Gabapentin for behavioral agitation in Alzheimer's disease.
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Biomedical subjects
Publications and source records attributed to W M Regan.
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We discuss the assessment of testamentary capacity (ability to execute a valid will) in elderly people. Such assessment should include evaluation of the person's knowledge regarding the purpose of the will, the extent of the property involved, the legal heirs, and how the property is distributed according to the will. Some conditions may invalidate a will, including insane delusions and undue influence; however, the mere presence of severe mental illness, such as schizophrenia or dementia, does not automatically render elderly people incompetent to execute a valid will.
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Clinicians should be on the alert for the possibility of underlying thyrotoxicosis in patients having an affective disturbance. An initial detailed medical history and complete physical examination is essential even in severely agitated, threatening patients. The danger of inappropriate diagnosis and treatment of these patients requires a high index of suspicion in detecting the underlying thyroid disturbance.
A case of carbamazepine-induced leukopenia with subsequent successful carbamazepine management is presented. Despite WBC suppression to a level of 2000/cu mm on an initial trial of carbamazepine, a challenge with a much lower dose and gradual titration permitted a full treatment course with therapeutic blood levels. Although many physicians are wary of the leukopenia associated with carbamazepine, it is a distinct entity from the rare agranulocytosis and aplastic anemia that have been associated with the drug. With careful clinical management, carbamazepine can be successfully used in patients with neurologic disorders despite significant WBC suppression.
Two paranoid schizophrenic young men murdered their mother and father while acutely delusional. To delineate the characteristics of homicidal, particularly parricidal patients, these two patients are compared with one parricidal and six homicidal patients. Preliminary warning signs, the contributory role of family life to the psychopathology, and the occurrence of parricide in schizophrenia are discussed.
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