Cem Sengul

Oxidative mechanisms in schizophrenia and their relationship with illness subtype and symptom profile

Aim:  The aim of the present study was to investigate the differences in the antioxidant–oxidant balance (AO‐OB) between schizophrenic patients and healthy individuals and to explore the relationship of AO‐OB with illness subtypes and symptom profiles.

The association of olanzapine-induced weight gain with peroxisome proliferator-activated receptor-γ2 Pro12Ala polymorphism in patients with schizophrenia.

Olanzapine is a second-generation antipsychotic that may cause weight gain and metabolic syndrome in some cases. The peroxisome proliferator-activated receptor (PPAR)-gamma is an important gene in the progress of type II diabetes and metabolic syndrome. In recent studies the polymorphism of the PPAR-gamma has been studied in type II diabetes mellitus, polycystic ovary syndrome, and insulin resistance syndrome. It is aimed to evaluate the association between polymorphism of PPAR-gamma gene and olanzapine-induced weight gain. Our study comprised 95 unrelated subjects who strictly met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for schizophrenia, and all were of Turkish origin. All patients were evaluated with rating scales, and genetic analyses were performed. We found statistically significant differences between pretreatment and posttreatment body mass index and weight change in Pro12Ala polymorphism of PPAR-gamma2. Our results suggest that genetic polymorphism of PPAR might be important in olanzapine-induced weight gain and that genetic variance of people might be considered in antipsychotic medication selection.

Synaptosomal-associated protein 25 (Snap-25) gene Polymorphism frequency in fibromyalgia syndrome and relationship with clinical symptoms

BackgroundSNAP-25 protein is contributory to plasma membrane and synaptic vesicle fusions that are critical points in neurotransmission. SNAP-25 gene is associated with behavioral symptoms, personality and psychological disorders. In addition, SNAP-25 protein can be related to different neurotransmitter functions due to its association with vesicle membrane transition and fusion. This is important because neurologic, cognitive, and psychologic disorders in fibromyalgia syndrome (FMS) can be related to this function. This relationship may be enlightening for etiopathogenesis of FMS and treatment approaches. We aimed to study a SNAP-25 gene polymorphism, which is related to many psychiatric diseases, and FMS association in this prospective study.MethodsWe included 71 patients who were diagnosed according to new criteria and 57 matched healthy women in this study. Both groups were evaluated regarding age, height, weight, BMI, education level, marital and occupational status. A new diagnosis of FMS was made from criteria scoring, SF-36, Beck depression scale, and VAS that were applied to the patient group. SNAP-25 gene polymorphism and disease activity score correlations were compared.ResultsMean age was 38±5,196 and 38.12±4.939 in patient and control groups, respectively (p=0.542). No significant difference was found between groups regarding age, height, weight, BMI, education level, marital or occupational status (p > 0.05). Ddel T/C genotype was significantly higher in the patient group (p = 0.009). MnlI gene polymorphism did not show a correlation with any score whereas a significant correlation was found between Ddel T/C genotype and Beck depression scale and VAS score (p < 0.05).ConclusionFMS etiopathogenesis is not clearly known. Numerous neurologic, cognitive and psychological disorders were found during studies looking at cause. Our study showed increased SNAP-25 Ddel T/C genotype in FMS patients compared to the control group, which is related to behavioral symptoms, personality and psychological disorders in FMS patients.

Antidepressants and menstruation disorders in women: a cross-sectional study in three centers

OBJECTIVE The relationship between menstruation disorders and antidepressant drugs usage in women remains unclear. In this study, we aimed to investigate the incidence rate of antidepressant-related menstruation disorders and to examine whether or not antidepressant use is associated with menstrual disorders in women. METHODS The study sample was gathered from three centers and four hospitals. A total of 1432 women who met the criteria of inclusion were included in the study. The sample was divided into two groups: the antidepressant group (n=793) and the control group (n=639). The menstruation disorders were established with reports from the study participants on the basis of related gynecological descriptions. RESULTS The prevalence of menstrual disorders was significantly higher in the antidepressant group (24.6%) than the control group (12.2%). The incidence of antidepressant-induced menstruation disorder was 14.5%. The antidepressants most associated with menstrual disorders were paroxetine, venlafaxine, sertraline and their combination with mirtazapine. Overall, the incidence rate was similar in women receiving selective serotonin reuptake inhibitors and serotonin noradrenaline reuptake inhibitors. CONCLUSIONS The results of the present study suggest that menstruation disorders are frequently observed in women taking antidepressants and that it appears to be associated with antidepressant use at least in some women.

Association of Adult Attention Deficit Hyperactivity Disorder With Dopamine Transporter Gene, Dopamine D3 Receptor, and Dopamine D4 Receptor Gene Polymorphisms

Objective: Attention deficit hyperactivity disorder (ADHD) is a developmental disorder which is characterized by inattention, impulsiveness, and hyperactivity. The etiology of ADHD is not completely understood, but it is well known that the disorder has a moderate to high genetic component, with an estimated heritability of 76%. Polymorphic variants in several genes involved in regulation of the dopamine and related neurotransmitter pathways have been reported to be associated with ADHD. In this research we aimed to investigate the relationship between adult ADHD and DAT1 (dopamine transporter), DRD4 (dopamine D4 receptor), DRD3 (dopamine D3 receptor) gene polymorphisms. Method: Our study comprised unrelated 79 subjects who met DSM-IV criteria for adult ADHD and 75 controls and all were living in Denizli. All of the patients were evaluated with Wender-Utah Rating Scale and Adult ADD/ADHD DSM IV- Based Diagnostic Screening and Rating Scale. With written informed consent, a blood sample was drawn from each subject individual. Venous blood samples were collected in ethylene diamine tetra acetic acid (EDTA) containing tubes. DNA was extracted from whole blood and genetic analyses were performed as described in the literature by using Polymerase Chain Reaction method. SSPSS 15.0 for Windows was used for statistical analyses. Results: Twenty-three of ADHD patients were defined as predominantly inattentive type, 22 of ADHD patients were defined as predominantly hyperactive-impulsive, and the rest of them were defined as combined type ADHD. 10/10 and 9/10 repeats were most relevant genotypes in both study and control group for DAT1 VNTR (variable number of tandem repeat) polymorphism. 4/4 and 4/7 repeats were mostly found in both study and control groups for DRD4 7- repeat allele gene polymorphism. Ser/Ser polymorphism was the most relevant genotype in both study and control group for DRD3 Ser9Gly gene polymorphism. DAT1 VNTR, DRD3 Ser9Gly, and DRD4 7- repeat allele gene polymorphisms were not associated with ADHD. These gene polymorphisms were also not associated with subtypes of ADHD. Conclusions: We couldn?t detect any association between DAT1 VNTR, DRD3 Ser9Gly, and DRD4 7- repeat allele gene polymorphisms and adult ADHD. Ethnicity and sample size are important factors at case control type genetic studies. European studies mostly reported an association between polymorphism of these genes and ADHD, but majority of Middle Eastern and Asian studies didn?t report such an association between these genes and ADHD. Multi centered future studies using genome wide scan and variable tandem repeat techniques with larger samples would be helpful for understanding the role of dopaminergic system at ADHD genetics.

Maintenance electroconvulsive therapy combined with long-acting risperidone in the treatment of resistant bipolar affective disorder.

Maintenance electroconvulsive therapy is used for refractory bipolar disorder. We present a middle-aged man with refractory bipolar disorder who was successfully treated with maintenance electroconvulsive therapy and long-acting risperidone.

Practice of Acute and Maintenance Electroconvulsive Therapy in the Psychiatric Clinic of a University Hospital from Turkey: between 2007 and 2013.

Objective Electroconvulsive therapy (ECT) can be given as the form of acute, continuation or maintenance ECT according to the process of administration. We report our 7 years’ observation with acute and maintenance ECT in a university hospital in Turkey. Methods The medical records of the hospitalized patients treated with acute or maintenance ECT between the years 2007 and 2013 was retrospectively analyzed. The sociodemographic characteristics, diagnosis, data of ECT and the co-administered psychotropic drugs were recorded. The frequency of ECT was calculated by identifying the total number of the hospitalized patients during the study period from the hospital records. Results A total number of 1,432 female and 1,141 male patients hospitalized in a period of 7 years, with a total number of 111 patients treated with ECT. The ratio of ECT was 4%, maintenance/acute ECT 11%. For acute ECT, affective disorders (65.3%) and psychotic disorders (21.6%) were among the leading diagnoses. Maintenance ECT, the diagnosis was; 6 affective disorders, 4 psychotic disorders and 1 obsessive compulsive disorder. There was a significant difference between the patients receiving acute and maintenance ECT in terms of age, duration of illness, and number of previous hospitalizations and ECTs. Conclusion The percentage of patients treated with acute ECT is lower in our institution than that in many other institutions from our country. Acute and maintenance ECT should be considered as an important treatment option particularly for patients with long disease duration, a high number of hospitalizations and a history of benefiting from previous ECTs.

The combined treatment of venlafaxine and ECT in treatment-resistant depressive patients

Objective To evaluate the efficacy and safety of the combination treatment of ECT and venlafaxine among treatment-resistant depressive patients. Methods We reviewed 21 depressive patients who were treated with a combination of electroconvulsive therapy (ECT) and venlafaxine. The indication of the ECT-venlafaxine treatment was inadequate response to at least one antidepressant trial of adequate doses and duration. Propofol was used as an anesthetic agent during ECT treatments. Results Ninety percent of the patients benefited from the combined treatment. The responsivity to the combination treatment was not associated with high dose of venlafaxine. In most of the patients, the combined treatment was safe and well tolerated. Adverse reactions occurred in 57% of the patients and included concentration difficulties (four patients), memory problems (seven patients) and headache (one patient). No asystole was observed. Treatment was safe with a low dose of venlafaxine equal to or lower than 225 mg/day. Conclusions It seems that treatment of ECT combined with low dose venlafaxine and propofol as anesthetic agent is effective and safe. This strategy may be a therapeutic option in treatment-resistant depressive patients.

Neurobiology, genetics and treatment of alcohol craving

Alcohol craving has increasingly been considered an important issue in alcohol use disorders in the last decade. Biologic studies on alcohol craving were mainly focused on neurobiology, genetics and pharmacological treatment of this condition. In this report, we started from receptor systems, than we explained genetics and epigenetics of alcohol craving. At last, we described the main drugs currently used in the treatment of alcohol craving. Other potential drugs and future choices for treating alcohol craving were also described.