Open Access Case Study

Dextromethorphan for Tardive Dyskinesia

Jungjin Kim, James Donovan, Thomas L. Schwartz

International Neuropsychiatric Disease Journal, Page 136-140
DOI: 10.9734/INDJ/2014/7970

Aims: To report three cases of successful treatment of tardive dyskinesia (TD) with dextromethorphan.

Study Design:  Retrospective chart review.

Place and Duration of Study: Private outpatient practice in Syracuse, NY.

Methodology: A retrospective chart review of patients with TD who were treated with dextromethorphan between 2003 and 2013 was conducted.

Results: Three consecutive patients experienced marked improvement of TD with dextromethorphan.

Conclusion: Dextromethorphan may be a useful drug for treating TD. Further prospective studies are needed.


Open Access Short Research Article

Pharmacotherapy in Patients with Drug-induced Parkinsonism: A Case Series

Rabin Bhandari, Arun Aggarwal

International Neuropsychiatric Disease Journal, Page 115-120
DOI: 10.9734/INDJ/2014/8046

Drug-induced Parkinsonism develops in a number of patients with schizophrenia or schizo-affective disorders. Conventionally, anti-parkinsonism drugs, such as levodopa and dopamine agonists have been avoided due to their potential to result in an increase in psychotic symptoms, hallucinations and behavioral disturbance.

We present ten cases series of drug-induced Parkinsonism in whom a trial of anti-parkinsonism medications administered commenced with good effect. In particular, there was no deterioration in psychotic symptoms. A number of cases had asymmetrical signs, suggesting that these patients had a component of idiopathic Parkinson’s disease in addition to long standing drug-induced Parkinsonism.

The diagnosis of idiopathic Parkinson’s disease on clinical grounds is often difficult in patients who have been on or are currently on an anti-psychotic drug. A trial of levodopa or a dopamine agonist is worth considering, albeit cautiously. In our series of cases a relapse or exacerbation of psychotic symptoms did not occur after commencing levodopa and dopamine agonists.


Open Access Short Communication

Soluble Cytokine Receptor Subunits Modulate Catecholaminergic Cell Activity

Ankur Patel, Jagadeesh Batana, Ishdeep Narang, Steven S. Zalcman

International Neuropsychiatric Disease Journal, Page 121-126
DOI: 10.9734/INDJ/2014/7231

Soluble cytokine receptors (SCR) modulate cytokine signaling and are increased in states of abnormal immune activation. SCR’s are also increased in psychiatric and neurological disorders associated with altered brain catecholaminergic activity; although, there is no evidence that any soluble cytokine receptor alone modulates such activity. One such soluble cytokine, soluble IL-2 receptor (sIL-2R) modulates lymphocyte activity. Here, we discovered that soluble IL-2 receptors (sIL-2Rα, sIL-2Rβ) dose-dependently increase cAMP levels in differentiated PC12 cells. sIL-2Rγ and sIL-6Rα have produced no effect. Co-treatment of sIL-2Rs with IL-2 alters cAMP levels in a concentration-dependent manner. This is the first evidence that soluble receptors modulate catecholaminergic cell activity. Thus, soluble cytokine receptors, including the α and β subunits, may represent new therapeutic targets for relevant psychiatric and neurological disorders.


Open Access Original Research Article

The Impact of Breast Cancer on the Emotional Component of Health

Zivana Gavric

International Neuropsychiatric Disease Journal, Page 104-114
DOI: 10.9734/INDJ/2014/5421

Aim: The aim of this study was to examine how the breast cancer affects the quality of life of women, especially in the emotional component of health compared to women without this disease in our community.

Study Design:  Cross-sectional study.

Place and Duration of Study: Department of Social Medicine, Medical Faculty, University of Banja Luka with the Association of women “Iskra” and the Association of nurses from Banja Luka, Bosnia and Herzegovina, from 10 June to 15 August 2011.

Methodology: The study included 100 women treated for breast cancer from “Iskra" Banja Luka and 100 women from the Association of nurse aged 20-75, using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).

Results: In monitoring the parameters on functional scales in women treated for breast cancer, the score for emotional scale and social functioning has shown the lowest value, with a statistically significant difference compared to the highest score in cognitive and physical functioning. Changes in emotional scale at large were associated with symptoms that occur in women treated for breast cancer, where nearly ½ (48%) of those women had pain and the pain interfered with the daily activities. Insomnia was present quite a bit (53%) and very much (5%) in women treated for breast cancer. In women treated for breast cancer, a statistically significant difference was found in scores for symptoms of fatigue, insomnia and pain in relation to other symptoms which were present to a lesser extent. More than 2/3 (73%) said they were concerned about their health in the future.

Conclusion: Changes on emotional scale indicate the need to monitor the quality of emotional health of patients treated for breast cancer in order to implement preventive programs to help women treated for breast cancer to cope with this problem.


Open Access Original Research Article

Social History Matters–The Impact of Illicit Drug Use on tPA Use and In-Hospital Mortality in Acute Ischemic Stroke

Matthew H. M. Marx, Karen C. Albright, Amir Shaban, Amelia K. Boehme, T. Mark Beasley, Sheryl Martin-Schild

International Neuropsychiatric Disease Journal, Page 127-135
DOI: 10.9734/INDJ/2014/7708

Aims: The objective of this descriptive study was to compare time to medical evaluation, intravenous tissue plasminogen activator (IV tPA) use, and short-term outcomes in illicit drug users compared to non-users presenting with acute ischemic stroke (AIS).

Study Design: This is a retrospective study performed from our stroke registry using de-identified patient information.

Place and Duration of Study: Tulane Medical Center Primary Stroke Center (PSC). Consecutive AIS patients presenting to our PSC from July 2008 to December of 2010 were identified from our prospectively collected stroke registry. 

Methodology: Patients were categorized as toxicology positive (TP) or toxicology negative (TN).  We compared baseline characteristics, clinical presentation, tPA use, and short-term outcomes in TP and TN patients.

Results: Two hundred and sixty-three patients met inclusion criteria (median age 63, 35.4% female, 66.5% Black).  Nearly 40% of toxicology screens were positive.  Stroke severity was similar with the median National Institute of Health Stroke Scale (NIHSS) of 6 in both groups; however, a higher proportion of TN patients were treated with IV tPA (32.1% vs. 21.2%).  After adjustment for time from last seen normal to emergency department arrival (LSN-to-ED arrival), the odds of being treated with tPA for TP patients were similar to TN patients (OR 0.69, 95% CI 0.36-1.31, p=0.255).  After adjustment for age, NIHSS, glucose, and tPA, the odds of in-hospital mortality in TP patients was 3 times that of TN patients (OR 3.17, 95% CI 1.07-9.43, p=0.038).

Conclusion: We found that the disparities observed in tPA use were attenuated after adjustment for time from LSN-to-ED arrival, suggesting an area for future intervention.  Additionally, we found that TP patients may be at higher risk for in-hospital mortality.  Further study on the role of substance abuse in time to ED arrival, tPA use, and outcome in AIS patients is warranted.