Hypomania from the left frontal AVM resection.
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Adult↗
Biomedical subjects
K R Ozbayrak
Publications and source records attributed to K R Ozbayrak.
Prevalence and patterns of psychotropic and anticonvulsant medication use in children and adolescents referred to residential treatment.
The prevalence and patterns of use of psychiatric and anticonvulsant medications were studied in 83 seriously emotionally disturbed children and adolescents at the time of their admission to a residential treatment facility. Youths (aged 5-19, mean = 13.6 years), consecutively admitted over 17 months, were assessed for the prevalence and patterns of use of psychotropic and anticonvulsant treatments. At admission, 76% of the youths were receiving psychiatric pharmacotherapy, 40% with more than one psychiatric agent, and 15% with a combination of psychotropic and anticonvulsant medications. Frequently prescribed medications were neuroleptics (35 % of the medicated youths), sedative-hypnotics (26 %), and anticonvulsants (15%). Psychostimulants (16%) and antidepressants (22%) were under-prescribed relative to their diagnostic indications. Over 50 different medication combinations were used. The neuroleptic + lithium combination was most common (25 % of the polypharmacological treatments). Neuroleptics were the most commonly prescribed medication and mostly used for nonpsychotic, nontic, and nonbipolar indications (55% of neuroleptic trials). Neuroleptics were used primarily for aggression regardless of diagnosis. Neuroleptics were used more in symptomatic treatments than in treatments for indicated diagnoses. The high prevalence of psychiatric and antiepileptic medication use in children and adolescents admitted to a residential treatment facility, and especially the pattern of their use, raises questions about prescribing practices for youths entering residential treatment and about pediatric psychopharmacotherapy in general.
Adolescent↗
Combined pharmacotherapy in children and adolescents in a residential treatment center.
OBJECTIVE: To investigate characteristics of children and adolescents with a history of combined pharmacotherapy (CPT) and compare them with a group with no history of CPT. METHOD: Eighty-three consecutive admissions to a residential treatment center were divided into a CPT and a no-CPT group based on treatment history and compared by chart review. Prevalence of lifetime psychiatric medication use and CPT exposure were assessed. Demographic, diagnostic, treatment, behavioral, and medication variables were compared across the two groups. RESULTS: Medication use was present in the treatment history for 89.2% and a history of CPT was found for 60.3% of subjects. Admission to current placement from inpatient psychiatry, lifetime number of psychiatric placements, lifetime number of psychiatric diagnoses, and nonseizure neuropsychiatric comorbidity were significantly associated with CPT. Aggression and neuroleptic use were also significantly associated with CPT. Admission psychiatric diagnostic comorbidity was not associated with CPT. CONCLUSIONS: A high prevalence of psychiatric medication use and CPT was found in this population. Variables assessing illness severity, aggressive behavior, and nonseizure neuropsychiatric comorbidity may identify youths in psychiatric treatment settings with a high prevalence of past or current CPT exposure. Further research on the CPT of aggression is warranted.
Adolescent↗
A pilot study of nadolol for overt aggression in developmentally delayed individuals.
OBJECTIVE: The aim of this preliminary pilot study was to investigate the safety and efficacy of open-label nadolol as an adjunctive pharmacological treatment for aggression and/or inattention/overactivity in a developmentally delayed child, adolescent, and young adult population. METHOD: Twelve subjects enrolled and completed (mean age 13.8 years, range 9 through 24) a 5-month, open, prospective protocol of nadolol (mean dose 109 mg, range 30 through 220 mg) with systematic baseline and outcome evaluations and weekly clinical assessment. RESULTS: All subjects were developmentally delayed and most were cognitively delayed. Ten subjects (83%) showed clinical improvement while receiving nadolol. Significant improvements were noted on observer-rated overt categorical aggression, severity of illness, and global impressions of improvement. No significant effects were found for inattention/overactivity. Nadolol was well tolerated, with few side effects. CONCLUSIONS: Overt categorical aggression presenting in developmentally delayed children, adolescents, and young adults may respond to nadolol treatment.
Adolescent↗
Case study: neuroleptic withdrawal dyskinesia exacerbated by ongoing stimulant treatment.
Risk factors for neuroleptic withdrawal dyskinesia in children have not been well studied. The authors present a case of a child who had been treated with a combination of neuroleptics and stimulants for nonpsychotic aggressive behavior. A severe withdrawal dyskinesia precipitated by neuroleptic tapering was ameliorated by discontinuation of the psycho-stimulant. Although stimulants have been reported to increase certain involuntary movement disorders, this is the first known report of psychostimulant exacerbation of withdrawal dyskinesia.
Antipsychotic Agents↗
Attitudes of pediatricians toward psychiatric consultations.
This study attempts to evaluate the psychiatric consultation services in both a university and a non-university children's hospital by requesting opinions from 121 pediatricians. A 26-item questionnaire asked pediatricians to comment on the percentage of their patients with psychological problems and their level of ease in dealing with them, problems making psychiatric referrals, and their level of satisfaction with psychiatric consultations and other consultation activities. There were no significant differences between the attitudes of physicians from the two hospitals. Overall, the level of satisfaction was very low, indicating a need for a better working relationship between pediatric and child psychiatry units. There appears to be a high level of readiness on the pediatricians' side to enhance the relationship between the two clinical disciplines.
Adjustment Disorders↗
Left occipital hypoperfusion in a case with the Asperger syndrome.
The Asperger syndrome, a less severe variant of autism, has drawn increasing interest among child psychiatrists. Cerebral blood flow studies with autistic subjects have failed to reveal consistent findings. We are reporting a case with the Asperger syndrome, whose single photon emission computed tomography showed left occipital hypoperfusion.
Adult↗
Concordance: sequencing of psychiatric recommendations.
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Ethics, Medical↗