Clonidine and Tizanidine for Management of Bipolar Disorder Due to Dengue Encephalopathy: A Case Report

Pariwatcharakul, Pornjira; Srifuengfung, Maytinee

doi:10.1016/j.psym.2020.08.001

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…At 6-24 months' follow-up after dengue infection, the rates of depression were 15%. 20 There are multiple case reports of manic presentation, [24][25][26][27][28][29][30][31] acute polymorphic psychosis, [32][33][34][35][36][37][38][39] prolonged depression, 40 and catatonia 29,41 and one on rapid cognitive decline. 42 However, the evidence for a psychotic, manic, or catatonic presentation from observational studies is lacking.…”

Section: Psychiatric Manifestationsmentioning

confidence: 99%

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Dengue and Psychiatry: Manifestations, Mechanisms, and Management Options

Dinakaran

Sreeraj

Venkatasubramanian

2021

Indian Journal of Psychological Medicine

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Dengue is an arboviral infection endemic in tropical countries. Neurological sequelae to dengue infection are not uncommon, and psychiatric manifestations are increasingly reported. This narrative review aims to present the varied manifestations, postulated mechanisms, and the available treatment options for psychiatric morbidity associated with dengue. The evidence available from eight observational studies is summarized in this review. Depression and anxiety are noted to be prevalent during both the acute and convalescent stages of the infection. The presence of encephalopathy and other neurological conditions is not a prerequisite for developing psychiatric disorders. However, treatment options to manage such psychiatric manifestations were not specified in the observational studies. Anecdotal evidence from case reports is outlined. Special attention is paid to the role of epigenetic modifications following dengue infections and the role of histone deacetylase inhibitors in the management. DNA methylation inhibitors such as valproic acid play a significant role in reversing stress-, viral-, or drug-induced epigenetic modifications.

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Section: Psychiatric Manifestationsmentioning

confidence: 99%

“…Seven of the reviewed reports utilized any one agent (valproate, quetiapine, or carbamazepine) with HDAC/DNMT inhibition. [24][25][26][27][28][29]31,34 These reports suggested an early and favorable outcome. However, reports utilizing other agents without HDAC/DNMT inhibition also suggested favorable outcomes.…”

Section: Review Articlementioning

confidence: 99%

Dengue and Psychiatry: Manifestations, Mechanisms, and Management Options

Dinakaran

Sreeraj

Venkatasubramanian

2021

Indian Journal of Psychological Medicine

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Multiple drugs

2021

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Identification of a psychiatric risk gene NISCH at 3p21.1 GWAS locus mediating dendritic spine morphogenesis and cognitive function

Yang

Cai

Ding

et al. 2023

BMC Med

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Background Schizophrenia and bipolar disorder (BD) are believed to share clinical symptoms, genetic risk, etiological factors, and pathogenic mechanisms. We previously reported that single nucleotide polymorphisms spanning chromosome 3p21.1 showed significant associations with both schizophrenia and BD, and a risk SNP rs2251219 was in linkage disequilibrium with a human specific Alu polymorphism rs71052682, which showed enhancer effects on transcriptional activities using luciferase reporter assays in U251 and U87MG cells. Methods CRISPR/Cas9-directed genome editing, real-time quantitative PCR, and public Hi-C data were utilized to investigate the correlation between the Alu polymorphism rs71052682 and NISCH. Primary neuronal culture, immunofluorescence staining, co-immunoprecipitation, lentiviral vector production, intracranial stereotaxic injection, behavioral assessment, and drug treatment were used to examine the physiological impacts of Nischarin (encoded by NISCH). Results Deleting the Alu sequence in U251 and U87MG cells reduced mRNA expression of NISCH, the gene locates 180 kb from rs71052682, and Hi-C data in brain tissues confirmed the extensive chromatin contacts. These data suggested that the genetic risk of schizophrenia and BD predicted elevated NISCH expression, which was also consistent with the observed higher NISCH mRNA levels in the brain tissues from psychiatric patients compared with controls. We then found that overexpression of NISCH resulted in a significantly decreased density of mushroom dendritic spines with a simultaneously increased density of thin dendritic spines in primary cultured neurons. Intriguingly, elevated expression of this gene in mice also led to impaired spatial working memory in the Y-maze. Given that Nischarin is the target of anti-hypertensive agents clonidine and tizanidine, which have shown therapeutic effects in patients with schizophrenia and patients with BD in preliminary clinical trials, we demonstrated that treatment with those antihypertensive drugs could reduce NISCH mRNA expression and rescue the impaired working memory in mice. Conclusions We identify a psychiatric risk gene NISCH at 3p21.1 GWAS locus influencing dendritic spine morphogenesis and cognitive function, and Nischarin may have potentials for future therapeutic development.

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Clonidine and Tizanidine for Management of Bipolar Disorder Due to Dengue Encephalopathy: A Case Report

Cited by 3 publications

References 15 publications

Dengue and Psychiatry: Manifestations, Mechanisms, and Management Options

Dengue and Psychiatry: Manifestations, Mechanisms, and Management Options

Multiple drugs

Identification of a psychiatric risk gene NISCH at 3p21.1 GWAS locus mediating dendritic spine morphogenesis and cognitive function

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