scholarly journals Acute Extrapyramidal Side Effects from Smoked Haloperidol

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Angeline Pham ◽  
Joo-Young Lee ◽  
Christopher W. T. Miller
Keyword(s):  
Emergency Department ◽  
Side Effects ◽  
Psychotic Disorders ◽  
Medical Literature ◽  
Extrapyramidal Side Effects ◽  
Case Presentation ◽  
Dopamine Receptor Antagonist ◽  
Second Generation Antipsychotics ◽  
Other Substances ◽  
High Doses

Introduction. Haloperidol is a dopamine receptor antagonist used to treat patients with psychotic disorders. Especially at high doses, haloperidol carries a higher risk of extrapyramidal symptoms (EPS) compared to second-generation antipsychotics. Few cases of haloperidol misuse are found in the medical literature. Case Presentation. We describe a patient with schizophrenia who smoked marijuana mixed with crushed haloperidol tablets. After the smoking of cannabis and haloperidol, the patient presented to the emergency department (ED) with suicidal ideation, psychosis, and acute dystonia. With the administration of intramuscular diphenhydramine at the ED, the dystonia resolved in less than an hour. To our knowledge, this is the first report on haloperidol misuse by smoking. Conclusion. Clinicians should be aware that patients might misuse prescribed antipsychotics via unconventional routes, potentially combined with other substances.

Somatic Treatments for Psychotic Disorders

2016 ◽  
Author(s):  
Justin C. Ellison ◽  
Jason B. Rosenstock ◽  
Michael J. Marcsisin
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Gold Standard ◽  
Psychotic Disorders ◽  
Mood Stabilizers ◽  
Positive Symptoms ◽  
Second Generation Antipsychotics ◽  
Treatment Refractory ◽  
Long Acting ◽  
Somatic Therapies

A variety of somatic therapies can be used to treat individuals suffering from psychosis. Most commonly, providers will prescribe antipsychotics, which generally block dopamine receptors and are particularly useful at reducing positive symptoms. Second-generation antipsychotics have fewer movement side effects than older agents do, but they are more expensive and have more metabolic side effects. Long-acting injectable (LAI) antipsychotics can be useful for improving outcomes, especially in non-adherent patients, and clozapine is the gold standard for treatment-refractory psychosis. Other agents may be useful for adjunct therapy, or in early psychosis, such as antidepressants, mood stabilizers, and benzodiazepines. In this chapter, we will also review other somatic therapies such as electroconvulsive therapy (ECT) and other neuromodulation approaches.

scholarly journals Expanding our Understanding of Atypical Antipsychotics: Acute Urinary Retention Secondary to Olanzapine

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Hannah Mirzakhani ◽  
Mariam Rahim ◽  
Jacob Mathew
Keyword(s):  
Side Effects ◽  
Urinary Retention ◽  
Primary Care Physicians ◽  
Acute Urinary Retention ◽  
Psychotic Disorders ◽  
Improve Patient Care ◽  
Second Generation Antipsychotics ◽  
Full Profile ◽  
Increasing Demand

Antipsychotics are considered the most efficacious drugs in the treatment of schizophrenia and other psychotic disorders. While clinicians monitor for the onset of extrapyramidal symptoms (EPSs), many do not consider the antimuscarinic and histaminergic side effects that can occur with second generation antipsychotics. We present the case of a 62-year-old male who presented with acute urinary retention that was found to be due to the recent initiation of olanzapine. Gradual cessation of the medication and follow-up with urology revealed resolution of his symptoms. With the increasing demand for psychiatric care but limited psychiatric resources, more and more primary care physicians find themselves dealing with the complex challenges of mental illness and managing antipsychotic medications. As a result, coordinating care among multiple specialties and understanding the full profile of side effects that are associated with psychiatric medications can yield quicker diagnoses and improve patient care.

scholarly journals Antipsychotic-induced extrapyramidal side effects: A systematic review and meta-analysis of observational studies

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257129
Author(s):  
Tilahun Ali ◽  
Mekonnen Sisay ◽  
Mandaras Tariku ◽  
Abraham Nigussie Mekuria ◽  
Assefa Desalew
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Tardive Dyskinesia ◽  
Publication Bias ◽  
Psychotic Disorders ◽  
Meta Analysis ◽  
Extrapyramidal Side Effects ◽  
Bias Analysis ◽  
Pharmacological Management ◽  
Early Management

Background Antipsychotic agents are the basis for the pharmacological management of acute and chronic schizophrenia, bipolar disorders, mood disorders with psychotic feature, and other psychotic disorders. Antipsychotic medication use is frequently associated with unfavorable adverse effects such as extrapyramidal side effects (EPSEs). Hence, this systematic review and meta-analysis was aimed to determine the magnitude of antipsychotic-induced EPSEs. Method A literature search was conducted using legitimate databases, indexing services, and directories including PubMed/MEDLINE (Ovid®), EMBASE (Ovid®), google scholar and WorldCat to retrieve studies. Following screening and eligibility, the relevant data were extracted from the included studies using an Excel sheet and exported to STATA 15.0 software for analyses. The Random effects pooling model was used to analyze outcome measures at a 95% confidence interval. Besides, publication bias analysis was conducted. The protocol has been registered on PROSPERO with ID: CRD42020175168. Result In total, 15 original articles were included for the systematic review and meta-analysis. The pooled prevalence of antipsychotic-induced EPSEs among patient taking antipsychotic medications was 37% (95% CI: 18–55%, before sensitivity) and 31% (95% CI: 19–44%, after sensitivity). The prevalence of antipsychotic-induced parkinsonism, akathisia, and tardive dyskinesia was 20% (95% CI: 11–28%), 11% (95% CI: 6–17%), and 7% (95% CI: 4–9%), respectively. To confirm a small-study effect, Egger’s regression test accompanied by funnel plot asymmetry demonstrated that there was a sort of publication bias in studies reporting akathisia and tardive dyskinesia. Conclusion The prevalence of antipsychotic-induced EPSEs was considerably high. One in five and more than one in ten patients experienced parkinsonism and akathisia, respectively. Appropriate prevention and early management of these effects can enhance the net benefits of antipsychotics.

scholarly journals Extrapyramidal side-effects of antipsychotics in a randomised trial

2008 ◽  
Vol 193 (4) ◽  
pp. 279-288 ◽  
Author(s):  
Del D. Miller ◽  
Stanley N. Caroff ◽  
Sonia M. Davis ◽  
Robert A. Rosenheck ◽  
Joseph P. McEvoy ◽  
...  
Keyword(s):  
Side Effects ◽  
Concomitant Medication ◽  
First Generation ◽  
Second Generation ◽  
Rating Scales ◽  
Mixed Model ◽  
Randomised Trial ◽  
Extrapyramidal Side Effects ◽  
Second Generation Antipsychotics ◽  
Secondary Analyses

BackgroundThere are claims that second-generation antipsychotics produce fewer extrapyramidal side-effects (EPS) compared with first-generation drugs.AimsTo compare the incidence of treatment-emergent EPS between second-generation antipsychotics and perphenazine in people with schizophrenia.MethodIncidence analyses integrated data from standardised rating scales and documented use of concomitant medication or treatment discontinuation for EPS events. Mixed model analyses of change in rating scales from baseline were also conducted.ResultsThere were no significant differences in incidence or change in rating scales for parkinsonism, dystonia, akathisia or tardive dyskinesia when comparing second-generation antipsychotics with perphenazine or comparing between second-generation antipsychotics. Secondary analyses revealed greater rates of concomitant antiparkinsonism medication among individuals on risperidone and lower rates among individuals on quetiapine, and lower rates of discontinuation because of parkinsonism among people on quetiapine and ziprasidone. There was a trend for a greater likelihood of concomitant medication for akathisia among individuals on risperidone and perphenazine.ConclusionsThe incidence of treatment-emergent EPS and change in EPS ratings indicated that there are no significant differences between second-generation antipsychotics and perphenazine or between second-generation antipsychotics in people with schizophrenia.

Methamphetamine Use and Antipsychotic-related Extrapyramidal Side-effects in Patients with Psychotic Disorders

2020 ◽  
Vol 16 (2) ◽  
pp. 208-217
Author(s):  
Henk S. Temmingh ◽  
Wim van den Brink ◽  
Fleur Howells ◽  
Goodman Sibeko ◽  
Dan J. Stein
Keyword(s):  
Side Effects ◽  
Psychotic Disorders ◽  
Extrapyramidal Side Effects ◽  
Methamphetamine Use

scholarly journals The Untimely Popping Phial: Poppers as an Unusual Cause of Skin Corrosion of the Thigh

2020 ◽  
Vol 2020 ◽  
pp. 1-2
Author(s):  
Fabienne Moret ◽  
Gregor Lindner ◽  
Bertram K. Woitok
Keyword(s):  
Emergency Department ◽  
Side Effects ◽  
Muscle Relaxant ◽  
Rare Case ◽  
Alkyl Nitrates ◽  
Potential Harm ◽  
Case Presentation ◽  
Burning Pain ◽  
Alkyl Nitrites ◽  
Skin Contact

Background. Alkyl nitrites or “poppers” are widely used as sex-drugs due to their aphrodisiac and muscle relaxant effects. We describe the rare case of a large-sized dermatitis after direct skin contact with the poppers-fluid in a poppers user. Case Presentation. A 52-year-old patient presented to the emergency department due to burning pain on his proximal right thigh and scrotum. Clinical examination showed an 8 × 5 cm measuring burning wound resembling lesion. During further history the patient mentioned that the day before presentation a “poppers” phial unintentionally opened in his pocket and the fluid leaked. Conclusions. The present case shows severe skin defects after skin-contact with alkyl nitrates in a “poppers” user. Maculopathy and methemoglobinemia are prominent unwanted side effects of “poppers” use. However, our report demonstrates that attention should also be paid to potential harm for the skin.

Recent antipsychotics in the treatment of psychoses

1999 ◽  
Vol 11 (3) ◽  
pp. 85-92
Author(s):  
M.J.A.J.M. Hoes
Keyword(s):  
Side Effects ◽  
Negative Symptoms ◽  
Clinical Problem ◽  
New Drugs ◽  
Clinical Aspects ◽  
Extrapyramidal Side Effects ◽  
Treatment Resistant ◽  
Short And Long Term ◽  
High Doses

SummaryAntipsychotic drugs are effective in psychoses, whatever the etiology of the disorder. The positive symptoms tend to respond more readily. The need for developing new drugs arises from the refractoriness of the negative symptoms, the 10-25% of the patients that are treatment-resistant and the problems of short-, and long-term extrapyramidal side-effects. Thus far, six drugs, differing from the classical antipsychotics, have been licensedfor use: olanzepine, risperidone and quetiapine; the longest registration exists for sulpiride and clozapine while the most recent one is for amisulpride. This review starts with a brief introduction to symptomatology, and takes differences with the classical drugs in pharmacology, pharmacokinetics, clinical aspects and side-effects into consideration. Clozapine, risperidone and sulpiride may be considered for clinical use in refractory patients; these three, olanzapine and amisulpride when extrapyramidal side-effects cause a clinical problem. Amisulpride and sulpiride have a dual therapeutic acion: On negative symptoms at low dose, on positive symptomen at high doses.

High Dosage Haloperidol in Chronic Schizophrenia

1977 ◽  
Vol 131 (3) ◽  
pp. 310-316 ◽  
Author(s):  
Robin G. McCreadie ◽  
Ian M. MacDonald
Keyword(s):  
Alkaline Phosphatase ◽  
Side Effects ◽  
Serum Alkaline Phosphatase ◽  
Controlled Trial ◽  
Chronic Schizophrenia ◽  
Drug Resistant ◽  
Extrapyramidal Side Effects ◽  
Double Blind ◽  
High Doses

In a double blind chlorpromazine-controlled trial, high dosage haloperidol (100 mg daily) given for three months, appreciably improved the mental state of male chronic ‘drug resistant’ schizophrenic in-patients in the rehabilitation/long-stay unit of one psychiatric hospital. The results of a three-month follow-up suggested that the improvement could be maintained in some patients on lower doses of the drug.Serious extrapyramidal side effects were not seen at high doses. However, the majority of patients on haloperidol showed a deterioration in ward behaviour, possibly related to drowsiness, and developed raised serum alkaline phosphatase levels. These side effects disappeared in the follow-up period when either the drug was discontinued or the dose of haloperidol reduced.

scholarly journals Bowel Perforation in the Emergency Department Related to Bevacizumab Therapy and Recurrent Ovarian Cancer

2020 ◽  
Vol 4 (2) ◽  
pp. 227-229
Author(s):  
Stuart Ostby ◽  
Michael Olushoga ◽  
Charles Leath ◽  
Samuel Burleson
Keyword(s):  
Ovarian Cancer ◽  
Emergency Department ◽  
Side Effects ◽  
Bowel Perforation ◽  
Recurrent Ovarian Cancer ◽  
Imaging Findings ◽  
Case Presentation ◽  
Portal Venous Gas ◽  
Surgical Evaluation

Case Presentation: We describe the presentation to the emergency department of a patient with recurrent ovarian cancer treated with bevacizumab with the complication of bowel perforation. Discussion: We review the frequency and outcomes of bevacizumab-related bowel perforation. We also report the patient’s imaging findings, including the radiologic presentation of free intraperitoneal air and portal venous gas, both indicative of bowel perforation and the need for emergent surgical evaluation. Our case also illustrates the potentially catastrophic side effects of bevacizumab and other targeted oncologic therapies of which emergecny physicians may not be aware.

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