Clinical neuropharmacology
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Clin Neuropharmacol · Nov 2014
Case ReportsNocturnal bruxism in a patient with Behçet disease and posttraumatic stress disorder successfully treated with gabapentin.
Bruxism is an involuntary movement, including teeth grinding and clenching, which occur primarily during sleep. Although Behçet disease and posttraumatic stress disorder both have a high prevalence of sleep problems, bruxism is extremely rare in these 2 disorders. Here, we report a rare case of concurrent Behçet disease and posttraumatic stress disorder, which presented with antidepressant-refractory sleep disturbance accompanied by teeth grinding, clenching, and snoring that was successfully treated with gabapentin.
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Clin Neuropharmacol · Mar 2014
Benefit of additional screening for progressive multifocal leukoencephalopathy in patients with multiple sclerosis taking natalizumab: a decision analysis.
Patients with multiple sclerosis (MS) taking natalizumab are at risk for progressive multifocal leukoencephalopathy (PML). We sought to describe the outcomes of discontinuing natalizumab on the basis of PML risk and those of obtaining additional screening across a range of scenarios using decision tree models. ⋯ The highest PML risk identified by stratification is below 2.9%, suggesting that continuing natalizumab outweighs PML risk for most patients on the basis of theoretical calculations. However, decisions based on additional screening with high-specificity tests, including polymerase chain reaction cerebrospinal fluid tests for John Cunningham virus, may provide benefit and should be clinically tested. Increased precision of probabilities and quality-of-life values are also needed to improve decision making.
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Clin Neuropharmacol · Jan 2014
Randomized Controlled Trial Multicenter StudyLong-term safety of rivastigmine in parkinson disease dementia: an open-label, randomized study.
This study investigated the long-term safety of rivastigmine (12 mg/d capsules, 9.5 mg/24 h patch) and effects on motor symptoms in patients with mild-to-moderately severe Parkinson disease dementia. ⋯ This study supports the long-term safety of rivastigmine in Parkinson disease dementia. The rate of worsening of motor symptoms was in the range expected due to the natural progression of Parkinson disease, no new or unexpected safety issues emerged in the long-term.
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Clin Neuropharmacol · Nov 2013
ReviewAtypical antipsychotics in the treatment of posttraumatic stress disorder.
This study reviewed extant published articles on the efficacy and safety of atypical antipsychotics for the treatment of posttraumatic stress disorder (PTSD). ⋯ This review found that atypical antipsychotics seemed to be effective and tolerable in the management of PTSD, although the evidence was limited.
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Mania is generally associated with bipolar disorder; however, it can be iatrogenic. For instance, antibiotics and corticosteroids can cause manic symptoms. ⋯ Adverse events of psychotic mania have been rarely reported with erythromycin and acetaminophen with codeine, despite these being commonly prescribed medications. Clinicians should be aware that these drugs may be an iatrogenic cause of psychiatric disturbances and that these adverse events are more likely to occur during their concomitant use.