References for "Breaking free from nicotine dependence"

Benowitz NL. "Nicotine Addiction," The New England Journal of Medicine (June 17, 2010): Vol. 362, No. 24, pp. 2295–303. Fiore MC, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, May 2008. Hatsukami DK, et al. "Immunogenicity and Smoking-Cessation Outcomes for a Novel Nicotine Immunotherapeutic," Clinical Pharmacology & Therapeutics (Jan. 26, 2011): E-publication. (Locked) More »

References for "Treating intermittent explosive disorder"

Coccaro EF. "A Family History Study of Intermittent Explosive Disorder," Journal of Psychiatric Research (November 2010): Vol. 44, No. 15, pp. 1101–05. Coccaro EF, et al. "A Double-Blind, Randomized, Placebo-Controlled Trial of Fluoxetine in Patients With Intermittent Explosive Disorder," Journal of Clinical Psychiatry (April 21, 2009): Vol. 70, No. 5, pp. 653–62. Coccaro EF, et al. "Amygdala and Orbitofrontal Reactivity to Social Threat in Individuals With Impulsive Aggression," Biological Psychiatry (July 15, 2007): Vol. 62, No. 2, pp. 168–78. (Locked) More »

References for “Medications for Alzheimer’s disease”

Atri A, et al. "Long-Term Course and Effectiveness of Combination Therapy in Alzheimer's Disease," Alzheimer's Disease & Associated Disorders (July/Sept. 2008): Vol. 22, No. 3, pp. 209–21. Ballard C, et al. "The Dementia Antipsychotic Withdrawal Trial (DART-AD): Long-Term Follow-Up of a Randomised Placebo-Controlled Trial," Lancet Neurology (Feb. 2009): Vol. 8, No. 2, pp. 151–57. Birks J. "Cholinesterase Inhibitors for Alzheimer's Disease," Cochrane Database of Systematic Reviews (Jan. 25, 2006): Doc. No. CD005593. (Locked) More »

Breaking free from nicotine dependence

More than 46 million adults in the United States smoke cigarettes, cigars, or pipes, and a few million use snuff or chewing tobacco. Although 70% of smokers say they'd like to stop, nicotine is so addictive that only 3% successfully quit each year. Smoking sends nicotine straight to the lungs, where it is absorbed by oxygenated blood, delivered to the heart, and pumped into the arteries and to the brain. The nicotine in snuff and chewing tobacco, which is absorbed mainly through the mucous membranes of the mouth, reaches the brain more slowly, but constant use maintains a steady level in the blood and brain. Once in the brain, nicotine triggers the release of the neurotransmitter dopamine in the nucleus accumbens, which is the brain's reward and motivation center. Each hit of nicotine produces pleasurable feelings. But as it gets washed out of the body, the feelings of pleasure are replaced by uncomfortable symptoms of withdrawal — trouble concentrating, nervousness, headaches, increased appetite, dizziness, irritability, anxiety, depression, and sleeping problems. This prompts most users to reach for more tobacco. For people who want to stop using tobacco, two hurdles must be jumped: overcoming the physical addiction to nicotine and breaking the psychological habit. (Locked) More »

Medications for Alzheimer's disease

Thanks to longer life expectancy, the senior population is steadily growing in the United States. A 2010 report from the Alzheimer's Association estimates that, by 2030, the 65+ population will be 71 million — double what it is today. By then, the number of people with Alzheimer's disease will be 7.7 million, more than a 50% increase from the 5.1 million people ages 65 and over currently suffering from the disease. Because age is the most significant risk factor for Alzheimer's, efforts to develop effective therapies are more important than ever. However, while there are a variety of therapies on the horizon, some in the form of new drugs that may quell the disease by blocking the chain of events that underlies its destructive process, truly effective therapies remain years away. Available medications can only alleviate symptoms temporarily; no current treatments prevent or stop cognitive deterioration due to Alzheimer's. A number of medications can help with behavior problems in this illness, such as outbursts of anger. But these are best used in conjunction with environmental approaches, such as simplifying the home environment. (Locked) More »

Treating intermittent explosive disorder

Intermittent explosive disorder (IED) is characterized by disproportionate rage responses, leading to serious harm through violent words or deeds.  Several studies suggest that the disorder is associated with abnormal activity of the neurotransmitter serotonin in parts of the brain that play a role in regulating, even inhibiting, aggressive behavior. Impulsive aggression in general is associated with low serotonin activity as well as damage to the prefrontal cortex, a center of judgment and self-control. One study found that on some neuropsychological tests, people with IED performed similarly to patients who had suffered damage to the prefrontal cortex. Research on drug treatment has been limited. A number of medications are known to reduce aggression and prevent rage outbursts, including antidepressants (namely selective serotonin reuptake inhibitors, or SSRIs), mood stabilizers (lithium and anticonvulsants), and antipsychotic drugs. In one study, impulsively aggressive patients who took the SSRI fluoxetine (Prozac) showed increased activity in the prefrontal cortex. Cognitive behavioral therapy (CBT) that combines cognitive restructuring, coping skills training, and relaxation training looks promising.  More »

Commentary: A biomarker for PTSD risk?

Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter, discusses post-traumatic stress disorder and research into a biomarker that may identify those at increased risk of developing it. (Locked) More »