Michael Soyka

..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...

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

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

..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...

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

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

..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...

..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...

..Conflicting results were reported on the role of the mu-opioid receptor (OPRM1) polymorphism A118G (Asn40Asp, rs1799971) in the development of alcoholism...

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

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

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

..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...

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

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

..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...

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

..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...

..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...

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..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...

..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...

..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...

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

..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...

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

..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...

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

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

..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...

..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...

..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...

..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...

..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...

..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...

..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...

..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...

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

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

..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...

..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...

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

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

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..Maintenance therapy is effective in the reduction in both narcotics-related and acquisition crime...

..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...

..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...

..007. The results were discussed in the context of the Classical, Operant Conditioning Theory, the Cognitive Craving Theory of Tiffany, Gilbert's STAR Model, and the Self-Medication Hypothesis...

..Few medications have been tested for outpatient alcohol detoxification. Previously we had shown a combination of carbamazepine and tiapride to be effective in an open study. This database is an extension of our previous work...

..We therefore investigated whether acamprosate normalizes HPA hyperactivity in alcoholics within the first 3 weeks of abstinence, employing a combined dexamethasone/corticotropin-releasing hormone (Dex-CRH)-test...

..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?..

..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...

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

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..Our findings question the hypothesis of reduced platelet MAO activity to be a possible vulnerability marker for alcoholism...

..A better understanding of the glutamatergic mechanisms in alcohol dependence may therefore also be of relevance for the development of new anti-craving-drugs and therapy-research...

..The negative results in this study question the role of these polymorphisms in the pathogenesis of alcohol withdrawal-induced seizures and delirium tremens...

..A significant association between suicide attempts and the 5-HTT promoter polymorphisms (5-HTTLPR) S-allele has been reported in a sample of French alcohol-dependent subjects, and this paper evaluates this phenomenon in a German sample...

..Alcohol intoxication did not elevate S-100B levels in group 3 or 4 subjects. Our data indicate for the first time that alcohol intoxication does not influence the diagnostic value of S-100B measurements in patients after MHT...

..05), and especially for the sustained influx at the end of the observation period (P = 0.001). The detailed mechanisms of this disturbed calcium homeostasis need further investigation...

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..Chronic pain is only rarely mentioned as reasons for cannabis use, psychological or social reasons prevail. Psychiatric complications in cannabis consumers and its relevance for mental health are discussed...

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

..The aim of this study is to test the potential influence of a bi-allelic cannabinoid receptor gene (CNR1) polymorphism (G1359A) on severe alcohol withdrawal syndromes...

..The possible implications of these findings are discussed...

..The majority of alcohol-dependent individuals had one or more comorbid axis II disorders. Univariate and multivariate analyses indicate that different PDs are related to age at first dinking and alcoholism severity...

..In conclusion, our results suggest that single SNPs, respectively, haplotypes of the HOMER 1 and 2 genes are unlikely to play a major role in the pathophysiology of AD...

..Furthermore we wanted to know whether functional polymorphisms (5-HTTLPR and 5HT2C Ser23Cys), have any influence on this responsivity...

..In conclusion, auditory P300 had a low discriminative power with regards to subgroups of inpatient alcoholics defined by family history and antisocial personality traits. Reasons for the negative findings in this study are discussed...

..Adult antisocial personality occurred more often in males than females. Possible implications of these findings are discussed...

..Current IBZM SPECT data do not support a dopamine receptor dysfunction in alcohol hallucinosis but TRODAT SPECT showed reduced dopamine transporter binding. Possible implications of these findings are discussed...

..Although this result is suggestive for a significant role of this polymorphism in the pathogenesis of delirium tremens in alcohol-dependent individuals, further investigation and confirmation are warranted...

..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...

..This finding suggests that in patients with ASPD, alcohol dependence might be a secondary syndrome as suggested by previous research...

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

..These findings support the hypothesis that the GRIN1 locus may modify the susceptibility to seizures during alcohol withdrawal. This novel finding warrants replication...

..These findings are in line with a number of more recent studies questioning the association between novelty-seeking and DRD4 dopamine receptor gene polymorphism. Possible implications of these findings are discussed...

..Furthermore, the potential influence of concurrent personality disorders and depressive conditions were assessed...

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

..Alcohol dependents were investigated because these personality disorders and impulsive behavior are very frequent in alcohol dependence anf of clinical relevance...

..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...

..K(D) might be influenced by duration of alcohol dependence, but not sufficiently to yield differences between alcohol-dependent and control subjects...

..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...

..Alcohol consumption by opioid-addicted patients treated with methadone or DHC presents a serious medical problem. Co-abuse of alcohol will receive more attention...

..Nevertheless, the question arises whether self-reports of drinking are more reliable than gamma-GT as a measure of recent alcohol consumption...

..Collectively, these data establish glutamate as a link between dysfunction of the circadian clock gene Per2 and enhanced alcohol intake...

..Moreover, we hypothesized that another genetic variation within GRIN2B (rs1806191) may have an effect in the etiology of alcoholism or withdrawal-related traits...

..Despite many short-term studies, little is known about the long-term (12-month) effects of these treatments in different settings, i.e. primary care-based (PMC) and specialized substitution centers (SSCs)...

..Higher serotonin levels among carriers of the S allele might exhibit increased liability of serotonin-mediated, psychopathology-like anxiety and depression and may impair social skills reflected by harm avoidance...

..The present study describes the association between 2 years of heroin treatment and improvements in health and social stabilization, as well as illicit drug use...

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

..The COBRA study provides a unique comprehensive database, informing about the natural allocation and intervention processes in routine care and about the course and outcome of patients treated with buprenorphine or methadone...