Cough mixture misuse in Hong Kong--an emerging psychiatric problem?

Addiction. 1996 Sep;91(9):1375-8.

Lam LC, Lee DT, Shum PP, Chen CN.

Department of Psychiatry, Chinese University of Hong Kong, Shatin, Hong Kong.

Abstract

Cough mixture misuse has become a focus of concern in Hong Kong since the late 1980s. Psychiatric admissions related to cough mixture misuse have been reported with increasing frequency during the past 5 years. A retrospective chart review of psychiatric admissions related to cough mixture misuse for a 54-month period was conducted in two psychiatric units in Hong Kong. Twenty-seven subjects were identified. The main psychiatric presentations included acute organic brain syndrome, schizophreniform psychosis and affective episode. They appeared to be associated with the pharmacological activities of opiates, antihistamines and sympathomimetics, the main ingredients of most cough mixtures.

PMID: 8854373 [PubMed - indexed for MEDLINE

Cough mixture induced psychosis.

Br J Clin Pract. 1996 Oct-Nov;50(7):400-1.


Lee DT, Lam LC, Chan KP, Leung HC.
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong.

Abstract

Cough mixture is the third most commonly abused substance in Hong Kong. Over the last two years, ten cases of cough mixture-induced psychosis were admitted to a University hospital. All of them were clinically indistinguishable from paranoid schizophrenia, but the psychotic symptoms often resolved promptly with the cessation of cough mixture use or a small dose of haloperidol. A representative case is described. The possible underlying aetiological mechanism and the treatment principle are discussed.


PMID: 9015916 [PubMed - indexed for MEDLINE]

Mania following head trauma.

Am J Psychiatry. 1987 Jan;144(1):93-6.

Shukla S, Cook BL, Mukherjee S, Godwin C, Miller MG.

Abstract

The authors present psychiatric and neurologic data on 20 patients who developed mania after closed head trauma. An association was seen between severity of head trauma (based on length of posttraumatic amnesia), posttraumatic seizure disorder, and type of bipolar disorder. The manic episodes were characterized by irritable mood rather than euphoria and by assaultiveness. Psychosis occurred in only 15% of the sample, and 70% had no depressive episodes. Bipolar disorders were absent among 85 first-degree relatives. The authors suggest that posttraumatic seizures may be a predisposing factor in posttraumatic mania.



PMID: 3799847 [PubMed - indexed for MEDLINE]

Manic syndrome following head injury: another form of secondary mania.

J Clin Psychiatry. 1987 Jan;48(1):29-30.

Riess H, Schwartz CE, Klerman GL.

Abstract

Two cases of mania secondary to head injury are reported. Only four well-documented reports of head trauma as a cause of secondary mania were found in an English and foreign literature search, although such a search is made difficult by the paucity of cases meeting modern diagnostic criteria for mania. Previous reviews of the causes of secondary mania have not included head injury, but the two case reports confirm that head injury may be an additional cause. A diagnosis of mania secondary to head trauma should be considered in manic patients with atypical age of onset, absence of previous psychiatric illness, negative family history for bipolar illness, and close temporal proximity of head trauma to subsequent mania.

PMID: 3804982 [PubMed - indexed for MEDLINE]

Organic causes of mania.

Mayo Clin Proc. 1988 Sep;63(9):906-12.

Larson EW, Richelson E.
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905.

Comment in:
Mayo Clin Proc. 1989 Jan;64(1):129-30.

Abstract

Manic syndromes have many neurologic, toxic, and metabolic causes. It is important for clinicians to be able to distinguish these organic disorders from primary idiopathic mania (bipolar disorder). The cardinal symptom of organic mania is an abnormally and persistently elevated or irritable mood. Organic mania usually develops in patients who are older than 35 years of age, whereas bipolar disorder generally has its onset between late adolescence and age 25 years. In patients with the first episode of mania, the clinician should thoroughly elicit information about current symptoms, recent infections, use of drugs, and past or family history of psychiatric disorders. In addition, a complete medical examination, computed tomography of the head, electroencephalography, and screening for drugs and toxins should be done. Treatment of organic mania includes correcting the underlying disorder when possible.



PMID: 3137394 [PubMed - indexed for MEDLINE]

Hyponatremia-induced change in mood mimicking late-onset bipolar disorder.

Gen Hosp Psychiatry. 2011 Jan-Feb;33(1):83.e5-7. Epub 2010 Oct 27.


McKnight RF, Hampson S.
Department of Psychiatry, Warneford Hospital, University of Oxford, Warneford Lane, OX3 7JX Oxford, UK.

Abstract
OBJECTIVE: Hyponatremia and bipolar disorder are rarely considered to have common features. This report describes a case of hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH) presenting as late-onset bipolar disorder and discusses the evidence linking hyponatremia to mood disorders.

METHOD: Case report and review of published literature.

RESULTS: This case provides evidence that mood changes identical to those seen in bipolar disorder may be caused by hyponatremia at a variety of concentrations.

CONCLUSIONS: Further research is required to determine causes of SIADH in psychiatric patients with symptomatic hyponatremia and to elucidate the mechanism by which hyponatremia causes changes in mood. In older patients presenting with new-onset bipolar disorder, a physical etiology must always be excluded.

Copyright © 2011 Elsevier Inc. All rights reserved.

PMID: 21353139 [PubMed - in process]

Herpes simplex type 2 virus encephalitis presenting as psychosis

Kalarickal J. Oommen, M.D.,

Peter C. Johnson, M.D.

C. George Ray, M.D.
Kalarickal J. Oommen, M.D.


Affiliations

Requests for reprints should be addressed to Dr. Peter C. Johnson, Department of Pathology, Arizona Health Sciences Center, Tucson, Arizona 85724.

From the Departments of Neurology, Pathology and Pediatrics, Arizona Health Sciences Center, Tucson, Arizona.


Accepted 20 January 1982.

Abstract


The current literature recognizes two antigenic types of herpes simplex virus, type 1 and 2. Type 1 is the most common cause of sporadic necrotizing encephalitis in the United States, with a mortality rate of 30 to 70 percent, and leaves various neurologic sequelae in the survivors. Herpes simplex virus type 2 has been recognized as an etiologic agent in fatal infections in neonates and a mild meningitis in adults, but its role in encephalitis in adults is less well known. We report a case of herpes simplex virus type 2 encephalitis with an analysis of four additional cases previously documented in the literature. Herpes simplex virus type 2 may cause more infections than is presently recognized, and we suggest that some cases of acute psychosis may, like in our case, represent herpes simplex virus type 2 encephalitis.

Click here for full article.

[Mania following the use of a decongestant].

Tijdschr Psychiatr. 2007;49(2):125-9.

[Article in Dutch]

Stuer K, Claes S.

Psychiatrisch Ziekenhuis Heilig Hart, Ieper, België. katrien.stuer@gmail.com

Abstract

We report on the case of a 56-year-old woman with no psychiatric history who had a manic episode after taking a decongestant containing pseudoephedrine (a secondary or organic mania). The aetiology, differential diagnosis, treatment and risk factors for a manic episode are discussed. In addition, we review published articles on the subject of mania induced by pseudoephedrine.

PMID: 17290343 [PubMed - indexed for MEDLINE]

Organic affective illness associated with lead intoxication.

Am J Psychiatry. 1984 Nov;141(11):1423-6.

Schottenfeld RS, Cullen MR.

Abstract

Psychiatrists treating patients with depression or nonspecific somatic complaints seldom think of lead intoxication as a possible cause. Because occupational exposure to lead is so common, these disturbances may often be associated with lead intoxication. To facilitate earlier clinical recognition and proper treatment among the many individuals at risk, the authors describe four cases of organic affective disturbance associated with lead intoxication, review the neuropsychiatric disturbances that have been reported with chronic exposure to lead, and report the results of their experience evaluating the psychiatric aspects of lead intoxication among individuals exposed in their work.

PMID: 6496787 [PubMed - indexed for MEDLINE]

Psychiatric side effects attributed to phenylpropanolamine.

Pharmacopsychiatry. 1988 Jul;21(4):171-81.

Lake CR, Masson EB, Quirk RS.

Dept. of Psychiatry, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

Abstract

Phenylpropanolamine (PPA) is a sympathomimetic drug similar in structure to amphetamine which, in the United States, is present in over 130 medications, primarily decongestants, cough/cold remedies, and anorectic agents. We have reviewed 37 cases (published in North America and Europe since 1960) that received diagnoses of acute mania, paranoid schizophrenia, and organic psychosis and that were attributed to PPA product ingestion. Of the 27 North American case reports, more reactions followed the ingestion of combination products than preparations containing PPA alone; more occurred after ingestion of over-the-counter products than those obtained by prescription or on-the-street; and more of the cases followed ingestion of recommended doses than overdoses. Groups at particular risk appear to be those with a past or family psychiatric history, children under the age of 6 and post-partum women. Failure to recognize PPA as an etiological agent in the onset of symptoms usually led to a diagnosis of schizophrenia or mania, lengthy hospitalization, and treatment with substantial doses of neuroleptics or lithium. While generally safe at recommended doses, PPA can be hazardous to susceptible individuals and we urge physicians to be alert to the potential for PPA related psychiatric reactions. We have compiled an alphabetized table (Table 1: Prescription and Over-the-Counter Products Containing Phenylpropanolamine) allowing busy clinicians quick access to those drugs containing PPA.

PMID: 3060884 [PubMed - indexed for MEDLINE]

MANIC-DEPRESSIVE PSYCHOSIS AS PREVALENT MANIFESTATION OF MS

Rev Neurol (Paris). 2008 May;164(5):472-6. Epub 2008 Apr 24.
[Manic-depressive psychosis as prevalent manifestation of multiple sclerosis]
[Article in French]
El Moutawakil B, Sibai M, Bourezgui M, Boulaajaj FZ, Rafai MA, Gam I, Slassi I.
Service de neurologie-explorations fonctionnelles, CHU Ibn-Rochd, 9, rue Ahmed-Naciri, quartier Palmier, Casablanca, Maroc. elmoutawakilb@yahoo.fr

INTRODUCTION: Manic-depressive psychosis (MDP) and multiple sclerosis (MS) coexistence is unusual but well-proven.

OBSERVATIONS: We report two cases observed in two women aged 30 and 31, who were followed up for neurological episodes associated with concomitant or deferred manic or depressive fits. Brain magnetic resonance imaging revealed multiple zones of high intensity signals in the white matter. Biological balance was normal. The diagnosis of multiple sclerosis (MS) was established. Given to treat acute episodes, high-dose corticosteroids enabled regression of the psychological fits. Similarly, long-term treatment in one patient enabled significant regression of fits, which became less frequent and less severe.

DISCUSSION/CONCLUSION: The MDP-MS association may be due to local MS-related brain damage or to common genetic susceptibility. The positive effect of corticosteroids against psychological fits is another finding favouring an organic cause of these disorders.

PMID: 18555881 [PubMed - indexed for MEDLINE]

ACUTE PSYCHOTIC MANIA: ANTI-NMDA ENCEPHALOPATHY

Med J Aust. 2009 Sep 7;191(5):284-6.
Acute psychiatric illness in a young woman: an unusual form of encephalitis.

Parratt KL, Allan M, Lewis SJ, Dalmau J, Halmagyi GM, Spies JM.
Department of Neurology, Royal Prince Alfred Hospital, Sydney, NSW. drksharp@bigpond.net.au

A 21-year-old woman was admitted to hospital with a diagnosis of acute psychotic mania, but developed, over approximately 6 weeks, seizures, delirium, catatonia, movement disorder and autonomic dysfunction. She was found to have antibodies to N-methyl-D-aspartate (NMDA) NR1-NR2 receptors in both serum and cerebrospinal fluid, consistent with anti-NMDA-receptor encephalitis, a severe, potentially lethal but treatment-responsive encephalitis often associated with ovarian tumour. With aggressive immunotherapy and bilateral oophorectomy, she recovered over a period of 14 months from her initial presentation. No ovarian tumour was identified.

PMID: 19740054 [PubMed - indexed for MEDLINE]