eJournal of Medicine

 

The possibility? Obligation? n to set options for New Zealand psychotic? logos? Currently est? considering. The m? Physicians were asked? sull’opportunit express opinions? of such action and make suggestions about the needs of formation? No additional. Undoubtedly, a thorough knowledge of the side effects of these medications can be prescribed to be? A need.

In reality?, La comprehension? N of possible side effects of medicaci? Na short and long term in general? gi? a? area that deserves much more? s? attention? n by all those working in mental health. The potentially severe consequences on the mental health of the ingestion? N est certain prescription drugs? N described in a series of drug inserts. Adem? S, agencies such as the Food and Drug Administration (FDA) issued? notices warning against the use of some prescription drugs that the state can? cause severe psychiatric disorders? tric. Tambi? No proposals are currently in the United Kingdom to give each new drug approved in a composite score? N of suicide. ”

This reform, based on a system recently approved in the U.S.? been driven by a growing body of evidence that drugs can affect the brain? strongly influence behavior through? s seemingly innocuous changes in the qu? mica body. Medicines to treat acne, swelling n, burning, pain, obesity?, President? No high blood cholesterol, bacterial infections, smoking and insomnia has been recently associated with psychiatric problems? Tric. (Mostrous, 2008).

One of these drugs? isotretino? na (also? n known as Accutane or Roaccutane), indicated for the treatment of acne. This derivative of vitamin A, manufactured by Hoffman-La Roche? one of the greatest? a drug? popular and controversial of the company?. For the most? To it? Recent warnings from the FDA (FDA, 2005), said:

FDA ALERT [7 / 2005]: suicidal thoughts or actions: Adem? S to strengthen The management? No risk program, the FDA continues to assess reports of suicide or suicide attempts associated with the use isotretino? Na. All patients treated with isotretino? Na should be closely monitored for s? Symptoms of depression or suicidal thoughts, such as state? Minimum sad, irritable?, Acting on dangerous impulses, anger, p? Loss of interest? So pleasure in activities? social or sports activities, sleeping too much or too little change, weight or appetite, school or play, or the work will ya?, or difficulty concentrating, or mood disorders, psychosis, aggression? n? o. Patients should stop isotretino? Na and they or their caregiver should contact your doctor immediately if the patient has any of the s? Symptoms mentioned above. The interrupt? No treatment can? An evaluation to? n insufficient and may require m? s.

The “information leaflet Patient n” of this drug also? N says:

serious mental health problems: The isotretino? na may? Cause:

- The depression? N

- Psychosis (seeing or hearing things that are not real)

- Suicidal thoughts or actions

“The aggressive and violent behavior

Although approved for the treatment of “m? S? Severe form of acne? (Acn? Nodular) that can not be resolved by the treatments for acne?” (FDA, 2005), isotretino? Na? been m? s and m? s? used to treat most? to forms? the acne? mild to moderate. “In 1995, the m? Doctors have estimated that s? As ten percent of the prescriptions were of a serious illness” (Girling, 2002). As a result, it is estimated that millions and millions have been treated with isotretino? Na in the world. Unfortunately, the n? Number of people who reported suffering severe side effects of mental health continues to grow. An investigation? No documentary, presented in November 2006, cited m? S? 6000 cases of psychiatric effects? tric isotretino use? na, with “the authorities? the health of the United States, this estimation? n is about one percent of those actually affected (Tinari, 2006). In line with this declaration? n, Carleton, Smith, Gelin and Heathcote (2007) identified? ADRs (adverse drug reactions) as a major cause of morbidity? and mortality? not? oy said that up to 95% of ADRs are not reported. In a survey of students in New Zealand secondary school (Purvis, Robinson, and Watson, 2004), 14. 1% report? having acne problem?. E ‘estim? that 5,000 j? Venes isotretino NZ take? na (Lawrence, 2006). For a? or 2006, the Centre for Adverse Drug Reactions Monitoring (CARM) had? has received 93 reports of adverse reactions to this drug (MARC, 2006). If Sanit? the estimates are correct Authority USA (Tinari and H? Ner, 2006), and about 930 New Zealanders have not significantly affected.

 

The isotretino? Na? entered the market as a treatment for acne? in 1982. In 1983, Hazen, Carney and Walker and hab? To? public? details of 24 cases of depression? n associated with their use. These results reinforce the previously reported Myskens (1982), which room? Been treated with an isotretino? Na as a treatment for patients with c? Advanced cancer. About 25 percent of patients suffering? “Psychological changes? Gicos.” These include 18 cases of depression? N. Four patients who had? An attempted suicide. The a? Following years there has been much debate about the strength of a causal link? between isotretino? na and mental health problems. The means of communication? No place in this debate and the drug “has the kind of security normally reserved for mass murderers or cat? Disaster to? Areas” (Girling, 2002). In 2007, Carleton et al. lead? out an? retrospective analysis of 1,193 Canadian suspected adverse reactions in the kids (including teens 58. 6%). The f? Drug is m? S? mentioned? isotretino? na is the descriptor most? and reaction? n? frequently? psychiatric disorders? tric. In his summary of the investigation? N exists linking the isotretino? Na to depression? N, psychosis, suicide, and O’Donnell (2003), then? S to discuss known birth defects caused by the ingestion? n the isotretino? na during pregnancy, arrived? at the conclusion? n:

Least known? the risk of this fat-soluble substance that affect the central nervous system. Reports of hypertension n intracranial depression? Ne ideation? No suicide Accutane use have led to an examination of his life serious potential threat … p? PUBLIC must be informed of the indication? n limited right to use, because of the depression? ny suicide is? followed in patients with no history of s? psychiatric symptoms? tric or suicide attempts.

 

Against this Conclusion? N, however, were the results of Cohen, Adams, and Patten (2007), using scales to assess depression? No signs of mental health disorders at baseline and after? S isotreinoin two months of treatment. They found no correlation? N between the use of isotretino? Na and development of the Depression in their actions. This study also? N has been criticized as “the most? To the complaints about the depression? N (isotretino? Na below) comes four months after they started s of treatment” (“Study”, 2005) . However, the researcher Siegfried (who hab? Has made this comment) and his colleagues (Chia, Lane, Chibnall, Allen, and Siegfried, 2005) ASSESSMENT? N levels of depression? N four months later? S treatment isotretino? na, too? n found? The signs of this disease were m? s? common in these patients in the conservative treatment group. In both studies, midi? the depression? n using the Center for Epidemiol? gicos of Depression? n (CES-D) or Zung Self-Rating Depression Scale? n. By? Finally, in line with these results, Bremner et al. (2005) report? that among the sample, there were significant increases in depression scores? n (Scale of Depression? n Hamilton) after? s four months of treatment with isotretino? na. However, the study Bremner? much more? s? Another famous by the discoveries made during this research? N. In a world first, Bremner measure brain function in tem? Policy through? S of [18F] fluorodeoxyglucose tomography,? A single photon emission? N tomography before and after? S four months of treatment with isotretino? Na or antibiotics ? ticos. The results clearly showed that treatment with isotretino? Na, but treatment with antibiotics? Law? been associated with reduced brain metabolism in the orbitofrontal cortex (-21% in comparison? n with the rate of 2% in exchange for antibiotics? ticos). This? a? area of the brain known to mediate the s? symptoms of depression? n. It seems that these changes can be seen in brain function? produce s? symptoms (eg anger, aggression? n?, paranoia) is not? No well measured with depression? n detection tools? n are used in isolation. scales of depression? n “can not? take the place of an interview cl? complete unique to confirm a diagnosis? stico of depression? n” (WHO, 2008).

 

In a recent study carried out in Universit? Bath and Texas, the researchers were able to monitor the effect of the drug in the qu? Mica The cells that produce serotonin. They found that the c? Cells in culture increases? production significantly? n of proteins and metabolites of c? cells that are known to reduce the availability? serotonin (O’Reilly, Trento, Bailey, and Lane, 2007). Researcher Sarah Bailey, said: “The important substance serotonin qu? Mica transmitting it? Signals of the c? Nerve cells to other c? Cells of the body … in the brain thought to play? An important role in the regulation ? n from a variety of behaviors such as aggression? n?, anger. and the dream o. Low levels of serotonin have been associated with depression? ny bipolar disorders and anxiety “(” mechanism “, 2007 .) Previous research by some of the very scienti? Ficosa (O’Reilly, Shumake, Gonz? Lez Lima, Lane and Bailey, 2006) arrived? at the conclusion? n the isotretino? na caused depressive behavior in mice. These results were supported by those of Crandall et al. (2004) who showed that a dose of “cl? Nica of 13-cis-RA (the active component of the drug) in mice significantly reduced the proliferation? N cell in the hippocampus and the subventricular zone, the neurogenic? Genesis of the hippocampus and deleted? capacity? Seriously disturbed to learn a maze …. “In art? ass Member Review? n by pi? Recently, Strahan and Raimondi (2006), taking into account these findings, concluded?: “It ‘s clear that the isotretino? Na may impede growth and hormones affect neurotransmitters, including systems known to be involved in psychopathology “A”. This Conclusion? n? similar to that of Bremner and McCaffery (2008), auditor’s report? a very recent, which describes several m? all that can be targets? retinoic acid (isotretino? na component) and contribute to the pathophysiology? to the depression? n.

 

By? Finally, several published studies have documented the development of the s? Psychiatric symptoms? Tric next? S of isotretino? Na use. Barak et al. (2005) described? a “series of cases of hobby you? Developed over a period, but a year you in association? No treatment with isotretino? na and resulted suicidalit? progressive? na psychosis and long term. The cases were taken from 500 soldiers hab? an been evaluated in a cl? unique dermatologist? logo military specialists “for acne? severe. “Immediately after? s of this, Friedman et al. (2006) takes? out a review and? n of five year and report? a significantly increased use of mental health services by 1,419 soldiers in the forces israel armed? is that ten? an history of use of isotretino? na and the control group. There are many case studies, presentations, reports s? abnormal symptoms similar to those described by Barak et al. (2005). Bachmann, Grabarkiewicz Thiesen and Remschmidt (2007), for example, present? the case of a no? or 16 years who had two episodes of depression? n “strongly associated” with the treatment isotretino? na and require ” care unit locked. “arrived at the conclusion? n:” In the present case report suggests that isotretino? na may cause Depression in patients idiosyncratic? As musicians? that prescribers of the drug should be aware of the adverse drug reactions and, if necessary, refer patients to mental health institutions? “..

 

According to this recommen? N for a referral to an institution? N mental, “the FDA (2005), then? S to evaluate all the available results of the investigation? N on isotretino? Na, followed by its recommendation? N with the caveat that “. A reference to a mental health professional can? need for “C”? a fancy, use, therefore, that these mental health professionals who receive these reports have the knowledge and skills to manage an individual suffering from psychiatry? tric side effects of the exhibition? the isotretino na? na. Unfortunately, for ‘, c’? been a serious failure to educate m? doctors about this. Many have little, if any, knowledge of the implications of isotretino? Na RESEARCH? Nyc? Mo these translate into effective and managed clients? N patients. The cr? Policies to support offered to people who value their exhibition? The isotretino na? Na s? Psychiatric symptoms? Tric abound. Numerous media reports ym? Forensic doctors “of suicides related to isotretino? Na are related to slow or inadequate responses by mental health professionals and lack of knowledge of the isotretino? Na – v disease? Mental LINKS. (Medication the acne, 2004, Girling, 2002; Sims, 2005;? Tinari & H Ner, 2006). Without a thorough understanding of the possible side effects of isotretino? na, m? doctors can not do An evaluation? n precise factors causing the problems, failing to help clients / patients in their understanding? n of these factors responsible for disease can not make notifications of adverse drug reactions and not to refer to clients / patients to health workers m? s? probability? to provide intervention? n successful.

 

I think a lack of communication? No significant between those who approved? the distribution? No drug as isotretino? na and health professionals who become responsible for the treatment of side effects. In 2006, the records of adverse reactions New Zealand’sMedicines Commission? N plead? following:

The Committee? Consider? The dermatologist? logos are aware of the possible association? n between isotretino? na and depression, use, mood swings, and were aware of the need? counsel patients about a possible effect on the state? minimum and the time of discontinuation. The commission? No discussion? if m? physicians who prescribe these products need to be reminded of the possible association? n between isotretino? na and the effect on the state? minimum. (MARC, 2006)

 

? Qu? seems that although the dermatologist? logos ym? physicians (possibly) were informed of the possible psychiatric side effects? tric of isotretino? na, these warnings have not reached the controllers of the impaired isotretino? na activated. To date, no treatment guidelines spec? Ficas or published studies outlining strategies for successful treatment. S not recognize the symptoms do customers like isotretino? Na related caused the subsequent disability? to share information? n about? successes and failures of treatment.

 

While psychotic? Logos in New Zealand to look at the pros and cons of the prescription? No rights to add your responsibility? professional? should consider improving our knowledge base and strategies ASSESSMENT? No previous drug related customers to use “other that may cause or influence that their problems are, and should influence treatment options. The good pr? PRACTICE cl? nica should include:

 

 

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