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Biological Profile and Cardiovascular Risk in Patients Receiving neuroleptics at the Psychiatric Department of the University Hospital Center of Brazzaville

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Journal of Biosciences and Medicines 2024年第6期12卷 33-42页

作者： Landry Martial Miguel Paul Gandou Justecidi Kiang Choupette Ravelle Dobhat-Doukakini Didier Gesril Njilo Tchatchouang Childerick Lekana Destin Mbemba Bahamboula Archange Emmanuel Mboungou Malonga Donatien Moukassa Alain Maxime Mouanga Ange Antoine Abena Biochemical and Pharmacology Laboratory Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of Congo Psychiatric Department University Hospital Center Brazzaville Republic of Congo Department of Biological Sciences Dnis Sassou-NGuesso University Kintl Republic of Congo

Several studies report the problem of cardiovascular tolerance of treatments with neuroleptics, given the important number of morbidities in patients with mental illnesses. This preliminary work aimed to describe the epidemiological and biological profile of patients taking neuroleptics and followed in the psychiatry department of Brazzaville University Hospital, from the angle of cardiovascular risk. Fifty (50) patients (17 men and 33 women), with a mean age of 33.9 10.7 years, were included. Epidemiological data (sex, age, tobacco or alcohol consumption) were collected on pre-established survey forms. Biochemical (total cholesterol, HDL-c, triglycerides and atherogenicity index) and inflammatory parameters (ultra-sensitive CRP, troponin I and NT-ProBNP) were investigated using enzymatic and indirect immunofluorescence technical, respectively. The results obtained showed that 54% of patients were obese, 94% were non-smokers, and 12% had high blood pressure. 10% of patients had high total cholesterol levels and 90% had HDL cholesterol levels below 60 mg/dl. Triglycerides and atherogenicity index were significantly elevated in relation to Body Mass Index (BMI). Ultrasensitive CRP was elevated in 38% of patients. In conclusion, this study revealed an association between lipid parameters (triglycerides and atherogenicity index) in relation to BMI in patients taking neuroleptics followed in the Psychiatry Department of University Hospital Center of Brazzaville.

关键词： neuroleptic Cardiovascular Risk Psychiatry Brazzaville

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Atypical neuroleptic Malignant Syndrome: Pitfalls and Challenges in the Delirious Substance Abuser

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Open Journal of Anesthesiology 2012年第2期2卷 53-57页

作者： Nirav N. Shah Kristin G. Fless Mikhail Litinski Fariborz Rezai Paul C. Yodice Henry Rosenberg Department of Medical Education and Clinical Research St. Barnabas Medical Center Livingston USA Department of Surgery and Critical Care Medicine St. Barnabas Medical Center Livingston USA

Introduction: A rare and atypical form of neuroleptic Malignant Syndrome (NMS) can be a deceptive and life threatening condition if not diagnosed properly in acute and critical care settings. Methods: The management of a patient presenting with atypical NMS without prominent rigidity, but with extensive rhabdomyolysis after the administration of haloperidol and ziprasidone is described in this report. Results: Prompt recognition of atypical features of NMS was managed by intensive care unit admission, supportive care and pharmacotherapy, leading to a complete resolution of the syndrome and a favorable outcome verified by laboratory findings. Conclusion: Early stages and atypical features of NMS may be variable in presentation and clinical course. The absence of muscle rigidity may not rule out NMS. A strong clinical suspicion based on clinical history is crucial for early diagnosis and treatment. Termination of dantrolene therapy may not be necessary during rhabdomyolysis and elevated aminotransferase levels.

关键词： Atypical neuroleptic Malignant Syndrome Haloperidol Ziprasidone Dantrolene Rhabdomyolysis Creatinine Phosphokinase Aminotransferase

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Dendritic and spine alterations in areas 9 and 17 in schizophrenia and Huntington chorea and the role of neuroleptic exposure

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Open Journal of Psychiatry 2012年第3期2卷 243-248页

作者： Latchman Somenarain Liesl B. Jones Department of Biological Sciences Lehman College New York USA Department of Biology/MLT Bronx Community College New York USA

Recent morphological studies in schizophrenia suggest atrophic changes in the neuropil of the prefrontal cortex. Most recently, we showed a schizophrenia-associated decrease in MAP2 in schizophrenia, which we believed is not due to neuroleptic exposure. MAP2 is a very important protein in the assembly of micro-tubule in neurons;therefore, it plays a major role in neuronal processes like dendrites, spines and synapses. Additionally, recent studies from our lab showed decreases in dendrites in area 32 and area 9. In this study we examined the dendrites and spines in area 9 and 17 to determine if neuroleptic drugs play a role. Huntington’s patients take neuroleptics similar to schizophrenics;therefore, by comparing the two groups to controls we can determine if neuroleptics play a role in the deficits reported in schizophrenia. Our results showed a significant decrease in both basal dendrites and spines for both layers III and V in area 9 in schizophrenia compared to controls. The Huntington’s brains, on the other hand, showed no significant difference compared to controls. In area 17, there was also no significant difference when comparing the three groups. The data suggest that neuroleptic drugs may not be responsible for the changes observed in schizophrenia.

关键词： Schizophrenia Huntington neuroleptic Spines Dendrites Pyramidal Cells Prefrontal Cortex Area 9 and Area 17

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Re-Challenge with Clozapine after neuroleptic Malignant Syndrome and Seizure in a Patient with Di-George Syndrome: Case Report and Review of Literature

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Open Journal of Psychiatry 2020年第1期10卷 9-14页

作者： Geetha Chandrashekar Ganesh Gopalakrishna Austin Campbell Katherine Edwards Muaid Ithman Department of Psychiatry University of Missouri Columbia USA Department Psychiatry University of Arizona Tucson USA Department of Pharmacy University of Missouri Health Care Columbia USA

Background: Individuals with 22q11.2DS, a genetic subtype of Schizophrenia, respond as well to clozapine as those with other forms of Schizophrenia. It has been reported that serious and rare adverse events like seizures, and myocarditis have been associated with clozapine treatment in this population. To the best of our knowledge, the incidence of neuroleptic malignant syndrome (NMS) as an adverse effect of antipsychotic use in patients with this disorder has not yet been reported. Aim: In this article, we discuss a case of clozapine-induced NMS and subsequent re-challenge in a patient with 22q11.2DS-associated schizophrenia. The aim of this study is to accumulate scientific data about rare presentations, and serve as a major educational tool, and highlight the unique challenges faced when using clozapine in a patient with DiGeorge Syndrome. Methods: This is a descriptive case report of a patient encountered in the inpatient unit which includes retrospective review of the patient’s electronic medical record and a literature review of antipsychotic medications-induced NMS. Conclusion: This study demonstrates a successful re-challenge with clozapine after the patient developed NMS and seizures during the initial treatment and also highlights how, in addition to drug level monitoring, considering pharmacogenetic testing early in treatment might help minimize adverse drug reactions in individuals with known genetic disorders such as 22q11.2DS.

关键词： Clozapine DiGeorge Syndrome 22q11.2 Deletion Syndrome neuroleptic Malignant Syndrome (NMS) Seizure Re-Challenge

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Slow and Steady: The Cautious Use of neuroleptics in a Patient with Andersen-Tawil Syndrome

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Case Reports in Clinical Medicine 2022年第10期11卷 414-421页

作者： Fahad Alkhalfan Bharadwaj Adithya-Sateesh Girma M. Ayele Merve Otles Rediet T. Atalay Miriam Michael Department of Internal Medicine University of Maryland Baltimore USA Department of Internal Medicine College of Medicine American University of Antigua Antigua Antigua and Barbuda Department of Internal Medicine Howard University Hospital Washington DC USA

Long QT syndrome (LQT) is a disease of cardiac repolarization caused by alterations in the transmembrane potassium and sodium currents. This results in prolongation of the QT interval on electrocardiography (EKG) and can result in torsade de pointes and sudden cardiac death. We present a case of a patient who has Anderson Tawil syndrome;a congenital long QT syndrome, with a history of cardiac arrhythmias who developed acute paranoid schizophrenia that was refractory to treatment with non-QT-prolonging drugs and required institution of neuroleptics to control her psychiatric symptoms.

关键词： Long Q-T Schizophrenia neuroleptic Anderson Tawil Syndrome Congenital Long QT Syndrome

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Tinospora cordifolia attenuates antipsychotic drug induced hyperprolactinemia in Wistar rats

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Asian pacific Journal of Reproduction 2019年第3期8卷 132-140页

作者： Prashant Tiwari Sunil Kumar Dubey Pratap Kumar Sahu Department of Pharmacology School of Pharmaceutical SciencesSiksha O Anusandhan(Deemed to be University)BhubaneswarOdisha751029India Department of Pharmacy Birla Institute of Technology and SciencePilaniIndia

Objective: To evaluate the anti-hyperprolactinemic effect of methanolic extract of Tinospora cordifolia against antipsychotic/neuroleptic drug induced hyperprolactinemia. Methods: A total of 48 Wistar albino rats were chosen in the study. To induce hyperprolactinemia, haloperidol at 5 mg/kg/day was intraperitoneally administered for 16 continuous days and sulpiride at 20 mg/kg/day was administered intraperitoneally for 28 continuous days. Methanolic extract of Tinospora cordifolia at 200 mg/kg/day and 400 mg/kg/day were administered orally 30 min before administration of haloperidol and sulpiride for 16 and 28 days, respectively. Then, we had evaluated prolactin, dopamine and antioxidant status in the treatment group as compared to haloperidol and sulpiride. Results: There was a significant (P<0.05) increase in serum prolactin level and decrease in dopamine level in the haloperidol and sulpiride treated animals. However, methanolic extract of Tinospora cordifolia significantly (P<0.05) decreased serum prolactin level and increased brain dopamine level. Further, superoxide dismutase and catalase level were also decreased significantly in the haloperidol and sulpiride treated groups as compared to those of the control group and the antioxidant status was restored significantly on treatment with methanolic extract of Tinospora cordifolia. Furthermore, methanolic extract of Tinospora cordifolia also reduced total leukocyte count, and increased red blood cell count and hemoglobin concentration. In addition, the spleen did not show signs of infection or inflammation in the experiments. Conclusions: Methanolic extract of Tinospora cordifolia has a significant anti-hyperprolactinemic effect which may be attributed to neuroprotective and antioxidant effects of its signature constituents like stepharanine.

关键词： Antipsychotic neuroleptic Dopamine Prolactin Superoxide dismutase Catalase

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Dantrolene in the Treatment of Refractory Hyperthermic Conditions in Critical Care: A Multicenter Retrospective Study

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Open Journal of Anesthesiology 2015年第4期5卷 63-71页

作者： Shonali C. Pawar Henry Rosenberg Robert Adamson Jennifer A. LaRosa Ronald Chamberlain Department of Surgery Saint Barnabas Medical Center Livingston USA Department of Medical Education and Clinical Research Saint Barnabas Medical Center Livingston USA Corporate Pharmaceutical Sciences Barnabas Health Care Livingston NJ USA Department of Pulmonary and Critical Care Medicine Newark Beth Israel Medical Center Newark NJ USA

Purpose: To examine the use of intravenous dantrolene in hospitalized patients. Materials and Methods: Medical Records of patients treated with intravenous dantrolene between 2007 and 2012 at 6 teaching hospitals were reviewed. Temperature, muscle rigidity, creatine kinase levels, and mortality were assessed in association with dantrolene use. Results: Twenty-five patients received intravenous dantrolene, 9 patients with neuroleptic malignant syndrome (NMS), 8 with hyperthermia due to sepsis, 4 with NMS and sepsis, 2 for malignant hyperthermia (MH), and 2 with hypermetabolic syndrome associated with juvenile diabetic ketoacidosis. Dantrolene was administered as a bolus of 1 - 3 mg/kg. Core temperature decreased after dantrolene administration in all groups but significant only for MH, NMS cases (Pre 102.3 ± 0.9°F vs. Post 99.5 ± 0.9°F;p Conclusion: Dantrolene was associated with reductions in temperature and rigidity in hyperthermia of diverse origins in patients admitted to Intensive care settings.

关键词： Dantrolene Malignant Hyperthermia neuroleptic Malignant Syndrome Sepsis

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Procalcitonin interest to assess a septic state inducing the death

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Forensic Medicine and Anatomy Research 2013年第4期1卷 67-69页

作者： Nouredine Sadeg Frédéric Tarlier Laurence Veneau Hafid Belhadj-Tahar Association Française de la Promotion de la Recherche Médicale (AFPreMed) Toulouse France Laboratoire Claude Bernard Centre Hospitalier René Dubos Pontoise France Unité Médico-Judiciaire Centre Hospitalier Emmanuel Rain Gonesse France Service des Urgences-SMUR Centre Hospitalier Léon Binet Provins France

In this prospective study, we evaluated the use of PCT when collecting the body which was carried out. The chosen cut-off was set at 10 ng/mL because at this level, the PCT was associated to a multiorgan failure attributable to a septic shock.For 90 cases, two groups were stratified by their final diagnosis: 33 of for non violent deaths and 57 of violent deaths. There was no significant elevation of procalcitonin rate (PCT) in the group of violent deaths. We noted 6 elevations of PCT rate above 10 ng/mL for non violent deaths (15.4%) and in 3 cases there wasan evidence for an infectious context (recent anti- infectious treatments, chemotherapy in progress).Control of CRP performed on blood samples found initial elevations above 10 mg/L in 3 of the 6 cases (including 2 of 3 cases associated with an infectious context). There is no evidence of PCT rate increase for intermediate PMI (post mortem interval), long PMI and undefined PMI. This study found a PPV (positive predictive value) and clinical specificity of 100% for a cut-off set at 10 ng/mL. By taking this threshold, no significant PCT increase was observed in presence of death cases related to a violent origin as well as a fatal multiorgan failure due to malignant hyperthermia syndrome induced by neuroleptic use. The PCT appears to remain stable over time and whatever the conservation conditions of the body.

关键词： Procalcitonin Sepsis Biomarker neuroleptic Malignant Syndrome

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