Psychosis beas a rare side effect of sildenafil: a case report

BACKGROUND

Sildenafil citrate is a commonly used medication for the management of erectile dysfunction. Previous studies have described some neuropsychiatric side effects of this medication. So far, however, there has been little discussion about sildenafil-induced psychosis.

CASE PRESENTATION

We here present the case of a 32-year-old Iranian male, without a known psychiatric history, who developed psychotic symptoms following initiation of sildenafil. We also postulate a mechanism by which this may occur.

CONCLUSIONS

This report highlights the importance of watchful observation for the occurrence of this rare but serious side effect. Further studies are needed to clarify the precise mechanism that causes sildenafil-induced psychosis.

Evaluation of antidepressant-like effect Lavandulifolia stachys in the forced swimming test in comparison with imipramine and fluoxetine

Depression is a global problem associated with multiple social and health issues. In the present study, we analyzed the antidepressant effects of Lavandulifolia stachys, an herbal planton forced swimming test (FST). In this study, 36 rats were used. We gavaged the aqueous extract of plant (50, 100, 150 mg/kg), imipramine and fluoxetine (20 mg/kg) as standard antidepressant drug and normal saline for control group for a week. Then, their behavioral responses including climbing, swimming and immobility were recorded during the 5-min FST. Our experiments showed significant effects of Lavandulifolia stachys on swimming and immobility but not effect on climbing behaviors. Imipramine and fluoxetine increased climbing and swimming, respectively, and both reduced immobility, compared to saline control. Finally, our results show the extract of Lavandulifolia stachys could play an important role in treatment of depression like fluoxetine.

Pantothenate kinase-associated neurodegeneration: Clinical aspects, diagnosis and treatments

Pantothenate Kinase-Associated Neurodegeneration (PKAN) is an autosomal recessive disorder characterized by a mutation in the PANK2 gene. The clinical presentation may range from only speech disorder to severe generalized dystonia, spasticity, Visual loss, dysphagia and dementia. The hallmark of this disease is eyes of the tiger sign in the medial aspect of bilateral globus pallidus on T2-weighted MRI that is a hyperintense lesion surrounded by hypointensity. Common treatments for PKAN disease include anticholinergics, botulinum toxin, Oral and Intrathecal baclofen, Iron chelation drugs and surgical procedures such as ablative pallidotomy or thalamotomy, Deep brain stimulation. There are many controversies about the pathogenesis and treatment of this disease, and in recent years interesting studies have been done on PKAN disease and other similar diseases. This review summarizes the clinical presentation, etiology, imaging modalities and treatment.

A pilot trial of deferiprone in pantothenate kinase-associated neurodegeneration patients

Pantothenate kinase-associated neurodegeneration (PKAN) is the most common form of neurodegeneration with brain iron accumulation, it is an autosomal recessive disease due to mutation in PANK 2 on chromosome 20, which causes the accumulation of iron in basal ganglia and production of free radicals that cause degeneration of the cells. Deferiprone is an iron chelator that was used in treatment of thalassemia patients, it can cross the blood-brain barrier and reverse the iron deposition in the brain. Five patients with genetically confirmed PKAN received 15 mg/kg deferiprone twice daily. All patients were examined at baseline, 12 and 18 months and magnetic resonance imaging (MRI) was done at the baseline and after 18 months. In our study qualitative evaluation of MRI showed that deferiprone was able to reduce the iron load in globus pallidus of all the patients and the results of clinical rating scales show that in four patients, there is an improvement in the first 12 months. The results of our paper show that deferiprone can prevent the progression of the disease.