The Experts below are selected from a list of 12 Experts worldwide ranked by ideXlab platform
Hsin-ling Yin - One of the best experts on this subject based on the ideXlab platform.
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Topiramate-associated sexual dysfunction: A systematic review.
Epilepsy & Behavior, 2017Co-Authors: Louis Wei-hsi Chen, Melody Yun-si Chen, Kuo-yen Chen, Hung-sheng Lin, Chia-chang Chien, Hsin-ling YinAbstract:Abstract Introduction Sexual pharmacotoxicity renders patients with epilepsy at a risk for sexual dysfunction (SD). This study is aimed to analyze the relationship between sexual function and topiramate to avoid topiramate-associated SD. Methods A systematic review following the PRISMA guidelines was performed to elucidate any SD occurrence in patients receiving topiramate. Results A total of 17 publications were reviewed. Based on limited polytherapy observational studies, the frequency of self-reported topiramate-associated SD, Libido Disorder, and orgasmic Disorder in patients with polytherapy was 9.0%, 9.0%, and 2.6%, respectively (grade C evidence). Female patients mainly had anorgasmia, whereas male patients principally had erectile dysfunction. The daily dose of topiramate in patients with SD was within the recommended dose. Sexual adversity usually occurred from 4 weeks after topiramate use but favorably subsided without eventful complications after topiramate substitution or dose reduction in all patients. Conclusions Topiramate can elicit different patterns of SD, especially anorgasmia in women and erectile dysfunction in men, even with a therapeutic dose. Detailed drug education and careful monitoring are necessary to maximize sexual health, especially in persons undergoing polytherapy and with other risks for SD. Moreover, a rapid response, such as substitution or reduction of the dose, is suggested when SD occurs during its use.
Yarnal Rodney - One of the best experts on this subject based on the ideXlab platform.
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Identifying and Treating Depression across the Life Span: Symptoms, Course, and Treatment Vary Based on Patients' Age, Stage of Life
Current psychiatry, 2011Co-Authors: Manepalli Jothika, Thaipisuttikul Papan, Yarnal RodneyAbstract:Most clinical trials of major depressive Disorder (MDD) have focused on diagnosis and treatment of adults, but many younger and older patients also suffer from this condition. The prevalence of MDD is estimated to be 2% in children and 6% in adolescents. (1) Up to 25% of adults age +++++60 experience MDD, dysthymic Disorder, or "minor" depression.(2) [ILLUSTRATION OMITTED] Although diagnosis and treatment of depression is similar regardless of a patient's age, younger and older patients may not exhibit typical depressive symptoms (Table 1). (1), (2) For example, older adults may be more likely to report a lack of emotions than depressed mood. Vigilance for these types of distinct clinical manifestations can improve early recognition and treatment. In addition, evidence suggests there are differences in MDD treatment for younger and older patients. Table 1 Major depressive Disorder: Age-related differences Children/adolescents Adults Older adults Prevalence 2% in children; 6% in 20% 25% I adolescents Male-to-female 1:1 in children; 1:2 1:2 1:2 ratio in adolescents DSM-IV-TR criteria Similar Similar Similar Clinical Irritability, temper Typical Irritability, features tantrums, somatic DSM-IV-TR motor complaints, features. agitation, hypersomina, weight Psychomotor restlessness, gain, auditory retardation, somatic hallucinations, middle and complaints, psychomotor terminal diarrhea and agitation, separation insomnia constipation, anxiety, social; decreased phobia, panic Libido, Disorder, drug abuse, cognitive poor self-esteem impairment, delusions, anxiety, panic, worsening of medical comorbidities Source: References 1,2 This article reviews common challenges in recognizing and treating MDD in children, adolescents, and older adults. Varying clinical features Children/adolescents. The clinical presentation of MDD in children and adolescents is similar to that of adults. Children usually display anxiety, irritability, temper tantrums, and somatic complaints before verbally expressing depressive feelings. Psychotic depression in children manifests more often as auditory hallucinations than delusions. (1) Younger vs middle-age adults. Researchers who evaluated baseline clinical and so-ciodemographic information of 1,498 patients enrolled in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study found that the presentation of depressive symptoms in young adult patients (age 18 to 35) differed from those of middle-age (age 36 to 50) patients. (3) Younger patients were more likely to be irritable, complain of weight gain and hypersomnia, and have a negative view of life and the future. They also were more likely to report previous suicide attempts and endorse symptoms consistent with generalized anxiety Disorder, social phobia, panic Disorder, and drug abuse. Middle-age patients had more depressive episodes, deceased Libido, and middle insomnia, and more frequently reported gastrointestinal symptoms such as diarrhea or constipation. (3) Older adults. In our experience, typical MDD mood symptoms often are absent in older patients. Frequently, we see somatic complaints, motor restlessness, or psychomotor retardation; these symptoms may be attributable to a concurrent medical illness. …
Louis Wei-hsi Chen - One of the best experts on this subject based on the ideXlab platform.
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Topiramate-associated sexual dysfunction: A systematic review.
Epilepsy & Behavior, 2017Co-Authors: Louis Wei-hsi Chen, Melody Yun-si Chen, Kuo-yen Chen, Hung-sheng Lin, Chia-chang Chien, Hsin-ling YinAbstract:Abstract Introduction Sexual pharmacotoxicity renders patients with epilepsy at a risk for sexual dysfunction (SD). This study is aimed to analyze the relationship between sexual function and topiramate to avoid topiramate-associated SD. Methods A systematic review following the PRISMA guidelines was performed to elucidate any SD occurrence in patients receiving topiramate. Results A total of 17 publications were reviewed. Based on limited polytherapy observational studies, the frequency of self-reported topiramate-associated SD, Libido Disorder, and orgasmic Disorder in patients with polytherapy was 9.0%, 9.0%, and 2.6%, respectively (grade C evidence). Female patients mainly had anorgasmia, whereas male patients principally had erectile dysfunction. The daily dose of topiramate in patients with SD was within the recommended dose. Sexual adversity usually occurred from 4 weeks after topiramate use but favorably subsided without eventful complications after topiramate substitution or dose reduction in all patients. Conclusions Topiramate can elicit different patterns of SD, especially anorgasmia in women and erectile dysfunction in men, even with a therapeutic dose. Detailed drug education and careful monitoring are necessary to maximize sexual health, especially in persons undergoing polytherapy and with other risks for SD. Moreover, a rapid response, such as substitution or reduction of the dose, is suggested when SD occurs during its use.
Melody Yun-si Chen - One of the best experts on this subject based on the ideXlab platform.
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Topiramate-associated sexual dysfunction: A systematic review.
Epilepsy & Behavior, 2017Co-Authors: Louis Wei-hsi Chen, Melody Yun-si Chen, Kuo-yen Chen, Hung-sheng Lin, Chia-chang Chien, Hsin-ling YinAbstract:Abstract Introduction Sexual pharmacotoxicity renders patients with epilepsy at a risk for sexual dysfunction (SD). This study is aimed to analyze the relationship between sexual function and topiramate to avoid topiramate-associated SD. Methods A systematic review following the PRISMA guidelines was performed to elucidate any SD occurrence in patients receiving topiramate. Results A total of 17 publications were reviewed. Based on limited polytherapy observational studies, the frequency of self-reported topiramate-associated SD, Libido Disorder, and orgasmic Disorder in patients with polytherapy was 9.0%, 9.0%, and 2.6%, respectively (grade C evidence). Female patients mainly had anorgasmia, whereas male patients principally had erectile dysfunction. The daily dose of topiramate in patients with SD was within the recommended dose. Sexual adversity usually occurred from 4 weeks after topiramate use but favorably subsided without eventful complications after topiramate substitution or dose reduction in all patients. Conclusions Topiramate can elicit different patterns of SD, especially anorgasmia in women and erectile dysfunction in men, even with a therapeutic dose. Detailed drug education and careful monitoring are necessary to maximize sexual health, especially in persons undergoing polytherapy and with other risks for SD. Moreover, a rapid response, such as substitution or reduction of the dose, is suggested when SD occurs during its use.
Kuo-yen Chen - One of the best experts on this subject based on the ideXlab platform.
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Topiramate-associated sexual dysfunction: A systematic review.
Epilepsy & Behavior, 2017Co-Authors: Louis Wei-hsi Chen, Melody Yun-si Chen, Kuo-yen Chen, Hung-sheng Lin, Chia-chang Chien, Hsin-ling YinAbstract:Abstract Introduction Sexual pharmacotoxicity renders patients with epilepsy at a risk for sexual dysfunction (SD). This study is aimed to analyze the relationship between sexual function and topiramate to avoid topiramate-associated SD. Methods A systematic review following the PRISMA guidelines was performed to elucidate any SD occurrence in patients receiving topiramate. Results A total of 17 publications were reviewed. Based on limited polytherapy observational studies, the frequency of self-reported topiramate-associated SD, Libido Disorder, and orgasmic Disorder in patients with polytherapy was 9.0%, 9.0%, and 2.6%, respectively (grade C evidence). Female patients mainly had anorgasmia, whereas male patients principally had erectile dysfunction. The daily dose of topiramate in patients with SD was within the recommended dose. Sexual adversity usually occurred from 4 weeks after topiramate use but favorably subsided without eventful complications after topiramate substitution or dose reduction in all patients. Conclusions Topiramate can elicit different patterns of SD, especially anorgasmia in women and erectile dysfunction in men, even with a therapeutic dose. Detailed drug education and careful monitoring are necessary to maximize sexual health, especially in persons undergoing polytherapy and with other risks for SD. Moreover, a rapid response, such as substitution or reduction of the dose, is suggested when SD occurs during its use.