Abstract：
:Ziconotide is used intrathecally in the management of severe chronic pain that contains a warning against neuropsychiatric adverse events. The definition of psychiatric events is broad and management strategies are vague. This case report describes a 49-year-old female who was admitted to the acute psychiatric unit to address auditory hallucinations and paranoid ideation persisting for 3 weeks. Approximately 3 months ago, an intrathecal pump with ziconotide was implanted to treat pain. Upon hospital admission, the pump was infusing at a rate of 4.9 mcg/24 hours. Because the drug could not be immediately discontinued, risperidone 0.5 mg nightly was initiated and subsequently, the pump was drained of ziconotide, rinsed, and refilled with normal saline. The patient reported no hallucinations or apparent delusions several hours later and was eventually discharged with resolution of psychotic symptoms and continuation of risperidone for 10 days. Despite the identification of neuropsychiatric effects, limited information is available to characterize the presentation and guide specific management aside from recommendations to discontinue the infusion and possible use of psychotropic medications or necessity for hospitalization. This case report characterizes one presentation of hallucinations and paranoia associated with ziconotide intrathecal infusion. Clinicians should be aware of the management strategies to mediate these adverse effects, including expected time to adverse effect resolution, removal of ziconotide from the pump, and role for short-term use of antipsychotics.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Phan SV,Waldfogel JMdoi
10.1016/j.genhosppsych.2014.10.001subject
Has Abstractpub_date
2015-01-01 00:00:00pages
97.e11-2issue
1eissn
0163-8343issn
1873-7714pii
S0163-8343(14)00263-1journal_volume
37pub_type
杂志文章abstract：:Parasuicide is usually associated with low suicidal intent and research data show that rising rates remain a challenging clinical and research problem. Hopelessness, a core characteristic of depression, appears to be the link between depression and suicidal behavior in high-risk patients. Previous research in this reg...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(88)90021-7
更新日期：1988-05-01 00:00:00
abstract：:This article presents research involving the comparison of levels of occupational stress across multiple units of a large teaching hospital. Using a scale designed to measure a four-component model of occupational stress in medical environments, the results indicated that a significant amount of the variation in this ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(87)90053-3
更新日期：1987-11-01 00:00:00
abstract：:Bone marrow transplantation offers new hope for cure in a variety of leukemias, aplastic anemia, and other immunodeficiency and hematologic disorders. But the psychologic circumstances accompanying this procedure are often profoundly stressful. The evolution of consultation--liaison services on a bone marrow transplan...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(88)90006-0
更新日期：1988-09-01 00:00:00
abstract：OBJECTIVE:This study examined the differences in the level of perceived helpfulness of treatments received for a major depressive episode (MDE) from a general medical provider only, a specialty mental health provider only or both. METHOD:This study examined a sample of 8900 respondents from the 2008-2012 National Surv...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2015.04.006
更新日期：2015-07-01 00:00:00
abstract：:The interrater reliability and validity of brief interview rated measures of psychosocial adjustment were examined in four sequential studies. A total of 25 videotaped interviews with cancer patients were rated by 105 social workers, nurses, physicians, and specialists in psychosocial oncology. The Rating of Psychosoc...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(81)90048-7
更新日期：1981-06-01 00:00:00
abstract：OBJECTIVES:The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety an...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2012.07.012
更新日期：2012-11-01 00:00:00
abstract：OBJECTIVE:Thyroid dysfunction is common during pregnancy and the postpartum period and is known to cause psychiatric disturbances. A woman with Graves' disease and psychosis in the postpartum period is described. METHODS:A 22-year-old woman with Graves' disease developed fluctuating orientation, catatonia, delusions o...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.07.003
更新日期：2014-11-01 00:00:00
abstract：BACKGROUND:Many patients treated in the emergency department (ED) for non-psychiatric complaints have elevated suicide risk. Universal screening can detect occult suicide risk, but gold standard risk measurement tools, such as the Beck Scale for Suicidal Ideation (BSS), are too long and cumbersome for ED use. OBJECTIV...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2018.08.004
更新日期：2020-01-01 00:00:00
abstract：:Systematic assessment of the effect of clinical research studies on child and parent participants has been limited. Such assessment could provide an empirical basis for the ethical conduct of research, assisting investigators and institutional review boards in balancing the need for sound research with the need to pro...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(02)00200-1
更新日期：2002-09-01 00:00:00
abstract：OBJECTIVES:This study aimed to compare the characteristics of psychiatric and nonpsychiatric suicidal inpatients in one general hospital and examine the predictors of completed suicide in the patients with suicidal acts during hospitalization. METHODS:One hundred ten study subjects were identified by the adverse event...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2008.12.008
更新日期：2009-03-01 00:00:00
abstract：OBJECTIVE:This study aimed at determining the prevalence of psychosis in tuberculosis (TB) patients in comparison to nontuberculosis control and its correlation with disease pattern. METHOD:One hundred and fifteen patients with TB and 112 family members visiting the multidrug treatment-resistant treatment center at Un...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2015.05.012
更新日期：2015-11-01 00:00:00
abstract：:This study describes and evaluates the adequacy of sociodemographic and clinical descriptors as potential predictors of unplanned discharge from and completion of psychiatric day treatment programs. A 2-year retrospective chart review was completed on all patients (N = 327) attending three university-affiliated day tr...
journal_title：General hospital psychiatry
pub_type： 杂志文章,多中心研究
doi：10.1016/s0163-8343(97)00052-2
更新日期：1997-09-01 00:00:00
abstract：:We are gaining experience in small intestine transplantation, however, the procedure is still experimental. Morbidity and mortality can be significant with frequent rehospitalizations. The indications for small intestine transplantation are varied though most patients have developed short gut syndrome requiring total ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(96)00079-5
更新日期：1996-11-01 00:00:00
abstract：:Little is known about which factors may adversely affect response to psychotherapy in diabetic patients with major depression. We studied the relationship of various demographic, diabetes, and depression characteristics to change in depression in 42 patients with type 2 diabetes who completed a randomized clinical tri...
journal_title：General hospital psychiatry
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0163-8343(98)00039-5
更新日期：1998-09-01 00:00:00
abstract：OBJECTIVE:To characterize temporal trends and outcomes of invasive mechanical ventilation (MV) for people with severe mental disorders (SMD) admitted due to natural causes. METHODS:We identified all 224,507 hospitalizations of patients aged 15-69 who underwent MV in Spain between 2000 and 2015, excluding poisonings an...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2020.04.007
更新日期：2020-01-01 00:00:00
abstract：OBJECTIVE:To explore the relationship between treatment setting characteristics and diagnostic attributions of depression among community-dwelling African Americans. METHODS:Data come from the National Survey of American Life, a nationally representative sample of African Americans and Caribbean Blacks. Major Depressi...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.12.002
更新日期：2011-01-01 00:00:00
abstract：OBJECTIVE:We investigated the views of service users and staff regarding contact-based interventions (e.g., letters, telephone calls or crisis cards) following self-harm. METHOD:Self-harm patients recently discharged from an emergency department were selected using purposive sampling (n=11). Clinical staff from releva...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2011.01.009
更新日期：2011-03-01 00:00:00
abstract：OBJECTIVE:The objective was to estimate the prevalence of both dementia and depression among community-dwelling older Americans and to determine if hospitalization is independently associated with dementia or depression in this population. METHOD:This cross-sectional study utilized data from a nationally representativ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2013.11.008
更新日期：2014-03-01 00:00:00
abstract：:The present study aims to validate the Spanish version of the Hospital Anxiety and Depression Scale (HADS) and to determine the use of this tool for screening mood and anxiety disorders. Psychometric properties of the HADS were assessed in different groups of general medical outpatients attending the Hospital Clínic i...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(03)00043-4
更新日期：2003-07-01 00:00:00
abstract：BACKGROUND:Psychological morbidity in both patients and family members related to the intensive care unit (ICU) experience is an often overlooked, and potentially persistent, healthcare problem recognized by the Society of Critical Care Medicine as Post-intensive Care Syndrome (PICS). ICU diaries are an intervention in...
journal_title：General hospital psychiatry
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.genhosppsych.2020.06.017
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS). OBJECTIVES:The objective of this study was to identify the predictors of chronic PTSD in SARS survivors. DESIGN:PTSD at 30 months after the SARS ou...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.07.007
更新日期：2010-11-01 00:00:00
abstract：:Critical, intertwined objectives for consultation psychiatry include 1) the development of data-based clinical practices, and 2) heightening the effectiveness of consultation. Toward these ends, the Consultation Psychiatry Service at the University of Minnesota has previously conducted systematic studies of consultati...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(85)90020-9
更新日期：1985-04-01 00:00:00
abstract：:The psychosocial skills of 24 PGY I medical residents receiving psychiatric training every other week during the internship year were evaluated and compared to a control group of 13 PGY I residents. After the internship year, the psychiatrically trained residents showed an increase in their ability to recognize emotio...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(86)90088-5
更新日期：1986-03-01 00:00:00
abstract：:Of growing concern has been the phenomenon of psychoactive chemicals legally marketed as a variety of products such as "bath salts" or "herbal incense." There is little in the formal literature about actual adverse effects of such chemicals. We have two cases of a paranoid psychosis in individuals consuming methylened...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2011.04.010
更新日期：2011-11-01 00:00:00
abstract：INTRODUCTION:Intimate partner violence (IPV) is a common form of violence experienced by pregnant women and is believed to have adverse mental health effects postnatally. This study investigated the association of postnatal depression (PND) and suicidal ideation with emotional, physical and sexual IPV experienced by wo...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2015.10.005
更新日期：2016-01-01 00:00:00
abstract：:The psychiatric consultant is dependent upon the consultee for the implementation of many of his or her recommendations. Therefore, research as to the fate of recommendations suggested to the consultee is of eminent importance. The concordance (performing a suggested recommendation) paradigm, as developed by Popkin et...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(90)90059-l
更新日期：1990-07-01 00:00:00
abstract：:Although dialysis discontinuation is the second leading "cause" of death among individuals who are maintained with chronic dialysis, little attention is accorded in the literature to patient ambivalence with this crucial decision. Three cases are presented of clinical situations involving termination of dialysis and a...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/s0163-8343(96)00091-6
更新日期：1996-11-01 00:00:00
abstract：:The pattern of inpatient referral to a general hospital psychiatry department was examined in the present study. The referral rate of 3.6% was higher than those reported by other investigators from India. The majority of the patients had concurrent physical illness. Neurotic depression and alcohol dependence were the ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(87)90072-7
更新日期：1987-09-01 00:00:00
abstract：:Bromocriptine, an ergot alkaloid dopamine agonist, is a recent common treatment for suppression of lactation in postpartum women. A case is presented of a postpartum woman prescribed bromocriptine for suppression of lactation who developed hypertension, headaches, blurry vision, seizures, and pituitary hemorrhage. Dif...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(91)90131-f
更新日期：1991-07-01 00:00:00
abstract：:Prior literature suggested that psychiatric liaison on medical wards would produce a more positive attitude towards psychiatry, more psychosocial chart documentation, and a higher consultation request rate. Over 3 years, liaison was conducted on two medical wards, and its effect was contrasted with two control (consul...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(89)90050-9
更新日期：1989-03-01 00:00:00
