Neuropsych Dis Treat
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Neuropsych Dis Treat · Jan 2013
Profile of lacosamide and its role in the long-term treatment of epilepsy: a perspective from the updated NICE guideline.
The goal of antiepileptic treatment is to achieve seizure freedom or seizure control. The aim of this paper is to review the evidence for the use of lacosamide for adjunctive treatment of refractory focal seizures with or without secondary generalization, within the scope of the 2012 update of the Clinical Guideline published by the National Institute for Health and Clinical Excellence (NICE). ⋯ Lacosamide was included as part of the recommended AEDS to be used in tertiary epilepsy centers. The evidence review showed that more participants who received lacosamide as an adjunctive treatment had at least a 50% reduction in seizure frequency compared with those taking placebo. However, more participants on lacosamide were found to experience adverse events and withdrawal from treatment compared with those on placebo. The cost-effectiveness analysis showed that compared with placebo, the benefits gained from adjunctive lacosamide were modest and uncertain, whereas the costs were significantly high. Compared with other AEDs licensed for adjunctive therapy in focal seizures, lacosamide was associated with fewer quality-adjusted life years and higher costs. Therefore, the Guideline Development Group noted that the balance of benefit and harm needs to be carefully monitored in all patients.
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Neuropsych Dis Treat · Jan 2013
A validation study of the Chinese-Cantonese Addenbrooke's Cognitive Examination Revised (C-ACER).
There is no valid instrument for multidomain cognitive assessment to aid the detection of mild cognitive impairment (MCI) and mild dementia in Hong Kong. This study aimed to validate the Cantonese Addenbrooke's Cognitive Examination Revised (C-ACER) in the identification of MCI and dementia. ⋯ C-ACER is a sensitive and specific bedside test to assess a broad spectrum of cognitive abilities, and to detect MCI and dementia of different severity. It can be used and interpreted with ease, without the need to adjust for education level in persons aged 60 or above.
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Neuropsych Dis Treat · Jan 2013
Salivary alpha-amylase and cortisol responsiveness following electrically stimulated physical stress in bipolar disorder patients.
Bipolar disorder (BP) is often associated with a change in hypothalamus- pituitary-adrenal axis function change due to chronic stress. Salivary α-amylase (sAA) levels increase in response to psychosocial stress and thus function as a marker of sympathoadrenal medullary system activity. However, sAA has been studied less often than salivary cortisol in BP patients. ⋯ These preliminary results suggest that sAA may be a useful biological marker for BP patients.
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Neuropsych Dis Treat · Jan 2009
Excited delirium: Consideration of selected medical and psychiatric issues.
Excited delirium, sometimes referred to as agitated or excited delirium, is the label assigned to the state of acute behavioral disinhibition manifested in a cluster of behaviors that may include bizarreness, aggressiveness, agitation, ranting, hyperactivity, paranoia, panic, violence, public disturbance, surprising physical strength, profuse sweating due to hyperthermia, respiratory arrest, and death. Excited delirium is reported to result from substance intoxication, psychiatric illness, alcohol withdrawal, head trauma, or a combination of these. ⋯ Excited delirium involves behavioral and physical symptoms that are also observed in medical and psychiatric conditions such as rhabdomyolysis, neuroleptic malignant syndrome, and catatonia. A useful contribution of this communication is that it links the state of excited delirium to conditions for which there are known and effective medical and psychiatric interventions.
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Neuropsych Dis Treat · Dec 2008
Post-traumatic stress, depression, and anxiety in patients with injury-related chronic pain: A pilot study.
To investigate, in patients with injury-related chronic pain, pain intensity, levels of post-traumatic stress, anxiety and depressions. ⋯ The findings of relationships between pain intensity, post-traumatic stress, depression, and anxiety may have implications for clinicians and underline the importance of considering all these factors when managing patients with injury-related chronic pain.