Reha Bayar

Genetic polymorphism of angiotensin I-converting enzyme (ACE), but not angiotensin II type I receptor (ATr1), has a gender-specific role in panic disorder

Aims:  Angiotensins were shown to have some role in the development of panic disorder (PD). In this study, we aimed to determine the frequency of polymorphisms in two angiotensin‐related genes, angiotensin I‐converting enzyme (ACE) and angiotensin II type I receptor (ATr1), in a sample of Turkish patients with PD and to evaluate their association with PD development.

EEG Correlates of Startle Reflex with Reactivity to Eye Opening in Psychiatric Disorders: Preliminary Results

Previous studies have shown alterations of eyeblink reflex in patients with various psychiatric disorders. It has previously been demonstrated by our group that EEG measures of the reactivity to eye opening could effectively predict patient-reported startle response in patients with acute stress reaction. In our present study, EEG spectral power analysis and eyeblink electrical startle responses were acquired from a total of 39 patients diagnosed with various psychiatric disorders: 7 patients with schizophrenia, 10 patients with major depressive disorder (MDD), 10 patients with panic disorder, 5 patients with posttraumatic stress disorder (PTSD) and 7 patients with generalized anxiety disorder (GAD). EEG percent power data of each frequency band (delta, theta, alpha, beta) obtained from the 19 leads under open or closed eyelid conditions were used to calculate the arithmetical difference between eyes-open and eyes-closed states as representative of “EEG reactivity to eye opening.” Data was analyzed separately for each diagnostic group. For all of the disorders, right-sided R2c (contralateral secondary component) latency was the single eyeblink startle measure that was found to be significantly correlated with EEG reactivity to eye opening. The correlation was most significant for right temporal theta frequency in schizophrenia, right temporal theta frequency in MDD, left central beta frequency in panic disorder, left parietotemporal delta frequency in PTSD and right occipital alpha frequency in GAD. Findings showed a newly identified pattern that has potential scientific and clinical value with respect to psychiatric medicine.

Serotonin-2a receptor and catechol-O-methyltransferase polymorphisms in panic disorder

Catechol-O-methyltransferase (COMT) and serotonin receptor 2A (5HTR2A) polymorphisms have been investigated for their possible role in panic disorder (PD). The aim of this study was to investigate the genotype distribution of the COMT val158met and 5HTR2A 102T/C polymorphisms in PD. COMT val158met is a polymorphism at codon 158 that results in variations in COMT enzymatic activity with high- (H) and low-activity (L) alleles. The 5HTR2A 102T/C polymorphism comprises a T-to-C mutation at position 102. The effects of symptom severity, gender, and age of onset were also investigated. The participants were 105 outpatients with PD and 130 controls. The severity of the symptoms of PD was assessed by the Panic and Agoraphobia Scale (PAS). Polymorphisms of the 5HTR2A and COMT genes were identified using polymerase chain reaction and restriction fragment length polymorphism analysis. A significant relationship was found between the COMT Val158Met polymorphism and PD. No significant differences were found in genotype distributions or allele frequencies of the 5HTR2A polymorphisms between the PD and control groups. There were no significant relationships between the COMT and 5HTR2A polymorphisms and age of onset, gender, presence of agoraphobia, or PAS scores in the PD group (p>0.05).

Postictal catatonia in a schizophrenic patient and electroconvulsive treatment.

Catatonic state has been related to variable medical, neurological, and psychiatric disorders. Although it is commonly associated with schizophrenia, epilepsy presenting as catatonialike seizures or ictal catatonia was rarely reported. Moreover, the coexistence of schizophrenia and epilepsy in a patient complicates the diagnosis and management. Here we report a case of postictal catatonia in a patient with schizophrenia who was successfully treated by electroconvulsive treatment, and in this context, we aimed to review the therapeutic effect of electroconvulsive treatment in postictal catatonia.

The influences of depression and venlafaxine use at therapeutic doses on atrial conduction

Abstract Patients with depression have increases risk of cardiac mortality. Overdose with venlafaxine has been accused of supraventricular tachycardia, atrial fibrillation and other cardiac effects. Discontinuous and inhomogeneous propagation of sinus impulses in atrium plays a major role in atrial fibrillation. We aimed to measure the effects of venlafaxine therapy on propagation of sinus impulses reflections in electrocardiography in depression. Eligible 19 participants were outpatients with depression. 75 mg/day dose of venlafaxine was administered to the patients. The patients were asked to complete both Beck Depression and Anxiety Inventories. 17 healthy participants enrolled in the study. The electrocardiography records were obtained while patients were drug naive and one week after treatment. The baseline durations of P minimum and P maximum in the patient group were significantly shorter than controls (p < 0,05). The differences between baseline and after venlafaxine therapy among electrocardiographical variables were statistically insignificant. There were no significant correlations between age, sex, body mass index, clinical inventories and electrocardiographical variables in both patients and controls. Autonomic dysregulation in myocardium is still inconclusive in depression. Venlafaxine at therapeutic dose of 75 mg/day does not seem to be associated with myocardial conduction dysregulation.

A Review of the Etiology Delirium

Delirium, also called as organic brain syndrome, acute brain syndrome, acute brain failure, acute confusional episode and reversible or masked dementia, as a concept, stretches back to the age of Hypocrates (Burns et al., 2004). Delirium is described as a condition characterized by a disturbance of consciousness with reduced ability to focus, sustain, or shift attention according to the Diagnostic and Statistical Classification of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria (American Psychiatric Association, 2000). Also, delirium involves a change in cognition (such as memory deficit, disorientation, language disturbance) or the development of a perceptual disturbance that is not better accounted for by a preexisting, established, or evolving dementia (American Psychiatric Association, 2000). In addition to these, impairment in the brain’s ability to integrate perceptions correctly, coupled with memory deficits and confusion may result in psychotic symptoms in delirium. Hallucinations (especially visual and tactile), delusions, paranoia, illusions, and bizarre behavior are the commonly encountered psychotic symptoms in delirium (Leigh, 2008).

Successful Treatment of Benzodiazepine-Resistant Malignant Catatonia With Electroconvulsive Therapy

mm 3 , and CPK levels decreased to 2,230 U/liter. Olanzapine was initiated at a dose of 10 mg/day. The patient was reevaluated by the consulting neurologist, who recommended cranial MRI and thyroid function tests (TFT), to exclude Hashimoto thyroiditis. Both the MRI and TFT were within normal limits. The WBC count and CPK levels decreased over the ensuing days, but the clinical signs and symptoms of catatonia did not change. Olanzapine treatment was ceased at the 5th day of treatment, and diazepam dose was increased gradually to a dose of 20 mg/day on the 7th day of treatment. At this point, as his general-medical condition was stabilized, ECT was initiated. The motor behaviors and