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Biomedical subjects

B Croissant

Publications and source records attributed to B Croissant.

16 recordsLinked to original sources
PubMed2007

[Carbamazepine intoxication. Complication of alcohol detoxification with combined carbamazepine and tiapride].

The advantages of alcohol detoxification treatment with combined carbamazepine and tiapride compared to benzodiazepines or clomethiazole is a lower level of sedation and lack of addictive potential. We report a case of carbamazepine intoxication with serum levels up to 19 mg/l in an otherwise healthy 45-year-old alcohol-dependent male after treatment with 600 mg carbamazepine and 600 mg tiapride per day. Medication was discontinued immediately and a purgative was administered. We were able to combat the intoxication but the assumed good tolerance of the combined treatment with carbamazepine and tiapride for alcohol detoxification still has to be proven.

Alcoholism↗
PubMed2007

[Compulsive shopping--current considerations on classification and therapy].

Compulsive shopping is classified by ICD-10 (F63.8) as an "impulse control disorder, not otherwise classified". Several authors consider compulsive shopping rather as a variety of dependence disorder. It is characterized by the impulsive or compulsive buying of unneeded things, personal distress, impaired social and vocational functioning, and/or financial problems. In this case, we discuss a two-way therapy consisting of addiction-specific psychological education and high dose selective serotonin reuptake inhibitors (SSRIs). We further point to compliance problems caused by SSRI side effects.

Behavior, Addictive↗
PubMed2006

Quetiapine in relapse prevention in alcoholics suffering from craving and affective symptoms: a case series.

PURPOSE: Quetiapine is a novel antipsychotic, which is efficacious in the treatment of positive and negative symptoms in schizophrenia. Research has shown that atypical antipsychotic also reduce the craving and consumption for stimulants and alcohol. Due to Quetiapine's particulars and the promising receptor profile concerning addiction medicine, we set out to examine the tolerability and efficacy concerning relapse prevention of withdrawn alcoholics suffering from craving and affective symptoms. SUBJECTS AND METHODS: Our case observations attempted to evaluate nine alcoholics after withdrawal suffering from persisting craving, sleep disorder, excitement, depressive symptoms or anxiety symptoms. The patients were treated with quetiapine as relapse prevention and we followed them up in our outpatient clinic. RESULTS: Eight out of nine patients were abstinent under quetiapine over a period of 2-7 months. One of these patients relapsed after he stopped taking the preparation at his own initiative after 10 weeks. The ninth patient stopped taking the preparation immediately because of swollen nasal mucosae. All target symptoms disappeared in the patients after an average of (mean+/-S.D.) 24.5+/-18.1 days. The overall tolerability was considered to be very good; however, initial sleepiness appeared in four patients. CONCLUSION: Although uncontrolled case observations can only be interpreted with caution quetiapine seems to deserve further investigation and may hold the potential for preventing alcohol relapse in alcoholics suffering from additional above-mentioned symptoms.

Adult↗
PubMed2006

Galantamine reduces smoking in alcohol-dependent patients: a randomized, placebo-controlled trial.

INTRODUCTION: The high morbidity and mortality caused by smoking highlights the importance of investigating new strategies for smoking cessation or reduction. Galantamine is an acetylcholinesterase inhibitor that increases the effect of acetylcholine (ACh). The nicotinic ACh receptor is activated via positive allosteric modulation (APL). METHODS: We investigated whether galantamine reduces smoking by performing a 24-week randomized, placebo-controlled, multicentric clinical trial in recently detoxified alcohol-dependent patients. We included all study subjects irrespective of an intention or motivation to abstain from nicotine. Specific treatment for cessation or reduction of smoking was not provided. Smoking behavior was assessed by means of patients' diaries. The nicotine metabolite cotinine was measured to verify the number of smoked cigarettes as documented in the patient's diary. RESULTS: 114 randomized smokers received galantamine (n = 56) or placebo (n = 58) for 12 weeks. Follow-up examinations were terminated after an additional 12 weeks without treatment. Smoking behavior did not differ between both groups at baseline. After treatment, the intention-to-treat analysis revealed significant differences with a 20% lower cumulative number of smoked cigarettes and a 15% lower number of smoking days in the galantamine group compared to placebo. The average number of smoked cigarettes per smoking day as well as the cotinine values decreased about 10%. Cotinine values showed a positive correlation with the number of documented cigarettes, validating the patients' diaries. CONCLUSION: Our tentative data indicate that galantamine reduces smoking behavior even without any additional specific intervention. We suggest introducing the term "substitution therapy" into the treatment of smoking. This result could open up a new treatment approach for groups of patients which usually have a low motivation for change.

Administration, Cutaneous↗
PubMed2005

Galantamine: a cholinergic patch in the treatment of alcoholism: a randomized, placebo-controlled trial.

OBJECTIVES: The involvement of the central cholinergic system in alcohol abuse behavior is well known. It is possible that the reinforcing effects of ethanol are partially mediated by nicotinic receptors, which modulate neurotransmitter release. It was demonstrated that the application of a cholinesterase inhibitor reduces alcohol consumption in alcohol-preferring rats. This suggests that galantamine (GAL), a cholinesterase inhibitor, could be effective when seeking to prolong abstinence in recently detoxified alcoholics. This study represents the first reported clinical trial of a cholinergic drug in alcohol-relapse prevention. PATIENTS AND METHODS: We investigated the efficacy and safety of GAL by conducting a 24-week randomized, placebo-controlled, multicentric clinical trial on 149 recently detoxified alcoholics. Survival analyses (Kaplan-Meier) were performed to reveal evidence of prolonged abstinence periods in patients who received GAL. RESULTS: Our findings did not support our hypothesis. GAL did not extend the time to first severe relapse. However, additional post hoc analyses suggest that relapsed patients treated with GAL consume less ethanol per drinking day than patients treated with placebo. CONCLUSIONS: GAL seems to be ineffective when used in relapse prevention of detoxified alcoholics. It is possible that alcohol needs to be "on board" for GAL to be beneficial. This could explain why our post hoc analysis showed that GAL possibly reduces the alcohol consumption of relapsers. If confirmed, GAL could play a role in the reduction of harmful alcohol use and at-risk consumption.

Administration, Cutaneous↗
PubMed2005

Reduction of side effects by combining clozapine with amisulpride: case report and short review of clozapine-induced hypersalivation-a case report.

Side effects from a high-dose clozapine treatment for a schizophrenic patient led to massive compliance problems. The dose of clozapine could be halved without recurrence of an acute psychotic symptomatology by concomitantly administering amisulpride. The side effects, especially hypersalivation, disappeared almost entirely, which in turn led to good compliance. In a short review we would like to present the pathophysiology and therapeutic options of clozapine-induced hypersalivation.

Adult↗
PubMed2005

Scheme-based benzodiazepine detoxification with oxcarbazepine -- a case report.

We attempted to evaluate the tolerability and efficacy of the antiepileptic drug oxcarbazepine in benzodiazepine detoxification, by observing several cases. Detoxification followed a predefined dosage scheme. All patients detoxified with oxcarbazepine completed the withdrawal successfully, without withdrawal symptoms. The administration of oxcarbazepine according to the scheme proved to be tolerable. The dosage was sufficient. Though uncontrolled case observations must be interpreted with caution, oxcarbazepine appears to be a promising drug in inpatient benzodiazepine withdrawal. It should be examined in further randomized placebo-controlled studies including long-term follow-ups.

Anticonvulsants↗
PubMed2005

Neuroimaging of gender differences in alcohol dependence: are women more vulnerable?

BACKGROUND: Alcoholic brain damage has been demonstrated in numerous studies using neuropathology and brain imaging techniques. However, gender differences were addressed only in a few studies. Recent research has shown that development, course, and consequences of alcohol dependence may differ between female and male patients. Our investigation was built upon earlier research where we hypothesized that women develop alcoholic brain damage more readily than men do. To further compare the impact of alcohol dependence between men and women, we examined brain atrophy in female and male alcoholics by means of computed tomography (CT). METHODS: The study group consisted of a total of 158 subjects (76 women: 42 patients, 34 healthy controls; 82 age-matched men: 34 patients, 48 healthy controls). All patients had a DSM-IV and ICD-10 diagnosis of alcohol dependence. CT with digital volumetry was performed twice in patients (at the beginning and end of the 6-week inpatient treatment program) and once in controls. RESULTS: Patients of both genders had consumed alcohol very heavily. Although the average alcohol consumption in the year before the study was significantly lower in female alcoholics, this gender difference disappeared when controlled for weight. However, women had a significantly shorter duration of alcohol dependence. Despite this fact, both genders developed brain atrophy to a comparable extent. Brain atrophy was reversible in part after 6 weeks of treatment; it did not reach the level in the control groups. CONCLUSIONS: Gender-specific differences in the onset of alcohol dependence were confirmed. This is in line with the telescoping effect, where a later onset and a more rapid development of dependence in women were described. Under the assumption of a gradual development of consequential organ damage, brain atrophy seems to develop faster in women. As shown in other organs (i.e., heart, muscle, liver), this may confirm a higher vulnerability to alcohol among women.

Adult↗
PubMed2004

[Drug-induced headache and pain reduction medication with amitriptyline in an 11-year old pupil].

We report on an 11-year-old pupil who present-ed to a neurological practice in the company of his parents because of migraine and strong headaches. Precise anamnesis of drugs yielded the diagnosis of a drug-induced headache with underlying migraine disease. The boy was afflict-ed with a hereditary taint, as both parents also suffered from migraine. The mother was also continuously in treatment because of a chronic pain disorder. Therapy with up to 50 mg per day of amitriptyline enabled the boy to stop consuming analgesics without suffering from head-aches. Moreover, under 47.5 mg per day of metoprolol, the migraine symptoms did not re-occur.

Amitriptyline↗
PubMed2003

[Outpatient alcohol detoxification].

Increasing significance is being attributed to outpatient detoxification treatment of alcohol-dependent patients. Many patients want to undergo outpatient detoxification or even carry it out without professional supervision. In some Scandinavian countries and in the USA, outpatient detoxification under medical supervision has increased substantially. In these countries,numerous studies describe outpatient alcohol detoxification as a safe and cost-reducing method. These studies vary in many aspects, especially regarding the nature and dose of the withdrawal medication, but also concerning the inclusion criteria of patients. Medications to treat or prevent alcohol withdrawal symptoms are rather heterogeneous. Besides well-known standard medication established in inpatient treatment (e.g.,benzodiazepines and carbamazepine), interesting studies report the application of rather uncommon substances such as physostigmine and psychotropic analgesic nitrous oxide (PAN) for alcohol detoxification. This article provides an overview on outpatient alcohol detoxification and discusses its transfer to practical application.

Alcohol Deterrents↗
PubMed2000

[Alcohol withdrawal syndrome and its treatment].

When alcoholics decrease or interrupt alcohol intake abruptly, they will in general experience alcohol withdrawal symptoms. Clinically in most cases it develops a vegetative syndrome with gastroenteropathy, cardiovascular diseases, neurological and psychopathological symptom. Usually alcohol withdrawal symptoms abate after four to seven days, longer courses are rare. Application of drugs is required in approximately one third to one half of the patients. A variety of drugs was suggested for the treatment of alcohol withdrawal. In the first hours of alcohol detoxification, the sensitivity of epinephrine receptors is reduced, but rises afterwards substantially. The number of NMDA-receptors increases during chronic intoxication with ethanol. The standard therapy in Europe (except of Great Britain) is an oral mono therapy with clomethiazole in a dose which depends on the severity of the symptoms. Severe withdrawal symptoms may require treatment on an intensive care unit with infusion therapy, e.g. in the context of a delirium tremens, which represents a life-threatening status. In this case, benzodiazepines have been used successfully as an alternative to clomethiazole.

Alcohol Withdrawal Delirium↗
PubMed1999

[Feelings without speech or speech without feelings? Further evidence for the decoupling hypothesis of alexithymia].

The theoretical background of the present investigation was the decoupling hypothesis of alexithymia, which presumes for alexithymic individuals a dissociation of psychophysiological indicators of emotion from verbal cognitive awareness of one's emotional state. To study alterations in reactivity to emotionally distressing stimuli in alexithymic individuals, 12 high-alexithymic and 14 low-alexithymic subjects (separated by TAS) out of a general sample of 54 were investigated. All subjects were exposed to cognitive (CPT) and affect inductive (film sequences) distress. During stimulus exposition electrodermal activity (spontaneous fluctuations) was recorded. After stimulus exposition the subjects assessed their emotional reaction towards the film sequences (DAS). Concerning electrodermal activity no differences were found between high and low alexithymics under cognitive distress. In any case a significant autonomous arousal was registered. However, only the low alexithymic subjects but not the high alexithymics showed a significant increase of spontaneous fluctuations as expression of autonomous arousal during presentation of affect inductive stimuli. The altered psychophysiological reactivity found in high alexithymics in contrast to low alexithymic subjects was revealed specifically for the processing of emotional qualified stimuli. However, there was no difference between the groups in cognitive self assessment of emotional response towards the film sequences. The findings are discussed with reference to neurophysiological and psychodynamic models and the decoupling hypothesis of alexithymia.

Adult↗
PubMed1996

[Alexithymia--psychometric phantom or psychophysiologic reality?].

To study alterations in reactivity to emotionally distressing stimuli in somato-psychosomatic patients 12 patients suffering from ulcer and 24 psychoneurotic patients were compared with 18 healthy controls. All were exposed to cognitive and emotional distress and examined in regard to their electrodermal activity (EDA). Alexithymic features were documented with the TAS in somato-psychosomatic and psychoneurotic patients. In contrast to the neurotic patients the ulcer patients did not differ markedly from the controls in the GT-S and the FPI-R. Concerning EDA no differences were found between ulcer patients and healthy controls under cognitive distress. In any case a significant autonomous arousal was registered. However, only healthy controls and neurotic patients but not the ulcer patients showed a significant increase of EDA as expression of the autonomous activation during presentation of emotion inducing stimuli. The altered psychophysiological reactivity found in somato-psychosomatic patients in contrast to healthy controls was thus ascertainable specifically for the processing of emotional qualified stimuli. The findings are discussed with reference to neurophysiological models and the still disputed conception of alexithymia.

Adult↗
PubMedDate not supplied

[Drug addiction prevention in the workplace--feasibility study in a company from the chemical industry].

INTRODUCTION: In recent years drug prevention at the place of work has became increasingly important for programmes focussing on health promotion at the place of work. Drug prevention programmes aim at reducing cost and protecting the employees from physical harm. There are virtually no reliable figures from surveys in companies. To date intervention programme in companies have hardly been verified. In this feasibility study we intended to examine the practicability of an evaluation of an intervention programme in a large chemical company by means of questionnaires and we present preliminary intervention effects. METHODS: In the context of a pilot study we conducted and evaluated a drug prevention programme at the place of work. Focus was on illegal designer drugs. The programme was conducted as a one-day workshop for trainers in superior management positions. We used a feedback form and a detailed questionnaire on drug prevention in the working place. 41 trainers who participated in the seminar were compared with a control group of 12 trainers who did not participate. RESULTS: The intervention programme was well accepted by the participants. Follow-up data demonstrated, that participants in the seminar had far better knowledge of the employment agreement on addiction and drugs and of the possible ways to get help and they were far more active in realising the employment agreement. CONCLUSION: To achieve a long-term improvement of drug abuse in companies it is not enough to include and implement a passage on drug abuse and addiction in the employment agreement. Well-instructed trainers talk far often with colleagues displaying abnormal or addictive behaviour, resulting in more rapid therapeutic interventions.

Chemical Industry↗