Reversible stroke-like symptoms with severe hyponatremia.

A 65-year-old Caucasian female was brought to the Emergency Department by her husband for increasing generalized weakness, slurred speech and new-onset facial droop. A non-contrast computerized tomography scan of her brain was negative; however, she was found to have a sodium level of 99 mmol/L. Her daily medications included hydrochlorothiazide, omeprazole and irbesartan.

Management of acute extrapyramidal effects induced by antipsychotic drugs.

The management of acute extrapyramidal effects (EPEs) induced by antipsychotic drugs is reviewed. EPEs associated with antipsychotics include acute dystonias, pseudoparkinsonism, and akathisia. Acute dystonias consist of abnormal muscle spasms and postures and usually occur three to five days after antipsychotic therapy begins or the dosage is increased.

The cardiovascular effects of bupropion and nortriptyline in depressed outpatients.

The cardiovascular effects of bupropion hydrochloride and nortriptyline were compared in a double-blind, randomized, 6-week trial in adult outpatients with major depression. After a 1-week placebo phase, 58 patients were randomized to treatment with bupropion (225-450 mg/day) and 57 to nortriptyline (75-150 mg/day). Nortriptyline-treated patients had statistically significant heart rate increases at each assessment as determined by RR intervals on electrocardiogram (14.