SYMPOSIA

Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org
Poster Presentations
[PP-097] Ref. No: 123
Various reasons for self-destructive acts and objects used to commit them in 1991
Elena Valzdorf
Irkutsk Regional Psychoneurologic Dispensary
E-mail: elenavalzdorf@yandex.ru
Objective: The objective of the research was to study and assess the reasons for self-destructive acts committed by the individuals that
underwent outpatient forensic psychiatric examination in 1991 and to give a brief characteristic of the objects used to commit the selfdestructive
acts.
Methods: The statistical method and comparative analysis were employed to study the historical data of 30 archive acts of outpatient
forensic psychiatric examinations covering the period of January-March, 1991.
Results: The analysis of the archive of acts revealed 30 males aged between 15 and 51 (the age range of 20 and 41 dominated). The
reasons for committing self-destructive acts by the examined individuals who underwent outpatient forensic psychiatric examination in
1991 included the following: Conflicts with people around them (in 12 patients), conflict situations with parents and other close relatives
(sister, brother, wife) (in 5), conflicts with inmates in place of imprisonment (in 4), conflict situations during military service (for example,
a self-destructive act was committed by a serviceman to be closer to his parents house) 9in 3), an effect of command hallucinations in 2,
ongoing investigation (in 1), conflict with loved ones (woman) (in 1), protest (investigator refused to allow relatives to visit the patient) (in
1), and severe headache in combination with high blood pressure (the suicide was attempted to ease the pain) (in 1). Also according to
the archive documents of forensic psychiatric examination 18 out of 30 individuals used sharp, cutting, or piercing objects (razor, kitchen
knife, or pen knife, glass, fragment of a broken mirror, wire, sharpened coin, cigar case, etc.), 3 individuals used washing line or belt, 3
patients used a medicine in tablet form, 1 individual used a medicine in liquid form, and 1 patient used the effect of low temperatures
(long deliberate stay in cold weather in winter).
Conclusion: The research findings demonstrated that the most common reasons for self-destructive acts committed by the examined
patients in 1991 were conflict situations with individuals, out of prison, and in the society rather than conflicts in place of imprisonment
or in place of military services. The objects used to commit self-destructive acts included: Sharp, cutting, or piercing objects (most often
razor and kitchen knife), washing line, and a medicine in tablet form (antibiotics, phenazepam, cyclodolum, etc.).
Key words: Self-destructive acts, outpatient forensic psychiatric examination, archive documents
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S181
[PP-098] Ref. No: 296
Topiramate induced acute psychotic disorder
Serkan Barlak, Alpay Ateş, Cengiz Başoğlu, Servet Ebrinç
Department of Psychiatry, GATA Haydarpasa Training Hospital, Istanbul, Turkey
E-mail: drserkanbarlak@yahoo.com.tr
Introduction: The use of topiramate has increased in recent years. It is now used in several specialties to treat a wide range of medical
conditions. A small number of case reports describes psychosis as an adverse event of topiramate. While using topiramate as an option
for treatment-resistant epilepsy, clinicians need to be aware of the possibility of topiramate-induced psychosis in patients who have
not previously had a psychotic episode. Although there is a small literature in neurology journals regarding psychiatric adverse events
in epileptic patients, the psychiatric literature is silent about the topic. We report a patient without a previous history of psychosis, who
developed psychosis after use of topiramate.
Case: The patient on multiple antiepileptic drugs with refractory tonic-clonic epilepsy was prescribed topiramate. The patient developed
definite psychotic symptoms including auditory halucinations and paranoid-persecutory delusions and other behavioral symptoms
fifteen days after beginning topiramate. The psychotic and other psychiatric symptoms resolved quickly with discontinuation of
topiramate and by using a second-generation antpsychotic drug.
Discussion: Topiramate was originally discovered as an oral hypoglycaemic, afterwards was approved as an anticonvulsant agent and is
now used as an adjunct to various treatments. The several mechanisms of action include inhibition of sodium conductance, decreased
frequency of generated action potentials, activated gamma-aminobutyric acid activity, inhibition of AMPA receptor, and weak inhibition
of carbonic anhydrase (1). The mechanism underlying psychotic symptoms induced by topiramate is not clear, but overactivity of
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