Neural Correlate of Anterograde Amnesia in Wernicke-Korsakoff Syndrome.

The neural correlate of anterograde amnesia in Wernicke-Korsakoff syndrome (WKS) is still debated. While the capacity to learn new information has been associated with integrity of the medial temporal lobe (MTL), previous studies indicated that the WKS is associated with diencephalic lesions, mainly in the mammillary bodies and anterior or dorsomedial thalamic nuclei. The present study tested the hypothesis that amnesia in WKS is associated with a disrupted neural circuit between diencephalic and hippocampal structures.

Multicenter study on the clinical effectiveness, pharmacokinetics, and pharmacogenetics of mirtazapine in depression.

Pharmacogenetic tests and therapeutic drug monitoring may considerably improve the pharmacotherapy of depression. The aim of this study was to evaluate the relationship between the efficacy of mirtazapine (MIR) and the steady-state plasma concentrations of its enantiomers and metabolites in moderately to severely depressed patients, taking their pharmacogenetic status into account. Inpatients and outpatients (n = 45; mean age, 51 years; range, 19-79 years) with major depressive episode received MIR for 8 weeks (30 mg/d on days 1-14 and 30-45 mg/d on days 15-56).

[A metaphor of the nurse's work in addictology].

The mechanism of addiction can be compared to a rut in a road, towards which patients are attracted and into which they inevitably fall. The role of the nurse in addictology is to lead the patient to consider other roads, to tread a new path taking them in a more positive direction. It is on this condition that programmes based on substitution can prove effective.

The potential interest of topiramate in addiction.

Topiramate is one of the currently most promising compounds in the field of addiction medicine. This paper discusses its potential utility related to a phase model of addiction development, focusing on the assumption that addiction is a continuous process involving different neurobiological pathways, depending on the stage of addiction. A specific emphasis will be made on the development of dysfunctional automatic behaviors in late stage of addiction and the central role of glutamate and AMPA receptors.

Khat use: lifestyle or addiction?

The khat plant contains psychoactive alkaloids with psychostimulant properties, and has been used for centuries as a recreational and religious drug, mainly in some African and Middle Eastern countries. With changing migration patterns, epidemiological and clinical outcomes may have changed. The aim of this article is to review current knowledge on pharmacological, epidemiological and clinical aspects of khat use.

Internet use by patients with psychiatric disorders in search for general and medical informations.

Background: Internet is commonly used by the general population, notably for health information-seeking. There has been little research into its use by patients treated for a psychiatric disorder.

Aim: To evaluate the use of internet by patients with psychiatric disorders in searching for general and medical information.

Off-label utilization of antidepressants.

Unlabelled: While antidepressant prescription rules are established for approved indications by large-scale studies, off-label utilization naturally often lacks the validation by large scientific databases, and is at its best based on expert consensus. The aim of the present survey was to study the prescription habits of hospital psychiatrists with regard to antidepressants, comparing patients treated for depressions and anxiety disorder with patients receiving off-label antidepressant treatment.

Methods: Data on drug use for this study were based on 6 reference days from April 1999 to November 2001 in the 98-bed psychiatric hospital of the University of Lausanne, Switzerland.

Attitudes toward psychopharmacology among hospitalized patients from diverse ethno-cultural backgrounds.

Background: Biological factors influencing individual response to drugs are being extensively studied in psychiatry. Strikingly, there are few studies addressing social and cultural differences in attitudes toward psychotropic medications. The objective of this study was to investigate ethno-culturally determined beliefs, expectations and attitudes toward medication among a sample of hospitalized psychiatric patients.

The "rut metaphor": a conceptualization of attractor-shaping properties of addictive drugs.

The development of nonlinear models might yield better insight into the dynamics of substance use-related disorders than linear models. Nonlinear modelizations are, however, not always easily intelligible. A metaphor is presented illustrating a nonlinear conceptualization of the development of drug addiction based on recent findings on neural plasticity.

Over- and underreporting of recent drug use in subjects entering an inpatient detoxification unit.

Unlabelled: Underreporting of drug use is commonly found more often than overreporting. Overreporting may, however, occur in particular settings, e.g.

You don't believe in a patient's depression? Watch the watch!

Depressive states may at times be particularly tricky to ascertain or confirm during a time-limited consultation. For example, a patient may present with what has been termed as smiling depression. We present the case of a female patient with bipolar II disorder whose difficult-to-ascertain depression could be confirmed by her automatic wristwatch, which regularly stopped when she was hypokinetic as a result of her depression.

Swiss psychiatrists beliefs and attitudes about cannabis risks in psychiatric patients: ideologically determined or evidence-based?

The objective of this survey was to assess the beliefs of Swiss psychiatrists about the risks associated with cannabis, and to assess their prohibitive attitudes toward their patients. Eighty-two doctors agreed to fill-up the questionnaire. Cluster analysis retained a 3-cluster solution.

Efficacy and tolerability of quetiapine in cluster B personality disorder: an open-label study.

Objective. The aim of this open-label 8-week study was to assess the effectiveness of quetiapine on aggressive behaviour and social dysfunctions in patients suffering from a cluster B personality disorder (DSM-IV). Methods.

Naltrexone-assisted rapid methadone discontinuation: a pilot study.

Slow downtitration as a methadone discontinuation method is time-consuming and associated to high dropout rates. Whereas ultra-rapid opiate detoxification methods have recently gained some popularity, they are expensive and may be associated with particular problems in methadone patients. In the present study, a 3-day detoxification procedure accelerated with a unique dose of naltrexone was used in 10 methadone-substituted patients.

[Psychoeducational and cognitive behavioral treatments of bipolar disorder].

Unlabelled: Bipolar disorder is a severe mood disorder characterized by recurrence of mania and depression. Despite the use of mood stabilizers, a significant proportion of bipolar patients experience relapse, psychosocial impairment and persistent symptoms. A significant part of patients show poor adhesion to the pharmacological treatment.

Reduced valproate plasma levels possible after introduction of efavirenz in a bipolar patient.

The case of a bipolar patient with concomitant multidrug addiction is described who presented a decrease in valproate plasma level of more than 50% shortly after antiretroviral therapy was initiated. Despite important dose augmentations of up to 4 g/day, plasma levels were difficult to raise to the target concentration of 50 mg/dL. The possible mechanisms underlying the observed pharmacokinetic changes are discussed: (i) a uridine diphosphate-glucuronosyl transferase induction by efavirenz; and (ii) a plasma protein displacement of valproate by efavirenz with subsequent increased elimination of the free fraction.

Topiramate for smoking cessation.

Due to its AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid)/kainate antagonism, topiramate would be particularly interesting in addiction treatment. Flexible-dose topiramate was prescribed to 13 smokers (10 smokers who wanted to stop smoking, and three who received topiramate for other reasons). Six out of 13 smokers were abstinent at 2 months and two more subjects had reduced their cigarette consumption by >50%.

Topiramate in the treatment of compulsive sexual behavior: case report.

Background: Among the multiple mechanisms of action of topiramate, AMPA/kainate antagonism may be particularly interesting for the treatment of disorders characterized by conditioned cognitive and behavioral cue reactivity.

Case Presentation: We report the case of a patient consulting primarily for obesity and cue triggered snacking, who responded well on topiramate at doses up to 50 mg. Coincidentally he reported on an improvement of compulsive nonparaphilic sexual behaviors (consumption of prostitution), which was also strongly triggered by environmental cues.

Acute generalized exanthematous pustulosis induced by olanzapine.

The case of a 56 years old man is presented, who developed acute generalized exanthematous pustulosis 5 days after the introduction of olanzapine 10 mg. Multiple 1-mm pustules appeared on the whole body, concentrated especially on her neck and face. Within 2 days, the eruption was increasingly accompanied by erythema and pruritus.