SYMPOSIA
SYMPOSIA
SYMPOSIA
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org<br />
Poster Presentations<br />
[PP-001] Ref. No: 133<br />
Visual hallucinations induced by bupropion: A case report<br />
Sevda Korkmaz 1 , Murat Kuloglu 2 , Sadullah Saglam 3 , Murad Atmaca 2<br />
1 Department of Psychiatry, 3 Department of Neurology, Psychiatric Hospital<br />
2 Department of Psychiatry Firat University School of Medicine, Elazig-Turkey<br />
E-mail: skorkmaz23@hotmail.com<br />
Bupropion is an antidepressant, which inhibits reuptake of norepinephrine and dopamine. It is a relatively reliable antidepressant in terms<br />
of side effects and also is used in the treatment of nicotine deprivation (1, 2). Most frequent side effects are insomnia, dry mouth, and<br />
headache (3). Here we present a case who developed visual hallucinations during bupropion treatment.<br />
Case: F.Y: A 51 year old woman was admitted to the outpatient clinic with complaints of hump, horror, and seeing spider images. Visual<br />
hallucinations, anxiety, irritability, insomnia, and anhedonia were noted on psychiatric examination. Except for the visual hallucinations,<br />
there was no other perception abnormality nor other psychotic symptoms. History: she reported to a psychiatrist with complaints<br />
of joylessness, weakness, fatigue, and anhedonia. She was diagnosed with major depressive disorder and subsequently was put on<br />
bupropion 150mg/day. After a week, the dosage of bupropion was increased to 300mg/day. On the first day of the bupropion dose<br />
increase to 300 mg/day, spider images developed in both of her eyes and in the following days these images increasingly continued. The<br />
images lasted for days and scared the patient, ruined her sleep pattern, and increased her anxiety. The patient saw an ophthalmologist<br />
with these complaints and at the medical examination there was no evidence of an organic or pathological disorder. Her blood pressure<br />
was under control with treatment. The patient had been treated with escitalopram and duloxetine 6 years ago with a diagnosis of<br />
depressive disorder, but the patient specified that she had not had any visual complaints. There were not any relevant symptoms at<br />
that time and patient was not describing any clear stress factors. The family history was unremarkable. The patient did not have such<br />
complaints as dizziness, tinnitus, or paraesthesia and there was not any pathological finding at the neurological examination. Also there<br />
were no abnormal findings in the blood tests, urinalysis, and MR imaging. The Beck depression, Beck anxiety, and SCL-90 scales showed<br />
high levels of anxiety and moderate depression. After the assessment of all these data, suspicion was focused on the bupropion as the<br />
main cause of the spider images (visual hallucinations). The patient did not accept hospitalization, thus she was followed up periodically.<br />
First the dosage of bupropion was decreased to 150 mg and bupropion treatment was stopped completely in a few days. Alprazolam 0.5<br />
mg/day treatment was started to decrease the patient’s anxiety. Paroxetine 10 mg/ day was started and increased to 30 mg/day in two<br />
weeks. Following the discontinuation of the bupropion, the visual hallucinations disappeared in a few days. The patient came for controls<br />
monthly and at the end of the 6th month the symptoms of depression and anxiety had decreased considerably.<br />
Comment: Bupropion has become a popular antidepressant in the treatment of depressive disorders in Turkey and is preferred frequently<br />
because of its relatively low incidence of side effects. Nevertheless every kind of side effects including psychotic symptoms that appear<br />
during treatment should be assessed carefully.<br />
Key words: Bupropion, hallucination, antidepressant<br />
References:<br />
1. Ascher JA, Cle JO, Colin JN, et al. Bupropion: A review of its mechanism of antideressant activity. J Clin Psychiatry 1995;56:395-401.<br />
2. Englisch S, Inta D, Eer A, Zink M (2010) Bupropion for depression in schizophrenia. Clin Neuropharmacol; 33(5): 257-259.<br />
3. Hurt RD, Sachs DPL, Glover ED, Offord KP, Johnston JA, Dale LC, et al. A comparison of sustained release bupropion and placebo. N Engl J Med 1997;337:1195-1202.<br />
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S121<br />
[PP-002] Ref. No: 139<br />
Clinical features of patients with panic disorder in outpatient clinics of a psychiatric<br />
training and research hospital<br />
Ramazan Konkan 1 , Erkan Aydın 1 , Oya Güçlü 1 , Ömer Şenormancı 1 , Mehmet Z. Sungur 2<br />
1 MD, Psychiatrist in Deparment of Psychiatry in Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul Turkey<br />
2 MD, Proffessor in Deparment of Psychiatry, Marmara University School of Medicine, Istanbul Turkey<br />
E-mail: ramazankonkan@gmail.com<br />
Objective: Panic disorder is a disorder characterized by recurrent unexpected panic attacks where the patient may exhibit avoidance<br />
S121