Biomedical subjects

Brigitta Baran

Publications and source records attributed to Brigitta Baran.

3 recordsLinked to original sources

PubMed2005

[Neuropsychiatric symptoms caused by mefloquine (report of several cases)].

INTRODUCTION: The number of Hungarian citizens travelling to countries infected with malaria is increasing year by year. Mefloquine is the most effective medicine in the prophylaxis and treatment of malaria. However, neuropsychiatric side-effects can more often be seen with the use of mefloquine compared to other anti-malaria drugs. AIMS: To assess the neuropsychiatric side-effects with mefloquine prophylaxis; to screen those patients who are possibly affected by the side-effects and to explore factors that forecast the possible side-effects. METHOD: The retrospective analysis of patients, who in the past 2 years, have had mefloquine prophylaxis and then turned up at Semmelweis University, Department of Psychiatry and Psychotherapy and at Szent László Hospital, Outpatient Department of Psychiatry and Addictology because of neuropsychiatric symptoms. RESULTS: Out of the 6 cases presented, whose neuropsychiatric symptoms ranged from slight dizziness, malaise through panic attacks and depression to psychosis, the preceeding psychiatric condition was positive in 4 cases. Even the most serious psychiatric symptoms disappeared within a few days using temporary drug-treatment. In those cases in whom the side-effects were more serious, a positive psychiatric history or a more sensitive personality differing from the average was established. CONCLUSIONS: Because of the low number of cases it is not possible to draw a general conclusion. After analysis of the data the authors assume, that besides the psychiatric history, the premorbid personality can also be a factor that forecasts the possible neuropsychiatric side-effects caused by mefloquine prophylaxis.

Adult↗

PubMed2002

[Utility of electroshock therapy in epilepsy-associated psychosis].

Psychiatric disorders which indicate the use of electroconvulsive therapy (ECT) also occur in epileptic patients, but there is a lack of medical authority concerning the use of ECT in epileptic patients. This is surprising because in recent years it has been proved that ECT has an anti-convulsive effect to some degree. A case study of an epileptic patient is presented whose progress has been monitored for several years. Antiepileptic drugs were seemingly able to control his epilepsy but at the same time progressive behavioural disturbance (schizophreniform psychosis) accompanied by agitation and violent behaviour developed. Considering the recurrent psychotic decompensations and the relative ineffectiveness of antipsychotics, the authors decided to administer ECT. As a result they were able to bring about the longest symptom free balanced period in the patient. According to the data based on previous medical studies and the experience they can suppose that ECT is not immediately contraindicated by the presence of epilepsy with active interictal focus if the psychopathological condition makes it necessary. In view of the epileptogenic risk factors of classical neuroleptics, the epileptogenic effects of accompanying psychosis and the probable anticonvulsive potential of ECT in cases of severe psychiatric complications accompanying epilepsy ECT could be used more frequently.

Adolescent↗

PubMed2002

Anxiety in epilepsy--based on two case reports.

There are a great number of psychopathological symptoms which manifest themselves in 70-75% of epileptic patients but most of them remain unrecognised and untreated. These symptoms may affect the patients' quality of life more negatively than the epileptic seizures themselves. Anxiety is one of the most frequently occurring interictal psychopathological symptom. A number of specialists agree that chronic epilepsy causes the amplification of endogenic seizure suppressing mechanisms which hinder the epileptic seizures and are responsible for the development of interictal psychopathological symptoms. However the physiological effects of the interictal psychopathological conditions (e.g. anxiety) have epileptogenic effect as well. There is a high chance that the conditions of epilepsy and anxiety will mutually create a destructive vicious circle and it will be illustrated by our two case reports. In our experience, before modifying the pharmacotherapy of a patient suffering from chronic epilepsy with increased frequency of seizures, the anxiety level should be defined; and if it is high it should be treated first. From our perspective, the so-called "rational bitherapy" is very effective when a high potential antiepileptic drug is combined with an anxiety reducing method. The latter can be drug related or consists only of psychotherapy. We need more controlled clinical research to prove that inside epilepsy there are risk groups as well as conditions of high risk when the connection between anxiety and epilepsy is more than evident. The described cases seem to indicate that the existence of periictal anxiety can be a risk factor in developing later interictal anxiety.

Adult↗