M. Relja

English

HRČAK - Portal of Croatian Scientific and Professional Journals

1st CROATIAN CONGRESS ON SIDE EFFECTS OF PSYCHOTROPICS Psychiatria Danubina, 2009; Vol. 21, No. 1, pp 129–147    132We analyzed ADRs reported to the Agency for the period from March 2005. to December 2008. caused by drugs from ATC group N with special interest to psycholeptics (N05) and antidepressants (N06A). ADRs were evaluated according to their seriousness and expectedness. All ADRs which resulted in death or were life threatening, required inpatient hospitalization/ prolongation of existing hospitalisation, resulted in persistent or significant disability/incapacity, a congenital anomaly/birth defect or were other important medical event were labeled as serious. ADRs were considered expected if they were described in approved SmPC in Croatia.  We found that 15 % of all reported ADRs were caused by drugs from ATC group N. 60% of these were caused by drugs belonging to ATC subgroups N05 and N06A. Additionally, most of the serious ADRs were associated with drugs from ATC group N. These data show importance of ADRs caused by psycopharmacs. Majority of ADRs caused by antipsychotics and antidepressants were reported by psychiatrists, while almost all ADRs caused by anxiolytics and hypnotics and sedatives were reported by primary care physicians.    DYSTONIA AS SIDE EFFECT OF NEUROLEPTICS M. Relja Department of Neurology, Clinical Hospital Center Zagreb, School of Medicine, Zagreb University, Zagreb, Croatia e-mail: mrelja@mef.hr  Dystonia is characterized with permanent contractions of the muscles, often causing spasms along with pathological position of part of the body-joint. Primary dystonia and dystonia plus are chronic and incapacitating illnesses with diverse clinical presentations especially in young persons. Differential diagnose towards other movement disorders, as well as causal diagnose present special problem. Division of dystonias is based on 3 levels: a) Etiology;b) Age of occurrence of symptoms;c) Distribution-affected parts of the body. Etiologically, we differentiate primary (idiopathic) dystonia and secondary dystonia (symptomatic). In primary (idiopathic) illness, dystonia is the only clinical sign and there is no known cause or hereditary degenerative disorder - example: DYT1 dystonia. In dystonia plus dystonia is the leading symptom, but it is accompanied with other movement disorders. There are no signs of neurodegeneration - example: myoclonus-dystonia (DYT11). In the secondary (or symptomatic) illness dystonia is sign-symptom of neurological disorder, for example: heredodegenarative illnesses (example: Wilson's disease), brain lesions (tumors, traumas), taking medications and/or chemical products.  Dystonia as a side effect of medications is typical for therapy with neroleptics that is blocators of dopaminergic (DA) receptors. It occurs in all ages and opposite to other extrapyramidal effects of neuroleptics it is also typical in younger age. We can differentiate acute dystonic reaction (possible generalized form) that occurs after application of antiemetics-blocators DA receptors during childhood. During treatment with neroleptics of adults the occurrence of focal dystonias is possible in the clinical practice and very often it presents a diagnostic problem. It is necessary to have knowledge about clinical presentation and distribution of dystonia in order to treat the disorder efficiently. The most common form of focal dystonia is cervical dystonia that strikes musculature of the neck, and is characterized by torticolis (torsion of the neck), retro/anterocolis (extension of the neck onward or backward), and laterocolis (laterally). Retrocolis presents the most frequent form of side effects of neuroleptics, while other forms appear often in idiopathic illness. Early recognition is necessary for successful treatment.  

DYSTONIA AS SIDE EFFECT OF NEUROLEPTICS

Abstract

Similar works

Full text

Available Versions

HRČAK - Portal of Croatian Scientific and Professional Journals