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Eliezer DD, Lam C, Smith A, Coomarasamy JM, Samnakay N, Starkey MR, Deshpande AV. Optimising the management of children with concomitant bladder dysfunction and behavioural disorders. Eur Child Adolesc Psychiatry 2023; 32:1989-1999. [PMID: 35767104 PMCID: PMC10533605 DOI: 10.1007/s00787-022-02016-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 05/26/2022] [Indexed: 11/03/2022]
Abstract
Bladder dysfunction and behavioural disorders in children are commonly concomitant; hence, it is difficult to treat each in isolation. Pharmacotherapy is common treatment for behavioural disorders, and these medications may have intended or unintended positive or negative bladder sequelae. This review identifies the literature regarding the effects of behavioural pharmacotherapy on bladder functioning and possible bladder management strategies in children with concomitant behaviour and bladder disorders to enable clinicians to better manage both conditions. A PROSPERO registered PRISMA-guided review of three major databases was performed. After an initial scoping study revealed significant heterogeneity, a narrative approach was undertaken to discuss the results of all relevant cases relating to children being treated with pharmacotherapy for behaviour disorders and outcomes related to bladder function. Studies were screened to identify those that described effects of commonly prescribed medications in children with behavioural disorders such as stimulants, alpha 2 agonists, tricyclic antidepressants (TCA), serotonin and noradrenergic reuptake inhibitors (SNRI), selective serotonin reuptake inhibitors (SSRI) and antipsychotics, and the findings and implications were summarised. The review identified 46 studies relevant to behavioural pharmacotherapy and bladder function (stimulants (n = 9), alpha 2 agonists (n = 2), TCAs (n = 7), SNRIs (n = 8), SSRIs (n = 8) and antipsychotics (n = 6). Six studies focused specifically on bladder management in children with behavioural disorders with concurrent behavioural pharmacotherapy. This review identifies useful factors that may assist clinicians with predicting unintended bladder effects following initiation of behavioural pharmacotherapy to facilitate the best approach to the treatment of bladder dysfunction in children with behavioural disorders. With this evidence, we have provided a useful decision-making algorithm to aide clinicians in the management of these dual pathologies.
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Affiliation(s)
- Dilharan D Eliezer
- John Hunter Children's Hospital, New Lambton Heights, NSW, Australia.
- University of Newcastle, Newcastle, NSW, Australia.
- Urology Unit, Department of Surgery, Department of Paediatric Surgery, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.
| | - Christopher Lam
- John Hunter Children's Hospital, New Lambton Heights, NSW, Australia
- University of Newcastle, Newcastle, NSW, Australia
| | - Angela Smith
- Hunter New England Library, New Lambton Heights, NSW, Australia
| | | | - Naeem Samnakay
- Department of Surgery, Perth Children's Hospital, Nedlands, WA, Australia
- Division of Surgery, Medical School, University of Western Australia, Crawley, WA, Australia
| | - Malcolm R Starkey
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, Australia
| | - Aniruddh V Deshpande
- John Hunter Children's Hospital, New Lambton Heights, NSW, Australia
- University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Urology Unit, Department of Surgery, Department of Paediatric Surgery, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
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Arasteh A, Mostafavi S, Zununi Vahed S, Mostafavi Montazeri SS. An association between incontinence and antipsychotic drugs: A systematic review. Biomed Pharmacother 2021; 142:112027. [PMID: 34392083 DOI: 10.1016/j.biopha.2021.112027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/06/2021] [Accepted: 08/07/2021] [Indexed: 11/29/2022] Open
Abstract
To date, due to the increasing prevalence of psychiatric diseases, the use of antipsychotic drugs has expanded. One of the proven side effects of these drugs is incontinence. Treatment of this complication improves the quality of life in these patients, increases self-confidence, and betters cope with their psychiatric illness. The exact mechanism of this side effect is not fully understood, but various methods have been used experimentally to deal with it. Strategies such as behavior therapy, discontinuation or change of drugs, reducing the dose of drugs, and adding drugs with less incontinence have been used. Each of these methods and studies has different results that need to be summarized to make optimal use of them. Since most of these reports are case reports with a low statistical population, our study has systematically reviewed these studies to find a comprehensive model to deal with this complication.
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Affiliation(s)
- Amin Arasteh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soroush Mostafavi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Low-Dose Aripiprazole-Induced Nocturnal Enuresis in a 9-Year-Old Boy: A Case Report and the Possible Underlying Mechanism. Clin Neuropharmacol 2021; 44:108-109. [PMID: 33811196 DOI: 10.1097/wnf.0000000000000450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Aripiprazole is an atypical antipsychotic commonly used in the treatment of psychiatric disorders, such as schizophrenia, bipolar disorder, and irritability associated with autism spectrum disorder. Common adverse effects associated with aripiprazole usage in children and adolescents are nausea, vomiting, extrapyramidal adverse effects, akathisia, sedation, tremor, and increased appetite. Enuresis is one of the least expected adverse effects during aripiprazole use. The pathophysiology of aripiprazole-induced enuresis has not been fully clarified. To our knowledge, our report presents enuresis related to aripiprazole use at the lowest dose in the literature. In this report, we present the case of a 9-year-old boy who developed nocturnal enuresis after the beginning of low-dose aripiprazole treatment.
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Iasevoli F, Barone A, Buonaguro EF, Vellucci L, de Bartolomeis A. Safety and tolerability of antipsychotic agents in neurodevelopmental disorders: a systematic review. Expert Opin Drug Saf 2020; 19:1419-1444. [DOI: 10.1080/14740338.2020.1820985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Felice Iasevoli
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Annarita Barone
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Elisabetta Filomena Buonaguro
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Licia Vellucci
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Andrea de Bartolomeis
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
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Dikshit R, Karia S, De Sousa A. Risperidone-induced Enuresis in a 12-year-old Child. J Neurosci Rural Pract 2019; 8:122-123. [PMID: 28149096 PMCID: PMC5225694 DOI: 10.4103/0976-3147.193530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Risperidone has been documented to be effective in the management of behavior problems, aggression, and conduct disorder in children. While metabolic side effects like weight gain and obesity have been attributed to Risperidone use in children, side effects of the drug related to the urinary bladder are rare. We present a case of Risperidone-induced enuresis in a 12-year-old boy with conduct disorder that resolved completely after stopping the medication.
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Affiliation(s)
- Reetika Dikshit
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Sagar Karia
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
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Khalaj M, Saghazadeh A, Shirazi E, Shalbafan MR, Alavi K, Shooshtari MH, Laksari FY, Hosseini M, Mohammadi MR, Akhondzadeh S. Palmitoylethanolamide as adjunctive therapy for autism: Efficacy and safety results from a randomized controlled trial. J Psychiatr Res 2018; 103:104-111. [PMID: 29807317 DOI: 10.1016/j.jpsychires.2018.04.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 04/28/2018] [Accepted: 04/30/2018] [Indexed: 11/25/2022]
Abstract
Inflammation as well as glutamate excitotoxicity have been proposed to participate in the propagation of autism. Palmitoylethanolamide (PEA) is an endocannabinoid proven to prevent glutamatergic toxicity and inhibit inflammatory responses simultaneously. The present randomized, parallel group, double-blind placebo-controlled trial is the first study depicted to probe the efficacy of co-treatment with risperidone and PEA over 10 weeks in children with autism. Seventy children (aged 4-12 years) with autism and moderate to severe symptoms of irritability were randomly assigned to two treatment regimens. The study outcomes were measured using the Aberrant Behavior Checklist-Community Edition (ABC-C). At trial endpoint (week 10), combination of PEA and risperidone had superior efficacy in ameliorating the ABC-irritability and hyperactivity/noncompliance symptoms (Cohen's d, 95% confidence interval (CI) = 0.94, 0.41 to 1.46, p = 0.001) compared with a risperidone plus placebo regimen. Interestingly, effect of combination treatment on hyperactivity symptoms was also observed at trial midpoint (week 5) but with a smaller effect size (d = 0.53, p = 0.04) than that at the endpoint (d = 0.94, p = 0.001). Meanwhile, there was a trend toward significance for superior effect of risperidone plus PEA over risperidone plus placebo on inappropriate speech at trial endpoint (d = 0.51, p = 0.051). No significant differences existed between the two treatment groups for the other two ABC-C subscales (lethargy/social withdrawal and stereotypic behavior). The findings suggest that PEA may augment therapeutic effects of risperidone on autism-related irritability and hyperactivity. Future studies are warranted to investigate whether PEA can serve as a stand-alone treatment for autism.
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Affiliation(s)
- Mona Khalaj
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Amene Saghazadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shirazi
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Shalbafan
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Kaveh Alavi
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Mitera Hakim Shooshtari
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Yousefi Laksari
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Maryamalsadat Hosseini
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Mohammadi
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Aripiprazole-Related Diurnal Enuresis in Children: 2 Cases (Aripiprazole-Related Enuresis). Clin Neuropharmacol 2017. [DOI: 10.1097/wnf.0000000000000223] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kılınç S, Hergüner A, Hergüner S. Cessation of Nocturnal Enuresis with Aripiprazole. J Child Adolesc Psychopharmacol 2017; 27:213-214. [PMID: 27893286 DOI: 10.1089/cap.2016.0127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Saliha Kılınç
- 1 Department of Child and Adolescent Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University , Konya, Turkey
| | - Arzu Hergüner
- 2 Konya Training and Research Hospital , Child and Adolescent Psychiatry Clinic, Konya, Turkey
| | - Sabri Hergüner
- 1 Department of Child and Adolescent Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University , Konya, Turkey
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Aman M, Rettiganti M, Nagaraja HN, Hollway JA, McCracken J, McDougle CJ, Tierney E, Scahill L, Arnold LE, Hellings J, Posey DJ, Swiezy NB, Ghuman J, Grados M, Shah B, Vitiello B. Tolerability, Safety, and Benefits of Risperidone in Children and Adolescents with Autism: 21-Month Follow-up After 8-Week Placebo-Controlled Trial. J Child Adolesc Psychopharmacol 2015; 25:482-93. [PMID: 26262903 PMCID: PMC4545698 DOI: 10.1089/cap.2015.0005] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Risperidone has demonstrated efficacy for acute (8 week) and intermediate length (6 month) management of severe irritability and aggression in children and adolescents with autism. Less is known about the long-term effects of risperidone exposure in this population. We examined the tolerability, safety, and therapeutic benefit of risperidone exposure over a 1-2 year follow-up period. METHODS In a naturalistic study, 84 children and adolescents 5-17 years of age (from an original sample of 101) were assessed an average of 21.4 months after initial entry into a placebo-controlled 8 week trial of risperidone for children and adolescents with autism and severe irritability. They were assessed at baseline and at follow-up on safety and tolerability measures (blood, urinalysis, electrocardiogram [ECG], medical history, vital signs, neurological symptoms, other adverse events), developmental measures (adaptive behavior, intelligence quotient [IQ]), and standardized rating instruments. Treatment over the follow-up period, after completion of protocol participation, was uncontrolled. Statistical analyses assessed outcome over time with or without prolonged risperidone therapy. RESULTS Two-thirds of the 84 subjects continued to receive risperidone (mean 2.47 mg/day, S.D. 1.29 mg). At follow-up, risperidone was associated with more enuresis, more excessive appetite, and more weight gain, but not more adverse neurological effects. No clinically significant events were noted on blood counts, chemistries, urinalysis, ECG, or interim medical history. Regardless of drug condition at follow-up, there was considerable improvement in maladaptive behavior compared with baseline, including core symptoms associated with autism. Height and weight gains were elevated with risperidone. Social skills on Vineland Adaptive Behavior Scale (VABS) improved with risperidone. Parent-rated Aberrant Behavior Checklist (ABC) Irritability subscale scores were reduced in those taking risperidone at follow-up. Several other measures of maladaptive behavior (some related to socialization) also showed improved functioning in association with risperidone on the ABC or on the Modified Real Life Rating Scale. CONCLUSIONS Increased appetite, weight gain, and enuresis are risks associated with long-term risperidone. Our data suggest that these risks were balanced by longer-term behavioral and social benefits for many children over 1.8 years of ongoing treatment.
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Affiliation(s)
- Michael Aman
- Nisonger Center, Ohio State University, Columbus, Ohio
| | - Mallikarjuna Rettiganti
- Biostatistics Program, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Haikady N. Nagaraja
- Biostatistics, College of Public Health, Ohio State University, Columbus, Ohio
| | | | - James McCracken
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine UCLA - Semel Institute, University of California, Los Angeles, California
| | | | | | | | | | | | - David J. Posey
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | - Naomi B. Swiezy
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | | | | | - Bhavik Shah
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine UCLA - Semel Institute, University of California, Los Angeles, California
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Yamak WR, Hmaimess G, Makke Y, Sabbagh S, Arabi M, Beydoun A, Nasreddine W. Valproate-induced enuresis: a prospective study. Dev Med Child Neurol 2015; 57:737-41. [PMID: 25808512 DOI: 10.1111/dmcn.12737] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2015] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to determine the frequency and characteristics of secondary enuresis in children initiated on valproate treatment. METHOD This was a prospective study conducted in children aged 5 to 12 years with suspected newly diagnosed epilepsy and maintained on valproate for at least 1 month. Adverse events spontaneously reported by parents were recorded at each follow-up visit. In addition, we specifically asked about enuresis and other side effects known to occur with valproate treatment. We assessed the frequency of enuresis and its association with a number of variables. RESULTS Seventy-two children (43 males and 29 females) with a mean age of 8 years 7 months (range 5-12y) were included in this study. Secondary enuresis developed in 17 (24%) of these children after, on average, 19.8 days of exposure to valproate. The data obtained from a multivariate analysis indicate that age was the only significant factor in predicting the development of enuresis. Enuresis ceased in all children after discontinuation of valproate use, and in 10 out of 11 children still on the drug. INTERPRETATION Secondary enuresis is a common adverse event associated with valproate use in children, which is not usually spontaneously reported and is reversible in most cases.
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Affiliation(s)
- Wissam R Yamak
- Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghassan Hmaimess
- Department of Pediatrics, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Yamane Makke
- Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Sandra Sabbagh
- Department of Pediatrics, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Maher Arabi
- Department of Neurology, Ibn Sina Hospital, Kuwait
| | - Ahmad Beydoun
- Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Wassim Nasreddine
- Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon
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Karakurt MN, Süren S. Desmopressin Use in the Treatment of Aripiprazole-Induced Nocturnal Enuresis in a Child Diagnosed with Autıstıc Disorder. J Child Adolesc Psychopharmacol 2015. [PMID: 26222623 DOI: 10.1089/cap.2015.0003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Melih Nuri Karakurt
- Department of Child and Adolescent Psychiatry, Samsun Mental Health and Diseases Hospital , Samsun, Turkey
| | - Serkan Süren
- Department of Child and Adolescent Psychiatry, Samsun Mental Health and Diseases Hospital , Samsun, Turkey
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Gontkovsky ST. Prevalence of enuresis in a community sample of children and adolescents referred for outpatient clinical psychological evaluation: Psychiatric comorbidities and association with intellectual functioning. J Child Adolesc Ment Health 2015; 23:53-8. [PMID: 25859895 DOI: 10.2989/17280583.2011.594253] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Research suggests a higher prevalence of coexisting behavioural disorders, particularly Attention-Deficit Hyperactivity Disorder (ADHD), among children with enuresis in comparison to the general population. Studies generally have consisted of participants attending general paediatric medical clinics as opposed to facilities specialising in the treatment of psychiatric disorders. This descriptive investigation examined the frequency of enuresis and its psychiatric comorbidities among 363 children and adolescents referred for outpatient clinical psychological evaluation during a 12-month period. Results revealed that 16% of participants met diagnostic criteria for enuresis and that of these 98% had at least one comorbid psychiatric disorder. Mood disorders were the most common coexisting diagnoses, followed by ADHD and Oppositional Defiant Disorder. No association was found between a diagnosis of enuresis and participant intelligence. Implications for mental health providers are discussed.
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Affiliation(s)
- Samuel T Gontkovsky
- a Methodist Rehabilitation Center , 1350 East Woodrow Wilson Drive , Jackson , Mississippi , 39216
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Réus GZ, dos Santos MAB, Abelaira HM, Quevedo J. Animal models of social anxiety disorder and their validity criteria. Life Sci 2014; 114:1-3. [DOI: 10.1016/j.lfs.2014.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 08/01/2014] [Accepted: 08/04/2014] [Indexed: 11/28/2022]
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UROPSYCHIATRY: The Relationship Between Overactive Bladder and Psychiatric Disorders. CURRENT BLADDER DYSFUNCTION REPORTS 2012. [DOI: 10.1007/s11884-012-0164-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Ellington EE, McGuinness TM. Mental Health Considerations in Pediatric Enuresis. J Psychosoc Nurs Ment Health Serv 2012; 50:40-5. [DOI: 10.3928/02793695-20120306-03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 02/02/2012] [Indexed: 11/20/2022]
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Dopamine and oxytocin interactions underlying behaviors: potential contributions to behavioral disorders. CNS Neurosci Ther 2010; 16:e92-123. [PMID: 20557568 DOI: 10.1111/j.1755-5949.2010.00154.x] [Citation(s) in RCA: 243] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Dopamine is an important neuromodulator that exerts widespread effects on the central nervous system (CNS) function. Disruption in dopaminergic neurotransmission can have profound effects on mood and behavior and as such is known to be implicated in various neuropsychiatric behavioral disorders including autism and depression. The subsequent effects on other neurocircuitries due to dysregulated dopamine function have yet to be fully explored. Due to the marked social deficits observed in psychiatric patients, the neuropeptide, oxytocin is emerging as one particular neural substrate that may be influenced by the altered dopamine levels subserving neuropathologic-related behavioral diseases. Oxytocin has a substantial role in social attachment, affiliation and sexual behavior. More recently, it has emerged that disturbances in peripheral and central oxytocin levels have been detected in some patients with dopamine-dependent disorders. Thus, oxytocin is proposed to be a key neural substrate that interacts with central dopamine systems. In addition to psychosocial improvement, oxytocin has recently been implicated in mediating mesolimbic dopamine pathways during drug addiction and withdrawal. This bi-directional role of dopamine has also been implicated during some components of sexual behavior. This review will discuss evidence for the existence dopamine/oxytocin positive interaction in social behavioral paradigms and associated disorders such as sexual dysfunction, autism, addiction, anorexia/bulimia, and depression. Preliminary findings suggest that whilst further rigorous testing has to be conducted to establish a dopamine/oxytocin link in human disorders, animal models seem to indicate the existence of broad and integrated brain circuits where dopamine and oxytocin interactions at least in part mediate socio-affiliative behaviors. A profound disruption to these pathways is likely to underpin associated behavioral disorders. Central oxytocin pathways may serve as a potential therapeutic target to improve mood and socio-affiliative behaviors in patients with profound social deficits and/or drug addiction.
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Mendhekar DN, Andrade C. Risperidone-related reversal of primary enuresis: an unusual case report. World J Biol Psychiatry 2010; 11:514-5. [PMID: 20014956 DOI: 10.3109/15622970903369965] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Occasional reports have documented treatment-emergent enuresis with medication regimens that include risperidone. In contrast to these reports, we present a 12-year-old girl with mild mental retardation and primary nocturnal enuresis who received risperidone (0.5 mg/day) for the isolated symptom of inappropriate smiling. Surprisingly, in addition to reduction in inappropriate smiling, risperidone also substantially decreased the frequency of enuresis. These benefits with risperidone were confirmed in an on-off-on treatment sequence. To our knowledge, this is the first case in literature of primary enuresis responding to low-dose risperidone. Low-dose risperidone may merit study in children with enuresis. Clinical implications and possible mechanisms are discussed.
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Chevreuil C, Reymann JM, Frémaux T, Polard E, Séveno T, Bentué-Ferrer D. [Risperidone use in child and adolescent psychiatric patients]. Therapie 2009; 63:359-75. [PMID: 19154706 DOI: 10.2515/therapie:2008059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In a plural and multidisciplinary process of care, it would be fruitful to ally complementary, pharmacologic and psychodynamic approaches. We have done a review of the literature on the effectiveness and the cautions for prescription of risperidone, a second generation antipsychotic drug. Risperidone has proved helpful in treating children and adolescents with autism spectrum, conduct and bipolar disorders, Tourette's syndrome, and schizophrenia. The principal side effects are sedation, weight gain, and metabolic disturbances. Extrapyramidal symptoms, QTc prolongation, and hyperprolactemia with clinical signs are infrequent and not clinically significant. The benefit/risk is clearly in favor of the prescription when it is accompanied with the precautions and with the adequate monitoring.
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Affiliation(s)
- Claire Chevreuil
- Psychiatrie Infanto-juvénile, CH Guillaume Régnier, Rennes, France
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Hergüner S, Mukaddes NM. Risperidone-induced double incontinence. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:1085-6. [PMID: 18387724 DOI: 10.1016/j.pnpbp.2008.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Revised: 02/18/2008] [Accepted: 02/18/2008] [Indexed: 11/28/2022]
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2008. [DOI: 10.1002/pds.1486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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