J. Sever

Shalvata Mental Health Center, Ramatayim, Central District, Israel

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Publications (4)10.32 Total impact

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    ABSTRACT: To assess the impact of lithium treatment alone or combined with other medications on TSH levels and WBC count in hospitalized bipolar and non-bipolar children, adolescents and young adults using data extracted from electronic medical records.Method The study investigated serum TSH and WBC count in lithium treated hospitalized youth, aged 12–24 years. The study included 122 BP (N = 67) or non-BP (N = 55) disorder inpatients treated with lithium for mean duration of 173 days. TSH and WBC values were examined at baseline and at the end of the hospitalization. Subjects were divided into two groups for analysis: group 1 was treated with lithium as monotherapy and group 2 was treated with lithium combined with other psychotropic agents (polypharmacy).ResultsThe mean end-point TSH levels were significantly higher (3.16 ± 2.68 vs 1.52 ± 0.92 mU/L, P < 0.05) after lithium treatment. Sixteen children of the 54 (29%) had TSH values above the upper normal value of 4 mU/L at the end-point. A positive correlation was found between pre- and post-treatment TSH levels (Pearson's correlation: r = 0.568, P < 0.05). A statistical significant difference was also found in mean WBC's count (7195.3 ± 2151.88 vs 7944.1 ± 2096.53 count/mm3 cells, P < 0.05). No differences were detected between the monotherapy and the polypharmacy groups.Conclusions Lithium treatment is associated with significant increase in thyrotropin levels and WBC counts in youth. Higher-baseline TSH level is associated with higher TSH levels in lithium-treated subjects. Close monitoring of thyroid functions in lithium treated children and adolescents is recommended.
    No preview · Article · Dec 2012 · European Psychiatry
  • Pavel Golubchik · Jonatan Sever · Abraham Weizman
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    ABSTRACT: Attention deficit hyperactivity disorder (ADHD) often persists into adulthood. Stimulants, including methylphenidate, as well as non-stimulants, have shown efficacy in treating adult ADHD. Comparative, double blind, placebo controlled studies, in adults with ADHD, demonstrate good efficacy and safety profile. Methylphenidate was found to be tolerable and safe in short term treatment when given in its immediate release and long-acting preparations to adults with ADHD. Methylphenidate treatment is recommended in cases when ADHD diagnosis was confirmed. Follow-up is required with special attention to possible cardiovascular, psychiatric and abusive side effects.
    No preview · Article · Oct 2011 · Harefuah

  • No preview · Article · Dec 2009 · European Psychiatry
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    ABSTRACT: Both adolescent suicide and attention deficit hyperactivity disorder (ADHD) are troubling phenomena with high comorbidity, including impulsivity, depression and personality disorders (PD). Studies on the association between these two phenomena are relatively rare. This pilot study's aim was to estimate the rate of ADHD in adolescents attempting suicide. Subjects constituted consecutive admissions to the psychiatric emergency room (ER) who were admitted as a result of attempting suicide. Assessment included the use of the Kiddie-SADS, Strengths and Difficulties Questionnaire (SDQ) and the Conners' Rating Scale (CRS). Those diagnosed as suffering from ADHD were assessed by a standardized Continuous Performance Test (Test of Variables of Attention [TOVA]) that included methylphenidate (MPH) challenge. Twenty-three (23) adolescents completed the study. M:F ratio was 5:18, respectively. Of the 23 participants who completed the study, 65% were diagnosed with ADHD, 43.5% with depression and 39% with cluster B PD. ADD/ADHD ratio was 66%:34%. Only five of the patients were formerly diagnosed as ADHD, only three had been medicated and 14 out of 15 adolescents responded well to MPH challenge. These preliminary results suggest a significant association between ADHD and suicidal behavior in adolescents. Further study is needed to establish this association and assess the causality.
    No preview · Article · Sep 2009 · European Psychiatry