Electroconvulsive therapy performed 6 days after repair of an intracranial aneurysm using a liquid embolic system.

There exists a small, but growing body of literature that describes electroconvulsive therapy (ECT) performed on patients with intracranial aneurysms. These reports include patients with unrepaired aneurysms and others in which aneurysms have been repaired by clipping or coil embolization methods. To date, these cases have described favorable results and minimal complications.

A pilot, open-label safety study of quetiapine for treatment of moderate psychotic agitation in the emergency setting.

Objective: The goal of this pilot study was primarily to explore the safety and, secondarily, the efficacy of the use of "prn" quetiapine for treatment of moderate agitation accompanied by psychosis in an emergency department setting.

Methods: This was an open-label study in which 20 patients with psychotic agitation were treated in the emergency department with 100, 150, or 200 mg of quetiapine. Physicians who were unaffiliated with the study established the diagnoses and selected the doses to be used for each patient.

Innovations: Emergency psychiatry: Relative accuracy of breath and serum alcohol readings in the psychiatric emergency service.

Management of changes in physiologic and mental status due to alcohol is a core skill utilized in the psychiatric emergency service. Blood alcohol concentrations are commonly approximated by measuring breath alcohol at triage. However, the blood-breath ratio is highly variable, and breath tests have produced lower readings than blood tests.

Behavioural manifestations of anabolic steroid use.

The use of anabolic androgenic steroids (AAS) for gains in strength and muscle mass is relatively common among certain subpopulations, including athletes, bodybuilders, adolescents and young adults. Adverse physical effects associated with steroid abuse are well documented, but more recently, increased attention has been given to the adverse psychiatric effects of these compounds. Steroids may be used in oral, 17alpha-alkylated, or intramuscular, 17beta-esterified, preparations.

Treatment of Comorbid Tuberculosis and Depression.

Tuberculosis (TB) remains a leading infectious cause of mortality worldwide. While the overall prevalence of TB in the United States has declined in the general population, certain groups remain at high risk, including the homeless, those who are HIV seropositive, individuals with a history of alcohol or drug abuse, and immigrants from a country in which TB is endemic. Many recipients of psychiatric services possess 1 or more of these risk factors, and consequently TB may be overrepresented in this population.