Factitious disorder on an inpatient psychiatry ward.

The authors present 6 cases of factitious disorder seen on a general adult inpatient psychiatry unit of a university hospital. They review the clinical features of this disorder and suggest that factitious disorder is much more prevalent among psychiatric inpatients than is commonly recognized. Strategies to assist in the diagnosis and management this disorder are detailed.

An open-label study of tiagabine as augmentation therapy for anxiety.

Background: At least 50% of patients with anxiety disorders experience only partial response to pharmacotherapy and require augmentation therapy. Gamma-aminobutyric acid (GABA) is the major inhibitory neurotransmitter in the CNS, and agents that modulate GABA neurotransmission have shown promise in the treatment of anxiety disorders and are often used as augmentation agents.

Objective: This study evaluated tiagabine, a selective GABA reuptake inhibitor (SGRI), as augmentation therapy.

"A comparison of the effectiveness of two hypnotic agents for the treatment of insomnia".

Objective: To compare the effectiveness and tolerability of two hypnotic agents, trazadone (Desyrel) and zaleplon (Sonata) on psychiatric inpatients with insomnia.

Methods: Fifteen patients who were psychiatric inpatients were assigned openly and randomly to receive either trazodone (50-100 mg) or zaleplon (10-20 mg) doses on an "as-needed basis" and followed throughout their hospital stay. Efficacy and side effect profile were subsequently assessed.

Safety and tolerability of extended-release venlafaxine in severe medical and surgical illness.

Objective: This study attempted to determine if extended-release venlafaxine is safe for use in severely medically and surgically ill depressed patients.

Method: The charts of 16 patients who were admitted to medical and surgical inpatient services and given extended-release venlafaxine were retrospectively evaluated for dose and duration of drug treatment, blood pressure changes, medication changes, and side effects.

Results: There was 50%-75% improvement in depressive symptoms, with a statistically insignificant mean elevation in blood pressure.

Drug addiction in sickle cell disease: case report.

There has been widespread speculation that patients with sickle cell disease (SCD) may become drug dependent if their painful crisis is treated with narcotics. However, there has been no scientific evidence to support this assertion. Paradoxically, individuals suffering from sickle cell disease who are not adequately treated may develop an addiction to narcotics due to self-medication to treat their pain.