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Levetirazetam: antiepileptic-induced psychosis
- C. Vilella Martín, P. García Vázquez, Y. Barrera García, P. Fernández Perea, A. Serrano García, M.Á. Alonso De La Torre López, R. Gómez Martínez, C. Franch Pato
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S732
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Introduction
Levetirazetam is an antiepileptic drug with psychiatric adverse reactions. It includes psychosis, paranoia or hallucinations. The frequency is less than 1%.
ObjectivesTo describe a case of Psychosis produced by Levetirazetam
MethodsRetrospective review of clinical records and complementary test, including psychiatry, electrophysiology and neurology. Diagnosis schales such as Salamanca Questionnaire were used as suport.
ResultsA 42-year-old woman diagnosed with tuberous sclerosis and undergoing treatment with levetirazetam acudes to the emergency department for behavioral disorders. She has presented an episode of aggression against a relative threatening him with a kitchen knife. The family reports that since the change in antiepilepticus 1 month ago, the patient has presented strange behaviors. Te Patient is conscious, uncooperative. Barely Approachable. Suspicious of her surroundings, with psychomotor restlessness, self-reference ideas and sparse speech. Auditory hallucinations seem to be present, as well as depressed and irritable mood. Psychic and somatic anxiety is found.
Levetirazetam is discontinued, being replaced by valproic acid. Risperidone is started at a 3 mg dose. Treatment is well tolerated, and clinical stability is achived. Cluster A personality traits are found. Complementary test Blood and Urine simples, Imaging tests (CT and MRI), electroencephalogram and Electrocardiogram show no alterations
ConclusionsLevetirazetam can cause psychiatric adverse effects. it is important to make a proper diagnosis before a first psychotic outbreak in later life. Drugs that can produce psychiatric side effects should be identified and patients should be inform.
DisclosureNo significant relationships.
Levetirazetam psychosis
- C. Vilella Martín, M.Á. Alonso De La Torre López, P. García Vázquez, I. Gonzalez Rodríguez, S. Nuñez Sevillano, A. Serrano García
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S775
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Introduction
Levetirazetam is an antiepileptic drug with psychiatric adverse reactions. It includes psychosis, paranoia or hallucinations. The frequency is less than 1%.
ObjectivesTo describe and study a case of Psychosis produced by Levetirazetam
MethodsRetrospective review of clinical records and complementary test, including psychiatry, electrophysiology and neurology. Diagnosis schales such as Salamanca Questionnaire were used as suport.
ResultsA 42-year-old woman diagnosed with tuberous sclerosis and undergoing treatment with levetirazetam acudes to the emergency department for behavioral disorders. She has presented an episode of aggression against a relative threatening him with a kitchen knife. The family reports that since the change in antiepilepticus 1 month ago, the patient has presented strange behaviors. Te Patient is conscious, uncooperative. Barely Approachable. Suspicious of her surroundings, with psychomotor restlessness, self-reference ideas and sparse speech. Auditory hallucinations seem to be present, as well as depressed and irritable mood. Psychic and somatic anxiety is found. Levetirazetam is discontinued, being replaced by valproic acid. Risperidone is started at a 3 mg dose. Treatment is well tolerated, and clinical stability is achived. Cluster A personality traits are found. Complementary test Blood and Urine simples, Imaging tests (CT and MRI), electroencephalogram and Electrocardiogram show no alterations
ConclusionsLevetirazetam can cause psychiatric adverse effects. it is important to make a proper diagnosis before a first psychotic outbreak in later life. Drugs that can produce psychiatric side effects should be identified and patients should be inform.
DisclosureNo significant relationships.
P01-236 - ADHD Symptomatology in bipolar disorder and descendant
- M.D. Ortega García, C. Martinez Martínez, R. Gómez Martínez, C. Dominguez Martín, C. Salazar Li, G. Rodríguez Carretero, P. Blanco del Valle, A. Agúndez Modino, M.A. Alonso de la Torre, A. Rodríguez Campos
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- Journal:
- European Psychiatry / Volume 25 / Issue S1 / 2010
- Published online by Cambridge University Press:
- 17 April 2020, 25-E442
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Objective
Describe Attention Deficit Hyperactive Disorder's (ADHD) prevalence in Bipolar Disorders (BD) and relatives.
Methods78 admissions for Bipolar Disorder (DSM-IV) in Impatient Psychiatric Unit, in Hospital Clínico Universitario of Valladolid (Spain). Only 36/78 patients participate in study. Demographic, social and clinical information were registered. ADHD symptomatology was evaluated from patient and descendant (Conners short version).
ResultsADHD symptomatology suggestive in childhood/adolescence were detected in 13,9% (5/36). Conners score were negative (below 15) in all case.
ADHD symptomatology suggestive in their children were detected in 6,25% (n=3). Conner score were positive in 2,1%. Family psychiatry history in 72,2% (n=26), affective disorder in 60,52% (n=23). No family history with ADHD diagnosis. Only one case (2,8%) with symptomatology suggestive of ADHD in relatives.
ConclusionsThe ADHD prevalence in our sample of BD and relatives weren’t higher than general population.
Bibliography:
- Frontiers Between Attention Deficit Hyperactivity Disorder and Bipolar Disorder. Cathryn A. Galanter, MDa, Ellen Leibenluft, MD. Child Adolesc Psychiatric Clin N Am 17 (2008) 325-346.
- Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children.
Singh MK, DelBello MP, Kowatch RA, Strakowski SM.Review Article Bipolar Disorders 2006: 8: 710-720
P03-292 - Suicidal Behavior In Psychotic Patients
- R. Gómez Martínez, M.D. Ortega García, C. Martinez Martínez, A. Rodríguez Campos, M.A. Alonso de la Torre, L. Gómez Martínez, A. Agúndez Modino, I. Alvarez Silva
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- Journal:
- European Psychiatry / Volume 25 / Issue S1 / 2010
- Published online by Cambridge University Press:
- 17 April 2020, 25-E1346
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Introduction
Suicide is one of the most frequent causes of death. In 1993, Bleuler emphasized its importance in his “Suicidal behavior is the most serious symptom of schizophrenia”. Since then, various studies have confirmed importance of suicide in schizophrenia, and today it's clear that his research and knowledge is one of the great challenges of psychiatry.
Objectives- Establish clinical-socio-demographic profile and risk factors for psychotic people with autolytic behaviors.
- Determine frequency of suicides in psychotic disorders in our area of care.
Material and methodsRetrospective study(3 years evolution) that includes psychotic patients(diagnosed according DSM IV-TR) admitted to the HCU of Valladolid. With data provided by hospital medical records, analyzed socio-demographic variables and clinics. Study consists of two groups:group of cases(those patients who have suicidal behavior) and control group (those that haven't autolytic gesture during the study period). Statistical evaluation was performed with SPSS.
Results- The sample includes 191 patients:41(21%) have attempted suicide.
- Of them:73% are males;88% singles;51% have basic studies;61% we re unemployed;37% were 31-40 aged;54% started disease 21-30 aged and 63.5% are schizophrenic.
- Considering statistical study we find that suicidal patient profile is male(p = 0.039),diagnosed with schizophrenia(p = 0.033),with previous suicide attempts(p = 0.009)and lack of social support(p = 0.007).
Conclusions:
- 21% of hospitalized psychotic patients have presented some autolytic attempt.
- Profile of suicidal psychotic patient is a male, single, 21-40 aged, primary education, unemployed, with a primary diagnosis of schizophrenia, particularly paranoid, with ten years evolution,without acceptable social support, number of revenues higher than non-suicidal psychotic and a personal history of previous autolytic attempts.
P02-200 - The Beginning of Dual Pathology Psychiatric Inpatient Care Section (UPD)
- C. Martinez Martinez, R. Gómez Martínez, M.D. Ortega García, L. Díez Garrido, C. Salazar Li, M.A. Alonso de la Torre, A. Rodríguez Campos, G. Rodríguez Carretero, J.D. Martínez Manjarrés, P. Blanco del Valle, A. Agúndez Modino
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- Journal:
- European Psychiatry / Volume 25 / Issue S1 / 2010
- Published online by Cambridge University Press:
- 17 April 2020, 25-E815
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Introduction
UPD is a regional referral hospital psychiatric care unit, endowed with multidisciplinary equipment. It provides care to people with light/moderate/severe intellectual incapacity coexisting with mental disease and/or severe behavioral disorders. It offers attention to patients who need a protected therapeutical environment for correcting behavior disorders. It was opened in September 2008.
ObjectivesDescription of:therapeutic goals, inclusion/exclusion criteria, admission protocol and psychotherapeutic/pharmacological interventions.
Analysis of inpatients's sociodemographic/clinical characteristics and preliminary assessment of therapy goals.
MethodologyRetrospective study(13-month) of patients admitted to UPD of Leon Hospital from its inception to date. Data are collected from medical histories.
Results47 referrals have been received,5 of them have been rejected not to fulfill criteria. We’ve 16 patients on waiting list.32 incomes have been realized and 22 discharges have occurred.
19 of the incomes correspond to Mild,6 to Moderate,6 to Severe and 1 to Profound mental Retardation.
Regarding co-morbidity:22 patients presented serious behavioral disorder. From this group, 2 met criteria for autistic disorder, 5 had schizophrenia or unspecific psychotic disorders, 5 presented Personality Disorder and one ADHD.
10 patients did’nt present any important behavioral disturbance. From this group 2 were diagnosed with OCD,3 presented problems due to Alcohol and Substance-related Disorders,3 had Psychotic Disorders, one met criteria for Impulse Control Disorder and one presented Mood Disorder.
Before admission, 12 patients resided in specific handicappeds center, 5 intermittently at selected centers and in family, and 15 lived with family.
ConclusionsPsychotherapeutic intervention and treatment were useful in most cases. It was particularly helpful in treatment of behavioral disturbances. Now we must determine effectiveness in maintenance of improvement when they return to their community.
A case of psoriasis: The skin that expresses the emotional silence
- C. Martinez Martinez, M.D. Ortega Garcia, J.D. Martínez Manjarrés, M.A. Alonso de la Torre, P. Blanco del Valle, B. Arribas Simon, M.R. Gómez Martínez, C. Salazar Li, A. Agundez Modino
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- Journal:
- European Psychiatry / Volume 26 / Issue S2 / March 2011
- Published online by Cambridge University Press:
- 16 April 2020, p. 1736
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Introduction
Alexithymia is a term to describe a state of deficiency in understanding, processing, or describing emotions. It expresses the cognitive-emotional state of vulnerable subjects who prone to suffer from psychosomatic illnesses. It’s characterized by difficulties in relationship and emptiness of feelings. It has been incriminated in genesis and maintenance of various psychosomatic pathologies, included psoriasis. Psychological stress is important in onset and exacerbation of psoriasis. We assume hypothesis that emotions that cannot be expressed through the appropriate symbolic language will be expressed through a symbolic somatic symptom.
ObjectivesA case study of psoriasis in a woman of 27 years without a previous psychiatric history. She was treated jointly by the service of psychiatry and dermatology. Methodology: We performed a detailed history in the course of the disease, summarizing vital changes and outstanding events of her lifetime in the different vital areas (family, work, school and sex life).
ResultsFrom the comprehensive revision of the ailments and pathobiography we can establish a clear relationship between physical-psychological symptoms.
ConclusionsSkin is an envelope that represents the boundary line between body-psyche. Skin and psyche interact in many ways. The skin reacts to feelings and perceptions. Psychosomatic patients feel extreme anxiety when they have to cope with separation and merger situations. They experience these situations as if they were to lose their physical limit. Broadly speaking, because of their alexithymia, they cannot process a painful emotion properly, and though they will express it through somatisation disorders and the development of diseases. In the case of our patient, the skin verbalizes her emotional silence.