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Clinical Neuropharmacology

Kensuke Miyazaki, Masabumi Otaka, Norio Yasui-Furukori
BACKGROUND: Rhabdomyolysis involves the release of intracellular contents secondary to muscle cell injury; it generally presents with muscle pain and weakness. Although several psychotropic agents have been documented as causes of rhabdomyolysis, there are no reports of tandospirone-induced rhabdomyolysis. CASE: We present the case of a 15-year-old Japanese girl who had posttraumatic stress disorder after the Great East Japan Earthquake. She received a dose of 60 mg of tandospirone while taking 10 mg of tandospirone and 400 mg of valproic acid every day...
September 10, 2018: Clinical Neuropharmacology
Grace H Lee, Jonathan T Stewart
Musical hallucinations (MHs) are relatively uncommon phenomena sometimes encountered in older patients, especially older women. They usually involve popular, overlearned music, either entire songs or repetitive snippets. While MHs are most commonly associated with hearing loss, they may occur in a variety of psychiatric, neurologic, and iatrogenic conditions. We report a 91-year-old man whose MHs were causally related to the antidepressant mirtazapine. Although mirtazapine is generally well tolerated, it may rarely cause MHs or other psychotic symptoms...
September 10, 2018: Clinical Neuropharmacology
Masayuki Masuda, Hiroya Utsumi, Sachiko Tanaka, Akemi Maeno, Mamiko Yamamoto, Kentaro Sugiyama, Toshihiko Hirano, Hitoshi Aizawa
OBJECTIVES: The objective of this study was to investigate the influence of treatment with cholinesterase inhibitors (ChEIs) and calcineurin inhibitors (CNIs) on the occurrence of cramps in myasthenia gravis (MG) patients. METHODS: The frequency and duration of cramp and serum electrolytes were evaluated in 81 patients with MG. The patients were classified using Myasthenia Gravis Foundation of America postintervention status scores based on the treatment and the responsiveness to the treatment...
August 20, 2018: Clinical Neuropharmacology
Gianna Sepede, Marco Lorusso, Maria Chiara Spano, Piero Di Nanno, Giuseppe Di Iorio, Massimo Di Giannantonio
OBJECTIVES: Bipolar disorder (BD) patients with a comorbid substance use disorder (SUD) are notoriously difficult to treat. Atypical antipsychotics (AAPs) are widely prescribed in BD, but their efficacy in patients with comorbid SUD is still debated. The aim of the present article is to systematically review the literature findings on the efficacy and safety of AAPs in BD patients with comorbid SUD. METHODS: We searched PubMed to identify original studies focused on the treatment of dual diagnosed BD with AAPs...
July 21, 2018: Clinical Neuropharmacology
Manuela Contin, Luca Mancinelli, Alessandro Perrone, Loredana Sabattini, Susan Mohamed, Cinzia Scandellari, Matteo Foschi, Veria Vacchiano, Alessandra Lugaresi, Roberto Riva
OBJECTIVES: We aimed to assess the potential relationship between intrasubject 9-tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray plasma profiles and clinical effects elicited by subacute dosing in chronically treated patients with multiple sclerosis (MS). METHODS: The study design was pilot, single center, open, and prospective. The patients were challenged with a morning test dose of 2 THC/CBD sprays at a 15-minute interval. Venous blood samples were collected before the first spray administration and every 30 minutes after the second spray, until 240 minutes postdosing...
July 18, 2018: Clinical Neuropharmacology
Fatma Çoşkun, Ayhan Bilgiç
Skin-picking disorder is regarded as a type of obsessive-compulsive and related disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Selective serotonin reuptake inhibitors (SSRIs) are reported to be effective in the treatment of skin-picking disorder. However, these agents can cause opposite effects in some cases. There is a report on SSRI-induced skin-picking disorder in adults. However, to our knowledge, there are no data regarding SSRI-induced skin picking in children...
July 18, 2018: Clinical Neuropharmacology
Adit Friedberg, Ilana Erikh, Maria Nassar, Elliot Sprecher, Ilana Schlesinger
OBJECTIVE: The aim of this study was to assess clinical response to a high-dose intravenous (IV) amantadine given for 5 consecutive days in patients with multiple system atrophy parkinsonism (MSA-P). METHODS: Subjects with a diagnosis of MSA-P treated with IV amantadine were included. Patients' disease severity before and after therapy was evaluated using the Unified Multiple System Atrophy Rating Scale (UMSARS). RESULTS: Fourteen subjects (8 females) were included...
July 18, 2018: Clinical Neuropharmacology
Joseph H Friedman
INTRODUCTION: Pimavanserin (Pim) is a 5HT2A inverse agonist that is the only Food and Drug Administration-approved treatment for Parkinson disease (PD) psychosis. The published open-label experience is limited. METHODS: This report is a chart review of all patients who were started on the drugs since the one earlier report on 15 patients. All patients were included, whether or not they completed 6 weeks of treatment, the time required for maximum benefit found in the published phase 3 trial...
July 13, 2018: Clinical Neuropharmacology
Betül Akbaş, Ayhan Bilgiç
Fluoxetine is a selective serotonin reuptake inhibitor that is commonly used in children and adolescents. Several reports exist regarding the relationship of fluoxetine use and sleep bruxism. We report the case of a 6-year-old girl who was successfully treated with once-nightly dosing of buspirone for fluoxetine-induced sleep bruxism, which was confirmed with clear on-off-on treatment sequence.
July 3, 2018: Clinical Neuropharmacology
Hyeon Su Kim, Na Young Kim, Yong Wook Kim
Paroxysmal sympathetic hyperactivity (PSH) is characterized by increased activity of the sympathetic nervous system. Although several treatments have been proposed for PSH, their efficacies are uncertain. We report a case of a patient with intractable PSH after pontine hemorrhage who was treated with intrathecal baclofen (ITB). A 61-year-old man was diagnosed with pontine hemorrhage expanding to the bilateral midbrain. Beginning 2 weeks after onset, he developed paroxysmal hyperthermia, tachycardia, tachypnea, hypertension, and generalized dystonic movements...
July 2018: Clinical Neuropharmacology
Sherifa Ahmed Hamed
OBJECTIVES: Pregabalin (PGB) is a gabapentinoid (ie, GABA analog), which has been Food and Drug Administration-approved for treatment of partial epilepsy in adults and neuropathic pain. It also has off-label uses for the treatment of generalized anxiety disorders, fibromyalgia, and tension headache and prevention of migraine. Few cases were reported with sexual dysfunctions (SDs) as adverse effects of PGB and gabapentin, and the majority were dose related (≥900 mg/d for gabapentin)...
July 2018: Clinical Neuropharmacology
Ariana Helena Ribeiro de Barros, João Paulo Fiadeiro Sequeira, Ary Severino Lopes de Sousa, Carlos Miguel Cheganças Capela, Rui Manuel Gomes Pedrosa, Manuel Alexandre Dos Santos Manita
OBJECTIVES: The aim of this study was to evaluate postmarketing fingolimod safety and effectiveness in a real-world clinical population. METHODS: This was a retrospective, single-center study with active multiple sclerosis patients treated with fingolimod with at least 12 months of follow-up. Demographic and clinical and imaging characteristics, including annualized relapse rate (ARR), Expanded Disability Status Score, previous treatment, adverse events, treatment duration, and reason for discontinuation, were analyzed...
July 2018: Clinical Neuropharmacology
Rukiye Çolak Sivri, Hayriye Hizarcioğlu Gülşen, Arzu Yilmaz
Phagophobia is a condition characterized by an avoidance of swallowing foods and an intense fear of choking while eating solid foods in the absence of physiological and anatomical abnormalities. Phagophobia is mentioned in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and International Classification of Diseases, 11th Edition in the new diagnostic category of avoidant/restrictive food intake disorder. The literature concerning phagophobia is sparse, and there is no specific treatment modality for this life-threatening condition...
July 2018: Clinical Neuropharmacology
Lucía Ameghino, Verónica Bruno, Marcelo Merello
OBJECTIVE: The aim of this study was to evaluate the relationship between antiparkinsonian treatments, especially dopamine agonist (DAs) and the development of postural disorders in patients with Parkinson's disease (PD). METHODS: We performed an exploratory case-control study. Cases were PD patients with camptocormia, Pisa syndrome, or anterocollis. Control subjects were PD patients without postural disorders matched by sex and age. Demographic and clinical data including pharmacologic treatments history were collected retrospectively...
July 2018: Clinical Neuropharmacology
Mao-Hsuan Huang, Yu-Chuan Chiu, Chia-Fen Tsai
PLA2G6-associated neurodegeneration is a major subtype of neurodegeneration with brain iron accumulation. Patients with PLA2G6-associated neurodegeneration usually present degenerative motor symptoms with neuropsychiatric disturbance. This report presents a patient with PLA2G6-related dystonia-parkinsonism, who had neuropsychiatric symptoms preceding movement symptoms. Antipsychotic drug was prescribed, and he developed parkinsonism years later. Differential diagnosis between drug-induced parkinsonism and PLA2G6-related dystonia-parkinsonism could be challenging...
July 2018: Clinical Neuropharmacology
Petr Bušek, Jitka Bušková, Eva Miletínová, Karolína Mladá, Soňa Nevšímalová, Karel Šonka
INTRODUCTION: Modafinil may affect autonomic functions in healthy subjects. The aim of the study was to assess the long-term modafinil administration influence on the cardiac autonomic reactivity to orthostatic load in patients with narcolepsy type 1. METHODS: In 15 patients (4 male; 11 female; median age, 47 years; range, 18-70 years) with narcolepsy type 1 treated with modafinil in daily dose of 100 to 300 mg, the short-term spectral analysis of heart rate variability (HRV) in supine-standing-supine test was performed before and after 72 hours of modafinil discontinuation...
July 2018: Clinical Neuropharmacology
Pedro Vicente Ferreira Naves, Marcelo Calderaro, Luis Otavio Caboclo
Myoclonic status epilepticus (MSE) in patients without epilepsy, or de novo MSE, is a rare condition associated with several acute symptomatic etiologies, including drugs and toxins. We describe a 94-year-old woman with Alzheimer dementia and long use of mirtazapine 30 mg/d and alprazolam 1 mg/d who developed MSE approximately 24 hours after abrupt discontinuation of alprazolam. The patient was taking sulfamethoxazole/trimethoprim for urinary tract infection, diagnosed 2 weeks before admission. She had no history of seizures...
July 2018: Clinical Neuropharmacology
Seung Jae Lee, Jin Sung Cheong, Han Uk Ryu, Hyun Goo Kang
OBJECTIVES: Patients with chronic proximal middle cerebral artery (MCA) occlusion do not present with severe symptoms, but early recanalization of acute occlusion is associated with high morbidity and mortality. Tissue plasminogen activator (tPA) is a recombinant thrombolytic agent approved for treating ischemic stroke, although only a few cases of tPA administration in chronic MCA occlusion have yielded positive results. METHODS: A 71-year-old patient had a history of right MCA territorial infarction with the occlusion occurring 12 years ago (November 2005)...
July 2018: Clinical Neuropharmacology
Andrea Maria DʼArrigo, Laura Campiglio, Chiara Casellato, Chiara Gambini, Daniela Belvedere, Manuela Secchi, Chiara Rosci, Alberto Priori
Hyperkinetic movement disorders may be difficult to treat, but cases where patients respond to alcohol and/or drugs with similar effects have been described. We report the case of a 64-year-old man with tardive dyskinesia characterized by severe uncontrolled dystonic and myoclonic jerks of the face, shoulders, and arm and forearm muscles, which improved with oral sodium oxybate. Our case suggests the possibility to test sodium oxybate in patients with severe, drug-resistant hyperkinetic syndromes, especially when they are known to improve with alcohol...
June 20, 2018: Clinical Neuropharmacology
Omid Hesami, Mohammad Sistanizad, Elnaz Asadollahzade, Mohammad-Sadegh Johari, Nahid Beladi-Moghadam, Homa Mazhabdar-Ghashghai
OBJECTIVES: To evaluate the prophylactic effects of atorvastatin on frequency, intensity, and duration of migraine attacks compared with sodium valproate. METHODS: In this randomized, double-blind, single-center controlled trial, patients with 6 to 15 migraine attacks per month, which were candidates of preventive treatment, were recruited. The patients were randomly allocated into 2 groups. The first group (A) received atorvastatin 40 mg daily, and the second group (B) received sodium valproate 500 mg daily...
May 2018: Clinical Neuropharmacology
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