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Samir Kumar Praharaj

Publications and source records attributed to Samir Kumar Praharaj.

6 recordsLinked to original sources
PubMed2006

Clozapine effective in olanzapine-induced Pisa syndrome.

OBJECTIVE: To report a case of olanzapine-induced Pisa syndrome that improved after treatment with clozapine. CASE SUMMARY: A 22-year-old male with paranoid schizophrenia presented with insidious onset tonic truncal flexion with axial rotation and difficulty in walking after exposure to olanzapine in doses up to 15 mg/day for 9 months. An objective causality assessment suggested that Pisa syndrome was probably related to olanzapine. There was improvement in his symptoms after 6 weeks of treatment with clozapine in doses gradually titrated to 350 mg/day. DISCUSSION: Pisa syndrome is a type of dystonia that has been associated with both typical and atypical antipsychotics. Both acute and insidious onset cases have been described in the literature, which have different course and treatment response. Clozapine was found to be effective in reducing the severity of olanzapine-induced Pisa syndrome. CONCLUSION: Clozapine may be a useful treatment option for Pisa syndrome that has been caused by olanzapine.

Adult↗
PubMed2006

Paroxetine useful for palmar-plantar hyperhidrosis.

OBJECTIVE: To report a case of palmar-plantar hyperhidrosis (PPH) in which paroxetine was found to be helpful. CASE SUMMARY: A 32-year-old man with a history of excessive sweating of the palms and soles since childhood was diagnosed with PPH and was prescribed paroxetine 10 mg/day, which was increased to 20 mg/day. After one month, he experienced a marked reduction in sweating and improvement in socio-occupational functioning, which were sustained during follow-up at 6 months without any emergent adverse effects. DISCUSSION: Paroxetine's anticholinergic action may be responsible for its beneficial effect in PPH, as it may override the adrenergic mechanism, which has a minor effect on sweating from eccrine glands. Alternatively, paroxetine's beneficial effect in PPH may be secondary to its antianxiety effect, through central mechanisms. CONCLUSIONS: Paroxetine may be a useful option in the treatment of PPH.

Adult↗
PubMed2006

Clozapine-induced sialorrhea: pathophysiology and management strategies.

RATIONALE: Clozapine is an atypical antipsychotic agent with proven efficacy in refractory schizophrenia, but its widespread use is limited by adverse effects such as agranulocytosis, seizures, sedation, weight gain, and sialorrhea. Clozapine-induced sialorrhea (CIS) is bothersome and has socially stigmatizing adverse effects, which result in poor treatment compliance. The pathophysiology of this condition is poorly understood and the treatment options available are based mostly on case reports and open-label studies. OBJECTIVE: To review the available studies on CIS. METHOD: All relevant studies available through PUBMED search supplemented with manual search were undertaken. RESULT: The clinical features, complications, assessment, pathophysiology, and management of CIS are discussed. CONCLUSION: Although the studies evaluating the therapeutic options has limitations and no drug has been found to be superior, judicious use of pharmacological agents along with behavioral methods will reduce this troublesome side effect and enhance compliance.

Adrenergic alpha-Agonists↗
PubMed2005

Is clonidine useful for treatment of clozapine-induced sialorrhea?

Clozapine has shown superior efficacy in treatment of refractory schizophrenia, but its use is limited by emergent side-effects. Among other adverse effects, sialorrhea is a troublesome side-effect, its stigmatizing nature results in poor treatment compliance. Several hypotheses have been put forward in the etiology of clozapine-induced sialorrhea. 2 adrenergic antagonism is hypothesized to be involved in its pathophysiology, based on the response to clonidine and lofexidine. Oral clonidine (50 to 100 g/day) was tried on 12 stable outpatients of schizophrenia maintained on clozapine. Wet area over the pillow as reported by the patients was recorded at baseline and at 4 weeks of treatment along with the subjective response after the treatment. Most of the patients reported a decrease in sialorrhea without any adverse events. We describe encouraging results in an open case series of oral clonidine for clozapine-induced sialorrhea.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

Nonfatal suicidal olanzapine overdose: a case report.

There is an increase in the usage of olanzapine because of its relatively benign adverse effect profile. We report a case of suicidal overdose who survived after ingestion of 1600 mg of olanzapine requiring minimal intervention. Fluctuation in mental status suggestive of toxic delirium was noted during recovery from overdose. There was minimal alteration in the clinical and biochemical parameters. Olanzapine is safe in monointoxication as evident from this case study.

Adult↗