A prospective multicenter study of competency evaluations by psychiatric consultation services.

Psychiatric consultation for assessment of competency is common but infrequently studied. Past studies have used chart reviews. The authors prospectively studied 88 consecutive psychiatric consultations at 3 centers.

Pergolide: an antidepressant adjuvant for mood disorders?

Pergolide, a dopamine (DA) agonist, can be a useful adjunct to antidepressant pharmacotherapy, both with tricyclic antidepressants and with monoamine oxidase inhibitors (MAOIs). Pergolide improved or very much improved (as measured by the Clinical Global Impressions Global Improvement Scale) 11 of 20 previously refractory unipolar and bipolar patients. Patients typically described an improvement in their mood, interest, and energy within a week.

Monoamines in the brain cerebrospinal fluid of facial pain patients.

The purpose of the study was to assay monoamines in cerebrospinal fluid (CSF) obtained from the trigeminal cistern of 64 patients with intractable facial pain. The CSF was analyzed for homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylglycol (MHPG), end-product markers of activity for the dopamine, serotonin, and norepinephrine systems, respectively. HVA averaged 121 ng/mL in these facial pain patients, compared to 150 to 550 ng/mL in 10 studies of ventricular brain CSF in assorted psychiatric and pain patients.