Hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study

Dominik Strzelecki, Justyna Szyburska, Magdalena Kotlicka-Antczak, Olga KałużyńskaDepartment of Affective and Psychotic Disorders, Medical University of Lódz, Central Clinical Hospital, Lódz, PolandAbstract: Glutamate is the main excitatory neurotransmitter in the central nerv...

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Autores principales:	Strzelecki D, Szyburska J, Kotlicka-Antczak M, Kałużyńska O
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/2b6139f2702e437c8f373a2e5e523b37
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spelling	oai:doaj.org-article:2b6139f2702e437c8f373a2e5e523b372021-12-02T00:02:11ZHypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study1178-2021https://doaj.org/article/2b6139f2702e437c8f373a2e5e523b372015-02-01T00:00:00Zhttp://www.dovepress.com/hypomania-after-augmenting-venlafaxine-and-olanzapine-with-sarcosine-i-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021 Dominik Strzelecki, Justyna Szyburska, Magdalena Kotlicka-Antczak, Olga KałużyńskaDepartment of Affective and Psychotic Disorders, Medical University of Lódz, Central Clinical Hospital, Lódz, PolandAbstract: Glutamate is the main excitatory neurotransmitter in the central nervous system. Dysfunction of the glutamatergic system plays an important and well-established role in the pathogenesis of schizophrenia. Agents with glutamatergic properties such as N-methyl-D-aspartate receptor coagonists (ie, glycine, D-cycloserine) and glycine transporter type 1 inhibitors (eg, sarcosine, bitopertin) are investigated in schizophrenia with special focus on negative and cognitive symptomatology. In this article, we describe a case of a 34-year-old woman with diagnosis of schizophrenia with persistent moderate negative and cognitive symptoms, a participant of the Polish Sarcosine Study (PULSAR) treated with olanzapine (25 mg per day) and venlafaxine (75 mg per day). During ten weeks of sarcosine administration (2 g per day) the patient’s activity and mood improved, but in the following 2 weeks, the patient reported decreased need for sleep, elevated mood, libido and general activity. We diagnosed drug-induced hypomania and recommended decreasing the daily dose of venlafaxine to 37.5 mg per day, which resulted in normalization of mood and activity in about 1 week. After this change, activity and mood remained stable and better than before adding sarcosine, and subsequent depressive symptoms were not noted. We describe here the second case report where sarcosine induced important affect changes when added to antidepressive and antipsychotic treatment, which supports the hypothesis of clinically important glutamate–serotonin interaction.Keywords: MNDA receptor, glutamatergic system, serotoninergic systemStrzelecki DSzyburska JKotlicka-Antczak MKałużyńska ODove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2015, Iss default, Pp 533-536 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Strzelecki D Szyburska J Kotlicka-Antczak M Kałużyńska O Hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study
description	Dominik Strzelecki, Justyna Szyburska, Magdalena Kotlicka-Antczak, Olga KałużyńskaDepartment of Affective and Psychotic Disorders, Medical University of Lódz, Central Clinical Hospital, Lódz, PolandAbstract: Glutamate is the main excitatory neurotransmitter in the central nervous system. Dysfunction of the glutamatergic system plays an important and well-established role in the pathogenesis of schizophrenia. Agents with glutamatergic properties such as N-methyl-D-aspartate receptor coagonists (ie, glycine, D-cycloserine) and glycine transporter type 1 inhibitors (eg, sarcosine, bitopertin) are investigated in schizophrenia with special focus on negative and cognitive symptomatology. In this article, we describe a case of a 34-year-old woman with diagnosis of schizophrenia with persistent moderate negative and cognitive symptoms, a participant of the Polish Sarcosine Study (PULSAR) treated with olanzapine (25 mg per day) and venlafaxine (75 mg per day). During ten weeks of sarcosine administration (2 g per day) the patient’s activity and mood improved, but in the following 2 weeks, the patient reported decreased need for sleep, elevated mood, libido and general activity. We diagnosed drug-induced hypomania and recommended decreasing the daily dose of venlafaxine to 37.5 mg per day, which resulted in normalization of mood and activity in about 1 week. After this change, activity and mood remained stable and better than before adding sarcosine, and subsequent depressive symptoms were not noted. We describe here the second case report where sarcosine induced important affect changes when added to antidepressive and antipsychotic treatment, which supports the hypothesis of clinically important glutamate–serotonin interaction.Keywords: MNDA receptor, glutamatergic system, serotoninergic system
format	article
author	Strzelecki D Szyburska J Kotlicka-Antczak M Kałużyńska O
author_facet	Strzelecki D Szyburska J Kotlicka-Antczak M Kałużyńska O
author_sort	Strzelecki D
title	Hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study
title_short	Hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study
title_full	Hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study
title_fullStr	Hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study
title_full_unstemmed	Hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study
title_sort	hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/2b6139f2702e437c8f373a2e5e523b37
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Hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study

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