Psychopharmaca are used in treatment of psychiatric illnesses and disorders, among other therapeutic possibilities. The choice of the psychopharmaca is determined by the specific psychopathology of the patient, within the diagnostic categories, according to the current classification of diseases and disorders. With the advances in pharmaco industry, the range of drugs used in the everyday clinical practice is occurring at a very rapid pace. Antipsychotic medications are used in treatment of mainly psychotic disorders. However, the new generation of antipsychotics, due to their specific receptor affinities, is sometimes used in treatment of affective disorders as well. We are reporting a case of a female patient who was hospitalized several times. Amisulpride was introduced in the treatment and due to a series of unfortunate events and changes that followed (i. e. frequent hospitalizations and changes of therapists, different mental institutions) dose of amisulpride was gradually increased to its antipsychotic doses, which did not help achieve therapeutic benefits, but serious side effects.
Bolesnica u dobi od 59 godina, tijekom života nije bila u psihijatrijskom tretmanu. Povremeno bi uzimala alprazolam tablete (ukupno tri tablete dnevno od 0, 5 mg) zadnjih godinu dana. Na pregledu psihijatra kod kojeg se javila zbog problema sa spavanjem negirala je uzimanje bilo kakvih lijekova, a na upite o uzimanju benzodiazepina navodila je da samo povremeno uzme tabletu alprazolama 0, 5 mg. Buduci da je u psihickom statusu dominirala depresivna simptomatila u terapiju je ukljucen fluvoksamin u dnevnoj dozi od 100 mg, uz alprazolam u dnevnoj dozi od 0, 5 mg i zolpidem u vecernjoj dozi od 5 mg. Treceg dana lijecenja bolesnica se javila u bolnicu zbog izražene napetosti, razdražljivosti, tjeskobe, tremora ruku, pojacanog znojenja i problema sa spavanjem. Ucinjena je obrada koja je iskljucila organski supstrat, a bolesnica je potvrdila uzimanje visokih doza alprazolama prije zapocinjanja psihijatrijskog tretmana. Tijekom bolnickog lijecenja doza alprazolama je postupno snižena i potom je alprazolam iskljucen iz terapije. Pri otpustu iz bolnice bolesnici je preporuceno da u terapiji dalje uzima fluvoksamin u vecernjoj dozi od 100 mg, uz zolpidem u vecernjoj dozi od 10 mg.
Even though memory dysfunction is not considered to be a diagnostic criterion for schizophrenia, results of a neuropsychological research indicate significant damage in mnestic functioning, especially in verbal memory (Saykin et al. 1991). This type of a disorder is recorded in patients with a first episode of schizophrenia, as well as in chronic patients (Saykin et al. 1994). These researches show that this deficit is not influenced by neuroleptics. Paulsen and associates suggest that the deficit of verbal learning in schizophrenia is related to difficulties in encoding retrieving information without significant storage (rapid forgetting) problems (Paulsen at al. 1995). We will present a case of a 36 - year old male who is suffering from a paranoid schizophrenia.
This article reports the case of a patient with partial agenesis of the corpus callosum manifested with corpus callosum syndrome together with signs of brain hemispheres dysfunction: mental impairment, epilepsy and pyramidal signs. The patient's malformation is combined with left-handedness while signs of callosal disconnection are not present. Mild cognitive impairment and late epilepsy onset require a multidisciplinary approach since the patient also displays elements of central nervous system malformations.