Fortschritte der Neurologie-Psychiatrie
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Fortschr Neurol Psychiatr · May 2005
Review[Therapy of pain syndromes in multiple sclerosis -- an overview with evidence-based recommendations].
While pain is a common problem in multiple sclerosis (MS) patients, it is frequently overlooked and has to be asked for actively. Pain can be classified into 4 diagnostically and therapeutically relevant categories. 1. PAIN DIRECTLY RELATED TO MS: Painful paroxysmal symptoms like trigeminal neuralgia or painful tonic spasms are treated with carbamazepine as first choice, or lamotrigine, gabapentin, oxcarbazepine and other anticonvulsants. ⋯ Pain unrelated to MS such as back pain or headache are frequent in MS patients and may be worsened by the disease. Treatment should be follow established guidelines. In summary, a careful analysis of the pain syndrome will allow the design of the appropriate treatment plan using various medical and non-medical options and thus will help to ameliorate the patients' quality of life.
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Fortschr Neurol Psychiatr · Dec 2004
Review Guideline[AWMF-guideline: cocaine-, amphetamine-, ecstasy- and hallucinogen-related disorders].
Actually, guidelines for treatment of substance-related disorders were written under the overall control of the DG-Sucht e. V. and the DGPPN e. ⋯ The leading objective of these guidelines is the description of the current scientifically proven and evidence-based medicine in addiction to derive recommendations to therapy. In this context, the guideline for treatment of cocaine-, amphetamine-, ecstasy-, and halluzinogen-related disorders is introduced.
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Fortschr Neurol Psychiatr · Jul 2004
Review[The impact of Alzheimer's disease on the pain processing].
It is well known that patients with Alzheimer's disease report less pain in comparison to their age group. However, little is yet known about the underlying mechanisms causing the decreased pain report. In order to learn more about these mechanisms, experimental studies are indispensable, since only in experimental settings, noxious input and pain experience can be assessed independently. ⋯ As possible explanations we discuss age-related changes in pain perception and neuroanatomical changes in Alzheimer's disease. Particularly the atrophy of limbic structures may have a modifying impact on the pain experience. We also discuss what influence communicational deficits have on pain report.
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Fortschr Neurol Psychiatr · Jun 2004
Meta Analysis[Meta-analysis of effectiveness and tolerability of treatment of mild to moderate depression with St. John's Wort].
After anxiety, depression is one of the most common psychiatric diseases, showing a lifetime prevalence of 4.4 - 18 %. St. John's Wort is a herbal antidepressant combining a long tradition of use with well-proven medical research. ⋯ John's Wort should be attempted for milder forms of depression. Funnel plot analysis suggested publication bias could exist for the comparison with placebo. To put this in a perspective the fail-safe-N-test calculated that 423 studies with no effect would be needed to negate the presented result for placebo studies.