News

In a variety of creative fields, psychiatrists have been portrayed in many ways. This Special Report is psychiatry's turn to address creativity with offerings as diverse as the creative arts themselves. From Shakespeare to rock 'n' roll, there's something for everyone.

Even as data mount in support of rasagiline (Agilect) as an alternative therapy for the motor symptoms of Parkinson disease (PD), additional research on the next generation of dopamine agonists suggests that this class of drugs will not be dispensed with any time soon. Findings presented in April at the annual meeting of the American Academy of Neurology (AAN) linked symptom improvement not only to the monoamine oxidase type B inhibitor but also to several nonergoline agonists, including 2 that target receptors other than D1 and D2 and are delivered transdermally.

Perceptions

Sometimes it pays to look at something in a different way. Growing up in rural Georgia, I hated kudzu. My disdain began as soon as I was old enough to mow the lawn. The creeping vines relentlessly tried to expand from their ceded territory and take over the civilized section of my parents' property.

At first glance, PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection) has little in common with the cuddly bear that roams the bamboo forests of southwest China. But, in fact, they share 2 important features: both are rare and both are threatened with extinction.

A progressive, debilitating disorder, multiple sclerosis (MS) is the most common cause of disability in young adults with the exception of traumatic injury. The neurologic symptoms are the result of an autoimmune attack on the myelin enveloping the axons in the brain and spinal cord.

Mental Notes

Can a common cough medicine contribute to effective treatment of symptoms in persons with neurologic disorders? The evidence is mounting in its favor. At the recent American Academy of Neurology annual meeting, research results were presented from a phase 3, double-blind, placebo-controlled, multicenter study into the safety and efficacy of a dextromethorphan/quinidine capsule in

Of concern is the safety of our roadways as the effects of aging take their toll upon drivers nationwide. Are there accurate ways to test the cognition and response ability of elderly drivers?

Joseph I. Sirven, MD, and Joseph F. Drazkowski, MD, neurologists at the Mayo Clinic in Phoenix, led a recent study in partnership with the Walter Cronkite School of Journalism and Mass Communication at Arizona State University (ASU) to determine how well medical risks and treatment advances for neurologic conditions are conveyed in US newspaper articles.

Signals

It may be possible to predict whether a patient will have an untoward reaction to a selective serotonin reuptake inhibitor-or potentially another class of antidepressant-by "pretreating" them with a placebo and by monitoring its effect on brain activity.

When Gordon R. Kelley, MD, was called to the ICU in Kansas City, Mo, to evaluate a deteriorating patient who had apparently overdosed on methadone, he was puzzled. CT and MRI scans revealed an obstructive hydrocephalus associated with abnormal signals throughout the cerebellum, basal ganglia, and hippocampi. He knew that these findings were not consistent with a typical cerebrovascular injury, but he and other treating physicians were unsure of the cause of the findings. Reaching for his handheld computer, he entered several key words into his favorite program, NERVLINE: cerebellum . . . heroin . . . leukoencephalopathy

Diagnosis of the two main major eating disorders, anorexia nervosa and bulimia nervosa, can be difficult because of denial of symptomatology by the patients and problems with some of the diagnostic criteria. Although CBT has been the most effective, there are no treatments available that can guarantee a cure for either disorder. Medication is only a helpful adjunct to the treatment of anorexia, while many controlled studies that show antidepressant medications are effective in reducing binge/purge behavior in bulimia.

The FDA has issued a "black box" warning about the use of all antidepressants in the pediatric population due to a 1.8-fold increase in suicidality on drug compared to placebo. Yet these medications can be an effective tool in treating depression. How should parents and patients be educated, considering this information?

Autism is a highly prevalent, highly heterogeneous disorder of unknown etiology. Studies to clearly establish the efficacy of various classes of psychoactive drugs are scarce. Nonetheless, available findings do support the efficacy of atypical antipsychotics and antidepressants in treating the core symptoms of repetitive behavior.