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Dopamine agonists in PD: need to explain risks of problem gambling

 

An estimated 6-8% of PD patients treated with a dopamine agonist develop problem gambling, according to a new review of the literature (Djamshidian et al. Mov Disord 2011; 26: 1976-1984). Patients and their families need to be informed of the risks and to report any behavioural changes during treatment.

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Vitamin B in MCI: VITACOG results

 

A number of prospective studies have suggested that elevated serum total homocysteine (tHcy), and low folate and vitamin B12 levels are a risk factor for Alzheimer’s disease (Clarke et al. Arch Neurol 1998; 55: 1449-1455). In the Prospective Population Study of Women in Gothenburg, elevated tHcy in midlife was associated with a hazard ratio of 2.1 for developing AD and 2.4 for AD with no cerebrovascular disease (Zylberstein et al. Neurobiol Aging 2011; 32: 380-386). B vitamins (folate, B6, B12) are cofactors or substrates for enzymes in homocysteine metabolism.

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Expert recommendations for determining tHcy levels and assessing risk of cognitive impairment were published in 2004 (Refsum et al. Clin Chem 2004; 50: 3-32; free full text at www.clinchem.org/cgi/content/full/50/1/3).

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Psychoactive medications effective in TSC

 

A majority of patients with psychiatric comorbidities secondary to tuberous sclerosis complex (TSC) respond to psychoactive medications, according to a single-centre analysis of clinical records (Chung et al. Ann Clin Psychiatry 2011; 23: 263-269).

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Future look: novel AD therapies in phase III testing

 

Two novel compounds currently in development – bapineuzumab and solanezumab – for the treatment of Alzheimer’s disease expect to release phase III data in 2012. Those results may usher in a new era, or may add names to the list of high-profile setbacks in AD therapeutics such as tarenflurbil (Myriad), semagacestat (Lilly/Elan), tramiprosate (Neurochem) and AN1792 (Elan).

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