Clinical neuropharmacology
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Clin Neuropharmacol · Nov 2009
Effects of methylphenidate on cerebral glucose metabolism in patients with impaired consciousness after acquired brain injury.
To evaluate the effects of methylphenidate on cerebral glucose metabolism in patients with impaired consciousness after acquired brain injury. ⋯ Our findings suggest that the posteromedial parietal cortex, which is part of the neural network for consciousness, may be the relevant structure for the pharmacological response to methylphenidate treatment in patients with impaired consciousness after acquired brain injury.
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Clin Neuropharmacol · Sep 2009
Randomized Controlled Trial Comparative StudyEfficacy and safety of botulinum neurotoxin NT 201 in poststroke upper limb spasticity.
To assess the impact of the new botulinum neurotoxin type A preparation NT 201 (Xeomin; Merz Pharmaceuticals GmbH, Frankfurt, Germany) on muscle tone, functional disability, and caregiver burden in patients with poststroke upper limb spasticity in a randomized, placebo-controlled, double-blind study. ⋯ NT 201 led to statistically significant improvements in muscle tone and disability and was well tolerated in patients with poststroke upper limb spasticity.
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Addiction is increasingly understood as a neurobiological illness where repetitive substance abuse corrupts the normal circuitry of rewarding and adaptive behaviors causing drug-induced neuroplastic changes. The addictive process can be examined by looking at the biological basis of substance initiation to the progression of substance abuse to dependence to the enduring risk of relapse. Critical neurotransmitters and neurocircuits underlie the pathological changes at each of these stages. ⋯ In the path from substance abuse to addiction, the neurochemistry shifts from a dopamine-based behavioral system to a predominantly glutamate-based one marked by dysregulated glutamate transmission from the prefrontal cortex to the nucleus accumbens in relation to drug versus biologically oriented stimuli. This is a core part of the executive dysfunction now understood as one of the hallmark features of addiction that also includes impaired decision making and impulse dysregulation. Understanding the neurobiology of the addictive process allows for a theoretical psychopharmacological approach to treating addictive disorders,one that takes into account biological interventions aimed at particular stages of the illness.
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Clin Neuropharmacol · May 2009
ReviewN-desmethylclozapine: is there evidence for its antipsychotic potential?
N-Desmethylclozapine (NDMC), one of clozapine's major metabolites, has become a recent focus of study for both its antipsychotic and metabolic effects. The aim of this review is to examine NDMC's biological activity in the context of the pathophysiology of schizophrenia and to critically evaluate the few recent preclinical and clinical studies of NDMC's potential antipsychotic effects to predict its therapeutic potential. ⋯ Although there is some suggestion based on animal data that NDMC may have a somewhat different biological profile than clozapine, clinical data on its antipsychotic efficacy are scant at this point. This makes it necessary to test NDMC alone compared with established antipsychotic compounds in clinical trials to elucidate its effects on schizophrenia symptoms, clinical outcome, and physiologic/metabolic side effects.
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Clin Neuropharmacol · May 2009
Case ReportsOxcarbazepine treatment of restless legs syndrome: three case reports.
Restless legs syndrome is a sensorimotor neurological condition that affects sleep and daytime functioning. The 4 classes of medication most used for restless legs syndrome include dopaminergic agents, benzodiazepines, opioids, and anticonvulsants such as gabapentin or carbamazepine. Here, we report 3 cases of restless legs syndrome successfully treated with oxcarbazepine, the keto-derivative of carbamazepine.