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Dissociative Amnesia

Dissociative Amnesia

The essential feature of dissociative amnesia is a sudden inability to recall important personal information that can’t be explained by ordinary forgetfulness. The patient typically can’t recall all events that occurred during a specific period, but other types of recall disturbance also are possible.

This disorder commonly occurs during war and natural disasters. Although it’s more common in adolescents and young women, it also is seen in young men after combat experience. The amnesic event typically ends abruptly, and recovery is complete, with rare recurrences.

Causes

Dissociative amnesia follows severe psychosocial stress, often involving a threat of physical injury or death. Amnesia also may occur after thinking about or engaging in unacceptable behavior such as an extramarital affair.

Symptoms

The most common symptom of dissociative amnesia is memory loss. Shortly after becoming amnesic, a person may seem confused. Many people with dissociative amnesia are somewhat depressed or very distressed by their amnesia.

Diagnosis

The doctor carefully reviews the person’s signs and symptoms, and performs a physical examination to exclude physical causes of amnesia. Tests, including electroencephalography and blood testing for toxins and drugs, are sometimes needed to exclude physical causes. A psychologic examination is also performed. Special psychologic tests often help the doctor better characterize and understand the person’s dissociative experiences to develop a treatment plan.

Treatment

Psychotherapy aims to help the patient recognize the traumatic event that triggered the amnesia and the anxiety it produced. A trusting therapeutic relationship is essential to achieving this goal. The therapist subsequently attempts to teach the patient reality based coping strategies.

Prevention

Strategies for the prevention of child abuse might lower the incidence of dissociative amnesia in the general population. There are no effective preventive strategies for dissociative amnesia caused by traumatic experiences in adult life in patients without a history of childhood abuse.

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References

Depersonalization Disorder

Depersonalization Disorder

Persistent or recurrent episodes of detachment characterize depersonalization disorder. During these episodes, self-awareness is temporarily altered or lost; the patient often perceives this alteration in consciousness as a barrier between himself and the outside world. The sense of depersonalization may be restricted to a single body part such as a limb, or it may encompass the whole self.

Although the patient seldom loses touch with reality completely, the episodes of depersonalization may cause him severe distress.

Depersonalization disorder usually has a sudden onset in adolescence or early in adult life. It follows a chronic course, with periodic exacerbations and remissions, and resolves gradually.

Causes

Depersonalization disorder typically stems from severe stress, including war experiences, accidents, and natural disasters.

Symptoms

The primary symptom of depersonalization disorder is a distorted perception of the body. The person might feel like he or she is a robot or in a dream. Some people might fear they are going crazy and might become depressed, anxious, or panicky. For some people, the symptoms are mild and last for just a short time. For others, however, symptoms can be chronic (ongoing) and last or recur for many years, leading to problems with daily functioning or even to disability.

Treatment

Psychotherapy aims to establish a trusting therapeutic relationship in which the patient can come to recognize the traumatic event and the anxiety it evoked. The therapist subsequently teaches the patient to use reality-based coping strategies rather than to detach himself from the situation. A person in treatment for a dissociative disorder might benefit from antidepressants or anti-anxiety medication.

Prevention

Some clinicians think that depersonalization disorder has an undetected onset in childhood, even though most patients first appear for treatment as adolescents or young adults. Preventive strategies could include the development of screening techniques for identifying children at risk, as well as further research into the effects of emotional abuse on children. It is also hopeful that further neurobiological research will lead to the development of medications or other treatment modalities for preventing, as well as treating, depersonalization.

References

What Celebrities have Used Phenq

The new hottest trend in weight loss is formulated from capsicum and it is called Phenq. Phenq makes bold claims with slogans like “slim while you sit” and “lose weight at your desk”. This weight loss supplement has snagged headlines across the nation claiming that you can lose weight simply from consuming red chili peppers without having to diet or exercise!

Personal trainers across the country are raving about the product. Even “A listers” like Brad Pitt, Angelina Jolie, Britney Spears, and Jennifer Lopez have been known to use and support this method of weight loss. We have all heard the stories about Beyonce Knowles engaging in a diet that consists of maple syrup and cayenne pepper. These stars are raving about the weight loss properties of the stuff with no bad side effects. Surely if it is good enough for the stars to use it, it must be effective.

PhenQ Promo

You can’t find Phenq at stores since it is only available to purchase from the manufacturer direct online. So don’t look for it at your local phenq uk stockists. It was developed in the UK but it is being sold now around the world. One Phenq bottle contains a 30-day supply. All you have to do is take one capsule per day with a glass of water. For the best results possible you should take Phenq 30 to 60 minutes before exercising. If you don’t want to exercise you can still reap the benefits. No dieting is necessary either.

Taking one capsule will burn 278 calories whether you are working out or not. You can also eat whatever you like. This is the same amount of calories burned during a 25-minute jog or walking briskly for 80 minutes. That is correct. You burn those same calories without lifting a finger other than to take your daily dose.

The primary ingredient in Phenq, capsicum, is responsible for these amazing figures. Capsicum is an extract that speeds up your metabolism. This increased metabolism burns more calories and fat stored in your body. It would not normally be possible for you to ingest the amount of capsicum needed to see these types of results. The reason is that it would irate the mouth and throat and might even result in gastric problems. However Phenq utilizes a special coating that protects your mouth, throat, and digestive system. The coating is formulated so that the capsule is digested in the intestine where the acids nullify the painful effects of capsicum. There are none of the negative side effects from ingesting the capsicum in this form that you would normally experience. In fact there are no known negative side effects that have been associated with the consumption of Phenq. This miracle coating is top secret and it is one of the things that set Phenq apart from the rest along with the fact that it is 100% natural. So give it a try. It is safe and fast acting. The stars sure believe in it.

Anorexia Nervosa

Anorexia Nervosa

The key feature of anorexia nervosa is self-imposed starvation resulting from a distorted body image and an intense and irrational fear of gaining weight, even when obviously emaciated. An anorexic patient is preoccupied with her body size, describes herself as “fat,” and commonly expresses dissatisfaction with a particular aspect of her physical appearance. Although the term anorexia suggests that the patient’s weight loss is associated with a loss of appetite, this is rare.

Anorexia nervosa and bulimia nervosa can occur simultaneously. In anorexia nervosa, the refusal to eat may be accompanied by compulsive exercising, self­induced vomiting, or abuse of laxatives or diuretics.

Anorexia occurs in 5% to 10% of the population; more than 90% of those affected are females. It occurs primarily in adolescents and young adults but also may affect older women and, occasionally, males.

Causes

The cause of anorexia nervosa is unknown. Researchers in neuroendocrinology are seeking a physiologic cause but have found nothing definite. Clearly, social attitudes that equate slimness with beauty play some role in provoking this disorder; family factors also are implicated. Most theorists believe that refusing to eat is a subconscious effort to exert personal control over life or to protect oneself from dealing with issues surrounding sexuality.

Signs and symptoms

One important sign that someone may be suffering from anorexia nervosa is grossly distorted body image, meaning that the person feels they are overweight and, in fact, appear thin. Other symptoms may include unnatural fear of weight gain, compulsive exercising, self-starvation, loss of energy, and, in girls who have started menstruating, amenorrhea, or absence of at least three consecutive menstrual cycles. Those with anorexia nervosa may begin to appear emaciated.

Over time, the disorder may cause serious health problems including sudden death, congestive heart failure, dental problems, growth retardation, stomach rupture, swelling of the salivary glands, anemia, abnormalities of the blood, loss of kidney function and osteoporosis.

Treatment

Appropriate treatment aims to promote weight gain or control the patient’s compulsive binge eating and purging and to correct malnutrition and the underlying psychological dysfunction. Hospitalization in a medical or psychiatric unit may be required to improve the patient’s precarious physical state. Hospitalization may be as brief as 2 weeks or may stretch from a few months to 2 years or longer.

A team approach to care – combining aggressive medical management, nutritional counseling, and individual. group, or family psychotherapy or behavior modification therapy – is the best approach. Treatment is difficult, and results may be discouraging. Many clinical centers are now developing inpatient and outpatient programs specifically for managing eating disorders.

Treatment may include behavior modification (privileges depend on weight gain); curtailed activity for physical reasons (such as arrhythmias); vitamin and mineral supplements; a reasonable diet, with or without liquid supplements; subclavian, peripheral, or enteral hyperalimentation (enteral and peripheral routes carry less risk of infection); and group, family, or individual psychotherapy.

Supportive care by health care providers, structured behavioral therapy, psychotherapy, and anti-depressant drug therapy are some of the methods that are used for treatment. Severe and life-threatening malnutrition may require intravenous feeding.

Prevention

Preventive measures to reduce the incidence of anorexia are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the child’s normal growth and development, and improve the quality of life experienced by children or adolescents with anorexia nervosa. Encouraging healthy eating habits and realistic attitudes toward weight and diet may also be helpful.

References

  1. https://en.wikipedia.org/wiki/Anorexia_nervosa
  2. https://www.nhs.uk/conditions/anorexia/

Delusional Disorders

Delusional Disorders

According to the DSM-IV. delusional disorders are characterized by false beliefs with a plausible basis in reality. Formerly referred to as paranoid disorders, delusional disorders are known to involve erotomanic, grandiose, jealous, or somatic themes as well as persecutory delusions. Some patients experience several types of delusions; other patients experience unspecified delusions that have no dominant theme.

Delusional disorders commonly begin in middle or late adulthood, usually between ages 40 and 55, but they can occur at a younger age. These uncommon illnesses affect less than 1 % of the population; the incidence is about equal in men and women. Typically chronic, these disorders often interfere with social and marital relationships but seldom impair intellectual or occupational functioning significantly.

Causes

Delusional disorders of later life strongly suggest a hereditary predisposition. At least one study has linked the development of delusional disorders to inferiority feelings in the family. Some researchers suggest that delusional disorders are the product of specific early childhood experiences with an authoritarian family structure. Others hold that anyone with a sensitive personality is particularly vulnerable to developing a delusional disorder.

Certain medical conditions are known to exaggerate the risks of delusional disorders: head injury, chronic alcoholism, deafness, and aging. Predisposing factors linked to aging include isolation, lack of stimulating interpersonal relationships, physical illness, and diminished hearing and vision. In addition, severe stress (such as a move to a foreign country) may precipitate a delusional disorder.

Symptoms

The presence of non-bizarre delusions is the most obvious symptom of this disorder. Other symptoms that might appear include:

  • An irritable, angry, or low mood
  • Hallucinations (seeing, hearing, or feeling things that are not really there) that are related to the delusion (For example, a person who believes he or she has an odor problem may smell a bad odor.)

Diagnosis

Patients with delusional symptoms should undergo a thorough physical examination and patient history to rule out possible organic causes (such as dementia). If a psychological cause is suspected, a mental health professional will typically conduct an interview with the patient and administer one of several clinical inventories, or tests, to evaluate mental status

Treatment

Effective treatment of delusional disorders, consisting of a combination of drug therapy and psychotherapy, must correct the behavior and mood disturbances that result from the patient’s mistaken belief system. Treatment also may include mobilizing a support system for the isolated, aged patient.

Drug treatment with antipsychotic agents is similar to that used in schizophrenic disorders. Antipsychotics appear to work by blocking postsynaptic dopamine receptors. These drugs reduce the incidence of psychotic symptoms, such as hallucinations and delusions, and relieve anxiety and agitation. Other psychiatric drugs, such as antidepressants and anxiolytics, may be prescribed to control associated symptoms.

High-potency antipsychotics include fluphenazine, haloperidol, thiothixene, and trifluoperazine. Loxapine succinate, molindone, and perphenazine are intermediate in potency, and chlorpromazine and thioridazine are low-potency agents. Haloperidol decanoate, fluphenazine decanoate, and fluphenazine enanthate are depot formulations that are implanted I.M. and release the drug gradually over a 30-day period, improving compliance.

Clozapine, which differs chemically from other antipsychotic drugs, may be prescribed for severely ill patients who fail to respond to standard neuroleptic treatment. This agent effectively controls a wider range of psychotic symptoms without the usual adverse effects.

However, clozapine can cause drowsiness, sedation, excessive salivation, tachycardia, dizziness, and seizures, as well as agranulocytosis, a potentially fatal blood disorder characterized by a low white blood cell count and pronounced neutropenia. Routine blood monitoring is essential to detect the estimated 1 % to 2% of all patients taking clozapine who develop agranulocytosis. If caught in the early stages, the disorder is reversible.

Prevention

Effective means of prevention have not been identified.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874764/
  2. https://www.health.harvard.edu/diseases-and-conditions/delusional-disorder

Conversion Disorder

Conversion Disorder

Previously called hysterical neurosis, conversion type, a conversion disorder allows a patient to resolve a psychological conflict through the loss of a specific physical function, for example, by paralysis, blindness, or the inability to swallow. Unlike factitious disorders or malingering, the patient’s loss of physical function is involuntary. However, laboratory tests and diagnostic procedures don’t disclose an organic cause.

Conversion disorder can occur in either sex at any age. An uncommon disorder, it usually begins in adolescence or early adulthood. The conversion symptom itself isn’t life-threatening and usually has a short duration.

Causes

The patient suddenly develops the conversion symptom soon after experiencing a traumatic conflict that he believes he can’t handle. Two theories explain why this occurs. According to the first, the patient achieves a “primary gap,” when the symptom keeps a psychological conflict out of conscious awareness. For example, a person may experience blindness after witnessing a violent crime.

The second theory suggests that the patient achieves secondary gain from the symptom by avoiding a traumatic activity. For example, a soldier may develop a “paralyzed” hand that prevents him from entering into combat.

Signs and symptoms

Common signs of a conversion disorder include:

  • Sudden onset of physical symptoms
  • Recent history of a stressful experience
  • Inappropriate lack of concern over the physical symptoms

The symptoms of conversion disorder involve the loss of one or more bodily functions. These may include blindness, paralysis or the inability to speak. The loss of physical function is involuntary and diagnostic testing does not show a physical cause for the dysfunction.

Treatment

Psychotherapy, family therapy, relaxation therapy, behavior therapy, or hypnosis may be used alone or in combination (two or more) to treat conversion disorder.

References

  1. https://medlineplus.gov/ency/article/000954.htm
  2. https://www.msdmanuals.com/professional/psychiatric-disorders/somatic-symptom-and-related-disorders/conversion-disorder

Autistic Disorder

Autistic Disorder

Autistic disorder is a severe, pervasive developmental disorder marked by unresponsiveness to social contact, gross deficits in intelligence and language development, ritualistic and compulsive behaviors, restricted capacity for developmentally appropriate activities and interests, and bizarre responses to the environment.

The disorder usually becomes apparent before the child reaches age 3, but in some children the actual onset is difficult to determine. Occasionally, autistic disorder isn’t recognized until the child enters school. when his abnormal social development becomes obvious.

Autistic disorder is rare, affecting 4 to 5 children per 10,000 births. It affects four to five times more males than females, usually the firstborn male. Although the degree of impairment varies, the prognosis is poor and most patients require a structured environment throughout life.

Causes

The causes of autistic disorder remain unclear but are thought to include psychological. physiologic, and sociologic factors. Previously, it was thought that most parents of autistic children were intelligent, educated people of high socioeconomic status; recent studies suggest that this may not be true.

The parents of an autistic child may appear distant and unaffectionate toward the child. However, because autistic children are clearly different from birth, and because they are unresponsive or respond with rigid, screaming resistance to touch and attention, parental remoteness may be merely a frustrated, helpless reaction to this disorder, not its cause.

Some theorists consider autistic disorder related to early under stimulation that causes the child to seek contact with the world through self-stimulating behaviors or consider it related to overwhelming over stimulation that leads to regression, muteness, and unresponsiveness to external stimuli. Controlled studies haven’t confirmed this etiology.

Recent studies have pointed to an association between neurobiological factors and autism. Defects in the central nervous system that may arise from prenatal complications (such as rubella or phenylketonuria), high maternal stress in the first trimester, and genetic factors appear to playa role in the development of autism.

Signs and symptoms

  • does not socially interact well with others, including parents
    • shows a lack of interest in, or rejection of physical contact. Parents describe autistic infants as “unaffectionate.” Autistic infants and children are not comforted by physical contact.
    • avoids making eye contact with others, including parents
    • fails to develop friends or interact with other children
  • does not communicate well with others
    • is delayed or does not develop language
    • once language is developed, does not use language to communicate with others
    • has echolalia (repeats words or phrases repeatedly, like an echo)
  • demonstrates repetitive behaviors
    • has repetitive motor movements (such as rocking and hand or finger flapping)
  • is preoccupied, usually with lights, moving objects, or parts of objects
  • does not like noise
  • has rituals
  • requires routines

Treatment

The difficult and prolonged treatment of autistic disorder must begin early, continue for years (through adolescence), and involve the child, parents, teachers, and therapists in coordinated efforts to encourage social adjustment and speech development and to reduce self-destructive behavior.

Behavioral techniques are used to decrease symptoms and increase the child’s ability to respond. Positive reinforcement, using food and other rewards, can enhance language and social skills. Providing pleasurable sensory and motor stimulation (jogging, playing with a ball) encourages appropriate behavior and helps eliminate inappropriate behavior. Pharmacologic intervention may be helpful. Haloperidol often
mitigates withdrawn and stereotypical behavior patterns, making the child more amenable to behavior modification therapies.

Treatment may take place in a psychiatric institution, in a specialized school, or in a day-care program, but the current trend is toward home treatment. Helping family members to develop strong one-on-one relationships with the autistic child commonly initiates responsive, imitative behavior. Because family members tend to feel inadequate and guilty, they may need counseling.

Prevention

Until the causes of infantile autism are known, prevention isn’t possible.

References

  1. https://www.chw.org/medical-care/child-development-center/developmental-disorders/pervasive-developmental-disorders-pdd/autistic-disorder
  2. https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml
  3. https://medlineplus.gov/autismspectrumdisorder.html

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD

The patient with attention deficit hyperactivity disorder has difficulty focusing his attention, engaging in quiet passive activities, or both. Some patients have an attention deficit without hyperactivity; they’re less likely to be diagnosed and receive treatment.

Attention-deficit hyperactivity disorder (ADHD) is one of the most common reasons children are referred for mental health services.  It affects as many as one in every 20 children. This disorder occurs in roughly 3% to 5% of school­age children. Males are three times more likely to be affected than females. The presence of other psychiatric disorders also needs to be determined.

Causes

Attention deficit hyperactivity disorder is thought to be a physiologic brain disorder with a familial tendency. Some studies indicate that it may result from altered neurotransmitter levels in the brain.

Signs and symptoms

The kinds of symptoms professionals look for in diagnosing ADHD include

  • difficulty following instructions or completing tasks
  • difficulty ‘sticking to’ an activity
  • easily distracted and forgetful
  • Having trouble waiting his or her turn
  • Interrupting or intruding on others
  • difficulty playing quietly
  • always seeming to be “on the go”
  • blurts out answers without waiting for the question to finish
  • difficulty in waiting or taking turns

In order to be diagnosed with ADHD some of these problems would have been apparent before the age of six or seven years.

These behaviours must normally occur in more than one setting (for example at home as well as at school) for ADHD to be diagnosed.

Treatment

Education is the first step in effective treatment of attention deficit hyperactivity disorder. The entire treatment team (which ideally includes parents, teachers, and therapists as well as the patient and the doctor) must fully understand the nature of this disorder as well as the disorder’s effect on the individual’s ability to function.

Specific treatments vary, depending on the severity of signs and symptoms and their effects on the patient’s ability to function adequately. Behavior modification, coaching, external structure, use of planning and organizing systems, and supportive psychotherapy can all help the patient more effectively cope with the disorder.

Some patients benefit from medication to relieve symptoms. Ideally, the treatment team identifies the symptoms to be managed, selects appropriate medication, and then tracks the patient’s symptoms carefully to determine the effectiveness of the medication. Stimulants, such as methylphenidate and dextroamphetamine, are the most commonly used agents. However, other drugs, including tricyclic antidepressants (such as desipramine and nortriptyline), mood stabilizers, and beta blockers, sometimes help control symptoms. Tomoxetine, currently in clinical trials, has been found in preliminary studies to be effective; further research will involve extending the duration of treatment to determine the effects of the medication.

Special parenting skills are often required because children with AD/HD may not respond as well to typical parenting practices. Also, because ADHD tends to run in families, parents often have some problems with organization and consistency themselves and need active coaching to help learn these skills.

Prevention

Preventive measures to reduce the incidence of ADHD in adolescents are not known at this time. However, early detection and intervention can reduce the severity of symptoms, decrease the interference of behavioral symptoms on school functioning, enhance the adolescent’s normal growth and development, and improve the quality of life experienced by children or adolescents with ADHD.

References

  1. https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
  2. https://www.cdc.gov/ncbddd/adhd/index.html
  3. https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/symptoms/

Alcoholism Fact – Signs & Symptoms, Treatment

Alcoholism

Alcoholism is a chronic disorder most often described as the uncontrolled intake of alcoholic beverages that interferes with physical and mental health, social and familial relationships, and occupational responsibilities. Alcoholism cuts across all social and economic groups, involves both sexes, and occurs at all stages of the life cycle. beginning as early as elementary school age.

Most adults in the United States are light drinkers; a minority – about 10% of the population – account for 50% of all alcohol consumption. About 13% of all adults over age 18 have suffered from alcohol abuse or dependence at some time in their lives. The prevalence of drinking is highest between the ages of 21 and 34, but current statistics show that up to 19% of 12- to 17-year-olds have a serious drinking problem. Males are, two to five times more likely to abuse alcohol than are females. According to some statistics, alcohol abuse is a factor in 60% of all automobile accidents. Alcoholism has no known cure.

Causes

Numerous biological, psychological, and sociocultural factors may cause alcohol addiction, but no clear evidence confirms the influence of any of these factors. Family background may playa significant part: An offspring of one alcoholic parent is seven to eight times more likely to become an alcoholic than is a peer without such a parent. Biological factors may include genetic or biochemical abnormalities, nutritional deficiencies, endocrine imbalances, and allergic responses.

Psychological factors may include the urge to drink alcohol to reduce anxiety or symptoms of mental illness; the desire to avoid responsibility in familial, social, and work relationships; and the need to bolster self-esteem.

Sociocultural factors include the availability of alcoholic beverages, group or peer pressure, an excessively stressful lifestyle, and social attitudes that approve frequent imbibing. Advertising supports society’s message that alcohol consumption is part of a healthy lifestyle. Paradoxically, many alcoholics come from families in which alcohol is forbidden.

Signs and symptoms

Most alcoholics deny that they have a drinking problem. Other indications of alcoholism and alcohol abuse include:

  • Keeping alcohol in unlikely places at home, at work or in the car
  • Gulping drinks, ordering doubles, becoming intoxicated intentionally to feel good or drinking to feel “normal”
  • Nausea and vomiting
  • Having legal problems or problems with relationships, employment or finances
  • Rapid heart rate and sweating
  • Restlessness or agitation

Treatment

Total abstinence is the only effective treatment. Supportive programs that offer detoxification, rehabilitation, and aftercare, including continued involvement in Alcoholics Anonymous (AA), may produce long-term results.

Acute intoxication is treated symptomatically by supporting respiration, preventing aspiration of vomitus, replacing fluids, administering I.V. glucose to prevent hypoglycemia, correcting hypothermia or acidosis, and initiating emergency treatment for trauma, infection, or GI bleeding.

Treatment of chronic alcoholism relies on medications to deter alcohol use and treat effects of withdrawal; psychotherapy, using behavior modification techniques, group therapy, and family therapy; and appropriate measures to relieve associated physical problems.

Aversion, or deterrent, therapy uses a daily oral dose of disulfiram to prevent compulsive drinking. This drug interferes with alcohol metabolism and allows toxic levels of acetaldehyde to accumulate in the patient’s blood, producing immediate and potentially fatal distress if the patient consumes alcohol up to 2 weeks after taking it.

Disulfiram is contraindicated during pregnancy and in patients with diabetes, heart disease, severe hepatic disease, or any disorder in which such a reaction could be especially dangerous. Another form of aversion therapy attempts to induce aversion by administering alcohol with an emetic.

For long-term success with aversion, or deterrent, therapy, the sober alcoholic must learn to fill the place alcohol once occupied in his life with something constructive. For patients with abnormal dependence or for those who also abuse other drugs, aversion therapy with disulfiram may only substitute one drug dependence for another; so it should be used prudently.

Tranquilizers, particularly benzodiazepines, occasionally are used to relieve overwhelming anxiety during rehabilitation. However, these drugs have addictive potential (substituting one substance abuse problem for another), and they can precipitate coma or even death when combined with alcohol. Naltrexone may be useful as an adjunct to psychotherapy, especially when there are high levels of cravings. Antipsychotics are prescribed to control hyperactivity and psychosis. Anticonvulsants, anti emetics, and antidiarrheals also are used to treat symptoms of alcohol withdrawal.

Supportive counseling or individual. group, or family psychotherapy may improve the alcoholic’s ability to cope with stress, anxiety, and frustration and help him gain insight into the personal problems and conflicts that may have led him to alcohol abuse. Ongoing support groups also can help him overcome his dependence on alcohol. In AA, a self-help group with more than a million members worldwide, the alcoholic finds emotional support from others with similar problems. About 40% of AA members stay sober as long as 5 years, and 30% stay sober longer than 5 years.

Prevention

Educational programs and medical advice about alcohol abuse have been successful in decreasing alcohol abuse and its associated problems. Alcohol dependency requires more intensive management.

The National Institute on Alcohol Abuse and Alcoholism recommends that women have no more than 1 drink per day and men no more than 2 drinks per day. One drink is defined as a 12-ounce bottle of beer, a 5-ounce glass of wine, or a 1 1/2-ounce shot of liquor.

References

  1. https://medlineplus.gov/alcoholismandalcoholabuse.html
  2. https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243

Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS)

Repetitive transcranial magnetic stimulation (rTMS) is a new technology that is showing promise as a treatment for depression.

Transcranial magnetic stimulation (TMS) is a technique for gently stimulating the brain. It utilizes a specialized electromagnet placed on the patient’s scalp that generates short magnetic pulses, roughly the strength of an MRI scanner’s magnetic field but much more focused. The magnetic pulses pass easily through the skull just like the MRI scanner fields do, but because they are short pulses and not a static field, they can stimulate the underlying cerebral cortex (brain). Low frequency (once per second) TMS has been shown to induce reductions in brain activation while stimulation at higher frequencies (> 5 pulses per second) has been shown to increase brain activation. It has also been shown that these changes can last for periods of time after stimulation is stopped. TMS was first developed in 1985, and has been studied significantly since 1995.

How Transcranial magnetic stimulation works?

The exact details of how TMS functions are still being explored, but the MIT Technology Review listed some potential mechanisms:

A doctor typically holds a powerful magnet over the frontal regions of the patient’s skull and delivers magnetic pulses for a few minutes a day, over the course of a few weeks. The treatment alters the biochemistry and firing patterns of neurons in the cortex, the part of the brain nearest the surface. Preliminary research indicates that the treatment affects gene activity, levels of neurotransmitters like serotonin and dopamine, and the formation of proteins important for cellular signaling-any of which could play a role in alleviating depression. What’s more, magnetic stimulation seems to affect several interconnected brain regions, starting in the cortex and moving to the deep brain, where new cell growth may be important in regulating moods.

In practice, TMS and rTMS are able to influence many brain functions, including movement, visual perception, memory, reaction time, speech and mood. The effects produced are genuine but temporary, lasting only a short time after actual stimulation has stopped.

How many times do you need to receive TMS?

Research protocols vary in the treatment duration, but most require at least two weeks of daily stimulation given five times per week, some require up to 6 weeks.

Safety Issues

Generally, TMS appears to be free from harmful effects. Research using animals and human volunteers has showed little effect on the body in general as a result of stimulation, and examination of brain tissue submitted to thousands of TMS pulses has shown no detectable structural changes. It is possible in unusual circumstances to trigger a seizure in normal patients, but a set of guidelines which virtually eliminate this risk are available. Research continues, but TMS is certainly free of obvious side-effects like those of electro-convulsive therapy (ECT), which still makes quite an impact on patients despite refinements in technique.

Conclusions

TMS shows promise as a novel antidepressant treatment. Systematic and large-scale studies are needed to identify patient populations most likely to benefit and treatment parameters most likely to produce success. In addition to its potential clinical role, TMS promises to provide insights into the pathophysiology of depression through research designs in which the ability of TMS to alter brain activity is coupled with functional neuroimaging.

References

  1. https://en.wikipedia.org/wiki/Transcranial_magnetic_stimulation
  2. https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625
  3. https://www.health.harvard.edu/blog/transcranial-magnetic-stimulation-for-depression-2018022313335