Talk:Labile affect

Hi

Hi, I have a bit of an issue with this:

"It is related to the condition known as Witzelsucht, sufferers of which show an uncontrollable tendency to pun, make bad jokes and tell meaningless stories at inappropriate moments."

I haven't come across the term Witzelsucht before but punning is related to pressure of speech in aphasia, mania, and catatonia, whereas some of the other symptoms there appear related to frontal lobe disinhibition as found in frontotemporal dementia. Unless someone comes up with some references I'd also suggest deleting the article Witzelsucht; you certainly would not expect this cluster of symptoms to be related to degeneration of motor neurones. --PaulWicks 19:45, 10 September 2005 (UTC)

I think such symptoms could arise from damage in the wernicke area of the non dominant brain hemisphere - anonymous

My understanding was that, by definition, Wernicke's area is only in the dominant hemisphere. Also why would an area involved in language comprehnension be involved in production of disinhibited speech? Would be interested to see some references or something to support this hypothesis. --PaulWicks 13:10, 26 September 2006 (UTC)

affect vs. effect

I've never heard "affect" used as a noun. Seems like this article would need to use "effect". Anybody have insight? --Coryma 00:40, 1 August 2006 (UTC)

[1] -Ravedave 02:15, 1 August 2006 (UTC)

http://en.wikipedia.org/wiki/Affect_%28psychology%29 I think this is what it meant. 24.205.46.249 23:41, 3 September 2006 (UTC)

affect is a psychological term. "generalized feeling tone" is one definition. --Chrispounds 21:41, 30 October 2006 (UTC)

neurodex

I think it would be better to refer to dextrometorphan instead of "neurodex". I feel it's more appropiate for an encyclopedia (it feels weird to read it like that; a little like an advertisement) - anonymous

But it's not dextromethorphan, it's a combination of that and quinidine. The trial was on the combination of those two drugs, which is called Neurodex. If it was plain old DM I'd agree with you, but that's not what the trial used. --PaulWicks 13:07, 26 September 2006 (UTC)

Use of the chemical names is preferred to the branded name for pharmaceuticals. Nuerodex is NOT an FDA approved name.--Chrispounds 02:59, 31 October 2006 (UTC)

Is what I've done better? Changed it to DM+Q? That's what the original paper did. --PaulWicks 21:58, 30 October 2006 (UTC)

My opinion is that unapproved therapies should not be listed--just so that wikipedia does not become an online showcase for off-label promotion nor an avenue for unproven "natural remedies." It looks like this compound is going to get an up or down from the FDA right away and we can add some color once that decision has been made. I think the details of the trial would go on the product page (which would be listed under the INN chemical name). I would default to the research name (AVP 923) and give a mention to the potential trade name of the product. This trade name is not final until the FDA gives its approval and many of the recent ones have been changed at approval. I probably cut this back too far, so do not worry about starting an editing war if you want to add more to the description. --Chrispounds 02:59, 31 October 2006 (UTC)

I was unable to verify the epi claims. There is an article in JAMA. 2002;288:1475-1483. that puts affective disorders at 2.5% in AD patients. That is a ton lower than the corporate claim. --Chrispounds 03:06, 31 October 2006 (UTC)

I labile affect is an important and under-recognised symptom in several diseases, that causes a significant amount of social stigma and affects the quality of personal relationships. The data from the trial showed this quite convincingly. So far there have been no trials of SSRI's, which many neurologists prescribe for the treatment of labile affect (see Dallas Forshew's (2003) paper [2]). If Neurodex does what it says it can, we have a potentially very valuable tool. I don't really see why we need to wait until FDA approval to discuss it on this page. Moving forward, I would be willing to create a new section on clinical trials or research and refer to the drug as AVP923 as you've suggested. Let me know what you think. Cheers, --PaulWicks 15:02, 31 October 2006 (UTC)

Looks like the FDA wants more data and Avanir has a new name for the compound (Zenvia). I am assuming that the FDA changed the name and will not change it again. I also checked a source that agrees that affective disorders are often under-diagnosed when there are neurological comorbidities. Still, I would like to see this page talk about the disorder first and possible treatments second. Given that the other products are used off-label, we might want to mention that "No product currently has the indication for this disease. However..." A source that indicates that which of these compounds are used would also be good, just for verification purposes. --Chrispounds 00:14, 1 November 2006 (UTC)

Chris, by all means, be bold. If you have a contact who knows a lot about EL then perhaps you could get them to contribute something? I will have a crack at this in the future. --PaulWicks 07:28, 1 November 2006 (UTC)

Labile affect without neurological damage

I'm interested in knowing what kind of issues would lead to a labile affect without neurological damage. I would imagine that someone in severe depression, or grief would commonly have a labile effect to crying. This article seems to mostly deal with labile effect to laughing, and less with labile affect to crying/smiling beyond a short mention at the beginning. —Preceding unsigned comment added by Puellanivis (talk • contribs) 19:13, 10 December 2007 (UTC)

Hi there, I think "labile affect" is referring quite specifically to the neurological manifestation which either occurs without stimuli or is much more exaggerated than one would normally expect. By contrast, tearfulness during depression or bereavement is a perfectly normal symptom and so isn't really pathological in the way that labile affect is. Yes, labile crying is the most easily identified symptom as it is often out of context. Smiling and laughter occur much more frequently for most people so it is harder to spot when something is up. Also there is a lot more evidence for labile crying and laughing but relatively little for smiling. My own research has shown some patients with ALS/MND get labile yawning! --PaulWicks (talk) 19:44, 10 December 2007 (UTC)

While I certainly agree that depression and bereavment provide a backdrop and can be used to express a cause of the "labile affect", however the patient still shows signs of labile affect, crying spontanteously, or when enjoying themselves, or for just the random obstacles that get in everyone's way everyday. Crying and sobing deeply because "I can't open the pickle jar," is certainly not an appropriate response, depression or bereavment asside. Also, while filling out a psychological evaluation for me, my physician had marked that I was "emotionally labile". There are no underlying neurological reasons, I'm simply so stressed out that everyday molehills become unsurmountable mountains. --Puellanivis (talk) 20:44, 10 December 2007 (UTC)

OK, well I would argue that your physician is not using the term diagnostically, but descriptively. --PaulWicks (talk) 00:03, 14 December 2007 (UTC) Since the 1960's, a number of medications have been found to eliminate or reduce IEED (labile affect). SSRI's have a good deal of supporting literature. No harm in presenting the research with a cautionary statement. —Preceding unsigned comment added by 152.131.8.133 (talk) 16:00, 30 July 2008 (UTC)