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Drug-induced nightmares

Milton Packer
The injection of mesenchymal stem cells into the injured myocardium to induce cardiac regeneration has yielded disappointing results, conceivably because cells with cardioreparative potential must be supplied for long periods of time to produce a salutary effect. Accordingly, investigators have devised ways of directing such cells to the heart on an ongoing basis: by enhancing the action of endogenous peptides that function as cardiac homing signals (eg, stromal cell-derived factor-1). Stromal cell-derived factor-1 is released during acute cardiac injury and heart failure, but it has a short half-life because of degradation by dipeptidyl peptidase-4...
May 8, 2018: Circulation
Maximilian Gahr, Bernhard J Connemann, René Zeiss, Albrecht Fröhlich
OBJECTIVE:  Psychopharmacotherapy is essential in the treatment of many mental disorders. Adverse drug reactions (ADR) have impact on compliance and tolerability. Sleep disorders or impaired sleep may occur as ADRs of psychopharmacotherapy. Sleep disorders are associated with an increased risk for physical and mental illness and may impair cognition, impulse control, emotion regulation and mood. Objective of the following study was the systematic presentation of type and risk of sleep disorders/impairments of sleep of frequently prescribed psychotropic drugs...
March 2, 2018: Fortschritte der Neurologie-Psychiatrie
Michael A Mancano
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: Your report will be published anonymously unless otherwise requested...
February 2018: Hospital Pharmacy
Adam Wichniak, Aleksandra Wierzbicka, Małgorzata Walęcka, Wojciech Jernajczyk
PURPOSE OF REVIEW: The aim of this review article was to summarize recent publications on effects of antidepressants on sleep and to show that these effects not only depend on the kind of antidepressant drugs but are also related to the dose, the time of drug administration, and the duration of the treatment. RECENT FINDINGS: Complaints of disrupted sleep are very common in patients suffering from depression, and they are listed among diagnostic criteria for this disorder...
August 9, 2017: Current Psychiatry Reports
Arvind Muthukrishnan, Laliytha Bijai Kumar, Gomathi Ramalingam
Medication-related osteonecrosis of the jaw (MRONJ) is a complication in patients who are on anti-bone resorptive drugs. These drugs are prescribed for patients with multiple myeloma, osteoporosis, metastatic carcinoma and Paget's disease. Common anti-bone resorptive drugs such as bisphosphonate and monoclonal antibodies such as denosumab are prescribed for these patients to prevent bone resorption. Although very effective in preventing bone resorption, a complication arising from these groups of drugs is the development of osteomyelitis of the jaw...
April 6, 2016: BMJ Case Reports
Nadezda Apostolova, Haryes A Funes, Ana Blas-Garcia, Maria J Galindo, Angeles Alvarez, Juan V Esplugues
The NNRTI efavirenz has long been one of the most frequently employed antiretroviral drugs in the multidrug regimens used to treat HIV infection, in accordance with its well-demonstrated antiretroviral efficacy and favourable pharmacokinetics. However, growing concern about its adverse effects has sometimes led to efavirenz being replaced by other drugs in the initial treatment selection or to switching of therapy to efavirenz-free regimens in experienced patients. Neurological and neuropsychiatric reactions are the manifestations most frequently experienced by efavirenz-treated patients and range from transitory effects, such as nightmares, dizziness, insomnia, nervousness and lack of concentration, to more severe symptoms including depression, suicidal ideation or even psychosis...
October 2015: Journal of Antimicrobial Chemotherapy
V K Viswanathan
Antibiotics and antibiotic resistance made news on several fronts in the past year. Many public health organizations, including the CDC, used terms such as "crisis", "catastrophic consequences", and "nightmare scenario" to highlight the rapid emergence and spread of antibiotic resistance. A report from the Pew Commission on Industrial Farm Animal Production, on the fifth anniversary of the publication of its landmark 2008 report, noted that state and federal legislative efforts to limit non-therapeutic use of antibiotics in animal production were thwarted by drug and food animal industries...
January 2014: Gut Microbes
Veronica Brito, Chrisoula Politis, Shalinee Chawla
SESSION TYPE: Miscellaneous Case Report Posters IPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Hypnagogic hallucinations are hallucinatory experiences that accompany the onset of awakening, they can occur in certain states, such as sleep deprivation and conditions such as narcolepsy. Main neural structures responsible for muscle atonia in REM sleep are dorsolateral portions of the pons and brainstem, cholinergic and cholinoceptive REM sleep-on neurons, monoaminergic REM sleep-off neurons...
October 1, 2012: Chest
Yoshiaki Okamoto, Satoru Tsuneto, Hitoshi Tanimukai, Yoichi Matsuda, Yumiko Ohno, Mamiko Tsugane, Etsuko Uejima
BACKGROUND: Ketamine is often used to manage neuropathic pain in patients with cancer. However, it occasionally causes psychotomimetic effects such as vivid dreams, nightmares, illusions, hallucinations, and altered body image. OBJECTIVE: To examine whether gradual dose titration of ketamine for management of neuropathic pain prevents psychotomimetic effects in patients with advanced cancer. METHODS: This was a retrospective chart review. We administered ketamine when neuropathic pain in patients with advanced cancer became refractory to opioids and oral adjuvant analgesics...
August 2013: American Journal of Hospice & Palliative Care
Toshiyuki Kobayashi, Mina Yamauchi
We report on rare side effects of paroxetine. A 67-year-old female patient who had been suffering from prolonged depression for over a year but had not received appropriate treatment was administered 20-mg paroxetine daily. However, the patient required hospital admission after 16 days because of behavioural disturbances and delusions that she was being chased by evil persons from a religious group. The delusions were ultimately confirmed to be serial nightmares and an oneiroid state. The nightmares gradually disappeared following discontinuation of paroxetine...
March 2012: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Bernard Maillère, Stéphanie Delluc, Gilles Ravot
Immunogenicity of therapeutic proteins is a nightmare for industrials because induced antibodies can neutralize the therapeutic activity and provoke autoimmune symptoms. It was believed that sequence humanization would be sufficient to tackle these problems but multiple clinical examples now demonstrate that humanization does not suffice to abrogate immune responses. In order to predict immunogenicity of therapeutic proteins, different approaches have been developed, among which the most relevant ones are based on the evaluation of the response of naïve CD4 T lymphocytes specific for therapeutic proteins...
January 2012: Médecine Sciences: M/S
Frédéric Pochard
Stays in intensive care units (ICUs) are a source of psychological and physical stress, sometimes resulting in psychological disorders that may persist after ICU discharge. ICU stressors include exhaustion, drug-induced sleep privation, intubation, pain, noise, and a disrupted light-dark cycle. Patients remember traumatic experiences, such as a fear of being killed or abandoned, nightmares, and panic attacks. Depression is frequent but difficult to detect. Psychiatric disorders such as delirium and confusion (hallucinations, agitation, stupor) occur in almost half of all ICU patients...
February 2011: Bulletin de L'Académie Nationale de Médecine
C Diack, O Ackaert, B A Ploeger, P H van der Graaf, R Gurrell, M Ivarsson, D Fairman
Drug-induced sleep fragmentation can cause sleep disturbances either via their intended pharmacological action or as a side effect. Examples of disturbances include excessive daytime sleepiness, insomnia and nightmares. Developing drugs without these side effects requires insight into the mechanisms leading to sleep disturbance. The characterization of the circadian sleep pattern by EEG following drug exposure has improved our understanding of these mechanisms and their translatability across species. The EEG shows frequent transitions between specific sleep states leading to multiple correlated sojourns in these states...
December 2011: Journal of Pharmacokinetics and Pharmacodynamics
Ingo Kleiter, Ralf Luerding, Gerhard Diendorfer, Helga Rek, Ulrich Bogdahn, Berthold Schalke
The case of a 23-year-old mountaineer who was hit by a lightning strike to the occiput causing a large central visual field defect and bilateral tympanic membrane ruptures is described. Owing to extreme agitation, the patient was sent into a drug-induced coma for 3 days. After extubation, she experienced simple and complex visual hallucinations for several days, but otherwise largely recovered. Neuropsychological tests revealed deficits in fast visual detection tasks and non-verbal learning and indicated a right temporal lobe dysfunction, consistent with a right temporal focus on electroencephalography...
2009: BMJ Case Reports
Pamela Foral, Jon Knezevich, Naresh Dewan, Mark Malesker
OBJECTIVE: To review the literature for medication-induced sleep disturbances. DATA SOURCE: MEDLINE/PUBMED searches (January 2000-May 2010) were conducted to identify pertinent English-language studies. STUDY SELECTION AND DATA EXTRACTION: References were reviewed to identify literature that provided evidence of sleep disturbances caused by prescription medications. DATA SYNTHESIS: Review of studies was performed to determine the effect a given medication had on subjects' sleep architecture or those that induced common sleep disorders...
June 2011: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Alan R Felthous, Philip J Wenger, Rod Hoevet
Tricyclic antidepressants decrease rapid eye movement (REM) sleep and may suppress sleep atonia. Reports indicate that these agents can induce visual hallucinations, sometimes characterized as hypnopompic or associated with a dissociated sleep-wakefulness state. In addition, disturbing dreams and confusional states were reported during clinical trials and in subsequent studies. To our knowledge, only two cases of nightmares associated with mirtazapine, a tetracyclic antidepressant, have been previously reported...
April 2010: Pharmacotherapy
Rune Amundsen, Anders Asberg, Ida Robertsen, Nils T Vethe, Stein Bergan, Anders Hartmann, Karsten Midtvedt
BACKGROUND: Obesity is a common problem following renal transplantation. Rimonabant, a cannabinoid-1 receptor blocker, offers a new approach for reducing obesity. METHODS: The potential pharmacokinetic interaction between rimonabant and cyclosporine A (CsA, n=10) and tacrolimus (Tac, n=8) was assessed in stable renal transplant recipients 6.2 (0.9-21.7) years posttransplant. A 12-hour pharmacokinetic profile was obtained before and after two months of concomitant treatment with 20 mg rimonabant each morning...
April 27, 2009: Transplantation
Jane Vella-Brincat, A D Macleod
Opioids, defined as drugs that stimulate opioid receptors, are primarily used in the treatment of moderate to severe pain. They induce central nervous system (CNS) adverse effects which can be divided into three groups. The first group includes effects that lower the level of consciousness-sedation, drowsiness and sleep disturbance. The second group affects the thinking process and the ability to react-cognitive impairment, psychomotor impairment, delirium, hallucinations, dreams and nightmares. The third group is of the direct toxic effects of opioids on neurons and includes myoclonus (perhaps), hyperalgesia and tolerance...
2007: Journal of Pain & Palliative Care Pharmacotherapy
Ingo Kleiter, Ralf Luerding, Gerhard Diendorfer, Helga Rek, Ulrich Bogdahn, Berthold Schalke
The case of a 23-year-old mountaineer who was hit by a lightning strike to the occiput causing a large central visual field defect and bilateral tympanic membrane ruptures is described. Owing to extreme agitation, the patient was set to a drug-induced coma for 3 days. After extubation, she experienced simple and complex visual hallucinations for several days, but otherwise recovered largely. Neuropsychological tests revealed deficits in fast visual detection tasks and non-verbal learning, and indicated a right temporal lobe dysfunction, consistent with a right temporal focus on electroencephalography...
April 2007: Journal of Neurology, Neurosurgery, and Psychiatry
Gabriele Arendt, Dominique de Nocker, Hans-Juergen von Giesen, Thorsten Nolting
The non-nucleoside analogue inhibitor of the reverse transcriptase, efavirenz (EFV), has become commonly used in highly active antiretroviral combination therapy in the treatment of HIV infection. Although being effective in suppressing plasma viral load, neuropsychiatric side effects have been reported in individuals treated with EFV. There are early complications, such as acute psychosis resembling reactions to LSD intake, as well as nightmares occurring for several days up to 4 weeks after the start of therapy...
March 2007: Expert Opinion on Drug Safety
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