Michael Soyka

..2 to 39.8%. Withdrawal symptoms, craving and compliance improved significantly after transfer to (R)-methadone. We conclude that transfer from racemic to (R)-methadone is a safe and practical procedure...

..Neuroimaging studies may well help further elucidate the interrelationship between neurocognitive functioning, personality traits, and antisocial and violent behavior...

..Future studies on the role of different subtypes of alcoholics according to their genetic or psychological profile to explain or even predict the effects of opioid antagonists in the treatment of alcohol dependence are needed...

..We conclude that delusional jealousy is a comparatively rare phenomenon that is most frequent in schizophrenia and related psychoses. Quite a number of affected patients are aggressive, which may indicate a risk of future violence...

..As previously demonstrated in another sample of schizophrenic patients, the AMDP syndromes mania (and hostility) is associated with a higher risk of later criminal behavior...

..More longitudinal research and studies controlling for the effects of dosage and duration of opioid addiction are necessary to examine whether cognitive ability may improve under long-term MMT...

..Selective attention improved in both patient groups during treatment. We propose that the improvement of attention may facilitate rehabilitation of drug-dependent patients...

..To develop evidence-based practice guidelines for the pharmacological treatment of opioid abuse and dependence...

..Based on own experience in this area, some typical cases are described. Physicians with substance use and legal problems are especially common. Some general guidelines for psychiatric assessment are discussed...

..To study the value of demographic and alcohol-related variables for predicting 24-month treatment outcome in an outpatient setting...

..INTROduction: Cognitive impairment has been reported in drug-dependent patients under opioid maintenance treatment...

..To date German psychiatrists have surprisingly not been outspoken on this issue. The author would like to make an emphatic plea against"brain doping" in healthy individuals...

..We assessed whether patients under buprenorphine, a partial mu-opioid agonist, perform better in cognitive tests measuring psychomotor performance as described in previous nonrandomized studies...

..The aim of the study was to examine the practicability and implementation efficacy of an alcohol outpatient detoxification model and the concomitant 'motivational' psychotherapeutic approach...

..This first part of the guidelines covers the treatment of alcohol dependence; Part 2 will be devoted to the treatment of drug dependence...

..The intensity of withdrawal symptoms showed the strongest correlation with drop-out. Future studies are warranted to further address patient profiles and outcome under different substitution regimens...

..This may indicate that comorbid psychiatric symptoms need to be considered when assessing brain responses in alcohol-dependent patients...

..048, P = 0.049, d.f. = 2), which did not remain significant after correction for multiple testing. There was no association between SLC6A9 glycine transporter polymorphisms and alcohol dependence, and also none in haplotype analysis...

..Violence and criminality in patients with schizophrenia has been described in several studies but prediction of later criminal behavior is difficult...

..This prospective study investigated predictors for relapse 3 years after completion of an intensive outpatient treatment programme for alcoholism...

..Among patients with risperidone, seven patients (35%) passed all test parameters without major failures. Clinical implications of these findings are discussed...

..The aim of the present study was to analyze these variants in a large sample of the Munich Gene Bank of Alcoholism...

..Several studies have reported criminal and violent behaviour in people with schizophrenia but few have investigated the association between affective disorders and violent behaviour...

..Additional treatment with antidepressants, depending on the patient's psychopathology, as well as with anti-craving agents should be considered...

..Benefits in the treatment of alcohol dependence might be optimized by matching the efficacy profiles of specific antidipsotropics with the motivational status of alcohol-dependent patients...

..Taking into account the high comorbidity of opioid dependent patients and the severity of dependence, the mortality rate of approximately 1% confirms that maintenance treatment could be regarded as a fairly safe treatment...

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..In summary, results of this study indicate a favorable outcome of socially stable alcohol-dependent patients and patients with a lower degree of depression, anxiety and craving in an intensive outpatient rehabilitation program...

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..OCDS scores were higher in patients with a less favorable outcome. In line with previous findings, our results showed that the intensity of craving as measured by the OCDS may predict outcome in outpatient alcoholics...

..The results emphasize the importance of monitoring trait anxiety in studies regarding cognitive functions in subjects with alcohol use disorder...

..Previously, we reported a high prevalence of aggression in a large sample of schizophrenic patients treated between 1990-1995 in the psychiatric hospital of the University of Munich...

..The impact of other personality disorders does not play a substantial role in subtyping alcoholics...

..Our results do not provide evidence for an involvement of NEUROD2 polymorphisms in the pathophysiology of alcohol dependence. Further association studies are needed to confirm our findings...

..In line with previous research, the results from this study give further evidence that a combination of the anticonvulsant carbamazepine and tiapride is an effective and safe treatment for alcohol withdrawal treatment...

..Tricyclics have been found to be more effective than serotonin reuptake inhibitors in improving depressive symptoms in these patients...

..Although the efficacy of flupenthixol as an anti-craving drug in dual diagnosis patients has to be explored in further studies, the drug may be considered a promising medication for these patients...

..Regarding the high success rate in the placebo group the influence of psychosocial treatment in studies investigating drug effects on the course of alcohol dependence has to be considered...

..To determine abstinence rates and to obtain safety data during the use of integrated therapy with acamprosate and the main established psychotherapeutic intervention programmes in the treatment of alcohol dependence...

..The present study examined whether craving as measured by the obsessive-compulsive drinking scale (OCDS) predict long-term outcome in alcohol-dependent inpatients...

..Results from this study suggest that a combination of the anticonvulsant carbamazepine and tiapride is an effective and safe treatment for outpatient alcohol detoxification in patients with moderate severity of withdrawal syndrome...

..Preexisting psychiatric disorders or present methadone substitution should no longer be regarded as contraindications to treatment of chronic hepatitis C with IFN-alpha and ribavirin in an interdisciplinary setting...

..Alcoholism is a widespread disorder with substantial mortality and negative treatment outcomes. To date, few medications have been found to reduce relapse rates or drinking in alcohol-dependent patients...

..Only 1 (5%) subject passed all subtests without major failures and could be regarded as competent to drive. Among patients with atypical neuroleptics, 7 patients (24%) passed all test parameters without major failures...

..Taking the substantial numbers of animal studies suggesting a possible role of CB1 antagonists for the treatment of alcohol dependence into account, it seems worthwhile to further test cannabinoid blockers in the treatment of alcoholism...

..Some centers suggest naltrexone not only for patients aiming for abstinence but also for patients for whom continued drinking is a therapeutic possibility or a clinical inevitability...

..1995) and relapse during and after completion of an intensive outpatient treatment programme...

..05) were associated with concomitant daily consumption of BZDs in opioid dependent subjects. These finding underline the need to further explore the causes, interactions and consequences of concomitant BZD and opiate use...

..CCT and ECG were normal. To our knowledge, this is the first description of a seizure related to hyponatremia in an adult carbamazepine-treated patient...

..Irritability is often linked with problem drinking. The aim of this study is to examine the possible influence of irritability on craving induced by a cue-exposure paradigm...

..Despite numerous established psychosocial approaches, relapse to heavy drinking is common in alcohol-dependent patients after detoxification and relapse prevention remains a significant medical challenge...

..Further analysis are needed to confirm these results...

..This grouping, with subsequent characterization according to symptom levels, provides important information indicating possible needs for aftercare and suggests areas for improvement of previous care...

..Conversely, younger drivers rather underassessed their performance...

..The strongest relationship between AASE and treatment outcome could be found for subjects in short-term inpatient treatment. The impact of the results for clinical practice is discussed...

..These results are in line with prior research on this topic...

..Therapeutic success of psychosocial programs for relapse prevention is moderate and could be increased by an adjuvant treatment with the opioid antagonists naltrexone and nalmefene...

..Yet, we believe that the medical specialties of addiction medicine/psychiatry are not attracting the interest and enthusiasm of young physicians. What can be done?..

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..When the second patient was retested after clinical recovery, FDG PET findings were normalized, suggesting the probable thalamic dysfunction to be a functional rather than a structural abnormality...

..Thus, the scopolamine-induced effects in the present study seem to be more relevant to Alzheimer's disease in an advanced phase than to normal aging...

..Although the number of patients dependent on legal drugs is estimated to be as high as 1.9 million, very few are in clinical treatment. Research deficits in this area are evident...

..To study the validity of the EuropASI in the patient allocation context and to measure the alcohol severity changes with treatment...

..Implications for the self-medication hypothesis for substance use in schizophrenia and future research in this area are discussed...

..Psychopathological symptoms significantly associated with aggression were e.p. delusional ideas and disorganized thinking. Possible risk factors for aggression in schizophrenia and clinical implications are discussed...

..We consider this pilot project a successful starting point for further development of treatment approaches targeted more specifically at this group of patients...

..The greater benefit of HAT in reducing alcohol use may be due to the greater daily frequency of dispensing heroin coupled with a requirement of sobriety at each dosing occasion...

..Some recent studies have suggested a lower risk of fatal intoxications in drug-dependent patients under buprenorphine compared to methadone treatment...

..We examined the analogy of both treatment elements used in inpatient rehabilitation of alcohol dependents and the published knowledge concerning the effectiveness of therapy elements...

..Dual diagnosis" schizophrenics had a significantly higher rate of suicide attempts and were less likely to be married. Possible clinical implications of these findings are discussed...

..Little is known about long-term effects on mental health after treatment independent from viral response and the influence of pre-existing psychiatric risk-factors...

..Future studies should focus on dosing issues, the differentiation between short- and long-term effects and the identification of subgroups of patients with particular psychopathology...