3 results
Metformin as a tool to control antipsychotic-induced metabolic syndrome - case report
- L. Horosan, D. E. Nistor, I. Paunica, R. A. Stoica
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1010
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Introduction
The decreased capacity of testing reality causes patients with psychosis consequences regarding their families, professional life, and social interactions, with an overall reduction in quality of life. In these cases, antipsychotic treatment is mandatory to recreate the patient’s connection with the environment. Second-generation antipsychotics (SGAs), particularly clozapine and olanzapine, can have severe metabolic side effects that impact body weight, insulin resistance, and glucose metabolism. The specific mechanism that determines such metabolic processes is not yet fully understood. Recent research has demonstrated that metformin may be utilized to regulate metabolic processes. The ultimate purpose of using this adjunctive therapy is to effectively control both physical and mental health difficulties among psychiatric patients.
ObjectivesThe primary purpose of this report is to underline the importance of adverse metabolic reactions of antipsychotics and to study the effectiveness of metformin regarding this matter.
MethodsOur patient is a 33 years-old man who was diagnosed with schizoaffective disorder around the age of 32. He was initially treated with olanzapine; during the first year, he gained more than 20kg. Severe weight gain was a significant health factor that determined us to search for therapeutic alternatives. Metformin was added, monitoring BMI and abdominal circumference. Because of the severe body weight gain, switching from olanzapine to aripiprazole was attempted, but the psychiatric symptoms worsened. Paliperidone was considered and administered, concomitant with rising doses of metformin. Although an initial increase in body weight was documented when paliperidone was administered, his body weight deescalated significantly after metformin reached a therapeutic dose of 2000mg per day.
ResultsMetformin co-administered with antipsychotic medication helped to control the severe metabolic adverse effects in this case. Reaching a lower BMI index after adding metformin to paliperidone was a therapeutic goal and essential for the patient’s physical and psychological health.
ConclusionsMetformin is a complex treatment widely prescribed as an antidiabetic drug. Lately, attention has shifted towards its effects on controlling the adverse metabolic effects of antipsychotics. This case underlines the importance of the metabolic syndrome as an adverse reaction of the SGAs and presents the results of this treatment option for schizoaffective disorder treated with antipsychotics. Although the current recommendation is to switch to another antipsychotic with lower metabolic risk, the new drug may not control the psychiatric symptoms in all cases. Therefore, metformin is an adjuvant solution in situations where antipsychotic treatment can cause severe metabolic reactions with a significant impact on the patient’s physical health.
Disclosure of InterestNone Declared
Obsessive-compulsive disorder after long-term cannabis use – case report
- D. E. Nistor, M. Corban, L. Horosan
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S659
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Introduction
Obsessive-compulsive disorder (OCD) is characterised by intrusive thoughts and repetitive behaviours that considerably impact general functioning. Recent evidence links the endocannabinoid system to OCD neurobiology, and several case reports describe significant improvement after using dronabinol (synthetic tetrahydrocannabinol) in patients with severe OCD. Nevertheless, to what extent this new information can change our perspective on pharmacological treatment in OCD is unclear.
ObjectivesWe present the case of a patient with obsessive-compulsive symptoms triggered after increased long-term cannabis use. Our purpose is to emphasise the necessity of continuous research and a better understanding of the correlation between OCD and cannabis derivates before formulating treatment recommendations.
MethodsWe used psychiatric assessments to evaluate the patient’s symptoms and evolution over time and exclude other possible causes that could have triggered the disorder.
ResultsOur patient is a 37-year-old man who has been frequently brought to the hospital by the police in the last 11 years for psycho-motor agitation after cannabis use. This year, he came to the hospital by himself, complaining about intrusive thoughts that required motor and mental repetitions to reduce anxiety. His obsessions were mainly about the need for symmetry and exactness and his checking compulsions about his mother’s health. The symptoms required more than half a day and caused functional impairment. A detailed history did not outline any obsessive-compulsive symptoms before the previous year. The patient denies using new drugs, and we did not identify other medical conditions that could better explain the symptoms. However, he admits to increasing the doses and frequency of cannabis use during the last year. After two weeks of cannabis abstinence and Sertraline treatment, his symptomatology improved significantly, with a reduction of more than 50% in the time spent daily on mental and motor compulsions, reduced anxiety, and a noticeable increase in overall functionality. In addition, the Yale-Brown Obsessive Compulsive Scale result decreased from 35 on the first day to 17 on discharge.
ConclusionsRecent studies support the use of cannabis derivates for treating OCD symptoms. However, this case report outlines that prolonged cannabis use could also trigger OCD. Therefore, further studies are necessary to identify not only the potential benefits but also the potential risks of using cannabinoids as a pharmacological intervention.
ReferencesNicolini H et.al.CannabisUseInPeopleWithOC.FrontPsychiatry.2021May10; 12:664228.doi:10.3389/fpsyt.2021.664228.PMID:34040556;PMCID:PMC8141625
KayserR.R. et.al.TheEndocannabinoidSystem:ANewTreatmentTargetforOCD? CannabisandCannabinoidResearch.Jun2019.7787.doi10.1089/can.2018.0049
GoodmanWK et.al.1989.YBOCS:Archives of General Psychiatry,1006–1011.doi10.1001/archpsyc.1989.01810110048007
Disclosure of InterestNone Declared
Structural studies of diamond thin films grown from dc arc plasma
- L. C. Nistor, J. Van Landuyt, V. G. Ralchenko, A. A. Smolin, K. G. Korotushenko, E. D. Obraztsova
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- Journal:
- Journal of Materials Research / Volume 12 / Issue 10 / October 1997
- Published online by Cambridge University Press:
- 31 January 2011, pp. 2533-2542
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- October 1997
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Diamond thin films grown from a dc-arc discharge in CH4/H2 mixtures on Si wafers were examined by transmission electron microscopy and Raman spectroscopy. This deposition method provides good diamond crystallinity at high CH4 concentrations (3%–9%). Seeding the substrate with 5 nm diamond particles at a density of 2 × 1012 cm−1 followed by argon laser irradiation to reduce their agglomeration gives, just after starting deposition, a density of growth centers of 1010cm−2. At 3% CH4 concentration the film grows with almost perfect crystallites. Richer CH4 mixtures (5% and 9%) produce crystallites with twins and stacking faults. An amorphous 20–70 nm SiC interlayer is present at these CH4 concentrations, which was not observed at 3% CH4. Amorphous sp3- and sp2-bonded carbon was detected by Raman spectroscopy at all CH4 concentrations and correlated with TEM data.