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    Chronic Manganese Intoxication Due to Methcathinone (Ephedron) Abuse: A Case Report
    (Turkiye Sinir Ve Ruh Sagligi Dernegi, 2009) Yildirim, Ejder Akguen; Essizoglu, Altan; Koksal, Ayhan; Dogu, Basri; Baybas, Sevim; Gokalp, Peykan
    Chronic Manganese Intoxication Due to Methcathinone (Ephedron) Abuse: A Case Report Known as an occupational disease, chronic manganese intoxication is recently being observed among abusers of psychoactive substances. Methcathinone hydrochloride is obtained by combining ephedrine/pseudoephedrine and potassium permanganate. Various neuropsychiatric symptoms have been reported among Efedron users. Our patient is a 29 year old male, who was referred to our hospital from a state general hospital with a diagnosis of Conversion Disorder. He was hospitalized and preliminary diagnoses of Facititous Disorder, Conversion Disorder, Psychiatric Disorder due to a General Medical Condition and Antisocial Personality Disorder. He was abstinent from any substance for five years upon referral to our hospital and had a history of methcathinone abuse for 4.5 years. The backache dated back to 6 years ago and a disturbance of gait was added to the clinical picture. A speech disturbance, falling while walking downhill and walking on tiptoe were added in the last 2-3 years. In the neurological examination, extrapyramidal system findings, gait disturbance and the report on use of manganese compunds were found. The setting was changed from psychiatric ward to neuorology ward and evaluated by consultant neurologist. The case was diagnosed as 'Manganese Intoxication'. The aim of this report is to demonstrate and emphasize the importance of questioning the presence of manganese compounds in case of history of substance abuse. Other areas of interest are the shortage of data on the intravenous use of manganese and the cases reported in the literature coming from the former Soviet Union.
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    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, Mustafa
    Objective: 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)