International Neuropsychiatric Disease Journal <p style="text-align: justify;"><strong>International Neuropsychiatric Disease Journal (ISSN:&nbsp;2321-7235)</strong>&nbsp;aims to publish high quality papers (<a href="/index.php/INDJ/general-guideline-for-authors">Click here for Types of paper</a>) in all areas of ‘Neuropsychiatric Disease related research’. By not excluding papers based on novelty, this journal facilitates the research and wishes to publish papers as long as they are technically correct and scientifically motivated. The journal also encourages the submission of useful reports of negative results. This is a quality controlled, OPEN peer-reviewed, open-access INTERNATIONAL journal.</p> SCIENCEDOMAIN international en-US International Neuropsychiatric Disease Journal 2321-7235 Early Detection of White Matter Changes with Cognitive Decline in Parkinson's Patients <p><strong>Objective: </strong>The aim of this study was to detect changes in white matter in patients with Parkinson's disease applied by diffusion tensor imaging to predict cognitive impairment.</p> <p><strong>Methods: </strong>Montreal cognitive assessment was applied to 50 Parkinson's disease patients to confirm cognitive decline (M: F = 41:9; age: 62.72±9.07 years) and to 20 Parkinson's disease patients with no cognitive impairment as a control (M: F =13:7; age 58.95±11.22). All patients underwent disease severity testing by using Modified Hoehn and Yahr Scale, Unified Parkinson disease rating scale and Diffusion tensor imaging (DTI) for the corpus callosum and cingulum including their involved parts to define affected tracts.</p> <p><strong>Results: </strong>In PD with cognitive impairment subjects, the cognitive affection correlated with abnormal DTI parameters of the corpus callosum and cingulum. There were FA or MD differences in both the corpus callosum and cingulum pathways. These findings were independent of age, sex and total white matter volume.</p> <p><strong>Conclusion: </strong>Patients with Parkinson's disease associated with cognition decline are detected by tractography changes of the corpus callosum and cingulum.</p> Shimaa Ahmed Ibrahim Elgamal Maha Hazem Khalil Omar Abd-Elsalam Ahmed Adel Galal El-Badrawy Ahmed Esmael Shady Khalil El-Rashedy Tamer Mohamed Ebrahim Belal ##submission.copyrightStatement## 2022-08-08 2022-08-08 8 17 10.9734/indj/2022/v17i430208 The Efficacy of an Oral Diazepam Based Protocol in Improving Care and Reducing Duration of Hospitalization in Alcohol Withdrawal <p><strong>Background: </strong>Complications from alcohol abuse are the fourth leading preventable cause of death in the United States. Hospital length of stay (LOS) for patients experiencing alcohol withdrawal syndrome (AWS) has become of particular concern and effective treatment protocols are needed.&nbsp;</p> <p><strong>Objective: </strong>At Danbury Hospital, a 371-bed community hospital in Danbury, Connecticut, the average LOS for AWS was historically nine days. We therefore designed a protocol for the treatment of AWS to provide effective treatment and thereby reduce LOS.</p> <p><strong>Design: </strong>Our study was a single centre, retrospective observational study of patients who were admitted to Danbury Hospital with a diagnosis of AWS.</p> <p><strong>Setting:</strong>&nbsp; Danbury Hospital.</p> <p><strong>Subjects and Methods: </strong>A total of 307 patients were included in this study. All patients 18 years and older admitted to Danbury Hospital between June 2015 and December 2016, with a primary diagnosis of AWS were included. A loading dose regimen was used whereby 20mg of oral Diazepam was given hourly for a total of eight doses within the first 24 hours until clinical improvement or mild sedation was achieved. The comparison group consisted of patients treated with a symptom-triggered regimen using Lorazepam.</p> <p>We compared the primary outcome of LOS and secondary outcomes including need for transfer to a critical care unit, restraint use for aggressive behaviour related to withdrawal, the need for a safety companion, and the need for Psychiatry consultation between the two groups.</p> <p><strong>Main Outcome Measures:&nbsp; </strong>Hospital length of stay for patients experiencing alcohol withdrawal syndrome.</p> <p><strong>Results: </strong>In the Diazepam group versus the comparison group, LOS was reduced to about four days, and fewer Psychiatry consultations were needed.&nbsp;</p> <p><strong>Conclusion: </strong>We conclude that a loading dose regimen of Diazepam may be used to safely reduce LOS in AWS patients.</p> John Chronakos Aashutosh Ramakar Rutvik Shah Ahmad Alharbi Rahila Ogunnaike Eman Hurissi ##submission.copyrightStatement## 2022-08-10 2022-08-10 18 24 10.9734/indj/2022/v17i430209 Extrapyramidal Symptoms and Novel Antipsychotic Drugs <p>One of the challenges of antipsychotic medication is the occurrence of Extrapyramidal Symptoms. These cannot be easily eliminated considering the pathophysiology of schizophrenia and the established mechanism of action of classical antipsychotics. The antipsychotics help improve symptoms of schizophrenia by binding to dopamine receptors in the central nervous system and blocking dopamine. This prevents the basal ganglia from getting enough dopamine. Many drugs used in the treatment of mental disorders such as the neuroleptics and antidepressants adversely affect extrapyramidal system function, resulting in symptoms such as tremors and muscle rigidity collectively known as extrapyramidal symptoms. Treatment generally involves lowering the dose or trying a different antipsychotic but drugs may also be used specifically to treat symptoms. This review examines the attempt to eliminate extrapyramidal symptoms by generations of antipsychotic medications and their comparative efficacy in the treatment of schizophrenia. A wide internet search was carried out using keywords and phrases that include; Antipsychotics, Typical Antipsychotics, Atypical Antipsychotics, Dopaminergic, Extrapyramidal symptoms, comparative efficacy of Antipsychotics and Adverse Effect of Antipsychotics. This will further reinforce knowledge and prescription patterns for antipsychotic medications.</p> M. O. Nwokike S. I. Ghasi A. O. Ogbonna M. N. Ezenwaeze A. C. Ezinwa ##submission.copyrightStatement## 2022-08-01 2022-08-01 1 7 10.9734/indj/2022/v17i430207