Reply to Nutritional Approach to Bipolar Disorder
Notice bibliographique
Résumé
Mania Associated With Initiation of ZiprasidoneSir: The efficacy of atypical antipsychotics in the treatment of psychotic disorders is well established.Although olanzapine carries an additional indication for bipolar disorder, there are cases of mania associated with risperidone 1,2 and olanzapine 3,4 treatment in some patients.We present a case report of mania that was apparently induced in a patient shortly after beginning therapy with another atypical antipsychotic, ziprasidone. Case report.Mr. A was a 20-year old man with a history of auditory hallucinations, paranoid delusions, flat affect, and social withdrawal.His symptoms worsened over several weeks, necessitating admission to our inpatient psychiatric unit.Haloperidol and risperidone trials had been attempted in the past, but he had refused treatment for 8 months prior to meeting us.Regarding this period, family members related waxing and waning of symptoms throughout, and they urged him to resume treatment.He had no history of drug/alcohol abuse, and his past medical/neurologic history was unremarkable.With the patient meeting DSM-IV-TR diagnostic criteria for schizophrenia, we began ziprasidone, 20 mg b.i.d., with 20-mg b.i.d.increases over 4 days to 80 mg b.i.d.Due to daytime sedation, his dose was changed to 160 mg h.s.That night, because he slept poorly but related no other symptoms, ziprasidone was decreased to 80 mg h.s.The following night, he displayed increased energy with elated mood.He had increased religiosity and jumped over chairs, danced, and sang on a table.Lorazepam (2 mg) was emergently administered twice over 36 hours for his agitation and manic behavior.The ziprasidone therapy was discontinued, and olanzapine therapy was initiated as he refused lithium and valproic acid.The manic symptoms resolved over 48 hours, and his psychotic symptoms resolved over 30 days.Follow-up at 3 months, during which time he was maintained on 20 mg of olanzapine daily, revealed no further symptoms of mania, although some paranoid delusions remained.On the basis of a recent literature search, this case represents the first report of mania associated with ziprasidone.Despite reports of the induction of mania by atypical antipsychotics, many authors find these agents (including ziprasidone 5 ) helpful in treating manic symptoms seen in bipolar and schizoaffective disorders.In a review of risperidone/olanzapine-induced mania, it was speculated the cause was due to 5-HT 2 /D 2 receptor occupancy.6 However, ziprasidone differs from the older atypicals in its profound 5-HT 1D and 5-HT/norepinephrine (NE) reuptake inhibition effect-similar to amitriptyline and imipramine.Perhaps the tricyclic-like antidepressant effect of ziprasidone precipitated our patient's mania.We acknowledge that this case could represent a manic break in a patient who suffers from schizoaffective disorder.However, when the criteria proposed by Aubry et al. 6 are ap-Dr.Nolan reports no financial or other relationship relevant to
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,019 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,003 |
| Communication savante | 0,003 | 0,004 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,024 | 0,036 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».