Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Secondary side-effects often occur in women undergoing hormonal stimulation treatment with clomiphene citrate. In general 10.4% of women experience hot flushing, 5.5% have complaints caused by enlargement of the ovaries and 3.5% experience central nervous symptoms (nervousness, sleeplessness, headaches, visual disturbances, vertigo). During ovarian stimulation with clomiphene citrate for in-vitro fertilization, a 32 year old patient developed psychotic symptoms, commencing 3 days after initiation of treatment. Hospitalization in the psychiatric ward became necessary when severe formal and rational thought disturbances arose together with perceptory and sensory delusions. Under neuroleptic treatment the symptoms improved. Nevertheless, follow-up psychiatric care on an outpatient basis was deemed necessary. The infertility treatment was continued with human menopausal gonadotrophin stimulation. Psychiatric instability occurred neither at this point nor during the 2 year follow-up observation period. Both an exogenous psychosis (ICD F23.9) as well as the exacerbation of an endogenous psychosis (ICD F29) may be considered for the differential diagnosis. The stimulation with clomiphene citrate in connection with the physical and psychic stress of the infertility therapy can be regarded as the trigger factor. For patients with evidence of psychiatric illness in their case history, ovulation-inducing substances such as clomiphene citrate should be implemented with particular care.
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PMID:Clomiphene citrate as a possible cause of a psychotic reaction during infertility treatment. 915 29

The author believes that psychocutaneous medicine has indeed come of age and is being incorporated into mainstream medical practice. Patients presenting to dermatologists today are more sophisticated and are frequently dissatisfied with traditional medical therapies. They actively seek alternative approaches and adjuncts to standard treatments. In contrast to many other "alternative" (or) "holistic" treatments offered through non-medical venues, dermatologists can assure their patients that controlled studies support the efficacy of psychocutaneous techniques in improving many dermatologic conditions. Psoriasis, rosacea, herpes simplex, body dysmorphic disorder, acne, eczema, urticaria, neurotic excoriations, excoriated acne, trichotillomania, dysesthetic syndromes, and delusions parasitosis are included in this incomplete list. The author believes it is helpful for both the patient and therapist to define concrete and realistic goals for psychocutaneous intervention. Concrete observable or measurable goals can help the patient and clinician gauge therapeutic progress and success. Specifically, goals can include reduction in pruritus (rating severity from 1-10), decreased scratching activity, decreased plaque extent or thickness, decreased number of urticarial plaques, decreased flushing, decreased anxiety, decreased anger, decreased social embarrassment, decreased social withdrawal, and improved sleep. More global goals can include an improved sense of well-being, increased sense of control, and enhanced acceptance of some of the inevitable aspects of a given skin disease. Cure should never be a goal, because most disorders amenable to psychocutaneous techniques are chronic in nature; thus, cure as an endpoint would only lead to disappointment. The author encourages dermatologists to align themselves with what he euphemistically calls "a skin-emotion specialist." The skin-emotion specialist may be a psychiatrist, psychologist, social worker, biofeedback therapist, or other mental health or behavioral specialist. Patients are more likely to accept a referral to a "skin-emotion specialist," because this term destigmatizes psychologic interventions. Incorporating these techniques and specialists into a clinical practice will expand therapeutic horizons and improve the quality of life of many of the patients afflicted with chronic skin disease. A final caveat must be offered about attempting to make prognostic statements regarding the likelihood of therapeutic success. Although all patients can potentially benefit from psychocutaneous interventions, those with severe psychopathology and poor pretreatment functional status are likely to be more difficult to treat and to achieve less optimal outcomes. Patients with personality disorders such as borderline, narcissistic, and schizotypal disorders, and patients with any active psychotic process certainly constitute a more resistant and difficult population with whom therapeutic success is less likely. These patients, however, are often the ones in the greatest subjective distress and certainly can profit from any of the described interventions. Quoting W. Mitchell Sams, Jr., "although the physician is a scientist and clinician, he or she is and must be something more. A doctor is a caretaker of the patient's person--a professional advisor, guiding the patient through some of life's most difficult journeys. Only the clergy share this responsibility with us." This commitment is and must always be the guiding force in the provision of comprehensive and compatient patient care.
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PMID:Nonpharmacologic treatments in psychodermatology. 1185 91

Antipsychotics have been found to induce recurrent psychotic episodes lasting minutes to hours, mostly accompanied by oculogyric crisis (OGC). To characterize this side effect, antipsychotic-induced and postencephalitic OGCs that were reported in the literature were compared to find out common characteristics of OGCs and their associated symptoms. Both postencephalitic and antipsychotic-induced OGCs were found to occur late in the day and at regular intervals, and were associated with autonomic symptoms such as profuse sweating, facial flushing, transitory hypertension and difficulty in micturition. They were often associated also with transient psychiatric episodes: visual hallucinations and illusions, auditory hallucinations, delusions, catatonic phenomena, obsessive thoughts and panic attacks. These (OGC) characteristics will be useful in recognizing antipsychotic-induced psychiatric episodes. The associated psychiatric episodes were noted to recur occasionally also without OGC in a few postencephalic cases, and during gradual dose reduction or after a switch to a novel or low-potency antipsychotic in drug-induced cases. These findings suggest that episodes with the OGC characteristics but without OGC per se, may be less severe reactions to antipsychotic medication than those with OGC, and may represent manifestations of subclinical OGC.
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PMID:Psychiatric symptoms associated with oculogyric crisis: a review of literature for the characterization of antipsychotic-induced episodes. 1668 78

The scopolamine patch is usually used to reduce postoperative nausea and vomiting associated with anesthesia and/or surgery. It is also commonly used for the prevention of motion sickness. Transdermal scopolamine patches have been used for decades and there are few reports in the literature of toxic psychosis associated with the product. Most documented cases of acute psychosis following administration of scopolamine or other anticholinergic agents have been from the adult population. Here we present a 4-year-old boy with deteriorated cognitive function and changed mental status acutely. Besides flushing skin and psychotic behaviors including bizarre actions, hallucinations, aggressive behavior, hyperactivity, and incoherent speech were also noticed. Symptoms and signs were resolved after removal of scopolamine patch and conservative management. This case is possibly one of the youngest patients to exhibit such toxic effects. We hope to relay information about common agents with anticholinergic effects to clinical practitioners and remind that drug-induced psychosis should be considered in children with acute changes in behavior.
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PMID:Delirium due to scopolamine patch in a 4-year-old boy. 2149 84

Mechanisms of cortical psychoses are approached by complementing big data-driven genetics and imaging with a putatively subverted neurovascular "reverse plumbing" by arteries. The "cortical spread" of grey matter loss in schizophrenia and the mid-pericallosal "congestion" in fMRI of periodic catatonia - treatable electromagnetically along arteries - are interpreted in terms of the fastest interstitial outflow through the Cerebral IntraMural Reverse Arterial Flow-engine (CIMURAF, Treviranus 2018-19) draining "waste" via arterio-adventitial lymphatics to the neck. Such repetitively sliding segments of CIMURAF are wrung downstream by muscles likely steered by the neurovascular pterygopalatine ganglion. At the pericallosal artery, along its ideal long straight segment, this likely happens diverging from the mid-callosum towards the front and the back. In the case of a convergent inversion a mid-callosal clash will result, which is observable in psychoses as a mid-callosal high-flow-spot simultaneously with hyper-perfusions of branches and "backwatering" of pial vessels with reactive waste - till date interpreted psycho-mathematically. CIMURAF might also accelerate the perivascular intrusion of MCs by flushing autocrine signals (of which electro-magnetism moves the dipoles) through a putative periadventitial counter-current. Psychoses plausible occur through tryptase-mediated attacks operated by mast cells against oligodendrocytes' cytoskeleton (Medic 2009) and probably via complement-4 (Schizophrenia WG, 2014) against neurons. Usually MCs are essential long-lived "orchestrators" of homeostases and immune or barrier defences interacting with nerves, immunocytes, organs, and routes. MCs after somatic programming as to "destination & destiny" (Treviranus 2017a, 6.2., 2018) rapidly intrude also into the brain's parenchyma, first within the lymphatics and then putatively by crossing-over to extraluminal arterial routes. MCs transverse the BBBs, while macrophages only trespass in "disease" (Faraco et al. 2017). Both can be "subverted" by a list of microbes (and putatively blown up by COVID-19 within walls). Enuresis and MCs' reactions to clozapine add to the interactive support from (epi-)genetics and imaging.
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PMID:Psychoses by Attacks from Subverted Mast Cells: A Role for Arterial Intramural Flow Badly Steered by the Nasal Ganglia? 3289 Mar 71