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Biomedical subjects

Sanjeev Sockalingam

Publications and source records attributed to Sanjeev Sockalingam.

9 recordsLinked to original sources
PubMed2005

Review of awakening agents.

Brain injuries are a serious burden of illness to Canada and the US. Advances in managing head trauma have allowed more patients to emerge from decreased levels of consciousness and helped them cope with neurocognitive, neurobehavioural, and neuropsychiatric deficits. In this article, we review the current (1986-2002) evidence surrounding the pharmacological management of arousal states and the aforementioned neurological sequelae of head injury in either acute or chronic conditions. This article will review the evidence for the use of psychostimulants (methylphenidate), antidepressants (amitriptyline, selective serotonin reuptake inhibitors, and buproprion), Parkinson's medications (amantadine, bromocriptine, carbidopa/levodopa), anticonvulsants (valproic acid), modafinil (Provigil), lactate, hyperbaric oxygen chamber, electroconvulsive therapy, and transmagnetic stimulation, in patients following a head injury. The review did not include all anticonvulsants, neuroleptics, beta-blockers, benzodiazepines, azospirones or cognitive enhancers. Unfortunately, the quality of the evidence is generally poor, and sometimes conflicting, which in turn results in indecisive guidelines for treating patients. Accepting the inherent flaws in the evidence we feel that this paper may serve as a stepping-stone for future researchers to improve data gathering that targets neurocognitive, neurobehavioural and neuropsychiatric symptoms following a head injury.

Brain Injuries↗
PubMed2005

Major depressive episode with psychotic features induced by pegylated interferon-alpha-2b and ribavirin treatment.

Recent evidence has demonstrated the efficacy of pegylated interferon-alpha (IFN-alpha) in treating hepatitis C virus infection. Neuropsychiatric complications commonly occur during the course of IFN treatment, with depressive symptoms usually appearing within the first 12 weeks. Few cases of the pegylated interferon-alpha-induced psychosis and depression have been reported compared to standard interferon-alpha therapy. We report the first case of a major depressive episode with psychotic features induced by pegylated IFN-alpha-2b and ribavirin in the last 2 weeks of therapy.

Adult↗
PubMed2005

Treatment of agitation following traumatic brain injury: a review of the literature.

Agitation, restlessness, and aggression are frequent neurobehavioural sequelae in the early stages of recovery from traumatic brain injury (TBI). These behavioural symptoms disrupt patient care and impede rehabilitation efforts. We review the current literature (1985 onwards) examining the pharmacological management of post-TBI agitation in both acute and post-acute conditions. This article will assess the evidence for the use of selected alkylphenols, benzodiazepines, estrogens, antiandrogens, neuroleptics/antipsychotics, antidepressants, anti-Parkinsonian agents, antipsychotics, anticonvulsants, lithium carbonate, buspirone, beta-blockers, and psychostimulants in agitated TBI survivors. Review of the literature suggests that there is limited evidence to accurately guide clinicians in the management of this patient population.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Cardiac angiography and conversion disorder.

BACKGROUND: Somatoform disorders are disorders in which "psychic energy" is transferred to somatic symptoms secondary to stressors. The concept of somatoform disorders and their associations among patients with cardiac disease is a relatively unfamiliar area. OBJECTIVE: The authors present a case that illustrates how conversion disorder, a specific type of somatoform disorder, may be associated with the psychologic stressor involved with cardiac angiography. The authors will discuss the literature concerning the identification and treatment of this disorder. METHODS: The relevant literature in the area of conversion disorder and cardiac angiography was reviewed. RESULTS: This report is the first documented case of a woman who developed conversion disorder after coronary catheterization. Using the case, a summary of diagnostic and treatment modalities used in this disorder is provided. CONCLUSIONS: The case highlights how conversion disorder can occur as a sequelae of coronary catheterization. The principles involved in the diagnosis and treatment of conversion disorder were successful in managing this patient. It is hoped that the case can aid cardiologists in becoming cognizant of this uncommon psychiatric disorder.

Angina, Unstable↗
PubMedDate not supplied

Delirium in the postoperative cardiac patient: a review.

UNLABELLED: BACKGROUND AND AIM OF REVIEW: Cardiac surgery is increasingly common and relatively safe, but there are frequent reports of neuropsychiatric sequelae occurring in the postoperative period. One of the most common neuropsychiatric presentations of cardiac surgery is delirium, also called postcardiotomy delirium (PCD). Despite the vast numbers of cardiac surgeries performed today, there is a paucity of data on risk factors and management options of PCD available to the clinician. This review aims to summarize available information, increase clinicians' awareness of PCD and suggest effective management of this illness. METHODS: Our literature search was completed using the databases Medline and CINAHL; it was limited to human and English language studies from 1964 to the present. Search terms included "delirium," "agitation," "postoperative," "cardiac," "neuropsychiatric," "neuroleptics," "psychosis," "surgery," "treatment," "postcardiotomy," and "pharmacotherapy." RESULTS: Our review of the literature revealed several risk factors for PCD, as well as various options for its pharmacological management. CONCLUSIONS: A multifactorial model should be applied when considering risk stratification for and prevention of delirium postoperatively. Pharmacologically, conventional antipsychotic agents, such as haloperidol, have long been used to manage delirium. In light of haloperidol's side effects, particularly those applicable to the cardiac patient, further research is required into the role of second generation antipsychotics. These agents are common in clinical use, and may be the preferred medications.

Cardiac Surgical Procedures↗