1/45. Opioid withdrawal during risperidone treatment.A small but significant percentage of opioid-dependent patients will require neuroleptic treatment. Several classes of drugs have been shown to affect opioid metabolism. Two patients who were hospitalized with a diagnosis of opioid dependence received concomitant treatment with opioids and risperidone. After receiving risperidone for several days, both patients exhibited symptoms of opioid withdrawal despite having no change in their opioid doses. These withdrawal symptoms resolved soon after risperidone was discontinued. This finding suggests the possibility that risperidone may precipitate opioid withdrawal in opioid-dependent patients.- - - - - - - - - - ranking = 1keywords = affect (Clic here for more details about this article) |
2/45. A case of seizures 1 week after the cessation of interferon-alpha therapy.We report on a 60-year-old woman with a history of bipolar mood disorder who had seizures and developed a delirious state 1 week after the cessation of interferon-alpha (IFN-alpha) for chronic hepatitis c. The IFN-alpha was administered to the patient for 7 weeks (266 million IU). One week after the cessation of IFN-alpha therapy, the patient had four generalized tonic-clonic seizures over a 2-day period and developed a delirious state for 2 months. We consider these seizures and delirious state to be related to IFN-alpha.- - - - - - - - - - ranking = 660.39982763927keywords = mood (Clic here for more details about this article) |
3/45. Decreased methadone effect after ritonavir initiation.Combination antiretroviral therapy including protease inhibitors such as ritonavir has added significant potency to therapy for human immunodeficiency viral (hiv) infection as well as substantial drug-drug interactions. methadone metabolism is affected by cytochrome P450 (CYP) 3A4 inhibitors or inducers. Because ritonavir can induce CYP3A, it can decrease methadone plasma levels. An hiv-infected patient receiving methadone maintenance experienced withdrawal symptoms after ritonavir, saquinavir, and stavudine were added to his regimen; the most likely cause was ritonavir.- - - - - - - - - - ranking = 1keywords = affect (Clic here for more details about this article) |
4/45. Withdrawal of synthetic hormones during the perimenopause: a case study.A single case study was used to explore the experiences of a perimenopausal woman following withdrawal of synthetic hormones. The respondent, aged 51 years, had experienced severe physiologic, affective and cognitive dysfunction following withdrawal of synthetic hormones. She was approached while attending a family planning clinic in regional new south wales, australia. Information was obtained through a retrospective chart review and in-depth interview. The findings suggest that affective and cognitive dysfunction may be triggered by the sudden withdrawal of artificial hormones in perimenopausal women. Practitioners should be aware that some women, especially those unable to produce sufficient natural hormones, might experience severe physiologic, affective and cognitive dysfunction when hormone supplements are withdrawn. Detailed history-taking and close monitoring following the withdrawal or introduction of hormones may alert practitioners to the incidence of withdrawal symptoms or side-effects. Moving beyond the scientific interpretations, future research should address these concerns and investigate the potential for addiction when hormones are prescribed.- - - - - - - - - - ranking = 3keywords = affect (Clic here for more details about this article) |
5/45. Intraoperative high-dose remifentanil in a patient on naltrexone therapy.naltrexone hydrochloride is a synthetic opioid receptor antagonist recently used in efforts to provide rapid opioid detoxification. Other clinical uses include alleviating itch due to cholestasis or uraemia. We report a case where unrecognised naltrexone therapy for itch affected anaesthesia, resulting in high opioid requirements. We also discuss other analgesic options utilized.- - - - - - - - - - ranking = 1keywords = affect (Clic here for more details about this article) |
6/45. Treatment of alcohol withdrawal with gabapentin.Gabapentin is an anticonvulsant agent, also effective in the treatment of mood disorders and anxiety disorders. Three cases of alcohol withdrawal treated with gabapentin are presented. All patients received gabapentin 400 mg tid for 3 days, 400 mg bid for 1 day, and finally 400 mg for 1 day. Withdrawal symptoms subsided and no adverse effects were observed. The possible effectiveness of gabapentin in the treatment of alcohol withdrawal warrants further investigation by systematic and well-designed studies.- - - - - - - - - - ranking = 660.39982763927keywords = mood (Clic here for more details about this article) |
7/45. bupropion for amphetamine withdrawal syndrome.This study was a case report of an amphetamine abuser who came to see doctor because of amphetamine withdrawal syndrome three days after stopping prolonged use of amphetamine. The patient was treated him with a slow-release bupropion at the dose of 150 mg per day. After taking bupropion, his withdrawal symptoms i.e. dysphoric mood, fatigue, somnolence, and psychomotor retardation gradually disappeared within two to three days. Moreover, his craving for amphetamines was absent. The authors discussed the possible application for the clinical use for amphetamine abusers or dependence.- - - - - - - - - - ranking = 660.39982763927keywords = mood (Clic here for more details about this article) |
8/45. Can stimulant rebound mimic pediatric bipolar disorder?The authors describe the case of a 7-year-old girl diagnosed with attention deficit hyperactivity disorder (ADHD) who, following an unsuccessful trial of stimulant medication and subsequent mood symptoms, was diagnosed with bipolar disorder. Following a comprehensive, multidisciplinary assessment, and withdrawal of her complex medication regimen, she was rediagnosed with ADHD. She displayed a positive response to behavioral parent training and pharmacological treatment with a long-acting stimulant. The case illustrates the benefits of a comprehensive, multidisciplinary evaluation and multimodal treatment. Her dramatic response to the long-acting stimulant suggests that many of her affective symptoms were due to stimulant "rebound" versus bipolar disorder. This case highlights the complexities of differentiating severe ADHD from bipolar disorder and suggests that stimulant rebound and other iatrogenic effects should be considered during the differential diagnostic process as potential mimics of bipolar disorder.- - - - - - - - - - ranking = 661.39982763927keywords = mood, affect (Clic here for more details about this article) |
9/45. Self-medication with gamma-hydroxybutyrate to reduce alcohol intake.We describe a 52-year-old man who self-medicated with gamma-hydroxybutyrate (GHB), a widely available illicit substance, to obtain a decrease in ethanol consumption. He successfully reduced his ethanol intake over a 3-month period, but he was unable to sustain abstinence. Although case reports on the use of GHB to induce euphoria have been published, this is the first report of GHB self-medication to facilitate ethanol abstinence. This report highlights the importance of considering GHB self-medication not only for euphoric and mood altering effects, but also as a potential treatment for ethanol intake reduction.- - - - - - - - - - ranking = 660.39982763927keywords = mood (Clic here for more details about this article) |
10/45. Transient restless legs-like syndrome as a complication of opiate withrawal.In most cases, restless legs syndrome (RLS) is an idiopathic disorder affecting patients of middle and older age. Usually, the intensity of symptoms is constant or progressive. Here, we describe two opiate addicts developing RLS during opiate withdrawal. Their RLS disappeared along with the remission of withdrawal symptoms. Both cases responded well to a treatment with Madopar (L-dopa plus benserazid). This observation encouraged us to perform a retrospective analysis of all cases of opiate addicts detoxified in our unit during a 5-month period. This analysis revealed 15 out of 120 patients who had described the symptoms of transient RLS emerging during opiate detoxification treatment. Transient RLS during opiate detoxification merits further interst in order to improve the treatment of sleep disturbances during detoxification and as a model of interaction of the dopaminergic and endorphine system in motor activity.- - - - - - - - - - ranking = 1keywords = affect (Clic here for more details about this article) |
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