Depression mental retardation with

ADHD, attention-deficit hyperactivity disorder EKG, electrocardiogram GI, gastrointestinal MD, major depression MR, mental retardation OCD, obsessive-compulsive disorder PTSD, post-traumatic stress disorder. Trade names are in parentheses. Doses are general guidelines. All doses must be individualized with appropriate monitoring. Weight-corrected doses are less appropriate for obese children. 

According to the Expert Consensus Panel for Mental Retardation Rush and Frances, (2000), the mainstays of the pharmacological treatment of acute mania or bipolar disorder in adults are anticonvulsant medications (divalproex, valproic acid, or carbamazepine) or lithium. Both divalproex or valproic acid and lithium were preferred treatments for classic, euphoric manic episodes. Divalproex or valproic acid was preferred over lithium and carbamazepine for mixed or dysphoric manic episodes and rapid-cycling mania. For depressive episodes associated with bipolar disorder, the addition of an antidepressant (SSRI, bupropion, or venlafaxine) was recommended. According to the Expert Consensus Panel, the presence of MR does not affect the choice of medication for these psychiatric disorders in adults. 

All of the CNS depressants can pass through the placenta. Newborn babies with dependent mothers may be physically dependent themselves and have withdrawal symptoms that include tremors, irritability, hyperactivity, and feeding and breathing problems. There may be birth defects such as fetal alcohol syndrome, which consists of abnormal facial features, a small head, mental retardation, and poor coordination. 

A serious genetic disorder is associated with the salvage pathways, the Lesch-Nyhan syndrome. It is believed that it is caused by a failure to control the de novo purine biosynthetic pathway. In the Lesch-Nyhan syndrome, the enzyme HGPRTase is severely depressed. Because the de novo pathway is controlled largely via feedback effects of purine nucleotides, the pathway is derepressed and excessive quantities of purine nucleotides and their degradation product, uric acid, are accumulated. This results is neurologic effects, self-mutilation, and mental retardation. 

The efficacy and safety of risperidone have been examined in special groups of patients, such as those with psychotic depression (4), autistic disorders (41), bipolar disorder (5), mental retardation (6), and children and adolescents (7). 

Older classifications of psychiatric disorder divided diseases into psychoses and neuroses. The term psychosis is still widely used to describe a severe mental illness with the presence of hallucinations, delusions or extreme abnormalities of behaviour including marked overactivity, retardation and catatonia, usually accompanied by a lack of insight. Psychotic disorders therefore include schizophrenia, severe forms of depression and mania. Psychosis may also be due to illicit substances or organic conditions. Clinical features of schizophrenia may be subdivided into positive symptoms, which include hallucinations, delusions and thought disorder and negative symptoms such as apathy, flattening of affect and poverty of speech. 

Hypothyroidism (thyroid hormone deficiency) may result from autoimmune disease (Hashimoto s disease) or from deficient synthesis of TSH or TRH (thyroid-stimulating hormone-releasing factor). Because adequate ingestion of iodine is a prerequisite for thyroid hormone synthesis, iodine deficiency also causes hypothyroidism. In children, thyroid hormone deficiency (called cretinism) causes depressed growth and mental retardation. Severe hypothyroidism in adults (myxedema) results in symptoms such as edema (abnormal fluid accumulation) and goiter. Hypothyroidism is usually treated with hormone replacement therapy. 

The dibenzapine derivatives are called tricyclic antidepressants and include imipramine (Tofranil), desipramine (Norpramin), amitriptyline (Elavil), nortriptyline (Aventyl), protriptyline (Vivactil), and doxepin (Adapin). Amitriptyline is indicated in depression major depression with melancholia or psychotic symptoms depressive phase of bipolar disorder depression associated with organic disease, alcoholism, schizophrenia, or mental retardation anorexia or bulimia associated with depression (see Figure 20). 

Desipramine is a tricyclic antidepressant, inhibits reuptake of norepinephrine and serotonin in CNS, and is indicated in relief of symptoms of depression. Desipramine (75 to 150 mg p.o./day in divided doses) is indicated in endogenous depression major depression with melancholia or psychotic symptoms depression associated with organic brain disease, alcoholism, schizophrenia, or mental retardation and the depressive phase of manic-depressive disorder. Desipramine is absorbed rapidly from the GI tract, distributed widely in the body, and appears also in breast miUc. It is bound to plasma proteins to the extent of 90%, undergoes extensive first-pass metabolism, and its metabolites are excreted in urine. Desipramine strongly blocks the norepinephrine uptake mechanism and has no effect on the uptake of serotonin. Desipramine has weak alpha -adrenergic and... 

Nalbuphine is less likely to depress respiratory function than meperidine Tolerance to ocular and gastrointestinal effects develops rapidly during chronic use Mental retardation, microcephaly, and underdevelopment of the mid face region in an infant is associated with chronic maternal abuse of (A) Amphetamine Cocaine Ethanol Mescaline Phencyclidine... 

Disability has heen traditionally associated with mental retardation, extreme mental illness, visual or hearing impairment, physical illness, or injury that affects an individual s mohihty, daily functions, and self-sufficiency. However, according to the World Health Organization, depression is the leading cause of disability (as measured by years lost due to disability), and the fourth leading contributor to the global burden of disease. 

Ketamine is an excellent anesthetic, analgesic, and sedative in specialized settings. It can be used in patients who cannot tolerate barbiturates, in settings where cardiovascular depression must be avoided, and in patients with refractory bronchospasm. It is useful in one-lung ventilation, asthmatic patients, or when there is need for an intramuscular route of administration. It is very helpful in specific situations such as the need for anesthesia in uncontrollable, mentally retarded patients. It can be simply mixed with syrup if oral premedication is desired. 

Adverse reactions of corticosteroids are frequent with the long-term immunosuppressive regimens which are often needed and include an increased risk of infections, Cushing-like symptoms, hypertension, hyperglycemia, osteoporosis, growth retardation in children and mental reactions such as dysphoria, psychosis and depression. 

Thyroxine (also known as Levothyroxine or T4) is the ultimate metabolism regulator. Its reactions and products influence carbohydrate metabolism, protein synthesis and breakdown, and cardiovascular, renal, and brain function. Thyroxine is essential to an animal s functions and it is essential for development in the young. Tadpoles won t develop into frogs, for example. Untreated human babies will develop cretinism, a condition marked by severe mental and physical retardation. Adult humans with low thyroxine levels (hypothyroidism) suffer mental slowness, weight gain, depression, and fatigue. ... 

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