Konrad Puchalski

Pharmacotherapy in Psychiatry and Neurology

Epilepsy is a common chronic neurological disorder that causes recurrent seizures, reduces quality of life, and increases the risk of unexpected death. The development of seizure-detection systems through mobile health technology has become possible due to rapid progress in wearable sensor technology and portable electroencephalography devices, and smartphone-based applications. This review examines existing research on these tools, which help treat epilepsy in both adult and paediatric patients. A medical literature search from 2015 to 2025 included systematic reviews and meta-analyses, randomised controlled trials, and clinical guidelines evaluating seizure-detection precision, self-management tools, telemonitoring functions, and patient-reported outcomes. Mobile applications which allow users to track seizures, send medication alerts, and access educational content show potential to enhance treatment compliance, although more research is needed to confirm their effectiveness. The combination of wearable devices with portable electroencephalography technology allows extended surveillance which successfully identifies generalised tonic-clonic seizures in clinical tests; however, their performance decreases when used in home environments because of increased false alerts. Telemedicine systems that combine application data with detector information allow healthcare providers to track patients remotely, which results in enhanced safety results for patients who have recurring seizures or nocturnal events. Future research should evaluate the medical value and deployment methods of mobile applications, wearable devices, and portable electroencephalography systems which show promise as innovative epilepsy treatment solutions.

Background. Sports-related concussion (SRC) is a common sports injury which frequently goes undetected in sports medicine practice. Symptoms are usually mild but it can result in extended recovery periods and neurological problems. The review aimed to present evidence-based information about diagnostic methods and treatment strategies and return-to-play protocols following international guidelines and research evidence.Material and methods. The PubMed/MEDLINE database was searched for English and Polish studies from January 2020 to November 2025. The research included reviews and meta-analyses and clinical guidelines and narrative reviews focused on SRC diagnosis through SCAT6, SCOAT6, CRT6 and clinical management and RTP/Return-to-Learn (RTL) procedures. The researchers selected 25 papers.Results. The assessment of SRC requires multiple evaluations through updated tools (SCAT6, SCOAT6) and tracking of cognitive and balance and autonomic symptoms. The Amsterdam 2022 Consensus advises patients with symptom-limited physical activity at the start of treatment rather than resting completely. Research shows that young athletes recover faster and experience fewer concussion repeats when they follow a six-stage RTP protocol which advances in stages.Conclusions. The current recommendations support personalized SRC evaluation and treatment plans which require multiple healthcare professionals and a stepwise recovery process. Athlete safety and injury prevention depend on the education of athletes and healthcare professionals.

Informations and purpose: Parabens are widely used preservatives found in cosmetics, pharmaceuticals, foods and household products. Increasing evidence shows that women of reproductive age, including pregnant women, are consistently exposed to these endocrine-disrupting chemicals, which may influence fetal and early-life development. Understanding exposure levels and potential health consequences is important for both public health and clinical practice. Methods: A systematic literature search was performed to identify studies evaluating paraben exposure during pregnancy and its effects on fetal and early childhood health. The literature search included studies published from 2019-2024 and contained searches of PubMed, Scopus, Science Direct and open access databases. Results: Parabens are widely detected in maternal and fetal matrices. Exposure to parabens in utero has been shown to result in changes to fetal size, metabolic and hormone-related factors and an increased risk of developing atopic and respiratory diseases in early childhood.Reported mechanisms involve endocrine disruption(specifically acting like estrogens and anti-androgens), oxidative stress, immune modulation and possible epigenetic effects. Conclusion: Current evidence indicates that parabens may influence child development through several biological pathways, with effects observable from fetal life into early childhood. Although causality remains to be fully established, reducing paraben exposure in pregnancy and early life—particularly from cosmetic and dermal sources—appears advisable. Public health measures promoting informed consumer choices may further mitigate exposure.

Background. Chronic inflammatory skin diseases (CISDs) such as atopic dermatitis, psoriasis, hidradenitis suppurativa and chronic spontaneous urticaria significantly impair health-related quality of life (HRQoL). Symptoms (itch, pain), heat/sweat sensitivity, and psychosocial burden (stigma, anxiety) may also reduce physical activity participation and undermine long-term exercise adherence, yet the evidence remains fragmented across conditions. Aim. To synthesize current evidence on the relationship between HRQoL impairment and exercise participation/adherence in individuals with CISDs and to identify recurring barriers and facilitators relevant for clinical and exercise counseling. Material and methods. A narrative review was conducted using targeted searches of PubMed and Google Scholar and reference-list screening. Search terms combined CISD diagnoses (atopic dermatitis, psoriasis, hidradenitis suppurativa, chronic urticaria) with HRQoL and physical activity constructs (DLQI, Skindex, physical activity, exercise, adherence, barriers, facilitators, lifestyle intervention). English-language publications were prioritized; selected non-Russian sources in other languages were considered when relevant. Conclusions. Exercise adherence in CISDs is shaped by interacting symptom, psychosocial, and environmental factors closely aligned with HRQoL domains. Multi-component, individualized strategies combining optimized disease control with barrier-aware exercise counseling are most likely to support sustainable physical activity.

Background: Hypercholesterolemia has become one of the main, modifiable risk factors to develop atherosclerotic cardiovascular diseases.Diet modification and lipid‑lowering pharmacotherapy are standard of care, but some patients decline these options. Regular physical activity can improve lipid profile and blood pressure without any medications and diet . Aim: To evaluate the effect of regular, multicomponent physical activity, without concurrent dietary change or pharmacotherapy on lipid profile, blood pressure and body mass in a previously inactive 62‑year‑old man. Material and methods: A 62‑year‑old male patient with elevated total cholesterol (TC) and LDL‑cholesterol (LDL‑C) , previously sedentary, declined diet modification and lipid‑lowering medications. In April 2025 he initiated a multicomponent program: running ( 5 km, three times per week), swimming (twice per week), and resistance training (twice per Results: Over 6 months, TC decreased from 217 to 174 mg/dL (−19.8%; 5.61 to 4.50 mmol/L), LDL‑C from 147 to 116 mg/dL (−21.1%; 3.81 to 3.00 mmol/L), and HDL‑C increased from 49 to 54 mg/dL (+10.2%; 1.27 to 1.40 mmol/L). Non‑HDL cholesterol declined from 168 to 120 mg/dL (−28.6%; 4.35 to 3.10 mmol/L). Blood pressure decreased from 135/85 to 122/80 mmHg, and body mass from 85 to 83 kg (−2.4%). Conclusions: In this previously inactive adult, 6 months of systematic, multicomponent physical activity without dietary or pharmacologic changes was associated with clinically meaningful improvements in LDL‑C, non‑HDL cholesterol, HDL‑C, blood pressure and body mass. The case supports multicomponent exercise as a practical, non‑pharmacologic intervention in primary prevention for patients declining standard lipid‑lowering strategies.

Background: Hypercholesterolemia has become one of the main, modifiable risk factors to develop atherosclerotic cardiovascular diseases.Diet modification and lipid‑lowering pharmacotherapy are standard of care, but some patients decline these options. Regular physical activity can improve lipid profile and blood pressure without any medications and diet . Aim: To evaluate the effect of regular, multicomponent physical activity, without concurrent dietary change or pharmacotherapy on lipid profile, blood pressure and body mass in a previously inactive 62‑year‑old man. Material and methods: A 62‑year‑old male patient with elevated total cholesterol (TC) and LDL‑cholesterol (LDL‑C) , previously sedentary, declined diet modification and lipid‑lowering medications. In April 2025 he initiated a multicomponent program: running ( 5 km, three times per week), swimming (twice per week), and resistance training (twice per Results: Over 6 months, TC decreased from 217 to 174 mg/dL (−19.8%; 5.61 to 4.50 mmol/L), LDL‑C from 147 to 116 mg/dL (−21.1%; 3.81 to 3.00 mmol/L), and HDL‑C increased from 49 to 54 mg/dL (+10.2%; 1.27 to 1.40 mmol/L). Non‑HDL cholesterol declined from 168 to 120 mg/dL (−28.6%; 4.35 to 3.10 mmol/L). Blood pressure decreased from 135/85 to 122/80 mmHg, and body mass from 85 to 83 kg (−2.4%). Conclusions: In this previously inactive adult, 6 months of systematic, multicomponent physical activity without dietary or pharmacologic changes was associated with clinically meaningful improvements in LDL‑C, non‑HDL cholesterol, HDL‑C, blood pressure and body mass. The case supports multicomponent exercise as a practical, non‑pharmacologic intervention in primary prevention for patients declining standard lipid‑lowering strategies.

Background. Acne vulgaris is a chronic inflammatory skin condition that often leads to scarring and psychological distress. Oral isotretinoin is the most effective systemic medication for severe or treatment-resistant acne, but concerns about its adverse effects remain. Aim. This review summarizes the current state of knowledge on isotretinoin in acne therapy, highlighting safety issues and implications for everyday clinical practice. Material and methods. A narrative literature review was conducted using PubMed/MEDLINE for articles published between January 2016 and November 2025. Human studies and reviews on systemic isotretinoin for acne vulgaris treatment, along with selected articles providing relevant epidemiological and clinical context for acne, were included if they reported efficacy, remission, adverse effects, impact on tissue regeneration, or monitoring recommendations. Randomized trials, observational studies, systematic reviews, meta-analyses, and high-quality narrative reviews were eligible for inclusion. Non-acne indications, animal-only studies, and non-peer-reviewed publications were excluded. Results. Isotretinoin addresses all major pathogenic mechanisms of acne, leading to high clearance and long-term remissions. Mucocutaneous dryness is the most common adverse effect, but it is manageable with proper skincare. Laboratory abnormalities involve mild, reversible dyslipidemia and liver enzyme elevations. The most dangerous side effect is teratogenicity, which requires strict pregnancy-prevention programs. Studies have not confirmed an increased incidence of depression or inflammatory bowel disease; however, clinical monitoring remains essential. Musculoskeletal and ophthalmologic adverse effects are generally mild and dose-dependent. Conclusions. Structured risk management, regular clinical and laboratory checks, along with the lowest possible dose, enable safe and effective acne control through individualized isotretinoin treatment.

Background. Women and older adults and patients with neurogenic lower urinary tract dysfunction experience rUTIs as a common and troublesome condition which causes pain and sleep disturbances and psychological issues and life quality deterioration and multiple antibiotic treatments. The increasing threat of antimicrobial resistance and microbiota disruption has led scientists to explore alternative preventive methods which do not involve antibiotics like OM-89 (Uro-Vaxom®) bacterial lysates. Aim. The research examines rUTIs pathogenesis and treatment limitations through an analysis of OM-89 oral bacterial lysate immunological effects and clinical data on rUTI prevention in physically active adults and athletes. Material and methods. The research team conducted a narrative review of published studies through database searches of PubMed Scopus Web of Science and Google Scholar from 1989 to 2025. The search terms used for this review included “bacterial lysate” and “OM-89” and “Uro-Vaxom” and “urinary tract infection” and “recurrent UTI” and “immunotherapy” and “mucosal immunity” and “non-antibiotic prophylaxis” and “athletes” and “physically active adults”. Results. Experimental studies show that oral bacterial lysates enhance host defence by activating antigen-presenting cells, increasing secretory IgA and systemic IgG and inducing trained immunity. Conclusions. The protected non-antibiotic solution OM-89 in oral bacterial lysates serves as a preventive treatment for rUTI because it strengthens host defenses instead of directly eliminating pathogens. The development of sports medicine research must establish quantitative measures for training availability and time-loss illness and performance impact while creating optimal preventive strategies for athletes.

Purpose: The aim of this review is to synthesize existing literature regarding the neuropharmacological effects and potential drug interactions of the most commonly used adaptogens: Withania somnifera and Rhodiola rosea; and develop practical guidelines for the safe use of these supplements with psychotropic medications. Methods: This narrative review examined clinical, observational, and mechanistic studies regarding Ashwagandha and Rhodiola that were identified through a search of PubMed, Cochrane and ScienceDirect between 2013 and 2024. Results: Ashwagandha has been shown to have significant anxiolytic and stress reducing effects, and has a relatively favorable pharmacokinetic profile. However, it has GABAergic activity which can lead to pharmacodynamic interactions with benzodiazepines, z-drugs, and other central nervous system depressants. Rhodiola, on the other hand, has been shown to have activating and antidepressant-like effects, and has been found to modulate monoaminergic transmission, as well as inhibit the activity of cytochrome P450 enzymes CYP2D6 and CYP3A4. These findings suggest that Rhodiola may increase the risk of serotonin toxicity when combined with certain psychotropic medications, and potentially increase the plasma concentrations of co-administered psychotropics due to decreased metabolic clearance. Conclusions: Based on the findings of this review, both Ashwagandha and Rhodiola cannot be viewed as pharmacologically inert supplements that can be safely used in conjunction with prescription medications for the treatment of psychiatric disorders. Therefore, they should be carefully assessed prior to initiating therapy, with consideration of the individual's concurrent prescription medications and comorbid medical conditions. Furthermore, they should be initiated at low doses and monitored closely for symptoms of sedation, serotonergic effects, and signs of drug accumulation.