Clinical Neuropharmacology最新文献

{"title":"Postictal Psychosis: A Case Report.","authors":"Lia Marie Dopp, Jaekeun Jung, Olivia Lee Markert, Danielle La'Nea Frazier, Nathalie Louis, Taseya D Coleman, Chris Fungwe","doi":"10.1097/WNF.0000000000000644","DOIUrl":"10.1097/WNF.0000000000000644","url":null,"abstract":"<p><strong>Objectives: </strong>Postictal psychosis (PIP) is one of the most common psychoses for patients with epilepsy and is defined as psychotic symptoms presenting at least 1 week after a cluster of seizures. This case report illustrates an important example of a clinical presentation of postictal psychosis.</p><p><strong>Methods: </strong>This case report identifies a 29-year-old male with a medical history of asthma and epilepsy who presented with multiple seizures and delirium. He has had multiple hospital admissions and ED visits over the past 1 to 2 years for recurrent seizure-like activity suggestive of PNES. On previous admissions for seizure-like activity, he has been intubated due to uncooperativeness. On this admission, he presented to the ED after multiple at-home seizures. In the ED, he became increasingly delirious with no return to baseline mental status between seizures. He was then intubated with bilateral wrist restraints for nonsensical speech and agitation.</p><p><strong>Results: </strong>On day 4 in the ICU, he returned to baseline mental status. The patient was cooperative with medical treatment, alert, aware and attentive, and no longer agitated. The patient was able to remember the previous episode of seizure that led him to the ED. He was discharged on lacosamide 200 mg twice daily.</p><p><strong>Conclusions: </strong>It is important to consider postictal psychosis as a diagnosis in a patient with epilepsy and changes in affect, mood, or the presence of delusions with no clear lucid interval to ensure timely and effective treatment and limit potential future complications.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"135-137"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case of Acute Encephalopathy Associated With Montelukast.","authors":"Rebecca Fetter, James Wyant","doi":"10.1097/WNF.0000000000000652","DOIUrl":"10.1097/WNF.0000000000000652","url":null,"abstract":"<p><strong>Introduction: </strong>Montelukast has been associated with neuropsychiatric adverse events including mood disorders, suicidality, and anxiety disorders. Studies have shown a possible association between montelukast and delirium; however, most of this research has been focused on children and adolescents.</p><p><strong>Case report: </strong>A 59-year-old female was admitted for management of spinal osteomyelitis, psoas abscess, epidural abscess, and bacteremia. On hospital day 19, she had new onset of encephalopathy, and workup revealed no clear etiology. On hospital day 41, her home dose of montelukast was stopped, and her mentation improved over the next several days. This improvement in cognition was sustained even though other medical factors continued to fluctuate.</p><p><strong>Discussion: </strong>There were many factors that may have contributed to this patient's encephalopathy, but the temporal relationship between cessation of montelukast and improvement in her mentation suggests an association between this medication and her symptoms.</p><p><strong>Conclusion: </strong>We present a hospitalized patient with acute encephalopathy, which resolved after discontinuing montelukast.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"141-144"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Study of Drug Therapy Combined With Scraping in Patients With Primary Parkinson Disease.","authors":"Maohua Ye, Yuanbo Wang, Qiping He, Ziye Song, Kaiju Xiong","doi":"10.1097/WNF.0000000000000648","DOIUrl":"10.1097/WNF.0000000000000648","url":null,"abstract":"<p><strong>Objectives: </strong>Scraping is a nondrug treatment method of traditional Chinese medicine, which has potential advantages for treating nervous system disorders.</p><p><strong>Methods: </strong>To confirm the clinical effect of drug therapy combined with scraping on primary PD, 120 patients with primary PD from March 2020 to March 2022 were chosen as the research objects. The control group (n=60) was treated with simple Traditional Western Pharmacological Treatment. In the combined treatment group (n=60), scraping therapy was added based on drug therapy. The MDS-UPDRS Ⅲ score, nonmotor symptom scale (NMSS) score, IL-6 and IL-1β levels, and clinical efficacy were compared between the 2 groups to determine the advantages of combined treatment. After 3 courses of treatment, the MDS-UPDRS Ⅲ scores, NMSS scores, and the expression of IL-1β and IL-6 were lower than those before treatment ( P <0.05).</p><p><strong>Results: </strong>This result was also confirmed by analyzing the results at 1 month of follow-up. At the same time, the scores of MDS-UPDRS Ⅲ and NMSS and the levels of IL-1β and IL-6 in the combined treatment patients were lower than those in the control group ( P <0.05).</p><p><strong>Conclusions: </strong>The combined treatment group's clinical effect was better after treatment than the control group. These findings represent preliminary evidence that scraping in combination with medication can be beneficial for the treatment of primary PD in the early to middle stages. Although it's promising to show overall improvements in motor dysfunction and nonmotor symptoms, further investigation with larger studies is needed to evaluate these effects further.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"163-170"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haloperidol Versus Atypical Antipsychotics for Delirium in Hospitalized and ICU Patients: A Systematic Review and Meta-analysis.","authors":"Murilo Marmori Cruccioli, Pedro Henrique Teixeira Carneiro, Jorge Ferreira Jasmineiro Pitanga, Camila Carneiro Ferreira, Regina Carneiro Leão, Milena Lima Loures, Caio Rezende Lima, Pedro Fraiman, Filipe P Sarmento","doi":"10.1097/WNF.0000000000000650","DOIUrl":"10.1097/WNF.0000000000000650","url":null,"abstract":"<p><strong>Background: </strong>While there is still debate over the benefit of antipsychotics in delirium management, surveys indicate their frequent use in clinical practice. Previous systematic reviews and meta-analyses have focused on assessing the effectiveness of antipsychotics versus placebo in delirium management. However, despite increasing access to atypical antipsychotics in hospital settings, robust analyses of studies comparing the effectiveness of haloperidol and atypical antipsychotics are lacking.</p><p><strong>Objectives: </strong>To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the effectiveness and safety of haloperidol versus atypical antipsychotics in the management of delirium patients.</p><p><strong>Methods: </strong>We conducted a systematic search of Medline, Scopus, and Cochrane for RCTs comparing atypical antipsychotics with haloperidol in delirium patients. Odds ratio (OR) was used to analyze dichotomous variables. Continuous outcomes were compared using mean difference (MD) and standardized mean difference (SMD). The random effects model was applied to all endpoints.</p><p><strong>Results: </strong>Eleven RCTs (n=1450 patients) met the eligibility criteria. Delirium severity (SMD, -0.03; [95% CI, -0.20 to 0.15]; P = 0.78) and overall mortality (OR, 1.26; [95% CI, 0.88-1.80]; P = 0.20) did not differ significantly between groups. However, patients treated with haloperidol had significantly higher odds of experiencing extrapyramidal symptoms compared with those treated with atypical antipsychotics (OR, 2.72; [95% CI, 1.26-5.87]; P = 0.01).</p><p><strong>Conclusions: </strong>While there were no significant differences in the effectiveness between treatments, patients treated with haloperidol had nearly a 3-fold increase in the incidence of extrapyramidal symptoms, indicating a potential advantage of atypical antipsychotics in minimizing adverse effects.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"145-150"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"Cannabis (Medical Marijuana) Treatment for Motor and Non-Motor Symptoms of Parkinson Disease\".","authors":"Muhammad Mursaleen, Muhammad Umer Suleman, Umer Khalil, Muhammad Bilal, Abdul Saboor, Shahbaz Azam Khan","doi":"10.1097/WNF.0000000000000646","DOIUrl":"10.1097/WNF.0000000000000646","url":null,"abstract":"","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"179"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viceroys in the Garden With the Monarch Butterflies: Medical Mimics of Catatonia.","authors":"Alexandre Yacques, Alexander Culver, Alexander LaFever, Brendan T Carroll","doi":"10.1097/WNF.0000000000000647","DOIUrl":"10.1097/WNF.0000000000000647","url":null,"abstract":"<p><strong>Objectives: </strong>Catatonia is a neuropsychiatric syndrome with diverse etiologies, often presenting significant diagnostic and research challenges due to an extremely heterogenic symptomology and pathology. The differential for catatonia is further complicated by distinct, non-catatonic medical mimics of catatonia that present similarly. We propose a new delineation of medical mimics of catatonia and an approach to differential diagnosis that will better account for the complexities of catatonia and its mimics, ultimately leading to more clinically relevant outcomes.</p><p><strong>Methods: </strong>We obtained all case reports and case series from a Regional Medical Center in a 6-month period. All patients were diagnosed initially with F06.1 Catatonia. All patients had assessments with Bush-Francis Catatonia Rating Scale and the KANNER catatonia rating scale. Data included diagnoses, comorbidities, treatment approaches, and outcomes.</p><p><strong>Results: </strong>We found 12 cases that met the inclusion criteria. We identified the primary diagnosis of catatonia and comorbid diagnoses. There were 3 case studies, 4 case series (N=2), and 1 presentation. Six of the 12 had co-existing medical conditions that are classified as medical mimics of catatonia. The treatment approach, diagnostic workup, and outcomes were available for all cases.</p><p><strong>Conclusions: </strong>Our finding of 50% medical mimics in our study of catatonia is analogous to encountering Viceroys in the Butterfly Garden with the Monarchs. The medical mimics, the Viceroys, are often excluded from the study of catatonia, the Monarchs, and reduce the study population. Nonetheless, the Viceroys encountered on psychiatric units, outpatient clinics, emergency rooms and consultation-liaison services still warrant assessment and treatment.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"158-162"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bálint Syndrome From Posterior Cerebral Artery Infarctions Case Report.","authors":"Luke Leidy, Anna Dickinson","doi":"10.1097/WNF.0000000000000645","DOIUrl":"10.1097/WNF.0000000000000645","url":null,"abstract":"<p><strong>Objectives: </strong>Bálint syndrome is a debilitating, rare neurological condition characterized by a triad of visuospatial distortions: simultanagnosia, optic ataxia, and oculomotor apraxia. We highlight the pathways involved with infarction of the posterior cerebral artery (PCA), which may be an important underlying factor leading to the development of clinical presentations found in Bálint syndrome.</p><p><strong>Methods: </strong>We present a case of a middle-aged patient who presents with Bálint syndrome following a PCA infarction.</p><p><strong>Results: </strong>A 49-year-old male bus driver with a recent PCA infarction presented with all 3 components of Bálint syndrome. His clinical course was notable for simultanagnosia, optic ataxia, oculomotor apraxia, and a right greater than left lower visual field deficit. Neuroimaging revealed infarctions in the P1 and bilateral P2 segments of the posterior cerebral arteries, affecting the parieto-occipital regions known to underlie visuospatial processing. Laboratory workup helped exclude opportunistic and systemic causes, supporting a stroke-related etiology.</p><p><strong>Conclusions: </strong>Posterior cerebral artery infarctions may be responsible for the clinical presentation of Bálint syndrome; however, further investigation into vascular and neuronal networks underlying the clinical signs and symptoms of Bálint syndrome is needed.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"138-140"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Efficacy of Cognitive Enhancers in Electroconvulsive Therapy: A Randomized Controlled Trial of Rivastigmine and Memantine.","authors":"Parniyan Molaee, Nafiseh Jahangiri Zarkani, Maria Tavakoli-Ardakani, Seyedeh Morvarid Neishabouri, Fateme Kazemi Khaledi, Alireza Shamsi","doi":"10.1097/WNF.0000000000000651","DOIUrl":"10.1097/WNF.0000000000000651","url":null,"abstract":"<p><strong>Objective: </strong>Electroconvulsive therapy (ECT) is an effective treatment for severe psychiatric disorders but is frequently associated with cognitive side effects. This study aimed to evaluate the effects of rivastigmine and memantine on cognitive function following ECT.</p><p><strong>Methods: </strong>In this multicenter, randomized, double-blind, placebo-controlled trial (registration number: IRCT20190119042417N2), 45 patients receiving ECT were allocated equally to rivastigmine, memantine, or placebo groups. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) at baseline, week 2, and week 6. Individual slopes of MoCA change over time were computed using simple linear regression, and group-level comparisons were conducted using t tests and adjusted linear models.</p><p><strong>Results: </strong>Patients receiving rivastigmine showed a significantly greater improvement in weekly MoCA scores compared with placebo (mean slope=+0.42 vs. -0.11 points/week; P =0.006; Cohen d=1.40). Memantine was associated with a positive slope (+0.24 points/week), but the effect was not statistically significant after adjusting for baseline cognitive status and covariates.</p><p><strong>Conclusions: </strong>Rivastigmine may enhance cognitive recovery following ECT. Memantine showed a positive but nonsignificant effect. These findings support the potential utility of cholinergic modulation in mitigating ECT-related cognitive deficits. Future research should explore combination therapies and utilize more sensitive, domain-specific cognitive assessments.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"171-178"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Oxcarbazepine as Monotherapy for Prevention of Epileptic Seizures in Patients With Supratentorial Brain Tumors: A Prospective Multicentric Study.","authors":"Ibrahim Omerhodžić, Bekir Rovčanin, Almir Džurlić, Mirsad Hodžić, Rasim Skomorac, Hakija Bečulić, Salko Zahirović, Fahrudin Alić, Enra Suljić, Aziz Šukalo, Meliha Mehić, Amna Tanović Avdić, Una Glamočlija","doi":"10.1097/WNF.0000000000000639","DOIUrl":"10.1097/WNF.0000000000000639","url":null,"abstract":"<p><strong>Objectives: </strong>Brain tumor-related epilepsy management poses significant challenge in clinical practice. Healthcare providers must tailor treatment based on each patient's unique circumstances. Different antiepileptic drugs can be used, including oxcarbazepine. Several studies show this drug's efficacy and safety in brain tumor-related epilepsy.</p><p><strong>Methods: </strong>Observational, prospective study, monitoring the efficacy and safety of the drug oxcarbazepine in the prevention of epileptic seizures, included adult patients of both sexes with a supratentorial tumor and a risk of epileptic seizures after neurosurgery.</p><p><strong>Results: </strong>The study included 153 hospitalized patients. The percentages of amplified waves, sharp waves, and spike waves decreased in the second and third compared with the first visit. Significantly lower percentages of sharp waves ( P = 0.028) on the second compared with the first measurement and spike waves ( P = 0.002) on the third compared with the first measurement were determined. Deterioration from normal to low hemoglobin concentration was observed in 40 (26%) patients at the second visit and 17 (12%) at the third visit, compared with the first visit. However, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration values did not change significantly during the 6 months of follow-up. A transient drop in the number of thrombocytes was observed on the second visit. Adverse reactions to the drug were mild. Therapeutic adherence was low, as measured by the Morisky Medication Adherence Scale (MMAS-4).</p><p><strong>Conclusions: </strong>The drug oxcarbazepine has shown good efficacy and safety in the prevention of epileptic attacks after neurosurgery in patients with supratentorial tumors. Additional education of patients on the importance of taking regular therapy is crucial.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"122-126"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic Effects of Continuous Intravenous Midazolam in Refractory Status Epilepticus.","authors":"Meaghan Rettele, Grace Conroy, Adam Barron, Danielle Marut","doi":"10.1097/WNF.0000000000000635","DOIUrl":"https://doi.org/10.1097/WNF.0000000000000635","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective of this study was to determine the proportion of patients who developed hemodynamic compromise (HDC) while receiving continuous intravenous midazolam (cIV-MDZ) for refractory status epilepticus (RSE). Secondary objectives included comparing cIV-MDZ and ketamine exposures, baseline and treatment characteristics, and clinical outcomes in patients that developed HDC to those that did not.</p><p><strong>Methods: </strong>This retrospective nested case-control study included patients receiving cIV-MDZ for RSE at a tertiary academic medical center. Descriptive statistics and univariate analyses were used to compare exposures and outcomes in patients who developed HDC, defined as the initiation or escalation of vasopressors, to those who did not.</p><p><strong>Results: </strong>Of 112 patients included, 76 (67.9%) developed HDC and 36 (32.1%) did not. Patients who developed HDC received higher mean maximum doses of cIV-MDZ (0.88 mg/kg/h [standard deviation (SD) ± 0.58] vs. 0.55 mg/kg/h [SD ± 0.45], P < 0.001) and longer median durations of cIV-MDZ (2.5 days [interquartile range (IQR), 1.6-3.6] vs. 1.5 days [IQR, 0.7-2.1], P < 0.001). Patients who developed HDC also had longer intensive care unit (ICU) length of stay (13.7 days [IQR, 7.7-19.6] vs. 8.9 days [IQR, 4.7-16.6], P = 0.05) and hospital admissions (21.2 days [IQR, 14.8-30.5] vs. 13.3 days [IQR, 8-23.5], P < 0.01). Seizure recurrence (HDC vs. no HDC, 34.2% vs. 25%; P = 0.33) and mortality (HDC vs. no HDC, 23.7% vs. 19.4%; P = 0.62) were similar between groups.</p><p><strong>Conclusions: </strong>The majority of patients receiving cIV-MDZ for RSE developed HDC. These results may help guide further studies seeking optimal cIV-MDZ doses for efficacy while minimizing adverse effects.</p>","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":"48 4","pages":"112-117"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}