09.27.12

• d-Cycloserine may accelerate the effects of exposure-based therapy for anxiety disorders.
• One week after treatment, phobic patients who received exposure plus d-cycloserine exhibited a qualitatively different neural response to feared stimuli compared to patients who received exposure plus placebo.
• d-Cycloserine augmentation of exposure therapy may enhance ventromedial prefrontal brain activity during and after exposures to phobic stimuli.

• Cytochrome P450 2D6 (CYP2D6) poor metabolizers are at an increased risk for QT prolongation at standard doses of pimozide because of higher drug concentrations.
• People who are CYP2D6 poor metabolizers should not receive more than 4 mg of pimozide daily if adults or 0.05 mg/kg daily (up to 4 mg daily) if children.
• Clinicians can refer to the US Food and Drug Administration pimozide label for new guidance on dosing, titration, and CYP2D6 status testing recommendations.

• Obesity, in particular abdominal adiposity, is a risk factor for depression.
• Leptin impaired central action (resistance) may represent a biological mechanism relating abdominal adiposity with depression onset in obese persons.
• In obese depressed patients, the development of therapeutic interventions on leptin downstream pathways should target leptin central resistance rather than leptin itself.

• Compensatory cognitive training is a brief, manualized, low-tech intervention aimed at improving cognitive impairment and everyday functioning abilities in people with schizophrenia.
• Our results showed that compensatory cognitive training led to improvements in attention, memory, functional capacity, negative symptom severity, and patient-rated quality of life.

• A subset of young men who take finasteride develop persistent sexual side effects accompanied by severe depressive symptoms and suicidal thoughts.
• Prescribers and potential users of finasteride should be aware of the potential CNS side effects of this medication.

• Most recently diagnosed, first-episode schizophrenia patients stop their antipsychotic medication within the first year of outpatient treatment.
• Early initiation of long-acting antipsychotic therapy seems to delay but not prevent the onset of nonadherence in this patient population.
• Nonadherence to oral therapy was usually not recognized in “real time” by the treating clinician. Given the likelihood of unrecognized nonadherence in first-episode patients, long-acting therapy offers an “information advantage” regarding efficacy and safety of the prescribed antipsychotic.

• Combining wake therapy, light therapy, and sleep time stabilization with duloxetine treatment induced a very rapid and sustained increase in antidepressant response in patients with treatment resistance; this method offers an alternative to polypharmacy treatment.
• Exercise in combination with duloxetine also induced a clinically meaningful antidepressant response, but less than the wake therapy, light therapy, and sleep time stabilization combined with duloxetine.
• We found that the individually tailored exercise program was easy to implement and that patients were highly compliant and had very few side effects. We believe that the weekly assessment and guidance by a physiotherapist was very important in obtaining this high level of compliance.
• Wake therapy was well tolerated, with a high level of compliance. Patients experienced only a moderate degree of sleepiness during the wake nights. Light therapy was also well tolerated, with a high degree of compliance. The sleep diary was found to be a helpful tool in stabilizing the sleep-wake cycle.

• Panic attacks occur in a wide range of psychiatric disorders; that is, their occurrence is not limited to panic disorders or anxiety disorders.
• Clinicians should be aware of the risk of onset of psychiatric disorders when patients present with panic attacks.
• In patients with panic (panic disorders, panic attacks, past panic attacks), both mental functioning and physical functioning are more impaired than in those without panic.

• Studies have shown an association between peripheral blood levels of polyunsaturated fatty acids (PUFAs) and dementia and predementia syndrome.
• Intervention with n-3 PUFAs might be beneficial for patients with dementia or predementia syndrome, but the outcomes are not consistent.
• The results of this meta-analysis suggest that patients with dementia and predementia syndrome have lower levels of n-3 PUFAs, supporting an important role of n-3 PUFAs in cognitive disorders.

• The study is the first large randomized, placebo-controlled clinical trial to show the impact on agitation of individualized nonpharmacologic interventions based on the unmet need model.
• The effect size of the intervention was larger than in a previous study, probably due to (1) a rigorous methodology of ascertaining the optimal nonpharmacologic intervention, (2) greater experience in discerning and delivering the interventions, and (3) the accumulation of a wide variety of materials that could be matched to individual backgrounds and needs.
• Nonpharmacologic interventions not only decreased agitation but also increased pleasure and interest, suggesting that these interventions contribute to improved quality of life for persons with dementia.