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Biomedical subjects

V Dewan

Publications and source records attributed to V Dewan.

7 recordsLinked to original sources
PubMed2001

Possible serotonin syndrome associated with clomipramine after withdrawal of clozapine.

OBJECTIVE: To report on the possible development of serotonin syndrome in a patient receiving clomipramine after clozapine was withdrawn from the treatment regimen. CASE REPORT: A 44-year-old white man with a 23-year history of undifferentiated schizophrenia and obsessive-compulsive behavior had been treated with clozapine and clomipramine for several years. He tolerated both agents together well, with the exception of experiencing chronic constipation. Clomipramine was tapered and reduced to 50 mg over a period of 10 days. A worsening of ritualistic behavior was noted, and the clomipramine dosage was increased to 150 mg/d over 14 days. Simultaneously with the clomipramine dosage increase, clozapine was tapered and stopped ever a period of 19 days. The day after clozapine was stopped, while he was still receiving clomipramine 150 mg/d, he began behaving oddly, started sweating profusely, shivering, and became tremulous, agitated, and confused. He was diagnosed with possible serotonin syndrome; his symptoms resolved after clomipramine was stopped but before clozapine was restarted eight days later. DISCUSSION: There are similarities in symptoms between serotonin syndrome and clozapine withdrawal. This article discusses the reasons why this case may represent serotonin syndrome rather than clozapine withdrawal and the possible pharmacologic mechanisms involved. CONCLUSIONS: Clinicians should be aware that removing a serotonin-2a (S-HT2a) antagonist 1mm a treatment regimen including an agent that increases serotonin in the synaptic cleft may worsen clozapine withdrawal or potentially result in serious adverse drug reactions, such as serotonin syndrome.

Adult↗
PubMed1997

The use of selective serotonin reuptake inhibitors for depression and psychosis complicating dementia.

This retrospective chart review examines the impact of selective serotonin reuptake inhibitors on 20 patients with both depression and psychosis complicating dementia of the Alzheimer type (DAT) and other dementias. Fifteen of the 20 patients had moderate to marked improvement in depressive and psychotic symptoms. Eleven of 12 patients with DAT had moderate to marked improvement compared to only four of eight patients with dementia from other causes. The drugs were effective in diminishing or eliminating psychotic symptoms in six patients who had previously not responded to a trial of a neuroleptic. The selective serotonin reuptake inhibitors may have an important role to play in patients with DAT who have coexisting depression and psychosis. These drugs are very well tolerated and may have a place as first-line agents in non-emergent settings where a clinician might otherwise think of instituting a neuroleptic or as a second-line agent when a neuroleptic has proven ineffective.

1-Naphthylamine↗
PubMed1995

A randomized controlled trial of vitamin A supplementation in acute diarrhea.

Effect of vitamin A supplementation on duration of diarrhea was evaluated in 108 cases between 6 months to 5 years of age suffering from acute diarrhea of less than 3 days duration and results were compared with equal number of age and sex matched controls having comparable feeding pattern, nutritional and socio-economic status and clinical profile who did not receive vitamin A supplementation. There was no significant difference in the mean duration of diarrhea in cases who received vitamin A and the controls. However, on subgroup analysis of the study and control groups a significant (p = 0.009) beneficial effect of vitamin A supplementation was noticed in cases who had a pre-existing vitamin A deficiency with CIC stage 3/5 and above. Even though vitamin A supplementation in malnourished children did not significantly alter the duration of diarrhea, a beneficial effect was observed in children who had CIC state 3 and above in association with malnutrition (p = 0.025). Our results indicate that vitamin A supplementation does not significantly reduce the duration of a diarrheal episode. However, in children with pre-existing vitamin A deficiency particularly those who have associated malnutrition it may have a beneficial effect.

Child↗