ADHD is a common comorbidity in bipolar patients, and it adversely affects the course of the disease and disrupts the social adjustment of the patients. Regular monitoring of ADHD will help to prevent problems and complications that could arise in the course of the disease, particularly in patients with early onset bipolar disorder. © 2008 Springer

Comorbidity of anxiety disorder among patients with bipolar I disorder in remission

PubMedID: 12239436The aim of this study was to assess the comorbidity of lifetime and current prevalences of anxiety disorders among 70 patients with bipolar I disorder in remission using structured diagnostic interviews and to examine the association between comorbidity and several demographic and clinical variables. Forty-three (61.4%) bipolar I patients also met DSM-IV criteria for at least one lifetime comorbid anxiety disorder. Obsessive-compulsive disorder (39%) was the most common comorbid lifetime anxiety disorder, followed by simple phobia (26%) and social phobia (20%). First episode and male sex were found to have lower rates of comorbid current anxiety disorders. The presence of anxiety disorders was related to significantly higher scores on both anxiety and general psychopathology scales. The results of the present study support previous findings of a high comorbidity rate of anxiety disorders in bipolar I disorder cases and indicate that the presence of an anxiety disorder leads to more severe psychopathology levels in bipolar I patients. Copyright © 2002 S. Karger AG, Basel

Long-term Treatment in Bipolar Disorder

Although the importance of long-term prophylactic treatment is certain in bipolar disorder, there is stil debate on how to which patients and evaluate the treatment response. Efficacious long-term treatment can reduce morbidity and mortality significantly and improve quality of life of bipolar patients. The concept of ideal response should also be defined very clearly in order to discuss the difficulties of measuring the effectiveness of the prophylactic treatment. The aims of this paper are to determine whether our currently methods and criteria are valid, reliable and sensitive evaluating the efficacy of the treatment response and to briefly inform the clinicians about the drugs used in pharmacologic prophylaxis in accordance with relevant data

Personality disorders in patients with bipolar-I disorder

WOS: 000165731700468

Oedema associated with risperidone - A case report and literature review

WOS: 000176267000011

Clozapine and suicide

Suicidal ideation, suicide plans, attempted and completed suicide cc cur frequently in patients with schizophrenia. About 50 percent of all schizophrenic patients attempt suicide, and 10 to 15 percent of them die because of suicide. Suicide risk has been reported to be high especially for treatment-resistant and treatment-intolerant cases. Clozapine is a novel antipsychotic drug in the treatment of schizophrenic patients who are resistant or intolerant to conventional antipsychotics. Clozapine is found to cause decreased suicidality in high risk patients like antipsychotic resistant or intolerant patients. In this case report, we presented a schizophrenic patient who committed suicide during clozapine treatment and discussed the notion of reduced suicidality in schizophrenic patients with clozapine treatment in the light of literature and this case

Interferon alpha 2a in discoid lupus erythematosus

Discoid lupus erythematosus (DLE) is an autoimmune, chronic skin disease. It may lead to cosmetic unacceptable scars on the face and when it is localized on the scalp, it may lead to permanent cicatricial alopecia. In various publications, interferon (IFN) alpha was found to be efficient in autoimmune disease such as multiple sclerosis, arthritis rheumatica and thrombocytopenic purpura. This study has been done to investigate the therapeutic effect of IFN alpha 2a in DLE. Six patients were studied. These subjects were diagnosed as DLE by clinical and histopathological data. Patients who have not been treated by any systemic and topical treatment for DLE within the last month, were included. 18-27 millions IU of IFN alpha 2a per week was administered under hospital conditions for four weeks. The influenza-like symptoms, occurring during daily treatment of 3-4.5 millions IU IFN alpha 2a were treated by paracetamol. The fading of the erythema and the reduction of the diameter were used as healing criteria. So, 50% healing in three cases and 70% in two cases, were observed while in the remaining one case the healing rate was under 50%. Our data support that IFN alpha 2a is a potential agent either for curative or adjunct treatment of DLE