RESUMO
INTRODUCTION: An acute discontinuation of tizanidine, an alpha-2-agonistic muscle relaxant, is associated with reflex tachycardia, hypertension, tremor, hypertonicity and anxiety. CASE REPORT: We describe a 53-year-old patient with broken-heart syndrome, who developed serious tizanidine withdrawal symptoms after high-dosed long-term treatment within the framework of stress cardiomyopathy. CONCLUSION: Central muscle relaxants like tizanidine might have an impact on the development of delirium. Tizanidine withdrawal should be considered in patients who manifest signs and symptoms of withdrawal from medications. The drug should be gradually reduced in dosage under observation by a psychiatrist. When prescribing tizanidine, the possible pharmacological side effects and interactions should be taken into careful account.
Assuntos
Agonistas de Receptores Adrenérgicos alfa 2/efeitos adversos , Clonidina/análogos & derivados , Relaxantes Musculares Centrais/efeitos adversos , Síndrome de Abstinência a Substâncias/psicologia , Cardiomiopatia de Takotsubo/complicações , Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Clonidina/efeitos adversos , Clonidina/uso terapêutico , Eletrocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , Relaxantes Musculares Centrais/uso terapêutico , Síndrome de Abstinência a Substâncias/fisiopatologia , Cardiomiopatia de Takotsubo/tratamento farmacológicoRESUMO
INTRODUCTION: The bidirectional connection between the brain and the gut within psychiatric entities has gained increasing scientific attention over the last years. As a regulator of intestinal permeability, zonulin acts as a key player on the interface of this interplay. Like several psychiatric disorders, intestinal permeability was associated with inflammation in previous findings. METHODS: In this study we explored differences in zonulin serum levels in currently depressed (n = 55) versus currently euthymic (n = 37) individuals with an affective disorder. Further, we explored sex differences and possible influences on zonulin and affective symptoms like medication, age, body mass index, and smoking status. RESULTS: Serum zonulin was significantly higher in females than in men independent from affective status (z = -2.412, p = .016). More specifically, females in the euthymic subgroup had higher zonulin levels than euthymic men (z = -2.114, p = .035). There was no difference in zonulin serum levels in individuals taking or not taking a specific psychopharmacotherapy. We found no correlation between zonulin serum levels and depression severity. DISCUSSION: Increased serum zonulin levels as a proxy for increased intestinal permeability in women may indicate a state of elevated susceptibility for depression-inducing stimuli.