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PEER REVIEWED, EVIDENCE-BASED INFORMATION FOR CLINICIANS AND RESEARCHERS IN NEUROSCIENCE

November-December 2012 Issue Highlights

Dear Colleagues:

Welcome to the November–December issue of Innovations in Clinical Neuroscience. We start this issue with our “Research to Practice” column, which was contributed by Lyketsos et al. The authors bring us an interesting review on deep brain stimulation and its potential use in Alzheimer’s disease.

Following this, Shuman et al examine whether a drop in white blood cell/absolute neutrophil count for clozapine patients on antibiotics is a normal response to the resolution of infection or if the concurrent administration resulted in an abnormal drop in blood counts and further reduction of white blood cell/absolute neutrophil below baseline prior to infection. In their retrospective analysis titled, “Hematologic Impact of Antibiotic Administration on Patients Taking Clozapine,” the authors find that the use of either ciprofloxacin or moxifloxacin may have less risk of reductions in white blood cell/absolute neutrophil counts than are seen with penicillins, cephalosporins, and other antibiotics that may ultimately require interruption or discontinuation of clozapine therapy.

Next, Spiegel and Webb present a case report and brief review titled, “A Case of Treatment Refractory Hyperemesis Gravidarum in a Patient with Comorbid Anxiety, Treated Successfully with Adjunctive Gabapentin: A Review and the Potential Role of Neurogastroentereology in Understanding its Pathogenesis and Treatment.”  The authors present a case of a woman with anxiety symptoms who was experiencing severe nausea and vomiting since Week 2 of pregnancy, with minimal reduction of these symptoms on standard medications utilized in hyperemesis gravidarum. The patient had marked reduction of nausea and vomiting with adjunctive gabapentin. After a brief review of relevant neurogastroenterology, the authors discuss a possible mechanism for the added gabapentin.

Following this, Kaur et al present a unique case report titled,“Successful Use of Rasagiline in Combination with Two Antidepressants.” The authors describe a case of a 58-year-old woman who failed most of the pharmacologic treatments for Parkinson’s disease, including deep brain stimulation, and was recently prescribed rasagiline with good response. The patient was also treated concurrently for major depressive disorder with venlafaxine and bupropion—agents that are typically contraindicated with use of rasagiline.

Next, Sansone and Sansone examine the phenomenon of doctor shopping in this month’s “The Interface.” The authors found that the reasons for doctor shopping are varied and aren’t always driven by a desire to obtain prescription medications. The authors discuss the various patient justifications for doctor shopping and stress that being aware of these reasons is important in understanding and managing these challenging patients in the clinical setting, whether they emerge in psychiatric or primary care environments.

Following this, Harvey and Keefe provide this month’s “Update on Cognition” column with their article titled, “Technology, Society, and Mental Illness: Challenges and Opportunities for Assessment and Treatment.” The authors review the state of technology as it affects daily activities, as well as previous efforts to use technology positively for both the assessment and treatment of psychiatric conditions. The authors conclude that technology-based interventions and assessment strategies have the potential to deliver benefit to a wide array of older people and those with severe mental illness, including reaching people who would not have had access otherwise.

Finally, in this month’s “Risk Management” column, Vanderpool discusses the increasing enforcement of HIPAA’s Privacy and Security Rules by the federal government in her article, “HIPAA—Should I be Worried?”

We hope you enjoy reading this month’s issue. As always, we invite your feedback and submissions.

Sincerely,

Amir Kalali, MD

Editor, Innovations in Clinical Neuroscience