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Bolu, A (Bolu, Abdullah) ; Akarsu, S (Akarsu, Suleyman) ; Pan, E (Pan, Erdal) ; Aydemir, E (Aydemir, Emre) ; Oznur, T (Oznur, Taner)
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CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE
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Seizures are believed to be a dose-dependent side effect of clozapine. In this case report, we describe a patient who had tonic-clonic seizures after using a low dose clozapine who did not have any seizure risk. The 29-year-old male patient had been followed-up with a diagnosis of schizophrenia for about 5 years. When using clozapine 200 mg/day he had a tonic-clonic seizure with bilateral diffuse epileptic activity in electroencephalography (EEG). In the literature, there are a few case reports about low-dose clozapine-induced seizure. Seizures were observed in our case with a low dose of clozapine (200 mg/day) making this case remarkable. EEG monitoring at regular intervals and examination of plasma levels of clozapine could be useful in preventing the development of seizures.
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Clozapine Adverse effects Seizures Safety
Fractional Anisotropic Changes of Corpus Callosum Associated with Antipsychotic Treatment in First-Episode Antipsychotic Drug-Naive Patients with Schizophrenia
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Pan, E (Pan, Erdal) ; Ates, MA (Ates, Mehmet Alpay) ; Algul, A (Algul, Ayhan) ; Aytekin, A (Aytekin, Aykut) ; Basoglu, C (Basoglu, Cengiz) ; Ebrinc, S (Ebrinc, Servet) ; Cetin, M (Cetin, Mesut) ; Kose, S (Kose, Samet)
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KLINIK PSIKOFARMAKOLOJI BULTENI-BULLETIN OF CLINICAL PSYCHOPHARMACOLOGY
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Objective: Schizophrenia involves white matter abnormalities that might have a central role in the pathophysiology. Abnormal brain connectivity especially in prefrontal and temporal heteromodal cortex has been suggested as the leading structural impairment in patients with schizophrenia. In this study we examined the relationship between potential white matter changes and clinical response, as well as associations with antipsychotic treatment follow-up.
Methods: 18 first-episode schizophrenia (FES) patients were recruited from the outpatient unit of the GATA (Gulhane Military Medical Academy) Haydarpasa Research and Training Hospital, between June 2009-February 2010. Fourteen patients with FES were recruited, and 16 healthy control subjects were recruited from the community. Diffusion tensor MRI (DT-MRI) was obtained from participants at baseline and after 4 weeks of standard antipsychotic treatment. A color-coded fractional anisotropy map for each 11 patient was extracted from the 4-week follow-up and the baseline splenium and genu FA measurements. According to Basser and others major eigenvector linear maps were transformed into the color-coded maps. Differences in Positive and Negative Syndrome Scale (PANSS) scores and Brief Psychiatric Rating Scale (BPRS) scores between baseline and follow up were also evaluated.
Results: In this study; in the FES patients, both genu FA (p=0.001) and the splenium FA (p=0.013) values were statistically significantly lower than the healthy control group. There were mild FA increases respectively genu and splenium (p=0.533, p=0.318) in the FES patients after the treatment. But the FA changes did not correlate with the changes in clinical symptoms. A negative, moderate, statistically significant correlation (Pearson's r=-0.569, p=0.034) was found between baseline splenium FA values and BPRS scores. The duration of illness prior to treatment was negatively, weak, statistically non-significantly correlated (r=-0.066; p=0.846) between baseline and follow-up splenium FA changes.
Conclusions: The reduced mean Callosal FA (CFA) values might indicate myelination defects and problems in axonal transport. The existence of white matter changes even in first episode drug-naive schizophrenia patients supports the view that these problems occurs in earlier stages of development. Although the callosal FA changes did not correlate with symptom improvement or the dose of antipsychotic medication, there was a mild increase in follow-up FA measurements. These findings show that CC which is the main conduit of interhemispheric connection is affected distinctly in patients with schizophrenia. Further collaborative studies are needed to clarify the potential long-term effects of antipsychotics on white matter microstructure and also its reversibility.
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Author Keywords
First-episode schizophrenia fractional anisotropy antipsychotic treatment corpus callosum
Folie a Famille: Case Report
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TURK DERMATOLOJI DERGISI-TURKISH JOURNAL OF DERMATOLOGY
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Delusional parasitosis (DP) is a very rare chronic psychiatric disorder. Although there are no any clinical symptoms in patients, there is a false and fixed belief that they are infected with parasites. Folie a famille is characterized as a shared psychotic disorder within all the family members. Herein, we present a family total of five people including mother, father, daughter, grandmother and grandfather who diagnosed with DP and have shared psychotic disorder.
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Delusional parasitosis folie a famille shared psychotic disorder
Prevalence of Sexually Transmitted Diseases and Blood-Borne Transmitted Infections among Male Patients with Antisocial Personality Disorder
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Yildiz, H (Yildiz, Hamza) ; Pan, E (Pan, Erdal) ; Bolu, A (Bolu, Abdullah) ; Bilgili, ME (Bilgili, Memet Ersan) ; Gümüs, I (Gumus, Ismail) ; Abuaf, ÖK (Abuaf, Ozlem Karabudak)
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TURK DERMATOLOJI DERGISI-TURKISH JOURNAL OF DERMATOLOGY
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Objective: The aim of this study was to compare the patients who have antisocial personality disorder (ASPD) and the healthy individuals in terms of sexually transmitted diseases (STDs) and Blood-Borne Transmitted Infections (BTIs) prevalences.
Methods: This study is a prospective, single-center, open-label, non-randomized controlled clinical study. There were two groups in the study. The patient group consistsed of 100 males who were diagnosed as ASPD with a clinical interview form. The control group consisted of 98 healthy males who did not have any psychiatric disorder. Dermatologic examination was performed, and clinical findings were recorded.
Results: The mean age of the patient group was 21.96+/-2.40 (range 20-37) years. The mean age of the control group was 24.20+/-2.88 (21-36) years. The most common disease was gonorrhea (25%) followed by genital wart (11%), molluskum contagiosum (5%), HBsAg (4%), and HSV-2 seropositivity (4%) in the patients group. In the control group, HSV-2 seropositivity (4.08%), genital wart (3.06%), molluskum contagiosum (3.06%), and gonorrhe (1.02%) were commonly seen in the control group. STDs and/or BVTIs were found more common in the patients group (82%) than that in the control group (45.91%) (X-2=30.62, p=0.000).
Conclusions: The patients with ASPD are at greater risk than normal population to catch a STDs or BTIs because of their lower educational levels and riskier behaviors. This condition entertains a risk in the general population and the patients themselves.
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Antisocial personality disorder sexually transmitted diseases blood-borne viral diseases genital wart molluskum contagiosum gonorrhe
Bipolar disorder and oxidative stress
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Erdem, M (Erdem, Murat) ; Akarsu, S (Akarsu, Suleyman) ; Pan, E (Pan, Erdal) ; Kurt, YG (Kurt, Yasemin Gulcan)
The evidence about the role of oxidative stress on the pathophysiology of bipolar disorder (BD) has been increased recently. It has been considered that oxidative stress and its effects cause damage in the critical brain circuits regulating affective functions, emotions, motor behaviors and so that the symptoms seen in BD occur by the deterioration of mood-stabilizing mechanisms. In clinical trials, significant changes were determined in the BD patients' levels of antioxidant enzymes, lipid peroxidation and nitric oxide. Because of the different clinical features of the disorder such as manic/hypomanic, depressive, or mixed episode, the data associated with oxidative stress might vary among the patients. Some mood stabilizers used in the treatment are known to have antioxidant effects. Normalization of the oxidative stress parameters had been reported in the treatment process of BD. It makes a positive contribution to the treatment process that these drugs increase the neurotrophic factors and protect against apoptosis as well as reducing the effects of oxidative stress. Reactive oxygen species occur with the escape of some electrons from the chain during their flow in the mitochondria complex and mitochondrial dysfunction develops after the inhibition of electron transport chain. Mitochondrial dysfunction found to be associated with the pathogenesis of BD. Mitochondrial dysfunction and oxidative stress may create symptoms of the BD secondary to the changes in intracellular signaling system, balance of intracellular calcium, and DNA structure. Using antioxidants, in addition to the treatment, is expected to provide positive contribution to the prognosis in bipolar patients. Systematic studies including each period of the disorder are needed for using the findings indicating deterioration of oxidative balance as biological markers in BD.
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bipolar disorder oxidative stress mood stabilizers
Relationship of Substance Use Disorder to Aggression in Male Subjects with Antisocial Personality Disorder
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Algül, A (Algul, Ayhan) ; Semiz, UB (Semiz, Umit Basar) ; Ates, MA (Ates, M. Alpay) ; Basolu, C (Basolu, Cengiz) ; Doruk, A (Doruk, Ali) ; Ebrinç, S (Ebrinc, Servet) ; Pan, E (Pan, Erdal) ; Çetin, M (Cetin, Mesut)
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DUSUNEN ADAM-JOURNAL OF PSYCHIATRY AND NEUROLOGICAL SCIENCES
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Objective: Aggression is a particular problem commonly observed in personality disorders, especially in antisocial personality disorder (APD). It is well known that APD is closely related to substance use disorder (SUD). Individuals with higher aggression levels have also been suggested to have higher rates of SUD. The aim of this study is to investigate aggression levels and substance use characteristics of APD subjects with and without violent criminal behavior.
Method: A total of 124 male subjects with APD consecutively admitted to the Forensic Psychiatry Department of GATA Haydarpasa Training Hospital were involved in the study. All subjects were evaluated with an assessment battery using a semistructured interview for socio-demographic, APD, and substance use characteristics, APD section of SCID-II, SCID-I, and Aggression Questionnaire. The sample was divided into 2 groups in terms of having a history of violent criminal behavior and compared correspondingly.
Results: Of the APD subjects, 90.3 % reported a lifetime history of substance abuse and 75.8 % had a current co-diagnosis of SUD. APD subjects with violent criminal behavior were more likely to be diagnosed with SUD as compared to those with out violent crimes. Moreover, APD subjects with SUD had higher aggression levels than those without SUD.
Conclusion: Our results indicate that substance use may mediate the association between APD and aggression. Therefore, the treatment of substance abuse in APD subjects is an important target particularly for prevention of violent criminal behaviors.
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Antisocial personality disorder substance use disorder aggression