RESUMEN
OBJECTIVE: To explore the evidence around clozapine re-challenge following myocarditis. CONCLUSION: This case adds to the 17 cases of clozapine re-challenge following myocarditis, of which 71% were successful (12 cases). This demonstrates that re-challenge could be performed safely and effectively in the context of clozapine-induced myocarditis, if accompanied by a strict and rigorous monitoring protocol.
Asunto(s)
Antipsicóticos , Clozapina , Miocarditis , Antipsicóticos/uso terapéutico , Clozapina/uso terapéutico , HumanosAsunto(s)
Catatonia , Terapia Electroconvulsiva , Inflamación , Microglía , Trastornos Psicóticos , Sustancia Blanca/patología , Adulto , Catatonia/diagnóstico por imagen , Catatonia/inmunología , Catatonia/patología , Catatonia/terapia , Femenino , Humanos , Inflamación/diagnóstico por imagen , Inflamación/inmunología , Inflamación/patología , Inflamación/terapia , Imagen por Resonancia Magnética , Trastornos Psicóticos/diagnóstico por imagen , Trastornos Psicóticos/inmunología , Trastornos Psicóticos/patología , Trastornos Psicóticos/terapia , Sustancia Blanca/diagnóstico por imagenAsunto(s)
Trastorno Depresivo Resistente al Tratamiento/terapia , Dexmedetomidina/uso terapéutico , Terapia Electroconvulsiva/efectos adversos , Hipnóticos y Sedantes/uso terapéutico , Agitación Psicomotora/tratamiento farmacológico , Agitación Psicomotora/etiología , Femenino , Humanos , Resultado del Tratamiento , Adulto JovenAsunto(s)
Antipsicóticos/uso terapéutico , Clozapina/uso terapéutico , Síndrome de Cogan/complicaciones , Resistencia a Medicamentos , Trastornos Psicóticos/complicaciones , Trastornos Psicóticos/tratamiento farmacológico , Síndrome de Cogan/tratamiento farmacológico , Resistencia a Medicamentos/efectos de los fármacos , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND AND OBJECTIVES: Serotonin transporter polymorphisms, 5-HTTVNTR and 5-HTTLPR, have been found to be associated with obsessive-compulsive disorder (OCD) and particularly with neurotic characteristics. In the present study we looked for an association between OCD and these polymorphisms in OCD patients and controls of south Indian origin. METHODS: 5-HTTVNTR and 5-HTTLPR/rs25531 were genotyped in 93 OCD patients and 92 healthy controls. The allelic distribution and genotype frequency in cases and controls were compared using chi square test. In order to test for the effects of genotype on heterogeneity of the illness, linear regression analysis was undertaken for co-morbid depression status and YBOCS score (severity index). RESULTS: There was no significant association with the 5-HTTVNTR or the 5-HTTLPR polymorphism. No significant association of OCD with the 5-HTTLPR genotype was found even on inclusion of the rs25531 locus, which is part of the transcription factor binding site as reported in earlier studies. However, severity of the illness showed a modest association with the dominant model. INTERPRETATION AND CONCLUSIONS: Our data show that genetic variation in the SLC6A4 gene regulatory region may not have a significant effect on OCD in the present population. Further replication in a large and independent cohort with an equal number of female subjects would help to ascertain if the absence of association in this cohort is due to the nullifying effect of the larger proportion of male subjects in our sample population. The marginal effect of the 5-HTTLPR (A/G) genotype obtained on linear regression with disease severity is suggestive of a potential role for this locus in the disease process.