The Journal of neuropsychiatry and clinical neurosciences
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J Neuropsychiatry Clin Neurosci · Jan 2006
Comparative StudyPosttraumatic stress disorder symptoms during the first six months after traumatic brain injury.
Controversy exists regarding the rate and risk factors for posttraumatic stress disorder (PTSD) following traumatic brain injury (TBI). The authors determined the rate and phenomenology of PTSD symptoms in the 6 months after TBI by conducting a prospective cohort study of 124 subjects who completed the PTSD Checklist-Civilian Version. The cumulative incidence of meeting PTSD symptom criteria at 6 months was 11% and full criteria 5.6%. ⋯ Eighty-six percent had another psychiatric disorder and 29% a history of PTSD. Symptoms were associated with not completing high school, assault, recalling being terrified or helpless, and positive toxicology. PTSD after TBI is rare and the relation to risk factors and comorbidities must be examined.
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J Neuropsychiatry Clin Neurosci · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialDose effects of modafinil in sustaining wakefulness in narcolepsy patients with residual evening sleepiness.
Excessive sleepiness associated with narcolepsy lasts throughout the waking day. The authors conducted two randomized, double-blind studies to compare the efficacy of modafinil once-daily versus split doses in maintaining wakefulness throughout the day. ⋯ All modafinil dosing regimens were well tolerated. In patients who experience excessive sleepiness in the late afternoon/evening, despite satisfactory treatment earlier in the day, a split dose of modafinil may promote wakefulness throughout the waking day.
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J Neuropsychiatry Clin Neurosci · Jan 2005
Review Comparative StudyTreatment of acute ischemic stroke: does it impact neuropsychiatric outcome?
Stroke is a leading cause of disability globally. Although neuropsychiatric symptoms are produced by stroke and adversely effect stroke outcome, it is unclear whether neuropsychiatric outcome can be improved by acute stroke treatment. ⋯ Of the 190 trials reviewed, only seven included specific measures of neuropsychiatric outcome, usually a short test of cognition or mood. Further studies are needed to determine the potential benefits of acute stroke treatment on both poststroke neuropsychiatric symptoms and the relationship between such symptoms and stroke outcome.
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J Neuropsychiatry Clin Neurosci · Jan 2005
Case ReportsAdjunctive valproic acid for delirium and/or agitation on a consultation-liaison service: a report of six cases.
The authors present six cases in which valproate was used in patients seen by a consultation-liaison service (CLS) to manage delirium and/or psychotic agitation. The intravenous (IV) preparation (Depacon, Abbott Laboratories) was used in two nothing by mouth (NPO) patients, while the liquid oral preparation (Depakene, Abbott Laboratories) was used via nasogastric tube (NGT) in the other patients. All of these cases had suboptimal responses and/or concerning side effects from conventional therapy with benzodiazepines and/or antipsychotics. ⋯ Consultation-liaison psychiatrists should consider the addition of valproic acid to control behavioral symptoms of delirium when conventional therapy is inadequate. This may be especially advisable when problematic side effects result from more conventional psychopharmacological management. Specifically, intravenous valproate sodium may be a viable option for NPO patients.