Amnesia therapy

Although the evidence base for this relatively rare disorder is not well developed, patients who are dependent on GHB appear to benefit from cognitive and motivational psychosocial therapies and from support of recovery in a manner similar to alcohol-dependent patients. However, because of the high likelihood of amnesia and cognitive dysfunction during the acute and subacute phases of GHB withdrawal, psychosocial interventions should, when possible, include significant others who can review and reinforce with the patient the negative consequences of GHB dependence. 

Inquire about carryover sedation and anterograde amnesia from therapy. 

Macrolides cause increases in the serum concentrations, AUCs, and half-lives and reductions in the clearance of triazolam and midazolam (138-140). These changes can result in clinical effects, such as prolonged psychomotor impairment, amnesia, or loss of consciousness (141). Erythromycin can increase concentrations of midazolam and triazolam by inhibition of CYP3A4, and dosage reductions of 50% have been proposed if concomitant therapy is unavoidable (142). 

Thiamin deficiency in alcoholics may be caused by decreased intake, reduced absorption, and impaired ability to use ihe absorbed vitamin. The ataxia and ocular symptoms associated with the deficiency in alcoholics are known as Wernicke s disease. Vitamin therapy can provide relief from nystagmus within a few hours of treatment and from ataxia within several weeks. The treatment of alcoholics also involves the supply of other nutrients lacking in the diet, such as folate, vitamin B12, and protein. Left imtreated, patients suffering from Wernicke s disease continue to develop Korsakoff s psychosis, which involves amnesia and confusion. Only about 25% of patients with Korsakoff s psychosis can be completely cured by thiamin treatment, which must be continued for a few weeks or months. The two conditions just described constitute the Wemicke-Korsakoff syndrome. The S5mdrome was named after two researchers. Karl Wernicke, a German, noted impaired or paralyzed eye movements and imstable walking and disorientation in his patients, most of whom were alcoholics. Polyneuropathy, a weakness of the hands, calves, and feet, was also noted. Sergei Korsakoff, a Russian, observed amnesia and confusion and an inability to learn new names or tasks in alcoholic patients. 

Hashemian, F., Khoshnood, K., Desai, M., Falahati, F., Kasl, S. and Southwick, S. 2006. Anxiety, depression and posttraumatic stress in Iranian survivors of chemical warfare. J. Am. Med. Assoc., 296 560-566. Hatta, K., Miura, Y., Asukai, N. and Hamabe, Y. 1996. Amnesia from sarin poisoning. Lancet, 347 1343. Hayward, I.J., Wall, H.G., Jaax, N.K., Wade, J.V., Marlow, D.D. and Nold, J.B. 1990. Decreased brain pathology in organophosphate-exposed rhesus monkeys following benzodiazepine therapy. J. Neurol. Set, 98 99-106. 

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