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A case of intractable psychosis following interferon therapy

Wu, Stephanie X; Qi, Wei; Liu, Albert; McGonigle, Daniel P
PMID: 31220917
ISSN: 1440-1614
CID: 3939362

Effects of aripiprazole on the QTc: a case report

Karz, Adam J; McGonigle, Daniel P; Goldberg, Joseph F; Kellner, Charles H; Calenda, Brandon S
The use of neuroleptics in the elderly has been a topic of debate since 2005 when the US Food and Drug Administration issued a black-box warning of increased risk of mortality in elderly patients with dementia-related psychosis. Antipsychotic alternatives such as divalproex are sometimes favored on an "off-label" basis to manage agitation in the demented elderly, and antipsychotic use is often clinically necessary to treat psychosis in older adults, with or without dementia. Concurrently, risk for iatrogenic corrected QT (QTc) prolongation on electrocardiogram (ECG) remains a concern with the use of many antipsychotic agents because of its associated potential for fatal arrhythmias.
PMID: 26717525
ISSN: 1555-2101
CID: 2042342

Pharmacological treatments of non-substance-withdrawal delirium: a systematic review of prospective trials

Friedman, Joseph I; Soleimani, Laili; McGonigle, Daniel P; Egol, Claudine; Silverstein, Jeffrey H
OBJECTIVE: Most reviews of pharmacological strategies for delirium treatment evaluate the effectiveness of these interventions for delirium prevention, reduction in duration and severity of ongoing delirium, and other outcomes that extend beyond the recommendations of expert treatment guidelines. However, little if any attention is given to substantiating the potential benefits of such treatment or addressing the methodological weaknesses that, in part, limit the pharmacological recommendations made by expert treatment guidelines. Therefore, the authors conducted a systematic review to provide the most up-to-date and inclusive review of published prospective trials of potential pharmacological interventions for the prevention and treatment of delirium, and they discuss potential benefits of pharmacological prevention of delirium and/or reduction of ongoing delirium episode duration and severity. METHOD: The analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, including prospective randomized and nonrandomized double-blind, single-blind, and open-label clinical trials of any pharmacological agent for the prevention or treatment of delirium and reviewing them systematically for effectiveness on several predefined outcomes. RESULTS: The pharmacological strategies reviewed showed greater success in preventing delirium than in treating it. Significant delirium prevention effects are associated with haloperidol, second-generation antipsychotics, iliac fascia block, gabapentin, melatonin, lower levels of intraoperative propofol sedation, and a single dose of ketamine during anesthetic induction and with dexmedetomidine compared with other sedation strategies for mechanically ventilated patients. CONCLUSIONS: These promising results warrant further study with consideration of the methodological weaknesses and inconsistencies of studies to date.
PMID: 24362367
ISSN: 1535-7228
CID: 1664262

Electroconvulsive therapy (ECT) for catatonia in a patient with schizophrenia and synthetic cannabinoid abuse: a case report [Case Report]

Leibu, Evan; Garakani, Amir; McGonigle, Daniel P; Liebman, Lauren S; Loh, Daniella; Bryson, Ethan O; Kellner, Charles H
We present the case of a young man with a long-standing history of schizophrenia who presented with severe and life-threatening catatonia in the setting of synthetic cannabis use who was successfully treated with electroconvulsive therapy. To our knowledge, this is the first reported case of severe and persistent catatonia in the setting of synthetic cannabis use and the first documented successful treatment.
PMID: 23670023
ISSN: 1533-4112
CID: 1664272