Risperidone-induced retrograde ejaculation and lurasidone may be the alternative.

Medication adherence with antipsychotics is adversely impacted by the burden of untoward adverse effects. In particular, sexual side effects are often underreported by patients, which may interfere with drug compliance. Presented here is the case of a 35-year-old male with schizophrenia, previously treated with risperidone following which he developed sexual dysfunction and hence was stopped. He was admitted to our psychiatric inpatient ward after a second psychotic exacerbation of the disorder after being drug free for about 6 months. On admission, treatment with risperidone was restarted, following which he developed retrograde ejaculation on oral risperidone therapy at a dose of 8 mg/day, with resolution of symptoms after cross tapering risperidone with lurasidone. Pharmacological interventions that may reduce antipsychotic-induced sexual dysfunction include changing the type of medication and administering other medications that are known to improve sexual dysfunction. This case emphasizes the need for routine inquiry into sexual dysfunction during atypical antipsychotic therapy.

Copper catalyzed oxidative homocoupling of terminal alkynes to 1,3-diynes: a Cu3(BTC)2 MOF as an efficient and ligand free catalyst for Glaser-Hay coupling.

A straightforward and efficient method has been demonstrated for the oxidative coupling of terminal alkynes using a simple Cu3(BTC)2-metal organic framework as a sustainable heterogeneous copper catalyst. A series of symmetrical 1,3-diynes bearing diverse functional groups have been synthesized in moderate to excellent yields via a Cu3(BTC)2 catalyzed Glaser-Hay reaction. The presence of the coordinatively unsaturated open CuII sites in Cu3(BTC)2 catalyzes the homocoupling in the presence of air, as an environment friendly oxidant without the use of external oxidants, ligands or any additives. The present methodology avoids stoichiometric reagents and harsher or special reaction conditions, and shows good functional group tolerance. The as-prepared catalyst could be separated easily by simple filtration and reused several times without any notable loss in activity. The hot filtration test has investigated the true heterogeneity of the catalyst. Additionally, the powder X-ray diffraction pattern of the reused catalyst revealed the high stability of the catalyst.

Hashimoto's Encephalopathy Presenting with Unusual Behavioural Disturbances in an Adolescent Girl.

Hashimoto's encephalopathy (HE) is a rare autoimmune disorder with neurological and neuropsychiatric manifestations and elevated titres of anti-thyroid antibodies. Here we are reporting a case of HE in a 19-year-old girl who presented with seizure-like episodes, confusion, and behavioural disturbances with catatonic symptoms such as posturing, echopraxia, echolalia, and ambivalence. Patient did not respond to antipsychotics and anticonvulsants. On further investigation, patient was found to have high serum anti-TPO antibodies of about 1261 U/mL with euthyroid status, which supported a suspicion of HE. Our consultant neurologist confirmed the diagnosis and she was started on injection of methylprednisolone 750 mg OD. Since patient started showing clinical improvement, her antipsychotic medications were tapered off. On follow-up, patient has recovered and is functioning well. Since HE is a diagnosis of exclusion, very high anti-TPO antibodies and good response to steroids supported the diagnosis of HE in this patient after excluding other etiological possibilities. This case has been reported because the clinical presentation was predominantly neurobehavioural manifestations which is uncommon with HE.

Caregiver Burden in Alcohol Dependence Syndrome.

BACKGROUND: Alcoholism is a major threat to the individual as well as the society and the maximum burden of the illness is borne by the family. AIM: The study is aimed at assessing the pattern of burden on the caregivers of alcohol dependent patients and at assessing the relationship between the severity of dependence and the burden on caregivers. SETTINGS AND DESIGN: Cross-sectional descriptive study conducted in the Department of Psychiatry, Sri Ramachandra Medical College and Research Institute. MATERIALS AND METHODS: A cross-sectional assessment was done in 200 patients with alcohol dependence and their caregivers. The severity of dependence and the pattern of burden on caregivers were assessed. STATISTICAL ANALYSIS: The data thus collected was analyzed using SPSS version 20. RESULTS: The study demonstrates that caregivers of alcohol dependent patients reported significant objective burden and subjective burden. Furthermore, the severity of alcohol dependence and the domains of burden such as financial burden, disruption of family interaction, and disruption of family routine activities were positively correlated with high level of significance. CONCLUSION: The current study has illustrated that all the caregivers experienced significant amount of burden which has to be addressed for better treatment outcome of the patients.