[The potential use of ayahuasca in psychiatry]. / Az ayahuasca pszichiátriai felhasználásának lehetoségei.

Ayahuasca is a decoctum made of admixture plants containing dimethyltryptamine and harmine. For millennia it has been used as a central element of spiritual, religious, initiation, and other - foremost healing - rituals, originally by the indigenous groups of the Amazon basin and later by the mestizo populations of the region. During the last two decades the brew has raised increased scientific and lay interest about its healing potentials within the framework of Western therapeutic settings. The typical ayahuasca effects consist of strong somatic reactions, vivid visions, relived personal memories, cathartic emotions, and insightful, introspective experiences when the emerging mental contents take different context and get deeper perspectives. The ayahuasca-experience can be exhausting necessitating the presence of an experienced leader for helping participants to pass difficult phases and for maximizing therapeutic benefits. No health damaging adverse effect has been confirmed thus far as result of its well-structured, institutionalized use. The scientific investigation of ayahuasca is hindered by legal issues, methodical problems, and sociocultural preconceptions. The present review outlines the therapeutic potentials of ayahuasca use in psychiatry with its psychobiological and spiritual background.

[Catatonia and neuroleptic malignant syndrome in view of a psychopathological and pathophysiological overlap: a brief review]. / Katatónia és neuroleptikus malignus szindróma a pszichopatológiai és patofiziológiai átfedések tükrében: rövid összefoglaló tanulmány.

Catatonia was first described in the 19th century as a syndrome with motor, affective and behavioral symptoms. During the 20th century it was rather regarded as a rare motoric manifestation of schizophrenia and that classification has almost resulted in the disappearance of catatonia among patients outside of the schizophrenia spectrum. With the introduction of neuroleptics, the incidence of catatonic schizophrenia also declined which was attributed to effective treatment. Simultaneously, neuroleptic malignant syndrome was described, which shows many similarities with catatonia. Recently, several researchers suggested a common origin of the two disorders. In this paper we review case reports of the last five years, in which both neuroleptic malignant syndrome and catatonia had emerged as a diagnosis. Additionally, based on the relevant literature, we propose a common hypothetical pathomechanism with therapeutic implications for the two syndromes. Besides underlining the difficulties of differential diagnosis, the reviewed cases demonstrate a transition between the two illnesses. The similarities and the possible shifts may suggest a neuropathological and pathophysiological overlap in the background of the two syndromes. Electroconvulsive therapy and benzodiazepines seem to be an effective treatment in both syndromes. These two treatment approaches can be highly valuable in clinical practice, especially if one considers the difficulties of differential diagnosis.

[Observations of MDPV users: a prospective-retrospective study]. / Tapasztalataink MDPV használók körében: prospektív-retrospektív vizsgálat.

INTRODUCTION: The spreading of "designer drugs" resulted in the appearance of "similar yet different" substances, the chemical structure of which are modified so regularly, which makes their research very difficult. We came across one of these substances, MDPV, while on night duty before it was mentioned in research papers. Our own research explores the changes in drug consumption patterns, especially in MDPV consumption patterns in the past few years, and gives a description of psychiatric and associated symptoms. METHOD: We compared cases of patients admitted to our ward between Jan 1., 2010 and November 30., 2012 with symptoms of drug consumption and its complications (BNO F15.00-F15.90, F19.00-F19.90). We examined symptoms that required inpatient care at the psychiatry ward. RESULTS: While in 2010 we treated only 3 MDPV users on 6 occasions, 4 Mephedrone users on 6 occasions, and 9 patients using other substances (Speed, Cannabis) on 10 occasions at our ward, in 2011 there were no Mephedrone-related hospitalizations and only 9 patients using other substances (Cannabis, Synthetic Cannabinoid, 5-MeO-AMT, Glue, Metamizole, Ketamine) were treated on 13 occasions. Between Jan 1. 2011. and Nov 30.2012 there were 40 recorded cases related to MDPV-use in the period: forty people were registered on 87 occasions. Nine people receive impatient care after observation on 10 occasions. In all these cases psychotic symptoms were recorded. CONCLUSION: The constant development of designer drugs requires better administration of the individual cases, symptoms and forms of treatments. Informing doctors about these details also seems necessary. We have found that the behaviours of drug users show a positive correspondence with changing legal environments, which calls for a more sensible drug-related policy.

[The effect of various stressors on the QT-interval and the T-wave]. / Különbözo stresszorok hatása a QT-idore és a T-hullámra.

UNLABELLED: Prolonged QT interval is associated with the generation of life-threatening arrhythmias and sudden death. However, neither the relation between QT duration and heart rate, nor the association between mental stress and QT time has been clarified. AIM: The relationship between QT duration and smoking, cardiovascular reactivity, and mental stress as well as newer methods of QT correction were studied. METHODS: In six laboratory experiments 166 volunteers were studied. Smoking, treadmill exercise, mental arithmetic and videogame were applied as stressors. Besides fixed formulae, study and subject-specific QT correction methods were also used. RESULTS: 1. Bazett formula is not appropriate to compare QT durations. 2. Acute smoking has no effect on QT time. 3. QT changes are related to cardiovascular reactivity. 4. Mental stress may induce QT prolongation. 5. Bifid T waves often develop during mental and isometric stress. CONCLUSIONS: New methods for QT correction are more reliable than preformed formulae. QT prolongation and bifid T waves may be the links between mental stress and life threatening arrhythmias.

Mental stress may induce QT-interval prolongation and T-wave notching.

BACKGROUND: The effects of active and passive mental stress (PMS) on the QT interval were studied by using an intraindividual regression method of QT-interval correction for heart rate. METHODS: Thirty healthy males (age 21.2 +/- 1.8 years) performed a mental arithmetic for 1 minute, which was considered as active mental stress (AMS) because of the performance requirement. A 1-minute unpleasant video clip was used for PMS. Two baseline and two (an early and a late) ECGs were prepared in both mental stress periods. The individual QT-RR relationship was assessed by linear regression analysis of 7-15 (11.0 +/- 1.9) controlled QT-RR data pairs, also obtained from ECGs gained during a successive set of 9 isometric stretching exercises. RESULTS: Heart rate has increased significantly at both measurements in response to AMS (P < 0.0001), but not in response to passive stress. QTc significantly prolonged early in AMS (P = 0.0004), then normalized by the end of the period. During PMS, no significant QTc changes were observed. The evolution of bifid T waves was noted in 14 subjects: 8 presented bifid T waves during both AMS and exercise, and 6 during only exercise. CONCLUSIONS: AMS and PMS elicit different cardiovascular reactions. Our results indicate that changes in the autonomic tone, probably abrupt sympathetic predominance, may cause QTc prolongation and bifid T waves. This suggests that besides stress quality and intensity, the dynamics of stress application and perception also influence repolarization.

Acute effects of cigarette smoking on the QT interval in healthy smokers.

This study assesses the effect of a first cigarette smoked in the morning on the QT interval duration in healthy habitual smokers after not smoking overnight. This study demonstrates that although after cigarette smoking the QT(Bc) values increase, the QT(Fc) and QT(Lc) values remained unchanged, and an increased sympathetic response was evident. The discrepancies between the results seen by different QT correction formulas emphasize the importance of selecting an accurate method for heart rate correction when evaluating and interpreting alterations in QT values.