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Alvaro Camacho

Publications and source records attributed to Alvaro Camacho.

9 recordsLinked to original sources
PubMed2006

Methylphenidate for alpha-interferon induced depression.

Interferon-Alpha (IFN) has been effective in the treatment of chronic viral infections and cancer albeit the added risk of severe depression. The literature has reported effectiveness in the use of antidepressants for interferon-induced depression. We report a case of severe protracted depression induced by IFN in a patient diagnosed with melanoma who responded rapidly to a course of methylphenidate using the Hamilton Depressive Rating Scale. Methylphenidate appeared to be effective in the treatment of neurovegetative symptoms of major depression induced by IFN. This report provides further clinical evidence that the neurovegetative symptoms of depression might respond better to a norepinephrine uptake inhibitor or psycho-stimulants.

Affect↗
PubMed2005

Proposal for a bipolar-stimulant spectrum: temperament, diagnostic validation and therapeutic outcomes with mood stabilizers.

BACKGROUND: Stimulant abuse and dependence in confusing admixtures with features of bipolar disorder has been variously conceptualized. DSM-IV-TR rules tend to be liberal in permitting the diagnosis of substance-induced disorder, and rather strict for a bipolar diagnosis in such cases. Accordingly, if bipolarity is ever considered in this interface, it usually pertains to syndromal bipolar I disorder. METHOD: We therefore focused on the more prevalent but relatively neglected admixture of stimulant abuse with bipolar II and lesser degrees of bipolarity. We examined in our dual diagnosis program the longitudinal progression of the dual pathology in 10 patients who had proven refractory to past efforts to treat the stimulant component. In doing so, we wished to better delineate the nature of the clinical interface of the stimulant bipolar spectrum and its response to anticonvulsant mood stabilizers. RESULTS: In nearly all cases cyclothymic and hyperthymic traits preceded the use of stimulants by years, which seemed to serve the purpose of controlling or maintaining the subthreshold rewarding mood condition. Eventually clinically more ominous and socially destructive pathology evolved, with contributions from both the bipolar diathesis and the addictive process. Seven of 10 cases had bipolar familial indicators. Nearly all evidenced hypomanic and/or irritable depressive states with mixed features during protracted sobriety from the stimulant. Except for two of the 10 patients, substantial (30-45 point) gains were made on DSM-IV-TR axis V general assessment of functioning (GAF) scores with the use of largely "mood-stabilizing" anticonvulsants. This was paralleled with the reduction of craving. These data highlight the human dimensions of the bipolar-stimulant abuse interface, and document functional outcomes (rather than mere changes in rating scales which may not necessarily reflect clinically relevant improvement). LIMITATION: Open case series of 10 patients. CONCLUSION: We propose a bipolar-stimulant spectrum-what the senior author has elsewhere labeled bipolar III-1/2-where subthreshold bipolar traits are complicated by stimulant abuse, eventually leading to pathology characteristic of both disorders. The contribution of bipolarity to this spectrum is supported by: (1) premorbid cyclothymic and hyperthymic traits; (2) familial bipolarity; (3) presence of subthreshold bipolar signs and symptoms during protracted sobriety. We further submit that anticonvulsants in this spectrum not only treat the acute escalation of activated and mixed depressive states, withdrawal phenomena, and craving for the stimulant, but also the craving for activation and mood enhancement of the underlying temperament. We submit that the latter might be crucial for the successful attenuation of the underlying diathesis for stimulant seeking behavior, abuse and dependence.

Adult↗
PubMed2005

Use of GHB compounds among college students.

There are increasing reports about the misuse of gamma hydroxybutyric acid (GHB) related compounds. The objective of this article is to examine the use of GHB-containing dietary supplements among college students. An anonymous survey was completed at a university health clinic. The survey asked participants about their experience using GHB compounds and their knowledge about the legal status of GHB and its addictive potential. Two hundred fifteen students responded to the survey. Twenty-eight percent had used GHRE and 19% had used GHB. Growth Hormone Release Extract (GHRE) users reported consumption 2-3 times per month and GHB users reported 1-2 times per month. Males tended to use GHB for euphoria and energy, while females tended to use the compounds for weight loss. GHB was particularly popular among homosexual and bisexual responders. There was little knowledge of the addictive potential and illegal status of GHB and related compounds. GHB compounds are commonly used among college students. Given the different reasons for use according to gender and sexual orientation, prevention programs need to sculpt their message according to the target audience.

Adolescent↗
PubMed2002

Depression treatment in rural California: preliminary survey of nonpsychiatric physicians.

Depressive disorders have been recognized as disabling conditions of public health proportions. However, in areas underserved by mental health professionals, the treatment of depressed patients becomes challenging. Furthermore, patients living in rural areas and communities underserved by health professionals are at risk for high levels of depressive symptoms and low access to care. Physicians (N = 58) of multiple nonpsychiatric specialties in Imperial County, a rural underserved area in California, were surveyed to ascertain their preferred strategies in the management of depressed patients. More than half (57%) of the respondents preferred to either refer patients to a mental health specialist (p < .01) as the only strategy, or in combination with counseling, prescribing medication, or both. The most commonly reported form of counseling was of a supportive nature. The most commonly prescribed drugs were selective serotonin reuptake inhibitors (in order of frequency:fluoxetine, sertraline, and paroxetine). Tricyclic antidepressants and benzodiazepines were identified as first-line drugs by some pediatricians and surgeons. The results of this study support the need for enhanced postgraduate training in the treatment of depression for nonpsychiatric physicians, and greater exposure of psychiatric residents to rural psychiatry.

California↗
PubMedDate not supplied

Use of herbal medications among 200 psychiatric outpatients: prevalence, patterns of use, and potential dangers.

We documented the use rates of herbal medication among a population of psychiatric outpatients to identify patients at risk for drug-herb interactions. Data were collected on 200 patients who, as part of their routine evaluation, provided information regarding their use of herbs. Fifteen percent of patients were currently taking herbs, the majority for treatment of psychiatric symptoms. There were no significant differences in use patterns across gender or between age groups. None of the current users charts, including the "high risk" patients, indicated that treating physicians were aware of potentially dangerous drug-herb combinations. Use of herbal medication was common among this sample of psychiatric outpatients. These data are consistent with reports from other patient populations. It is important for psychiatrists to ask all patients about their use of herbs and provide education about potentially dangerous drug-herb interactions.

Adult↗
PubMedDate not supplied

Use of GHB compounds by HIV-positive individuals.

Gamma hydroxybutyrate (GHB) has been used by body-builders to enhance performance and by young adults in rave parties. Warnings have been posted about its addictive potential. The use of these dietary compounds is currently banned by the Food and Drug Administration, but they are widely available through the Internet and in certain communities. The purpose of the study was to examine the use of these compounds by HIV-positive individuals and to investigate their knowledge of the addictive potential of GHB and its related dietary compounds. One hundred HIV-positive individuals from the UCSD outpatient HIV clinic responded to an anonymous survey that inquired about their knowledge, use, and effects produced by GHB containing dietary compounds. The most common reported dietary compound beside GHB was Growth Hormone Release Extract (GHRE). Fifty-two percent of individuals reported using at least one GHB containing dietary compound. Gay subjects reported the highest use of GHB compounds (76.9%; p < or = 0.001). The most common effect reported by users was increased energy (71%). Only 24% of the total responders knew about GHB's addictive potential. Among reported users of GHB containing compounds, fourteen (27%) knew about its addictive potential and nine (17%) knew that the compound is illegal. This study shows that HIV-positive gay individuals attending our clinic are using GHB compounds. Reported GHB users have limited knowledge about its addictive potential and serious adverse effects. More controlled studies are needed to evaluate long-term effects of dietary compounds containing GHB, especially among HIV-positive individuals who are actively receiving antiretroviral treatment.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The internet for medical information about cancer: help or hindrance?

OBJECTIVE: The authors tested a strategy for screening Internet sites to identify those that provide scientifically accurate information regarding complementary/alternative medicine treatments commonly used by cancer patients. METHOD: Separate Internet searches were conducted for three complementary/alternative medicine treatments: floressence, amalaki, and selenium. Sites (N=194) were assessed according to four criteria: availability of online purchasing, inclusion of patient testimonials, description of the treatment as a "cancer cure," and description of the treatment as "having no side effects." The presence of any of these criteria was considered a "red flag" denoting questionable scientific accuracy of the site. Sites were categorized based on the number of red flags. MEDLINE searches were performed and peer-reviewed literature used to determine the scientific accuracy of sites. RESULTS: Over 90% of the sites for floressence and amalaki had at least one red flag. In these searches, sites with no red flags provided some scientifically accurate information, while sites with red flags provided a large amount of vague and inaccurate information. Less than one-quarter of sites for selenium had at least one red flag, and sites in this search generally provided scientifically accurate information, regardless of the number of red flags. CONCLUSIONS: There is a staggering amount of medical misinformation on the Internet. For cancer treatments that have not been rigorously studied, the red flag criteria offer a rapid way of screening Internet sites for likely scientific accuracy. It may be advisable for patients to avoid sites with one or more red flags.

Humans↗
PubMedDate not supplied

Ethnicity and use of alternative products in psychiatric patients.

The use of herbal and natural products for medical purposes is common in all human civilizations, and use in Western societies has grown considerably in recent years. However, differences in usage patterns between different ethnic groups are yet to be delineated. The current study examined the frequency and type of complementary/alternative medications used by a sample of 453 rural psychiatric outpatients of two different ethnic groups. The products were classified as "natural" (herbal products requiring some preparation before consumption) and "processed" (products in "ready-to-use" form). There were significant ethnic differences in usage patterns of the various preparations: Hispanics, relative to Caucasians, were twice as likely to use natural products, whereas Caucasians were more likely than Hispanics to use processed products. The symptoms addressed were predominantly psychiatric, with natural products, and nonpsychiatric, with processed products. These results may increase awareness among healthcare providers regarding the usage frequency of such complementary/alternative medications products and the different usage patterns across ethnic groups.

California↗