Wow. Thanks for sharing.

Did you or anyone notice anything unusual beforehand? Such as paranoia or mild hallucinations? How impaired was your memory and speech? My dad is in the hospital with it right now and it’s going on 3 weeks. They said wernickes but then changed it to Korsakoff 2 weeks later. Took that back 3 days later because he was talking (but confused) all of a sudden and bc “thiamine was elevated” and then came back 5 days after that saying korsakoff psychosis. Not sure how it’s not Korsakoff and then all of a sudden it is again. Very concerned over here. They had him in restraints for 19 days before we got in town and threw a fit

@@amidstthesmile There were no symptoms that I noticed beforehand. Afterwards, my short term memory was shot and took several years to get back to normal for my age. Physically, I made a full recovery in about a year. This was all eighteen years ago. I was very lucky to make a full recovery. These days I can pass for normal.

Yes correct !

Thank you for your feedback and sharing your experience. Wish you well

Do not go gently into that good night. Take care.

I’m so sorry to hear. Thank you for sharing your experience . Hoping it can help others pick up this condition earlier . Wish you well. Take care

My sister has been diagnosed with schizophrenia. I don't know why doctors didn't think of treating her for this she drinks heavy. I'm just realizing after 8 years this could be what she is dealing with. It's horrible. What should I do at this point? She tells stories that are not true piecing them together. She thinks 7 years ago was yesterday. She's only 39.

@@tendresexton4957 So sorry to hear. Not advice - in general . Consider a neuropsychiatric assessment as a detailed cognitive assessment may be needed . the treating team would be able to advise. Wish your sister well.

It’s similar with transplants. And you know what? I agree with caregivers and this attitude. And I’m recovering!!!

True but alkies and addicts don't tend to take care of themselves either

Which they did

Thank you for the feedback 🙏🏼

Ha ha! 😁 Thank you so much for your feedback! Really appreciate it. Interestingly in my early days I was planning to go to Sweden 🇸🇪 after med school. Went to England instead. Tack så mycket / Dziękuję

Thanks for your feedback. 🙏🏼

Yes its a safe intervention that can prevent a significant illness

Well did he tell the doctors that he is a severe alcoholic?

Thank you for your feedback. 🙏🏼

Thanks for your feedback 🙏🏼

Sorry to hear. Was this linked to alcohol or any other risk factors ?

@@PsychiatrySimplified I don't drink so I am unsure. Is it possible to be hereditary?

@@brasshound4442 there are genetic metabolism conditions - but other aspects of absorption, surgery etc which covered in video . Currently, four genetic defects have been described causing impairment of thiamine transport and metabolism: SLC19A2 dysfunction leads to diabetes mellitus, megaloblastic anemia and sensory-neural hearing loss, whereas SLC19A3, SLC25A19, and TPK1-related disorders result in recurrent encephalopathy.

@@PsychiatrySimplified Thank you for the responses. I have been scheduled for CT scan due to my symptoms also being in line with pancreatic cancer. I get relief with B1 so I'm not sure what to think now, do the symptoms mimic each other? Either way I appreciate your content and responses have a blessed day.

@@brasshound4442 wish you well. A thorough medical evaluation is a good thing.

Good question. It takes 18 days for thiamine stores to be depleted and 3 weeks for thiamine levels to start falling. Supplementation of thiamine should be discussed with the doctor as it is required if risk factors are present. Thiamine is obtained from a good diet. But if risk factors are present as discussed in the video then supplementation may be necessary. Pa not medical advice

My friend has just been diagnosed with this , drinking everyday from waking to sleep and only eating a few times a week , took 2 years , onset of seizures , had to be shocked resuscitated 4 times , then placed on life support, five months has passed now and she is still in hospital, the damage to her brain has affected her short term memory & speech , she can read at a basic level but is unable to write. Also in intensive care tests discovered her liver was failing and the placed a Do not resuscitate order on her , meaning if she went into cardiac arrest they wouldn't of brought her back , thankfully her liver although damaged is now stable , removing the DNR She is only 45 , was drinking half a large bottle of spirits a day Writing this on the bus on they way home from seeing her on a hospital visit, Sure puts life into perspective 👍

Yes that's correct in case of severe AUD and thiamine deficiency.

@@PsychiatrySimplified Thank you for confirming. My son's doctor simply said to go supplement with thiamine and Folic acid and I'm guessing this may be a typical recommendation without even checking levels or any indication that absorption is an issue for someone with AUD! Also thiamine levels from a typical blood draw are notoriously inaccurate. To get accurate levels, you need transketolase testing. It may not be easy to find a lab to do this whole blood (the blood is frozen and sent in for testing) test, but if you want accuracy, it's what is needed. I'm checking to see if LabCorp offers this test and we will get it done on our own since his insurance will not cover it. If you could also address these issues in another video, that could be very helpful!

Yea it can but also depends on severity. In severe cases oral thiamine won’t be absorbed due to gastritis or gastric mucosa changes

@@PsychiatrySimplified Thanks for the response, much respect and love, always like your videos!'

Recheck after what do you mean? If alcohol use is significant then supplementation is recommended. I've covered high dose thiamine administration required in early stages of Korsakoff’s but if late it may not be reversible and yes it is like managing dementia.

Wow thanks for the quick response. I’m referring to rechecking the level after how many days of repletion, or is it that it takes the 2-3 days of IV Thiamine for mental status to return to baseline and safe to say adequately treated? I work in nursing homes and when I was working as a RN (USA) I had a patient with advanced wernickes, dysphagia, very bad dementia. He was only about 60 when he passed. I also had a friend in his 30s (bipolar diagnosis) who recently took his own life was a heavy drinker and was questionably delusional at times saying his dad beat him which wasn’t true according to everyone…and for our own curiosity and closure wondering if he could have had some advancement of Korsakoffs. Is there a particular antipsychotic or mood stabilizer that works well with managing irreversible damage from Korsakoffs? Thanks so much.

Yes pabrinex is an option ( contains Pabrinex Intravenous High Potency contains vitamins B1, B2, B6, nicotinamide, vitamin C and glucose.). In this video wanted to highlight the specific dose of thiamine. pabrinex comes as two ampoules - first one contains Thiamine. But you are correct Pabrinex can be administered : 2 to 3 pairs of 5 ml ampoules (1 pair = ampoule 1 + ampoule 2) diluted with 50 ml to 100 ml infusion solution (physiological saline or glucose 5%) and administered over 30 minutes every 8 hours, or at the discretion of the physician.

Wow that takes me down memory lane. Both can coexist and one can occur before the other from my understanding as dry - neurological / wet - CVS. Possibly wet after as may take more for CVS to be involved.

Great suggestion!

@@PsychiatrySimplified Maybe somewhat stupid in some way talking about drugs like those,but You r able to explain it good Dr Rege, I forgot to mention carisoprodol (Soma was brand name) ,it belongs there also ,i like your video mph vs amph-there was even a person in comments section,probably from U.S,,who said he used to take Desoxyn for adult add in high dose,maybe would be interesting comparing d-amphetamine vs methamphetamine aswell.. Even comapring hypnotics would be interisting,zolpidem/zopiclone vs benzo types flunitrazepam,triazolam,nitrazepam,temazepam etc vs secobarbital vs methaqualone.

@@sidka84 Really good suggestions. Now to find the time (:

Alcohol related brain involvement can be due to a range of reasons. Thiamine is one element that can be supplemented. However it can also result in Vit b12 deficiency ; liver related encephalopathy , nutritional deficiencies and vascular brain involvement. Hope he gets the treatment.

So sorry to hear. We hope things go well.

So sorry to hear . Sorry for your loss. Take care .

Iam so sorry to hear this & my heart goes to you ❤️❤️ I got placed on hospice due to Korsaoff brain disease non alcoholic at 42 years old so I feel your pain 💔💔 may I ask what caused your mother's?

@@kimberlysimpson8766 She got really depressed and just drank herself into a spiral. We didn't notice until it was too late. She was 53

I am so sorry to hear that. You are not alone.

It really depends. Fortification is for population level primary prevention. For individuals at risk or with actual deficiency this is unlikely to suffice as treatment is needed .

TTFD (Allithiamine) is the best absorption, Benfotiamine usually best for peripherial nerves.

B1 yes - best to discuss this with the pharmacist if using as a supplement. For acute treatment - it needs to be given IV / IM. But as prevention or supplementation - the pharmacist will able to advise the different options

@@PsychiatrySimplified Thank you. 🙏