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Increased libido as a buproion-SR side effect: Clinical description of a case
- L. Gallardo Borge, C. Noval Canga, L. Rodíguez Andrés, I. Sevillano Benito, M. Hernández García, A. Álvarez Astorga, R. Hernández Antón, S. Gómez Sánchez, G. Isidro García, P. Marqués Cabezas
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S545
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Introduction
Bupropion is a dual antidepressant, a norepinephrine and dopamine reuptake inhibitor. Its main use is in affective disorders as major depression. Antidepressants have been commonly associated with sexual side effects in the libido, sexual arousal, orgasm and erectile function. Bupropion has negative influence in sexual function, even it could increase the libido. Due to this, it could be a good option in patients with active sexual life and affective disorder.
Clinical reportA 58-year-old female with a long history of depression disorder for 5 years. History of lots of side effects with different treatments, sexual dysfunction with serotonin-antidepressants. Treated with bupropion SR 150 mg/day and alprazolam, she suffered a relapse. The bupropion was increased to 300 mg/day. Three days later she appeared in the consultation room, presented a sense of pre-orgasmic of 72 hours of evolution, high increased libido, tiredness, muscle tension and insomnia. This sense did not improve after the sexual act. It had never happened previously. The side effect improved when the bupropion was reduced to 150 mg/day and disappeared with its withdrawal.
ConclusionsThe case made a relationship between the increased of bupropion's dose and the appearance of unusual sexual side effects (increased of libido and pre-orgasmic sense). Not only bupropion is one of the antidepressants that do not cause sexual dysfunction, if not it was reported in some trials that could be a treatment against this dysfunction due to its prosexual effects. The mechanism is unknown but could be related with norepinephrine or dopamine transmission.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
I am trapped in a wrong body
- R. Hernandez Anton, C. Noval Canga, E. Rybak Koite, H. De La Red Gallego, L. Gallardo Borge, A. Alonso Sanchez, I. Sevillano Benito, M.J. Garcia Cantalapiedra, P. Marques Cabezas, F. Uribe Ladron De Cegama, J.A. Espina Barrio, G. Isidro Garcia
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S590
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Introduction
Gender dysphoria is incoherence between the sex a person feels or expresses and the biological.
ObjectiveRevise the inclusion criteria for hormone therapy and sex reassignment surgery in gender dysphoria. Expose the multidisciplinary approach. Make differential diagnosis with other psychological disorders.
MethodologyA 45 years old male patient (biological female), who was sent from Endocrinology Unit for a psychiatric evaluation before restart a hormonal treatment. Since his childhood, he has presented dissatisfaction with his sexual characteristics; he has had fantasies and dreams, in which he belonged to the other sex. He has always chosen male activities and male stereotypes companies. He has presented preference for cross-dressing from 9 years. Always felt the sexual attraction for women. He first consulted for this reason in 1995.
ResultsIt reported favorably to start hormone treatment after completing the eligibility criteria: > 18 years old; knowledge of the effects of hormones; and more 3 months documented real-life experience. The hormone therapy caused the growth of microprolactinoma, which was treated with dopamine agonists until it disappeared and the cessation of galactorrhea. Testosterone treatment is restarted. Laboratory tests are done every 3 months during the first year and then, every 6 months.
ConclusionsIs the gender disphoria a pathology? The EU recommends a reclassification as no pathological disorders in ICD-11. The treatment of gender dysphoria is necessary, and there is no reason to postpone it. The main difficulty is the differential diagnosis; there may be comorbidity with others mental disorders which are not exclusive (psychotic disorder, OCD, personality disorders and other disorders of gender identity).
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Results of a smoking cessation program in primary care
- H. de la Red Gallego, Y. González Silva, T. Montero Carretero, Á. Delgado de Paz, M.F. Sánchez Añorga, E. Cañibano Maroto, G. Isidro García, A. Álvarez Astorga, A. Alonso Sánchez, M. Martín Fernández, A. Álvarez Hodel, I. Pérez González, S. Nieto Sánchez, S. Calvo Sardón, I. González Gurdiel, R. Hernández Antón, S. Gómez Sánchez, C. Noval Canga, M.S. Hernández García, L. Rodríguez Andrés
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, pp. S297-S298
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Introduction
Smoking is an addictive and chronic disease. Twenty-four percent of the Spanish population in 2012 smoked daily.
Aims and objectivesTo evaluate a smoking cessation program in a Primary Care Center.
MethodsObservational, prospective study. We describe an individualized smoking cessation in Plaza del Ejército Health Center (Valladolid). Inclusion criteria: active smoker, ≥ 18 years old and belonging to the Health Center. Exclusion: severe mental illness. Included patients from November 2013 until January2014. Ended in July 2014. Four Medical residents participated, we present the results of one of them. During the first consultation motivational interviewing was conducted, physical examination and treatment was prescribed (cognitive behavioral therapy or drug treatment: varenicline). In subsequent consultations interview and follow-up. Variables: age, gender, pack-years, nicotine dependence (Fagerstrom) and Prochaska and DiClemente phase, weight, treatment used, dropout rate and final withdrawal of snuff.
ResultsEleven patients, mean age 48.18 (13.61), 7 (63.6) women. Comorbidity: 6 (54.5) anxious-depressive pathology, 1 (9.1) dysthymia, 2 (18.2) endocrine pathology and 1 (9.1) respiratory disease. Four (36.4) showed high dependency and 2 (18.2) extreme. Media packages 20.50/year (19,20). Seven (63.6) were in action phase of Prochaska and DiClemente and 2 (18.2) in preparation. Visits range: 1-11. The average was 4.55 (3.64). Three (27.27) patients attended only the first visit. Four (36.4) achieved complete abstinence, 3 (27.27) met maintenance phase. One (9.1) reduced consumption in half. Patients gained average 0.5 kg (2.47).
ConclusionsThe results are similar to those reported in other series. Modest dropout rate. No pharmacological treatment was used due to high coexistence of comorbidities, the only patient who used varenicline suffered insomnia. Average age and media packages were superior to other series.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Recurrent hypersomnia: Kleine-Levin syndrome
- L. Rodríguez Andrés, A. Rodríguez Campos, L. Gallardo Borge, G. Isidro García, E. Mayor Toranzo
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S595
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Introduction
Kleine-Levin syndrome was first described by Kleine in 1925 and elaborated on by Levi in 1936. It is an infrequent syndrome that predominantly affects to teenagers, and boys are four times more likely to be affected than girls. It is rare for patients over 30 years although some cases have been reported. Kleine-Levin syndrome is a recurrent hypersomnia characterized by episodes of hypersomnia lasting for 2 days to 4 weeks associated with symptoms of hyperphagia, hypersexuality and cognitive impairment. It can be accompanied by other abnormal behavior such as aggression, personality changes and irritability. Deficits are resolved between episodes.
Case reportIt is presented the case report of a patient that suffers from recurrent episodes of hypersomnia associated with hyperphagia and abnormal behavior.
ElectroencephalographyEEG demonstrates slowing of drowsiness and a decrease in REM sleep. The test of multiple sleep latency is abnormal and the rest of complementary test are normal.
DiagnosisF51.1 Recurrent hypersomnia (Kleine-Levin syndrome) [307.44].
DiscussionKleine-Levin syndrome is an intriguing, severe and homogenous disease with no obvious cause or treatment. Treatment is generally supportive. It should be considered in any teenager presenting with recurrent episodes of hypersomnia concurrent with cognitive changes or disinhibition.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Goodbye Eros. Hello Narciso
- R. Hernandez Anton, S. Gomez Sanchez, A. Alvarez Astorga, S. Cepedello Perez, E. Rybak Koite, M.J. Garcia Cantalapiedra, L. Rodriguez Andres, A.I. Segura Rodriguez, L.D.C. Uribe, G. Isidro Garcia
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- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S718
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Introduction
Love has been one of the topics most discussed by philosophy, literature, anthropology, religion, psychology and medicine. “The feelings of love and hate are present in the background of all psychiatric disorders; love has been associated, in one way or another, in all patients that I have had” Dr. Perez Lanzac Trujillo.
Objectives(1) Analyze the possible relationship between psychotic symptoms and breakup (stressor). (2) Review the neurotransmitters involved in psychotic episodes and in love. (3) Postmodern culture and sexuality (agony of Eros and liquid love).
MethodologyA 17-years-old female patient, who presented psychotic symptoms without psychiatric history. We hypothesize that the affair was the symptom and the stressful event was the breakup. We believe that early bond with the mother is a decisive factor in shaping the psychic structure of every human being factor. In this case, it seems that there is an insecure attachment: absent parent + overprotective mother.
True love draws three triangles: records (demand, drive and desire); dimensions (beliefs, significant and encounter) and emotions (pride, hope and desire).
ResultsMost psychiatric disorders are especially alterations in the way of experiencing emotions. Some neurotransmitters involved in her psychosis and addiction are key players in the neurobiology of love.
ConclusionsTrue love is the neurotic experience closer to psychosis.
Overexcitement in today's society is a trauma for the psychic apparatus and it has consequences on the internal world, psychosexuality and loving bond.
The crisis of art and literature can be attributed to the disappearance of the other, to the agony of Eros.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Depression and suicide ideation in medical students
- A. Alonso Sanchez, A. Alvarez Astorga, H. De la Red Gallego, R. Hernandez Antón, S. Gómez Sanchez, C. Noval Canga, I. Sevillano Benitez, G. Isidro García, M. Hernandez García, F. De Uribe Ladrón de Cegama
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S595
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Background
Medical students have higher levels of depressive symptoms than the general population. Additionally, depressed students are more likely to commit suicide. Recent studies find up to 10% of medical students experiment depression and suicidal ideation, which is meaningfully higher than general population of similar age (5–8%). However, little is known about depression and suicidal ideation in medical students in Spain.
ObjectiveThis study aims to create a self-administered questionnaire to investigate the prevalence and factors involved in depression and suicidal behaviour in medical students from a Spanish University.
MethodsWe evaluated the main risk factors leaning to suicide in students. In addition, we selected an appropriate scale to assess depression among the existing ones. The evaluated items included demographic reports, academic information (academic course, unfinished subjects and accomplishment) and sanitary data (psychiatric family history, psychiatric personal history, psychotropic drug consumption, distress emotional events in the last twelve months and drugs consumption). Furthermore, we selected the 9-item Patient Health Questionnaire (PHQ-9) because of its rapidly implementation and proven efficacy.
ConclusionsRates of depression and suicidal ideation are high in medical students. Currently, there is no program to detect and prevent depression neither suicide in students. For that reason, we consider that creating a new instrument to evaluate mental health in student is useful in order to offer early detection and treatment at medical school.
Disclosure of interestThe authors have not supplied their declaration of competing interest.