Loss of impulse control

Chronic users also suffer from anxiety, loss of impulse control, and impaired judgment. The feeling of euphoria or high experienced after taking the drug may give way later to severe, suicidal depression. Death by suicide following stimulant use has been reported. 

Another study of children and youth age 8-16 in a university setting found that 50% developed two or more abnormal behavioral reactions to fluoxetine, including aggression, loss of impulse control, agitation, and maniclike symptoms (Riddle et al., 1990-1991). The effects lasted until the fluoxetine was stopped. 

Drug-induced disinhibition or loss of impulse control can cause serious harm to self and to others. I have evaluated in depth cases in which only one or two doses of a BZ such as alprazolam or clonazepam have led to suicidal or homicidal outbursts. 

When a therapist is evaluating a patient who demonstrates intermittent loss of impulse control, it is important to look for the sequence of events that kindled the condition. Sometimes, one discovers an obsessional antecedent to the loss of control, and this may respond very well to antiobsessional medication. The woman in the example that follows could have had an intermittent explosive disorder, a personality disorder, or other diagnoses but given her poverty and lack of health care insurance or access, she would probably have received no treatment. Had she been wealthy, she might have received psychotherapy, which may have helped, given time. However, medication management did result in prompt remission of her symptoms, and it may have saved her life and that of her son. In some cases, medication consultation for a patient with one of the impulse control disorders can be a life-saving collaboration between therapist and physician (see case example below). 

The functional significance of myelin is revealed by the neurological deficits observed in patients with multiple sclerosis. This disorder is caused by the demyelination of neurons in the brain, spinal cord, and optic nerve. The loss of myelin disrupts the normal conduction of impulses along the axons of these neurons and results in weakness, numbness, loss of bladder control, and visual disturbances. 

Since this work deals with the aggregated simulation and planning of chemical production processes, the focus is laid upon methods to determine estimations of the process models. For process control this task is the crucial one as the estimations accuracy determines the accuracy of the whole control process. The task to find an accurate process model is often called process identification. To describe the input-output behaviour of (continuously operated) chemical production plants finite impulse response (FIR) models are widely used. These models can be seen as regression models where the historical records of input/control measures determine the output measure. The term "finite" indicates that a finite number of historical records is used to predict the process outputs. Often, chemical processes show a significant time-dynamic behaviour which is typically reflected in auto-correlated and cross-correlated process measures. However, classic regression models do not incorporate auto-correlation explicitly which in turn leads to a loss in estimation efficiency or, even worse, biased estimates. Therefore, time series methods can be applied to incorporate auto-correlation effects. According to the classification shown in Table 2.1 four basic types of FIR models can be distinguished. 

Sodium pumps. Problems with the pumps resulting in unplanned energy losses occurred in 1981-1985, and were caused by unstable operation of the pump speed control stem. Impulses from the electric motors caused failures of the pump-motor couplings, and increased vibration and fatigue cracks in the pump shafts. The use of advanced shafts and couplings and changing to a steady mode of pump operation after attaining the preset reactor power level have eliminated any failures of the reactor coolant pumps since 1985. 

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