Topiramate in the treatment of compulsive sexual behavior: case report

BACKGROUND: Among the multiple mechanisms of action of topiramate, AMPA/kainate antagonism may be particularly interesting for the treatment of disorders characterized by conditioned cognitive and behavioral cue reactivity. CASE PRESENTATION: We report the case of a patient consulting primarily for obesity and cue triggered snacking, who responded well on topiramate at doses up to 50 mg. Coincidentally he reported on an improvement of compulsive nonparaphilic sexual behaviors (consumption of prostitution), which was also strongly triggered by environmental cues. Both addictive behaviors (snacking and consumption of prostitution) reoccurred after discontinuation of topiramate and again responded reintroduction of the drug. CONCLUSION: The present case report of topiramate's effect on comorbid obesity and nonparaphilic addiction could be interpreted as a further indication that topiramate acts on the common pathway underlying conditioned behaviors and seems to be a treatment of behavioral disorders associated with environmental cues

Santé mentale et santé publique : un lien incontournable

Le concept de santé mentale dépasse celui de la pratique clinique psychiatrique à proprement parler, et porte de manière additionnelle sur la promotion du bien-être somato-psychosocial, ainsi que sur les activités de prévention spécifiques. Cette discipline est donc soumise à des attentes de la part de nombreux et différents acteurs tels que les responsables politiques, les organisations d'usagers et de proches et la population générale. Si les professionnels oeuvrant dans ce domaine offrent des expertises techniques qui sont de l'ordre de la santé publique appliquée à la santé mentale, il est nécessaire d'identifier les actions spécifiques de santé mentale publique auxquelles les médecins généralistes et les spécialistes en psychiatrie peuvent contribuer. Mais pour ce faire, des connaissances en santé mentale publique sont requises, d'où le besoin d'une formation appropriée

You don't believe in a patient's depression? Watch the watch!

Depressive states may at times be particularly tricky to ascertain or confirm during a time-limited consultation. For example, a patient may present with what has been termed as smiling depression. We present the case of a female patient with bipolar II disorder whose difficult-to-ascertain depression could be confirmed by her automatic wristwatch, which regularly stopped when she was hypokinetic as a result of her depression