Lithium treatment of depressed and nondepressed alcoholics

Article Abstract:

The ability to treat alcoholism by use of medication has tremendous appeal both to patients and clinicians. More than fifteen years ago the drug lithium carbonate, effective in the treatment of manic-depressive illness, became the focus of research. In many of these studies lithium was given to depressed and non-depressed alcoholic patients; inconclusive results indicated that alcoholics may experience a diminished desire to drink alcohol when taking lithium. In a 52 week Department of Veterans Affairs Cooperative Study, lithium was again tested in the treatment of 457 white, male alcoholics who had either did or did not have a history of depressive illness. In both depressed and non-depressed patients who were given either lithium or a placebo, there were no reductions in the number of alcoholics who consumed alcohol, days of drinking reported, alcohol-related hospitalizations, or the severity of alcoholism. According to standard evaluations, whether depressed or non-depressed, all patients became substantially less depressed during the study. This may be due to decreased intake of alcohol and/or to the professional contact which occurred throughout the study period. Lithium did not relieve depression or affect alcoholism. Alcoholics have a low level of compliance in taking medication, which causes difficulty in interpreting the results of drug studies and in using medications in the treatment of this disease.

Care and treatment, Evaluation, Depression, Mental, Depression (Mood disorder), Alcoholism, Alcoholism treatment, Lithium, Lithium (Metal), United States. Department of Veterans Affairs

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Are human immunodeficiency virus test reports clear to clinicians?

Article Abstract:

In the United States the number of blood tests for HIV (human immunodeficiency virus; believed to cause AIDS) is rising because early medical intervention for HIV infection, even before symptoms develop, is proving to be valuable. More individuals are perceiving that the negative aspects of knowing they are positive for HIV are outweighed by the potential benefits of early medical attention. HIV tests are also being used in widespread mandatory screening of blood donors and military recruits. However, the decision to be tested for HIV does not assure accurate laboratory results. While testing technology necessarily involves some degree of error, clinicians are particularly concerned about the needless confusion caused by unclear laboratory reports. Standardized criteria for interpreting results are needed and should be clearly stated on the report forms. Physicians and laboratory personnel must communicate when there is doubt about the interpretation of a report, and collaborate concerning better ways to present results. Clarity in reports is particularly important since more physicians from all specialties will be ordering HIV testing in the future.

Standards, Reports, Diagnosis, Testing, Diagnostic errors, AIDS (Disease), editorial, Diagnosis, Laboratory, Laboratory diagnosis

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No evidence for a role of alcohol or other psychoactive drugs in accelerating immunodeficiency in HIV-1-positive individuals

Article Abstract:

Early studies of acquired immunodeficiency syndrome (AIDS) suggested that nitrite inhalants or other psychoactive drugs could be risk factors for the disease. Many of these drugs are commonly used by homosexual men and by intravenous drug abusers, two groups who are at high risk for AIDS. However, once HIV-1 (the human immunodeficiency virus, type 1) was identified as the cause of the disease, interest in the possible role of psychoactive drugs in affecting the immunodeficiency in these patients declined. The current 18-month study of 1,597 alcohol drinkers, and 1,662 users of psychoactive drugs who were infected with the AIDS virus (tested seropositive) showed no increased rate of acquiring AIDS. Psychoactive substances (alcohol and drugs) did not increase the rate of seropositive individuals who eventually developed AIDS, nor did they adversely affect the number of T helper cells, which are often taken as a measure of the progression of the disease.

Physiological aspects, Immunological deficiency syndromes, Immunologic deficiency syndromes, Alcohol, Ethanol, Psychotropic drugs, Lymphocytes

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