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usality is the non-applicability of many questions in these scales. The current case report of TEF associated with antenatal olanzapine exposure demonstrates the need for large clinical studies to generate more conclusive data concerning use of this drug during pregnancy. Conclusion On the basis of the present case and the literature, it is suggested that antenatal olanzapine exposure may be related to the development of TEF in newborns. However, the present case report can only be considered as preliminary evidence and further observational prospective studies of women with antenatal exposure to olanzapine should be conducted to explore the strength of association between TEF and olanzapine. Knowledge of the teratogenic potential of a drug is essential to prevent/reduce the morbidity and mortality associated with a congenital anomaly. Such post-marketing reports are effective tools to disclose the adverse PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19805727 effects of drugs, which are difficult to detect in clinical trials and may factually change the safety status of a drug. Compliance with Ethical Standards Conflict of interest Dr. Vikas Maharshi, Dr. Indranil Banerjee, Dr. Pravesh Nagar, and Dr. H. S. Rehan declare that they have no conflicts of interest. Funding No financial support was received for the preparation of this manuscript. Informed consent Written informed consent was obtained from the infant’s father for publication of this case report. Open Access This article is distributed under the terms of the Creative Commons Attribution-LOXO 101 supplier noncommercial 4.0 International License, which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author and the source, provide a link to the Creative Commons license, and indicate if changes were made. Hydroxychloroquine is a synthetic antimalarial drug derived from 4-aminoquinoline; it has been used for several decades for the treatment of some rheumatic diseases such as rheumatoid arthritis. A dosage between 3 and 6 mg/bodyweight/day is considered therapeutic. In obese individuals, the dosage must be assessed considering the patient’s ideal bodyweight. Hydroxychloroquine may potentially result in adverse effects on the central nervous system, mainly irritability, nervousness, emotional changes, nightmares, and even true psychoses. We describe the case of an elderly person with elderly-onset rheumatoid arthritis, where the use of therapeutic doses of HCQ was followed by the appearance of psychomotor agitation. & Ciro Manzo [email protected] 1 Internal and geriatric department, Rheumatologic outpatient clinic and geronthorheumatologic service, Hospital “Mariano Lauro”, viale dei Pini 1, 80065 Sant’Agnello, Naples, Italy Center for cognitive diseases and dementias, Catanzaro Lido, ASP Catanzaro, Catanzaro, Italy 2 6 Page 2 of 4 C. Manzo et al. Case Report EDC was an 80-year-old Caucasian woman affected with RA since 78 years of age. She was receiving pharmacologic treatment with methotrexate, oral folate supplementation, and low doses of oral corticosteroids. Her comorbidities were: familiar hypercholesterolemia; high blood pressure; and non-hemodynamically significant carotid atheromasia. She had no psychiatric history and no family history of psychiatric problems. After 2 years, RA was stable with an overall minimal disease activity, with a 28-item Disease Activity Score of 2.6 and a Clinical Disease Activity Index of 3.1. The patient asked the rheumatologist to sto