Navegando por Autor "Viana, Bernardo de Mattos"
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Item Melancholic features related to rimonabant.(2009) Viana, Bernardo de Mattos; Cano Prais, Hugo Alejandro; Daker, Maurício ViottiIntroduction: Obesity is currently considered a global epidemic and its prevention and treatment is a major public health concern, demanding treatment which may combine a sociocultural approach, lifestyle modification, nutritional, pharmacological or surgical strategies. Rimonabant, an endocannabinoid antagonist, has been proposed as an agent for an average weight loss of 4 kg. However, the development of anxiety and depressive symptoms can be major side effects. Case Report: A 27-year-old businessman, after using rimonabant (20 mg/day) for 1 month for weight loss, developed a major depressive episode with melancholic features, which remitted after the interruption of rimonabant. Discussion: To our knowledge, a major depressive episode with melancholic or atypical features specifier has not been described since the initiation of rimonabant pharmacological trials. The Hospital Anxiety and Depression Scale, used in the rimonabant trials, assesses several key points of depressive patients. However, it neglects the somatic symptoms that correspond to the additional criterion for both of the mentioned features as well as suicidal ideation. The severity of an episode could also be underestimated depending on the assessment tool or on the clinical interview. Conclusion: There may be an underestimation of depressive melancholic and atypical side effects related to Rimonabant use, due to the lack of consistent assessment with the appropriate screening tools. Pharmacological strategies should be adjunctive for obesity treatment when there is a failure in the lifestyle and nutritional modification strategies. Moreover, deeper global sociocultural changes should be made in the treatment and control of the global obesity epidemic.Item Reversible parkinsonism after chronic cyclosporin treatment in renal transplantation.(2009) Viana, Bernardo de Mattos; Moura, André de Souza; Moreira, Janaina Matos; Cano Prais, Hugo Alejandro; Cardoso, Francisco Eduardo CostaItem Ziprasidone-related oculogyric crisis in an adult.(2009) Viana, Bernardo de Mattos; Cano Prais, Hugo Alejandro; Camargos, Sarah Teixeira; Cardoso, Francisco Eduardo CostaIntroduction: Drug-induced dyskinesias arecommonside-effects of first-generation antipsychotics (FGAs) but are not usually related to second-generation antipsychotics (SGAs). Oculogyric crisis (OGC) is a disabling acute dystonia that affects extra-ocular muscles usually resulting in an upward deviation of the eyes, which lasts from minutes to hours. Case report:Wedescribe an adult patient, previously exposed to an FGA,whodevelopedOGCon 80 mg/day of ziprasidone. The movement disorder significantly improved after use of 1 mg/day of clonazepam without the need to switch to another SGA. Discussion: The clinical features of the movement disorder of our patient meet the criteria for OGC. It is, sometimes, difficult to directly correlate a drug-induced dyskinesia to a SGA due to previous exposures to FGAs. The onset of OGC after exposure to ziprasidone without simultaneous use of other antipsychotic suggests a casual relationship between the former and the movement disorder. It is possible that previous use of an FGA was a risk factor for the development of OGC. Conclusion: To the best of our knowledge, this is the first report of ziprasidone-related OGC in an adult patient. Physicians must be aware of its occurrence in order to improve care of patients treated with these agents.