The results of the 2007 -2008 National Health Survey reveal that more than 61.4% of Australians are either overweight or obese [1]. This has led to a renewed focus on strategies to control body weight with signifi cant government investment in such ventures. Patients with psychiatric illnesses warranting antipsychotic medication appear doubly disadvantaged. A recent study showed that 78.8% of patients receiving such medication increased their body weight by 7% [2]. Obesity is a known harbinger of adverse health outcomes. People with severe mental illness die up to three decades earlier than the general population. A recent survey suggests that obesity-related problems cost Australia an estimated $ 58.2 billion annually in direct and indirect costs [3]. While the mainstay of obesity treatment was centred on diet modifi cation and exercise, diet pills have gained popularity in recent years. The diet pill industry in Australia is estimated to be worth $ 208 million per annum, out of which $ 27 million is attributed to Duromine sales alone [4].Phentermine associated mood and psychotic problems have been reported since the late 1960s. A literature search by these authors revealed only fi ve case reports with psychosis or mood symptoms attributed to phentermine use [5]. We report a series of four patients who have developed psychotic symptoms while on treatment with Duromine. We believe that this will become an increasingly more common occurrence given the current preoccupation with weightrelated problems and discuss implications for psychiatric practice.Ms A, a 30 year old Caucasian woman with a history of bipolar affective disorder suffered several relapses of manic psychosis following the ingestion of phentermine. Depressive episodes would be characterized by poor self-image and increasing pre-occupation with weight prompting visits to her general practitioner with requests for diet pills. During the last episode she

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Objective: The aims of this study were to compare threshold and suprathreshold ictal electroencephalograms (EEGs) in right unilateral (RUL) ultrabrief (UB) electroconvulsive therapy (ECT) and to identify the differences between these EEGs.Methods: This study is a retrospective review of 125 pairs EEGs from titration and subsequent sessions across a 2-year period. All EEGs were independently rated for by 2 assessors using a scale based on qualities of an EEG used to guide ECT treatment dose adequacy, for example, midictal amplitude, regularity, interhemispheric coherence, seizure end point, and postictal suppression. The scores of threshold and suprathreshold EEGs were compared within and between groups based on 2 ECT types, that is, RUL UB ECT and RUL brief pulse (BP) ECT.Results: Paired t tests showed a statistically significant difference in between threshold and suprathreshold EEG scores in RUL UB ECT. There were no statistically significant differences between corresponding scores for RUL UB ECT and RUL BP ECT threshold and suprathreshold EEGs.Conclusions: There is a significant difference between the quality of threshold and suprathreshold EEGs in RUL UB ECT when measured with an EEG rating scale. Visual rating of ictal EEGs is as reliable in discriminating between threshold and suprathreshold seizure in RUL UB ECT as it is in RUL BP ECT.

Antipsychotic agents being used for schizophrenia accounts to cause adverse cutaneous reactions in approximately 5% of the individuals. Erythema multiforme caused by amisulpride therapy in a schizophrenic patient is not a commonly seen side effect. Reversal of lesion was seen after stopping the amisulpride which emphasized the cause of Erythema Multiforme.

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