Pregabalin withdrawal in patients without psychiatric disorders taking a regular dose of pregabalin: A case series and literature review

Pregabalin is a drug that can cause psychiatric symptoms via pregabalin withdrawal. Prior reports on pregabalin withdrawal have mainly focused on cases with pregabalin dependence or abuse, and little attention has been paid to patients who are prescribed regular doses of pregabalin. Herein, we report three cases of pregabalin withdrawal in patients without psychiatric disorders, taking regular doses of pregabalin, who developed psychiatric symptoms such as insomnia and anxiety after abrupt discontinuation of pregabalin. In addition, we conducted a systematic review of six case reports (previous studies) of pregabalin withdrawal under regular doses of pregabalin. Among the six cases, three patients had no comorbid mental or substance use disorders, the dose of pregabalin ranged from 150 to 600 mg/d, and the duration of pregabalin use ranged from a few weeks to many years. Of these six cases of pregabalin withdrawal, five had psychopathological symptoms, three had vegetative symptoms, and three had neurologic and physical complications. We concluded that since pregabalin withdrawal can occur even with regular doses and short-term use, clinicians must carefully reduce pregabalin doses when reducing or discontinuing treatment, paying close attention to withdrawal symptoms. Our case series sheds light on the scant evidence from previous research on physical dependence in patients who are taking regular doses of pregabalin. Furthermore, our cases were also valuable in demonstrating that pregabalin withdrawal can occur even after a relatively short period of 2 months

High energy resolution hard X-ray and gamma-ray imagers using CdTe diode devices

We developed CdTe double-sided strip detectors (DSDs or cross strip detectors) and evaluated their spectral and imaging performance for hard X-rays and gamma-rays. Though the double-sided strip configuration is suitable for imagers with a fine position resolution and a large detection area, CdTe diode DSDs with indium (In) anodes have yet to be realized due to the difficulty posed by the segmented In anodes. CdTe diode devices with aluminum (Al) anodes were recently established, followed by a CdTe device in which the Al anodes could be segmented into strips. We developed CdTe double-sided strip devices having Pt cathode strips and Al anode strips, and assembled prototype CdTe DSDs. These prototypes have a strip pitch of 400 micrometer. Signals from the strips are processed with analog ASICs (application specific integrated circuits). We have successfully performed gamma-ray imaging spectroscopy with a position resolution of 400 micrometer. Energy resolution of 1.8 keV (FWHM: full width at half maximum) was obtained at 59.54 keV. Moreover, the possibility of improved spectral performance by utilizing the energy information of both side strips was demonstrated. We designed and fabricated a new analog ASIC, VA32TA6, for the readout of semiconductor detectors, which is also suitable for DSDs. A new feature of the ASIC is its internal ADC function. We confirmed this function and good noise performance that reaches an equivalent noise charge of 110 e- under the condition of 3-4 pF input capacitance.Comment: 6 pages, 10 figures, accepted for publication in IEEE Transactions on Nuclear Scienc

Caregiver Burden for Impaired Elderly Japanese with Prevalent Stroke and Dementia under Long-Term Care Insurance System

Background: Limited data are available on caregiver burden for stroke and dementia patients. We examined the associations of prevalent stroke and dementia with family caregiver burden in Japanese general populations. Methods: A total of 916 Japanese home caregivers, whose family members were covered by long-term care insurance, responded to the caregiver burden questionnaire. The questionnaire included the caregiver\u27s age, sex and employment status, the patient-caregiver relationship, the patient\u27s history of stroke, symptoms of dementia, care levels under long-term care insurance and the Zarit Caregiver Burden Interview. Results: The mean total score from the Zarit Caregiver Burden Interview was 12% higher in patients with stroke than in those without (p = 0.02) and 40% higher in those with dementia than in those without (p < 0.001). Compared with nonstroke patients without dementia, the mean total score was 21% higher in stroke patients without dementia (p = 0.01), 49% higher in nonstroke patients with dementia (p < 0.001) and 55% higher in stroke patients with dementia (p < 0.001). After adjustment for the caregiver\u27s age, sex and employment status, the patient-caregiver relationship, and the patient\u27s care level and community, the higher scores remained statistically significant for nonstroke patients with dementia and for stroke patients with dementia but not for stroke patients without dementia. Conclusions: Prevalent stroke and, more strongly, dementia were associated with increased family caregiver burden. Among patients with dementia, the presence of stroke did not enhance caregiver burden further

The joint impact on being overweight of self reported behaviours of eating quickly and eating until full : cross sectional survey

Objective To examine whether eating until full or eating quickly or combinations of these eating behaviours are associated with being overweight