Pleurothotonus: epidemiology in a Psychiatric Institution and literature review
Biotechnology and Health Sciences: February 28, 2018,
5 (1); e57589
February 01, 2018
Article Type: Research Article
February 13, 2017
August 23, 2017
L. et al. Pleurothotonus: epidemiology in a Psychiatric Institution and literature review,
Biotech Health Sci.
Background: Drug-induced Pisa syndrome is an unusual condition. It has been invocated to be more frequent in long-stay Psichiatric Institutions, but a few studies have been published in this setting.
Objectives: To know clinical characteristics and response to therapy of drug-induced Pisa syndrome in a long-stay Psychiatric Institution.
Methods: An observational retrospective cohort study was conducted along three years, over inpatients of Instituto Psiquiátrico José Germain (IPJG). Detected cases of pleurothotonus were evaluated by a multidisciplinary team compounded by a Psychiatrist, an Internal Medicine Doctor and a Chemist. Clinical features were recorded in the electronic medical history; as well as complete medication and response to therapy.
Results: Cumulative incidence was 2.54% in three years and 60% of cases were males. Mean age was 53 years (SD 10.17). Drugs implicated were: paliperidone depot, quetiapine, levomepromazine, zyprasidone, olanzapine and clozapine. All cases were resolved after treatment adjustments: 40% of them responded to anticholinergic therapy; but finally 80% of the patient needed withdrawal of offending drug.
Discussion: Drug-induced Pisa syndrome is a rare condition, with a higher rate of apparition in patients with a long history of mental disease. High grade of suspicion is needed to get a correct diagnosis. Usually it responds to treatment adjustments; so is mandatory to diagnose it to improve life quality of mental illness patients and to avoid adverse events.
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