tailieunhanh - Báo cáo y học: " Adding 5-hydroxytryptamine receptor type 3 antagonists may reduce drug-induced nausea in poor insight obsessive-compulsive patients taking off-label doses of selective serotonin reuptake inhibitors: a 52-week follow-up case report"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Adding 5-hydroxytryptamine receptor type 3 antagonists may reduce drug-induced nausea in poor insight obsessive-compulsive patients taking off-label doses of selective serotonin reuptake inhibitors: a 52-week follow-up case report. | Fornaro and Martino Annals of General Psychiatry 2010 9 39 http content 9 1 39 ANNALS OF GENERAL PSYCHIATRY CASE REPORT Open Access Adding 5-hydroxytryptamine receptor type 3 antagonists may reduce drug-induced nausea in poor insight obsessive-compulsive patients taking off-label doses of selective serotonin reuptake inhibitors a 52-week follow-up case report Michele Fornaro Matteo Martino Abstract Poor-insight obsessive-compulsive disorder PI-OCD is a severe form of OCD where the typically obsessive features of intrusive egodystonic feelings and thoughts are absent. PI-OCD is difficult to treat often requiring very high doses of serotonergic drugs as well as antipsychotic augmentation. When this occurs unpleasant side effects as nausea are common eventually further reducing compliance to medication and increasing the need for pharmacological alternatives. We present the case of a PI-OCD patient who developed severe nausea after response to off-label doses of the selective serotonin reuptake inhibitor SSRI fluoxetine. Drug choices are discussed providing pharmacodynamic rationales and hypotheses along with reports of rating scale scores administered within a follow-up period of 52 weeks. A slight reduction of fluoxetine dose augmentation with mirtazapine and a switch from amisulpride to olanzapine led to resolution of nausea while preserving the anti-OCD therapeutic effect. Mirtazapine and olanzapine have already been suggested for OCD treatment although a lack of evidence exists about their role in the course of PI-OCD. Both mirtazapine and olanzapine also act as 5-hydroxytryptamine receptor type 3 5-HT3 blockers making them preferred choices especially in cases of drug-induced nausea. Background Poor-insight obsessive-compulsive disorder PI-OCD is an unusual condition where the typically obsessive features of intrusive egodystonic feelings and thoughts are absent and the course and severity of the illness are usually more severe

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