SYMPOSIA

Poster Presentations
future, we expect that these new associations described through GWAS here and in other studies will lead to development of personalized
medicine approaches with application in pharmacogenomics and psychopharmacology.
Key words: AHP, Alzheimer’s disease, biomarker, GWAS, personalized medicine, pharmacogenomics, SNP prioritization
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S197-8
[PP-123] Ref. No: 287
A case report of a relapse in a major depression patient with valsartan/hydrochlorothiazide
Alev Büyükkınacı, Devrim Öztürk Can, Gökçe Silsüpür
Boylam Psychiatry Hospital, Ankara, Turkey
E-mail: alevkilicoglu@gmail.com
It is known that some drugs can cause depression. In particular, there is evidence that barbiturates, vigabatrine, topiramate, flunarizine,
corticosteroids, mefloquine, efavirenz, and interferon alpha have been shown to cause depression (1). Angiotensin II is a strong
vasopressor with various physiological effects especially regulating blood pressure. It regulates water retention and aldosterone secretion.
Angiotensin II has two known receptors, AT1 and AT2. Valsartan is a non-selective angiotensin AT selective blocker, which prevents
angiotensin binding to AT2 receptors and controls hypertension in this way (2). It has been shown that angiotensin converting enzyme
polymorphism is related to relapse in major depression patients after partial sleep deprivation and this was related to its effect on the
dopaminergic system (3). This finding shows that drugs targeting the angiotensin system may effect depression. Here we present a case
with recurrent depression who was in remission and relapsed after she was given an antihypertensive medication containing valsartan
and hydrochlorothiazide. She was a 56 year old single woman, living alone. She had a depressive episode in 1983 for the first time and had
other episodes in 1997, 2001, and the last one in 2003. After having used venlafaxine and paroxetine, she was given citalopram in 2003 at
40 mg/day, which she has been using until now. She did not have any depressive attacks after 2003. She was given an antihypertensive
containing valsartan and hydrochlorothiazide 3 months before she presented to our clinic. After taking the medication she had reluctance,
despondency, intense feelings of guilt with statements like “she will not be even accepted to hell.” There were no stressors that the patient
or her relatives defined. The patient was admitted to our clinic after her symptoms increased the month prior to her admission. Since there
were published articles on depression triggered by valsartan and similar antihypertensives and since the patient’s symptoms started after
taking the medication, we continued on her drug regimen with citalopram 40 mg/day and changed her antihypertensive medication to
a calcium channel blocker, amlodipine. After 2 weeks her symptoms started to decrease. We concluded that her depression was triggered
by valsartan. This case is important for showing that medications affecting the angiotensin system can trigger depression and there is a
need to study the role of the angiotensin system in the etiology of depression.
Key words: Valsartan, antihypertensives, depression, relapse
References:
1. Celano CM, Freudenreich O, Fernandez-Robles C, Stern TA, Caro MA, Huffman JC. Depressogenic effects of medications: a review.Dialogues Clin Neurosci.
2011;13(1):109-25.
2. Black HR, Bailey J, Zappe D, Samuel R.Valsartan: more than a decade of experience. Drugs. 2009;69(17):2393-414.
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S198
[PP-124] Ref. No: 158
Monosymptomatic hypochondriacal psychosis: A case report
Yasemin Şimşek, Gökçe Elif Sarıdoğan, Ebru Şahan, Melike Nebioğlu, Cem Cerit, Mecit Çalışkan
Haydarpaşa Numune Hastanesi Psikiyatri Kliniği, İstanbul, Turkey
E-mail: cemcerit@yahoo.com
Introduction: The somatic type of delusional disorder is also recognized as monosymptomatic hypochondriacal psychosis. According
to the DSM-IV, the disorder is characterized by the presence of a somatic delusion in which the person has a false belief of having some
physical defect or a general medical condition (1). The most substantial characteristic of the aforementioned disorder is the demand of
the patient attributing the symptoms to a serious physical illness, and seeking medical advice continuously in an effort to find transient
S198 Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org