Dear Collegues,
    The Neuroscience Alliance has assisted in the development of this CME 
program.  It will be held in Cleveland and attendees can obtain up to 6 hours of 
CME.
We have only 1 event in October (the 12th) and encourage you to consider this 
conference because it addresses many of the mental health issues of concern 
to all of us.  Please see the announcement below and the word document attached.
Brendan and Tressa Carroll
The Neuroscience Alliance   

Recent Advances in Brain Injury and Mental Health

Saturday, October 28, 2006
Ritz Carlton Hotel Cleveland 
Cleveland, OH

  8:30am    Registration and Continental Breakfast

  9:00am    Introductions by Dr. Brendan Carroll

  9:05am    Post Traumatic Stress Disorder -    Lad Vidergar, PhD, Chief, 
Psychology, John D Dingel VAMC
10:00am Bipolar - Wen-Hui Cai, MD, Attending Psychiatrist, Dallas VAMC

11:00am Substance Abuse -   John W Tsuang, MD, MS, Department of Psychiatry, 
UCLA Medical Center

12noon  Lunch

12:30pm Traumatic Brain Injury - Anil Malhotra, MD, Director of Neurology, 
Kaiser Cleveland

  1:30pm    Questions & Answers

  2:00pm    Conclude Program, Submit Evaluations and CME Credit Applications


**Faculty Disclosures are pending
Employees of Medical Education Collaborative, the accredited provider for 
this activity, have disclosed that they have no significant financial 
relationships.  

This activity is jointly sponsored by Henry M. Jackson Foundation for the 
Advancement of Military Medicine (HJF) and Medical Education Collaborative (MEC). 
 MEC is a non-profit organization that has been certifying quality 
educational activities since 1988.  HJF, 501(c)3, is a private, not-for-profit 
organization chartered by Congress in 1983.

Note: Please contact Susan Rullo, Abbott Labs Neuroscience Sales 
Representative
On her cellphone 1-614-562-5320
Or E-mail her at Susan.Rullo@abbott.com

To RSVP for this Educational Event

Rapid Cycling, 04/2005 Educational Grant, funded by: The Neuroscience Alliance: Karen Tugrul
In a meeting at The Chillicothe, V.A., Ohio 04/2005: The discussion was focused on Bi-Polar and Rapid Cycling:

Karen Tugrul, BS,RN. Prof. University of Cincinnati: She proposes that in order to properly diagnose the different degrees or stages in a bi-polar patient, a more comprehensive rating scale should be given to the patient at the initial onset. (for a copy of the rating scale, please send an e-mail to: BTCarroll1@cs.com) She remarks that a failure to get a true rating, particularly on a patient who has rapid cycling will not tell the true picture of the patient and if given anti-depressants, may trigger a manic episode. Ms. Tugrul was funded by a grant from The Neuroscience Alliance. We felt that this educational program was so important to the understanding of Bi-Polar patients, care givers and benefits physicians to get a more accurate picture as to where,(in the broad spectrum of Bi-Polar) a particular patient's illness is, at that particular time.
- Tressa Carroll, Neuroscience Alliance- 2005


Dr. Brendan Carroll has written an article about "Aggressive Dosing Strategies in Acute Mania". The article is currently online at: http://www.currentpsychiatry.com Should you need any further information about this article, please feel free to e-mail Dr. Carroll at: BTCarroll1@CS.com or you can contact me at: TressaDCarroll@aol.com

Sam Keith, M.D.
Presented his findings on the use of Risperidol Consta for the treatment of non compliant patients and partially compliant patients. Dr. Keith explained that even partial adherence put the patient at risk for a complete relapse. Long term studies vs. Targeted Maint. Biological, Treatment Resistance and Demoralization, contribute to lack of full recovery. Slides compared the actual damage to the lateral ventrical with each relapse.

Samuel J. Keith, M.D.-Brief Biographical Sketch

Dr. Keith is presently professor of psychiatry and psychology and chairman of the department of psychiatry at the University of New Mexico. He is the immediate past editor of Academic Psychiatry, the former editor of the Schizophrenia Bulletin and serves on the editorial advisory boards of Biological Therapies in Psychiatry Newsletter, the Journal of Clinical Psychiatry, the Schizophrenia Bulletin, and the Journal of Psychiatric Rehabilitation.

Dr. Keith has served on numerous national committees and advisory boards including the DSM III-R and DSM-IV workgroup on schizophrenia. Prior to coming to the University of New Mexico, Dr. Keith served at the National Institute of Mental Health for 20 years where he headed the Schizophrenia Research Program. He also directed both the Division of Epidemiology and Services Research and the Division of Clinical and Treatment Research. For his last three years at NIMH he served as the Institute's Acting Deputy Director. He has published widely on the treatment and diagnosis of schizophrenia, emphasizing the integration of biological and psychosocial aspects of the illness.

He is a founding member of the National Alliance for Research on Schizophrenia and Depression (NARSAD), and has been a member of their Science Advisory board for over 15 years. He is also a Founding Member of the National Alliance for the Mentally Ill. He was the recipient of the Arthur P. Noyes Award for Lifetime Contributions to Schizophrenia Research in 2001.

Dr. Keith received his undergraduate degree from Duke University and his medical degree and psychiatric training at Emory University School of Medicine. He is married to the former Susan Friedlander, President of Culture to Culture, an international marketing consulting firm, and has three children.





Trey Sunderland, M.D.,
Presented his findings on the Diagnosis and Treatment of Alzheimer's
Disease

On the evening on Thurs, April 1st
At New York, New York Restaurant
Chillicothe, OH

Trey Sunderland, M.D., Chief, NIMH Geriatric Psychiatry Branch has written books on Dementia and is an expert for the Alzheimer's Association of America

Dr. Sunderland's Dinner Presentation was open to Health Care Professionals in Chillicothe, Ohio and was sponsored by Megan Hawksley of PfizerPharmaceuticals.

The Neuroscience Alliance supports educational programs, and while we did not sponsor this program, we felt it was important to let you know, so that you check your calendar and attend if interested. We hope to have more Chillicothe-based programs this year and will keep you informed of any developments.

Brendan T. Carroll,MD and Tressa D.Carroll
www.NeuroscienceAlliance.com

Dr. Sunderland has stated "We're hopeful that biomarkers will eventually be developed to help detect incipient illness in younger people who are at risk but who may not yet show any symptoms. Clues from biochemical, genetic
and brain imaging studies could point to new possibilities for preventive interventions."His most recent research findings focus on 2 proteins: Tau and Beta
Amyloid.

The Tau-ists versus the B-aptists

Tau-ists -believe that Tau protein aggregations cause Alzhiemer's Disease

B-aptists -believe that plaques made of Beta Amyloid cause Alzheimer's Disease

The NIMH study examined cerebrospinal fluid (CSF) levels of two protein fragments, hallmarks of the disease process, found in brains of Alzheimer's victims: beta-amyloid, which clumps together to form brain-damaging plaques, and tau, which strangles neurons in tangled filaments. Like many previous studies,it found that CSF beta amyloid levels drop, while tau levels rise in Alzheimer's. What's new is that the confidence level in this finding has now been boosted by applying a meta-analysis of the world literature and adding "the largest cohort of Alzheimer's disease patients and controls evaluated to date".

Researchers must now learn if the protein changes occur as a result of brain damage caused by Alzheimer's, or whether they somehow precede it. Sunderland's group also would like to study how levels of the two substances fluctuate over time, in both people with Alzheimer's and in those with a healthy brain.









Our meeting, February 17th. was presented by Brian Fahey, D.O., of Neurologic Associates, Inc. Dr. Fahey is a consultant neurologist at Doctor's Hospital.

The presentation was on the "Maintenance Treatment of Migraine Headaches" he covered several classes of medicines used to prevent migraines. The discussion focused on the use of anticonvulsants and antidepressants.

Strategic Treatment:
Prophylactic
Abortive

Prophylactic treatment-Migraines
Manual- Physical Therapy / Manipulation
Non-steroidal/ Cox 2 inhibitor
Ibuprofen, Naproxen, Bextra.

Prophylactic Treatments- Migraines
Anticonvulsants
Depakote ER, Gabatril, Keppra, Neurotin, Topamax.
This formulation is most preferred, most of these work primarily on GABA. Depakote patients should have blood work done within 2 weeks, 2 months and then every 6 months. Dosing for Depakote ER is 250mg, 500mg, but higher doses such as 1000mg or 2000mg may be necessary. One of the clinical pearls discussed was to use extreme caution when patients are on both Depakote ER and Lamictal. This combination may lead to toxic levels of one or both of these medications.

Prophylactic Treatments- Migraines
Antihypertensive
B-Blockers, Atenolol, Propranolol
Calcium Channel Blockers
Verapamil; these help prevent Migraine headaches however; mild headaches are a side effect.

Prophylactic Treatment- Migraines
Tricyclic, Amitryptilline, Nortryptilline, in low doses help prevent Migraine headaches and chronic tension headaches. There are many side effects to Tricyclic antidepressants at higher doses.

Abortive- Migraines
There are multiple tryptans to choose from, they differ in their form half-life and duration. The clinical pearl is that tryptans have been reported to cause the Serotonin Syndrome in patients on SSRIs. This may have to do with their action at the 5HT-1D Serotonin receptor.

Very often a patient may require 2 treatments for two different kinds of headaches. For instance, a patient may be on Zoloft for tension headaches and Depakote ER for Migraine headaches

If you would like a copy of Dr. Fahey's article, please either e-mail or phone your request to: TressaDCarroll@aol.com or (614) 937-9427.

Thank you.
Tressa Carroll