Antipsychotics/dopamine-uptake-inhibitors/serotonin-uptake-inhibitors

  • PDF / 180,639 Bytes
  • 2 Pages / 595.245 x 841.846 pts (A4) Page_size
  • 81 Downloads / 226 Views

DOWNLOAD

REPORT


1 S

Various toxicities: 5 case reports A case series involving seven patients described three boys and two girls [including four patients aged 13–17 years and one child; not all ages stated], who developed weight gain, drowsiness, aggression, hyperactivity, increased appetite, insulin resistance, sedation, constipation or increased OCD symptoms during treatment with risperidone, amisulpride, quetiapine, clomipramine or methylphenidate [not all routes and outcomes stated; dosages and durations of treatments to reactions onsets not stated]. Case 1:- The 14-year-old boy (an 8th grade student) presented with complaints of flushing heart palpitations, difficulty focusing, decreased self-care, unwillingness to bathe, inability to sleep alone, fear of the dark, stealing money, persistent desire to go out, lying, spending a long time in the internet cafe, thoughts of suicide and outbursts of anger along with excessive weight gain (49kg to 82kg). The most important complaint according to his mother was excessive weight gain (4.5–5 kg/month). When he was in the 7th grade, he was treated for 26 days in a child psychiatry clinic. He was diagnosed with psychotic disorder and was discharged on haloperidol plus biperiden. Later, he was diagnosed with attention deficit hyperactivity disorder (ADHD), conduct disorder (CD) and mild mental retardation at another child psychiatry clinic. His treatment was started with risperidone 4 mg/day and valproic acid. At the time of current presentation, he behaved very aggressively. After first interview, he was diagnosed with bipolar disorder-mixed episode and ADHD according to the DSM-IV diagnostic criteria. His treatment was started with valproate and risperidone 3 mg/day. In the third week, he gained three more kilos (85kg), which was attributed to risperidone (antipsychotic). Therefore, topiramate 25 mg/day was added to his treatment. Dose of valproate was gradually increased over a period of 3 months. Since he reached weight of 92kg, the dose of topiramate was increased to 62.5 mg/day. Risperidone was stopped and aripiprazole was started due to the partial improvement in his condition following 14 weeks of therapy and the risk of metabolic syndrome. Additionally, due to the lack of efficacy of topiramate, it was planned to be discontinued gradually. In the evaluation made in the first month, weight was 85kg. A significant reduction in clinical symptoms was observed. During the follow-up, the dose of aripiprazole was increased further. In the evaluation made at 3 months, his mood was rated as "euthymic". He started 9th grade in the fifth month of the treatment and there was no apparent adjustment problem. His weight was 83kg. At that time, he was receiving valproate, topiramate 25 mg/day and aripiprazole. Case 2:- The 13-year-old girl (7th grade student) presented with school failure, intensive internet use, forgetfulness, distraction, difficulty maintaining sleep, thoughts of being followed and harmed, self-talk and laughter, introversion and irritability. She had been diagnosed with psy

Data Loading...