Biohackeři mění genetiku

prof. Ing. Jaroslav Petr, DrSc.

Psychiatr. praxi 2018; 19(1): 3  

Pharmacotherapy of Alzheimer disease and neuropsychiatric symptoms of dementia

PharmDr. Iva Prokopová, Ph.D.

Psychiatr. praxi 2018; 19(1): 7-10 | DOI: 10.36290/psy.2018.002  

Alzheimer disease is the most prevalent cause of dementia. A precise diagnosis is required for effective management. Cholinesteraseinhibitors are used as first line therapy to provide modest symptomatic benefit in some patients, memantine appears tohave modest benefits in patients with moderate to severe disease. Neuropsychiatric symptoms are common in dementia andcontribute to nursing home admission and caregiver stress. Identifying the genesis of the abnormal behavior is critical, in orderthat nonpharmacologic therapies are preferred over medication. Symptomatic pharmacologic treatment includes antidepressants,antipsychotics, anxiolytics and other...

Depression and suicidal behavior in childhood and adolescence

MUDr. Jiří Koutek, Ph.D., doc. PhDr. Jana Kocourková

Psychiatr. praxi 2018; 19(1): 12-15 | DOI: 10.36290/psy.2018.003  

Suicidal behavior in childhood and adolescence is often linked to depressive mood, whether in the context of a depressive episodeor other mental disorders. Completed suicide in childhood is rare, a certain increase in the incidence of suicidal behavior occursin the adolescent development period, particularly growing is incidence of suicidal attempt. The developmental point of viewhas to be taken into account when assessing the depth of depression and the suicidal risk. An important risk factor for suicidalbehavior is self-harm. The issue is illustrated by case reports.

Therapeutic approaches in drug-resistant treatment schizophrenia

prof. MUDr. Klára Látalová, Ph.D.

Psychiatr. praxi 2018; 19(1): 17-21 | DOI: 10.36290/psy.2018.004  

Schizophrenia for many patients is a lifelong mental disorder with significant consequences on most functional domains. One fifthto one third of patients with schizophrenia experience persistent psychotic symptoms despite adequate trials of antipsychotictreatment, and are considered to have treatment-resistant schizophrenia (TRS). Clozapine is the only medication to demonstrateefficacy for psychotic symptoms in such patients. However, clozapine is not effective in 40–70 % of patients with TRS and it hassignificant limitations in terms of potentially life-threatening side effects and the associated monitoring. Accordingly, a numberof pharmacological...

Is there an evidence for the efficacy of high-dose olanzapine?

MUDr. Martin Hýža

Psychiatr. praxi 2018; 19(1): 22-23 | DOI: 10.36290/psy.2018.005  

High-dose olanzapine is an option in the effort to break the pharmacoresistance in the treatment of schizophrenia. This is groundedboth by the expert recommendations and a few randomized, double-blind trials that compared the efficacy of high-doseolanzapine (25–45 mg/d) with recommended-dose clozapine and found the same efficacy of both. High doses are generally welltolerated with the exception of the increase of weight. Therapeutic drug monitoring is recommended while titrating high dosesand one has to take care of potential signs of toxicity.

Collaboration between a pain specialist and outpatient psychiatrist in the care of a patient with addiction

MUDr. Josef Trnka

Psychiatr. praxi 2018; 19(1): 24-27 | DOI: 10.36290/psy.2018.006  

Since ancient times, opioids have had an irreplaceable role in treating pain. Their comprehensive effect covers a wide range ofsymptoms accompanying painful conditions. Patients with both acute and chronic, particularly non-tumour-related, pain havea potential for developing an addiction. According to pain management standards, it is not the pain aetiology, but its intensitythat is the indication for opioid administration. Addiction to opioid-based pain medications is a relatively common and, whatis more, much-feared complication in patients treated for chronic non-tumour-related pain. It is a major burden for the patient,the health care system, and...

The effect of pregabalin in treatment of generalized anxiety disorder with comorbid depression in geriatric patient.

MUDr. Lenka Šebelová, MUDr. Antonín Šebela

Psychiatr. praxi 2018; 19(1): 29-30 | DOI: 10.36290/psy.2018.007  

There is a high prevalence of anxiety disorders in geriatric population. Generalized anxiety disorder is one of the most commonanxiety disorders and is frequently accompanied with comorbid psychiatric illness. We describe treatment of geropsychiatricpatient with generalized anxiety disorder, comorbid depression and alprazolam abuse. Clinical improvement was achieved bypregabalin in combination with clomipramine.

Positive influence of the vortioxetine in patients with sexual dysfunction

doc. MUDr. Jaroslav Zvěřina, CSc.

Psychiatr. praxi 2018; 19(1): 32-34 | DOI: 10.36290/psy.2018.008  

A short case history of 65 years man, psychiatric patient. Within a depressive stage was antidepressive agent paroxetine changedfor vortioxetine. The medication with paroxetine was able to improve the depressive mood, but the effect was connected withsome sexual dysfunctions. Under the multimodal antidepressant vortioxetine there have been observed substantial improvementof a sexual drive and reduction of feeling of sexual insufficiency. The short case history is of course not any universally recipe fora therapy of sexual dysfunctions in depressive patients. We try to demonstrate a possible positive influence the vortioxetine onthe sexuality in some...

Factitious disorder

MUDr. Birgita Slováčková, Ph.D., Mgr. Rastislav Žirko, doc. MUDr. Ladislav Slováček, Ph.D.

Psychiatr. praxi 2018; 19(1): 35-38 | DOI: 10.36290/psy.2018.010  

For a factitious disorder, the patient pretends to be symptomatic, aggravates, or self-inflicted. Unlike the simulation it does notdo it for consciously good reasons. The primary goal is to get medical attention and interest in others. The authors describe thecase of a young woman with serious facial disorder. They point to the complexity of more accurate diagnostics in patients withmultiple or severe somatic symptoms that are not sufficiently explained by current medical practices.

prof. MUDr. Jaroslav Bouček, CSc.

Psychiatr. praxi 2018; 19(1): 34