Psychotic syndromes

Psychiatric Scale (IMPS) is used to measure psychotic syndromes in hospitalized adults capable of being interviewed. The 89 items are rated on the basis of a psychiatric interview. This test has been well validated and requires 10 to 15 minutes following a 35- to 45-minute interview. There are ten scores excitement, hostile belligerence, paranoid projection, grandiose expansiveness, perceptual distortions, anxious intropunitiveness, retardation and apathy, disorientation, motor disturbances, and conceptual disorganization. 

Psychotic syndromes as sequelae of organic brain disorders (e.g. old age... 

According to a formulation of Heinrich (1976, p. 27), psychotic syndromes which are characterized by a lively emotional mobility, wealth of symptoms, active... 

Different drugs produce different psychotic syndromes, with no psychosis directly from opiates... 

SED-9, 8). The psychotic syndrome was indistinguishable from paranoid schizophrenia, with short periods of disorientation, and could occur after a single dose (many had taken the equivalent of some 500 mg of amfetamine or metamfetamine orally) with or without simultaneous alcohol, and was most pronounced in addicts (SED-9, 9). Amfetamine psychosis was also seen in 14 people in Australia (1) the predominant hallucinations were visual, which is unusual for schizophrenia (SED-8,11). Similarly, in contrast to schizophrenia, vision was the primary sensory mode in thinking disorders and body schema distortions in 25 amfetamine addicts (63). 

As 70% of baclofen is excreted unchanged in the urine (29), accumulation and overdosage of baclofen can occur in patients with end-stage renal disease. Confusion, drowsiness, and coma after standard doses have been reported (30). In addition, abdominal pain was a common adverse effect of baclofen in patients with severe renal insufficiency (31). Toxic reactions characterized by a psychotic syndrome and myoclonus have also been reported (32). Patients with severely impaired renal function typically present with altered consciousness after very small doses of baclofen (31). Symptoms of overdose may resolve after hemodialysis (30,31). 

A neurobioiogicai basis for schizophrenia and reiated psychotic syndromes remains eiusive. Compeiiing evidence iinking genetic factors to the etioiogy of schizophrenia is not apparent despite enormous progress in ... 

Antipsychotic medications are indicated in the treatment of acute and chronic psychotic disorders. These include schizophrenia, schizoaffective disorder, and manic states occurring as part of a bipolar disorder or schizoaffective disorder. The co-adminstration of antipsychotic medication with antidepressants has also been shown to increase the remission rate of severe depressive episodes that are accompanied by psychotic symptoms. Antipsychotic medications are frequently used in the management of agitation associated with delirium, dementia, and toxic effects of both prescribed medications (e.g. L-dopa used in Parkinson s disease) and illicit dtugs (e.g. cocaine, amphetamines, andPCP). They are also indicated in the management of tics that result from Gilles de la Tourette s syndrome, and widely used to control the motor and behavioural manifestations of Huntington s disease. 

Other sedative-hypnotic medications, such as barbiturates, may play a useful role in severe withdrawal from this group of drugs. For example, in a case series of GBL withdrawal, use of intravenous pentobarbital in the range of 1-2 mg/kg/hour lowered the total requirement for intravenous lorazepam (Sivilotti et al. 2001). Antipsychotic medications are often used to reduce psychotic agitation. However, because antipsychotic medications lower the seizure threshold and may contribute to loss of central control of temperature leading to hyperthermia or neuroleptic malignant syndrome (NMS), they are not indicated as first-line medications for GHB withdrawal delirium (Dyer and Roth 2001 McDaniel and Miotto 2001 Sharma et al. 2001). If anti-... 

Haverkos HW, Pinsky PF, Drotman DP, etal Disease manifestation among homosexual men with acquired immunodeficiency syndrome a possible role of nitrites in Kaposi s sarcoma. Sex Transm Dis 12 203-208, 1985 Haverkos HW, Kopstein AN, Wilson H, et al Nitrite inhalants history, epidemiology, and possible links to AIDS. Environ Health Perspect 102 858-861, 1994 Hernandez-Avila CA, Ortega-Soto HA, Jasso A, et al Treatment of inhalant-induced psychotic disorder with carbamazepine versus haloperidol. Psychiatr Serv49 812— 815, 1998... 

Zyprexa (Olanzapine) Bipolar disorders Gilles de la Tourette s syndrome Psychotic disorders 1.9 0.6 1996 - UK and US Once daily... 

The answer is c. (Hardman, pp 574—575.) Phencyclidine is a hallucinogenic compound with no opioid activity Its mechanism of action is amphetamine-like. A withdrawal syndrome has not been described for this drug in human subjects. In overdose, the treatment of choice for the psychotic activity is the antipsychotic drug haloperidol. 

The answer is b. (Katzung, pp 504-505.) Amoxapine is a heterocyclic antidepressant that has effects on norepinephrine and serotonin uptake. It is useful in psychotic patients who are depressed. The dopaminergic antagonism caused by amoxapine may lead to the amenorrhea-galactorrhea syndrome. 

Chronic cocaine use can cause a syndrome of insomnia, hallucinations, delusions, and apathy. This syndrome develops around the time when the euphoria turns to a paranoid psychosis, which resembles paranoid schizophrenia. Further, after cessation of cocaine use, the hallucinations may stop, but the delusions can persist. Still, the incidence of a persistent cocaine-induced psychosis appears to be rare. One study found only 4 out of 298 chronic cocaine users receiving a diagnosis of psychotic disorder (Rounsaville et al. 1991). This incidence is approximately the... 

Possible adverse reactions include headache anorexia nausea vomiting diarrhea palpitations tachycardia angina pectoris toxic reactions (particularly the LE cell syndrome) lacrimation conjunctivitis dizziness tremors psychotic reactions rash urticaria pruritus fever chills arthralgia eosinophilia constipation paralytic ileus lymphadenopathy splenomegaly nasal congestion flushing edema muscle cramps hypotension paradoxical pressor response dyspnea urination difficulty ... 

CNS - Asthenia, confusion, depression, dizziness, drowsiness, headache, nystagmus, peripheral neuropathy (see Warnings), psychotic reactions, vertigo. Dermatologic Erythema multiforme (including Stevens-Johnson syndrome), exfoliative dermatitis (rare) transient alopecia. 

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