International Neuropsychiatric Disease Journal

Aim: To present a patient suffering from multiple sclerosis (MS) with the noticeable conformity to dream elements with what had occurred in subsequent days (i.e. the relapse of MS).

Presentation of Case: The patient is a 27-year-old man who is a known case of MS. The sleep pattern of the patient changed simultaneously with the initiation of the disease. He had recurring nightmares. After some of these nightmares, the patient developed signs that mainly lasted for less than 24 hours; however, two nightmares were specifically followed by MS attacks.

Discussion: According to Revonsue’s theory, dreams are a reconstruction of stressful conditions from the environment that helps the brain face dangerous factors while awake. Therefore, stressful conditions can lead to an increase of nightmares. It is probable that the anxiety in MS patients can provide a stressful environment that, based on Revonsue’s theory, can explain the increase of nightmares in our patient.

Conclusion: It is possible that a nightmare, as a stress factor, prepares the patient for a relapse.

A 55-year-old female with no physical problems was initially hospitalized for psychotic mania but soon discharged. A month later she was rehospitalized for bipolar depression and treated with lamotrigine (25 mg/day), olanzapine (10 mg/day), and lorazepam (0.5 mg/day). On day 22, lamotrigine was stopped because of neutropenia. On the same day, the patient developed skin rashes with pruritus, which gradually spread. We present this case as evidence that neutropenia and pruritic rash are rare side effects of lamotrigine, and could have causal relationships with each other. Clinicians should be aware of the potential for these effects when using lamotrigine.

Introduction: Smoking is highly prevalent in patients with bipolar disorder and is associated with medical and psychiatric comorbidities. The main aims of this study were to determine the prevalence and correlates of smoking and the predictors of persistent smoking in patients with bipolar disorder in comparison to a non-psychiatric population, findings of which may be useful in planning a smoking cessation program for the concerned group.

Methods: In this case control study, consecutive patients with bipolar I disorder (BD), (251) were matched by age and gender with the controls who were recruited from the General Outpatients Department (GOPD) of the State Hospital Ibadan, Nigeria between January 2008 and June 2009. Information on demography and tobacco smoking, presence of psychotic symptoms, remission state and self-reports of common health conditions in the past year were obtained. Bivariate associations were determined using Chi square statistics and multivariate analysis was used for further exploration of variables that were significant during bivariate analysis.

Results: Persistent smoking was higher in those with psychotic symptoms, P < .001, those not in remission, P = .01. Persistent smoking was also significantly associated with malignancies, P = .02, cardiovascular diseases, P = .02, respiratory diseases, P = .02, high BMI, P = .02 and chronic pain, P = .001.  After adjusting for age and gender, presence of psychotic symptoms OR = 2.89, 95% CI (1.42-5.56), being in remission, OR = 0.49, 95% CI (0.009-0.76), high YMRS scores, OR = 2.63, 95% CI (1.42-5.20), high total PANSS scores OR = 3.23, 95% CI (1.79-6.28) and 3 or more episodes in the past year, OR = 1.89, 95% CI (1.12-4.08) remained associated with persistent smoking.

Conclusion: The present study demonstrates higher rates of lifetime and current smoking among individuals with BD and the association with socio-demographic and clinical factors and highlights the significance of these risk factors in effective tobacco prevention and cessation programs for patients with bipolar disorders.

Background: Drug addiction, especially among adolescents, is one of the major concerns of human society. Identifying factors which predispose an individual to drug -seeking behavior, can be beneficial in reducing risk of addiction in society.

Materials and Methods: Forty two adult male Sprague-Dawley rats were divided into four groups: 1) pair 2) isolated 3) pair for biased-CPP (Conditioned Place Preference) test 4) isolated for biased-CPP test. At the end of experiment, rats were assessed for memory, mood, neurogenesis, BDNF (brain derived neurotrophic factor) and MDA (malondialdehyde) levels. In addition, rats in biased-CPP test groups were tested for drug abuse preference.

Results: Avoidance memory was markedly impaired in isolated rats. Furthermore, isolated rats demonstrated depressive - behavior and had reduced neurogenesis and BDNF levels. Lipid peroxidation (MDA) was significantly enhanced in isolated rats as compared to paired rats. Rats in isolation spent more time in non-preferred compartment than pair rats during biased-CPP test.

Conclusion: Social isolation increases vulnerability to morphine addiction thus, creating socially interactive society can be beneficial in preventing drug abuse.

Primary headaches have a high prevalence in paediatric age and may pose a high strain on the quality of life of young patients. Adequate care involves a patient-by-patient approach, and this generally relies both on bio-behavioural measures and on pharmacological and non-pharmacological interventions. We performed an updated review on acute and preventive pharmacological treatments for juvenile primary headaches emphasizing the efficacy and tolerability of the various molecules. Our literature review emphasized that most of the available information on paediatric primary headaches is derived from relatively low quality data; therefore, results should be considered with caution, and quality data from future large series should be warranted. With these limitations, in general there is broad agreement in considering analgesics and NSAIDs as first-line pharmacological treatments in the acute phase both for migraine and TTH in children. As regards migraine, other medications used for attacks may include antiemetics and triptans, whereas calcium-channel blockers, antihypertensive drugs, serotonin modulators, antidepressants and antiepileptics may be used for prophylaxys. Data are more limited as regards prophylaxis of paediatric TTH, though amitriptyline and magnesium have been used in these cases. Non pharmacological interventions may also provide useful in both headache types, as well as alternative therapies, also in view of their more favourable tolerability profile, and these therapies should be conjugated with more traditional medications to maximise the patient’s benefit.