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A L Montejo González

Publications and source records attributed to A L Montejo González.

6 recordsLinked to original sources
PubMedDate not supplied

[Utility of quetiapine in tardive dyskinesia].

INTRODUCTION: Neuroleptic induced tardive dyskinesia is a late appearing extrapyramidal disorder of involuntary, choreoatetoid movements. It may appear during chronic treatment with classical neuroleptics or a short time after its prolonged administration is interrupted. At present, there is no agreement on what would be the best way to treat dyskinesias. Clozapine is an alternative treatment to take into account, although the risk of agranulocytosis may be excessive to use it when there is a mild or moderate form of dyskinesia. Cases of improvement of dyskinesias both with olanzapine as well as with risperidone, although in a lower number, have been reported. Due to its receptor profile, quetiapine is the atypical antipsychotic that is most similar to clozapine, which leads us to consider it for the treatment of dyskinesias. METHODS: The first patient is a 66 year old woman with schizoaffective disorder of 16 years of evolution who has received many classical neuroleptics and who presents a picture or orolingual dyskinesias with a score of 28 on the AIMS scale. Treatment was substituted with Quetiapine until reaching a dose of 400 mg/day over 4 months, obtaining a decrease in the AIMS score up to 9. The second patient is a 60 year old woman diagnosed of bipolar disorder under treatment since 26 years of age with delusional jealousy ideation. Different atypical antipsychotics were used, all of them causing dyskinetic symptoms in the orolingual region, that disappeared with low doses of quetiapine, with good stabilization of her psychopathology. The third patient is a 33 old male diagnosed of paranoid schizophrenia when he was 18 years old. He was under maintenance treatment with haloperidol, biperiden and lorazepam, until 27 years of age, when the treatment was changed to risperidone, after presenting an orofacial tardive dyskinesia with masticatory type movements and lingual protrusion, with a 19 score on the AIMS scale. The change to quetiapine 600 mg/day reduced the score on the AIMS scale to 3. DISCUSSION: Our experience, based on 3 cases, shows an early and lasting improvement of the tardive dyskinesia with quetiapine. This experience is reinforced by other investigators with similar cases. In all, we have 12 cases that support the efficacy of quetiapine in the treatment of tardive dyskinesias.

Adult↗
PubMedDate not supplied

[Once weekly fluoxetine, tolerability and safety according to use patterns in the psychiatric clinical practice].

INTRODUCTION: Treatment with selective serotonin reuptake inhibitors (SSRI) has become generalized in all the medical setting although its efficacy and good tolerability may be affected by long term non-compliance. Once weekly fluoxetine could improve compliance due to the comfort of its use. The objective is to evaluate the safety, tolerability and efficacy of once weekly fluoxetine (90 mg) in a sample of out-patients, following naturalistic criteria in the usual clinical practice. METHOD: A total of 46 patients (age: 41.89 +/- 1.85) who received once weekly fluoxetine for at least 3 months (mean time: 135.24 days) were analyzed retrospectively. Clinical Global Impression of Severity (CGI-S) at the onset and end of the period evaluated, presence of adverse events, drop-out index and impression of patient's satisfaction with the treatment and use pattern were used. RESULTS: The mean of the final CGI-S was 2.09, compared with the onset 3.09 (p < 0.02), indicating significant improvement in the efficacy with once weekly fluoxetine. The most frequent adverse effects were: anxiety (10.87 %), headache (8.69 %) and restlessness (8.69 %) related with once weekly fluoxetine. Compliance was very high at the onset (99 %) and at the end (96 %). Ten patients dropped-out of the treatment (27.74 %), 6 due to appearance of undesirable effects (anxiety, headache and insomnia), three due to voluntary wish and only one due to lack of efficacy. The CGI of satisfaction of clinical global efficacy on the final visit was 1.43 (satisfied-very satisfied) and the CGI of satisfaction for the treatment pattern was 1.17 (very satisfied). CONCLUSION: Change to once weekly fluoxetine generally improves satisfaction of treatment efficacy and its use pattern, although some patients return to the initial regime after adverse effects appear.

Adult↗
PubMedDate not supplied

[Aggressiveness and the teaching function].

The authors study aggression with the "Instrument I to measure aggression of Ledesma Jimeno, Rodrigues Isidoro and Izquierdo de la Torre" in a sample of teachers (N = 48) made up of 15 university professors and 33 non-university professors (primary school, secondary school and professional training). The teacher sample is compared with a control sample of 479 men. The group of non-university professors showed more self-aggression and less aggression toward others than the control sample and university sample did. Both groups of teachers showed high levels of "technical intelligence". The aggression of the university professors was very similar to the control group and showed special peculiarities giving high values of intrapsychic incoherence that made their conduct more unforeseeable, with higher creative dispositions and a higher risk to their mental health than the other two groups studied.

Adult↗
PubMedDate not supplied

[Implication of lead poisoning in psychopathology of Vincent van Gogh].

The authors, by means of documental research, study the possibility that the physical and psychic symptoms of Vincent van Gogh may have been due to chronic lead poisoning. The technique and materials used by Van Gogh are analysed as the cause of repeated exposure to lead as well as the possible means of penetration of the metal. Through historical-biographical analysis, the progressive symptoms of the illness are compared with those of lead poisoning. The authors conclude that the excessive and continuous use by Van Gogh of pigments which were highly toxic due to their high lead content, such as white lead (lead carbonate) and yellow chrome (lead chromium), could have penetrated his organism by digestive system (primarily) in minimal daily amounts, giving rise to a clinical condition of chronic lead poisoning. This type of poisoning coincides with the clinical symptoms Van Gogh describes in his autographed letters: initial debilitation, stomatitis with loss of teeth, recurring abdominal pains, anaemia (with a "plumbic" skin tone), neuropathy of the radial and saturnine encephalopathy including epileptic crises, progressive character changes and periods of delirium. The clinical symptoms shown by Van Gogh meet present criteria for diagnosis of Organic Mental Disorder due to cerebral lesion or somatic illness (F.06; CIE-10) (DSM-IV-R), and Organic Character Disorder (F.07; CIE-10) (DSM-IV-R).

Delirium↗