Amisulpride-associated pedal edema

Abstract

Post-stroke depression and cerebral laterality Sir, Stroke is the most common serious disorder in the world accounting for half of all the acute hospitalization cases of diseases [3]. Until recently, little attention has been paid to the neuropsychiatric sequelae of stroke. Current observations demonstrate that neuropsychiatric disorders are frequent after stroke and lesions of specific regions or functional systems of the brain result in behavioral syndromes similar to idiopathic conditions [1]. Views have been expressed that the risk of depression is greater with left and anterior hemispheric strokes as compared to posterior and right hemispheric strokes. However, the subject remains controversial. There are few reports in literature in which the symptoms of depression have been reported with right hemispheric stroke. In a study consisting of 15 patients with stroke, 10 had left sided lesions and depression was seen in seven patients (70%) whereas three (30%) had symptoms resembling generalized anxiety disorder. In rest of the five patients, lesions were found in the right hemisphere and out of these three (60%) had depression and one (20%) had symptoms resembling generalized anxiety disorder whereas one had symptoms resembling obsessive compulsive disorder. In a majority, the onset of symptoms was in the second week followed by those in third and fourth weeks. Hypertension was present in all the patients whereas four also had diabetes mellitus. There was family history of stroke in five patients. Depression occurs in 30-50% of patients after stroke [1]. Robbinson and Price [4] have found depression and vegetative symptoms in 63% of patients with left hemispheric injury and 1.4% in patients with right hemispheric injury. Carson et al. [2] did a meta-analysis of 143 articles and included 48 articles in the study. Only two reports of original data supported the views of association of post-stroke depression with site or laterality. In the present study also, no association of hemispheric laterality with depression was found in patients with stroke.

Self-limiting Atypical Antipsychotics-induced Edema: Clinical Cases and Systematic Review

“… Antipsychotic-induced edema can occur with any dose of atypical antipsychotic[ 14 28 40 ] Edema can occur in any peripheral area of the body including the face and eyelids Sudden increase of dose of medication may be a factor, and therefore, gradual increase is advised[ 38 ] Replacement with another antipsychotic is advocated, but in cases where the offending medication is necessary, it should be gradually reduced[ 11 17 20 22 41 ] Diuretics may be used in cases that have not resolved with the stoppage of the offending agents, although the long-term effect of using diuretic is not known[ 10 11 20 28 ] The use of co-medication should be done with caution[ 9 17 39 ] Even after drug-free period with the implicated drugs, edema could still re-occur after reinstatement,[ 22 41 ] and therefore, it is preferable not to rechallenge with the offending agent[ 8 37 ] During reinstatement of antipsychotic that was previously implicated as the cause of edema, it is advised that the dose should be small and gradually increased to therapeutic level[ 41 ] Antipsychotic-induced edema is not associated with any diagnosis[ 14 ] Comorbid physical factors may not be predisposing factor[ 13 ] Older age may be a risk factor. [ 9 14 ] …”

“…Immune reaction may be implicated in the mechanism of drug-induced edema. [ 10 11 21 38 ] Immune components that were reported in case reports include elevated immunoglobulin E in relation to ziprasidone and amisulpride,[ 10 11 ] low C 4 and C 1 esterase inhibitor in relation to risperidone (Conney and Nagy, 1995). [ 38 ] However, other studies that assessed immunological reactions as possible cause of drug-induced edema did not find any impairment.…”

“…[ 17 22 36 41 ] In other studies, the offending agent was reduced with the addition of diuretics. [ 11 20 ] On the other hand, most case reports stopped the offending antipsychotics and substituted them with others without reoccurrence of edema. [ 5 7 26 30 33 ]…”

Bilateral Pretibial Edema Associated with Paliperidone Palmitate Long-acting Injectable: A Case Report

“…In the literature, there are reported peripheral edema cases associated with antipsychotics 6,8,10). Paliperidone is the major active metabolite of risperidone and is available as both extended release oral tablet and long-acting injectable suspension for intramuscular use 4)…”

Ödeme durch Olanzapin

“…In der Literatur wird die Häu− figkeit von Olanzapin−induzierten Ödemen mit 2 ± 3 % angegeben. Auch bei der Behandlung mit anderen Neuroleptika wie Risperidon [9 ± 11], Amisulprid [12], Ziprasidon [13] und Clozapin [14,15] Für die klinische Praxis ist wichtig, dass durch Neuroleptika ver− ursachte Ödeme häufig flüchtig und selbstlimitierend sind, wo− durch sie selten erkannt werden, es sei denn, die Patienten be− richten selbst darüber oder der Behandler fragt und sieht gezielt danach. Wenn die Ödeme schließlich entdeckt werden, geht es vor allem darum, andere Ödemursachen auszuschließen und ± in Abhängigkeit von der Ausprägung der Ödeme ± das Absetzen der auslösenden Substanz zu erwägen.…”