RESUMEN
21 minors suffering from first-episode psychosis or related disorders were treated with the second-generation antipsychotic aripriprazole with serum levels being monitored over time. A significant variation of serum levels was observed in about half of the patients. Patients from Africa showed high levels of aripriprazole. In seven patients, i. e. ca. 35 % of the sample, aripriprazole treatment had to be stopped for various reasons. Therefore, serum levels of this antipsychotic (which in Germany is still considered off-label treatment before the age of 18) should be regularly monitored particularly in patients from Africa.
Asunto(s)
Antipsicóticos/sangre , Antipsicóticos/uso terapéutico , Aripiprazol/sangre , Aripiprazol/uso terapéutico , Trastornos Psicóticos/tratamiento farmacológico , Adolescente , Alemania , HumanosRESUMEN
Narcolepsy is a rare, multifactorial disease of the hypothalamus characterized by its leading symptoms of excessive daytime sleepiness and cataplexy. Sleep-EEG and a HLA-DR-genotype serve to secure the diagnosis. We report here on a 14-year-old girl suffering from anxieties, depression, school refusal, social withdrawal as well as very frequent attacks of sleep during the day and cataplexy. Currently, there is no approved drug for children and adolescents suffering from narcolepsy. Our patient benefited significantly and quickly from an off-label treatment with methylphenidate in combination with psychoeducation, cognitive behavioral therapy, and family therapy. Narcolepsy is a very rare but probably underestimated differential diagnosis applied to unclear daytime sleepiness, anxieties, or depression in childhood and adolescence. Both the key symptoms and the comorbid symptoms improve significantly under treatment with stimulants, albeit at a higher dosage.
Asunto(s)
Narcolepsia/diagnóstico , Narcolepsia/terapia , Adolescente , Catalepsia/diagnóstico , Catalepsia/epidemiología , Catalepsia/psicología , Catalepsia/terapia , Terapia Cognitivo-Conductual , Terapia Combinada , Diagnóstico Diferencial , Electroencefalografía , Terapia Familiar , Femenino , Genotipo , Antígenos HLA-DR/genética , Humanos , Metilfenidato/uso terapéutico , Narcolepsia/epidemiología , Narcolepsia/psicología , Educación del Paciente como Asunto , PolisomnografíaRESUMEN
Agenesis of the corpus callosum is associated with a wide range of neuropsychiatric symptoms. Cranial MRI confirms the diagnosis. We report a case of a 13-year-old boy with global developmental delay, mental retardation as well as neurological and psychiatric symptoms but without symptoms of ADHD who is unable to cope with school demands. Agenesis of the corpus callosum is a relatively rare, but possibly underestimated differential diagnosis of unclear retardations in development in children or suspicion of ADHD respectively.