bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychopathological descriptive model of hallucinogenic/psychedelic drugs effect in the treatment of depression and addictions
Authors: Girala N. 
Published: September 2022

IntroductionThere is a growing and renewed interest in the use of hallucinogenic drugs in the treatment of psychiatric disorders, especially since the FDA approval of ketamine treatment for resistant depression. The response to hallucinogenic psychedelic substances (ayahuasca, psilocybin, LSD, ketamine) in the treatment of depression and addictions calls for a theoretical explanatory model.ObjectivesProvide a descriptive / explanatory psychopathological model of the response to treatment with hallucinogenic drugs based on the descriptions of the subjects and the comparison with other extreme life experiences.MethodsRelevant published literature on subjective experiences in treatment with hallucinogenic drugs for depression and addictions is reviewed. It is compared with subjective experiences in life changing experiences.ResultsIntense emotional states, mystical-type experiences including feelings of oneness, transcendence, ineffability, and the complex emotion of awe seem to be consistently presented as psychic elements related to the efficacy of these treatments. The genetic and cultural (memetic) evolutionary value of these emotions in the cohesiveness of human groups and the genesis of affective symptoms, and in the recalibration of cognitions and emotions, is discussed.ConclusionsThe efficacy of hallucinogenic drugs used in the treatment of depression and addictions is accompanied by complex and varied emotions but with common psychopathological elements that could mediate their action.DisclosureNo significant relationships.
Comparison of toxic effects of lead and copper and protective power of glutathione on oxidative stress parameters
Authors: Jovanovic Mirkovic J. , Kocic G. , Alexopoulos C. , Jurinjak Z. 
Published: September 2022

IntroductionLead as an industrial pollutant can be detected at all stages of the working and living environment. Lead, based on its properties, solubility and mobility, accumulates in the soil, so that the average concentrations of oil in the soil are between 15 and 25 mg/kg (Radojević at all., 1999). Due to increased human activity, the amount of copper in the air, soil and water has increased. Glutathione (GSH) is an essential cofactor of many enzymes, such as: formaldehyde dehydrogenase, glyoxalase, prostaglandin endoperoxide isomerase, dehydrochlorinase and others. GSH is a biological redox in the metabolism of erythrocytes, it also plays a role in the transport of amino acids. Reactive forms of oxygen cause oxidative biomolecules (lipids, proteins, DNA) (Freidovich, 1999; Massaad i Klann, 2010).ObjectivesThe aim of this research was to examine the protective role of supplements GSH in conditions of chronic intoxication with sublethal doses of lead acetate and copper II sulfate.MethodsThe preparation of biomaterials for testing and making homogenates of brain tissue of albino rats of Wistar strain was performed and the activity of acid and alkaline DNase was measured spectrophotometrically (Kocić i sar., 1998).ResultsLead otherwise “as soft Lewis acid” has a pronounced affinity for interaction with “soft bases” such as S-atoms of the thiol group in antioxidants, natural biomolecules and supplements in this case in glutathione.ConclusionsIt can be said that GSH is a desirable supplement and antioxidant in the detoxification of reactive oxygen species in rats exposed to lead poisoning.DisclosureNo significant relationships.
Pseudologia Fantastica: a case report
Authors: Sneep S. , De Jong I. 
Published: September 2022

IntroductionPseudologia fantastica is a psychiatric phenomenon that occurs equally in men and women (1). The condition was first described in 1891 and contains fantasized events (2). Most of the time the fantasized events are not entirely unbelievable. They are based upon blurred fantasy and reality and are stable over time (1,3).ObjectivesWe present a case of possible pseudologia fantastica to raise awareness about this phenomenon and possible treatment.MethodsA literature search in English was performed using Pubmed with the following MeSh terms ‘pseudologia fantastica’.ResultsWe present a 20-year old women diagnosed with an intellectual disability (IQ=80) and a post traumatic stress disorder. She received treatment in an outpatient setting for a couple of years. The patient was treated by EMDR therapy and individual therapy sessions. She rejected other forms of therapy or any medication. During the treatment her symptoms were getting worse. The symptoms contained an increase of nightmares and moments of dissociation. The patient was telling she wasn’t able to eat, sleep and function on a daily basis. In individual sessions she reported life-events which worsened over time including; being a victim of rape, seeing her rapist in the subway, being touched and chased by a stranger on her bicycle. Literature search shows that confrontation is one of the treatment methods for this phenomenom.ConclusionsThe treatment of a patient with pseudologia fantastica requires attention for details and acknowledging the possibility of fantasized events, confronting techniques and maintaining an alliance between patient and therapist (2,4).DisclosureNo significant relationships.
Management of antipsychotic-related sexual dysfunction
Authors: Rodrigues C. 
Published: September 2022

IntroductionSexual dysfunction (SD) can often be a side-effect of treatment with antipsychotics (APS). It often jeopardizes long-term adherence to treatment, while deeply affecting the patient’s quality of life. The pathogenic mechanisms may be associated with postsynaptic dopamine antagonism, a1-antagonism and prolactin elevation. APS-induced hyperprolactinemia has been linked to the occurrence of galactorrhea, gynecomastia, amenorrhea and SD.ObjectivesTo synthesize the available evidence on the management of APS-related sexual dysfunction, with a main focus on the second-generation antipsychotics.MethodsA search for randomized controlled trials (RCT) published between 2021 and 2011 on PubMed was made using the keywords “sexual”; “dysfunction”; “antipsychotic” and “treatment”, from which resulted sixteen articles. Only six of those were considered relevant for the study’s objectives.ResultsThree studies focused on the comparison between different APS and prolactin levels and SD occurrence, showing that treatment with aripiprazole is mostly related to prolactin levels with the normal range and a lower incidence of sexual dysfunction. Addition of aripiprazole to previous APS may be associated with normalization of sexual function and pose as a possible management option. Adjunctive treatment with tadalafil showed no significant effect on its primary outcome.ConclusionsThere seems to be a general consensus that patients treated with first-generation antipsychotics (FGA), along with risperidone, paliperidone and amissulpride show higher prolactin levels and incidence of SD. Whether there is a causal relationship between these two variables still remains a question. Larger and more prolonged trials are still needed to evaluate APS-related sexual dysfunction and its management.DisclosureNo significant relationships.
A case report of eosinophilia associated with risperidone withdrawl in a patient with schizophrenia
Authors: Giourou E. , Theodoropoulou A. , Batzikosta P. , Prodromaki O. , Georgila E. , Gourzis P. 
Published: September 2022

IntroductionRisperidone, a second generation antipsychotic, shows high affinity with serotoninergic and dopaminergic D2 receptors, but also adrenergic and H1 histaminergic receptors. Previous studies have shown an increase in eosinophile count associated with the second-generation antipsychotics through the histaminergic path.ObjectivesThe presentation of a case in which eosinophilia was associated with risperidone withdrawl which has not been described so far.MethodsA 46-year-old woman with schizophrenia diagnosed at the age of 22 was admitted in our inpatient psychiatric clinic with psychotic symptoms relapse after she voluntarily discontinued risperidone. The patient was fully evaluated with full laboratory tests, a brain CT scan, EEG and her medical and psychiatric histories were recorded.ResultsRisperidone was reinitiated but due to the persistence of symptoms it was switched to clozapine which lead to full remission. It was observed though, that while gradually decreasing risperidone dosage (Figure 1.), eosinophile count was raising and it was normalized after complete discontinuation. Eosinophilia was also present in other instances that the patient discontinued taking risperidone according to her personal history. Other causes of eosinophilia (allergic, inflammatory) were fully excluded.ConclusionsRisperidone discontinuation could lead to an elevated eosinophile count. There is limited research in this topic and it is yet to be clarified whether the elevation is due to stopping one antipsychotic or switching between two different antipsychotics. It is important to run laboratory tests regularly with every treatment modification.DisclosureNo significant relationships.
Clozapine induced pneumonia: A case report of diagnostic difficulties in the time of Covid-19
Authors: Softic R. , Tahirovic A. , Sulejmanpasic G. , Memic Serdarevic A. , Cesir A. , Becarevic N. 
Published: September 2022

IntroductionClozapine is a drug that can cause several side effects. Among the less commonly described is a drug-induced lung disease. Due to its non-specific clinical presentation, it represents a diagnostic challenge. The diagnosis is made based on: 1. Association of exposure to the agent and development of symptoms, 2. Pulmonary infiltration, 3. Exclusion of other causes, 4. Withdrawal of symptoms when the agent is excluded from therapy. To date, there have been only a few descriptions of this condition.ObjectivesCase report of rare side effect of clozapine.MethodsCase reportResultsCase report: male patient (37) with schizophrenia, was hospitalized after a brutal suicide attempt. The PCR test for COVID-19 that was routinely performed on admission was negative. After the introduction of clozapine into therapy, the patient became febrile. There was a drop in oxygen saturation, a Lung CT scan showed inflammatory changes („ground-glass opacities“),
and COVID-19 pneumonia was suspected. Due to the worsening of the mental state, the dose of clozapine was increased. The physical condition further deteriorated: febrile, sO2 declining. After repeated PCR tests for COVID-19 (all negative), interstitial pneumonia caused by clozapine was suspected, and clozapine was excluded from therapy. The physical condition started to improve. Quetiapine was introduced, and occasional episodes of agitation were relieved with intramuscular diazepam. In the following days, the patient’s mental state improved and he was discharged.ConclusionsDespite its superiority over other antipsychotics, clozapine was with good rationale ranked third in treatment guidelines for schizophrenia.DisclosureNo significant relationships.
Incidence of clozapine-induced hematological side effects in a Tunisian population
Authors: Shiri M. , Ouertani A. , Madouri S. , Ouali U. 
Published: September 2022

IntroductionClozapine is commonly associated with adverse hematological outcomes. However, incidence of blood dyscrasias in the north African population is scarce.ObjectivesThe aim of this study was to assess the incidence of hematological side effects in a Tunisian sample of clozapine treated patients.MethodsWe conducted a retrospective longitudinal chart review of 64 patients on clozapine enrolled in our clozapine consultation between January 1, 2000 and September 2020.ResultsOur sample consisted of 15 women (23.5%) and 49 men (76.5%), mean age was 41.34 ±9.32 years. Patients were diagnosed with schizophrenia in 70.3% of the cases, 7 (10.9%) had a bipolar disorder and 12 (18.8%) had a schizoaffective disorder.We found blood dyscrasias in 21 patients (32.8%). Hematological abnormalities were as follow: 2 cases of agranulocytosis, 8 cases of neutropenia, 13 cases of thrombocytopenia, 5 cases of leukocytosis, 5 cases of eosinophilia and 3 cases of anemia. The incidence rate of hematological side effects was 0.1 case/year- person. The mean clozapine dose at the time of onset of the hematological side effect was 309.52 mg/day(range 25-600 mg/day).The median duration of clozapine treatment prior to developing hematological side effects was 119.71±126.52 days.Clozapine discontinuation was decided in 11 cases due to hematological side effects and reintroduced in 9 cases after normalization of blood count.ConclusionsThis study emphasis on the importance of a regular long-term monitoring of blood count to ensure early detection of hematological side effects.DisclosureNo significant relationships.
Hipersexuality in aripiprazole treatment : A case report
Authors: López Rodrigo M.V. , Palomo Monge M. , Padilla Romero P. , Osca Oliver A. , Pérez Fominaya M. 
Published: September 2022

IntroductionAripiprazole is an antipsychotic that differs from the group in that it is a partial agonist of the D2 receptor, being also a partial agonist of 5HT1A and an antagonist of 5HT2A.Most antipsychotics cause a decrease in libido, affecting both sexual desire and function. According to the literature, D2 partial agonists can cause the appearance of compulsive behaviors as an adverse effect in 6-24% of patients. Among these behaviors you can find hypersexuality. In most cases, it subsides when treatment is stopped. We describe the case of a patient with bipolar disorder who develops hypersexual behaviors following the aripiprazole treatment. This is a 61-year-old bipolar patient receiving valproate and risperidone. It requires hospital admission due to manic symptoms where dysfunctional tremor is observed. Change from risperidone to aripiprazole. Subsequently, hypersexual behaviors appear, increased libido, obsession with sexual activities (compulsive masturbation with TV programs, mobile applications, cartoons) as well as delusional ideas about “receiving sexual gazes” with no other maniac symptomps.ObjectivesTo determine the possibility that hypersexuality was induced by treatment with aripiprazole.MethodsThe appearance in the time line of hypersexuality after the change of treatment would be indicative of causality.ResultsAfter switching back to risperidone, compulsive sexual behaviors disappear but not the delusional idea of being the focus of sexual gazes by everyone.ConclusionsAlthough it is not a common adverse effect, hypersexuality is listed in the literature as a rare adverse effect.DisclosureNo significant relationships.
Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT): A Review
Authors: Fernandes Santos C. , Gomes R. 
Published: September 2022

IntroductionLithium has a narrow therapeutic window. Frequent monitoring of both serum levels and clinical signs of toxicity is warranted because toxicity may be present even when concentrations are within the therapeutic range. Persistent neurological signs and symptoms of lithium intoxication gained clinical attention in the 1980s and were named Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT).ObjectivesTo review the long-term neurological sequelae of lithium intoxication (SILENT) to highlight their clinical presentation, assessment, management and preventive measures.MethodsNon-systematic review of literature through search on PubMed/MEDLINE for publications up to 2021, following the terms syndrome of irreversible lithium-effectuated neurotoxicity.ResultsNeurological manifestations of lithium poisoning may persist, even after effective removal of the drug – SILENT. The most frequent sequelae are cerebellum and brain stem dysfunction, extrapyramidal symptoms and dementia. They may last for weeks, months or years. Infection, dehydration, deteriorating renal function or the addition of other drugs may precipitate acute toxicity. Irreversible damage is difficult to treat. Some cases show spontaneous recovery that may be total, but in others, sequelae persist. Helpful measures include the avoidance of acute intoxications with lithium, long-term and continuous dose adjustment and serum level monitoring, stricter exclusion criteria for starting lithium, and aggressive treatment of acute neurotoxicity. Once the long-term neurologic sequelae have set in, the patient should be managed according to the impediment (physical rehabilitation, speech, cognitive training).ConclusionsIt is important to raise the awareness of SILENT so that clinicians are able to avoid it. There should be a low threshold for suspecting the existence of toxicity.DisclosureNo significant relationships.
A case of trazodone induced prolonged hypogeusia
Authors: Tekdemir R. , Kandeğer A. 
Published: September 2022

IntroductionPlenty of antidepressants have been reported to induce unpleasant tastes and/or odors as well as altered chemosensations when administered alone or in combination with other medications. Trazodone induced hypogeusia (decreased taste sensation) is a rare side effect. In this report, we would like to present a male patient with with hypogeusia after trazodona use and persisting for 3 months after the drug was discontinued will be discussed.ObjectivesA 52-year-old male, Trazodone 50 mg/day was started 4 months ago due to difficulty in falling asleep. On the 25th day of her daily treatment, her sense of taste began to decrease and gradually became more severe. So he stopped his treatment and he applied to the internal medicine and neurology polyclinics. Routine blood tests were within normal limits. To rule out the possibility of covid 19, 2 pcr tests were done and it was found negative. No recommendations other than chewing gum. The patient applied to the psychiatry polyclinic with the complaint of decreased taste sensation that in the 3rd month of his complaints.MethodsCASE REPORTResultsCASE REPORTConclusionsChemosensory side effects due to drugs are frequently seen in the elderly and in polypharmacy. It is usually accompanied by a decrease in salivary secretion. It resolves shortly after the causative drug(s) are stopped. It is important that our patient is middle-aged, does not have additional medical diseases and does not use drugs, and his complaints continue for 3 months after the stopped of Trazodone.DisclosureNo significant relationships.
Management of Emotional Dysregulation in Adult ADHD
Authors: Tavares F. , Viseu M. , Barbosa Pinto M. , Solana C. 
Published: September 2022

IntroductionAttention-Deficit/Hyperactivity Disorder (ADHD) is characterized by impairing symptoms of inattention and/or hyperactivity/impulsivity. Although Emotional Dysregulation (ED) is not current criteria for ADHD, several clinical, imaging and genetic studies have been suggesting its inclusion. ED seems to impair social and occupational capacities, leading to poor quality life. In this regard, managing this situation is fundamental.ObjectivesED in ADHD review and its management, including pharmacological and nonpharmacological approaches.MethodsNon-systematic review through literature using databases as Pubmed and UpToDate. Keywords used: Attention-Deficit/Hyperactivity Disorder, Emotional Dysregulation, management, pharmacotherapy.ResultsLiterature refers to ADHD drugs, such as psychostimulants and atomoxetine, as the first line managing ED. However, some studies demonstrated that ADHD drugs have lower efficacy while treating emotional symptoms, when compared to attention or hyperactivity/impulsivity symptom control. Other medications, such as antidepressants or mood stabilizers, are not considered due to low efficacy and side effects (such as irritability or suicidality behaviour worsening). Regarding non pharmacological approaches, there have been results with cognitive behavioral treatment, and management techniques for anger, frustration and communication skills.ConclusionsAlthough the majority of studies demonstrate psychostimulants and atomoxetine role, there is an important lack of information regarding management of ADHD emotional dysregulation. It is a multifactorial condition, and, as such, non pharmacological and pharmacological management are needed to address this issue. More research is necessary, in order to improve patients’ quality of life.DisclosureNo significant relationships.
Ischemic colitis related to antipsychotics : A rare and serious entity to know
Authors: Moalla M. , Moalla M. , Boudabous M. , Tahri N. 
Published: September 2022

IntroductionIschemic colitis is a rare condition. It represents 3 to 10% of lower digestive hemorrhages. It preferentially affects the subject over the age of 50 with predisposing factors. Rare cases have been reported in young subjects with the use of cocaine, combined hormones or antipsychotics.ObjectivesThis work aimed to study the potential side effects of antipsychoticsMethodsWe report a case of ischemic colitis associated with antipsychotics.ResultsA 27-year-old patient, followed for 2 years for schizophrenia treated with antipsychotics (chlorpromazine and haloperidol) and an antiparkinsonian (Biperiden), consulted in the emergency room for rectorragies progressing for 3 days. The examination revealed the installation of diffuse abdominal pain associated with early postprandial vomiting which preceded the 7-day rectal bleeding. The physical examination revealed ascites without edema of the lower extremities. The stools were normal-colored on digital rectal examination. The biological workup revealed anemia and a biological inflammatory syndrome. The abdomino-pelvic scanner showed thickening of the entire colonic wall with signs of recent bleeding. The rectosigmoidoscopy showed an ecchymotic aspect of the sigmoid with less pronounced involvement of the rectum. Pathologic examination of the colonic biopsies concluded with ischemic colitis, showing hemorrhagic suffisions with numerous fibrinous thrombi of the vessels. The course was marked by the onset of multi-organ failure with acute renal failure, a picture of disseminated intravascular coagulation (DIC) and alveolar hemorrhage. Despite the resuscitation, the patient died 2 days after admission.ConclusionsIschemic colitis is a rare side effect of antipsychotics. Although rare, this entity should be evoked and diagnosed in time.DisclosureNo significant relationships.