Search PubMedSearch

Biomedical subjects

A Dorevitch

Publications and source records attributed to A Dorevitch.

12 recordsLinked to original sources

[Lithium carbonate augmentation in tricyclic antidepressant-resistant depression].

Combinations of lithium carbonate and tricyclic antidepressants are effective in the treatment of resistant unipolar depression. We present a case in which addition of lithium carbonate to a maximal dose of desipramine provided rapid and sustained improvement in a severely depressed 57-year-old woman. She had previously failed to respond to maximum doses of antidepressant drugs of 2 different classes. Although the lithium-tricyclic combination was successful in our case, we caution against its routine use.

Antidepressive Agents, Tricyclic

"Goodbye Sunshine": effects of a television program about melanoma on beliefs, behavior, and melanoma thickness.

Of 333 persons interviewed after a television show about the effects of melanoma, 113 (34%) saw the show and 73% believed that the sun protection/skin examination message applied to them. Fifty-six percent of persons examined their own skin and 36% examined someone else's skin after seeing the program. Fifteen persons (4.5% of the total sample) planned to visit a doctor for an abnormal skin spot as a result of the program, of whom three actually did so within 4 weeks of the show. An increase of 167% was observed in the number of melanomas diagnosed in the 3 months after the show, compared with those diagnosed in the same period the year before. There was a significant shift in the proportion of tumors removed in the thin, easily cured stage. The high rate of diagnosis of new tumors and the high proportion of thin tumors was maintained a year after the program. By extrapolation from these figures, it is estimated that 208,000 Victorians out of a total population of 4.1 million intended to seek a consultation after a single television program. Of these, it is estimated that about 27,000 actually sought attention in the month after the viewing.

Adolescent

Propranolol in the treatment of akathisia caused by antipsychotic drugs.

We have reported the case of a patient with neuroleptic-induced akathisia who had rapid amelioration of his symptoms after treatment with the highly lipophilic beta-blocker propranolol. His symptoms had previously failed to respond to traditional pharmacologic treatment. There is clearly a need for more double-blind studies to assess the efficacy of propranolol and other beta-blockers in the treatment of this troublesome side effect of antipsychotic medications.

Adult

Mania associated with clonazepam.

Clonazepam is a potent, long-acting benzodiazepine approved for use in myoclonic and petit mal seizures. Initial reports have demonstrated encouraging results with clonazepam in the treatment of acute mania as well as a favorable side-effect profile. A trial of adjunctive clonazepam was initiated in a 41-year-old patient with chronic schizophrenia. Two weeks later, while on an 8-mg dosage, he became manic, developing pressured speech, euphoria, inflated esteem, agitation, and insomnia. Initiation of electroconvulsive therapy with gradual tapering and discontinuation of the clonazepam resulted in amelioration of the manic episode and a return to his previous clinical status. Clinicians should be alerted to the potential of clonazepam to cause manic-like behavior in susceptible patients.

Acute Disease

Psychotic exacerbation attributed to low-dose bromocriptine treatment of galactorrhea and hyperprolactinemia.

Low-dose bromocriptine administered for antipsychotic drug-induced hyperprolactinemia and galactorrhea precipitated an acute psychotic state in a female patient. Discontinuation of the bromocriptine and increase in antipsychotic dosage resulted in complete remission. We advise caution in the use of bromocriptine especially in patients with a pre-existing psychiatric history and recommend monitoring for changes in mental status when bromocriptine is prescribed.

Acute Disease

[Bromocriptine-associated postpartum psychotic exacerbation].

2 cases are presented in which bromocriptine (Parlodel) was administered to suppress physiological lactation; parturition had precipitated deterioration in mental status and psychotic behavior. Discontinuation of bromocriptine and administration of antipsychotic medication resulted in gradual improvement in the psychotic symptoms, without complications of galactorrhea or breast engorgement. We recommend that changes in mental status be looked for when bromocriptine is given.

Adult