Topiramate-induced psychosis: the picture at 12 months.

A 19-year-old white British man, not previously known to psychiatric services, presented with acute onset of florid psychotic symptoms. His symptoms included auditory hallucinations, misidentification of family members, thought interference and delusions of control. His level of distress was high and did not respond to verbal or medical de-escalation; therefore, he required nursing in seclusion.

An unusual case of sporadic Creutzfeldt-Jakob disease (CJD).

A 49-year-old healthy white British female, not previously known to psychiatric services, presented with an acute onset of florid psychotic symptoms. Her symptoms included visual, auditory and tactile hallucinations as well as persecutory delusions. She was started on antipsychotic medication; however, her psychotic symptoms did not improve significantly in the first 3 months.

Reversible hyponatraemia with venlafaxine in a young patient.

A 28-year-old woman with a depressive episode developed hyponatraemia (126 mmol/l), in the absence of hypovolaemia, oedema, or diuretic use, 2 weeks after starting treatment with the antidepressant venlafaxine. Full blood count, potassium, urea, creatinine, thyroid function test, liver function test, amylase, serum cortisol, and glucose were all normal. A repeat blood test 3 days later revealed a further reduction in the sodium concentration to 123 mmol/l.

Managing acute behavioural problems in medicine.

This conference outlined the concepts of managing behavioural disturbances in general hospital settings, and highlighted the importance of pre-emptive work, recognition and prevention of aggression; it also discussed the value of non-pharmacologic intervention and advocated for better communication between agencies and improving staff training. Only in this context can safety of patients and staff in hospitals be ensured.

Cardiovascular effects of high dose venlafaxine XL in patients with major depressive disorder.

Objective: To assess cardiovascular safety profile of high dose Venlafaxine XL in patients with major depression.

Method: Effects of high dose venlafaxine (mean 346.15 mg;) on the cardiovascular system in 37 patients with major depressive disorder were evaluated: BP, ECG (PR, QT, QRSD and QTc intervals) and heart rate.