1/32. A case of interferon alpha-induced manic psychosis in chronic hepatitis c.It is well known that mood disorder such as depression occasionally develops during interferon (IFN) therapy for chronic viral hepatitis. So far, however, IFN-induced manic disorder has been rarely reported. We present a case of manic psychosis which developed during IFN treatment for chronic hepatitis c. A 35-year-old man with chronic hepatitis positive for hepatitis c virus rna in serum was treated with natural IFN alpha with a daily dosage of 5 million units. Six weeks later he complained of insomnia, and then became exhilarated, talkative, restless and aggressive. Since the mental state was compatible with manic disorder, IFN therapy was immediately ceased. Simultaneously, psychotropic drugs were administered. One week later, the psychiatric disturbances disappeared. He has been keeping his usual social interactions without the psychotropic drugs after that. It is suggested that manic psychosis happened secondary to IFN alpha treatment.- - - - - - - - - - ranking = 1keywords = mood (Clic here for more details about this article) |
2/32. Prolactin-secreting pituitary adenoma in neuroleptic treated patients with psychotic disorder.Three patients with psychoses and concomitant prolactin-secreting pituitary tumours are described. patients A and B had bipolar and schizoaffective disorders, respectively. They had both been treated with neuroleptics for 20 years before the prolactinomas were revealed. Patient C developed a paranoid psychosis after two years of continuous bromocriptine treatment for a pituitary tumour. In patient A the prolactin level was successfully normalized and a good antipsychotic effect was maintained by combined therapy with haloperidol and quinagolide but not bromocriptine. In patient B the prolactinoma was removed by surgery, in view of the serious nature of the psychotic disorder, to avoid psychotic relapse by treatment with a dopamine agonist. In patient C a good result was obtained with the combination of clozapine and bromocriptine. These case reports support the view that neuroleptics being dopamine antagonists and dopamine agonistic agents which are the primary treatment of prolactinomas can cancel out each other's effects. The combination of clozapine and quinagolide is recommended as the treatment of choice for most patients.- - - - - - - - - - ranking = 0.001048956499016keywords = affect (Clic here for more details about this article) |
3/32. multiple chemical sensitivity (MCS)--differential diagnosis in clinical neurotoxicology: a German perspective.The multiple chemical sensitivity syndrome (MCS) is a new cluster of environmental symptoms which have been described and commented on for more than 15 years now in the USA. In the meantime it has also been observed in European countries. The main features of this syndrome are: multiple symptoms in multiple organ systems, precipitated by a variety of chemical substances with relapses and exacerbation under certain conditions when exposed to very low levels which do not affect the population at large. There are no lab markers or specific investigative findings. In our view, MCS is not a separate clinical syndrome but a collective term. A very small part of the patients in question may actually exhibit a somatic or psychosomatic response to low levels of a variety of chemicals in the environment. For another part, even if the MCS symptoms are induced by chemical substances in the environment, the basic hypersensitivity is a psychological stress reaction. In the third and largest group, the patients have been misdiagnosed, i.e. a somatic or psychiatric disease has been overlooked. There is a fourth group of patients in whom there is no evidence of any exposure at all but instead a belief system installed by certain physicians, the media and other groups in society. This paper tries to describe the neurological and neurotoxic aspects of MCS problems and to illustrate it with examples of an alleged outbreak of chronic neurotoxic disease caused by pyrethroids in germany. research strategy should establish clearly determined diagnostic criteria, agreement on the use of specific questionnaires as well as clinical and technical diagnostic procedures, prospective clinical studies of MCS patients and comparative groups as well as experimental approaches.- - - - - - - - - - ranking = 0.001048956499016keywords = affect (Clic here for more details about this article) |
4/32. Overview of existing research and information linking isotretinoin (accutane), depression, psychosis, and suicide.isotretinoin (Accutane; Hoffmann-La Roche, Nutley, NJ) is a drug closely related to the chemical structure of vitamin a. The pharmacology and toxicology of these two retinoids are similar enough to warrant comparison. Accutane is a powerful drug that its manufacturer, Roche, indicates is limited for severe recalcitrant nodular acne. This potency is also reflected in Accutane's well-known ability to produce severe birth defects if taken during pregnancy. Less well known is the risk of this lipid-soluble chemical to affect the central nervous system. Reports of intracranial hypertension, depression, and suicidal ideation with Accutane use have prompted an examination of its serious and life-threatening potential. Although Roche has added a warning to its product label for signs of depression, and suicidal ideation, this product is overprescribed for all forms of acne, including mild and moderate cases that have not been treated with alternative medications with less risk of depression and suicide. There is no contesting that this drug is effective at clearing up the most severe forms of acne, but the public must be informed of the proper limited indication for its use, because depression and suicide can follow in patients with no prior history of psychiatric symptoms or suicide attempts.- - - - - - - - - - ranking = 0.001048956499016keywords = affect (Clic here for more details about this article) |
5/32. Adverse psychiatric effects of systemic glucocorticoid therapy.Glucocorticoid therapy causes psychiatric side effects in many patients. Although psychiatric side effects occur most commonly in women and middle-aged patients, no clinical features have been identified to predict which patients are at risk. The most frequent side effects are mood changes ranging from mild euphoria to hypomania, but other reactions, including depression, dementia and psychosis, are possible. The incidence of psychiatric side effects is directly related to dosage. The mechanism by which glucocorticoids produce psychiatric symptoms is probably multifactorial, including both direct and indirect effects on the brain. Psychiatric symptoms usually resolve with dosage reduction or controlled withdrawal of glucocorticoids, but antipsychotic medication may be indicated if symptoms are severe or prolonged.- - - - - - - - - - ranking = 1keywords = mood (Clic here for more details about this article) |
6/32. Adverse reaction to dental corticosteroids.The case of an 18-year-old woman who experienced prominent, episodic cognitive dysfunction and affective symptoms, which coincided with a brief administration of dexamethasone, has been presented. Because her symptoms were subtle and intermittent, and because she was no longer taking corticosteroids when she sought medical attention, the diagnosis of a corticosteroid-induced mental disorder was delayed. This case demonstrates the need for heightened awareness, among all practitioners, of the effects of corticosteroids on mental functions. Because it is not possible to predict who will experience mental disturbances with even small doses of corticosteroids, all patients (and their families, if possible) should be informed about the possibility of adverse reactions. dentists and physicians need to weigh the risks and benefits of corticosteroid therapy carefully. Clinicians also should be suspicious of psychiatric disturbances in proximity to corticosteroid use (i.e., even in a patient who is not taking corticosteroids, but who has a history of corticosteroid treatment).- - - - - - - - - - ranking = 0.001048956499016keywords = affect (Clic here for more details about this article) |
7/32. Organic mental disorders associated with bupropion in three patients.bupropion hydrochloride is a phenylaminoketone antidepressant whose clinical pharmacology is poorly understood. Part of bupropion's action may be attributed to inhibition of dopamine reuptake that may induce organic mental disorders in certain susceptible patients. We report three cases of organic mental disorders in patients receiving bupropion hydrochloride for treatment of the depressed phase of their bipolar-type mood instability. The organic mental disorders that occurred in these patients were characterized largely by visual disturbances--visual hallucinations and visual illusions--although one patient also experienced auditory hallucinations. The patients' use of concomitant medications and potential drug interactions are carefully evaluated and the literature on bupropion's ability to induce organic mental disorders is reviewed. We suggest a number of possible mediating mechanisms for these syndromes including dose-related dopaminergic augmentation, accumulation of toxic metabolites, predisposition to psychosis, and drug interactions.- - - - - - - - - - ranking = 1keywords = mood (Clic here for more details about this article) |
8/32. risperidone-induced psychosis and depression in a child with a mitochondrial disorder.OBJECTIVE: To our knowledge, this is the first published case report of an adolescent girl with a mitochondrial disorder and depression who displayed both new-onset psychotic and increased mood symptoms during treatment with risperidone. DATA: A 16-year-old girl was treated with risperidone for mood lability and impulsivity at a community hospital. Within days, she developed paranoid ideation, profound psychomotor retardation, increased depression, and fatigue. She was transferred to an inpatient psychiatric hospital, where she was taken off risperidone. Within 48 hours after discontinuation of the medication, she had complete resolution of psychotic symptoms, fatigue, and psychomotor retardation, and her depression improved. CONCLUSIONS: This observation of "on-off" risperidone treatment suggests that risperidone may have worsened both psychiatric and physical manifestations of the mitochondrial disorder in this adolescent. These findings are consistent with recent in vitro literature, which implicate a series of neuroleptic medications with mitochondrial dysfunction. Furthermore, the authors provide diagnostic and treatment options that are available for mitochondrial disorders, which are of interest to child psychiatrists due to the central nervous system manifestations of these disorders.- - - - - - - - - - ranking = 2keywords = mood (Clic here for more details about this article) |
9/32. Acute onset of steroid psychosis with very low dose of prednisolone in Sheehan's syndrome.Corticosteroid treatment is frequently associated with psychiatric disturbances. These adverse effects are unusual with low dose of corticosteroid. We describe a patient who rapidly developed a steroid-induced psychosis with very low dose of prednisolone. A 48-year-old woman of Sheehan's syndrome was admitted to hospital with insomnia, euphoric moods and visual hallucinations. She had taken prednisolone (10 mg in the morning and 5 mg at night) for 6 days before admission. These symptoms appeared after first dose of prednisolone. A diagnosis of acute psychosis was made. After improvement of acute psychosis with discontinuation, re-administration of prednisolone at a dose of 2.5 mg per day gave rise to agitation and insomnia. She recovered completely by gradual dosage increase of short-acting corticosteroid after the discontinuation of prednisolone.- - - - - - - - - - ranking = 1keywords = mood (Clic here for more details about this article) |
10/32. baclofen-induced psychosis.OBJECTIVE: To report a case of psychosis induced by therapeutic doses of baclofen. CASE SUMMARY: A 32-year-old Hindu man was prescribed oral baclofen 10 mg twice daily for relief of muscular spasms secondary to tetanus. After 4 weeks of baclofen use, he presented to the psychiatry emergency facility with a 4 day history of third-person auditory hallucinations and persecutory and referential delusions without underlying mood symptoms. These symptoms resolved within 1 week of discontinuing baclofen. Rechallenge with baclofen resulted in reemergence of psychotic symptoms, which disappeared after discontinuing baclofen. DISCUSSION: Reemergence of psychotic symptoms after rechallenge with baclofen suggests baclofen-induced psychosis. Use of the Naranjo probability scale indicates a probable association of baclofen with this patient's psychosis. The absence of underlying mood disorder makes this case different from previously reported ones. CONCLUSIONS: baclofen may be associated with the occurrence of psychosis. Clinicians should consider baclofen-induced psychosis as a differential diagnosis in patients presenting with psychosis during treatment with this drug.- - - - - - - - - - ranking = 2keywords = mood (Clic here for more details about this article) |
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