The following articles are currently In Press and will be published in the next issue of
Spontaneous Ejaculation Induced with Atomoxetine
By Ferhat YAYLACI, Begüm ŞAHBUDAK, and Önder KÜÇÜK
Attention Deficit and Hyperactivity Disorder is one of the most common psychiatric disorders of childhood, characterized by attention deficit, hyperactivity and impulsivity. The most effective treatment in ADHD is drug treatment. Stimulant and nonstimulant drug treatments are preferentially used. Atomoxetine is one of the nonstimulant treatments. Although sexual side effects of atomoxetine in adults are reported, there is limited knowledge about sexual side effects in children and adolescents. In this case report, we aimed to describe an adolescent 16-year old with spontaneous ejaculation, a rare sexual side effect, that started at the third day of the treatment and ended by discontinuing atomoxetine.
Carotid Artery Dissection Induced Acute Tongue Swelling In A Cocaine User
By Antonio Siniscalchi, Paolo Perrotta, Piergiorgio Lochner, and Luca Gallelli
Carotid artery dissection represents a well-recognized cause of hypoglossal nerve paralysis even if it is less known the cause of acute tongue swelling.
We report a 42-year old men who presented to our observation with acute tongue swelling and atrophy of left side of tongue from a hypoglossal nerve injury. A magnetic resonance imaging revealed a denervation of the left half of the tongue from a hypoglossal nerve injury due to left extracranial internal carotid artery (ICA) dissection, without evidence of ischemic stroke. The urine toxicology screen test revealed a positivity for cocaine.
This case report suggest to perform in young patient a toxicological drug screening test in presence of ICA dissection with hypoglossal nerve injury and an acute tongue swelling. However clinical data must be performed to validate this observation and to analyze the negative effect of cocaine use.
Efficacy Of Low-dose Aripiprazole For Treatment Of Psychotic Symptoms In A Patient With 22q11.2 Deletion Syndrome
By Konstantinos Kontoangelos, Eleni Lazaratou, Marina Economou, Konstantina G. Yiannopoulou
Objectives: The 22q11.2 deletion syndrome is one of the most prevalent genetic disorders and children suffering from this syndrome have been found to have a substantially greater risk for the development of schizophrenia and bipolar disorder. Psychiatric medications such as antipsychotics are commonly used in individuals with 22q11.2DS.
Experimental design: This is a case of 13 years male young man suffering from 22q11.2 deletion syndrome. Since adolescence, he presented with behavioural disorders, aggression, verbal abuse, sleep disorders.
Principal observations: The psychiatric examination confirmed the delusional idea, which was repeated in an obsessive way. There were also auditory hallucinations along with reference ideas. Aripiprazole was administered in 8mg daily which gave more spectacular results and was better tolerated.
Conclusions: In the present situation delusional ideas are no longer mentioned, but a cognitive deduction is found. Aripiprazole can be an effective pharmacological solution for the psychotic symptoms in patients suffering from 22q11DS.
Asenapine In The Treatment Of Bipolar Depression
By Rif S. El-Mallakh, Sharon Nuss, Dong Gao, Yonglin Gao, Surriya Colleen Ahmad, MD;1 Clare Schrodt, and Caleb Adler
Objectives: Asenapine, a potent serotonin 7 (5-HT7) receptor antagonist, was examined for efficacy as an antidepressant in depressed bipolar subjects. It was predicted that subjects with the genetic variant of the short form of the serotonin transporter (5HTTR) would be more likely to respond.
Experimental Design: A subset of patients participating in a randomized, placebo-controlled study of the efficacy of asenapine in bipolar I depression also underwent genetic testing for the 5HTTR. Montgomery Åsberg Depression Rating Scale (MADRS) score was ≥26 prior to randomization to asenapine or placebo for 8 weeks. Gene testing was performed before breaking the blind.
Principal Observations: Nine patients completing the study also underwent gene testing. At study end, the average MADRS improvement was -19.80 ± SD 8.59 for the 4 people randomized to asenapine and -3.80 ± 9.01 for the 5 people receiving placebo (P = 0.021, t = 2.88). Anxiety, as measured by the Hamilton Anxiety Rating Scale (HAM-A), also improved in asenapine-treated patients (-15.40 ± 6.15 vs. -2.80 ± 7.95, P = 0.023, t = 2.803). Six participants had the short form of the 5HTTR, and it is believed they influenced the significant outcome in this small sample.
Conclusions: While this is a very small sample, asenapine appears to have a beneficial effect on both depression and anxiety in depressed bipolar I patients compared to treatment with placebo. Due to the large fraction of subjects with the short form, the hypothesis that the SF-5HTTR might increase asenapine response could not be adequately tested.
Trial Registration: ClinicalTrials.gov identifier: NCT01807741