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Colla M, Offenhammer B, Scheerer H, Kronenberg G, Vetter S, Mutschler J, Mikoteit T, Bankwitz A, Adank A, Schaekel L, Eicher C, Brühl AB, Seifritz E. Oral prolonged-release ketamine in treatment-resistant depression - A double-blind randomized placebo-controlled multicentre trial of KET01, a novel ketamine formulation - Clinical and safety results. J Psychiatr Res 2024; 173:124-130. [PMID: 38522166 DOI: 10.1016/j.jpsychires.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 02/26/2024] [Accepted: 03/03/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION We investigated the antidepressant effects of a novel oral prolonged-release formulation of racemic ketamine (KET01) in patients suffering from treatment-resistant depression (TRD) as add-on therapy. MATERIAL AND METHODS Patients were randomized to an additional 160 mg/day or 240 mg/day KET01 or placebo for 14 days. The primary endpoint was change in Montgomery-Åsberg Depression Rating Scale (MADRS) scores from baseline to day 15. For treatment group comparisons, we used ANOVA with pairwise least squares mean difference tests in a mixed model repeated measures analysis. RESULTS Twenty-seven patients completed the double-blind protocol before trial premature termination due to poor recruitment during the COVID-19 pandemic. Mean (SD) MADRS scores on day 15 were 23 (10.32) in placebo, 25 (8.28) with 160 mg/day and 17 (10.32) with 240 mg/day KET01. MADRS change was numerically larger but statistically non-significant in the 240 mg/day KET01 group vs placebo on day 7 (-5.67; p = 00.106) and day 15 was (difference: 4.99; p = 00.15). In exploratory analysis, baseline leukocyte count correlated with response to KET01 (p = 00.01). Distribution of adverse event rates were comparable between the treatment arms. Safety analysis did not identify increased risk of suicidality, dissociation, hear rate, systolic and diastolic blood pressure associated with trial treatment. DISCUSSION Our results suggest that adjunctive oral administration of prolonged-release ketamine at a dose of 240 mg/day shows a positive, although statistically non-significant, trend towards antidepressant efficacy, however, the benefit could not be confirmed due to premature trial termination. Given its ease of use and low side effects, further trials are warranted to investigate this route of ketamine administration as a promising potential treatment of TRD.
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Affiliation(s)
- M Colla
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland.
| | - B Offenhammer
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - H Scheerer
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - G Kronenberg
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - S Vetter
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - J Mutschler
- Psychiatric Hospital Meiringen, Meiringen, Switzerland; Psychiatric Services Lucerne, Lucerne, Switzerland
| | - T Mikoteit
- Psychiatric Services Solothurn and University of Basel, Solothurn, Switzerland
| | - A Bankwitz
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - A Adank
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - L Schaekel
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - C Eicher
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - A B Brühl
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland; University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - E Seifritz
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
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Steinbach G, Bunjes D, Reske S, Buchmann I, Mutschler J. Myeloablative radioimmunotherapy with 188Re-CD66mAb before stem cell transplantation. Nuklearmedizin 2018. [DOI: 10.3413/nukmed-0200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Summary
Aim: Tumour necrosis factor-α (TNF-α) serum levels may increase due to intensive conditioning regimes with highdose- chemotherapy and total body irradiation (TBI) before stem cell transplantation. This increases the risk for developing acute graft versus host disease (aGvHD) after stem cell transplantation. In this prospective study we investigated the influence of radioimmunotherapy with 188Re- CD-66-mAb on changes on TNF-α serum levels. Patients, methods: In 18 patients we measured TNF-α before and up to 96 hours after radioimmunotherapy, in 2 patients in addition following TBI, in 9 patients also following chemotherapy. For measuring TNF-α we used an automated immunochemiluminescence assay (Immulite 1000 DPC Biermann, Bad Nauheim). The mean follow up period to record incidence of aGVHD was 100 days after stem cell transplantation. Results: Compared to the basal levels before, the levels of TNF-α after conditioning with 188Re-CD-66-mAb did not increase significantly and remained in the physiological range. In contrast, these initial physiological cytokine levels increased and became pathological following 48 h after total body irradiation (13.2 ± 6.6 pg/ml) and chemotherapy (10.8 ± 15.7 pg/ml). In our study we found a low incidence of aGvHD (22.2%, n = 4/18). Conclusion: These results demonstrate that additional conditioning therapy with 188Re-CD-66-mAb does not increase proinflammatory cytokine levels of TNF-α. This finding may indicate that additive radioimmunotherapy may not be a significant factor for increasing the rate of conditioning- associated aGvHD.
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Mutschler J, Grosshans M, Soyka M, Rösner S. Current Findings and Mechanisms of Action of Disulfiram in the Treatment of Alcohol Dependence. Pharmacopsychiatry 2016; 49:137-41. [PMID: 26987743 DOI: 10.1055/s-0042-103592] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
As an alcohol-aversive agent, disulfiram occupies an exceptional position in the pharmacological relapse prevention of alcohol dependence. In contrast to anti-craving drugs, disulfiram does not modulate neurobiological mechanisms of addiction, but rather works by producing an aversive reaction when combined with alcohol. Therapeutic and adverse effects are therefore closely related: On the one hand, the aversiveness of the disulfiram ethanol reaction has the potential to support abstinence in a subgroup of alcohol-dependent patients, while on the other hand it becomes a health threat if the patient fails to maintain complete abstinence. The exceptional position of disulfiram is also related to the role that expectations play in the mediation of therapeutic effects. These are not determined by the pharmacological effects or the actual occurrence of a disulfiram-ethanol reaction, but are attributable to patient awareness that the drug was consumed and the corresponding anticipation of an aversive reaction if combined with alcohol. This is in line with the findings of a recent meta-analysis that only showed significant effects for disulfiram in open-label trials. The authors of the meta-analysis conclude that due to expectations induced in both the treatment and placebo groups, blinded studies are incapable of distinguishing a difference between groups. The mediation of therapeutic effects through expectation has a number of consequences for clinical practice and future research on disulfiram.
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Affiliation(s)
- J Mutschler
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | - M Grosshans
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - M Soyka
- Privatklinik Meiringen, Meiringen, Switzerland
| | - S Rösner
- Forel Klinik, Ellikon an der Thur, Switzerland
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von der Goltz C, Jahn H, Mutschler J, Wiedemann K, Kiefer F. Intraperitoneal Atrial Natriuretic Peptide Attenuates Anxiety-related Behaviour during Alcohol Withdrawal in Mice. Pharmacopsychiatry 2014; 47:97-100. [DOI: 10.1055/s-0034-1372645] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- C. von der Goltz
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - H. Jahn
- Department of Psychiatry, University Hospital of Hamburg, Hamburg, Germany
| | - J. Mutschler
- Department of Psychiatry, Psychotherapy and Psychosomatics Center for Addictive Disorders, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - K. Wiedemann
- Department of Psychiatry, University Hospital of Hamburg, Hamburg, Germany
| | - F. Kiefer
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
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Mutschler J, Grosshans M, Mann K, Kiefer F. EPA-0373 – Disulfiram in the treatment of pathological gambling, a new therapeutic option? Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)77798-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Grosshans M, Lemenager T, Vollmert C, Kaemmerer N, Mutschler J, Wagner X, Kiefer F, Hermann D. EPA-0298 – Pregabalin abuse among opiate addicted patients. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)77742-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Pape E, Herdener M, Rösner S, Grosshans M, Mutschler J. Aktueller Stand der pharmakologischen Rückfallprophylaxe der Alkoholabhängigkeit. Suchttherapie 2013. [DOI: 10.1055/s-0033-1355362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- E. Pape
- Zentrum für Abhängigkeitserkrankungen, Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Psychiatrische Universitätsklinik Zürich, Schweiz
| | - M. Herdener
- Zentrum für Abhängigkeitserkrankungen, Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Psychiatrische Universitätsklinik Zürich, Schweiz
| | - S. Rösner
- Forel Klinik, Ellikon an der Thur/Schweiz
| | - M. Grosshans
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg
| | - J. Mutschler
- Zentrum für Abhängigkeitserkrankungen, Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Psychiatrische Universitätsklinik Zürich, Schweiz
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Mutschler J, Froehlich JM, Meier D, Herdener M, Hergan K, Gutzeit A. Effect of acute nicotine withdrawal and oral nicotine substitution treatment on insular glutamine concentration determined by proton magnetic resonance spectroscopy. Pharmacopsychiatry 2013. [DOI: 10.1055/s-0033-1353295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ansel A, Diehl A, Günes G, Grosshans M, Mann K, Kiefer F, Mutschler J. Clinical predictive factors to disulfiram treatment outcome in alcohol dependent patients - a cross-sectional study. Pharmacopsychiatry 2013. [DOI: 10.1055/s-0033-1353289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mutschler J, Dirican G, Funke S, Grosshans M, Mann K, Kiefer F, Diehl A. Experienced acetaldehyde-reaction is not associated with improved treatment response in patients treated with disulfiram. Pharmacopsychiatry 2011. [DOI: 10.1055/s-0031-1292522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Mutschler J, Grosshans M, Herwig U, Heekeren K, Kawohl W, Brühl A. Pregabalin-Induced Suicidal Ideations. Pharmacopsychiatry 2011; 44:119. [DOI: 10.1055/s-0031-1271689] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mutschler J, Bilbao A, der Goltz CV, Demiralay C, Jahn H, Wiedemann K, Spanagel R, Kiefer F. Stress-induced alcohol drinking and withdrawal in mice lacking functional natriruetic peptide-A receptors. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mutschler J, Grosshans M, Bühler M, Diehl A, Kiefer F. Disulfiram in the treatment of pathological gambling? Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Diehl A, Nakovics H, Mutschler J, Hermann D, Kiefer F. Rivastigmine reduces tobacco craving in alcohol-dependent smokers. Pharmacopsychiatry 2009; 42:89-94. [PMID: 19452376 DOI: 10.1055/s-0028-1103295] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Although alcohol-dependent smokers represent an important group for applying smoking interventions, a sufficient pharmacotherapy has not been established in this high-risk group so far. METHODS In order to examine the effect of the acetylcholinesterase inhibitor rivastigmine on tobacco dependence, we performed a 12-week, randomized, placebo-controlled trial. 26 alcohol-dependent smokers were randomized to rivastigmine 6 mg/day (n=14) or placebo (n=12). Assessments on addictive behavior included carbon monoxide (CO), severity of tobacco dependence (FTND), daily smoked cigarettes (diaries), and craving for tobacco (QSU) and alcohol (AUQ). RESULTS ANOVA revealed a significant treatment-by-time interaction for tobacco consumption and tobacco craving (each p<0.0001). The rivastigmine group showed a decrease in daily smoked cigarettes (-30%), in exhaled carbon monoxide (-32%) and in tobacco craving (-18%) whereas controls did not show significant changes. ANCOVA revealed rivastigmine effects to be more prominent in smokers suffering from more severe tobacco dependence. None of the patients developed an alcohol relapse or an increase in alcohol craving. DISCUSSION Our preliminary data indicate an effect of rivastigmine on tobacco craving and consumption. This pilot study encourages further investigation of acetylcholinesterase-inhibitors as a promising treatment approach regarding tobacco dependence.
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Affiliation(s)
- A Diehl
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health Mannheim, University of Heidelberg, Square J 5, Mannheim 68159, Germany.
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Grosshans M, Mutschler J, Hermann D, Kiefer F, Diehl A. Is Varenicline Able to Prevent Smoking Cessation Induced Affective Symptoms? Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)70656-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The selective alpha4-beta2 nicotinic acetylcholine receptor (nAChR) partial agonist varenicline has been shown to be effective in the treatment of tobacco dependence by counteracting withdrawal symptoms and reducing smoking reward. However, the need to test safety, especially in smokers with varying co-morbidities and risk patterns is highlighted. There are some publications reporting exacerbation of psychiatric symptoms in subjects with pre-existing psychiatric disorders associated with varenicline treatment.This case-report describes a patient whose several smoking cessation attempts led to enduring nicotine-related symptoms such as depression and suicidal tendencies. All further cessation attempts under medical control with nicotine patches, bupropion and psychotherapy failed. At lest reducing her daily dose by one cigarette already led to suicidal thoughts. We took her into inpatient treatment and started an uptitration with varenicline. Unlike earlier attempts there were no complications during the detoxication and depressive symptoms improved clearly.Affective symptoms like depression are known to develop during nicotine cessation. The improving of affective symptoms in this case might be a result of the partial agonistic effects of varenicline.
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Mutschler J, Steinbach G, Bunjes D, Reske SN, Buchmann I. [Myeloablative radioimmunotherapy with 188Re-CD66mAb before stem cell transplantation. No increase of proinflammatory cytokine levels of TNF-alpha]. Nuklearmedizin 2009; 48:30-36. [PMID: 19212609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM Tumour necrosis factor-alpha (TNF-alpha) serum levels may increase due to intensive conditioning regimes with high-dose-chemotherapy and total body irradiation (TBI) before stem cell transplantation. This increases the risk for developing acute graft versus host disease (aGvHD) after stem cell transplantation. In this prospective study we investigated the influence of radioimmunotherapy with 188Re-CD-66-mAb on changes on TNF-alpha serum levels. PATIENTS, METHODS In 18 patients we measured TNF-alpha before and up to 96 hours after radioimmunotherapy, in 2 patients in addition following TBI, in 9 patients also following chemotherapy. For measuring TNF-alpha we used an automated immunochemiluminescence assay (Immulite 1000 DPC Biermann, Bad Nauheim). The mean follow up period to record incidence of aGVHD was 100 days after stem cell transplantation. RESULTS Compared to the basal levels before, the levels of TNF-alpha after conditioning with 188Re-CD-66-mAb did not increase significantly and remained in the physiological range. In contrast, these initial physiological cytokine levels increased and became pathological following 48 h after total body irradiation (13.2+/-6.6 pg/ml) and chemotherapy (10.8+/-15.7 pg/ml). In our study we found a low incidence of aGvHD (22.2%, n=4/18). CONCLUSION These results demonstrate that additional conditioning therapy with 188Re-CD-66-mAb does not increase proinflammatory cytokine levels of TNF-alpha. This finding may indicate that additive radioimmunotherapy may not be a significant factor for increasing the rate of conditioning-associated aGvHD.
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Affiliation(s)
- J Mutschler
- Klinik für Nuklearmedizin, Universitätsklinik Ulm, Ulm.
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Abstract
Recently, we have been observing an increase in prescription of Disulfiram requiring medical knowledge concerning the overall effects, side effects and drug interactions of this substance. In the following report, we give an overview about the pharmacology and the side effects of Disulfiram. As an example we demonstrate a case, in which an acute neurological deficit was misjudged as a side effect of Disulfiram. Furthermore, the potential of Disulfiram as a promising treatment in addiction medicine will be discussed.
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Affiliation(s)
- J Mutschler
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Mannheim
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C.H. von der Goltz, Mutschler J, Jahn H, Wiedemann K, Kiefer F. Anxiolytic activity of Atrial Natriuretic Peptide and ß-Endorphin during acute Ethanol withdrawal in mice. Eur Psychiatry 2008. [DOI: 10.1016/j.eurpsy.2008.01.1072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Diehl A, Paslakis G, Mutschler J, Rockenbach C, Nakovics H, Mann K. Rivastigmine reduces smoking – an observational case series. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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von der Goltz C, Mutschler J, Kiefer F. Association between plasma atrial natriuretic peptide, ß-endorphin and anxiety in mice during acute ethanol withdrawal. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mutschler J, Bilbao A, Goltz C, Jahn H, Spanagel R, Wiedeman K, Kiefer F. Elevated alcohol consumption in mice lacking functional natriruetic peptide-A receptor. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Several national institutions are registering a significant increase in sales of prescription and illegal drugs from internet pharmacies. Psychoactive drugs are preferred; the clients are particularly young. Considering the current amount of data available, the extent and relevance to addiction medicine remain unclear. In the following report we present the case of a patient from our outpatient department who has suffered from an opioid dependency for several years and has been using a Spanish internet pharmacy to purchase tramadol without prescription.
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Affiliation(s)
- J Mutschler
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Quadrat J 5, 68159 Mannheim.
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Mutschler J, Binder C, Diehl A, Kiefer F. Akutes neurologisches Defizit fehlinterpretiert als Nebenwirkung von Disulfiram. Akt Neurol 2007. [DOI: 10.1055/s-2007-987702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mutschler J, Czell D, Kaps M, Manzl G. [Psychotic symptoms in a case of locked-in syndrome]. Nervenarzt 2006; 77:1483-6. [PMID: 17106731 DOI: 10.1007/s00115-006-2183-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In this case report we describe a patient who suffered brainstem bleeding mainly in the pons and mesencephalon leading to locked-in syndrome. During rehabilitation she suffered psychotic symptoms of threatening character. Due to location of the lesion and the coincidental appearance of the bleeding, we diagnosed an organic psychosis. After treatment with the atypical neuroleptic drug Quetiapine, the symptoms decreased, facilitating the patient's rehabilitation course.
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Affiliation(s)
- J Mutschler
- Kliniken Schmieder, Am Tafelholz 8, 78476 Allenbach, Germany.
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