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Although hyponatremia is a common, usually mild, and relatively asymptomatic disorder of electrolytes, acute severe hyponatremia can cause substantial morbidity and mortality, particularly in patients with concomitant disease. In addition, overly rapid correction of chronic hyponatremia can cause severe neurologic deficits and death, and optimal treatment strategies for such cases are not established. An expert panel assessed the potential contributions of aquaretic nonpeptide small-molecule arginine vasopressin receptor (AVPR) antagonists to hyponatremia therapies. This review presents their conclusions, including identification of appropriate treatment populations and possible future indications for aquaretic AVPR antagonists.

The authors surveyed a sample of psychiatrists, psychiatric residents, internists, general practitioners, and psychologists in Los Angeles County to determine the number of patients with adverse LSD reactions seen by these professionals during an 18-month period. Over 2,000 adverse reactions were reported on, and the authors regard this as a conservative estimate. Although many clinicians feel that the number of adverse LSD reactions is decreasing, the data reported here indicate a substantial increase from the first six-month period to the third.

The concept of institutional transference is defined and the literature on this subject reviewed. Emphasis is placed on the importance of this type of transference with respect to the return to functioning of many psychiatric patients. Residents develop a transference to their institutions, the nature of which is influenced by their degree of success in effectively coping with the institutional environment. Those residents who are unable to develop feelings of mastery in this area may be expected to have more difficulty in separating from the institution.

The authors, studying predictions of psychological state formed solely from dynamic formulations, found no correlation between correct predictions and length of professional psychiatric experience. They question the misuse of deductive reasoning and selection of statements in the formulations used in formal psychiatric examinations and suggest that the dynamic formulation may not be a useful predictor of diagnostic entities.

The recent practice of smoking dried banana scrapings to achieve a "psychedelic experience" led the authors to investigate the hallucinogenic properties of bananadine, or "mellow yellow." They conclude that the "active ingredient" in bananadine is the psychic suggestibility of the user in the proper setting.

Asthmador (a stramonium-belladonna mixture) caused poisoning in two individuals. At a time when Asthmador ingestion is becoming increasingly popular as a hallucinogen, it is well to include it in the differential diagnosis of acute psychotic reactions. The clinical picture may be similar to that of a lysergic acid diethylamide (LSD) psychosis. However, themarkedpupillary dilatation, failure of the pupils to accommodate, and tachycardia seen with intoxication from Asthmador may be helpful in making the differential diagnosis.