Pedal edema associated with atypical antipsychotics.

This study describes a patient diagnosed as a case of bipolar affective disorder complaining of bothersome incidence of pedal edema 1 month after the initiation of atypical antipsychotic regimen with risperidone and quetiapine. All hematological and biochemical profiles were found to be normal. On discontinuation of risperidone, the condition remained unresolved even after 2 weeks, and the edema progressed reaching her calves. On tapering the dose of quetiapine, she started showing gradual improvement in edematous condition. Quetiapine was slowly discontinued. No further recurrence of edema occurred, and hence, no further medication changes were implemented. Pedal edema was found to be resolved within weeks of dechallenge of the regimen. Naranjo adverse drug reaction probability scale gave a score of 7 which denotes "probable" adverse drug reaction with quetiapine.

Hypoglycemic episodes in a case of Prementrual Dysphoric Disorder on sertraline.

Sertraline is a selective serotonin reuptake inhibitor. It has been shown to blunt postprandial hyperglycemia in rats and to potentiate the hypoglycemic effects of sulfonylurea agents in humans. Here, we report a case of a 33-year-old nondiabetic patient with no history of glucose intolerance, who experienced multiple episodes of hypoglycemia that resolved after discontinuation of the drug. Healthcare professionals should consider sertraline among the possible causes of hypoglycemia occurring in patients receiving antidepressants.

Augmenting amisulpride with clozapine had led to unmasking of akathisia.

Amisulpride is a newer antipsychotic, which is very effective on its own, as well as augmenting other antipsychotic clozapine, which is an effective molecule for treatment resistant schizophrenia. In most cases, amisulpride is added on, in partial responders to clozapine. Here a case is reported where clozapine was added on, in an amisulpride partial responder but this produced side effect and had to be discontinued. The case later responded to clozapine alone. It has been discussed about possible reasons of this finding. It has also been suggested if sequence of introduction of medication is critical regarding getting the desired effect of the augmentation strategy.

Efficacy and safety of magnesium sulphate (MgSO4) in the treatment of eclampsia.

Use of magnesium sulphate (MgSO4) in the treatment of eclampsia has not yet become universal probably due to some perceived apprehension about its efficacy and toxicity. This study aimed to assess, in addition to foetomaternal outcome, its efficacy to control fits in eclampsia and toxicity if any. Fit control, occurence of toxicity and foetomaternal outcome were noted in 459 cases of eclampsia treated with MgSO4. MgSO4 was very effective in controlling fits with a very low (1.31%) fit recurrence rate and had an even lower incidence of toxicity (as evidenced by sluggish patellar reflex). None of the cases developed any life threatening toxicity like respiratory paralysis. Maternal mortality rate was 3.70% and perinatal mortality 9.15%. The results suggest that MgSO4 is very safe and effective for treating eclampsia and offers good prognosis for both mother and foetus.

Stress modulating antioxidant effect of Nardostachys jatamansi.

The rhizomes of Nardostachysjatamansi, the plant commonly known as Jatamansi have been described in Ayurveda for their soothing and sedative action on the central nervous system. In the present study, the anti-stress effect of hydroethanolic extract (70%) of N. jatamansi (NJE) was evaluated in reference to its antioxidant property. Wistar rats were divided into four groups: naive, stressed, and T-200 and T-500 stressed with oral pre-treatment of NJE 200 and 500 mg/kg, respectively. Restraint of rats in metallic chambers for 4 h at 4 degreesC was followed by sacrifice and assessment of stress-induced alterations in biochemical parameters, incidence and severity of ulcers. Lipid peroxidation (LPO) and NO levels in stomach and LPO, NO levels and catalase activity in brain, plasma corticosterone level and adrenal ascorbic acid were measured. In vitro antioxidant activity of NJE was studied by measuring the free radical scavenging activity. NJE showed potent antioxidant activity and significantly reversed the stress-induced elevation of LPO and NO levels and decrease in catalase activity in the brain. It inhibited the incidence of gastric ulcerations and reversed the alterations in biochemical parameters/markers of stress-induced gastric ulceration. NJE also significantly altered stress-induced increase in adrenal and spleen weights and decrease in level of ascorbic acid in adrenal gland. Elevation of plasma corticosterone level was negated dose- dependently. The findings suggest that the NJE possesses significant anti-stress activity, which may be due to its antioxidant activity.

The role of antioxidant properties of Nardostachys jatamansi in alleviation of the symptoms of the chronic fatigue syndrome.

An experimental model of chronic fatigue syndrome (CFS) is utilized for evaluation of antidepressant, anti-stress effects, wherein the rat is forced to swim in water for 15 min/day on 21 consecutive days. Rats were divided into stressed control, stressed plus standard drug (Panax ginseng) and stressed plus 200 and 500 mg/kg of test drug, i.e., Nardostachys jatamansi extract (NJE) given orally. The immobility during each 5 min periods of 0-5, 5-10 and 10-15 min of stress were noted. Similarly the climbing (struggling) behaviour was noted in the above four groups of rats in intervals of 5 min. The locomotor activity and also the anxiety state in animals were evaluated in an elevated plus maze after CFS in all the four groups. There was a significant increase in despair behaviour and anxiety in stressed control animals on successive days of CFS. Locomotor activity gradually decreased in stressed control group. Treatment with NJE (200 and 500 mg/kg) significantly reversed both paradigms. Biochemical analysis showed that CFS significantly increased lipid peroxidation, nitrite and superoxide dismutase levels and decreased catalase level in rat brain. Administration of NJE (200 and 500 mg/kg) tended to normalize both augmented lipid peroxidation, nitrite, superoxide dismutase activities and catalase level significantly. NJE per se has an antioxidant effect. The results indicate that CFS may lead to oxidative stress, which is mitigated by NJE and so its antioxidant property may be responsible for anti-stress effect of NJE.