Dependence on monoamine oxidase inhibitors in high dose

Article Abstract:

Monoamine oxidase inhibitors (MAOIs) are a class of antidepressant medication that have been reported to have some effects similar to stimulants, but there have been few reports of the development of tolerance or abuse of these drugs. In the few studies that have reported psychological and physical dependence on MAOIs, there has always been a previous history of sociopathological behavior on the part of the patient, of MAOIs being prescribed for depression, of tolerance and a progressive increase in dosage by the patient, and of few or no reported side effects despite large dosages and disregard for dietary restrictions necessary for those taking MAOIs. A case is presented of a woman who first received MAOIs after she complained of depression following an abortion at age 20. Despite reporting only slight depression, she progressively increased her dosage from 40 mg daily of tranylcypromine (a MAOI) to a minimum of 80 mg tranylcypromine per day. Later she increased her daily intake of tranylcypromine to 440 mg per day after her husband committed suicide and she maintained this for two years. She reported no serious side effects, she did not comply with dietary restrictions, and she reported that on several occasions she tried to lower the dosage unsuccessfully - she needed the energizing effect of the drug. After several unsuccessful attempts to lower the dosage through a clinic, the patient committed suicide by an overdose of MAOIs. This case fits the profile of the typical case, outlined above. It is thought that personality factors play a role in the small number of cases of MAOI dependency. Whether all MAOIs are equally addictive is unknown. Because of the evidence that some people may become seriously addicted to MAOIs, it is recommended that these drugs be prescribed and monitored with caution. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Case studies, Medication abuse, Prescription drug abuse, Monoamine oxidase, Tranylcypromine

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Psychiatric manifestation of systemic lupus erythematosus in Singapore: a cross-cultural comparison

Article Abstract:

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown cause. Symptoms include arthritis, a reddening of the nose and cheeks, fatigue, and weakness. Fever, sensitivity to light, and skin lesions can develop as the disease progresses. Treatment is often with steroids. SLE has been well studied, but the prevalence of psychiatric disorders in those with SLE is not well understood. Reports vary from a prevalence of 3 percent to 75 percent, and there has been a lack of cross-cultural studies. The present paper reports on 30 patients with SLE and 29 controls in Singapore and a comparison of these patients with 40 SLE patients and 27 controls in a previous study conducted in London. The methodology used in the two studies was similar. Patients were interviewed and mental status was assessed for psychiatric diagnosis. Sociodemographic information was gathered as well. In comparing the results, it was apparent that SLE patients in Singapore had a higher rate of psychiatric disorder than those in London and there was a significant correlation between disease activity and psychiatric disorder. Major depression was the most common psychiatric complication of SLE. It is therefore concluded that psychiatric illness is frequently seen in those with SLE, without regard for ethnic differences, though patients in Singapore were significantly more likely than those in London to be so affected. The patient's perception of the disease, and the clinical progression of disease are important factors as well. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Methods, Singapore, Systemic lupus erythematosus, Cross-cultural studies, Cross cultural studies, Lupus erythematosus

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