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Epilepsia. 2003;44 Suppl 5:16-22.
Broadening the perspective: treating the whole patient.

Kramer G.

Swiss Epilepsy Centre, Bleulerstrasse 60, CH-8008 Zurich, Switzerland. g.kraemewissepi.ch

Seizures are not the only obstacles that individuals with epilepsy must overcome. Treatment of epilepsy must take into consideration that patients with epilepsy often face some form of depression, such as peri-ictal depression, ictal depression, interictal depression, or postictal depression, as well as an elevated risk of suicide. Elderly patients, in particular, require special consideration, since aging affects pharmacokinetics and pharmacodynamics; women of childbearing age also require additional counseling. Treatment strategies that focus only on seizure reduction are inadequate and unsuccessful in up to one half of all patients with epilepsy. Epilepsy requires broad treatment strategies that address the needs of the whole patient. Age, genetic factors, gender, diet, use of alcohol and nicotine, comorbidities, and polypharmacy all are important factors to consider in determining a successful epilepsy treatment strategy. Epilepsy affects many aspects of psychosocial function, and optimal outcomes require that the needs of the whole patient be adequately addressed.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12859358&dopt=Abstract [PubMed - in process]

Psychiatry Res. 2003 Jul 15;119(1-2):177-82.
Low prevalence of smoking in patients with autism spectrum disorders.

Bejerot S, Nylander L.

Department of Psychiatry, Institute of Clinical Neuroscience, Karolinska Institute, St. Goran's Hospital, SE-112 81, Stockholm, Sweden

Psychiatric patients are significantly more often smokers than the general population, the only known exception being obsessive-compulsive disorder (OCD) and catatonic schizophrenia. We have investigated nicotine use in subjects with autism spectrum disorders (ASD). Ninety-five subjects (25 females and 70 males) consecutively diagnosed with any ASD and of normal intelligence were included in the study. Only 12.6% were smokers, compared with 19% in the general population and 47% in a control group of 161 outpatients diagnosed with schizophrenia or a schizophreniform disorder. The results suggest that smoking is rare among subjects with ASD, while the opposite was shown for schizophrenia. If replicated, this finding could suggest biological differences between non-catatonic schizophrenia and ASD, and support the theory of a biological link between ASD and a subtype of OCD, and between ASD and catatonic schizophrenia.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12860373&dopt=Abstract [PubMed - in process]

Eur J Pharmacol. 2003 Jul 4;472(1-2):99-110.
Decreased prepulse inhibition during nicotine withdrawal in DBA/2J mice is reversed by nicotine self-administration.

Semenova S, Bespalov A, Markou A.

Department of Neuropharmacology, CVN-7, The Scripps Research Institute, 10550 North Torrey Pines Rd., La Jolla, CA 92037, USA.

We characterized spontaneous and mecamylamine-precipitated nicotine withdrawal using intravenous nicotine self-administration, the acoustic startle response, prepulse inhibition and somatic signs of withdrawal in DBA/2J mice. Nicotine dependence was induced by continuous nicotine infusion through osmotic minipumps. Nicotine self-administration was studied before and after the induction of dependence. The initial test revealed significant nicotine self-administration at the 0.048 microg/infusion dose. During the second self-administration test, saline-treated mice exhibited increased aversiveness of response-contingent infusions of high nicotine doses; these changes were not seen in the nicotine-treated animals reflecting tolerance to nicotine's effects. Neither mecamylamine administration nor spontaneous withdrawal affected the expression of somatic signs, except that increases in jumping were observed during spontaneous withdrawal. Finally, nicotine withdrawal increased general activity in the startle chambers when no stimuli were presented, possibly reflecting increased body tremor and/or agitation, and decreased prepulse inhibition reflecting a sensorimotor gating deficit; the last two effects were reversed by nicotine self-administration. Thus, nicotine withdrawal results in modest, but yet detectable, changes in the behavior of mice.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12860478&dopt=Abstract [PubMed - in process]

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