Since it’s almost Friday the 13th, I thought I’d post some good news follow-ups to neutralize any bad luck juju that might be out and about:
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Unfortunately, the rainy season coincided with the pollen season this year, interfering with the smoothness of my yearly graph on Seasonal Dementia [a new entity… and seasonal dementia update…]:
As seasoned veterans know [pun intended], the times of greatest affliction don’t necessarily coincide with the highest pollen counts. In my case, it’s that second bump in later April that’s the killer. But this week has been great, and I declare Pollenarama-2016 officially over… -
I learned today that the blockbuster article that I can’t seem to stop talking about [The citalopram CIT-MD-18 pediatric depression trial: Deconstruction of medical ghostwriting, data mischaracterisation and academic malfeasance] will be published Open Access [full text on-line] [though it will take several days for the link to be changed]…
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Last summer, I saw a patient who presented with Delerium from an outrageous drug regimen – maximal doses of multiple psychiatric medications [blitzed…]:
- Seroquel 600 mg/day
- Trazadone 450 mg/day
- Depakote 2.5 Grams/day
- Neurontin [I forget how much too much]/day
- Cogentin
48 mg/day [?] - Prozac 80 mg/day
I began to taper the drugs, and what was lurking underneath was full blown Tardive Dyskinesia with constant back and forth jaw movement, hand wringing, athetoid shoulder shrugging, and restless legs. With continued tapering, her sensorium slowly cleared somewhat, but the Tardive Dyskinesia decidedly worsened [some truths are self-evident…, a story: getting near the ending[s]…, and the verb “to follow”…]. Even off medications, her cognition and memory remained impaired. So in March, I was finally able to gather enough family to get a coherent history that made it clear that her actual primary diagnosis was Traumatic Brain Injury from a fall two years before [cases…]. The TD symptoms were improving.
I saw her yesterday in the clinic, and for the first time in almost a year, she had no symptoms of Tardive Dyskinesia. She does have a residual painful TMJ syndrome from the months of constant jaw movements, but all of the TD symptoms themselves have cleared. She’s only on Aprazolam for sleep and Prozac 20 mg daily [per her request]. So, one big bullet dodged and a sigh of relief from everyone concerned…
Thus ends my pre-Friday-13th good news bulletin…
Re #2 Yay!
Please let us know when it goes live.
Take all the wins you can get, good for you.
Steve Lucas
More neurology than psychiatry, but a possible real breakthrough:
http://www.cbsnews.com/news/promising-duke-university-polio-brain-cancer-trial-given-breakthrough-status-60-minutes/
Great article Dr. O’Brien. I wish a friend’s mom had been alive to benefit from this treatment as she had the brain cancer mentioned. But I am so glad the treatment helped that young woman and hopefully, it will help many more people.
Cautious optimism. I remember when antiangiogenesis for cancer showed promise then fizzled. Sample sizes were small and more replication needed.