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Background. Interstitial pregnancy is a rare form of ectopic pregnancy that usually leads to uterine rupture resulting in sudden life-threatening haemorrhage, need for blood transfusion, and admission to intensive care unit. Mortality rate is 6–7 times higher than that in classical ectopic pregnancy. Uterine rupture has been typically reported to occur at more advanced gestational ages compared to tubal pregnancy although several recent reports have shown a high risk of rupture before 12 weeks of gestation. Cases Presentation. We report three cases of women affected by interstitial pregnancy, with different clinical symptoms, and managed to be treated with surgery or medical therapy. An emergency laparotomy was performed in the first case by the general surgeon, while in the second case laparoscopy was made by a gynecologist; last case shows the success of systemic administration of methotrexate. Conclusion. Interstitial pregnancy is still a challenging condition to diagnose and treat; early diagnosis may help to choose the proper management. [ABSTRACT FROM AUTHOR]

Aripiprazole is an atypical antipsychotic used for schizophrenia, manic and mixed episodes associated with bipolar I disorder and as adjunctive therapy for major depressive disorder. It functions as a partial agonist at dopamine D2 and 5-HT1A receptors, and as an antagonist at the 5-HT2A receptor. The most recent results obtained from scientific research showed that dopaminergic mechanisms are involved in motivation, reward, and reinforcement of substance abuse. The use of aripiprazole and partial dopamine agonists could represent a novel strategy for normalizing dopamine neurotransmission. Many studies in the last few years have highlighted aripiprazole as a potential candidate for the treatment of different types of substance dependence. This review aims to describe recent scientific research using aripiprazole in different substance abuse disorders (i.e., alcoholism, cocaine, amphetamine and nicotine use). Furthermore, the efficacy of aripiprazole compared to other pharmacological therapies will be described. Given the low number of studies, the frequent absence of placebo or active comparators, and the low statistical power of the studies, a clear conclusion about the use of aripiprazole in alcohol/substance dependence cannot be drawn. Therefore, we suggest the need for further studies, preferably randomized and placebo-controlled. [ABSTRACT FROM AUTHOR]

We report a case with refractory insomnia. We diagnosed her case as depression with high levels of anxiety, weakness, with diminished ability to think or concentrate and with a sensorymotor disorder. Although this last symptom was very distressing, it did not satisfy the criteria for RLS (Restless Legs Syndrome). After treatment with paroxetine (20 mg) and zolpidem (10 mg), anxiety and mood deflection were attenuated. Nevertheless, a mild depression, an intermittent awakening (fragmentation of the sleep-wake rhythm) and subsyndromal RLS persisted. Her resistant insomnia was treated with benzodiazepine sleeping drugs (triazolam 0.25 mg, lorazepam 2.5 mg, fluorazepam 30 mg) with only partial insomnia remission, antidepressants (trazodone 150 mg RP, mirtazapine 15-30 mg, agomelatine 50 mg) and antipsychotics (levomepromazine 25 mg, zuclopentixol 25 mg) without results. Her intractable insomnia was markedly responsive to pregabalin without side effects. Our hypothesis is that the therapy with pregabalin may be indicated for resistant insomnia associated with subsyndromal RLS, even when the latter does not satisfy fully all the criteria for diagnosis. [ABSTRACT FROM AUTHOR]

Introduction A certain degree of depressive symptoms is common in schizophrenic patients. The assessment and treatment of depressive symptoms in schizophrenia is clinically challenging. Objectives We conducted a cross-sectional study to investigate the depressive dimension of schizophrenic patients. Aims The aim was to evaluate the effect of pharmacotherapy on depressive symptomatology. Methods Thirty-four outpatients (18-65 years old) with stable schizophrenia in monotherapy with FGAs or SGAs. We evaluated: depressive symptoms with Calgary Depression Scale for Schizophrenia; positive and negative symptoms (with Positive and Negative Symptom Scale); neurocognition (with Matrics Cognitive Consensus Battery); social cognition (with Facial Emotional Identification Test); social functioning (with Personal and Social Performance Scale and with UCSD Performance-based Skills Assessment). Collected data underwent statistical analyses. Results A SGAs therapy was associated with: lower depressive symptoms (mean SGAs group = 4.0; mean FGAs group = 7.86, P < 0.05); lower mean positive symptoms (mean SGAs group = 12.65; mean FGAs group = 17.43, P < 0.05); lower negative symptoms (mean SGAs group = 21.35; mean FGAs group = 29.07, P < 0.05); lower scores on the PANSS-total (mean SGAs group = 71.05; mean FGAs group = 91.86, P < 0.01). After correction for multiple variables, the SGAs group still had significantly lower values towards the FGAs group ( P < 0.05). Conclusions Our study support the notion that switch from a FGA to a SGA could be a relatively simple first-step for the treatment of this condition. Atypical antipsychotics might exercise antidepressant effects with different potential mechanism including: remission of a FGA-induced depression and action on of 5-hydroxytryptamine, dopamine [other than postsynaptic D2], and α1-noradrenergic receptor sites. [ABSTRACT FROM AUTHOR]

We report a clinical case of a patient with a manic episode after taking methylphenidate (up to 120mgr per day) and cannabis in order to improve performance during exam period. He was hospitalized for disorganized behaviour, increased aggresion, delusions, grandiosity. He was affected by attention deficit and hyperactivity during childhood and recent episods of subthreshold depression. The therapy consisted of benzodiazepine and hydratation. In conclusion clinicians shuould ha ve caution in prescribing neurostimulant in vulnerable subjects. [ABSTRACT FROM AUTHOR]

Introduction Polydrug use is mostly common among adolescents and young adults, often with the intention of enhancing or counteracting the effects of another drug. It significantly increases the risks, due to drug synergy and increased side effects. Objectives We investigated the prevalence of polydrug users in a population of Italian young adults using a specifically designed questionnaire. Aims We aimed to assess the prevalence of polydrug abusers in a large sample of general population, and also to identify possible associations between alcohol misuse (e.g., binge drinking behaviours) and polydrug use. Methods We administered the questionnaire to a sample of 3000 subjects, aged 18 to 26, investigating socio-economic characteristics, alcohol abuse (with a specific focus on binge drinking) and use of psychoactive substances (cannabis, cocaine and Novel Psychoactive Substances-NPS). Collected data underwent statistical analyses. Results 80.5% of the sample habitually consumed alcoholic beverages. Among alcohol consumers, 34.2% used cannabis, 5.4% cocaine, 3.7% NPS, and 79,2% had binge drinking behaviours. Among those who did not consume alcohol, 4% used cannabis, 0.4% used cocaine, and 0% used NPS. Polydrug use was more common among binge drinkers. 35.6% of cocaine abusers also used NPS, in comparison to 1.4% of non-abusers. Conclusions According to scientific literature, alcohol and cocaine are the substances most commonly involved in risky polydrug use. Binge drinking and NPS appear to ben involved in polydrug use too. The combined effects of the different drugs need to be considered in identifying an appropriate and timely intervention strategy [ABSTRACT FROM AUTHOR]