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BACKGROUND: Phantom sensations like phantom vibration (PV) and phantom ringing (PR)- the sensations of vibration and ringing of the phone when they are not, respectively-are among the latest in the category of "techno-pathology" to receive global attention. This study was conducted with the aim to estimate the prevalence of such sensations among medical interns and their association with perceived stress levels and smartphone usage pattern. MATERIALS AND METHODS: Ninety-three medical interns using smartphone were recruited for the study. Data were collected anonymously using semi-structured questionnaire, perceived stress scale (PSS), and smartphone addiction scale-short version (SAS-SV). Data were analyzed using descriptive statistics, Chi-square test, independent t-test, ANOVA, and Pearson's correlation coefficient. RESULTS: Fifty-nine percent students had a high level of stress, whereas 40% had problematic smartphone use. Sixty percent students experienced PV, whereas 42% experienced PR and both were significantly associated with higher frequency of phone use and the use of vibration mode. Mean SAS-SV score was significantly lower in students who did not perceive PR/PV, whereas mean PSS score was significantly lower in students who did not perceive PV. CONCLUSION: This study confirms findings from other national and international researches about the experience of cell phone phantom sensations and their relationship with the pattern of phone use and stress level. It also brings to light high levels of stress and problematic smartphone use among medical students during the internship.
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BACKGROUND: Antipsychotic treatment-induced hyperprolactinemia is a highly distressing and disabling side effect for patients. The use of add-on aripiprazole has been identified as a possible treatment strategy in this situation. However, data on prolactin changes with add-on aripiprazole in a real-world naturalistic clinical setting from India are sparse. MATERIALS AND METHODS: The retrospective chart review was conducted at the specialty metabolic clinic at the National Institute of Mental Health and Neurosciences, Bengaluru, India. Sixteen patients (female: male = 13:3) who were on a stable dose of antipsychotic medications, complaining of either sexual dysfunction or menstrual irregularities, were prescribed add-on aripiprazole. The serum prolactin values were obtained before the initiation of aripiprazole and during the follow-up. RESULTS: Patients were on treatment with risperidone, amisulpride, and olanzapine and had a prolactin level of 87.1 ± 60.7 ng/ml. Add-on aripiprazole treatment was given with a mean dose of 13.8 ± 7.4 mg/day. Patients had a significant reduction in prolactin level (35.6 ± 29.1 ng/ml) following treatment with aripiprazole (P = 0.004). CONCLUSIONS: Add-on aripiprazole could be a clinically useful strategy in patients who develop antipsychotic-induced hyperprolactinemia.
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INTRODUCTION: Disulfiram was the first medication approved to treat alcohol dependence and has been found to be safe and efficacious. This cross sectional, observational, qualitative study was conducted with the aim to assess the pattern of dispensation of disulfiram among patients with alcohol use disorder (AUD). MATERIAL AND METHODS: Data was collected using a customized questionnaire consisting of 32 questions regarding socio-demographic characteristics, psychiatric history, pattern of dispensation of disulfiram/disulfiram-like product (DLP) and related knowledge. Descriptive statistics and frequency distribution tables were used for analysing the data using Microsoft Excel 2013. RESULTS: Thirty seven percent (n=100) of the total patients with ADS (n=268) screened had a history of administration of disulfiram/DLP. Tablets were the commonest (60%) formulation of disulfiram/DLP advised by the dispenser, only 4% of whom were psychiatrists. Surreptitious administration was preferred by family members (76%). Majority of the patients (44%) received the medication only once or twice. LIMITATIONS: The actual product - disulfiram and/or DLP - could not be chemically tested to confirm the identity. Considering the socio-economic and cultural background where the study was conducted, it would be difficult to generalize the findings. DISCUSSION: Disulfiram/DLP was prescribed by physicians and faith healers alike. They seem to promote surreptitious administration of disulfiram with full agreement of relatives, thereby potentially exposing the patient to life threatening complications. Hence it is recommended that disulfiram prescription should involve stricter guidelines and DLP like kudzu in traditional/herbal products should also be brought under the same purview as disulfiram.
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Disuasivos de Alcohol/administración & dosificación , Alcoholismo/tratamiento farmacológico , Disulfiram/administración & dosificación , Prescripciones de Medicamentos , Pautas de la Práctica en Medicina , Adulto , Estudios Transversales , Prescripciones de Medicamentos/normas , Prescripciones de Medicamentos/estadística & datos numéricos , Hospitales Generales/estadística & datos numéricos , Hospitales Rurales/estadística & datos numéricos , Humanos , India , Masculino , Persona de Mediana Edad , Pautas de la Práctica en Medicina/ética , Pautas de la Práctica en Medicina/normas , Pautas de la Práctica en Medicina/estadística & datos numéricos , Servicio de Psiquiatría en Hospital/estadística & datos numéricosRESUMEN
Toxoplasma gondii is one of the well-studied parasites because of its medical and veterinary importance, and its suitability as a model for cell biology and molecular studies. Latent toxoplasmosis in an immunocompetent host was considered benign until recently. The importance of this parasite has been steadily rising in the field of psychiatry and neurology as it has been implicated in numerous neuropsychiatric disorders. Researchers in India have unfortunately restricted themselves to finding the prevalence of toxoplasma antibodies in special populations and animals. On the other hand, there has been increasing research interest worldwide in T. gondii for its effects on human behaviour, manifestations of which range from psychoses and neuroses to Alzheimer's and Parkinson's disease. Toxoplasma infected organisms may be akin to living zombies. From changing the core natural defensive behaviour in mice to changing personality & leading to neuropsychiatric disorders in humans, Toxoplasma brings about subtle but significant & specific changes in its host. Surprisingly there is severe dearth of such studies from India even though prevalence rates of latent Toxoplasma infection are comparable, or in some regions, higher to those found elsewhere in the world. The potential for identifying Toxoplasma induced behavioural alterations is enormous in this part of the world which could have future treatment implications. It's high time that we move beyond researching the obvious and involve ourselves in more rigorous, novel and stimulating studies in the future.
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Priapism is a urologic emergency representing a true disorder of penile erection that persists beyond or is unrelated to sexual interest or stimulation. A variety of psychotropic drugs are known to produce priapism, albeit rarely, through their antagonistic action on alpha-1 adrenergic receptors. We report such a case of priapism induced by a single oral dose of 10 mg aripiprazole, a drug with the least affinity to adrenergic receptors among all atypical antipsychotics. Polymorphism of alpha-2A adrenergic receptor gene in schizophrenia patients is known to be associated with sialorrhea while on clozapine treatment. Probably, similar polymorphism of alpha-1 adrenergic receptor gene could contribute to its altered sensitivity and resultant priapism. In future, pharmacogenomics-based approach may help in personalizing the treatment and effectively prevent the emergence of such side effects.
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Phobia is a type of anxiety disorder characterized by circumscribed, marked fear or anxiety to a specific object or situation which is out of proportion to the actual danger posed by the concerned object or situation. Worldwide, the prevalence of specific phobia has been found to be 16% in 13-17 years olds. In India, specific phobia has been identified as one of the most common disorders in the school-going age group, with the prevalence of approximately 4.2%. Alektorophobia is the specific term for phobia to hen/chickens. We hereby report an 18-year-old female presenting with alektorophobia and successfully treated with graded exposure therapy. It has not been described in extant literature to the best of our knowledge.
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Phosphodiesterases (PDE) are exciting new targets in medical sciences. These enzymes are some of the key mediators of cellular functions in the body and hence are attractive sites for drug-induced modulations. With the finding that Tofisopam, a new anxiolytic, inhibits PDEs, the authors were inspired to look into the role of PDE and drugs acting on them in psychiatry. Hence, the review was undertaken. We found several research materials available highlighting the role of PDE in cellular functions and the possible newer etiological mechanisms of neuropsychiatric illnesses such as schizophrenia, depression/anxiety disorders, and cognitive dysfunction involving PDEs. We also found that there are many molecules acting on PDEs, which have the potential to alter the way we treat mental illnesses today. This article is intended to provide an in-depth look at these enzymes so that more cost-effective therapeutic molecules may be synthesized and marketed in India for managing mental illnesses.
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Encéfalo/efectos de los fármacos , Trastornos Mentales/tratamiento farmacológico , Modelos Neurológicos , Proteínas del Tejido Nervioso/metabolismo , Neuronas/efectos de los fármacos , Inhibidores de Fosfodiesterasa/uso terapéutico , Hidrolasas Diéster Fosfóricas/metabolismo , Animales , Ansiolíticos/efectos adversos , Ansiolíticos/farmacología , Ansiolíticos/uso terapéutico , Antidepresivos/efectos adversos , Antidepresivos/farmacología , Antidepresivos/uso terapéutico , Antipsicóticos/efectos adversos , Antipsicóticos/farmacología , Antipsicóticos/uso terapéutico , Ansiedad/tratamiento farmacológico , Ansiedad/enzimología , Ansiedad/metabolismo , Benzodiazepinas/efectos adversos , Benzodiazepinas/farmacología , Benzodiazepinas/uso terapéutico , Encéfalo/enzimología , Encéfalo/metabolismo , Trastornos del Conocimiento/tratamiento farmacológico , Trastornos del Conocimiento/enzimología , Trastornos del Conocimiento/metabolismo , Depresión/tratamiento farmacológico , Depresión/enzimología , Depresión/metabolismo , Humanos , Isoenzimas/antagonistas & inhibidores , Isoenzimas/metabolismo , Trastornos Mentales/enzimología , Trastornos Mentales/metabolismo , Terapia Molecular Dirigida/efectos adversos , Proteínas del Tejido Nervioso/antagonistas & inhibidores , Neuronas/enzimología , Neuronas/metabolismo , Nootrópicos/efectos adversos , Nootrópicos/farmacología , Nootrópicos/uso terapéutico , Inhibidores de Fosfodiesterasa/efectos adversos , Inhibidores de Fosfodiesterasa/farmacología , Hidrolasas Diéster Fosfóricas/química , Esquizofrenia/tratamiento farmacológico , Esquizofrenia/enzimología , Esquizofrenia/metabolismoRESUMEN
Cannabis in its various forms has been known since time immemorial, the use of which has been rising steadily in India. 'Bad trips' have been documented after cannabis use, manifestations ranging from vague anxiety and fear to profoundly disturbing states of terror and psychosis. Cannabis is known to affect various neurotransmitters, but 'bad trip' due to its anticholinergic effect has never been described in literature to the best of author's knowledge. Hereby, the author describes a case of a young adult male experiencing profound anticholinergic effects after being exposed for the first time in his life to bhang, a local oral preparation of cannabis.