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Braus BR, Rummans TA, Lapid MI, Morgan RJ, Sampson SM, Handler EM, Dimsdale JE. Clinicians and Cognitive Bias: A Case of Frontotemporal Dementia Misdiagnosed as Conversion Disorder. Am J Psychiatry 2019; 176:690-693. [PMID: 31474126 DOI: 10.1176/appi.ajp.2018.18050551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Benjamin R Braus
- The Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn. (Braus, Rummans, Lapid, Morgan, Sampson, Handler); and the Department of Psychiatry, University of California San Diego School of Medicine, San Diego (Dimsdale)
| | - Teresa A Rummans
- The Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn. (Braus, Rummans, Lapid, Morgan, Sampson, Handler); and the Department of Psychiatry, University of California San Diego School of Medicine, San Diego (Dimsdale)
| | - Maria I Lapid
- The Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn. (Braus, Rummans, Lapid, Morgan, Sampson, Handler); and the Department of Psychiatry, University of California San Diego School of Medicine, San Diego (Dimsdale)
| | - Robert J Morgan
- The Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn. (Braus, Rummans, Lapid, Morgan, Sampson, Handler); and the Department of Psychiatry, University of California San Diego School of Medicine, San Diego (Dimsdale)
| | - Shirlene M Sampson
- The Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn. (Braus, Rummans, Lapid, Morgan, Sampson, Handler); and the Department of Psychiatry, University of California San Diego School of Medicine, San Diego (Dimsdale)
| | - Elliot M Handler
- The Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn. (Braus, Rummans, Lapid, Morgan, Sampson, Handler); and the Department of Psychiatry, University of California San Diego School of Medicine, San Diego (Dimsdale)
| | - Joel E Dimsdale
- The Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn. (Braus, Rummans, Lapid, Morgan, Sampson, Handler); and the Department of Psychiatry, University of California San Diego School of Medicine, San Diego (Dimsdale)
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Leung JG, Rakocevic DB, Allen ND, Handler EM, Perossa BA, Borreggine KL, Stark AL, Betcher HK, Hosker DK, Minton BA, Braus BR, Dierkhising RA, Philbrick KL. Use of a Gabapentin Protocol for the Management of Alcohol Withdrawal: A Preliminary Experience Expanding From the Consultation-Liaison Psychiatry Service. Psychosomatics 2018; 59:496-505. [PMID: 29735241 DOI: 10.1016/j.psym.2018.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 03/17/2018] [Accepted: 03/19/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Benzodiazepines are the conventional mainstay to manage alcohol withdrawal; however, patients are subsequently at increased risk for poor sleep, cravings, and return to drinking. Research on alternative pharmacologic agents to facilitate safe alcohol withdrawal is scant. Gabapentin is one medication shown in small studies to reduce the need for benzodiazepines in the setting of alcohol withdrawal. The continuation of gabapentin after alcohol withdrawal appears to be safe during early sobriety and may aid in reducing alcohol-related cravings or returning to alcohol consumption. Use of a gabapentin-based, benzodiazepine-sparing protool began in early 2015 by the Mayo Clinic, Rochester, Consultation-Liaison Psychiatry Service. OBJECTIVE A retrospective chart review was conducted to detect any safety concerns with use of a gabapentin protocol for alcohol withdrawal syndrome. METHODS Secondary outcomes were derived by comparing a matched cohort of patients who received benzodiazepines for alcohol withdrawal syndrome. RESULTS Seventy-seven patients had their alcohol withdrawal managed via a gabapentin protocol during the study period. No patients required transfer to a higher level of care or had a documented withdrawal seizure. Length of stay between the gabapentin protocol group and benzodiazepine group were similar. CONCLUSION This preliminary data has supported the frequent use of this protocol in the general internal medicine practice and formalization of an institutional order set of this protocol for mild to moderate alcohol withdrawal syndrome. Prospective studies are required to validate findings.
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Affiliation(s)
- Jonathan G Leung
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
| | | | - Nicholas D Allen
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Elliot M Handler
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Bruno A Perossa
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | - Amy L Stark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Hannah K Betcher
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Daniel K Hosker
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Blaine A Minton
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Benjamin R Braus
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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