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Bangalore, India

The National Institute of Mental Health and Neuroscience - Deemed University located in Bangalore, is a Medical institute of National importance. Wikipedia.


Andrade C.,National Institute of Mental Health and Neuro Sciences
Journal of Clinical Psychiatry | Year: 2015

Research papers and research summaries frequently present results in the form of data accompanied by 95% confidence intervals (CIs). Not all students and clinicians know how to interpret CIs. This article provides a nontechnical, nonmathematical discussion on how to understand and glean information from CIs; all explanations are accompanied by simple examples. A statistically accurate explanation about CIs is also provided. CIs are differentiated from standard deviations, standard errors, and confidence levels. The interpretation of narrow and wide CIs is discussed. Factors that influence the width of a CI are listed. Explanations are provided for how CIs can be used to assess statistical significance. The significance of overlapping and nonoverlapping CIs is considered. It is concluded that CIs are far more informative than, say, mere P values when drawing conclusions about a result. © Copyright 2015 Physicians Postgraduate Press, Inc. Source


Andrade C.,National Institute of Mental Health and Neuro Sciences
Journal of Clinical Psychiatry | Year: 2014

Antipsychotic treatment is the mainstay in the management of schizophrenia. However, despite optimum use of antipsychotic drugs, many schizophrenia patients continue to exhibit residual positive, negative, cognitive, and other symptoms. Various antipsychotic augmentation strategies have been studied using non-antipsychotic augmenting agents; 2 innovative classes of drugs examined have been nonsteroidal anti-inflammatory drugs (NSAIDs) and 5-HT3 serotonin receptor antagonists. Meta-analysis of the NSAID studies in schizophrenia patients with positive symptoms (8 randomized controlled trials [RCTs], pooled N = 774) shows that NSAID augmentation is associated with a significant decrease in positive symptom ratings (standardized mean difference [SMD] = 0.19), with no significant change in negative or total symptom ratings. Meta-analysis of the 5-HT3 antagonist studies in stable schizophrenia patients (6 RCTs, pooled N = 311) shows that 5-HT3 antagonist augmentation is associated with significant reduction in negative symptom (SMD = 1.10), general psychopathology (SMD = 0.70), and total symptom (SMD = 1.03) ratings without reduction in positive symptom ratings. Neither NSAID nor 5-HT3 antagonist augmentation increases the dropout rate. Whereas the benefits with NSAID augmentation are, perhaps, too small to be clinically meaningful, antipsychotic augmentation with 5-HT3 antagonists may be a possible strategy to reduce persistent negative symptoms in schizophrenia. Both fields of inquiry require further investigation. © Copyright 2014 Physicians Postgraduate Press, Inc. Source


BACKGROUND: Some patients with schizophrenia suffer from continuous auditory hallucinations that are refractory to antipsychotic medications. METHODS: Transcranial direct current stimulation (tDCS) was used to treat a 24-year-old female schizophrenia patient who had severe, clozapine-refractory, continuous, psychosocially and cognitively disabling auditory hallucinations. The tDCS cathode was placed midway between T3 and P3, and the anode over F3, in the 10-20 electroencephalogram electrode positioning system. RESULTS: Once daily, 20-minute tDCS sessions at 1-mA intensity produced noticeable improvement within a week: cognitive and psychosocial functioning improved, followed by attenuation in the experience of hallucinations. There was greater than 90% self-reported improvement within 2 months. Benefits accelerated when the current was raised to 3 mA; treatment duration was increased to 30-minute sessions, and session frequency was increased to twice daily. The patient improved from a psychosocially vegetative state to near-normal functioning. Once- to twice-daily domiciliary tDCS was continued across nearly 3 years and is still ongoing. Benefits attenuated or were even lost when alternate day session spacing was attempted, or when electrode positioning was changed; benefits were regained when the original stimulation protocol was reintroduced. There was confirmation of benefit in 2 separate on-off-on situations, which occurred inadvertently and under blinded conditions. There were no adverse events attributable to tDCS. CONCLUSIONS: This is the first report in literature of the safe and effective use of daily to twice-daily, domiciliary, 30-min, 1- to 3-mA tDCS sessions across nearly 3 years for the treatment of continuous, disabling, clozapine-refractory auditory hallucinations in schizophrenia. Key learning points emerging from this case are presented and discussed. Copyright © 2012 by Lippincott Williams & Wilkins. Source


Andrade C.,National Institute of Mental Health and Neuro Sciences
Journal of Clinical Psychiatry | Year: 2014

Curcumin, an ingredient of turmeric, is widely available as a nutritional supplement. Curcumin has biological properties that suggest its use for a large number of health-related conditions, including depression. Curcumin is effective in animal models of depression. However, controlled clinical trials provide no convincing evidence that patients with major depressive illness fare better with different extracts of curcumin (dosed at 500-1,000 mg/d) than with placebo (or no treatment) after 5-8 weeks of monotherapy or antidepressant-augmentation therapy. At present, therefore, there is insufficient evidence to encourage depressed patients to consider curcumin as a possible alternative to standard antidepressant therapy. © Copyright 2014 Physicians Postgraduate Press, Inc. Source


Andrade C.,National Institute of Mental Health and Neuro Sciences
Journal of Clinical Psychiatry | Year: 2014

Elderly patients commonly receive statin drugs for the primary or secondary prevention of cardiovascular and cerebrovascular events. Elderly patients also commonly receive antidepressant drugs, usually selective serotonin reuptake inhibitors (SSRIs), for the treatment of depression, anxiety, or other conditions. SSRIs are associated with many pharmacokinetic drug interactions related to the inhibition of the cytochrome P450 (CYP) metabolic pathways. There is concern that drugs that inhibit statin metabolism can trigger statin adverse effects, especially myopathy (which can be potentially serious, if rhabdomyolysis occurs). However, a detailed literature review of statin metabolism and of SSRI effects on CYP enzymes suggests that escitalopram, citalopram, and paroxetine are almost certain to be safe with all statins, and rosuvastatin, pitavastatin, and pravastatin are almost certain to be safe with all SSRIs. Even though other SSRI-statin combinations may theoretically be associated with risks, the magnitude of the pharmacokinetic interaction is likely to be below the threshold for clinical significance. Risk, if at all, lies in combining fluvoxamine with atorvastatin, simvastatin, or lovastatin, and even this risk can be minimized by using lower statin doses and monitoring the patient. © Copyright 2014 Physicians Postgraduate Press, Inc. Source

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