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Background and Design: Bullous pemphigoid (BP) is an autoimmune disease characterised by widespread itchy plaques and subepithelial blisterings and usually affects the elderly population. Due to the chronic nature of the disease, to prevent the side effects of chronic steroid treatment, adjuvant immunosuppressive (mycophenolate mofetil, azathioprine, methotrexate) and anti-inflammatory (tetracycline, nicotinamide, dapsone) agents may be used. In this study, we retrospectively evaluated the clinical and demographic characteristics and applied treatments of 46 patients with the diagnosis of BP and compared with literature data. Materials and Methods: We retrospectively evaluated the records of 46 patients who received clinical and histopathological diagnosis of BP and followed up in our clinic between 2006 and 2013. Results: Of the 46 patients, 22 were female and 24 male. The mean age of onset was 69.54 years (range: 18-105). The duration of the lesion ranged from 1 week to 10 months with a median duration of 8 weeks. The most frequent comorbid chronic disease was hypertension detected in 28 (60.8%) patients. Only four patients had a history of malignancy before the onset of the disease. Nineteen patients (42%) used more than 5 agents for comorbid diseases. Thirty-two patients (69.5%) used systemic corticosteroids alone and ten (22%) patients needed additional adjuvant therapies. Conclusion: BP is a major cause of morbidity in the elderly population receiving multiple drug treatment. To avoid the side effects of steroid therapy, especially in patients with severe disease, short-term use of additional immunosuppressive agents appears to be safe and effective. [ABSTRACT FROM AUTHOR]

The neurobiology of switching phenomenon is unclear and no common definition exists to describe it. Several factors such as neurobiological problems, sleep deprivation, and drugs appear to be associated with mood switches. Frequently accused drugs are exogenous corticosteroids, dopaminergic agonists, and antidepressants. Lamotrigine is a mood stabilizer that is used in the treatment of treatment-resistant unipolar depression and bipolar depression. In many clinical trials, manic or hypomanic switch risk of lamotrigine has been reported to be not more than placebo. Here, we report a female patient with recurrent depressive disorder who developed manic switch after adding lamotrigine to her treatment regimen. [ABSTRACT FROM AUTHOR]

Objective: Purpose of this study is to review the studies investigating the efficacy and tolerability of extended-release quetiapine (quetiapine XR) as adjunctive therapy and monotherapy in major depressive disorder. Method: Nine articles were reviewed that were reached after the search in Medline/pubmed search engine by using "quetiapine XR", "depression", "anxiety" key words. The search was done in March 2011. The reviewed articles were published between 2009 and 2011. Results: In studies that investigate the efficacy of quetiapine XR as adjunctive therapy remission rates were found between 31%-42.5%. Remission rates were found between 20.8%-34.7% in studies that investigate the efficacy of quetiapine XR monotherapy. Studies showed that MADRS total scores were significantly reduced compared to placebo at week 1. Satistically significant improvements were seen in HAM-D total, HAM-A total, and HAM-A psychic anxiety cluster scores. Besides reducing depressive symptoms, quetiapine XR is also significantly effective in anxiety symptoms compared to placebo. Conclusion: Because of significant effectiveness, high tolerability rates, quetiapine XR emerges as a new treatment option in patients with major depressive disorder with an inadequate response, treatment resistance, concomitant anxiety symptoms. Moreover significant improvement in inner tension, reduced sleep, pessimistic thoughts as early as week 1 is clinically important [ABSTRACT FROM AUTHOR]