RESUMEN
OBJECTIVE: Few cases of seizures associated with olanzapine therapy and even fewer with mirtazapine have been published, most of them in patients with confounding risk factors. Our objective was to report a case of Status epilepticus in a patient receiving olanzapine and mirtazapine, with no previous history of seizure and no confirmed underlying cause for seizure. CASE SUMMARY: A 48-year-old white, psychotic woman developed generalized tonic-clonic seizures that progressed to Status epilepticus during hospitalization. 4 days before the incident, mirtazapine (30 mg) was added to the treatment, while 2 days before the incident, the treatment switched from quetiapine to olanzapine, and mirtazapine was increased to 60 mg. No other toxic, metabolic, electrolyte or anatomic abnormality was identified. After discontinuation of olanzapine, the patient remained seizure-free. CONCLUSION: To our knowledge, this is the second reported case of Status epilepticus that has been associated with the use of olanzapine, while only one report of seizures, but none of Status epilepticus connected to mirtazapine is found in the literature. Although olanzapine has infrequently been associated with epileptogenic risk, it should be used cautiously especially when concomitant medication or other predisposing factors exist.
Asunto(s)
Benzodiazepinas/efectos adversos , Mianserina/análogos & derivados , Estado Epiléptico/inducido químicamente , Antidepresivos Tricíclicos/efectos adversos , Antidepresivos Tricíclicos/uso terapéutico , Antipsicóticos/efectos adversos , Antipsicóticos/uso terapéutico , Benzodiazepinas/uso terapéutico , Interacciones Farmacológicas , Femenino , Humanos , Mianserina/efectos adversos , Mianserina/uso terapéutico , Persona de Mediana Edad , Mirtazapina , Olanzapina , Trastornos Psicóticos/tratamiento farmacológicoRESUMEN
One of the most challenging patient groups that the psychiatrist of consultation-liaison psychiatry is called to work with, are the patients with Renal Failure, since this disease is related to complicated and multidimensional physical and psychosocial problems. In this review, a holistic approach is attempted, considering the biological, psychological and psychosocial factors related to the disease and to specific therapeutical programs as well. The interaction of these factors and their impact not only on the course of the disease, but also on the quality of life are discussed. Finally, a brief report on psychosocial and pharmaceutical interventions indicated for this group of patients is made, especially concerning the psychological and psychosocial consequences of renal failure.