SummaryCatatonia is a common but underrecognised complication of bipolar disorder, with a quarter of in-patients with bipolar disorder developing catatonia. Almost 9 million people in the UK are deaf or have a significant hearing problem and British Sign Language is the preferred language of 50 000–70 000 people within the UK. Between 1 and 2% of these individuals (i.e. the same as in the rest of the population) will experience bipolar disorder in their lifetime and therefore the accurate diagnosis of catatonia is important. We report a case of catatonia presenting with dysphagia in a woman who is profoundly deaf–mute and who has bipolar disorder. This report highlights some modifications of presentation and difficulties of accurate diagnosis and management of catatonia in this patient. To the best of our knowledge, this is the first case report of catatonia in someone who is profoundly deaf–mute.
AimsThe aim of this Cochrane review is to evaluate the efficacy and safety of atypical antipsychotics compared with placebo in treating tics in patients with Tourette syndrome (TS).MethodsWe cross referenced atypical antipsychotics-risperidone, olanzapine, clozapine, amisulpiride, quetiapine, loxapine, ziprasidone, clotiapine, aripiprazole, remoxipride, sertindole, zotepine, sulpiride and their proprietary names with “Tourette Syndrome” and its derivations and searched the Cochrane Movement Disorder Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, issue 3), MEDLINE (1950–2010), EMBASE (1980–2010), PsycINFO(1987–2010), and CINAHL (2010). Grey literature, reference lists, hand searching, clinical trials websites and pharmaceutical company sites were also searched. All relevant randomised, controlled, double blind studies were considered for inclusion in this review.ResultsThe search identified three randomised controlled trials, two comparing risperidone and one comparing ziprasidone with placebo. Risperidone was superior to placebo in one trial although the 95% CIs were very large. Two trials showed no statistical difference between risperidone and ziprasidone against placebo. Methodological quality was rated as “unclear”. Clinical heterogeneity made meta-analysis inappropriate.ConclusionsIt is difficult to draw clear conclusions from the identified trials in the review as evidence is limited. Placebo controlled trials with longer duration and larger groups are needed to investigate the safety and efficacy of atypical antipsychotics as a pharmaceutical class in TS populations.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.