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Öğe Relation between seizure duration, apllied electrical dose and response speed to electroconvulsive therapy for patients with depression: a retrospective study(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2009) Essizoglu, Altan; Yasan, Aziz; Bulbul, Israfil; Akkoc, Hasan; Yildirim, Ejder Akguen; Ozkan, MustafaObjective: The aim of this study was to determine the relationship between speed of clinical response and both applied dose to produce seizure and seizure duration in inpatients with depression who underwent electroconvulsive therapy (ECT) in Dicle University Faculty of Medicine Psychiatry Service between 1st June 2006 and 1st June 2008. Methods: The sociodemodemographic and diagnostic features of 48 inpatients who underwent ECT in our clinic between 1st June 2006 and 1st June 2008 were examined retrospectively. In order to establish correlations between applied dose and seizure duration on the one hand and speed of clinical response during ECT treatment on the other, data of 21 inpatients with depression whose cure was completed in spite of adequate clinical response were analyzed using chi-square and Mann Whitney U tests. Results: In our study, 87 (16.3%) of the 533 inpatients were diagnosed with depression, 48 (9.0%) of all inpatients received ECT, 32 (66.7%) of ECT recipients were diagnosed with depression, 21 (65.6%) of those 32 recipients had adequate clinical response and completed the cure. 57.1% of the patients with depression who completed the cure received ECT with the indication of suicide attempt/suicidal ideation. Among patients who had adequate clinical response; our analyses indicated that patients received six and less ECT treatments needed lower dose and had longer seizure duration than patients received seven and more ECT treatment. Conclusion: The results of our study show that beginning from the first ECT treatment the droopiness of the applied dose to produce seizure and the length of seizure duration may predict that patients with depression will have more rapid clinical response during ECT treatment. However, further research which includes more patients is needed about this issue. (Anatolian Journal of Psychiatry 2009; 10: 286-292)Öğe Valproate Induced Hypoactive Delirium in a Bipolar Disorder Patient with Psychotic Features(Turkiye Sinir Ve Ruh Sagligi Dernegi, 2010) Ozen, Sakir; Bulbul, Israfil; Soyucok, EtemDelirium may present with hyperactive, hypoactive or mixed clinical pictures. The signs of hypoactive delirium Ore lethargy, confusion, apathy, hypersomnia, muttering, difficulty in maintaining attention, and difficulty in understanding and performing commands. Valproate is commonly used for the treatment of epilepsy and bipolar disorders. It is also used for the management of alcohol withdrawal delirium and agitative-aggressive deliriums. However few reports are available about the valproate-induced delirium. In this report, we present a 46 years-old woman with bipolar disorder for 14 years. During her lost two hospital admissions, she had been diagnosed with manic episode with psychotic features and she had received valproate. She experienced three hypoactive delirium episodes lasting 2-3 days throughout the treatment period of first week. The patient predominantly had the following signs; vomiting, hypersalivation, confusion, drowsiness, dysphasia, and hypoactivity. At the first day of delirium episode, serum valproate level was found to be within the therapeutic range (98.4, 117.1, and 65.6 mu g/ml, respectively). In addition, she had normal results of cranial MRI, complete blood count, urine analysis, electrocardiogram, ALT, AST albumin, bilirubin, BUN, creatinine and electrolytes. The serum ammonia level of the patient could not been measured due to limitations of laboratory facilities. The patient's consciousness improved dramatically 2-3 days after cessation of valproate. In conclusion, valproate can induce delirium at therapeutic blood levels in some patients via various mechanisms and this side effect has to be considered during valproate use.Öğe Venlafaxine Addiction without a History of Alcohol and Substance Abuse: A Case Report(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2012) Essizoglu, Altan; Yasan, Aziz; Bulbul, Israfil; Karabulut, Evindar; Gurgen, FarukVenlafaxine addiction without a history of alcohol and substance abuse: a case report In this paper, the aim was to present a patient who had no history of drug or alcohol abuse but was prescribed venlafaxine because of her complaints of headache and increased its dosage by herself on the pretext of a decrease in efficiency. A 35 year-old female patient complaining of headache was prescribed 75 mg/day venlafaxine by a psychiatrist, and the dosage was increased to 225 mg/day by the same doctor, and then the drug dosage was increased to 2100 mg/day by the patient herself. The patient was hospitalized and venlafaxine dosage was gradually decreased and stopped in 10 weeks. This case shows that antidepressant dependence may develop in patients without a history of drug or alcohol abuse.Öğe Venlafaxine dependency: A case report(Kure Iletisim Grubu A S, 2009) Essizoglu, Altan; Yasan, Aziz; Bulbul, Israfil; Karabulut, Evindar; Gurgen, FarukIn this case report, the aim was to present a patient who is complaining of headache and started to venlafaxine and increased the dosage of this drug with a reason of decreasing its efficiency. A 35 year-old woman patient who applied to the doctor complaining of headache is started to 75 mg/day venlafaxine by psychiatrist, the dosage was increased to 225 mg/day by the same doctor and then the drug dosage was increased to 2100 mg/day by client self-decision. The venlafaxine dosage of patient, who was investigated by hospitalization with the diagnosis of venlafaxine addiction along 10 weeks, was gradually decreased and stopped. However, this detoxification period was hardly carried out due to limited mental capacity of the patient. This case shows that the antidepressant addiction is able to develop in patients who have not drug and alcohol usage history.
