In this report we describe a case of a nonatopic patient who developed an anaphylactoid reaction immediately after receiving intravenous hydrocortisone. The patient recovered after reanimation techniques and intravenous administration of atropine, epinephrine and plasma expanders. Although allergic reactions to corticosteroids appear to be rare there are a few case reports in the literature. This case is presented to draw the attention of clinicians to the occasional hazard of intravenous corticosteroid preparations, specially hydrocortisone.

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IntroductionAripiprazole is the firstborn of the new dynasty of antipsychotic called third generation or neuromodulator of dopamine-serotonin system. It has proven to be an effective and well-tolerated antipsychotic. Dual Pathology represents the presence of comorbidity between mental illness and substance use disorders. It is an under-diagnosed problem and it is increasing frequency.ObjectivesThe aim of this study was to determine and describe the clinical profile of the patients admitted to the Dual Pathology Unit (UPD) at The Montalvos Hospital (Part of Salamanca University Teaching Hospital, Spain) treated with oral Aripiprazole.MethodsDescriptive, observational, retrospective study of a sample of patients admitted to the UPD to which oral aripiprazole was prescribed during hospitalization. A number of sociodemographic, clinical, and treatment-related variables are described.ResultsFrom a sample of 25 patients and according to DSM-5 criteria (APA, 2013) main diagnoses were: 14 cases of substance-induced psychotic disorder, 3 cases of schizophrenia; 3 cases of schizoaffective disorder; 2 cases of bipolar disorder; 1 case of schizophreniform disorder; 1 case of borderline personality disorder; 1 case of personality syndrome. The most used drugs before the admittance were cocaine, cannabis and opioids. The average dose of aripiprazole was 9 mg and no side effects or drug interactions were reported.ConclusionsApart from its well known efficacy in treament of psychosis, oral aripiprazole may be a first line treatment for Dual diagnosis patients, specially those with problems of non-compliance, due to high level prolactine side effects.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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