Hair loss from drugs and radiation
Jerry Shapiro, Nina Otberg in Hair Loss and Restoration, 2015
Drugs and radiation can affect cell cycling and may lead to alopecia. This chapter reviews which drugs have been implicated in hair loss and explores the mechanisms of how pharmaceutical agents and radiotherapy can alter hair cycling and structure. The workup for any patient with hair loss must include a thorough drug history. One must understand the basic mechanisms of hair growth and cycling to understand drug-induced hair loss. Hair loss occurring a few days after drug intake indicates an effect on hair matrix cells. Hair loss developing weeks to months after drug intake may be due to hair matrix effects, but may result from changes in keratin production or changes in the hair cycle. Patients are sometimes more afraid of the hair loss and cosmetic disfiguration than of the underlying disease or therapy itself. Hair loss is a possible adverse effect of lithium carbonate, and may be noticed within weeks or years after commencing therapy.
Depression
Hugh McGavock, Dennis Johnston in Treating Common Diseases, 2017
Cognitive behavioural therapy (CBT) and brief psychotherapy have been proved to be therapeutic in mild and moderate depression. Both aim to readjust the patient's thought processes away from a negative self-image and attitude towards a positive one. Regular, rhythmic exercise should be strongly advised, as it has been shown to improve all levels of depression. Dysthymic patients have persistently depressed mood, on most days, for most of the day, sometimes lasting for years. In Electroconvulsive therapy, an electric shock applied across the patient's temples causes a generalized central nervous system (CNS) convulsion. Manic-depressive disorder requires specialist management. Lithium carbonate is usually effective in 'ironing out' the peaks and troughs of mood, but it is a dangerous drug whose therapeutic dose is close to its toxic dose. The billion neurons in the CNS communicate with each other and with other parts of the brain and body by means of chemical signals - the neurotransmitters.
Charting the Course of Psychotic Episodes
James H. Kleiger, Ali Khadivi in Assessing Psychosis, 2015
The chapter presents past and present diagnostic concepts and diagnostic classifications. By understanding the diagnostic classification of psychotic disorders requires a review of historical changes in psychiatric ontological systems. Kraepelin distinguished two psychiatric conditions, dementia praecox and manic-depressive illness. Eugene Bleuler accepted Kraepelin's classification but emphasized the importance of assessing certain classes of psychological symptoms. Bleuler's now-famous four classes of diagnostic signs of schizophrenia, which became known as 'Bleuler's 4 A's' included: autism, association, affect, and ambivalence. Kurt Schneider was influenced by Kraepelin's concept that schizophrenia had a non-psychological origin. The role of affective symptoms is acute onset, presence of confusion, absence of schizoid premorbid adjustment. In 1970, Lithium carbonate was used successfully in the treatment of manic-depressive illness. DSM-III which is used for the diagnosis of schizophrenia should be made only when a patient showed psychotic symptoms either actively or predominantly for six months. DSM-5 which makes the importance of using bizarre symptoms as diagnostic indicators has been removed.
Cluster headache management and beyond
Published in Expert Opinion on Pharmacotherapy, 2015
The therapeutic management of cluster headache is based on a very stable triad of drugs. Acute treatment has, in subcutaneous sumatriptan, its gold standard if compared to pure oxygen or indomethacin. Preventative treatment is based on verapamil at high doses (≥ 360 mg) and is a gold standard if compared to lithium carbonate or topiramate. Transitional treatments, based on the short-term use of corticosteroids with either systemic or local administration (GON), can be useful for the suppression of most resistant cluster periods, but with a well-known carry-over phenomenon related to the length of the cluster period itself. The role of invasive or noninvasive neuromodulation approaches must still be determined on a large scale; therefore, its use is not recommended as of yet. Lifestyle changes, including alcohol avoidance during the active phase of the disease, sleep hygiene and use of vasodilation drugs, should be carefully considered and the patients should be fully informed.
Effectiveness of Normal Saline Diuresis in Treating Lithium Overdose
Published in Baylor University Medical Center Proceedings, 2008
David D. Boltan, Andrew Z. Fenves
Lithium carbonate is a common treatment for mood disorders, but it has a very narrow therapeutic index and can be toxic to multiple organ systems. Unfortunately, many patients suffer toxic effects through the course of their therapy. We describe a patient with toxic effects from a high dose of lithium who was successfully treated with normal saline diuresis. We discuss the properties that make lithium susceptible to normal saline diuresis and explore alternative options for treatment of lithium toxicity.
Lithium effects on vesicular trafficking in hepatocellular carcinoma cells
Published in Ultrastructural Pathology, 2019
Iuliia Taskaeva, Nataliya Bgatova, Izabella Gogaeva
Hepatocellular carcinoma (HCC) is one of the most commonly malignant tumors worldwide, characterized by the presence of many heterogeneous molecular cell events that contribute to tumor growth and progression. Endocytic processes are intimately involved in various pathological conditions, including cancer, since they interface with various cellular signaling programs. The ability of lithium to induce cell death and autophagy and affect cell proliferation and intracellular signaling has been shown in various experimental tumor models. The aim of this study was to evaluate the effects of lithium on vesicular transport in hepatocellular carcinoma cells. Using transmission electron microscopy we have characterized the endocytic apparatus in hepatocellular carcinoma-29 (HCC-29) cells in vivo and detailed changes in endocytotic vesicles after 20 mM lithium carbonate administration. Immunofluorescent analysis was used to quantify cells positive for EEA1-positive early endosomes, Rab11-positive recycling endosomes and Rab7-positive late endosomes. Lithium treatment caused an increase in EEA1- and Rab11-positive structures and a decrease in Rab7-positive vesicles. Thus, lithium affects diverse endocytic pathways in HCC-29 cells which may modulate growth and development of hepatocellular carcinoma.
Related Knowledge Centers
- Central Nervous System
- Amyotrophic Lateral Sclerosis
- Co
- Carbonates
- Biogenic Monoamines
- Lithium Compounds
- Electrolyte