M. Tayfun Turan

A pilot study evaluating anxiety and depressive scores in acne patients treated with isotretinoin

BACKGROUND: Isotretinoin therapy and its alleged adverse psychiatric effects have received considerable media attention during the past years. The aim of this pilot study was to investigate whether there was any association between isotretinoin therapy and anxiety, depression or suicidal ideation. METHODS: Forty‐five patients with severe recalcitrant acne were enrolled in this study. Isotretinoin was administered at a dose of 0.5–1 mg/kg per day in two divided doses with food for 16 weeks. All patients received a complete dermatological examination and the severity levels of their acne were scored according to the Leeds Revised Acne Grading system at baseline (before isotretinoin treatment) and follow‐up assessments at weeks 4, 8 and 16 of the treatment. Severity of anxiety and depressive symptoms were assessed with the Clinical Anxiety Scale and Montgomery‐Asberg Depression Rating Scale before and upon completion of the 16‐week isotretinoin treatment. RESULTS: Twenty‐three patients completed the final assessment. There was a statistically significant decrease in anxiety scores. Depression scores also decreased but were not statistically significant. No patient committed or attempted suicide. CONCLUSIONS: This pilot study was unable to detect an association between the use of isotretinoin and an increased risk for anxiety, depression, or suicidal thoughts.

Effects of olanzapine and haloperidol on serum prolactin levels in male schizophrenic patients

It has been proposed that new atypical antipsychotics cause minimal prolactin (PRL) elevation compared to traditional antipsychotic agents because they spare dopamine blockade within the brain’s tuberoinfundibular tract. The aim of this study was to compare the effects of olanzapine and haloperidol on PRL secretion in male schizophrenic patients. Twenty-nine male schizophrenic inpatients were included in the study. Fifteen of them were given olanzapine in a fixed dose of 10 mg/day PO and 14 of them were given haloperidol in a fixed dose of 10 mg/day PO for 6 weeks after a 2-week drug washout period. Fifteen age-matched healthy control subjects were used as control group. PRL levels were measured both before and after the 6-week treatment period in the patients. At the end of the 6th week, the PRL values observed with olanzapine treatment were significantly less than those observed with haloperidol, but not different from those of the controls. There was a significant positive correlation between the PRL values and the severity of extrapyramidal side effects in only the haloperidol group after the six week’s treatment period. Our data indicate that short-term olanzapine treatment at doses of 10 mg/day PO causes minimal elevations in PRL secretion in male schizophrenic patients in contrast to haloperidol. This finding is consistent with the previous reports and may be attributed to olanzapine’s differential effects on dopamine neurotransmission.  2001 Elsevier Science Ltd. All rights reserved.

Female-to-male transsexual with 47,XXX karyotype

BACKGROUND There are few reports describing chromosomal abnormalities in transsexuals. In rare cases, transsexualism and sexual chromosomal multiplicity coexist. Six cases of male-to-female transsexuals with 47,XYY chromosomal pattern have been previously reported. We have not encountered any female transsexual cases with 47,XXX karyotype in the literature. METHODS A 21-year-old female patient came to our outpatient department with depressive symptoms and suicidal thoughts. On psychiatric interview, she reported that she had feelings of discomfort with her gender identity and had desired to be male since her childhood. Then, we performed cytogenetic investigation using blood culture and G chromosome banding. RESULTS Histology and DNA histograms of the patient revealed a chromosomal pattern of 47,XXX. CONCLUSIONS We conclude that sexual chromosomal abnormalities in some transsexuals may cause a vulnerability to development of a gender identity disorder.