Abstract: Skilled clinical decision making in the diagnosis and treatment of chronic pain can create unique clinical and ethical challenges, particularly when opioid medications are involved. This report presents the case of a pregnant woman who sought treatment for an illicit opioid dependence, initiated by opioid analgesic treatment of chronic pain. While recognizing opioids’ high level of effectiveness for pain relief, the case demonstrates the potential harms of opioid medications for particular patients

Source: General Hospital Psychiatry

Abstract: Dystonia is a syndrome characterized by sustained muscle contractions frequently causing twisting and repetitive movements or abnormal postures. Dystonic reactions may be a complication of many drugs such as antipsychotics, anti-emetics and antidepressants. This report presents a 25 year- old patient who was admitted to an emergency department with acute dystonia following the use of varenicline, a pharmacological agent used for the treatment of nicotine addiction

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Abstract: Literature evidence suggests that onset of obsessive–compulsive disorder (OCD) at a later age is usually associated with brain lesions. However, none of previous reports suggest an association between arachnoid cyst and OCD. In this report, we present a case of OCD, starting at the age of 40 years, in which the obsessive symptoms were characteristically associated with fluctuating insight

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Abstract: Solifenacin-induced cognitive adverse effects have not been reported frequently, but solifenacin-induced delirium and hallucinations with successful switching to darifenacin, without additional drug, have not been reported in the literature. In this case report, we present an 80-year-old Caucasian male with insomnia and anxiety symptoms and overactive bladder who developed delirium and hallucinations when treated with solifenacin and trazodone. After solifenacin discontinuation and switching to darifenacin, symptoms significantly improved immediately.

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Abstract: Objective: The safety of concurrent mood stabilizers during the course of electroconvulsive therapy (ECT) is yet to be clearly established. Delirium with concurrent administration of ECT and lithium carbonate is described in this case report.Methods: A 30-year-old male with a past history of significant head injury developed delirium during the course of bitemporal ECT.Results: The clinical picture and the details of the cognitive impairment have been discussed in the report with a focus on relationship between the lithium carbonate administration and the concurrent ECT.Conclusion: Patients with preexisting organic brain damage could be prone to develop the cognitive adverse effect while on a combination of lithium and ECT.

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Abstract: Piracetam is a cognitive-enhancing agent that is used for the treatment of cognitive impairments of various etiologies. Little is known about its side effect profile, especially in those with psychiatric illness. We herewith present two cases with cognitive impairment who had contrasting responses to piracetam

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Abstract: Solifenacin-induced cognitive adverse effects have not been reported frequently, but solifenacin-induced delirium and hallucinations with successful switching to darifenacin, without additional drug, have not been reported in the literature. In this case report, we present an 80-year-old Caucasian male with insomnia and anxiety symptoms and overactive bladder who developed delirium and hallucinations when treated with solifenacin and trazodone. After solifenacin discontinuation and switching to darifenacin, symptoms significantly improved immediately

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Abstract: Objective: The safety of concurrent mood stabilizers during the course of electroconvulsive therapy (ECT) is yet to be clearly established. Delirium with concurrent administration of ECT and lithium carbonate is described in this case report.Methods: A 30-year-old male with a past history of significant head injury developed delirium during the course of bitemporal ECT.Results: The clinical picture and the details of the cognitive impairment have been discussed in the report with a focus on relationship between the lithium carbonate administration and the concurrent ECT.Conclusion: Patients with preexisting organic brain damage could be prone to develop the cognitive adverse effect while on a combination of lithium and ECT.

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