The Role of Psychotrop Medicines in Food Aspiration: A Case Report
    PDF
    Cite
    Share
    Request
    Case Report
    P: 212-215
    August 2023

    The Role of Psychotrop Medicines in Food Aspiration: A Case Report

    The Bulletin of Legal Medicine 2023;28(2):212-215
    1. Adalet Bakanlığı, Adli Tıp Kurumu, İstanbul, Türkiye
    No information available.
    No information available
    Received Date: 18.12.2022
    Accepted Date: 28.02.2023
    Publish Date: 01.08.2023
    PDF
    Cite
    Share
    Request

    ABSTRACT

    Although swallowing disorders are quite common in psychiatric patients and especially in patients with schizophrenia, they have not been adequately studied. Swallowing disorders are an important source of morbidity and mortality in patients with schizophrenia as a result of acute asphyxia resulting from airway obstruction or an insidious aspiration and pneumonia. Most swallowing disorders in schizophrenia are attributed to two main causes: The changes in eating and swallowing due to the disease itself and the effects of psychotropic drugs. Behavioral changes related to the illness include eating too fast or taking in inappropriately large amounts of food. Treatment-related problems are most often associated with drug-induced extrapyramidal side effects, including drug-induced parkinsonism, dystonia, and tardive dyskinesia. Also include dry mouth, sialorrhea, and sedation-related changes. In this case report, it is aimed to share the psychotropic drugs detected in a schizophrenic patient who developed mechanical asphyxia due to food aspiration and to examine their possible effects on food aspiration.

    Keywords: Dysphagia, antipsychotic, aspiration, dry mouth

    References

    1
    Owen MJ, Sawa A, Mortensen PB. Schizophrenia. Lancet. 2016;388(10039):86-97. https://doi.org/10.1016/s0140-6736(15)01121-6
    2
    Kulkarni DP, Kamath VD, Stewart JT. Swallowing Disorders in Schizophrenia. Dysphagia. 2017;32(4):467-471. https://doi.org/10.1007/s00455-017-9802-6
    3
    Cicala G, Barbieri MA, Spina E, de Leon J. A comprehensive review of swallowing difficulties and dysphagia associated with antipsychotics in adults. Expert Rev Clin Pharmacol. 2019;12(3):219-234. https://doi.org/10.1080/17512433.2019.1577134
    4
    Kohen I, Lester P. Quetiapine-associated dysphagia. World J Biol Psychiatry. 2009;10(4 Pt 2):623-625. https://doi.org/10.1080/15622970802176495
    5
    Crouse EL, Alastanos JN, Bozymski KM, Toscano RA. Dysphagia with second-generation antipsychotics: A case report and review of the literature. Ment Health Clin. 2018;7(2):56-64. https://doi.org/10.9740/mhc.2017.03.056
    6
    O’Neill JL, Remington TL. Drug-induced esophageal injuries and dysphagia. Ann Pharmacother. 2003;37(11):1675-1684. https://doi.org/10.1345/aph.1d056
    7
    Dziewas R, Warnecke T, Schnabel M, Ritter M, Nabavi DG, Schilling M, et al. Neuroleptic-induced dysphagia: case report and literature review. Dysphagia. 2007;22(1):63-67. https://doi.org/10.1007/s00455-006-9032-9
    8
    Bazemore PH, Tonkonogy J, Ananth R. Dysphagia in psychiatric patients: clinical and videofluoroscopic study. Dysphagia. 1991;6(1):2-5. https://doi.org/10.1007/bf02503456
    9
    Leopold NA. Dysphagia in drug-induced parkinsonism: a case report. Dysphagia. 1996;11(2):151-153. https://doi.org/10.1007/bf00417906
    10
    Sokoloff LG, Pavlakovic R. Neuroleptic-induced dysphagia. Dysphagia. 1997;12(4):177-179. https://doi.org/10.1007/pl00009533
    11
    Fioritti A, Giaccotto L, Melega V. Choking incidents among psychiatric patients: retrospective analysis of thirty-one cases from the west Bologna psychiatric wards. Can J Psychiatry. 1997;42(5):515-520. https://doi.org/10.1177/070674379704200509
    12
    Gregory RP, Smith PT, Rudge P. Tardive dyskinesia presenting as severe dysphagia. J Neurol Neurosurg Psychiatry. 1992;55(12):1203-1204. https://doi.org/10.1136/jnnp.55.12.1203
    13
    Nair S, Saeed O, Shahab H, Sedky K, Garver D, Lippmann S. Sudden dysphagia with uvular enlargement following the initiation of risperidone which responded to benztropine: was this an extrapyramidal side effect? Gen Hosp Psychiatry. 2001;23(4):231-232. https://doi.org/10.1016/s0163-8343(01)00145-1
    14
    Nieves JE, Stack KM, Harrison ME, Gorman JM. Dysphagia: a rare form of dyskinesia? J Psychiatr Pract. 2007;13(3):199-201. https://doi.org/10.1097/01.pra.0000271663.40211.56
    15
    Bhat PS, Pardal PK, Diwakar M. Dysphagia due to tardive dyskinesia. Ind Psychiatry J. 2010;19(2):134-135. https://doi.org/10.4103/0972-6748.90347
    16
    Food U. FDA Public Health Advisory: Deaths with Antipsychotics in Elderly Patients with Behavioral Disturbances. https://psychrights.org/drugs/FDAatypicalswarning4elderly.pdf 2005.
    17
    Knol W, van Marum RJ, Jansen PA, Souverein PC, Schobben AF, Egberts AC. Antipsychotic drug use and risk of pneumonia in elderly people. J Am Geriatr Soc. 2008;56(4):661-666. https://doi.org/10.1111/j.1532-5415.2007.01625.x
    18
    Trifirò G, Gambassi G, Sen EF, Caputi AP, Bagnardi V, Brea J, et al. Association of community-acquired pneumonia with antipsychotic drug use in elderly patients: a nested case-control study. Ann Intern Med. 2010;152(7):418-425. https://doi.org/10.7326/0003-4819-152-7-201004060-00006
    19
    Aparasu RR, Chatterjee S, Chen H. Risk of pneumonia in elderly nursing home residents using typical versus atypical antipsychotics. Ann Pharmacother. 2013;47(4):464-474. https://doi.org/10.1345/aph.1r510
    20
    Craig TJ. Medication use and deaths attributed to asphyxia among psychiatric patients. Am J Psychiatry. 1980;137(11):1366-1373. https://doi.org/10.1176/ajp.137.11.1366
    21
    Nielsen J, Meyer JM. Risk factors for ileus in patients with schizophrenia. Schizophr Bull. 2012;38(3):592-598. https://doi.org/10.1093/schbul/sbq137
    22
    Pinzani V, Peyriere H, Javot L, Horowicz S, Bejan-Angoulvant T, Osmont M, et al., editors. Quetiapine-induced ischemic colitis: review of the French Phamacovigilance database. Fundamental & Clinical Pharmacology; 2013.
    23
    Cuny P, Houot M, Ginisty S, Horowicz S, Plassart F, Mentec H, et al. Colite ischémique sous quétiapine associée à d’autres molécules anticholinergiques : à propos d’un cas [Quetiapine and anticholinergic drugs induced ischaemic colitis: A case study]. Encephale. 2017;43(1):81-84. https://doi.org/10.1016/j.encep.2015.12.027
    24
    Murphy PJ, Erskine R, Langton JA. The effect of intravenously administered diazepam, midazolam and flumazenil on the sensitivity of upper airway reflexes. Anaesthesia. 1994;49(2):105-110. https://doi.org/10.1111/j.1365-2044.1994.tb03363.x
    25
    Wyllie E, Wyllie R, Cruse RP, Rothner AD, Erenberg G. The mechanism of nitrazepam-induced drooling and aspiration. N Engl J Med. 1986;314(1):35-38. https://doi.org/10.1056/nejm198601023140107
    26
    Buchholz DW. Oropharyngeal dysphagia due to iatrogenic neurological dysfunction. Dysphagia. 1995;10(4):248-254. https://doi.org/10.1007/bf00431417
    2024 ©️ Galenos Publishing House