Dimebolin in dementia.

The treatment options for Alzheimer's type dementia are limited to the use of acetyl-cholinesterase inhibitors, along with memantine in some cases, and offer variable success in the treatment of cognitive impairment and to improve or stabilize activities of daily living, behavioral abnormalities, and impairment of global function. This review examines dimebolin, a nonselective antihistamine drug that has been used in Russia in the past for its antihistamine effect and has now generated considerable interest in the treatment of Alzheimer's type dementia, following results in the initial trials (Doody et al., 2008) and is currently under further evaluation. This article considers various theories proposed to explain its effect in the treatment of dementia. The results from further trials will help to clarify the future of dimebolin as a potential treatment for chronic neurodegenerative disorders that include dementia that affects 25 million people worldwide.

What information do general practitioners expect in letters from mental health services?

Background Psychiatrists and General Practitioners (GPs) communicate mainly by letters which often do not cover the necessary information. Setting Barnet PCT Question To identify what GPs regard as important and necessary information in psychiatric follow up letters. Method A postal questionnaire was sent to all GPs in the Borough of Barnet to determine their view on this matter. Results Out of 187 GPs, 129 responded to the questionnaire (69%). A mismatch was found between what psychiatrists write in their follow up letters and what GPs expect. Medication details, diagnosis, name of care coordinator and changes in mental state were considered very important to GPs. Conclusions Conveying information that GPs actually consider important may improve their ability to share care of mental health patients. This may be achievable by introducing standardised format letters.

Are one or two dangerous? Opioid exposure in toddlers.

Ingestions of opioid analgesics by children may lead to significant toxicity as a result of depression of the respiratory and central nervous systems. A review of the medical literature was performed to determine whether low doses of opioids are dangerous in the pediatric population under 6 years old. Methadone was found to be the most toxic of the opioids; doses as low as a single tablet can lead to death. All children who have ingested any amount of methadone need to be observed in an Emergency Department (ED) for at least 6 h and considered for hospital admission. Most other opioids are better tolerated in ingestions as small as one or two tablets. Based on the limited data available for these opioids, we conclude that equianalgesic doses of 5 mg/kg of codeine or greater require 4 to 6 h of observation in the ED. Data for propoxyphene and all extended-release preparations are limited; their prolonged half-lives would suggest the need for longer observation periods. All opioid ingestions leading to respiratory depression or significant central nervous system depression require admission to an intensive care unit.