Sertraline-Induced Leukocytoclastic Vasculitis with Definite Causal Association: A Case Report.

Antidepressants like sertraline are frequently used to treat psychiatric diseases like depression, panic disorder, and obsessive-compulsive disorder. Small-vessel vasculitis called leukocytoclastic vasculitis is defined histopathologically by immune complex-mediated vasculitis of the dermal capillaries and venules. Typically, it shows up as purpura on the lower extremities, either with or without systemic involvement. Leukocytoclastic vasculitis can be idiopathic but it can also happen in conjunction with several medications. Here, we present data on sertraline-induced leukocytoclastic vasculitis in a patient with major depressive disorder. To our knowledge, sertraline and other selective serotonin reuptake inhibitors have not previously been definitively linked to leukocytoclastic vasculitis, which is rare with antidepressants.

Safe and Effective Use of Low-Dose Clozapine for Tardive Dyskinesia in a Patient with Schizophrenia and Comorbid Epilepsy: A Case Report.

Atypical antipsychotic clozapine has a special therapeutic impact on tardive dyskinesia and treatment-resistant schizophrenia. Clozapine also has important adverse effects such as epileptic seizures. For this reason, most clinicians avoid using clozapine in patients with schizophrenia and epilepsy. Therefore, treating patients with schizophrenia, tardive dyskinesia, and epilepsy is challenging. Here, we describe the case of a 32-year-old woman who was already suffering from epilepsy, schizophrenia, and tardive dyskinesia. She experienced clozapine-related seizures. But at the same time, clozapine dose adjustments successfully improved her psychosis and tardive dyskinesia and also stabilized her epilepsy. This case study indicates that epilepsy does not preclude the use of this important agent whenever it is clinically appropriate.

Predictors of Caregiver Burden in Family Caregivers of Male Patients with Opioid Use Disorders.

Background: We aimed to determine the factors that correlate and best predict caregiver burden in family caregivers of male patients with opioid use disorders, specifically with heroin use. Methods: A total of 100 patients with opioid use disorders and their primary caregivers (n = 100) were included in the study. Both patients and caregivers completed sociodemographic data collection forms. The Addiction Severity Index was applied to the patients, and the Burden Assessment Scale, COPE Inventory, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale were applied to the caregivers. Patients and their caregivers were divided into groups according to sociodemographic and clinical characteristics and then the caregiver burden scores were compared. In addition, factors correlating with caregiver burden were determined. Finally, in considering all these data, the factors that best predict caregiver burden were identified using regression analysis. Results: Factors that increased the burden of caregivers were duration of care, at least 1 instance of inpatient treatment, the presence of verbal and physical violence between patients and other family members, intravenous drug use, and moderate or severe dependence, according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Caregivers' active coping scores, based on the COPE Inventory, were found to negatively predict caregiver burden, while the patients' family-social relationship scores, based on the Addiction Severity Index, were found to positively predict caregiver burden. Conclusions: Developing caregivers' coping skills and patients' family-social relationships may thus contribute to reducing the burden of disease related to heroin-addicted patients.