The US Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) issued the 2021 National Survey on Drug Use and Health (NSDUH) this week. The NDSUH offers a window into Americans’ experiences with mental health disorders, substance use, and their pursuit of treatment during the second year of the COVID epidemic through chosen estimates by race, ethnicity, and age group. Enough said—the outcomes aren’t appealing.

When there was insufficient or conflicting evidence, core authors from the Autoimmune Encephalitis Alliance Clinicians Network assessed the literature and administered an electronic survey to each member to get their personal opinions. The poll received 68 responses from respondents in 17 different nations. For patients with a general presentation, 84% of responders chose corticosteroids alone or in combination with other treatments (intravenous IG or plasmapheresis), 74% for patients who presented with faciobrachial dystonic seizures, 63% for NMDAR-IgG encephalitis, and 48.5% for classical paraneoplastic encephalitis. A summary of the diagnostic and therapeutic recommendations is provided at the end of the manuscript, which also includes a detailed presentation of the survey data.

The risk of symptomatic intracranial hemorrhage was lower among the 832 patients receiving direct oral anticoagulant treatment in this cohort study involving 33,207 patients with ischemic stroke who received intravenous thrombolysis at 64 centers in Europe, Asia, Australia, and New Zealand when compared to controls who received no anticoagulation. This outcome held true across subgroups and various selection methodologies.

Approved? Not-approved? What is “tentative approval?” Clinical trial data on this novel “once nightly” sodium oxibate showed the drug to be acceptable for narcolepsy. But legal issues are holding up the FDA approval process.

If eponyms are avoided, Wernicke encephalopathy, commonly known as Wernicke-Korsakoff syndrome or alcoholic encephalopathy, is a kind of thiamine (vitamin B1) deficiency that is frequently observed in alcoholics. Imaging typically reveals mamillary bodies, dorsomedial thalami, tectal plate, periaqueductal area, and/or the area around the third ventricle as areas of symmetrical enhanced T2/FLAIR signal.

Although research exists on the impact of CNS stimulants used in pregnancy, only a few small studies have looked at atomoxetine and pregnancy outcomes. This large cohort study of 4.2 million pregnancies ending in live births in northern Europe and the US reviewed nearly 1,000 pregnancies exposed to atomoxetine in the first trimester. Compared with non-exposed pregnancies, there was no observed increase in major congenital abnormalities with atomoxetine use in the first trimester.