Excessive weight gain after remission of depression in a schizophrenic patient treated with risperidone: case report

BACKGROUND: The use of atypical antipsychotics in schizophrenic patients has been associated with a risk of weight gain. Similarly, recovery from depression is often followed by improved appetite, greater food intake and potential increase in weight. CASE PRESENTATION: A Caucasian 33-year-old schizophrenic female patient was being treated with 6 mg/day of risperidone and 15 mg/day of clorazepate. She developed depressive symptomatology and 40 mg/day of fluoxetine was gradually added to her treatment regimen for about 9 months. After the remission of depression, and the discontinuation of fluoxetine, she experienced an increase in appetite and subsequently excessive weight gain of 52 kg. Re-administration of fluoxetine did not reverse the situation. The patient developed diabetes mellitus, which was successfully controlled with metformin 1700 mg/day. The addition at first of orlistat 360 mg/day and later of topiramate 200 mg/day has helped her to lose a significant part of the weight gained (30 kg). CONCLUSION: The case suggests a probable association between the remission of depressive symptomatology and weight gain in a schizophrenic patient

Insomnia and its correlates in a representative sample of the Greek population

<p>Abstract</p> <p>Background</p> <p>Insomnia is a major public health concern affecting about 10% of the general population in its chronic form. Furthermore, epidemiological surveys demonstrate that poor sleep and sleep dissatisfaction are even more frequent problems (10-48%) in the community. This is the first report on the prevalence of insomnia in Greece, a southeastern European country which differs in several socio-cultural and climatic aspects from the rest of European Community members. Data obtained from a national household survey (n = 1005) were used to assess the relationship between insomnia symptoms and a variety of sociodemographic variables, life habits, and health-related factors.</p> <p>Methods</p> <p>A self-administered questionnaire with questions pertaining to general health and related issues was given to the participants. The Short Form-36 (Mental Health subscale), the Athens Insomnia Scale (AIS) as a measure of insomnia-related symptoms, and the International Physical Activity Questionnaire (IPAQ) were also used for the assessment.</p> <p>Results</p> <p>The prevalence of insomnia in the total sample was 25.3% (n = 254); insomnia was more frequent in women than men (30.7% vs. 19.5%) and increased with age. Multiple regression analysis revealed a significant association of insomnia with low socio-economical status and educational level, physical inactivity, existence of a chronic physical or mental disease and increased number of hospitalizations in the previous year.</p> <p>Conclusions</p> <p>The present study confirms most findings reported from other developed countries around the world regarding the high prevalence of insomnia problems in the general population and their association with several sociodemographic and health-related predisposing factors. These results further indicate the need for more active interventions on the part of physicians who should suspect and specifically ask about such symptoms.</p

Insomnia and its correlates in a representative sample of the Greek population

Background: Insomnia is a major public health concern affecting about 10% of the general population in its chronic form. Furthermore, epidemiological surveys demonstrate that poor sleep and sleep dissatisfaction are even more frequent problems (10-48%) in the community. This is the first report on the prevalence of insomnia in Greece, a southeastern European country which differs in several socio-cultural and climatic aspects from the rest of European Community members. Data obtained from a national household survey (n = 1005) were used to assess the relationship between insomnia symptoms and a variety of sociodemographic variables, life habits, and health-related factors. Methods: A self-administered questionnaire with questions pertaining to general health and related issues was given to the participants. The Short Form-36 (Mental Health subscale), the Athens Insomnia Scale (AIS) as a measure of insomnia-related symptoms, and the International Physical Activity Questionnaire (IPAQ) were also used for the assessment. Results: The prevalence of insomnia in the total sample was 25.3% (n = 254); insomnia was more frequent in women than men (30.7% vs. 19.5%) and increased with age. Multiple regression analysis revealed a significant association of insomnia with low socio-economical status and educational level, physical inactivity, existence of a chronic physical or mental disease and increased number of hospitalizations in the previous year. Conclusions: The present study confirms most findings reported from other developed countries around the world regarding the high prevalence of insomnia problems in the general population and their association with several sociodemographic and health-related predisposing factors. These results further indicate the need for more active interventions on the part of physicians who should suspect and specifically ask about such symptoms

Combination therapy with amisulpride and antidepressants: Clinical observations in case series of elderly patients with psychotic depression

Psychotic depression is classified as a clinical subtype of major depressive disorder. The combination of an antidepressant with an antipsychotic agent has been demonstrated to be efficacious for the treatment of psychotic depression. However, in elderly patients with psychotic depression, little information is available on the efficacy of such combinations. Therefore, we have evaluated combination treatment for 5 weeks with amisulpride and antidepressants in non-demented elderly patients with psychotic depression. Eleven patients were treated with either citalopram 20-40 mg/day (n = 5) or mirtazapine 30-60 mg/day (n = 6), and amisulpride 75-100 mg/day for 5 weeks. Clinical status was evaluated at baseline and after 3 and 5 weeks using the Brief Psychiatric Rating Scale (BPRS), the Hamilton Depression Rating Scale-17 items (HDRS) and the Clinical Global Impression Scale (CGI-S). In 5 of the 11 patients there was remission of depression, while in another 5 patients there was partial remission of depression and in one patient there was no remission. Finally, there was resolution of psychotic symptoms in all the patients involved. One patient developed tremor and rigidity but insisted on continuing with the drug since her psychopathology has improved considerably after the addition of amisulpride to antidepressant treatment. In conclusion, some of the elderly patients with psychotic depression may benefit from the combination of amisulpride and antidepressant pharmacotherapy. (C) 2008 Published by Elsevier Inc

Jacksonian seizure in a manic patient treated with rTMS

This is a report of a jacksonian seizure in a non-psychotic manic patient who was treated with right prefrontal high frequency rTMS concomitant to pharmacotherapy

Posttraumatic stress disorder in outpatients with depression: Still a missed diagnosis

Comorbidity between major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) is a well-established fact but has been studied little among MDD patients and even less among outpatients. We assessed the prevalence and characteristics of comorbid MDD-PTSD patients in a sample of MDD outpatients in an effort to elucidate possible causes of MDD-PTSD comorbidity. A semistructured clinical interview was applied to 101 outpatients with MDD. Sociodemographic factors, psychiatric history, the presence of PTSD, and MDD-PTSD comorbidity were recorded. The prevalence of MDD-PTSD comorbidity was 38.6%, with 26.7% suffering currently from PTSD. The average duration of PTSD was 16 years, and in most cases (79.5%) PTSD started earlier than or simultaneously with MDD. Only 28.8% of patients with PTSD had a documented diagnosis in their medical record. The most significant factors predicting MDD-PTSD comorbidity were found to be chronic depression, a history of prolonged or repeated trauma, male gender, a younger age at onset of psychological symptoms, lower education, and a lower level of functioning. Our findings indicate that MDD-PTSD comorbidity still remains an overlooked fact. Prolonged trauma seems to be a major risk factor for MDD-PTSD comorbidity, predisposing subjects to PTSD and later on or simultaneously to comorbidity with MDD

Excessive weight gain after remission of depression in a schizophrenic patient treated with risperidone: case report

Abstract Background The use of atypical antipsychotics in schizophrenic patients has been associated with a risk of weight gain. Similarly, recovery from depression is often followed by improved appetite, greater food intake and potential increase in weight. Case presentation A Caucasian 33-year-old schizophrenic female patient was being treated with 6 mg/day of risperidone and 15 mg/day of clorazepate. She developed depressive symptomatology and 40 mg/day of fluoxetine was gradually added to her treatment regimen for about 9 months. After the remission of depression, and the discontinuation of fluoxetine, she experienced an increase in appetite and subsequently excessive weight gain of 52 kg. Re-administration of fluoxetine did not reverse the situation. The patient developed diabetes mellitus, which was successfully controlled with metformin 1700 mg/day. The addition at first of orlistat 360 mg/day and later of topiramate 200 mg/day has helped her to lose a significant part of the weight gained (30 kg). Conclusion The case suggests a probable association between the remission of depressive symptomatology and weight gain in a schizophrenic patient.</p