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Sample records for anxiolytics sedatives antidepressants

  1. Fractures in users of antidepressants and anxiolytics and sedatives: effects of age and dose.

    Science.gov (United States)

    Vestergaard, P; Prieto-Alhambra, D; Javaid, M K; Cooper, C

    2013-02-01

    Antidepressants have been associated with fractures. In a case-control study, increasing age was associated with more fractures in users of selective serotonin reuptake inhibitors and tricyclic antidepressants, whereas for anxiolytics and sedatives, more fractures were seen among the younger users. Depression per se did not seem associated with fractures. This study aims to study the effects of age and dose of selective serotonin reuptake inhibitors (SSRI), tricyclic antidepressants (TCA) and anxiolytics/sedatives on fracture risk. The study was designed as a case-control study. From the Danish National Health Service, we identified 124,655 fracture cases and 373,962 age- and gender-matched controls. Crude odds ratios were estimated, and propensity score adjustment was used to minimise confounding by indication. A higher risk of fractures was associated with an increasing dose of anxiolytics and sedatives; the highest excess risk was present in the age stratum below 40 years of age (p antidepressants, no particular trend with age or dose was observed. In our data, a hospital diagnosis of depression or manic depression was associated with fewer fractures. Caution should be shown upon prescription of SSRI to older subjects. A hospital diagnosis of depression or manic depression and thus potentially a more severe disease was not a risk factor for fractures.

  2. Extracts of Valeriana officinalis L. s.l. show anxiolytic and antidepressant effects but neither sedative nor myorelaxant properties.

    Science.gov (United States)

    Hattesohl, Miguel; Feistel, Björn; Sievers, Hartwig; Lehnfeld, Romanus; Hegger, Mirjam; Winterhoff, Hilke

    2008-01-01

    Extracts of Valeriana officinalis L. s.l. are used for treating mild sleep disorders and nervous tension. Despite intensive research efforts, the pharmacological actions accounting for the clinical efficacy of valerian remain unclear. Thus, it was the aim of this study to evaluate CNS-related effects of different valerian extracts using behavioral paradigms (mice and rats). Following oral administration two commercially available preparations (extraction solvents: 45% methanol m/m and 70% ethanol v/v), a 35% ethanolic v/v extract and a refined extract derived from it (patented special extract phytofin Valerian 368) were tested for sedative (locomotor activity, ether-induced anaesthesia) and anxiolytic (elevated plus maze) activity. Using the forced swimming and the horizontal wire test the latter two extracts were additionally tested for antidepressant and myorelaxant properties. Up to maximum dosages of 500 or 1000 mg/kg bw none of the valerian extracts displayed sedative effects. Neither spontaneous activity was reduced nor the duration of ether-induced narcosis was prolonged. In contrast, results obtained in the elevated plus maze test revealed a pronounced anxiolytic effect of the 45% methanolic and 35% ethanolic extract as well as of phyotofin Valerian 368 in a dose range of 100-500 mg/kg bw. Additionally and different from its primary extract (35% ethanolic extract) phytofin Valerian 368 showed antidepressant activity in the forced swimming test after subacute treatment. Myorelaxant effects were not observed in dosages up to 1000 mg/kg bw. Due to these findings it is proposed that not sedative but anxiolytic and antidepressant activity, which was elaborated particularly in the special extract phytofin Valerian 368, considerably contribute to the sleep-enhancing properties of valerian.

  3. Anxiolytic-like and sedative effects of Hydrocotyle umbellata L., Araliaceae, extract in mice

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    Fábio F. Rocha

    2011-02-01

    Full Text Available The plant Hydrocotyle umbellata L., Araliaceae (water pennywort, is widely used in Brazilian folk medicine to reduce anxiety. This work investigates the anxiolytic-like effects of the ethanol extract from H. umbellata subterraneous parts as well as the extract's other putative central nervous system effects that could justify its common use. Oral dosing of the extract (0.3 and 1 g/kg clearly showed an anxiolytic-like profile in the elevated plus maze test where it increased the percentage of entries into and the time spent in the open arms of the maze. In the marble-burying test, the extract induced anxiolytic-like effects only at a dose of 1 g/kg, which also causes mild sedative properties in other models. The sedated state was characterized by a slight reduction in spontaneous exploratory activity during the open field test and a potentiating of pentobarbital-induced hypnosis. No signs of motor impairment were detected in the rota rod or chimney tests. The extract did not show antidepressant properties in mice as assessed by the forced swimming test. These results support the use of H. umbellata in Brazilian folk medicine as an anxiolytic and contribute to the scientific knowledge of this possible phytotherapeutic resource.

  4. Antidepressant and Anxiolytic Potentials of Dichloromethane ...

    African Journals Online (AJOL)

    Furthermore, a diminution in the anxiety response was also observed against elevated plus maze and light dark tests, which signify its anti-anxiety activity when compared with standard anxiolytic drug, diazepam. Moreover, DMHBR has no significant effects on both the motor coordination of the mice in the rota rod test and ...

  5. Behavioral effects of Euphorbia hirta L.: sedative and anxiolytic properties.

    Science.gov (United States)

    Lanhers, M C; Fleurentin, J; Cabalion, P; Rolland, A; Dorfman, P; Misslin, R; Pelt, J M

    1990-05-01

    Lyophilised aqueous extract of Euphorbia hirta L. (Euphorbiaceae) has been evaluated for behavioral effects in mice. The extract did not induce any toxic effect when it was administered i.p. and orally. Sedative properties could be confirmed with high doses (100 mg of dried plant/kg, and more), by a decrease of behavioral parameters measured in non-familiar environment tests (activitest and staircase test), whereas anticonflict effects appeared at lower doses (12.5 and 25 mg of dried plant/kg), by an enhancement of behavioral parameters measured in the staircase test and in the light/dark choice situation test. These findings validate the traditional use of E. hirta as a sedative and reveal original anxiolytic properties.

  6. Anxiolytics, Sedatives, and Hypnotics Prescribed by Dentists in Brazil in 2010

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    Patrícia Azevedo Lino

    2017-01-01

    Full Text Available Objective. To describe dental prescriptions for anxiolytics, sedatives, and hypnotics for Brazilian outpatients in 2010. Methods. A cross-sectional study was conducted using data on the use of anxiolytics, sedatives, and hypnotics from the Brazilian Health Surveillance Agency, Brazil, 2010. For each prescription, prescribed drugs and the prescribed amount were identified. Prescribed medications were classified according to Anatomical Therapeutic Chemical code. We calculated the number of Defined Daily Doses (DDD for anxiolytics, sedatives, and hypnotics by code, their mean DDD, and DDD per inhabitant per year. Results. There were 16,436 prescriptions dispensed, including anxiolytics, sedatives, and hypnotics. These prescriptions corresponded to 3,555,780.50 mg, distributed as 2,286,200.50 mg (64.30% of anxiolytics and 1,269,580.00 mg (35.70% of sedatives and hypnotics. This amount allowed treating approximately 474,106 individuals (number of DDD. The anxiolytics most frequently dispensed were bromazepam (25.30%, alprazolam (19.19%, and diazepam (15.60%. Sedatives and hypnotics mostly prescribed were zolpidem (9.55%, midazolam (6.99%, and flunitrazepam (2.14%. The per capita rates (100,000 inhabitants of anxiolytics and sedatives/hypnotics were 6.83 and 1.78, respectively. Conclusions. Benzodiazepines and derivatives were the most frequently prescribed drugs. There was a low rate of dental prescriptions for anxiolytics, sedatives, and hypnotics, although excessive doses were concentrated in the same prescription.

  7. Antidepressant, Anxiolytic and Antinociceptive Activities of Constituents from Rosmarinus Officinalis.

    Science.gov (United States)

    Abdelhalim, Abeer; Karim, Nasiara; Chebib, Mary; Aburjai, Talal; Khan, Imran; Johnston, Graham A R; Hanrahan, Jane

    2015-01-01

    Rosmarinus officinalis, traditionally known as rosemary, has been widely used in traditional medicines and has long been known as the herb of remembrance. However, few studies have investigated the effects of non-volatile components of rosemary on central nervous system function. Fractionation of R. officinalis led to the isolation of salvigenin, rosmanol and cirsimaritin, which were investigated in mouse models of acute toxicity, antinociception (tail immersion and hot plate tests), depression (tail suspension and forced swim tests) and anxiety (elevated plus maze and light/dark box paradigms). Rosmanol, cirsimaritin and salvigenin were not found to exhibit any signs of acute toxicity (50-200 mg/kg), but elicited antinociceptive, antidepressant and anxiolytic activities. Rosmanol, cirsimaritin and salvigenin, all previously shown to have biphasic modulation of GABAA receptors, demonstrated CNS activity in mouse models of antinociception, antidepressant and anxiolysis. The anxiolytic activity of all three compounds was not ameliorated by flumazenil, but was inhibited by pentylenetetrazol, suggesting a mode of action via GABAA receptors at a site other than the high affinity benzodiazepine binding site. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.

  8. Subtypes of adolescent sedative/anxiolytic misusers: A latent profile analysis.

    Science.gov (United States)

    Hall, Martin T; Howard, Matthew O; McCabe, Sean Esteban

    2010-10-01

    Few empirically-based taxonomies of nonmedical prescription drug misusers have been published. This study used latent profile analysis (LPA) to identify classes of adolescent sedative/anxiolytic misusers. Interviews assessing substance use, psychiatric symptoms, antisocial traits/behavior, and traumatic life experiences were conducted with 723 Missouri youth in residential care for antisocial behavior. Sedative/anxiolytic misusers (N=247) averaged 15.8 (S.D.=1.1) years of age; a majority were male (83.8%), White (70.0%), and resided in rural/small town areas (53.8%). LPA yielded a three-class solution. Class 1 (59.1%) was comprised of youth with significantly lower levels of currently distressing psychiatric symptoms, fewer lifetime traumatic experiences, less problematic substance use histories, less frequent antisocial behavior, and less impulsivity than youth in Classes 2 and 3. Class 2 (11.3%) youth had high levels of currently distressing psychiatric symptoms and more frequent antisocial behavior compared to youth in Classes 1 and 3. Class 3 (29.5%) youth evidenced levels of psychiatric and behavioral problems that were intermediate to those of Class 1 and 2 youth. Frequency of sedative/anxiolytic misuse was significantly higher in Classes 2 and 3 compared to Class 1. Members of Class 2 and Class 3 also had the highest levels of psychiatric symptoms for which sedatives/anxiolytics are commonly prescribed. Significant differences between classes were observed across a range of health, mental health, personality, and behavioral variables. Adolescents who misused prescription sedatives/anxiolytics evidenced significant heterogeneity across measures of psychiatric and behavioral dysfunction. Youth with comparatively high levels of anxiety and depression reported significantly more intensive sedative/anxiolytic misuse than their counterparts and may be at high risk for sedative/anxiolytic abuse and dependence. 2010 Elsevier Ltd. All rights reserved.

  9. Study of sedative, preanaesthetic and anxiolytic effects of herbal extract of Lavandula stoechas in comparison with diazepam in rat

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    A Rezaie

    2010-11-01

    Full Text Available Lavandula stoechas grows naturally in most parts of the world specifically south France, the Mediterranean region and Torento. The plant has various pharmacological properties including analgesic, anti-inflammatory, antidepressant, hypnotic, sedative and tranquilizer, muscle relaxant, anticonvulsant, antibacterial and antispasmodic. For studying the effectiveness of sedative, preanesthetic and anxiolytic effects of Lavandula  stoechas in comparison with diazepam different groups of female Wistar rats with the same age and weight conditions received intraperitoneal injections of Lavandula  stoechas (100, 200, 400 mg/kg, ip, diazepam (1.2 mg/kg, ip, dimethyl sulfoxide (DMSO as a placebo with equal volume 30 minutes before assessing the sedative and preanesthetic effects (induced sleep duration by ketamine, 40 mg/kg, ip and anxiolytic effects (using Elevated plus maze and (Rotarod test. Statistical analysis of the results obtained represent a significant increase in sleep time induced with ketamine and also a significant increase in the time the rats spent in open arms of maze with high and low doses of Lavandula stoechas herbal extract (p

  10. Synthesis, Anticonvulsant, Sedative and Anxiolytic Activities of Novel Annulated Pyrrolo[1,4]benzodiazepines

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    Kumaraswamy Sorra

    2014-09-01

    Full Text Available Four new pentacyclic benzodiazepine derivatives (PBDTs 13–16 were synthesized by conventional thermal heating and microwave-assisted intramolecular cyclocondensation. Their anticonvulsant, sedative and anxiolytic activities were evaluated by drug-induced convulsion models, a pentobarbital-induced hypnotic model and an elevated plus maze in mice. PBDT 13, a triazolopyrrolo[2,1-c][1,4]benzodiazepin-8-one fused with a thiadiazolone ring, exhibited the best anticonvulsant, sedative and anxiolytic effects in our tests. There was no significant difference in potency between PBDT 13 and diazepam, and we proposed that the action mechanism of PBDT 13 could be similar to that of diazepam via benzodiazepine receptors.

  11. Synthesis, Anticonvulsant, Sedative and Anxiolytic Activities of Novel Annulated Pyrrolo[1,4]benzodiazepines

    OpenAIRE

    Sorra, Kumaraswamy; Chen, Chien-Shu; Chang, Chi-Fen; Pusuluri, Srinivas; Mukkanti, Khagga; Wu, Chi-Rei; Chuang, Ta-Hsien

    2014-01-01

    Four new pentacyclic benzodiazepine derivatives (PBDTs 13–16) were synthesized by conventional thermal heating and microwave-assisted intramolecular cyclocondensation. Their anticonvulsant, sedative and anxiolytic activities were evaluated by drug-induced convulsion models, a pentobarbital-induced hypnotic model and an elevated plus maze in mice. PBDT 13, a triazolopyrrolo[2,1-c][1,4]benzodiazepin-8-one fused with a thiadiazolone ring, exhibited the best anticonvulsant, sedative and anxiolyti...

  12. Sedative and anxiolytic effects of the extracts of the leaves of ...

    African Journals Online (AJOL)

    The investigations sought scientific evidence for the ethnomedicinal use of the leaves for the management of insomnia and anxiety as well as the neural mechanisms for the activities. The sedative and anxiolytic effects of the extracts of the leaves of Stachytarpheta cayennensis were examined in this study. The methanolic ...

  13. Differential role of AMPA receptors in mouse tests of antidepressant and anxiolytic action

    DEFF Research Database (Denmark)

    Andreasen, Jesper T; Fitzpatrick, Ciaran M; Larsen, Maria

    2015-01-01

    Depression and anxiety often co-occur, and conventional monoamine-facilitating antidepressants show efficacy against symptoms in both disorders. Rodent studies indicate that antidepressant effects of monoamine-based antidepressants involve increased α-amino-3-hydroxy-5- methyl-4-isoxazolepropionic...... a depressogenic-like effect in the TST but no effect in the FST. Conversely, GYKI-53655 produced marked anxiolytic-like effects in the EZM (≥ 2.5 mg/kg), MBT (≥ 2.5 mg/kg), and NIH tests (≥ 5 mg/kg), while LY451646 (≥ 3 mg/kg) increased anxiety-like behaviour in the EZM. Citalopram showed an antidepressant...

  14. CT-Screening for lung cancer does not increase the use of anxiolytic or antidepressant medication

    DEFF Research Database (Denmark)

    Kaerlev, Linda; Iachina, Maria; Pedersen, Jesper Holst

    2012-01-01

    CT screening for lung cancer has recently been shown to reduce lung cancer mortality, but screening may have adverse mental health effects. We calculated risk ratios for prescription of anti-depressive (AD) or anxiolytic (AX) medication redeemed at Danish pharmacies for participants in The Danish...... Lung Cancer Screening Trial (DLCST)....

  15. Stopping Antidepressants and Anxiolytics as Major Concerns Reported in Online Health Communities: A Text Mining Approach.

    Science.gov (United States)

    Abbe, Adeline; Falissard, Bruno

    2017-10-23

    Internet is a particularly dynamic way to quickly capture the perceptions of a population in real time. Complementary to traditional face-to-face communication, online social networks help patients to improve self-esteem and self-help. The aim of this study was to use text mining on material from an online forum exploring patients' concerns about treatment (antidepressants and anxiolytics). Concerns about treatment were collected from discussion titles in patients' online community related to antidepressants and anxiolytics. To examine the content of these titles automatically, we used text mining methods, such as word frequency in a document-term matrix and co-occurrence of words using a network analysis. It was thus possible to identify topics discussed on the forum. The forum included 2415 discussions on antidepressants and anxiolytics over a period of 3 years. After a preprocessing step, the text mining algorithm identified the 99 most frequently occurring words in titles, among which were escitalopram, withdrawal, antidepressant, venlafaxine, paroxetine, and effect. Patients' concerns were related to antidepressant withdrawal, the need to share experience about symptoms, effects, and questions on weight gain with some drugs. Patients' expression on the Internet is a potential additional resource in addressing patients' concerns about treatment. Patient profiles are close to that of patients treated in psychiatry. ©Adeline Abbe, Bruno Falissard. Originally published in JMIR Mental Health (http://mental.jmir.org), 23.10.2017.

  16. Antidepressant-like and anxiolytic-like effects of cannabidiol: a chemical compound of Cannabis sativa.

    Science.gov (United States)

    de Mello Schier, Alexandre R; de Oliveira Ribeiro, Natalia P; Coutinho, Danielle S; Machado, Sergio; Arias-Carrión, Oscar; Crippa, Jose A; Zuardi, Antonio W; Nardi, Antonio E; Silva, Adriana C

    2014-01-01

    Anxiety and depression are pathologies that affect human beings in many aspects of life, including social life, productivity and health. Cannabidiol (CBD) is a constituent non-psychotomimetic of Cannabis sativa with great psychiatric potential, including uses as an antidepressant-like and anxiolytic-like compound. The aim of this study is to review studies of animal models using CBD as an anxiolytic-like and antidepressant-like compound. Studies involving animal models, performing a variety of experiments on the above-mentioned disorders, such as the forced swimming test (FST), elevated plus maze (EPM) and Vogel conflict test (VCT), suggest that CBD exhibited an anti-anxiety and antidepressant effects in animal models discussed. Experiments with CBD demonstrated non-activation of neuroreceptors CB1 and CB2. Most of the studies demonstrated a good interaction between CBD and the 5-HT1A neuro-receptor.

  17. Anxiolytic-like and sedative effects of Kyllinga brevifolia in mice

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    María del Carmen Hellión-Ibarrola

    2012-09-01

    Full Text Available Kyllinga brevifolia Rottb., Cyperaceae, rhizomes have been widely used in the Paraguayan folk medicine as digestive, diuretic, sedative, tonic, antispasmodic and sudorific. The purpose of this study is to characterize the putative sedative, anxiolytic effects of the crude hydro-ethanolic extract (CEKb and fractions of the rhizome of K. brevifolia, in male mice. The behaviour of mice was assessed in the open field, hole board, rota-rod and elevated plus-maze (EPM test. Oral treatment with single doses of 10, 100 and 1000 mg/kg of CEKb and 10 mg/kg of ethyl acetate fraction (KbF-ethyl-ac increased the duration of the sleeping time induced by pentobarbital. Oral administration of 1, 10 and 100 mg/kg of CEKb and 0.1, 1 and 10 mg/kg of KbF-ethyl-ac also significantly increased the time-spent and arm entries into open arms of the elevated plus maze (EPM versus control group. These findings indicate that K. brevifolia exerts a weak sedative and an interesting anxiolytic-like effect in mice and suggest its potential usefulness for the treatment of anxiety in humans.

  18. Anxiolytic-like and sedative effects of Kyllinga brevifolia in mice

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    María del Carmen Hellión-Ibarrola

    2012-12-01

    Full Text Available Kyllinga brevifolia Rottb., Cyperaceae, rhizomes have been widely used in the Paraguayan folk medicine as digestive, diuretic, sedative, tonic, antispasmodic and sudorific. The purpose of this study is to characterize the putative sedative, anxiolytic effects of the crude hydro-ethanolic extract (CEKb and fractions of the rhizome of K. brevifolia, in male mice. The behaviour of mice was assessed in the open field, hole board, rota-rod and elevated plus-maze (EPM test. Oral treatment with single doses of 10, 100 and 1000 mg/kg of CEKb and 10 mg/kg of ethyl acetate fraction (KbF-ethyl-ac increased the duration of the sleeping time induced by pentobarbital. Oral administration of 1, 10 and 100 mg/kg of CEKb and 0.1, 1 and 10 mg/kg of KbF-ethyl-ac also significantly increased the time-spent and arm entries into open arms of the elevated plus maze (EPM versus control group. These findings indicate that K. brevifolia exerts a weak sedative and an interesting anxiolytic-like effect in mice and suggest its potential usefulness for the treatment of anxiety in humans.

  19. A comparative study of sedative and anxiolytic effects of the Hypericum perforatumin and diazepam on rats

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    Ali Rezaei

    2012-01-01

    Full Text Available Background: Hypericum perforatum or St. John’s wort is a plant known as a Raee flower (or Hypericum in Persian. Hyperisin and Hyperforin are the main constituents of this plant extract that are connected to sigma opioid and GABA receptors. Its various pharmacological effects, such as analgesia, sedation, anti-spasm, anti-convulsion, anti-anxiety, and anti-bacteria have already been known. Materials and Method: To conduct the study, the authors prepared the hydro alcohol extract taken from the aerial organ of the plant. Then, different groups of female Wistar rats, which were almost equal in age and weight, received doses of 500mg/kg and 250mg/kg of the extract, 1.2mg/kg of diazepam, and di-methyl solphoxid (as placebo with equal volumes. The intraperitoneal injections were administered 15min before assessing the sedative/hypnotic effects (i.e. duration of the induced sleep by ketamin with a dose of 40mg/kg and the anxiolytic effects by means of the elevated plus maze.Results: The results showed a statistically significant increase (p= 0.00 both in the duration of the induced sleep by ketamin and in the time lapsed in the open arms in the experimental groups with high and low doses of the extract.Conclusion: The findings suggest that the extract of Hypericum perforatum with a dose of 500mg/kg could have sedative, preanaesthetic, and anxiolytic effects.

  20. Association between bystander cardiopulmonary resuscitation and redeemed prescriptions for antidepressants and anxiolytics in out-of-hospital cardiac arrest survivors.

    Science.gov (United States)

    Bundgaard, Kristian; Hansen, Steen M; Mortensen, Rikke Nørmark; Wissenberg, Mads; Hansen, Malta; Lippert, Freddy; Gislason, Gunnar; Køber, Lars; Nielsen, Jimmi; Torp-Pedersen, Christian; Rasmussen, Bodil Steen; Kragholm, Kristian

    2017-06-01

    This study aimed to examine rates of redeemed prescriptions of antidepressants and anxiolytics, used as markers for cerebral dysfunction in out-of-hospital cardiac arrest (OHCA) survivors, and examine the association between bystander CPR and these psychoactive drugs. We included all 30-day survivors of OHCA in Denmark between 2001 and 2011, who had not redeemed prescriptions for antidepressants or anxiolytics in the last six months prior to OHCA. Main outcome measures were redeemed prescriptions of antidepressants and anxiolytics within one year after OHCA. Among 2,001 30-day survivors, 174 (8.6% died and 12.0% redeemed a first prescription for an antidepressant and 8.2% for an anxiolytic drug within one year after arrest. The corresponding frequencies for redeemed prescribed drugs among age- and sex-matched population controls were 7.5% and 5.2%, respectively. Among survivors who received bystander CPR, prescriptions for antidepressants and anxiolytics were redeemed in 11.1% [95% CI 9.2-13.3%] and 6.3% [95% CI 4.9-8.0%] of the cases, respectively, versus 17.2% [95% CI 13.9-21.1%] and 13.4% [95% CI 10.5-17.0%], respectively, among patients who had not received bystander CPR. Adjusted for age, sex, year of arrest, comorbidity, witnessed status and socioeconomic status, bystander CPR was associated with significant reductions in redeemed prescriptions for antidepressants, Hazard Ratio (HR) 0.71 [95% CI 0.52-0.98], P=0.031; and anxiolytics, HR 0.55 [95% CI 0.38-0.81], P=0.002. Relative to no bystander CPR, redeemed prescriptions for antidepressants and anxiolytics were significantly lower among 30-day survivors of OHCA who received bystander CPR, suggesting a cerebral dysfunction-lowering potential of bystander CPR. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Anxiolytic and sedative properties of hydroethanolic extract of Telfairia occidentalis leaves in mice

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    Mutiu Y. Ajao

    2013-04-01

    Full Text Available Telfairia occidentalis Hook. f., Cucurbitaceae, is a leafy vegetable used in soup and folk medicine in southern Nigeria. This study was conducted to investigate the anxiolytic and sedative activities of the hydroethanolic extract of the leaves of T. occidentalis in mice. The hole-board, elevated plus maze, open-field, light-dark, and social interaction tests were used in this study. T. occidentalis (50-400 mg/kg and diazepam (1 mg/kg were administered p.o. to different groups of mice and appropriate observations were made. T. occidentalis increased the number of sectional crossings (p<0.01 and duration of head dips (p<0.05 at doses of 50 and 100 mg/kg respectively; increased number of entries into open arms (p<0.01 at the dose of 100 mg/kg; increased number of central squares crossed (p<0.01 at the dose of 50 mg/kg; and increased number of social interactions (p<0.001 at doses of 50 and 100 mg/kg. At the dose of 400 mg/kg, T. occidentalis reduced number of head dips and sectional crossings (p<0.01; reduced time spent in open arms and increased time spent in closed arms (p<0.01, 0.001 at doses of 200 and 400 mg/kg; reduced number of assisted rearings (p<0.001 at doses of 200 and 400 mg/kg; increased latency of entry into and time spent in dark box (p<0.01, 0.001 at doses of 200 and 400 mg/kg; and reduced number of social interactions (p<0.001 at the dose of 400 mg/kg. The findings in this study suggest that T. occidentalis possess anxiolytic property at doses of 50 and 100 mg/kg, and sedative activity at doses of 200 and 400 mg/kg.

  2. Anxiolytic and sedative properties of hydroethanolic extract of Telfairia occidentalis leaves in mice

    Directory of Open Access Journals (Sweden)

    Mutiu Y. Ajao

    2012-11-01

    Full Text Available Telfairia occidentalis Hook. f., Cucurbitaceae, is a leafy vegetable used in soup and folk medicine in southern Nigeria. This study was conducted to investigate the anxiolytic and sedative activities of the hydroethanolic extract of the leaves of T. occidentalis in mice. The hole-board, elevated plus maze, open-field, light-dark, and social interaction tests were used in this study. T. occidentalis (50-400 mg/kg and diazepam (1 mg/kg were administered p.o. to different groups of mice and appropriate observations were made. T. occidentalis increased the number of sectional crossings (p<0.01 and duration of head dips (p<0.05 at doses of 50 and 100 mg/kg respectively; increased number of entries into open arms (p<0.01 at the dose of 100 mg/kg; increased number of central squares crossed (p<0.01 at the dose of 50 mg/kg; and increased number of social interactions (p<0.001 at doses of 50 and 100 mg/kg. At the dose of 400 mg/kg, T. occidentalis reduced number of head dips and sectional crossings (p<0.01; reduced time spent in open arms and increased time spent in closed arms (p<0.01, 0.001 at doses of 200 and 400 mg/kg; reduced number of assisted rearings (p<0.001 at doses of 200 and 400 mg/kg; increased latency of entry into and time spent in dark box (p<0.01, 0.001 at doses of 200 and 400 mg/kg; and reduced number of social interactions (p<0.001 at the dose of 400 mg/kg. The findings in this study suggest that T. occidentalis possess anxiolytic property at doses of 50 and 100 mg/kg, and sedative activity at doses of 200 and 400 mg/kg.

  3. Antidepressive and anxiolytic effects of ayahuasca: a systematic literature review of animal and human studies

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    Rafael G. dos Santos

    2016-03-01

    Full Text Available Objective: To conduct a systematic literature review of animal and human studies reporting anxiolytic or antidepressive effects of ayahuasca or some of its isolated alkaloids (dimethyltryptamine, harmine, tetrahydroharmine, and harmaline. Methods: Papers published until 3 April 2015 were retrieved from the PubMed, LILACS and SciELO databases following a comprehensive search strategy and using a predetermined set of criteria for article selection. Results: Five hundred and fourteen studies were identified, of which 21 met the established criteria. Studies in animals have shown anxiolytic and antidepressive effects of ayahuasca, harmine, and harmaline, and experimental studies in humans and mental health assessments of experienced ayahuasca consumers also suggest that ayahuasca is associated with reductions in anxiety and depressive symptoms. A pilot study reported rapid antidepressive effects of a single ayahuasca dose in six patients with recurrent depression. Conclusion: Considering the need for new drugs that produce fewer adverse effects and are more effective in reducing anxiety and depression symptomatology, the described effects of ayahuasca and its alkaloids should be further investigated.

  4. Antidepressive and anxiolytic effects of ayahuasca: a systematic literature review of animal and human studies.

    Science.gov (United States)

    Dos Santos, Rafael G; Osório, Flávia L; Crippa, José Alexandre S; Hallak, Jaime E C

    2016-03-01

    To conduct a systematic literature review of animal and human studies reporting anxiolytic or antidepressive effects of ayahuasca or some of its isolated alkaloids (dimethyltryptamine, harmine, tetrahydroharmine, and harmaline). Papers published until 3 April 2015 were retrieved from the PubMed, LILACS and SciELO databases following a comprehensive search strategy and using a predetermined set of criteria for article selection. Five hundred and fourteen studies were identified, of which 21 met the established criteria. Studies in animals have shown anxiolytic and antidepressive effects of ayahuasca, harmine, and harmaline, and experimental studies in humans and mental health assessments of experienced ayahuasca consumers also suggest that ayahuasca is associated with reductions in anxiety and depressive symptoms. A pilot study reported rapid antidepressive effects of a single ayahuasca dose in six patients with recurrent depression. Considering the need for new drugs that produce fewer adverse effects and are more effective in reducing anxiety and depression symptomatology, the described effects of ayahuasca and its alkaloids should be further investigated.

  5. Anxiolytic and antidepressive effects of magnesium in rats and their effect on general behavioural parameters

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    Samardžić Janko

    2011-01-01

    Full Text Available Magnesium (Mg is an essential element that catalyses more than 300 enzyme systems. Its effects on the central nervous system are exhibited through the blocking of activity of N-methyl D-aspartat (NMDA receptors and potentiating of GABA-ergic neurotransmission. Due to the vast importance of these two neurotransmission systems in the fine regulation of the central integrative function activity, the aim of this research was to test the anxiolytic and antidepressive effects of magnesium, after acute and repeated application, and its influence on general behavioural parameters. In this research Wistar albino rats were treated with increasing doses of Mg chloride 6-hydrate (MgCl 10, 20, 30 mg/kg. In order to determine anxiolytic and antidepressive properties of magnesium two models were used: elevated plus maze (EPM and forced swim test (FST. Behavioural parameters (stillness and mobility were recorded during acute and repeated administration of the active substance. Results of EPM testing showed no significant difference between groups, p>0.05. After acute application of increasing doses of magnesium chloride hydrate in FST, we showed the statistically significant difference in immobility time between the group of animals treated with Mg and the control group treated with the solvent, p<0.01. The statistically significant difference between groups treated with the lowest and the middle dose of magnesium and the controls was observed already on the first day of examining behavioural parameters (p=0.020, p=0.010. Our research has showed that magnesium, following acute administration, increases locomotor activity, and has an antidepressive but not an anxiolytic effect.

  6. Evaluation of anxiolytic and sedative effects of 80% ethanolic Carica papaya L. (Caricaceae) pulp extract in mice.

    Science.gov (United States)

    Kebebew, Zerihun; Shibeshi, Workineh

    2013-11-25

    Carica papaya has been used in the Ethiopian traditional medicine to relieve stress and other disease conditions. The present study was undertaken to evaluate the anxiolytic and sedative effects of 80% ethanolic Carica papaya (Caricaceae) pulp extract in mice. Carica papaya pulp extract was screened for anxiolytic effect by using elevated plus maze, staircase and open field tests, and ketamine-induced sleeping time test for sedation at doses of 50, 100, 200, 400 mg/kg. Distilled water and Diazepam were employed as negative and positive control groups, respectively. Carica papaya pulp extract 100 mg/kg significantly increased the percentage of open arm time and entry, and reduced the percentage of entry and time spent in closed arm in elevated plus maze test; reduced the number of rearing in the staircase test; and increased the time spent and entries in the central squares while the total number of entries into the open field were not significantly affected, suggesting anxiolytic activity without altering locomotor and sedative effects. A synergistic reduction in the number of rearing and an inverted U-shaped dose response curves were obtained with important parameters of anxiety The results of this study established a support for the traditional usage of Carica papaya as anxiolytic medicinal plant. © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Sedative and Anxiolytic-Like Actions of Ethanol Extract of Leaves of Glinus oppositifolius (Linn. Aug. DC.

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    Md. Moniruzzaman

    2016-01-01

    Full Text Available Glinus oppositifolius is a small herb, widely used in the traditional medicine of Bangladesh in treatment of a variety of diseases and disorders such as insomnia, pain, inflammation, jaundice, and fever. The present study evaluated the sedative and anxiolytic potentials of the ethanol extract of leaves of G. oppositifolius (EEGO in different behavioral models in mice. The sedative activity of EEGO was investigated using hole cross, open field, rotarod, and thiopental sodium- (TS- induced sleeping time determination tests, where the elevated plus maze (EPM and light-dark box (LDB exploration tests were employed to justify the anxiolytic potentials in mice at the doses of 50, 100, and 200 mg/kg. The results demonstrated that EEGO significantly inhibited the exploratory behavior of the animals both in hole cross and in open field tests in a dose-dependent manner. It also decreased motor coordination and modified TS-mediated hypnosis in mice. In addition, EEGO showed anxiolytic potential by increasing the number and time of entries in the open arm of EPM, which is further strengthened by increase in total time spent in the light part of LDB. Therefore, this study suggests the sedative and anxiolytic properties of the leaves of G. oppositifolius and supports the traditional use of this plant in treatment of different psychiatric disorders including insomnia.

  8. Use of Sedatives, Antidepressants and Antipsychotic Medicine among Seventh-day Adventists and Baptists in Denmark

    DEFF Research Database (Denmark)

    Rasmussen, Peter; Johansen, Christoffer; Hvidt, Niels Christian

    2017-01-01

    to less use of prescribed antidepressants, sedatives and antipsychotics by members of these religious societies than by the general population. In a cohort study, we examined records of all drugs redeemed by 3121 SDA and 2888 Baptists and 29,817 age- and gender-matched members of the general population...... between 1995 and 2010 in the Danish Prescription Register and compared the prevalence and incidence of use of antidepressants, sedatives and antipsychotics. The prevalence of antidepressant use by women was lower in 1998 but no different from that in controls in 2003 and 2008; the prevalence...... of antidepressant use by men was higher in both 1998 and 2008 than in the Danish population. The incidence of antidepressant use was lower for female members in 1996–2000, but no difference was observed in the other periods. The prevalence and incidence of use of sedatives and antipsychotics did not consistently...

  9. Association between bystander cardiopulmonary resuscitation and redeemed prescriptions for antidepressants and anxiolytics in out-of-hospital cardiac arrest survivors

    DEFF Research Database (Denmark)

    Bundgaard, Kristian; Hansen, Steen M; Mortensen, Rikke Nørmark

    2017-01-01

    AIM: This study aimed to examine rates of redeemed prescriptions of antidepressants and anxiolytics, used as markers for cerebral dysfunction in out-of-hospital cardiac arrest (OHCA) survivors, and examine the association between bystander CPR and these psychoactive drugs. METHODS: We included all......,001 30-day survivors, 174 (8.6% died and 12.0% redeemed a first prescription for an antidepressant and 8.2% for an anxiolytic drug within one year after arrest. The corresponding frequencies for redeemed prescribed drugs among age- and sex-matched population controls were 7.5% and 5.2%, respectively...

  10. Antidepressant- and anxiolytic-like activities of an oil extract of propolis in rats.

    Science.gov (United States)

    Reis, Julia S S; Oliveira, Gedeão B; Monteiro, Marta C; Machado, Christiane S; Torres, Yohandra R; Prediger, Rui D; Maia, Cristiane S F

    2014-09-25

    Propolis biological effects are mainly attributed to its polyphenolic constituents such as flavonoids and phenolic acids that were recently described in the chemical composition of an extract of propolis obtained with edible vegetal oil (OEP) by our group. The aim of this study was to evaluate the effect of OEP on the behavior of rats. An in vivo open field (OF), elevated Plus-maze (EPM), and forced swimming (FS) tests were performed to evaluate locomotor activity, anxiolytic- and antidepressant effects of the extract. Besides, oxidative stress levels were measured in rat blood samples after the behavioral assays by evaluation of the Trolox equivalent antioxidant capacity (TEAC) and nitric oxide levels. OEP increased locomotion in the OF test (50mg/kg) and central locomotion and open arm entries in the OF and EPM tests (10-50mg/kg) and decreased the immobility time in the FS test (10-50mg/kg). Moreover, OEP reduced nitric oxide levels in response to swim stress induced in rats. OEP exerted stimulant, anxiolytic and antidepressant effects on the Central Nervous System and antioxidant activity in rats, highlighting propolis as a potential therapeutic compound for behavior impairment of anxiety and depression. Copyright © 2014 Elsevier GmbH. All rights reserved.

  11. [Evolution of the use of antidepressants, anxiolytics and hypnotics in Valencia. Period 2000-2010].

    Science.gov (United States)

    Sempere Verdú, Ermengol; Salazar Fraile, José; Palop Larrea, Vicente; Vicens Caldentey, Caterina

    2014-10-01

    To describe the evolution in the use of antidepressants (AD), anxiolytics (A) and hypnotics (H) in the Comunitat Valenciana (CV) between 2000 and 2010, their expenditure, and the cost of the defined daily dose (DDD). Retrospective observational study. Prescriptions covered by the health public service of the CV during the period 2000-2010. Consumption of the therapeutic groups N06A (antidepressants), N05B (anxiolytics) and N05C (hypnotics) from the pharmacy database of the public Valencian Health Agency measured in defined daily dose per 1.000 inhabitants. During the period of study the use of AD increased by 81.2% and A and H, 11.7%. Selective serotonin reuptake inhibitors were the most prescribed AD and Selective serotonin and norepinephrine reuptake inhibitors experienced the higher rise (386.8%). The increase of escitalopram was 1.013%. Lorazepam, alprazolam and diazepam, accounted for the 80.4% of the anxyolitics, and lormetazepam and zolpidem the 88.7% of the hypnotics. The expenditure rise of AD was by 78.2% and that of the A and H was 14.5%; the cost of the DDD of both decreased by 29%. Antidepressant utilization has experienced a remarkable rise between 2000 and 2010 while that of A and H has been mild even though they are still more consumed than AD. In spite of the reduction of the DDD cost in both therapeutic groups, the whole expenditure on AD in the CV is still growing. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  12. Parent Report of Antidepressant, Anxiolytic, and Antipsychotic Medication Use in Individuals with Williams Syndrome: Effectiveness and Adverse Effects

    Science.gov (United States)

    Martens, Marilee A.; Seyfer, Daisha L.; Andridge, Rebecca R.; Foster, Jessica E. A.; Chowdhury, Monali; McClure, Kelsey E.; Coury, Daniel L.

    2012-01-01

    Williams syndrome (WS) is a neurodevelopmental genetic disorder characterized in part by anxiety and behavioral difficulties. We examine the effectiveness and adverse effects of antidepressant, anxiolytic, and antipsychotic medications in individuals with WS. A total of 513 parents/caregivers completed a survey of psychotropic medication usage…

  13. Fluorinated Cannabidiol Derivatives: Enhancement of Activity in Mice Models Predictive of Anxiolytic, Antidepressant and Antipsychotic Effects.

    Science.gov (United States)

    Breuer, Aviva; Haj, Christeene G; Fogaça, Manoela V; Gomes, Felipe V; Silva, Nicole Rodrigues; Pedrazzi, João Francisco; Del Bel, Elaine A; Hallak, Jaime C; Crippa, José A; Zuardi, Antonio W; Mechoulam, Raphael; Guimarães, Francisco S

    2016-01-01

    Cannabidiol (CBD) is a major Cannabis sativa constituent, which does not cause the typical marijuana psychoactivity. However, it has been shown to be active in a numerous pharmacological assays, including mice tests for anxiety, obsessive-compulsive disorder, depression and schizophrenia. In human trials the doses of CBD needed to achieve effects in anxiety and schizophrenia are high. We report now the synthesis of 3 fluorinated CBD derivatives, one of which, 4'-F-CBD (HUF-101) (1), is considerably more potent than CBD in behavioral assays in mice predictive of anxiolytic, antidepressant, antipsychotic and anti-compulsive activity. Similar to CBD, the anti-compulsive effects of HUF-101 depend on cannabinoid receptors.

  14. Fluorinated Cannabidiol Derivatives: Enhancement of Activity in Mice Models Predictive of Anxiolytic, Antidepressant and Antipsychotic Effects.

    Directory of Open Access Journals (Sweden)

    Aviva Breuer

    Full Text Available Cannabidiol (CBD is a major Cannabis sativa constituent, which does not cause the typical marijuana psychoactivity. However, it has been shown to be active in a numerous pharmacological assays, including mice tests for anxiety, obsessive-compulsive disorder, depression and schizophrenia. In human trials the doses of CBD needed to achieve effects in anxiety and schizophrenia are high. We report now the synthesis of 3 fluorinated CBD derivatives, one of which, 4'-F-CBD (HUF-101 (1, is considerably more potent than CBD in behavioral assays in mice predictive of anxiolytic, antidepressant, antipsychotic and anti-compulsive activity. Similar to CBD, the anti-compulsive effects of HUF-101 depend on cannabinoid receptors.

  15. S 47445 Produces Antidepressant- and Anxiolytic-Like Effects through Neurogenesis Dependent and Independent Mechanisms

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    Indira Mendez-David

    2017-07-01

    Full Text Available Glutamatergic dysfunctions are observed in the pathophysiology of depression. The glutamatergic synapse as well as the AMPA receptor’s (AMPAR activation may represent new potential targets for therapeutic intervention in the context of major depressive disorders. S 47445 is a novel AMPARs positive allosteric modulator (AMPA-PAM possessing procognitive, neurotrophic properties and enhancing synaptic plasticity. Here, we investigated the antidepressant/anxiolytic-like effects of S 47445 in a mouse model of anxiety/depression based on chronic corticosterone administration (CORT and in the Chronic Mild Stress (CMS model in rats. Four doses of S 47445 (0.3 to 10 mg/kg, oral route, 4 and 5 weeks, respectively were assessed in both models. In mouse, behavioral effects were tested in various anxiety-and depression-related behaviors : the elevated plus maze (EPM, open field (OF, splash test (ST, forced swim test (FST, tail suspension test (TST, fur coat state and novelty suppressed feeding (NSF as well as on hippocampal neurogenesis and dendritic arborization in comparison to chronic fluoxetine treatment (18 mg/kg, p.o.. In rats, behavioral effects of S 47445 were monitored using sucrose consumption and compared to those of imipramine or venlafaxine (10 mg/kg, i.p. during the whole treatment period and after withdrawal of treatments. In a mouse model of genetic ablation of hippocampal neurogenesis (GFAP-Tk model, neurogenesis dependent/independent effects of chronic S 47445 treatment were tested, as well as BDNF hippocampal expression. S 47445 reversed CORT-induced depressive-like state by increasing grooming duration and reversing coat state’s deterioration. S 47445 also decreased the immobility duration in TST and FST. The highest doses (3 and 10 mg/kg seem the most effective for antidepressant-like activity in CORT mice. Furthermore, S 47445 significantly reversed the anxiety phenotype observed in OF (at 1 mg/kg and EPM (from 1 mg/kg. In the CMS

  16. Antidepressant- and Anxiolytic-Like Effects of New Dual 5-HT₁A and 5-HT₇ Antagonists in Animal Models.

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    Karolina Pytka

    Full Text Available The aim of this study was to further characterize pharmacological properties of two phenylpiperazine derivatives: 1-{2-[2-(2,6-dimethlphenoxyethoxy]ethyl}-4-(2-methoxyphenylpiperazynine hydrochloride (HBK-14 and 2-[2-(2-chloro-6-methylphenoxyethoxy]ethyl-4-(2- methoxyphenylpiperazynine dihydrochloride (HBK-15 in radioligand binding and functional in vitro assays as well as in vivo models. Antidepressant-like properties were investigated in the forced swim test (FST in mice and rats. Anxiolytic-like activity was evaluated in the four-plate test in mice and elevated plus maze test (EPM in rats. Imipramine and escitalopram were used as reference drugs in the FST, and diazepam was used as a standard anxiolytic drug in animal models of anxiety. Our results indicate that HBK-14 and HBK-15 possess high or moderate affinity for serotonergic 5-HT2, adrenergic α1, and dopaminergic D2 receptors as well as being full 5-HT1A and 5-HT7 receptor antagonists. We also present their potent antidepressant-like activity (HBK-14-FST mice: 2.5 and 5 mg/kg; FST rats: 5 mg/kg and (HBK-15-FST mice: 1.25, 2.5 and 5 mg/kg; FST rats: 1.25 and 2.5 mg/kg. We show that HBK-14 (four-plate test: 2.5 and 5 mg/kg; EPM: 2.5 mg/kg and HBK-15 (four-plate test: 2.5 and 5 mg/kg; EPM: 5 mg/kg possess anxiolytic-like properties. Among the two, HBK-15 has stronger antidepressant-like properties, and HBK-14 displays greater anxiolytic-like activity. Lastly, we demonstrate the involvement of serotonergic system, particularly 5-HT1A receptor, in the antidepressant- and anxiolytic-like actions of investigated compounds.

  17. Antidepressant and anxiolytic activity of Lavandula officinalis aerial parts hydroalcoholic extract in scopolamine-treated rats.

    Science.gov (United States)

    Rahmati, Batool; Kiasalari, Zahra; Roghani, Mehrdad; Khalili, Mohsen; Ansari, Fariba

    2017-12-01

    Anxiety and depression are common in Alzheimer's disease (AD). Despite some evidence, it is difficult to confirm Lavandula officinalis Chaix ex Vill (Lamiaceae) as an anxiolytic and antidepressant drug. The effects of L. officinalis extract were studied in scopolamine-induced memory impairment, anxiety and depression-like behaviour. Male NMRI rats were divided into control, scopolamine alone-treated group received scopolamine (0.1 mg/kg) intraperitoneally (i.p.), daily and 30 min prior to performing behavioural testing on test day, for 12 continuous days and extract pretreated groups received aerial parts hydro alcoholic extract (i.p.) (100, 200 and 400 mg/kg), 30 min before each scopolamine injection. Memory impairment was assessed by Y-maze task, while, elevated plus maze and forced swimming test were used to measure anxiolytic and antidepressive-like activity. Spontaneous alternation percentage in Y maze is reduced by scopolamine (36.42 ± 2.60) (p ≤ 0.001), whereas lavender (200 and 400 mg/kg) enhanced it (83.12 ± 5.20 and 95 ± 11.08, respectively) (p ≤ 0.05). Also, lavender pretreatment in 200 and 400 mg/kg enhanced time spent on the open arms (15.4 ± 3.37 and 32.1 ± 3.46, respectively) (p ≤ 0.001). On the contrary, while immobility time was enhanced by scopolamine (296 ± 4.70), 100, 200 and 400 mg/kg lavender reduced it (193.88 ± 22.42, 73.3 ± 8.25 and 35.2 ± 4.22, respectively) in a dose-dependent manner (p ≤ 0.001). Lavender extracts improved scopolamine-induced memory impairment and also reduced anxiety and depression-like behaviour in a dose-dependent manner.

  18. Evaluation of the analgesic, sedative-anxiolytic, cytotoxic and thrombolytic potentials of the different extracts of Kalanchoe pinnata leaves

    Directory of Open Access Journals (Sweden)

    Md. Razibul Habib

    2015-12-01

    Full Text Available Objective: To evaluate the analgesic, neuropharmacological, cytotoxic and thrombolytic potentials of the aqueous, ethanol and ethyl acetate extracts of Kalanchoe pinnata leaves. Methods: At the dose of 400 mg/kg body weight, the analgesic activity of the extracts were evaluated by the acetic acid-induced writhing and formalin-induced persistent pain tests while neuropharmacological activity was evaluated by the open field, hole cross and elevated plus maze tests. The cytotoxic potential was observed by brine shrimp lethality bioassay and the thrombolytic potential was investigated by clot lysis test. Results: The aqueous extract significantly suppressed the number of writhing (96.78% as well as the formalin-induced persistent pain on the early phase (46.92% and on the late phase (40.98%. Again in case of hole cross and open field tests, the locomotor activity was decreased significantly (P < 0.001 mostly by the ethyl acetate extract. Furthermore, the sedative-anxiolytic activity was supported by the increased percent (P < 0.01 of frequency into the open arm on elevated plus maze test. Besides, the extracts showed moderate lethality and thrombolytic activity. Conclusions: The findings showed that activities are comparable to the standards and in some cases are stronger than the standards. Therefore, based on the results, it is evident that it has great analgesic and sedative-anxiolytic activity with moderate cytotoxic and thrombolytic potential.

  19. Antidepressant, anxiolytic and anti-nociceptive activities of ethanol extract of Steudnera colocasiifolia K. Koch leaves in mice model

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    Mohammad Shah Hafez Kabir

    2015-11-01

    Full Text Available Objective: To estimate the antidepressant, anxiolytic and antinociceptive activities of ethanol extract of Steudnera colocasiifolia K. Koch (S. colocasiifolia leaves. Methods: Swiss albino mice treated with 1% Tween solution, standard drugs and ethanol extract of S. colocasiifolia, respectively, were subjected to the neurological and antinociceptive investigations. The tail suspension test and forced swimming test were used for testing antidepressant activity, where the parameter is the measurement of immobility time. Anxiolytic activity was evaluated by hole board model. Anti-nociceptive potential of the extract was also screened for centrally acting analgesic activity by using formalin induced licking response model and acetic acid induced writhing test was used for testing peripheral analgesic action. Results: Ethanol extract of S. colocasiifolia significantly decreased the period of immobility in both tested models (tail suspension and forced swimming models of antidepressant activity. In the hole board model, there was a dose dependant (at 100 and 200 mg/kg and a significant increase in the number of head dipping by comparing with control (1% Tween solution (P < 0.05 and P < 0.001. In formalin induced licking model, a significant inhibition of pain compared to standard diclofenac sodium was observed (P < 0.05 and P < 0.001. In acetic acid induced test, there was a significant reduction of writhing response and pain in mice treated with leaves extract of S. colocasiifolia at 200 mg/kg body weight (P < 0.05 and P < 0.001. Conclusions: The results proofed the prospective antidepressant, anxiolytic and antinociceptive activities of ethanol extract of S. colocasiifolia leaves.

  20. Role for monoaminergic systems in the antidepressant and anxiolytic properties of the hydroethanolic leaf extract from Adenia cissampeloides.

    Science.gov (United States)

    Ishola, Ismail O; Olayemi, Sunday O; Yemitan, Omoniyi K; Akinseye, Kolawole

    2015-05-01

    Adenia cissampeloides (Planch ex. Hook) Harms (Passifloraceae) leaf infusion is used in traditional African medicine as a stimulant to treat depression and insanity. Thus, this study investigates antidepressant and anxiolytic activities of the hydroethanol leaf extract of Adenia cissampeloides (ACE) in mice. ACE (50-200 mg/kg, p.o.) was administered to mice 1 h before behavioral studies; the forced swimming test (FST), tail suspension test (TST), elevated-plus maze test (EPM) hole-board test (HBT) and open field test (OFT). In addition, the probable mechanisms of antidepressant- and anxiolytic-like actions of ACE were also investigated. ACE (100 and 200 mg/kg) produced significant (p<0.01) reduction in immobility, along with a significant increase in swimming activity (75.20%) and climbing (190.00%), respectively, similar to anti-immobility effect of imipramine in the FST. Also, in TST, ACE (100 and 200 mg/kg) treatment significantly (p<0.01) reduced the immobility time by 35.60%, and 35.27%, respectively, which was similar to anti-immobility effect of fluoxetine (32.50%). However, the antidepressant-like effect produced by ACE was prevented (p<0.01) by yohimbine (α2-adrenoceptor antagonist), or sulpiride (dopamine D2 receptor antagonist) pretreatment. ACE (50 and 100 mg/kg) treatment (p<0.01) increased number (41.67%) and duration of head-dips (52.27%) in HBT. Similarly, ACE (50-200 mg/kg) increased duration of open arm entries (p<0.001) in EPM. However, this effect was reversed (p<0.001) by pretreatment of mice with cyproheptadine (5-HT2 receptor antagonist) (60.87%). Findings from these studies revealed antidepressant-like effect of ACE mediated through interaction with dopamine D2- receptor or α2-adrenoceptor. Also an anxiolytic-like effect through interaction with 5-HT2 receptors.

  1. Anti-depressant and anxiolytic potential of Acacia hydaspica R. Parker aerial parts extract: Modulation of brain antioxidant enzyme status.

    Science.gov (United States)

    Afsar, Tayyaba; Razak, Suhail; Khan, Muhammad Rashid; Almajwal, Ali

    2017-04-24

    Oxidative stress may link to psychiatric disorders, and is being regarded as a plausible mechanism that can affect the regulation of these illnesses. The present study was undertaken to investigate the antidepressant and anxiolytic potential of A. hydaspica R. parkers. Brain oxidative stress enzyme levels were analyzed to correlate depression and stress with brain antioxidant status. Antidepressant and anxiolytic effect of methanol extract of A. hydaspica and its derived soluble fractions [n-hexane (AHH), ethyl-acetate (AHE), chloroform (AHC), n-butanol (AHB) and remaining aqueous fraction (AHA)] was investigated by using three behavioral models; the Forced swimming test, Tail suspension test and Elevated plus-maze test (EPM). Chronic unpredictable mild stress (CMS) was employed to induce stress in rats. AHM and AHE (200 mg/kg, p.o), fluoxetine (5 mg/kg, i.p) and diazepam (DZM) (1 mg/kg, p.o) were administered during the 7 day stress exposure period, and rats were assessed for antidepressant and anxiolytic behavioral despair paradigms. Antioxidant enzymes and oxidative stress markers were measured in brain tissue of depressed rats. Phytochemical analysis was done by GCMS experimentation. AHM and AHE (acute dose) significantly (p < 0.0001) reduced the immobility time and ameliorated climbing behavior as compared to the control in FST and TST, and similar to fluoxetine. AHM and AHE showed significant (p < 0.0001) anxiolytic potential in EPM, and comparable to DZM (1 mg/kg b.w., i.p). Significant decrease in antioxidant enzyme levels and increase in MDA, H 2 O 2 and NO level were observed in stressed rats. AHM and AHE (for 7 days/CMS) significantly improved behavior in FST, TST and EPMT. Treatment also improved antioxidant enzyme level and controlled the oxidative stress markers in brain tissues. GCMS analysis indicated the presence of 10 different chemical constituents in A. hydaspica. The present study revealed that A. hydaspica exerts an antidepressant

  2. The antidepressant- and anxiolytic-like effects following co-treatment with escitalopram and risperidone in rats.

    Science.gov (United States)

    Kaminska, K; Rogoz, Z

    2016-06-01

    Several clinical reports have documented a beneficial effect of the addition of a low dose of risperidone to the ongoing treatment with antidepressants, in particular selective serotonin reuptake inhibitors (SSRI), in the treatment of drug-resistant depression and treatment-resistant anxiety disorders. In the present study, we investigated the effect of treatment with the antidepressant escitalopram (SSRI) given separately or jointly with a low dose of risperidone (an atypical antipsychotic) in the forced swim test and in the elevated plus-maze test in rats. The obtained results showed that escitalopram at doses of 2.5 or 5 mg/kg evoked antidepressant-like effect in the forced swim test. Moreover, risperidone at low doses (0.05 or 0.1 mg/kg) enhanced the antidepressant-like activity of escitalopram (1 mg/kg) in this test by increasing the swimming time and decreasing the immobility time in those animals. WAY 100635 (a serotonin 5-HT1A receptor antagonist) at a dose of 0.1 mg/kg abolished the antidepressant-like effect induced by co-administration of escitalopram and risperidone. The active behavior in that test did not reflect an increase in general activity, since the combined treatment with escitalopram and risperidone failed to enhance the exploratory activity of rats. In the following experiment, we showed that escitalopram (5 mg/kg) and mirtazapine (5 or 10 mg/kg) or risperidone (0.1 mg/kg) induced an anxiolytic-like effect in the elevated plus-maze test, and the combined treatment with an ineffective dose of risperidone (0.05 mg/kg) enhanced the anxiolytic-like effects of escitalopram (2.5 mg/kg) or mirtazapine (1 and 2.5 mg/kg) in this test. The obtained results suggest that risperidone applied at a low dose enhances the antidepressant-like activity of escitalopram in the forced swim test, and that 5-HT1A receptors may play some role in these effects. Moreover, a low dose of risperidone may also enhance the anxiolytic-like action of the studied

  3. Milk Collected at Night Induces Sedative and Anxiolytic-Like Effects and Augments Pentobarbital-Induced Sleeping Behavior in Mice.

    Science.gov (United States)

    dela Peña, Irene Joy I; Hong, Eunyoung; de la Peña, June Bryan; Kim, Hee Jin; Botanas, Chrislean Jun; Hong, Ye Seul; Hwang, Ye Seul; Moon, Byoung Seok; Cheong, Jae Hoon

    2015-11-01

    Milk has long been known and used to promote sleep. The sleep-promoting effect of milk has been attributed to its psychological associations (i.e., the memory of a mother giving milk at bedtime) and its rich store of sleep-promoting constituents (e.g., tryptophan). Studies have shown that milk harvested at night (Night milk) contains exceptionally high amounts of tryptophan and melatonin. In the present study, we evaluated the psychopharmacological properties of Night milk, particularly its probable sleep-promoting/enhancing, and anxiolytic effects. Night milk was orally administered to ICR mice at various concentrations (100, 200, or 300 mg/kg). An hour after administration, assessment of its sedative (open-field and rotarod tests) and sedative sleep-potentiating effects (pentobarbital-induced sleeping test) was conducted. For comparison, the effects of Day milk (daytime milking) were also assessed. In addition, the effects of Night milk on anxiety behavior (elevated plus maze [EPM] test) and electroencephalographic (EEG) waves were evaluated. Night milk-treated animals exhibited decreased spontaneous locomotion (open-field test) and impaired motor balance and coordination (rotarod test). Furthermore, Night milk shortened the sleep onset and prolonged the sleep duration induced by pentobarbital sodium. These effects were comparable to that of diazepam. In addition, Night milk significantly increased the percentage of time spent and entries into the open arms of the EPM, indicating that it also has anxiolytic effects. No significant changes in EEG waves were observed. Altogether, these findings suggest that Night milk is a promising natural aid for sleep- and anxiety-related disturbances.

  4. Mexican medicinal plants with anxiolytic or antidepressant activity: Focus on preclinical research.

    Science.gov (United States)

    López-Rubalcava, Carolina; Estrada-Camarena, Erika

    2016-06-20

    of the mechanism of action is inconclusive. The need for systematic studies in preclinical and clinical research is evident, and efforts should be done to fulfill these research. Finally, it is important also to study possible drug-herbal interactions to establish specific recommendations for people that use these plants as anxiolytic or antidepressant treatments either alone or in combination with another type of medicine. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. GABA-A Receptor Modulation and Anticonvulsant, Anxiolytic, and Antidepressant Activities of Constituents from Artemisia indica Linn

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    Imran Khan

    2016-01-01

    Full Text Available Artemisia indica, also known as “Mugwort,” has been widely used in traditional medicines. However, few studies have investigated the effects of nonvolatile components of Artemisia indica on central nervous system’s function. Fractionation of Artemisia indica led to the isolation of carnosol, ursolic acid, and oleanolic acid which were evaluated for their effects on GABA-A receptors in electrophysiological studies in Xenopus oocytes and were subsequently investigated in mouse models of acute toxicity, convulsions (pentylenetetrazole induced seizures, depression (tail suspension and forced swim tests, and anxiety (elevated plus maze and light/dark box paradigms. Carnosol, ursolic acid, and oleanolic acid were found to be positive modulators of α1β2γ2L GABA-A receptors and the modulation was antagonized by flumazenil. Carnosol, ursolic acid, and oleanolic acid were found to be devoid of any signs of acute toxicity (50–200 mg/kg but elicited anticonvulsant, antidepressant, and anxiolytic activities. Thus carnosol, ursolic acid, and oleanolic acid demonstrated CNS activity in mouse models of anticonvulsant, antidepressant, and anxiolysis. The anxiolytic activity of all three compounds was ameliorated by flumazenil suggesting a mode of action via the benzodiazepine binding site of GABA-A receptors.

  6. Antidepressant and anxiolytic properties of the methanolic extract of Momordica charantia Linn (Cucurbitaceae) and its mechanism of action.

    Science.gov (United States)

    Ishola, I O; Akinyede, A A; Sholarin, A M

    2014-07-01

    The whole plant of Momordica charantia Linn (Cucurbitaceae) is used in traditional African medicine in the management of depressive illness. Momordica charantia (MC) (50-400 mg/kg, p.o.) was administered 1 h before behavioural studies using the forced swimming test (FST) and tail suspension test (TST) to investigate antidepressant-like effect while the anxiolytic-like effect was evaluated with elevated plus maze test (EPM), hole-board test (HBT), and light-dark test (LDT). Acute treatment with MC (50-400 mg/kg) significantly increased swimming time (86.51%) and reduced the duration of immobility (52.35%) in FST and TST with peak effects observed at 200 mg/kg, respectively, in comparison to control. The pretreatment of mice with either sulpiride (dopamine D2 receptor antagonist), or metergoline (5-HT2 receptor antagonist), or cyproheptadine (5-HT2 receptor antagonist), or prazosin (α1-adrenoceptor antagonist), or yohimbine (α2-adrenoceptor antagonist), and atropine (muscarinic cholinergic receptor antagonist) 15 min before oral administration of MC (200 mg/kg) significantly blocked its anti-immobility effect. Similarly, MC (200 mg/kg) significantly reduced anxiety by increasing the open arm exploration (64.27%) in EPM, number of head-dips in HBT (34.38%), and time spent in light compartment (29.38%) in the LDT. However, pretreatment with flumazenil (GABAA receptor antagonist) 15 min before MC (200 mg/kg) significantly blocked (54.76%) its anxiolytic effect. The findings in this study showed that MC possesses antidepressant-like effect that is dependent on the serotonergic (5-HT2 receptor), noradrenergic (α1- and α2-adrenoceptors), dopaminergic (D2 receptor), and muscarinic cholinergic systems and an anxiolytic-like effect that might involve an action on benzodiazepine-type receptor. © Georg Thieme Verlag KG Stuttgart · New York.

  7. The sedating antidepressant trazodone impairs sleep-dependent cortical plasticity.

    Directory of Open Access Journals (Sweden)

    Sara J Aton

    2009-07-01

    Full Text Available Recent findings indicate that certain classes of hypnotics that target GABA(A receptors impair sleep-dependent brain plasticity. However, the effects of hypnotics acting at monoamine receptors (e.g., the antidepressant trazodone on this process are unknown. We therefore assessed the effects of commonly-prescribed medications for the treatment of insomnia (trazodone and the non-benzodiazepine GABA(A receptor agonists zaleplon and eszopiclone in a canonical model of sleep-dependent, in vivo synaptic plasticity in the primary visual cortex (V1 known as ocular dominance plasticity.After a 6-h baseline period of sleep/wake polysomnographic recording, cats underwent 6 h of continuous waking combined with monocular deprivation (MD to trigger synaptic remodeling. Cats subsequently received an i.p. injection of either vehicle, trazodone (10 mg/kg, zaleplon (10 mg/kg, or eszopiclone (1-10 mg/kg, and were allowed an 8-h period of post-MD sleep before ocular dominance plasticity was assessed. We found that while zaleplon and eszopiclone had profound effects on sleeping cortical electroencephalographic (EEG activity, only trazodone (which did not alter EEG activity significantly impaired sleep-dependent consolidation of ocular dominance plasticity. This was associated with deficits in both the normal depression of V1 neuronal responses to deprived-eye stimulation, and potentiation of responses to non-deprived eye stimulation, which accompany ocular dominance plasticity.Taken together, our data suggest that the monoamine receptors targeted by trazodone play an important role in sleep-dependent consolidation of synaptic plasticity. They also demonstrate that changes in sleep architecture are not necessarily reliable predictors of how hypnotics affect sleep-dependent neural functions.

  8. Antidepressant & anxiolytic activities of N-(pyridin-3-yl quinoxalin-2-carboxamide: A novel serotonin type 3 receptor antagonist in behavioural animal models

    Directory of Open Access Journals (Sweden)

    Dilip Kumar Pandey

    2016-01-01

    Interpretation & conclusions: The present findings indicate the potential antidepressant-like and anxiolytic-like effects of QCF-21 at low doses in rodent behavioural models of depression and anxiety. Further studies need to be done to understand the underlying mechanism.

  9. The use of antidepressants, anxiolytics, and hypnotics in people with type 2 diabetes and patterns associated with use: the hoorn diabetes care system cohort.

    NARCIS (Netherlands)

    Mast, R.; Rauh, S.P.; Groeneveld, L.; Koopman, A.D.; Beulens, J.W.J.; Jansen, A.P.D.; Bremmer, M.; Heijden, A.A.W.A. van der; Elders, P.J.M.; Dekker, J.M.; Nijpels, G.; Hugtenburg, J.G.; Rutters, F.

    2017-01-01

    Objective <\\strong> With depression being present in approximately 20% of people with type 2 diabetes mellitus (T2DM), we expect equally frequent prescription of antidepressants, anxiolytics, and hypnotics. Nevertheless, prescription data in people with T2DM is missing and the effect of

  10. Study of sedative preanaesthetic and anxiolytic effects of herbal extract of Tilia platyphyllos scop in comparison with diazepam in the rat

    Directory of Open Access Journals (Sweden)

    A Rezaie

    2011-05-01

    Full Text Available Tilia platyphyllos scop belongs to the Tiliaceae family and mainly grows in northern parts of the country. It has various pharmacological effects including anxiolytic, antibacterial, anticonvulsant, spasmolytic, tranquilization and sedation, hypnotic and muscular relaxation. In order to study sedative, preanaesthetic and anxiolytic effects herbal extract of Tiliaplatyphyllos scop in comparison with diazepam in different groups of female Wistar rats with the same age and weight, doses of 150 mg/kg, 300 mg/kg and  450 mg/kg of herbal extract, 1.2 mg/kg of diazepam and equal volumes of dimethyl sulfoxide as a placebo were injected to rats intraperitoneally 30 minutes prior to evaluation of sedative and preanaesthetic effects (induced sleep duration following 40 mg/kg administration intraperitoneally and anxiolytic effects (using elevated plus maze and Rotarod test. Statistical results obtained represent a significant increase in sleep time induced with ketamine and also a significant increase in time spent by rats in open arms of maze with high and low doses of Tiliaplatyphyllos scop herbal extract (p

  11. Comparative Study of Sedative and Anxiolytic Effects of Herbal Extracts of Hypericum perforatum with Nardostachys jatamansi in Rats

    Directory of Open Access Journals (Sweden)

    Ali Rezaei

    2014-03-01

    Full Text Available Background: Nardostachys and hypericum due to the effects of sedation, anticonvulsant, analgesic and anti-depressants has especial place in traditional medicine. Principal component and the alkaloid extract of valerian and isovalerate, valeric acid and the extract of hypericum is hypersin and hyperforin. Materials and Methods: We conducted this study, valerian rhizome by chloroform: methanol (70:30 was extracted in order to obtain total extract produced the N-hexane and studied chemically have been took by Gc-Ms. Hydro-alcoholic extract of aerial valerian tea was prepared for study. In order to study the comparative effects of soothing extracts of valerian and hypericum in different groups of female rat extract of valerian with doses of 100 mg/kg, 200 mg/kg, 400 mg/kg, and extracts of hypericum with a dose of 250 mg/kg, 500 mg/kg and DMSO (control with the same volume of 15 minutes prior to the assessment of sedative and sleep (sleep duration induced with ketamine dose and 40 mg/kg were injected intraperitoneally. Results: The results indicate a significant increase in sleep time induced by ketamine in the treatment groups with high and low doses of valerian extracts and the hypericum is significant at the 0.01 level. Conclusion: The results show that the extract of valerian in the dose of 200 mg/kg in compress of dose of hypericum 500 mg/kg contains the significant anesthetic effects.

  12. Involvement of monoaminergic systems in anxiolytic and antidepressive activities of the standardized extract of Cocos nucifera L.

    Science.gov (United States)

    Lima, Eliane Brito Cortez; de Sousa, Caren Nádia Soares; Meneses, Lucas Nascimento; E Silva Pereira, Yuri Freitas; Matos, Natália Castelo Branco; de Freitas, Rayanne Brito; Lima, Nycole Brito Cortez; Patrocínio, Manoel Cláudio Azevedo; Leal, Luzia Kalyne Almeida Moreira; Viana, Glauce Socorro Barros; Vasconcelos, Silvânia Maria Mendes

    2017-01-01

    Extracts from the husk fiber of Cocos nucifera are used in folk medicine, but their actions on the central nervous system have not been studied. Here, the anxiolytic and antidepressant effects of the standardized hydroalcoholic extract of C. nucifera husk fiber (HECN) were evaluated. Male Swiss mice were treated with HECN (50, 100, or 200 mg/kg) 60 min before experiments involving the plus maze test, hole-board test, tail suspension test, and forced swimming test (FST). HECN was administered orally (p.o.) in acute and repeated-dose treatments. The forced swimming test was performed with dopaminergic and noradrenergic antagonists, as well as a serotonin release inhibitor. Administration of HECN in the FST after intraperitoneal (i.p.) pretreatment of mice with sulpiride (50 mg/kg), prazosin (1 mg/kg), or p-chlorophenylalanine (PCPA, 100 mg/kg) caused the actions of these three agents to be reversed. However, this effect was not observed after pretreating the animals with SCH23390 (15 µg/kg, i.p.) or yohimbine (1 mg/kg, i.p.) The dose chosen for HECN was 100 mg/kg, p.o., which increased the number of entries as well as the permanence in the open arms of the maze after acute and repeated doses. In both the forced swimming and the tail suspension tests, the same dose decreased the time spent immobile but did not disturb locomotor activity in an open-field test. The anxiolytic effect of HECN appears to be related to the GABAergic system, while its antidepressant effect depends upon its interaction with the serotoninergic, noradrenergic (α1 receptors), and dopaminergic (D2 dopamine receptors) systems.

  13. Investigation of antidepressant-like and anxiolytic-like actions and cognitive and motor side effects of four N-methyl-D-aspartate receptor antagonists in mice

    DEFF Research Database (Denmark)

    Refsgaard, Louise Konradsen; Pickering, Darryl S; Andreasen T., Jesper

    2017-01-01

    antagonists. MK-801, ketamine, S-ketamine, RO 25-6981 and the positive control, citalopram, were tested for antidepressant-like and anxiolytic-like effects in mice using the forced-swim test, the elevated zero maze and the novelty-induced hypophagia test. Side effects were assessed using a locomotor activity...... test, the modified Y-maze and the rotarod test. All compounds increased swim distance in the forced-swim test. In the elevated zero maze, the GluN2B subtype-selective RO 25-6981 affected none of the measured parameters, whereas all other compounds showed anxiolytic-like effects. In the novelty...

  14. Evaluation of Anticonvulsant, Antidepressant-, and Anxiolytic-like Effects of an Aqueous Extract from Cultured Mycelia of the Lingzhi or Reishi Medicinal Mushroom Ganoderma lucidum (Higher Basidiomycetes) in Mice.

    Science.gov (United States)

    Socala, Katarzyna; Nieoczym, Dorota; Grzywnowicz, Krzysztof; Stefaniuk, Dawid; Wlaz, Piotr

    2015-01-01

    Ganoderma lucidum is a well-known medicinal mushroom with a long history of use. This study was designed to assess the anticonvulsant potential of an aqueous extract from cultured G. lucidum mycelium in 3 acute seizure models: timed intravenous pentylenetetrazole infusion, maximal electroshock seizure threshold, and 6-Hz-induced psychomotor seizure tests in mice. Moreover, antidepressant-like and anxiolytic-like effects of G. lucidum were evaluated using the forced swim test and the elevated plus maze test in mice, respectively. No changes in seizure thresholds in the intravenous pentylenetetrazole and maximal electroshock seizure threshold tests after acute treatment with G. lucidum extract (200-600 mg/kg) was observed. However, the studied extract (100-400 mg/kg) significantly increased the threshold for psychomotor seizures in the 6-Hz seizure test. In the forced swim test, G. lucidum (100-400 mg/kg) significantly reduced the duration of immobility. No anxiolytic-like or sedative effects were reported in mice pretreated with the extract (400-600 mg/kg). G. lucidum extract (50-2400 mg/kg) did not produce toxic effects in the chimney test (motor coordination) or grip-strength test (neuromuscular strength). Further studies are required to explain the neuropharmacological effects of G. lucidum and to identify its active ingredients that may affect seizure threshold, mood, or anxiety.

  15. Inhalation of coriander volatile oil increased anxiolytic-antidepressant-like behaviors and decreased oxidative status in beta-amyloid (1-42) rat model of Alzheimer's disease.

    Science.gov (United States)

    Cioanca, Oana; Hritcu, Lucian; Mihasan, Marius; Trifan, Adriana; Hancianu, Monica

    2014-05-28

    The present study analyzed the possible anxiolytic, antidepressant and antioxidant proprieties of inhaled coriander volatile oil extracted from Coriandrum sativum var. microcarpum in beta-amyloid (1-42) rat model of Alzheimer's disease. The anxiolytic- and antidepressant-like effects of inhaled coriander volatile oil were studied by means of in vivo (elevated plus-maze and forced swimming tests) approaches. Also, the antioxidant activity in the hippocampus was assessed using catalase specific activity and the total content of the reduced glutathione. The beta-amyloid (1-42)-treated rats exhibited the following: decrease of the locomotor activity, the percentage of the time spent and the number of entries in the open arm within elevated plus-maze test and decrease of swimming and immobility times within forced swimming test. Exposure to coriander volatile oil significantly improved these parameters, suggesting anxiolytic- and antidepressant-like effects. Moreover, coriander volatile oil decreased catalase activity and increased glutathione level in the hippocampus. Our results suggest that multiple exposures to coriander volatile oil can be useful as a mean to counteract anxiety, depression and oxidative stress in Alzheimer's disease conditions. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Anti-depressant and anxiolytic like behaviors in PKCI/HINT1 knockout mice associated with elevated plasma corticosterone level

    Directory of Open Access Journals (Sweden)

    Wang Jia

    2009-11-01

    Full Text Available Abstract Background Protein kinase C interacting protein (PKCI/HINT1 is a small protein belonging to the histidine triad (HIT family proteins. Its brain immunoreactivity is located in neurons and neuronal processes. PKCI/HINT1 gene knockout (KO mice display hyper-locomotion in response to D-amphetamine which is considered a positive symptom of schizophrenia in animal models. Postmortem studies identified PKCI/HINT1 as a candidate molecule for schizophrenia and bipolar disorder. We investigated the hypothesis that the PKCI/HINT1 gene may play an important role in regulating mood function in the CNS. We submitted PKCI/HINT1 KO mice and their wild type (WT littermates to behavioral tests used to study anti-depressant, anxiety like behaviors, and goal-oriented behavior. Additionally, as many mood disorders coincide with modifications of hypothalamic-pituitary-adrenal (HPA axis function, we assessed the HPA activity through measurement of plasma corticosterone levels. Results Compared to the WT controls, KO mice exhibited less immobility in the forced swim (FST and the tail suspension (TST tests. Activity in the TST tended to be attenuated by acute treatment with valproate at 300 mg/kg in KO mice. The PKCI/HINT1 KO mice presented less thigmotaxis in the Morris water maze and spent progressively more time in the lit compartment in the light/dark test. In a place navigation task, KO mice exhibited enhanced acquisition and retention. Furthermore, the afternoon basal plasma corticosterone level in PKCI/HINT1 KO mice was significantly higher than in the WT. Conclusion PKCI/HINT1 KO mice displayed a phenotype of behavioral and endocrine features which indicate changes of mood function, including anxiolytic-like and anti-depressant like behaviors, in conjunction with an elevated corticosterone level in plasma. These results suggest that the PKCI/HINT 1 gene could be important for the mood regulation function in the CNS.

  17. Antinociceptive and Anxiolytic and Sedative Effects of Methanol Extract of Anisomeles indica: An Experimental Assessment in Mice and Computer Aided Models

    Directory of Open Access Journals (Sweden)

    Md. Josim Uddin

    2018-04-01

    Full Text Available Anisomeles indica (L. kuntze is widely used in folk medicine against various disorders including allergy, sores, inflammation, and fever. This research investigated the antinociceptive, anxiolytic and sedative effects of A. indica methanol extract. The antinociceptive activity was assessed with the acetic acid-induced writhing test and formalin-induced flicking test while sedative effects with open field and hole cross tests and anxiolytic effects with elevated plus maze (EPM and thiopental-induced sleeping time tests were assayed. Computer aided (pass prediction, docking analyses were undertaken to find out the best-fit phytoconstituent of total 14 isolated compounds of this plant for aforesaid effects. Acetic acid treated mice taking different concentrations of extract (50, 100, and 200 mg/kg, intraperitoneal displayed reduced the writhing number. In the formalin-induced test, extract minimized the paw licking time of mice during the first phase and the second phase significantly. The open field and hole-cross tests were noticed with a dose-dependent reduction of locomotor activity. The EPM test demonstrated an increase of time spent percentage in open arms. Methanol extract potentiated the effect of thiopental-induced hypnosis in lesser extent comparing with Diazepam. The results may account for the use of A. indica as an alternative treatment of antinociception and neuropharmacological abnormalities with further intensive studies. The compound, 3,4-dihydroxybenzoic acid was found to be most effective in computer aided models.

  18. High Resolution UHPLC-MS Metabolomics and Sedative-Anxiolytic Effects of Latua pubiflora: A Mystic Plant used by Mapuche Amerindians.

    Science.gov (United States)

    Sánchez-Montoya, Eliana L; Reyes, Marco A; Pardo, Joel; Nuñez-Alarcón, Juana; Ortiz, José G; Jorge, Juan C; Bórquez, Jorge; Mocan, Andrei; Simirgiotis, Mario J

    2017-01-01

    Latua pubiflora (Griseb) Phil. Is a native shrub of the Solanaceae family that grows freely in southern Chile and is employed among Mapuche aboriginals to induce sedative effects and hallucinations in religious or medicine rituals since prehispanic times. In this work, the pentobarbital-induced sleeping test and the elevated plus maze test were employed to test the behavioral effects of extracts of this plant in mice. The psychopharmacological evaluation of L. pubiflora extracts in mice determined that both alkaloid-enriched as well as the non-alkaloid extracts produced an increase of sleeping time and alteration of motor activity in mice at 150 mg/Kg. The alkaloid extract exhibited anxiolytic effects in the elevated plus maze test, which was counteracted by flumazenil. In addition, the alkaloid extract from L. pubiflora decreased [ 3 H]-flunitrazepam binding on rat cortical membranes. In this study we have identified 18 tropane alkaloids (peaks 1-4, 8-13, 15-18, 21, 23, 24, and 28), 8 phenolic acids and related compounds (peaks 5-7, 14, 19, 20, 22, and 29) and 7 flavonoids (peaks 25-27 and 30-33) in extracts of L. pubiflora by UHPLC-PDA-MS which are responsible for the biological activity. This study assessed for the first time the sedative-anxiolytic effects of L. pubiflora in rats besides the high resolution metabolomics analysis including the finding of pharmacologically important tropane alkaloids and glycosylated flavonoids.

  19. Anxiolytic and antidepressant profile of the methanolic extract of Piper nigrum fruits in beta-amyloid (1-42) rat model of Alzheimer's disease.

    Science.gov (United States)

    Hritcu, Lucian; Noumedem, Jaurès A; Cioanca, Oana; Hancianu, Monica; Postu, Paula; Mihasan, Marius

    2015-03-29

    Piper nigrum L. (Piperaceae) is employed in traditional medicine of many countries as analgesic, antiinflammatory, anticonvulsant, antioxidant, antidepressant and cognitive-enhancing agent. This study was undertaken in order to evaluate the possible anxiolytic, antidepressant and antioxidant properties of the methanolic extract of Piper nigrum fruits in beta-amyloid (1-42) rat model of Alzheimer's disease. The anxiolytic- and antidepressant-like effects of the methanolic extract were studied by means of in vivo (elevated plus-maze and forced swimming tests) approaches. Also, the antioxidant activity in the amygdala was assessed using superoxide dismutase, glutathione peroxidase and catalase specific activities, the total content of the reduced glutathione, protein carbonyl and malondialdehyde levels. Statistical analyses were performed using one-way analysis of variance (ANOVA). Significant differences were determined by Tukey's post hoc test. F values for which p < 0.05 were regarded as statistically significant. Pearson's correlation coefficient and regression analysis were used in order to evaluate the connection between behavioral measures, the antioxidant defence and lipid peroxidation. The beta-amyloid (1-42)-treated rats exhibited the following: decrease of the exploratory activity, the percentage of the time spent and the number of entries in the open arm within elevated plus-maze test and decrease of swimming time and increase of immobility time within forced swimming test. Administration of the methanolic extract significantly exhibited anxiolytic- and antidepressant-like effects and also antioxidant potential. Taken together, our results suggest that the methanolic extract ameliorates beta-amyloid (1-42)-induced anxiety and depression by attenuation of the oxidative stress in the rat amygdala.

  20. Evaluation of anxiolytic and sedative effect of essential oil and hydroalcoholic extract of Ocimum basilicum L. and chemical composition of its essential oil.

    Science.gov (United States)

    Rabbani, Mohammed; Sajjadi, Seyed Ebrahim; Vaezi, Arefeh

    2015-01-01

    Ocimum basilicum belongs to Lamiaceae family and has been used for the treatment of wide range of diseases in traditional medicine in Iranian folk medicine. Due to the progressive need to anti-anxiety medications and because of the similarity between O. basilicum and Salvia officinalis, which has anti-anxiety effects, we decided to investigate the anxiolytic and sedative activity of hydroalcoholic extract and essential oil of O. basilicum in mice by utilizing an elevated plus maze and locomotor activity meter. The chemical composition of the plant essential oil was also determined. The essential oil and hydroalcoholic extract of this plant were administered intraperitoneally to male Syrian mice at various doses (100, 150 and 200 mg/kg of hydroalcoholic extract and 200 mg/kg of essential oil) 30 min before starting the experiment. The amount of hydroalcoholic extract was 18.6% w/w and the essential oil was 0.34% v/w. The major components of the essential oil were methyl chavicol (42.8%), geranial (13.0%), neral (12.2%) and β-caryophyllene (7.2%). HE at 150 and 200 mg/kg and EO at 200 mg/kg significantly increased the time passed in open arms in comparison to control group. This finding was not significant for the dose of 100 mg/kg of the extract. None of the dosages had significant effect on the number of entrance to the open arms. Moreover, both the hydroalcoholic extract and the essential oil decreased the locomotion of mice in comparison to the control group. This study shows the anxiolytic and sedative effect of hydroalcoholic extract and essential oil of O. basilicum. The anti-anxiety and sedative effect of essential oil was higher than the hydroalcoholic extract with the same doses. These effects could be due to the phenol components of O. basilicum.

  1. Sedative antidepressants and insomnia Antidepressivos sedativos e insônia

    Directory of Open Access Journals (Sweden)

    Walter André dos Santos Moraes

    2011-03-01

    Full Text Available OBJECTIVE: The present review addresses the relationship between sleep and depression and how serotonergic transmission is implicated in both conditions. METHOD: Literature searches were performed in the PubMed and MedLine databases up to March 2010. The terms searched were "insomnia", "depression", "sedative antidepressants" and "serotonin". In order to pinpoint the sedative antidepressants most used to treat insomnia, 34 ISI articles, mainly reviews and placebo-controlled clinical trials, were selected from 317 articles found in our primary search. RESULTS: Sleep problems may appear months before the diagnosis of clinical depression and persist after the resolution of depression. Treatment of insomnia symptoms may improve this comorbid disease. Some antidepressant drugs can also result in insomnia or daytime sleepiness. Serotonin (5-HT demonstrates a complex pattern with respect to sleep and wakefulness that is related to the array of 5-HT receptor subtypes involved in different physiological functions. It is now believed that 5HT2 receptor stimulation is subjacent to insomnia and changes in sleep organization related to the use of some antidepressants. CONCLUSION: Some drugs commonly prescribed for the treatment of depression may worsen insomnia and impair full recovery from depression. 5-HT2 receptor antagonists are promising drugs for treatment strategies since they can improve comorbid insomnia and depression.OBJETIVO: Esta atualização aborda a relação entre sono e depressão e como a transmissão serotoninérgica está envolvida em ambas condições. MÉTODO: Foi realizada uma busca na literatura no PubMed e MedLine até março de 2010 com os termos "insônia", "depressão", "antidepressivos sedativos" e "serotonina". A fim de contemplar os antidepressivos sedativos mais utilizados no tratamento da insônia, 34 artigos ISI, principalmente revisões e estudos clínicos placebo-controlados, foram selecionados entre 317 artigos

  2. Investigation of the Anxiolytic and Antidepressant Effects of Curcumin, a Compound From Turmeric (Curcuma longa), in the Adult Male Sprague-Dawley Rat.

    Science.gov (United States)

    Ceremuga, Tomás Eduardo; Helmrick, Katie; Kufahl, Zachary; Kelley, Jesse; Keller, Brian; Philippe, Fabiola; Golder, James; Padrón, Gina

    As the use of herbal medications continues to increase in America, the potential interaction between herbal and prescription medications necessitates the discovery of their mechanisms of action. The purpose of this study was to investigate the anxiolytic and antidepressant effects of curcumin, a compound from turmeric (Curcuma longa), and its effects on the benzodiazepine site of the γ-aminobutyric acid receptor A (GABAA) receptor. Utilizing a prospective, between-subjects group design, 55 male Sprague-Dawley rats were randomly assigned to 1 of the 5 intraperitoneally injected treatment groups: vehicle, curcumin, curcumin + flumazenil, midazolam, and midazolam + curcumin. Behavioral testing was performed using the elevated plus maze, open field test, and forced swim test. A 2-tailed multivariate analysis of variance and least significant difference post hoc tests were used for data analysis. In our models, curcumin did not demonstrate anxiolytic effects or changes in behavioral despair. An interaction of curcumin at the benzodiazepine site of the GABAA receptor was also not observed. Additional studies are recommended that examine the anxiolytic and antidepressant effects of curcumin through alternate dosing regimens, modulation of other subunits on the GABAA receptor, and interactions with other central nervous system neurotransmitter systems.

  3. Positive allosteric modulation of AMPA receptors differentially modulates the behavioural effects of citalopram in mouse models of antidepressant and anxiolytic action

    DEFF Research Database (Denmark)

    Fitzpatrick, Ciarán Martin; Larsen, Maria; Madsen, Louise

    2016-01-01

    serotonin reuptake inhibitor (SSRI) citalopram (0-10 mg/kg) was investigated in mice, using the APAM LY451646 (0-3 mg/kg). Antidepressant-like effects were assessed with the forced swim test (FST), while anxiolytic-like effects were tested with the elevated zero maze (EZM) and the marble burying test (MBT......). LY451646 (3 mg/kg) increased swim distance in the FST and a sub-active dose of LY451646 (1 mg/kg) enhanced the effect of citalopram in the FST. In the EZM, LY451646 (3 mg/kg) did not show anxiogenic effects alone, but blocked the anxiolytic-like action of citalopram in the EZM, as reflected...

  4. Tolerance to the sedative and anxiolytic effects of diazepam is associated with different alterations of GABAA receptors in rat cerebral cortex.

    Science.gov (United States)

    Ferreri, M C; Gutiérrez, M L; Gravielle, M C

    2015-12-03

    The clinical use of benzodiazepines is limited by the development of tolerance to their pharmacological effects. Tolerance to each of the pharmacological actions of benzodiazepines develops at different rates. The aim of this work was to investigate the mechanism of tolerance by performing behavioral tests in combination with biochemical studies. To this end, we administered prolonged treatments of diazepam to rats for 7 or 14 days. Tolerance to the sedative effects of diazepam was detected by means of the open field test after the 7- and 14-day treatments, whereas tolerance to the anxiolytic actions of benzodiazepine manifested following only the 14-day treatment in the elevated plus maze. The cerebral cortical concentrations of diazepam did not decline after the diazepam treatments, indicating that tolerance was not due to alterations in pharmacokinetic factors. The uncoupling of GABA/benzodiazepine site interactions and an increase in the degree of phosphorylation of the GABAA receptor γ2 subunit at serine 327 in the cerebral cortex were produced by day 7 of diazepam treatment and persisted after 14 days of exposure to benzodiazepine. Thus, these alterations could be part of the mechanism of tolerance to the sedative effects of diazepam. An increase in the percentage of α1-containing GABAA receptors in the cerebral cortex was observed following the 14-day treatment with diazepam but not the 7-day treatment, suggesting that tolerance to the anxiolytic effects is associated with a change in receptor subunit composition. The understanding of the molecular bases of tolerance could be important for the development of new drugs that maintain their efficacies over long-term treatments. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

  5. Sedation

    African Journals Online (AJOL)

    agents and agent combinations; the level of surgical stimulus etc. The diagram below shows a generic approach to interpreting BIS readings as far as degree of CNS depression is concerned. 100 -F l Awake, Memory Intact. 80 --. Sedation l. 60 -l-. General Anesthesia. “Deep” Hypnosis, Memory Function Lost. 40 --.

  6. Evaluation of the antidepressant- and anxiolytic-like effects of a hydrophilic extract from the green seaweed Ulva sp. in rats.

    Science.gov (United States)

    Violle, Nicolas; Rozan, Pascale; Demais, Hervé; Nyvall Collen, Pi; Bisson, Jean-François

    2018-05-01

    The green seaweed Ulva sp. contains a large amount of ulvans, a family of sulphated polysaccharides. The present study was designed to investigate in rats the antidepressant- and anxiolytic-like effects of a hydrophilic extract of Ulva sp. (MSP) containing about 45% of ulvans. After a 14-day administration of MSP at doses of 10, 20 and 40 mg/kg/day, 48 and 60 male adult Wistar rats were respectively tested in the elevated plus-maze (EPM) and the forced swimming test (FST). In the FST, MSP effects were compared to the reference antidepressant drug imipramine (IMI) (10 mg/kg/day). Acute and sub-chronic toxicities of the extract were also assessed in male and female rats following OECD guidelines. MSP treatment did not modify anxiety-related behaviour in the EPM. In contrast, MSP induced a dose-dependent reduction of immobility behaviour in the FST. At the highest tested dose of 40 mg/kg, MSP displayed a significant antidepressant-like effect similar to IMI. MSP did not modify the exploratory behaviour of rats in the open field test and did not produce any toxic effect. MSP may potentially represent a good adjunct or alternative to existing antidepressant therapeutics. Further studies are necessary to confirm the mechanism of action of MSP and its modulation of brain functioning.

  7. Prescribing a sedative antidepressant for patients at work or on sick leave under conditions of routine care.

    Science.gov (United States)

    Linden, M; Westram, A

    2010-01-01

    Sedation can be a beneficial effect of medication, but it can also be an unwanted side-effect, especially in patients who have to work. The aim of this study is to analyze whether physicians prescribe sedative antidepressants differently for patients at work vs. those on sick leave. A drug utilization study of mirtazapine was conducted for 12 weeks on 594 depressed outpatients from 227 general practitioners or psychiatrists. There were 319 patients working and 275 patients on sick leave. The two groups were compared regarding sociodemographic variables, illness characteristics, mode and course of treatment. As expected, patients on sick leave were sicker than working patients; they were treated by specialists more often and received higher dosages of mirtazapine. Work status had no influence on dosage after controlling for severity of illness, patient sex, and physician specialty. The overall improvement of depression was similar in both patient groups. Under treatment with mirtazapine, 64.5% of patients on sick leave returned to work, while 2.6% of the patients initially at work went on sick leave by the end of the 12 weeks. Sedation as an undesired side-effect was reported in less than 1%. The rate of sedative polypharmacy declined during treatment with mirtazapine. The results suggest that in routine treatment physicians do not see a need to adjust prescribing of mirtazapine because of its sedative properties to the working status of the patients. The majority of patients on sick leave returned to work. Mirtazapine can help to reduce sedative polypharmacy. (c) Georg Thieme Verlag KG Stuttgart . New York.

  8. A Valepotriate Fraction of Valeriana glechomifolia Shows Sedative and Anxiolytic Properties and Impairs Recognition But Not Aversive Memory in Mice

    Science.gov (United States)

    Maurmann, Natasha; Reolon, Gustavo Kellermann; Rech, Sandra Beatriz; Fett-Neto, Arthur Germano; Roesler, Rafael

    2011-01-01

    Plants of the genus Valeriana (Valerianaceae) are used in traditional medicine as a mild sedative, antispasmodic and tranquilizer in many countries. This study was undertaken to explore the neurobehavioral effects of systemic administration of a valepotriate extract fraction of known quantitative composition of Valeriana glechomifolia (endemic of southern Brazil) in mice. Adult animals were treated with a single intraperitoneal injection of valepotriate fraction (VF) in the concentrations of 1, 3 or 10 mg kg−1, or with vehicle in the pre-training period before each behavioral test. During the exploration of an open field, mice treated with 10 mg kg−1 of VF showed reduced locomotion and exploratory behavior. Although overall habituation sessions for locomotion and exploratory behavior among vehicle control and doses of VF were not affected, comparison between open-field and habituation sessions within each treatment showed that VF administration at 1 and 10 mg kg−1 impaired habituation. In the elevated plus-maze test, mice treated with VF (10 mg kg−1) showed a significant increase in the percentage of time spent in the open arms without significant effects in the number of total arm entries. VF at 3 mg kg−1 produced an impairment of novel-object recognition memory. In contrast, VF did not affect fear-related memory assessed in an inhibitory avoidance task. The results indicate that VF can have sedative effects and affect behavioral parameters related to recognition memory. PMID:20047889

  9. A Valepotriate Fraction of Valeriana glechomifolia Shows Sedative and Anxiolytic Properties and Impairs Recognition But Not Aversive Memory in Mice

    Directory of Open Access Journals (Sweden)

    Natasha Maurmann

    2011-01-01

    Full Text Available Plants of the genus Valeriana (Valerianaceae are used in traditional medicine as a mild sedative, antispasmodic and tranquilizer in many countries. This study was undertaken to explore the neurobehavioral effects of systemic administration of a valepotriate extract fraction of known quantitative composition of Valeriana glechomifolia (endemic of southern Brazil in mice. Adult animals were treated with a single intraperitoneal injection of valepotriate fraction (VF in the concentrations of 1, 3 or 10 mg kg-1, or with vehicle in the pre-training period before each behavioral test. During the exploration of an open field, mice treated with 10 mg kg-1 of VF showed reduced locomotion and exploratory behavior. Although overall habituation sessions for locomotion and exploratory behavior among vehicle control and doses of VF were not affected, comparison between open-field and habituation sessions within each treatment showed that VF administration at 1 and 10 mg kg-1 impaired habituation. In the elevated plus-maze test, mice treated with VF (10 mg kg-1 showed a significant increase in the percentage of time spent in the open arms without significant effects in the number of total arm entries. VF at 3 mg kg-1 produced an impairment of novel-object recognition memory. In contrast, VF did not affect fear-related memory assessed in an inhibitory avoidance task. The results indicate that VF can have sedative effects and affect behavioral parameters related to recognition memory.

  10. Sedative, hypnotic, anxiolytic and opioid medicament use and its co-occurrence with tobacco smoking and alcohol risk drinking in a community sample

    Directory of Open Access Journals (Sweden)

    Ulbricht Sabina

    2007-11-01

    Full Text Available Abstract Background Sedative, hypnotic, anxiolytic and opioid medicament (SO use and its relation to tobacco smoking and alcohol risk drinking is largely unknown. Prevalence data for SO intake and its co-occurrence with tobacco smoking and alcohol risk drinking considering age are presented. Methods Random general population sample of individuals aged 20–79 drawn from a mixed rural and urban area in Germany (Study of Health in Pomerania, SHIP. All medicament intake during the past 7 days prior to the interview was assessed according to the Anatomical Therapeutic Chemical classification as part of an interview conducted in a health examination center. Results Among men, 3.0%, and among women 5.0% took SO. The proportion of SO users was higher (odds ratio 1.9; 95% confidence interval 1.1–3.4 whereas the proportions of current cigarette smokers and alcohol risk drinkers without SO use were lower among individuals aged 60–79 compared to those aged 20–39. The proportion of individuals with smoking, alcohol risk drinking or SO use was also lower among those aged 60–79 compared to the 20–39 year olds. Conclusion Although proportions of SO users in older adult age are higher than in younger adult age there are less subjects with any of the 3 substance use behaviors at older adult age compared to age 20–39.

  11. Evaluation of the anxiolytic and antidepressant effects of asiatic acid, a compound from Gotu kola or Centella asiatica, in the male Sprague Dawley rat.

    Science.gov (United States)

    Ceremuga, Tomás Eduardo; Valdivieso, Debra; Kenner, Catherine; Lucia, Amy; Lathrop, Keith; Stailey, Owen; Bailey, Heather; Criss, Jonathan; Linton, Jessica; Fried, Jordan; Taylor, Andrew; Padron, Gina; Johnson, Arthur Don

    2015-04-01

    Herbal medication use continues to rise and interactions with existing medications propose risks and may have significant effects and consequences on the administration of anesthesia. The purpose of this study was to investigate the anxiolytic and antidepressant effects of asiatic acid and its potential modulation of the γ-aminobutyric acid (GABAA) receptor. Fifty-five male Sprague Dawley rats were divided into 5 groups: vehicle (DMSO), asiatic acid (AA), midazolam, or a combination of flumazenil + AA or midazolam + AA, and injected intraperitoneally 30 minutes prior to testing. The rats were tested on the Elevated Plus Maze (EPM) and the Forced Swim Test (FST). Data were analyzed using a two-tailed multivariate analysis of variance (MANOVA). Significance was found regarding the ratio of open arm time, maximum speed, and time spent mobile in the AA group and the midazolam + AA group (P < .05). Flumazenil decreased the anxiolytic effects, suggesting that AA modulates the benzodiazepine site on the GABAA receptor. Further studies are recommended to determine the efficacy of prolonged treatment for anxiety and depression.

  12. Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years

    Science.gov (United States)

    dos Santos, Rafael G.; Osório, Flávia L.; Crippa, José Alexandre S.; Riba, Jordi; Zuardi, Antônio W.; Hallak, Jaime E. C.

    2016-01-01

    To date, pharmacological treatments for mood and anxiety disorders and for drug dependence show limited efficacy, leaving a large number of patients suffering severe and persistent symptoms. Preliminary studies in animals and humans suggest that ayahuasca, psilocybin and lysergic acid diethylamide (LSD) may have antidepressive, anxiolytic, and antiaddictive properties. Thus, we conducted a systematic review of clinical trials published from 1990 until 2015, assessing these therapeutic properties. Electronic searches were performed using the PubMed, LILACS, and SciELO databases. Only clinical trials published in peer-reviewed journals were included. Of these, 151 studies were identified, of which six met the established criteria. Reviewed studies suggest beneficial effects for treatment-resistant depression, anxiety and depression associated with life-threatening diseases, and tobacco and alcohol dependence. All drugs were well tolerated. In conclusion, ayahuasca, psilocybin and LSD may be useful pharmacological tools for the treatment of drug dependence, and anxiety and mood disorders, especially in treatment-resistant patients. These drugs may also be useful pharmacological tools to understand psychiatric disorders and to develop new therapeutic agents. However, all studies reviewed had small sample sizes, and half of them were open-label, proof-of-concept studies. Randomized, double-blind, placebo-controlled studies with more patients are needed to replicate these preliminary findings. PMID:27354908

  13. Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years.

    Science.gov (United States)

    Dos Santos, Rafael G; Osório, Flávia L; Crippa, José Alexandre S; Riba, Jordi; Zuardi, Antônio W; Hallak, Jaime E C

    2016-06-01

    To date, pharmacological treatments for mood and anxiety disorders and for drug dependence show limited efficacy, leaving a large number of patients suffering severe and persistent symptoms. Preliminary studies in animals and humans suggest that ayahuasca, psilocybin and lysergic acid diethylamide (LSD) may have antidepressive, anxiolytic, and antiaddictive properties. Thus, we conducted a systematic review of clinical trials published from 1990 until 2015, assessing these therapeutic properties. Electronic searches were performed using the PubMed, LILACS, and SciELO databases. Only clinical trials published in peer-reviewed journals were included. Of these, 151 studies were identified, of which six met the established criteria. Reviewed studies suggest beneficial effects for treatment-resistant depression, anxiety and depression associated with life-threatening diseases, and tobacco and alcohol dependence. All drugs were well tolerated. In conclusion, ayahuasca, psilocybin and LSD may be useful pharmacological tools for the treatment of drug dependence, and anxiety and mood disorders, especially in treatment-resistant patients. These drugs may also be useful pharmacological tools to understand psychiatric disorders and to develop new therapeutic agents. However, all studies reviewed had small sample sizes, and half of them were open-label, proof-of-concept studies. Randomized, double-blind, placebo-controlled studies with more patients are needed to replicate these preliminary findings.

  14. Targeting the Microbiota-Gut-Brain Axis: Prebiotics Have Anxiolytic and Antidepressant-like Effects and Reverse the Impact of Chronic Stress in Mice.

    Science.gov (United States)

    Burokas, Aurelijus; Arboleya, Silvia; Moloney, Rachel D; Peterson, Veronica L; Murphy, Kiera; Clarke, Gerard; Stanton, Catherine; Dinan, Timothy G; Cryan, John F

    2017-10-01

    The realization that the microbiota-gut-brain axis plays a critical role in health and disease, including neuropsychiatric disorders, is rapidly advancing. Nurturing a beneficial gut microbiome with prebiotics, such as fructo-oligosaccharides (FOS) and galacto-oligosaccharides (GOS), is an appealing but underinvestigated microbiota manipulation. Here we tested whether chronic prebiotic treatment modifies behavior across domains relevant to anxiety, depression, cognition, stress response, and social behavior. C57BL/6J male mice were administered FOS, GOS, or a combination of FOS+GOS for 3 weeks prior to testing. Plasma corticosterone, microbiota composition, and cecal short-chain fatty acids were measured. In addition, FOS+GOS- or water-treated mice were also exposed to chronic psychosocial stress, and behavior, immune, and microbiota parameters were assessed. Chronic prebiotic FOS+GOS treatment exhibited both antidepressant and anxiolytic effects. Moreover, the administration of GOS and the FOS+GOS combination reduced stress-induced corticosterone release. Prebiotics modified specific gene expression in the hippocampus and hypothalamus. Regarding short-chain fatty acid concentrations, prebiotic administration increased cecal acetate and propionate and reduced isobutyrate concentrations, changes that correlated significantly with the positive effects seen on behavior. Moreover, FOS+GOS reduced chronic stress-induced elevations in corticosterone and proinflammatory cytokine levels and depression-like and anxiety-like behavior in addition to normalizing the effects of stress on the microbiota. Taken together, these data strongly suggest a beneficial role of prebiotic treatment for stress-related behaviors. These findings strengthen the evidence base supporting therapeutic targeting of the gut microbiota for brain-gut axis disorders, opening new avenues in the field of nutritional neuropsychopharmacology. Copyright © 2017 Society of Biological Psychiatry. Published by

  15. Trends in Off-Label Prescribing of Sedatives, Hypnotics and Antidepressants among Children and Adolescents - A Danish, Nationwide Register-Based Study

    DEFF Research Database (Denmark)

    Nielsen, Eva Skovslund; Rasmussen, Lotte; Poulsen, Maja Hellfritzsch

    2016-01-01

    In recent years, psychotropic drug use among children and adolescents in Europe and USA has increased. However, the majority of psychotropic drugs are not formally approved for use in children and adolescents, and consequently, use is often off-label. The objectives were to describe time trends...... in off-label prescribing rates and the most commonly used types of psychotropic drugs by age and gender in Danish children and adolescents. Using the Register of Medicinal Product Statistics, we identified all prescriptions for sedatives, hypnotics and antidepressants filled for children and adolescents......, we found decreasing trends in off-label rates over time [range 94.5-65.6% (girls), 93.8-71.2% (boys)]. Off-label prescribing of psychotropic drugs to Danish children and adolescents is common. Off-label rates for sedatives and hypnotics increased in the period of 2006-2012, whereas off-label rates...

  16. Antidepressant-like effects of methanol extract of Hibiscus tiliaceus flowers in mice

    Science.gov (United States)

    2012-01-01

    Background Hibiscus tiliaceus L. (Malvaceae) is used in postpartum disorders. Our purpose was to examine the antidepressant, anxiolytic and sedative actions of the methanol extract of H. tiliaceus flowers using animal models. Methods Adult male Swiss albino mice were treated with saline, standard drugs or methanol extract of H. tiliaceus and then subjected to behavioral tests. The forced swimming and tail suspension tests were used as predictive animal models of antidepressant activity, where the time of immobility was considered. The animals were submitted to the elevated plus-maze and ketamine-induced sleeping time to assess anxiolytic and sedative activities, respectively. Results Methanol extract of H. tiliaceus significantly decreased the duration of immobility in both animal models of antidepressant activity, forced swimming and tail suspension tests. This extract did not potentiate the effect of ketamine-induced hypnosis, as determined by the time to onset and duration of sleeping time. Conclusion Our results indicate an antidepressant-like profile of action for the extract of Hibiscus tiliaceus without sedative side effect. PMID:22494845

  17. Antidepressant-like effects of methanol extract of Hibiscus tiliaceus flowers in mice

    Directory of Open Access Journals (Sweden)

    Vanzella Cláudia

    2012-04-01

    Full Text Available Abstract Background Hibiscus tiliaceus L. (Malvaceae is used in postpartum disorders. Our purpose was to examine the antidepressant, anxiolytic and sedative actions of the methanol extract of H. tiliaceus flowers using animal models. Methods Adult male Swiss albino mice were treated with saline, standard drugs or methanol extract of H. tiliaceus and then subjected to behavioral tests. The forced swimming and tail suspension tests were used as predictive animal models of antidepressant activity, where the time of immobility was considered. The animals were submitted to the elevated plus-maze and ketamine-induced sleeping time to assess anxiolytic and sedative activities, respectively. Results Methanol extract of H. tiliaceus significantly decreased the duration of immobility in both animal models of antidepressant activity, forced swimming and tail suspension tests. This extract did not potentiate the effect of ketamine-induced hypnosis, as determined by the time to onset and duration of sleeping time. Conclusion Our results indicate an antidepressant-like profile of action for the extract of Hibiscus tiliaceus without sedative side effect.

  18. Anxiolytic and sedative effects of a combined extract of Passiflora alata Dryander and Valeriana officinalis L. in rats = Efeito ansiolítico e sedativo do extrato combinado de Passiflora alata Dryander e Valeriana officinalis L. em ratos

    Directory of Open Access Journals (Sweden)

    Fernanda Jacques Otobone

    2005-07-01

    Full Text Available This work investigated the effects of a combined extract of Passiflora alata Dryander and Valeriana officinalis L. (EPV in rats under going elevated plus maze (EPM and open-field test (OFT. No effects were detected after acute or repeated (3 or 7-days treatment with EPV (5, 10 or 20 mg/kg, by gavage, on the EPM or the OFT. However, rats treated for 15 day (20 mg/kg with EPV showed increased percentage of entries and time spent in the open arms on the EPM without alter locomotor activity in the OFT compared to control group. Acute or a 15 day administration of diazepam (2 mg/kg, i.p.,increased the same parameters on the EPM and OFT. Acute treatment with 300 or 600 mg/kg of EPV, decreased the locomotor activity in the OFT. Results suggest anxiolytic and sedative effects for the EPV and reveal a wide dose range for the anxiolytic effect.Este trabalho investigou o efeito do extrato combinado de Passiflora alata Dryander e Valeriana officinalis L. (EPV em ratos submetidosaos testes do labirinto em cruz elevado (LCE e campo aberto (TCA. Nenhum efeito foi detectado após o tratamento agudo ou repetido por 3 ou 7 dias com EPV (5, 10 or 20 mg/kg, gavagem no LCE e TCA. Entretanto, ratos tratados por 15 dias com EPV (20 mg/kg mostraram aumento na porcentagem de entradas e tempo gasto nos braços abertosno LCE, sem alterar a atividade locomotora no TCA, comparado ao controle. Diazepan (droga de referência, i.p., aumentou os mesmos parâmetros analisados no LCE e OFT após o tratamento agudo ou por 15 dias. O tratamento agudo com 300 ou 600 mg/kg do EPV diminuiu significativamente a atividade locomotora no TCA. Estes resultadosmostram que EPV produz efeito ansiolítico e sedativo, com ampla margem de segurança para o efeito ansiolítico.

  19. Muscle Relaxant and Sedative-Hypnotic Activities of Extract of Viola betonicifolia in Animal Models Supported by Its Isolated Compound, 4-Hydroxy Coumarin

    Directory of Open Access Journals (Sweden)

    Naveed Muhammad

    2013-01-01

    Full Text Available The crude methanolic extract of the whole plant of Viola betonicifolia (VBME was investigated for anxiolytic, muscle relaxant, sleep induction, antidepressant, and sedative activities to ascertain its scientific values. VBME showed a significant (P<0.05 dose dependent anxiolytic action in staircase test. In muscle relaxant paradigms, a dose dependent muscle relaxation was observed. For phenobarbitone sleep induction test, VBME notably (P<0.05 reduced the latency time and increased total sleeping duration. Our tested extract was found free of any antidepressant activity, while the movement was significantly (P<0.05 shortened in locomotor activity. The whole plant of V. betonicifolia led to the isolation of 4-hydroxyl coumarin (4HC which showed substantial safety profile in acute toxicity test. When challenged in Traction and Chimney tests, it showed significant (P<0.05 muscle relaxant effect in both muscle relaxant paradigms at 20 and 30 mg/kg during various assessment times. Nevertheless, 4HC was devoid of sedative and hypnotic potentials. In conclusion, VBME had strong muscle relaxant and sedative-hypnotic properties, while its isolated compound, 4HC, possessed a significant muscle relaxant action with substantial safety profile without sedative-hypnotic effects.

  20. Evaluation of Lorazepam as an Anxiolytic Agent in Psychiatric Practice

    African Journals Online (AJOL)

    1974-04-06

    Apr 6, 1974 ... exception of 2 Asiatic patients, all were White. All had bers of this class, sedative, hypnotic and anxiolytic pro- ... beneficial hypnotic' and amnesic' effects. In patients with anxiety independent of, secondary ... It should be noted that laboratory work-Ups and EEGs would have been taken if required, but none ...

  1. Sedative properties of Mitracarpus villosus leaves in mice

    African Journals Online (AJOL)

    admin

    anxiolytics increase the head-dip counts. The reduction in the number of head dips shown by the extract is therefore an indication of the presence of psychoactive constituents that are sedative in nature. The sedative property of the plant was confirmed by its ability to potentiate the duration of diazepam induced sleep.

  2. Efeito ansiolítico e sedativo do extrato combinado de Passiflora alata Dryander e Valeriana officinalis L. em ratos - DOI: 10.4025/actascihealthsci.v27i2.1379 Anxiolytic and sedative effects of a combined extract of Passiflora alata Dryander and Valeriana officinalis L. in rats - DOI: 10.4025/actascihealthsci.v27i2.1379

    Directory of Open Access Journals (Sweden)

    Roberto Andreatini

    2005-03-01

    Full Text Available Este trabalho investigou o efeito do extrato combinado de Passiflora alata Dryander e Valeriana officinalis L. (EPV em ratos submetidos aos testes do labirinto em cruz elevado (LCE e campo aberto (TCA. Nenhum efeito foi detectado após o tratamento agudo ou repetido por 3 ou 7 dias com EPV (5, 10 or 20 mg/kg, gavagem no LCE e TCA. Entretanto, ratos tratados por 15 dias com EPV (20 mg/kg mostraram aumento na porcentagem de entradas e tempo gasto nos braços abertos no LCE, sem alterar a atividade locomotora no TCA, comparado ao controle. Diazepan (droga de referência, i.p., aumentou os mesmos parâmetros analisados no LCE e OFT após o tratamento agudo ou por 15 dias. O tratamento agudo com 300 ou 600 mg/kg do EPV diminuiu significativamente a atividade locomotora no TCA. Estes resultados mostram que EPV produz efeito ansiolítico e sedativo, com ampla margem de segurança para o efeito ansiolíticoThis work investigated the effects of a combined extract of Passiflora alata Dryander and Valeriana officinalis L. (EPV in rats under going elevated plus maze (EPM and open-field test (OFT. No effects were detected after acute or repeated (3 or 7-days treatment with EPV (5, 10 or 20 mg/kg, by gavage, on the EPM or the OFT. However, rats treated for 15 day (20 mg/kg with EPV showed increased percentage of entries and time spent in the open arms on the EPM without alter locomotor activity in the OFT compared to control group. Acute or a 15 day administration of diazepam (2 mg/kg, i.p., increased the same parameters on the EPM and OFT. Acute treatment with 300 or 600 mg/kg of EPV, decreased the locomotor activity in the OFT. Results suggest anxiolytic and sedative effects for the EPV and reveal a wide dose range for the anxiolytic effect

  3. Evaluation of anxiolytic activity of spray dried powders of two South Brazilian Passiflora species.

    Science.gov (United States)

    Reginatto, Flávio H; De-Paris, Fernanda; Petry, Raquel D; Quevedo, João; Ortega, George González; Gosmann, Grace; Schenkel, Eloir P

    2006-05-01

    The Passiflora extracts have been used in folk medicine because of its reputed sedative and anxiolytic properties. The present study aimed to compare the potential anxiolytic activity of two Passiflora spray-dried powders obtained from P. alata and P. edulis, known in Brazil as 'maracujá'. Male adult Swiss rats were treated with 200, 400 and 800 mg/kg of spray-dried powders p.o. and anxiolytic activity was evaluated using the elevated plus-maze test. The spray-dried powders showed anxiolytic activity in doses of 400 and 800 mg/kg. Our results support the potential anxiolytic effect of Passiflora spray-dried powders (P. alata and P. edulis). Copyright 2006 John Wiley & Sons, Ltd.

  4. Antidepressant effect and pharmacological evaluation of standardized extract of flavonoids from Byrsonima crassifolia.

    Science.gov (United States)

    Herrera-Ruiz, M; Zamilpa, A; González-Cortazar, M; Reyes-Chilpa, R; León, E; García, M P; Tortoriello, J; Huerta-Reyes, M

    2011-11-15

    Byrsonima crassifolia (Malpighiaceae) has been used in traditional medicine for the treatment of some mental-related diseases; however, its specific neuropharmacological activities remain to be defined. The present study evaluates the anxiolytic, anticonvulsant, antidepressant, sedative effects produced by the extracts of Byrsonima crassifolia, and their influence on motor activity in ICR mice. Additionally, we determine the acute toxicity profiles of the Byrsonima crassifolia extracts and the presence of neuroactive constituents. Our results show that the methanolic extract of Byrsonima crassifolia produces a significant (P0.05). Although the main compound of the methanolic extract was identified as quercetin 3-O-xyloside (12 mg/kg), our findings suggest that flavonoids, such as rutin (4.4 mg/kg), quercetin (1.4 mg/kg) and hesperidin (0.7 mg/kg), may be involved in the antidepressant effects. To the best of our knowledge, the present study constitutes the first report on the presence of the flavonoids with neuropharmacological activity rutin and hesperidin in Byrsonima crassifolia. In conclusion, the present results showed that the methanolic extract standardized on flavonoids content of Byrsonima crassifolia possesses potential antidepressant-like effects in the FST in mice, and could be considered as relatively safe toxicologically with no deaths of mice when orally administered at 2000 mg/kg. Copyright © 2011 Elsevier GmbH. All rights reserved.

  5. Stimulant and sedative effects of alcohol.

    Science.gov (United States)

    Hendler, Reuben A; Ramchandani, Vijay A; Gilman, Jodi; Hommer, Daniel W

    2013-01-01

    Alcohol produces both stimulant and sedating effects in humans. These two seemingly opposite effects are central to the understanding of much of the literature on alcohol use and misuse. In this chapter we review studies that describe and attempt to measure various aspects of alcohol's subjective, autonomic, motor, cognitive and behavioral effects from the perspective of stimulation and sedation. Although subjective sedative and stimulatory effects can be measured, it is not entirely clear if all motor, cognitive and behavioral effects can be unambiguously assigned to either one or the other category. Increased heart rate and aggression seem strongly associated with stimulation, but motor slowing and cognitive impairment can also show a similar time course to stimulation, making their relation to sedation problematic. There is good agreement that alcohol's ability to induce striatal dopamine release is the mechanism underlying alcohol's stimulatory effects; however, the change in brain function underlying sedation is less well understood. In general, stimulatory effects are thought to be more rewarding than sedative effects, but this may not be true for anxiolytic effects which seem more closely related to sedation than stimulation. The two major theories of how response to alcohol predicts risk for alcoholism both postulate that individuals at high risk for alcohol use disorders have a reduced sedative response to alcohol compared to individuals not at high risk. In addition one theory proposes that alcoholism risk is also associated with a larger stimulatory response to alcohol.

  6. Nitric Oxide Synthase Inhibitors as Antidepressants

    DEFF Research Database (Denmark)

    Wegener, Gregers; Volke, Vallo

    2010-01-01

    Affective and anxiety disorders are widely distributed disorders with severe social and economic effects. Evidence is emphatic that effective treatment helps to restore function and quality of life. Due to the action of most modern antidepressant drugs, serotonergic mechanisms have traditionally......, including serotonin, glutamate and GABA, are intimately regulated by NO, and distinct classes of antidepressants have been found to modulate the hippocampal NO level in vivo. The NO system is therefore a potential target for antidepressant and anxiolytic drug action in acute therapy as well...

  7. Linalool-rich essential oils from the Amazon display antidepressant-type effect in rodents.

    Science.gov (United States)

    Dos Santos, Éverton Renan Q; Maia, Cristiane Socorro F; Fontes Junior, Enéas A; Melo, Ademar S; Pinheiro, Bruno G; Maia, José Guilherme S

    2018-02-15

    The essential oils of the leaves of Aniba rosaeodora (pau-rosa), Aniba parviflora (macacaporanga) and Aeollanthus suaveolens (catinga-de-mulata), rich in linalool, are used in the traditional medicine of the Brazilian Amazon for its effects on the central nervous system, such as sedative, anticonvulsant and antidepressant, among other therapeutic properties. To analyze the chemical composition of these oils and to evaluate their neurobehavioral effects in rodents, based on different and established behavioral tests. The oils were distilled and analyzed by GC and GC-MS. Male Wistar rats received intraperitoneal doses of the oils of pau-rosa (3.5 and 35mg/kg), macacaporanga (8.5 and 85mg/kg) and catinga-de-mulata (7.5 and 75mg/kg), in addition to a linalool standard (30mg/kg). The neurobehavioral effects were evaluated using the tests: Open Field (spontaneous locomotion activity), Elevated Plus Maze (anxiolytic- type activity), Splash and Forced Swimming (antidepressive-type activity) and the Inhibitory Avoidance (memory retention). The three oils (highest dose) and standard linalool presented significant antidepressant activity in rodents. Linalool was identified as the major constituent of the oils (pau-rosa, 88.6%, macacaporanga, 45%, catinga-de-mulata, 49.3%). The standard linalool used was 97.0%. The pau-rosa, macacaporanga, and catinga-de-mulata oils presented antidepressant activity due to the presence of linalool, which, by the final synergistic action of other constituents found in oils, may have contributed to the increase or reduction of this behavioral effect in the treated animals. A relevant fact is that there was no compromise of spontaneous locomotion and the memory retention in the rodents. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Evaluation of adult outpatient magnetic resonance imaging sedation practices: are patients being sedated optimally?

    International Nuclear Information System (INIS)

    Middelkamp, J.E.; Forster, B.B; Keogh, C.; Lennox, P.; Mayson, K.

    2009-01-01

    To evaluate the use of anxiolytics in adult outpatient magnetic resonance imaging (MRI) centres and to determine whether utilisation is optimal based on the pharmacology of the drugs used, who prescribes these drugs, and how patients are managed after administration. Identical paper and Web-based surveys were used to anonymously collect data about radiologists' use of anxiolytic agents for adult outpatient MRI examinations. The survey questions were about the type of facility, percentage of studies that require sedation, the drug used and route of administration, who orders the drug, timing of administration, patient monitoring during and observation after the study, use of a dedicated nurse for monitoring, and use of standard sedation and discharge protocols. The χ2 analysis for statistical association among variables was used. Eighty-five of 263 surveys were returned (32% response rate). The radiologist ordered the medication (53%) in slightly more facilities than the referring physician (44%) or the nurse. Forty percent of patients received medication 15-30 minutes before MRI, which is too early for peak effect of oral or sublingual drugs. Lorazepam was most commonly used (64% first choice). Facilities with standard sedation protocols (56%) were more likely to use midazolam than those without standard sedation protocols (17% vs 10%), to have a nurse for monitoring (P = .032), to have standard discharge criteria (P = .001), and to provide written information regarding adverse effects (P = .002). Many outpatients in MRI centres may be scanned before the peak effect of anxiolytics prescribed. A standard sedation protocol in such centres is associated with a more appropriate drug choice, as well as optimized monitoring and postprocedure care. (author)

  9. Essential oils and anxiolytic aromatherapy.

    Science.gov (United States)

    Setzer, William N

    2009-09-01

    A number of essential oils are currently in use as aromatherapy agents to relieve anxiety, stress, and depression. Popular anxiolytic oils include lavender (Lavandula angustifolia), rose (Rosa damascena), orange (Citrus sinensis), bergamot (Citrus aurantium), lemon (Citrus limon), sandalwood (Santalum album), clary sage (Salvia sclarea), Roman chamomile (Anthemis nobilis), and rose-scented geranium (Pelargonium spp.). This review discusses the chemical constituents and CNS effects of these aromatherapeutic essential oils, as well as recent studies on additional essential oils with anxiolytic activities.

  10. Effects of Antidepressants on Sleep.

    Science.gov (United States)

    Wichniak, Adam; Wierzbicka, Aleksandra; Walęcka, Małgorzata; Jernajczyk, Wojciech

    2017-08-09

    The aim of this review article was to summarize recent publications on effects of antidepressants on sleep and to show that these effects not only depend on the kind of antidepressant drugs but are also related to the dose, the time of drug administration, and the duration of the treatment. Complaints of disrupted sleep are very common in patients suffering from depression, and they are listed among diagnostic criteria for this disorder. Moreover, midnocturnal insomnia is the most frequent residual symptom of depression. Thus, all antidepressants should normalize sleep. However, at least in short-term treatment, many antidepressants with so-called activating effects (e.g. fluoxetine, venlafaxine) may disrupt sleep, while others with sedative properties (e.g., doxepin, mirtazapine, trazodone) rapidly improve sleep, but may cause problems in long-term treatment due to oversedation.For sleep-promoting action, the best effects can frequently be achieved with a very low dose, administered early enough before bedtime and importantly, always as a part of more complex interventions based on the cognitive-behavioral protocol to treat insomnia (CBT-I). For successful treatment of depression, it is necessary to understand the effects of antidepressants on sleep. Each physician should also be aware that some antidepressants may worsen or induce primary sleep disorders like restless legs syndrome, sleep bruxism, REM sleep behavior disorder, nightmares, and sleep apnea, which may result from an antidepressant-induced weight gain.

  11. Anxiolytic-Like and Antinociceptive Effects of 2(S-Neoponcirin in Mice

    Directory of Open Access Journals (Sweden)

    Julia Moreno

    2013-06-01

    Full Text Available Study aims: 2(S-neopincirin (NEO is a constituent from of Clinopodium mexicanum, which is used in traditional Mexican herbal medicine for its tranquilizing and analgesic properties. This study investigated the anxiolytic-like, sedative and antinociceptive effects of NEO in several mice models. Material and methods: The anxiolytic-like effect was evaluated in the hole-board (HBT and Open Field Tests (OFT; sedative effect was evaluated in sleeping time induced by sodium pentobarbital, and its antinociceptive actions were measured in the hot plate test. To evaluate if the GABA receptor could be involved in the anxiolytic-like effect produced by NEO, in independent experiments, the effects produced by co-administration of NEO plus muscimol (MUS and NEO plus Pitrotoxin (PTX were evaluated in the HBT. Results: NEO was isolated from Clinopodium mexicanum leaves. The NMR, MS and optic rotation data helped establish its identity as (2S-5-hydroxy-4′-methoxyflavanone-7-O-{β-glucopyranosyl-(1→6-β-rhamnoside}. NEO showed an anxiolytic-like effect and was able to counter the nociception induced by a thermal stimulus in a dose-dependent manner. PTX blocked the anxiolytic-like effect of NEO, while MUS was able to enhance it. Conclusions: The findings of present work demonstrated that NEO possesses anxiolytic-like and antinociceptive effects in mice. Such effects are not associated with changes in the locomotor activity. These results supported the notion that anxiolytic-like effect of NEO involves the participation of GABAergic system.

  12. Avaliação da atividade ansiolítica e antidepressiva do extrato fluido e fração aquosa de folhas de Passiflora alata Curtis em camundongos = Evaluation of anxiolytic and antidepressant activities in mice with fluid extracts and aqueous fraction obtained from the leaves of Passiflora alata

    Directory of Open Access Journals (Sweden)

    Cássia Valério Romanini

    2006-07-01

    Full Text Available O extrato fluido (EF, preparado segundo a Farmacopéia Brasileira, e sua fração aquosa (FA obtidos de folhas de Passiflora alata foram administrados por via oral em camundongos. Seus efeitos comportamentais foram avaliados por modelos que detectam a atividade ansiolítica e antidepressiva de drogas, tais como: o labirinto em cruz elevado (LCE e o teste da suspensão pela cauda (TSC. Efeitos sobre a atividade locomotora geral dos animais foram monitorados no campo aberto. Efeitos sedativos foram observados com EF (100 e 300 mg kg-1 e EA (100, 300 e 600 mg kg-1, caracterizados por uma diminuiçãodo número de entradas nos braços fechados do LCE e uma diminuição no número de cruzamentos e levantamentos no campo aberto. No TSC, a administração de EF (100 mg kg-1 ou FA (100 e 300 mg kg-1 resultou em aumento do tempo de imobilidade. Esses resultados são relevantes, pois contribuem para validar o uso popular dessa planta.The fluid extract (FE, prepared according to the Brazilian Pharmacopoea, obtained from the leaves of Passiflora alata and its aqueous fraction (AF, were administered by oral route to mice, and the behavioural effects were evaluated using animal models that detect anxiolytic and antidepressant activities, such as the elevated plus maze (EPM and the tail suspension test (TST. Effects on general motor activity were monitored in the open field. Sedativeeffects were observed with FE (100 and 300 mg kg-1 and AF (100, 300 and 600 mg kg-1 and were characterized by a decreased number of entries in the enclosed arms of the EPM and a decrease in the number of crossings and rearing in the open field. In the TST, FE (100 mgkg-1 and AF (100 and 300 mg kg-1 induced an increase in the immobility time. These results are relevant because they contribute to validate the traditional use of this plant.

  13. ANTIDEPRESSANT THERAPY IN HIGH-RISK PATIENTS

    African Journals Online (AJOL)

    Table II pertains to important considerations regarding the moice of antidepressant therapy in patients with hepatic impairment, i.e. the possible risk of hepatotoxicity and the potential need for dosage adjustment. An increased susceptibility to the sedative effects of psychotropic drugs has been described in cirrhotic patients,.

  14. Antidepressant and antioxidant activities of Artemisia absinthium L ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-12-15

    Dec 15, 2009 ... Mora S, Millıan R, Lungenstrass H, Dııaz-Vıeliz G, Morıan JA, Herrera-. Ruiz M, Tortoriello J (2006). The hydroalcoholic extract of Salvia elegans induces anxiolytic- and antidepressant-like effects in rats. J. Ethnopharmacol. 106: 76-81. Morteza-Semnani K, Mahmoudi M, Riahi G (2007). Effects of essential.

  15. Anxiolytic-like effects after vector-mediated overexpression of neuropeptide Y in the amygdala and hippocampus of mice

    DEFF Research Database (Denmark)

    Christiansen, Søren Hofman Oliveira; Olesen, Mikkel Vestergaard; Gøtzsche, Casper René

    2014-01-01

    , injections of rAAV-NPY caused significant anxiolytic-like effect in the open field, elevated plus maze, and light-dark transition tests. In the hippocampus, rAAV-NPY treatment was associated with anxiolytic-like effect only in the elevated plus maze. No additive effect was observed after combined r......AAV-NPY injection into both the amygdala and hippocampus where anxiolytic-like effect was found in the elevated plus maze and light-dark transition tests. Antidepressant-like effects were not detected in any of the rAAV-NPY injected groups. Immobility was even increased in the tail suspension and forced swim tests...... after intra-amygdaloid rAAV-NPY. Taken together, the present data show that rAAV-NPY treatment may confer non-additive anxiolytic-like effect after injection into the amygdala or hippocampus, being most pronounced in the amygdala...

  16. Antidepressant Withdrawal

    Science.gov (United States)

    ... or two, such as: Anxiety Insomnia or vivid dreams Headaches Dizziness Tiredness Irritability Flu-like symptoms, including ... your doctor may prescribe another antidepressant or another type of medication on a short-term basis to ...

  17. Nitric Oxide Synthase Inhibitors as Antidepressants

    Directory of Open Access Journals (Sweden)

    Vallo Volke

    2010-01-01

    Full Text Available Affective and anxiety disorders are widely distributed disorders with severe social and economic effects. Evidence is emphatic that effective treatment helps to restore function and quality of life. Due to the action of most modern antidepressant drugs, serotonergic mechanisms have traditionally been suggested to play major roles in the pathophysiology of mood and stress-related disorders. However, a few clinical and several pre-clinical studies, strongly suggest involvement of the nitric oxide (NO signaling pathway in these disorders. Moreover, several of the conventional neurotransmitters, including serotonin, glutamate and GABA, are intimately regulated by NO, and distinct classes of antidepressants have been found to modulate the hippocampal NO level in vivo. The NO system is therefore a potential target for antidepressant and anxiolytic drug action in acute therapy as well as in prophylaxis. This paper reviews the effect of drugs modulating NO synthesis in anxiety and depression.

  18. Tricyclic Antidepressants and Tetracyclic Antidepressants

    Science.gov (United States)

    ... 2016. Amoxapine (prescribing information). Verna, Salcette Goa, India: Watson Pharma; 2014. http://www.accessdata.fda.gov/drugsatfda_ ... mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/ART-20046983 . Mayo Clinic Footer Legal Conditions and Terms ...

  19. Antidepressants and Weight Gain

    Science.gov (United States)

    Antidepressants and weight gain: What causes it? Can antidepressants cause weight gain? Answers from Daniel K. Hall- ... is a possible side effect of nearly all antidepressants. However, each person responds to antidepressants differently. Some ...

  20. Evaluation of the Anxiolytic Effect of Nepeta persica Boiss. in Mice

    Directory of Open Access Journals (Sweden)

    M. Rabbani

    2008-01-01

    Full Text Available The aim of the present study was to evaluate the anxiolytic effects of hydroalcoholic extract (HE of Nepeta persica Boiss. (Lamiaceae on the elevated plus-maze (EPM model of anxiety. The extract of arial parts of the plant was administered intraperitoneally to male NMRI mice, at various doses, 30 min before behavioural evaluation. The HE extract of N. persica at the dose of 50 mg kg−1 significantly increased the percentage of time spent and percentage of arm entries in the open arms of the EPM. This dose of plant extract affected neither animal's locomotor activity nor ketamine-induced sleeping time. The 50 mg kg−1 dose of the plant extract seemed to be the optimal dose in producing the anxiolytic effects, lower or higher doses of the plant produce either sedative or stimulant effects. At 100 mg kg−1, the plant extract increased the locomotor activity. These results suggested that the extract of N. persica at dose of 50 mg kg−1 possess anxiolytic effect with less sedative and hypnotic effects than that of diazepam and causes a non-specific stimulation at 100 mg kg−1.

  1. Switching antidepressants

    African Journals Online (AJOL)

    depressive disorder, with response rates of 50-60%. Switching within or between classes of antidepressants is often required in patients with an insufficient response to SSRIs.12 Because they share a similar mechanism of action, the immediate substitution of one SSRI for another is probably the easiest switching option.

  2. Anxiolytic properties of Valeriana officinalis in the zebrafish: a possible role for metabotropic glutamate receptors.

    Science.gov (United States)

    Del Valle-Mojica, Lisa M; Ortíz, José G

    2012-11-01

    Valerian extract is used in complementary and alternative medicine for its anxiolytic and sedative properties. Our previous research demonstrated valerian interactions with glutamate receptors. The purpose of this study was to determine if valerian anxiolytic properties are mediated by metabotropic glutamate receptors (mGluR) such as mGluR (1/5) (mGluR I) and mGluR (2/3) (mGluR II). Adult wild-type zebrafish (Danio rerio) prefer the black compartment and avoid the white compartment in the dark/light preference task. Zebrafish exposed to 1 mg/mL of valerian extract or 0.00117 mg/mL valerenic acid increased their residence time in the white side by 84.61 ± 6.55 % and 58.30 ± 8.97 %, respectively. LAP3 (mGluR I antagonist) and EGLU (mGluR II antagonist) significantly inhibited the effects of valerian and valerenic acid. These results demonstrated that valerian and valerenic acid have anxiolytic properties in the zebrafish. Moreover, the selective interaction of valerian with mGluR I and II represent an alternative explanation for the anxiolytic properties of this plant and support the role of mGluR in anxiety. Georg Thieme Verlag KG Stuttgart · New York.

  3. Nootropic, anxiolytic and CNS-depressant studies on different plant sources of shankhpushpi.

    Science.gov (United States)

    Malik, Jai; Karan, Maninder; Vasisht, Karan

    2011-12-01

    Shankhpushpi, a well-known drug in Ayurveda, is extensively used for different central nervous system (CNS) effects especially memory enhancement. Different plants are used under the name shankhpushpi in different regions of India, leading to an uncertainty regarding its true source. Plants commonly used under the name shankhpushpi are: Convolvulus pluricaulis Chois., Evolvulus alsinoides Linn., both from Convolvulaceae, and Clitoria ternatea Linn. (Leguminosae). To find out the true source of shankhpushpi by evaluating and comparing memory-enhancing activity of the three above mentioned plants. Anxiolytic, antidepressant and CNS-depressant activities of these three plants were also compared and evaluated. The nootropic activity of the aqueous methanol extract of each plant was tested using elevated plus-maze (EPM) and step-down models. Anxiolytic, antidepressant and CNS-depressant studies were evaluated using EPM, Porsolt?s swim despair and actophotometer models, respectively. C. pluricaulis extract (CPE) at a dose of 100 mg/kg, p.o. showed maximum nootropic and anxiolytic activity (p pluricaulis to be used as true source of shankhpushpi.

  4. Anti-anxiety and anti-depressant like effects of murraya koenigii in experimental models of anxiety and depression

    Directory of Open Access Journals (Sweden)

    Snigdha Sharma

    2017-01-01

    Full Text Available Background: Presence of free radical scavenging activity in Murraya koenigii, commonly known as Curry leaves, has been shown in previous studies. Oxidative stress plays an important role in the development of various neurobehavioral disorders including anxiety and depression. Aim: The present study aimed to evaluate the effects of Murraya koenigii in animal models of depression and anxiety. Materials and Methods: The effect of incremental doses of Murraya koenigii aqueous leaf extract was evaluated on spontaneous motor activity (SMA, open arm incursions in elevated plus maze, and despair behaviour in forced swim (FST and tail suspension (TST tests as compared to control groups in Swiss albino mice. Results: Murraya koenigii 300 mg/kg, p.o. (MK300 and 400 mg/kg, p.o. (MK400 reduced the SMA count from 754 ± 64.9 to 540 ± 29 and 295 ± 34 respectively, which was statistically significant. MK300 and MK400 reduced significantly the open arm count from 29 ± 8.6 to 16 ± 7 and 10 ± 3.9, respectively. On FST, MK400 reduced the duration of immobility from 145.5 ± 29 to 91 ± 17.3, which was statistically significant. On TST, MK produced a dose-dependent decrease in the duration of immobility; however, it was statistically significant only with MK400. Conclusion: Murraya koenigii aqueous leaf extract reduced the despair behavior in experimental animal models, suggesting an anti-depressant like activity. Murraya koenigii extract also reduced spontaneous locomotor activity in a dose-dependent manner suggesting a sedative and/or anxiolytic effect though there wasn't any anxiolytic effect in the elevated plus maze test.

  5. Use of SSRI and SNRI Antidepressants during Pregnancy: A Population-Based Study from Denmark, Iceland, Norway and Sweden.

    Science.gov (United States)

    Zoega, Helga; Kieler, Helle; Nørgaard, Mette; Furu, Kari; Valdimarsdottir, Unnur; Brandt, Lena; Haglund, Bengt

    2015-01-01

    The purpose was to describe utilization of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), including trends in prevalence, characteristics of users, drug switching and changes in prescribed doses in a large group of pregnant women across four Nordic countries. A drug utilization study based on linked individual-level data from the nationwide prescription- and medical birth registers in Denmark, Iceland, Norway and Sweden. The study population comprised all pregnancies in these countries, resulting in a live birth or stillbirth after gestational week 22 from January 1st 2008 to December 31st 2012 (N = 1 162 470). In addition to the main study drugs SSRIs and SNRIs, we included (concurrent) use of other antidepressants, antipsychotics, anxiolytics and hypnotics. A total of 38 219 (3.3%) pregnancies were exposed to SSRIs and 5 634 (0.5%) to SNRIs. Prevalence of SSRI and SNRI use varied by country (1.8% in Norway to 7.0% in Iceland). Use and prescribed dosages decreased with each passing trimester of pregnancy; prevalence was 2.7% at conception, and 2.1%, 1.7% and 1.3% respectively in 1st, 2nd and 3rd trimester. In 0.6% of pregnancies women filled a prescription before pregnancy and in every trimester. In one third of exposed pregnancies, women were also dispensed anxiolytics, hypnotics or sedatives. Use of SSRI and SNRI use during pregnancy varied between the Nordic countries, but the overall prevalence remained low and relatively stable from 2008 to 2012. The low prevalence of use and high proportion of women who discontinue treatment in pregnancy raise questions about adequate treatment of depression in pregnant women.

  6. Tricyclic Antidepressants

    Science.gov (United States)

    Schmidt, Gary J.

    The use of tricyclic antidepressant drugs is becoming increasingly prevalent for the treatment of depressed patients. It has been suggested that, analogous to many other drug substances, the tricyclic drugs exhibit clinical effectiveness within a defined therapeutic concentration range (1-10). Very recently, both Dito (11) and Orsulak and Schildkraut (12) have summarized the usefulness of measuring serum concentrations of these drugs. These authors suggest that knowledge of the plasma concentrations of these drugs aid the physician in determining patient compliance and initiating the best possible drug treatment.

  7. Pseudopheochromocytoma induced by anxiolytic withdrawal.

    Science.gov (United States)

    Páll, Alida; Becs, Gergely; Erdei, Annamária; Sira, Lívia; Czifra, Arpád; Barna, Sándor; Kovács, Péter; Páll, Dénes; Pfliegler, György; Paragh, György; Szabó, Zoltán

    2014-10-08

    Symptomatic paroxysmal hypertension without significantly elevated catecholamine concentrations and with no evidence of an underlying adrenal tumor is known as pseudopheochromocytoma. We describe the case of a female patient with paroxysmal hypertensive crises accompanied by headache, vertigo, tachycardia, nausea and altered mental status. Previously, she was treated for a longer period with alprazolam due to panic disorder. Causes of secondary hypertension were excluded. Neurological triggers (intracranial tumor, cerebral vascular lesions, hemorrhage, and epilepsy) could not be detected. Setting of the diagnosis of pseudopheochromocytoma treatment was initiated with alpha- and beta-blockers resulting in reduced frequency of symptoms. Alprazolam was restarted at a daily dose of 1 mg. The patient's clinical condition improved rapidly and the dosage of alpha- and beta-blockers could be decreased. We conclude that the withdrawal of an anxiolytic therapeutic regimen may generate sympathetic overdrive resulting in life-threatening paroxysmal malignant hypertension and secondary encephalopathy. We emphasize that pseudopheochromocytoma can be diagnosed only after exclusion of the secondary causes of hypertension. We highlight the importance of a psychopharmacological approach to this clinical entity.

  8. Sedation in the ICU

    DEFF Research Database (Denmark)

    Strøm, Thomas

    2012-01-01

    Standard treatment of critically ill patients undergoing mechanical ventilation is continuous sedation. This standard treatment to all patients has been greatly challenged over the last decade. At the general intensive care department at Odense University hospital the standard treatment has been......-sedation" method has however never been described in the literature or tested in a prospective randomized trial. Hypothesis: The main hypothesis was that a no sedation strategy reduces the time patients receive mechanical ventilation, decrease intensive care and total length of hospital stay. Secondary endpoints...... were: a no sedation strategy would reduce secondary organ failure such as kidney injury and would not increase the risk of post-traumatic stress disorder after hospital discharge....

  9. [Clinically relevant drug interactions with new generation antidepressants and antipsychotics].

    Science.gov (United States)

    Eckert, Anne

    2009-06-01

    Because antidepressants and antipsychotics are commonly described in combination with drugs used to treat comorbid psychiatric or somatic disorders (e.g. anxiolytics, mood stabilizers, cardiovascular drugs, antimicrobial agents), they may be involved in drug interactions. Furthermore, agents such as lithium and atypical antipsychotics may be used to augment the antidepressant response in cases of refractory depression. Based on their mechanisms, drug-drug interactions can be classified either as pharmacokinetic or pharmacodynamic in nature. The well-documented risk of potentially harmful pharmacodynamic drug interactions with first-generation anti-depressants, e.g. monoamine oxidase inhibitors (MAOIs), with regard to the induction of the serotonin syndrome, has contributed to a gradual decline in their use in clinical practise. Second- and third-generation antidepressants have gradually replaced tricyclic antidepressants (TCAs) and MAOIs, mainly because of their improved tolerability and safety profile. The second- and third-generation antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and other compounds with different mechanisms of action. These drugs and also the majority of antipsychotics are metabolized in the liver by the cytochrome P450 (CYP) enzyme system. Therefore, the use of these compounds may be associated with clinically relevant pharmacokinetic interactions with other medications. The knowledge about the CYP metabolism of drugs may be used to guide the selection of an antidepressant or an anti-psychotic with a low drug-drug interaction potential for an individual patient. The aim of the present article is to review drug-interaction potentials with specific focus on second-generation antidepressants (SSRIs), newer antidepressants (SNRIs: venlafaxine and duloxetine; bupropion, mirtazapine, trazodone), novel atypical antidepressants (agomelatine), as well as new generation

  10. Evaluation of anxiolytic activity of compound Valeriana jatamansi Jones in mice.

    Science.gov (United States)

    You, Jie-Shu; Peng, Min; Shi, Jin-Li; Zheng, Hu-Zhan; Liu, Yong; Zhao, Bao-Sheng; Guo, Jian-You

    2012-11-21

    Compound Valeriana jatamansi Jones is a formula for treating anxiety-related diseases in the clinic, which is composed of Valeriana jatamansi Rhizoma et Radix, Ziziphi Spinosae Semen, Albiziae Cortex and Junci Medulla. The purpose of this study was to explore the anxiolytic properties of this compound in mice. Male ICR mice were treated with compound Valerianae Jatamansi Jones (1.2 g/kg, 2.4 g/kg, 4.8 g/kg), saline, diazepam (2 mg/kg) orally for 10 days and then exposed to elevated maze-plus (EPM) and light-dark box (LDB). The effects of the compound on spontaneous activity were evaluated by locomotor activity test. We further investigated the mechanism of action underlying the anxiolytic-like effect of compound by pre-treating animals with antagonists of benzodiazepine (flumazenil, 3mg/kg) prior to evaluation using EPM and LDB. Compound Valerianae Jatamansi Jones (2.4, 4.8 g/kg, p.o.) significantly increased entries (P0.05). In addition, compound Valerianae Jatamansi Jones treatment didn't affect the spontaneous activity in mice (P> 0.05). The present study supports the hypothesis that compound Valeriana jatamansi Jones exert anxiolytic action but no sedative effects in mice and that this effect might be mediated by benzodiazepine receptors.

  11. Antiaging and Anxiolytic Effects of Combinatory Formulas Based on Four Medicinal Herbs

    Directory of Open Access Journals (Sweden)

    Rui Li

    2017-01-01

    Full Text Available The objective of the present study was to search for medicinal-herb combinations based on Radix Bupleurum chinense DC (“B”, Rhizoma Corydalis yanhusuo WT Wang (“Y”, Caulis Polygonum multiflorum Thunb (“P”, and Flos Albizia julibrissin Durazz (“A” for antiaging, anxiolytic, and sedative effects. Application of the D-galactose induced accelerated-aging model employing male ICR mice showed that oral administration of some combinations of B, Y, P, and A significantly improved spatial memory in Y-maze test and reduced brain levels of tumor necrosis factor-α and interleukin-6 based on immunoassays and oxidative stress marker malondialdehyde, based on the thiobarbituric acid test, and the loss of whiskers, indicating antiaging and antineurodegeneration effects. In addition, some of the combinatory formulas induced anxiolysis measured using the elevated plus-maze test and/or sedative effects measured using the hole-board test. Over the range of dosages examined, all possible combinations of the four herbs were devoid of any significant side effects in the form of altered locomotor activity, decreased muscle coordination, or anterograde amnesia assessed using the photobeam and rotarod and step-through passive avoidance methods, respectively. The results suggest that various combinations of the B, Y, P, and A herbs could be useful as nonsedative, antiaging and/or antineurodegenerative agents, or anxiolytic agents.

  12. Anxiolytic-Like Effects of Compound Zhi Zhu Xiang in Rats

    Directory of Open Access Journals (Sweden)

    Yan-Li Wang

    2012-01-01

    Full Text Available The purpose of this study was to determine whether compound zhi zhu xiang (CZZX exerts anxiolytic-like effects in rats. The animals were orally administered CZZX (0.75, 1.5, and 3 g/kg daily for 10 days and tested in the elevated plus maze (EPM, Vogel conflict test (VCT, and open field. Repeated treatment with CZZX (3 g/kg/day, p.o. significantly increased the percentage of both entries into and time spent on the open arms of the EPM compared with saline controls. In the VCT, repeated treatment with CZZX (1.5 and 3 g/kg/day, p.o. significantly increased the number of punished licks. The drug did not change the total entries into the open arms of the EPM or interfere with water consumption or nociceptive threshold, discarding potential confounding factors in the two tests. In the open field, locomotion was not reduced, discarding the possible sedative effect of CZZX. In the binding assay, the binding of [3H] Ro 15-1788 (flumazenil to the benzodiazepine binding site in washed crude synaptosomal membranes from rat cerebral cortex was affected by CZZX. These data indicate an anxiolytic-like profile of action for CZZX without sedative side effects, and this activity may be mediated by benzodiazepine binding site modulation at γ-aminobutyric acid-A receptors.

  13. Effects of antidepressant drugs on histamine-H1 receptors in the brain

    International Nuclear Information System (INIS)

    Hall, H.; Oegren, S.O.

    1984-01-01

    The histamine-H 1 receptor blocking properties of a number of structurally different antidepressant drugs have been evaluated using a 3 H-mepyramine binding assay and a guinea-pig ileum preparation. The tricyclic antidepressants all inhibited the histamine-H 1 receptor. Some newer antidepressant drugs, such as zimeldine and nomifensine were devoid of activity while others, such as iprindole and mianserin were very potent. It is concluded that antagonistic effects on the histamine-H 1 receptor is not associated with the therapeutic efficacy in depression, but may contribute to the sedative effects of the antidepressant drugs

  14. Depression, antidepressants, and sexual function.

    Science.gov (United States)

    Victor, B S

    1995-08-01

    Recent studies have suggested that serotonin reuptake inhibitors (SSRI's), prescribed for the relief of depression, can cause sexual dysfunction in up to fifty percent of those taking them. The SSRI's--including fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil)--affect mood stabilization by promoting the transmission of the neurotransmitter serotonin, although enhancing serotonergic function can decrease libido or lead to erectile difficulties. As an alternative to lowering antidepressant dosages and risking losing therapeutic gains, administering serotonin-blockers, such as cyproheptadine (Periactin) and yohimbine (Yocon), has been shown to restore sexual function. However, the serotonin antagonist, cyproheptadine, causes sedation and can reverse the antidepressant or anti-obsessive effect of the SSRI. Yohimbine enhances transmission of the neurotransmitter epinephrine, increasing the flow of blood to erectile tissue and stimulating sexual desire by activating the cerebral cortex. Its drawbacks are increased levels of panic attacks and higher required dosages. Other potential biochemical stratagems are: amantadine (Symmetrel), bromcriptine (Parlodel), and buspirone (Buspar), which enhance dopamine and serotonin transmission; and bethanecol (Urechline), which enhances choline transmission. One study indicates improved sexual response when the nonserotonergic, mildly dopamine-enhancing buproprion (Welbutrin) is substituted for fluoxetine.

  15. [Trends in the consumption of anxiolytic and hypnotic drugs in a Colombian population].

    Science.gov (United States)

    Machado-Alba, Jorge Enrique; Alzate-Carvajal, Verónica; Jimenez-Canizales, Carlos Eduardo

    2015-01-01

    In Latin America, psychotropic medications are the third most marketed drug group, especially antidepressants (35%) and anxiolytics (5%). The objective of this study was to determine the trends in the consumption and the costs of anxiolytic and hypnotic drugs in a population of patients enrolled in the Health System of Colombia. A descriptive, observational study was performed using the data recorded inprescriptions for any anxiolytic or hypnotic drug prescribed to outpatients in the period between January 2008 and December 2013 in a population of 3.5 million people. Sociodemographic, pharmacological variables, overall costs, and cost per thousand inhabitants per day (CHD), were also recorded. The number of patients who received the drugs studied varied from 11,097 to 19,231 between 2008 and 2013. The most used drugs were clonazepam (44.1% of formulations), alprazolam (31.2%), and lorazepam (13.2%). The invoiced value of anxiolytics increased from US$ 207,673.63 in 2008 to US$ 488,977 in 2013, an increase of 135.4%. The CHD was US$ 0.31 for benzodiazepines, and US$ 0.02 for zaleplon, zolpidem and zopiclone (Z drugs) for 2008, and US$ 0.36 and US$ 0.02 in 2013 respectively. The CHD declined after 2010 following the introduction of generic drugs. Patients receiving benzodiazepines in Colombia are mostly women, average age 55 years, with very low frequency in defined daily doses per thousand inhabitants when compared with other countries. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  16. Antidepressants and Alcohol

    Science.gov (United States)

    ... the concern? Why is it bad to mix antidepressants and alcohol? Answers from Daniel K. Hall-Flavin, M.D. It's best to avoid combining antidepressants and alcohol. It may worsen your symptoms, and ...

  17. Safety of antidepressants

    NARCIS (Netherlands)

    Swinkels, J. A.; de Jonghe, F.

    1995-01-01

    There are a number of criteria that can be used when selecting an antidepressant. In particular safety criteria are important, and a distinction can be drawn between "safe" and "less safe" antidepressants. The relative safety of different antidepressants has been assessed by looking at answers to

  18. The effects of tricyclic and 'atypical' antidepressants on spontaneous locomotor activity in rodents.

    Science.gov (United States)

    Tucker, J C; File, S E

    1986-01-01

    With the exception of amineptin, buproprion and nomifensine all tricyclic and 'atypical' antidepressants have been reported to reduce spontaneous motor activity in rodents, after both acute and chronic administration. However, with the diversity of chemical actions of these drugs it is unlikely that a single neurochemical mechanism is underlying this one behavioral effect. These widespread sedative effects have implications for interpreting behavioral changes in other test situations, since sedation generally occurs at doses that fall within the dose-range effective in other tests. We also review the effects on spontaneous motor activity of withdrawal from chronic antidepressant treatment.

  19. Antidepressants and dementia

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Søndergård, Lars; Forman, Julie Lyng

    2009-01-01

    BACKGROUND: It has been suggested that antidepressants may have neuroprotective abilities but it has newer been investigated lately whether treatment with antidepressants reduces the risk of dementia. METHOD: Linkage of registers of all prescribed antidepressants and diagnoses of dementia...... the rate increased with the number of prescriptions but continued long-term antidepressants treatment was associated with a reduction in the rate of dementia, however, not to the same level as the rate for the general population. This pattern was found for all classes of antidepressants (SSRIs, newer non...... in Denmark during a period from 1995 to 2005. RESULTS: Persons who purchased antidepressants once (N=687,552) had an increased rate of dementia compared to persons unexposed to antidepressants (N=779,831). Nevertheless, the rate of dementia changed over time; thus during the initial prescription periods...

  20. Antidepressants and dementia

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Søndergaard, Lars; Forman, Julie Lyng

    2009-01-01

    BACKGROUND: It has been suggested that antidepressants may have neuroprotective abilities but it has newer been investigated lately whether treatment with antidepressants reduces the risk of dementia. METHOD: Linkage of registers of all prescribed antidepressants and diagnoses of dementia...... in Denmark during a period from 1995 to 2005. RESULTS: Persons who purchased antidepressants once (N=687,552) had an increased rate of dementia compared to persons unexposed to antidepressants (N=779,831). Nevertheless, the rate of dementia changed over time; thus during the initial prescription periods...... the rate increased with the number of prescriptions but continued long-term antidepressants treatment was associated with a reduction in the rate of dementia, however, not to the same level as the rate for the general population. This pattern was found for all classes of antidepressants (SSRIs, newer non...

  1. Antidepressant-like effect of Kyllinga brevifolia rhizomes in male mice and chemical characterization of the components of the active ethyl acetate fraction.

    Science.gov (United States)

    Hellión-Ibarrola, M C; Montalbetti, Y; Heinichen, O Y; Kennedy, M L; Campuzano, M A; Alvarenga, N; Ibarrola, D A

    2016-12-24

    Kyllinga brevifolia rhizomes (Cyperaceae) are used in Paraguayan traditional medicine as a refreshing beverage, and is claimed to own digestive, diuretic, sedative, tonic, antispasmodic and sudorific properties. We have previously reported that its hydro- ethanolic rhizome extract possess sedative, anxiolytic and anti-aggressive-like effects in mice. However, information on its potential for treatment of syndromes associated with mood disorders is scarce. The purpose of this study is to characterize the putative antidepressant-like effects of the hydro-ethanolic extract (CEKb) and the ethyl acetate fraction (KbF-ethyl-ac) obtained from the rhizome of K. brevifolia (Rottb) on male mice exposed to forced swimming test. Also, chemical characterization of the components of the active ethyl acetate fraction was described. The antidepressant-like effects of CEKb and KbF-ethyl-ac were measured using the forced swimming test (FST) performance of male mice in single (acute), short-term and chronic modalities. Treatments in all modalities were made 1h before swimming test. The KbF-ethyl-ac was analyzed by LC-DAD-ESI-MS and LC-ESI-MS/MS in order to identify the active components. A single doses (1.0, 10.0 and 100.0mg/kg, p.o; pethyl-ac in male mice, a significant reduction of the immobility time were provoked. Likewise, short-term treatment (7 days) with 1.0, and 10.0mg/kg (pethyl-ac in male mice, a statistically significant reduction of the immobility time, were observed. Imipramine 32mg/kg/days, i.p, induced a statistically significant reduction of immobility time and was used as positive control to validate the method employed. Moreover, it was noted important differences in the onset of the antidepressant-like effect in the FST, depending on the modality of treatment with CEKb or KbF-ethyl-ac (acute, short-term or chronic). Both, efficacy and potency were higher when repeated administration of CEKb was used, and surprisingly the efficacy of 1.0mg/kg of KbF-ethyl-ac (14

  2. Evaluating different sedative drugs applied in procedural sedation

    Directory of Open Access Journals (Sweden)

    Azadeh Tafakori

    2014-12-01

    Full Text Available There are various criteria that affect the efficacy of the procedural sedation strategies required for performing different processes in emergency departments. Selecting the most effective and the safest sedative with or without analgesic effect for every individual patients and intervention is one of the main parts of the each emergency department practices. Based on previous studies, various sedative agents have been proposed, which have different benefits and adverse effects including propofol, ketamine, etomidate etc. Different side effects of administrating each drug, alone or in combination with each other, have been proposed such as vomiting, respiratory depression, hypoxia, hypotension and cardiac arrest. In this study we aimed to briefly review the properties of applied sedatives in different studies and also mention few related clinical trials with proper blinding, which were conducted to evaluate the efficacy of the sedative in procedural sedation.

  3. The benzodiazepine diazepam demonstrates the usefulness of Syrian hamsters as a model for anxiety testing: evaluation of other classes of anxiolytics in comparison to diazepam.

    Science.gov (United States)

    Gannon, Robert L; Lungwitz, Elizabeth; Batista, Natalia; Hester, Ian; Huntley, Christina; Peacock, Alyssa; Delagrange, Philippe; Millan, Mark J

    2011-03-17

    Clinical evidence in humans suggests that there is some linkage between dysfunction in the timing of circadian rhythms and certain types of depression. In animal models, Syrian hamsters have been used extensively to study the pharmacology of circadian rhythms, while rats and mice are used to screen putative anxiolytics/antidepressant compounds. It would be beneficial to be able to test anxiolytic/antidepressant compounds in hamsters in conjunction with circadian rhythm studies. Therefore, in this study, Syrian hamsters were used in three experimental paradigms to evaluate anxiety: the elevated plus maze, the t-tube, and the open field Thatcher-Britton conflict test. Diazepam, tested with 2mg/kg and 5mg/kg intraperitoneal injections, was found to induce anxiolytic activity in each of the three tests. Hamsters were more likely to spend time in the open arms in the plus maze, displayed more exploratory behavior in the t-tube, and were quicker to enter a brightly lit exposed field in the Thatcher-Britton conflict test following injections of diazepam. Diazepam (2mg/kg) was also tested at three times during the 24-h day in the elevated plus maze: at the beginning and end of the lights-on period (Zeitgeber times 23 and 11, respectively) and once in the dark just before the room lights came on (Zeitgeber time 20). Diazepam induced anxiolytic activity only at Zeitgeber 23. Therefore, the following known and putative anxiolytic compounds were also evaluated in each of the three tests at Zeitgeber 23: citalopram, the neurokinin(1) receptor antagonists GR205171 and vestipitant, the corticotropin releasing factor(1) receptor antagonist CP154526, the cannabinoid receptor(1) agonist CP55940, the serotonin(6) receptor antagonist SB399885, and the metabotropic glutamate receptor(5) antagonists fenobam and MTEP. Vestipitant displayed some anxiolytic activity in the elevated plus maze, but this effect was not confirmed with GR205171. None of the other compounds displayed any

  4. Neuropeptide S is a stimulatory anxiolytic agent: a behavioural study in mice.

    Science.gov (United States)

    Rizzi, A; Vergura, R; Marzola, G; Ruzza, C; Guerrini, R; Salvadori, S; Regoli, D; Calo, G

    2008-05-01

    Neuropeptide S (NPS) was recently identified as the endogenous ligand of an orphan receptor, now referred to as the NPS receptor. In vivo, NPS produces a unique behavioural profile by increasing wakefulness and exerting anxiolytic-like effects. In the present study, we further evaluated the effects of in vivo supraspinal NPS in mice. Effects of NPS, injected intracerebroventricularly (i.c.v.), on locomotor activity (LA), righting reflex (RR) recovery and on anxiety states (measured with the elevated plus maze (EPM) and stress-induced hyperthermia (SIH) tests) were assessed in Swiss mice. NPS (0.01-1 nmol per mouse) caused a significant increase in LA in naive mice, in mice habituated to the test cages and in animals sedated with diazepam (5 mg kg(-1)). In the RR assay, NPS dose dependently reduced the proportion of animals losing the RR in response to diazepam (15 mg kg(-1)) and their sleeping time. In the EPM and SIH test, NPS dose dependently evoked anxiolytic-like effects by increasing the time spent by animals in the open arms and reducing the SIH response, respectively. We provide further evidence that NPS acts as a novel modulator of arousal and anxiety-related behaviours by promoting a unique pattern of effects: stimulation associated with anxiolysis. Therefore, NPS receptor ligands may represent innovative drugs for the treatment of sleep and anxiety disorders.

  5. [On the proposed mechanism of action of antidepressants (author's transl)].

    Science.gov (United States)

    Le Fur, G

    1980-01-01

    Classical antidepressants (MAOI, uptake inhibitors) increase monoamine levels in the synaptic cleft. However other presynaptic mechanisms of action have been proposed: increase in release (amineptin), blockade of presynaptic alpha-adrenoceptors (mianserin). A postsynaptic approach is also possible: stimulation of beta-receptor (salbutamol), blockade of muscarinic receptor (quinupramine). Moreover the side effects have been correlated to a blockade of postsynaptic receptors: alpha 1 for aorthostatic hypotension, H1 for sedation and muscarinic for anticholinergic effects. However these effects do not explain the delay for the clinical efficiency of antidepressants. A desensitization of presynaptic receptors or a decrease in beta-postsynaptic receptors have been advanced. In fact a possible pharmacokinetic explanation for the delay of clinical efficiency, i.e. the necessary delay to reach brain steady state level, is possible. Finally the presence of imipramine binding sites might be a new approach of the mechanism of action of antidepressants.

  6. MRI and Anesthesia & Sedation

    Directory of Open Access Journals (Sweden)

    Asim Esen

    2017-08-01

    Full Text Available In 1945 Broch & Purcell described as Nuclear Magnetic Resonance. It wasused for chemical and biochemical analyses for long years. It was widelyused in medical applications after Lauterbur et al. ‘s study in 1973 (1.The primary screening method for breast cancer is mammography asknown. It is the only method that positively affects survival. But itssensitivity and specificity is not 100% and it can be an inadequate methodat some ages. Studies showed that: MRI imaging added mammographyincreased success rates but increased false positivity rates can cause someunnecessary invasive procedures. Although these breast MRI is widely usedfor screening, diagnosis and staging (2.More than 80 million MRI is worldwide applied yearly. Claustrophobia ratesare between 1-15% and more than 2 million breast MRI application isinterrupted for the necessitation of sedation (3. Melendez et al. noticedthat rate around 30%. Also 3-5% of these cases were interrupted due tothe sedation necessitation. Anxiety and claustrophobia can cause sequencerepeating, procedure cancellation and important time and labor loss.

  7. Safe sedation in general practice

    African Journals Online (AJOL)

    anxiolysis, amnesia, sedation or pain control? ∙ What will the effect of the drugs be on the airway, spontaneous breathing and cardiovascular system? The patient. As more procedures are performed OOR, the operator has retained the opportunity to evaluate patients pre-operatively. However, the sedation provider usually ...

  8. Chemical composition and anxiolytic-like effects of the Bauhinia platypetala

    Directory of Open Access Journals (Sweden)

    Francisco José Borges dos Santos

    2012-01-01

    Full Text Available The pantropical genus Bauhinia, Fabaceae, known popularly as cow's foot, is widely used in folk medicine as antidiabetic. Behavioral effects of the ethanolic extract and ethereal, aqueous and ethyl acetate fractions from B. platypetala Benth. ex Hemsl. leaves were studied in male Swiss mice. The ethanolic extract and fractions were administered intraperitoneally and its effects on spontaneous motor activity (total motility, locomotion, rearing and grooming behavior were monitored. Anxiolytic-like properties were studied in the elevated plus-maze test and the possible antidepressant-like actions were evaluated in the forced swimming test. The results revealed that only the highest dose of the ethereal fraction (50 mg/kg, i.p. caused a significant decrease in total motility, locomotion and rearing. Sole dose injected (50 mg/kg of ethanolic extract and ethereal fractions increased the exploration of the elevated plus-maze open arms in a similar way to that of diazepam (2 mg/kg, i.p.. In the forced swimming test, the ethanolic extract and their fractions (12.5, 25 or 50 mg/kg was not as effective as paroxetine (10 or 20 mg/kg, i.p. and imipramine (25 or 50 mg/kg, i.p. in reducing immobility. These results suggest that some of the components of the ethanolic extract and of the ethereal fraction from B. platypetala, such as p-cymene, phytol, D-lactic acid, hexadecanoic acid, among others, may have anxiolytic-like properties, which deserve further investigation. Furthermore, the results obtained indicate that ethanolic extract from B. platypetala and their fractions do not present antidepressive properties. However, these properties cannot be related to the chemical constituents identified in this specie.

  9. Effects of Calcium Channel Blockers on Antidepressant Action of Alprazolam and Imipramine

    Directory of Open Access Journals (Sweden)

    Gorash ZM

    2007-01-01

    Full Text Available Alprazolam is effective as an anxiolytic and in the adjunct treatment of depression. In this study, the effects of calcium channel antagonists on the antidepressant action of alprazolam and imipramine were investigated. A forced swimming maze was used to study behavioral despair in albino mice. Mice were divided into nine groups (n = 7 per group. One group received a single dose of 1% Tween 80; two groups each received a single dose of the antidepressant alone (alprazolam or imipramine; two groups each received a single dose of the calcium channel blocker (nifedipine or verapamil; four groups each received a single dose of the calcium channel blocker followed by a single dose of the antidepressant (with same doses used for either in the previous four groups. Drug administration was performed concurrently on the nine groups. Our data confirmed the antidepressant action of alprazolam and imipramine. Both nifedipine and verapamil produced a significant antidepressant effect (delay the onset of immobility when administered separately. Verapamil augmented the antidepressant effects of alprazolam and imipramine (additive antidepressant effect. This may be due to the possibility that verapamil might have antidepressant-like effect through different mechanism. Nifedipine and imipramine combined led to a delay in the onset of immobility greater than their single use but less than the sum of their independent administration. This may be due to the fact that nifedipine on its own might act as an antidepressant but blocks one imipramine mechanism that depends on L-type calcium channel activation. Combining nifedipine with alprazolam produced additional antidepressant effects, which indicates that they exert antidepressant effects through different mechanisms.

  10. [Antidepressants in epilepsy].

    Science.gov (United States)

    Castaño-Monsalve, Beatriz

    2013-08-01

    Depression is a common condition in patients with epilepsy that entails a deterioration of the quality of life of this population and that, therefore, requires appropriate treatment. The potential risk of antidepressants in relation to the seizure threshold is overestimated by many professionals, and this has an influence when it comes to making the decision to treat them. It sometimes means that the patients do not receive antidepressant drugs. In this regard, the aim of this review is to present the current state of the art in terms of the safety of antidepressants in patients with epilepsy. A search of the medical literature was conducted and, following its analysis, the most significant results are presented. Current information indicates that most antidepressants are safe for epileptic patients at therapeutic doses and that the risk of seizures occurs mainly in cases of overdose. Preferred drugs for treating depression in epilepsy are serotonin reuptake inhibitors. Bupropion and tricyclic antidepressants must be avoided.

  11. Antidepressants and platinum drugs.

    Science.gov (United States)

    Engelmann, Brigitte J; Ryan, John J; Farrell, Nicholas P

    2014-01-01

    Antidepressants are frequently prescribed concurrently with anti-cancer drugs and may have synergistic, additive or antagonistic effects. The present work investigated the effect of antidepressants on the cytotoxicity of platinum agents cisplatin, carboplatin and oxaliplatin. The cytotoxicity of platinum drugs alone or in combination with antidepressants was measured in HCT116 wild-type (wt), HCT116 (p53 -/-), HT-29, SKOV3 and A2780 cells using an apoptosis-based assay. The effect of antidepressants on platinum cytotoxicity is both cell type- and drug dependent. Mostly additive effects were observed. Desipramine and fluoxetine caused the greatest effects, with cisplatin in general being most sensitive to their presence. There is little effect of p53 status on the drug-drug interaction while the calmodulin inhibitor W7 augmented cisplatin cytotoxicity relative to carboplatin and oxaliplatin. The drug-drug interaction between antidepressants and platinum anti-cancer agents requires detailed evaluation for optimization of patient care.

  12. Analgesic, Anxiolytic and Anaesthetic Effects of Melatonin: New Potential Uses in Pediatrics

    Directory of Open Access Journals (Sweden)

    Lucia Marseglia

    2015-01-01

    Full Text Available Exogenous melatonin is used in a number of situations, first and foremost in the treatment of sleep disorders and jet leg. However, the hypnotic, antinociceptive, and anticonvulsant properties of melatonin endow this neurohormone with the profile of a drug that modulates effects of anesthetic agents, supporting its potential use at different stages during anesthetic procedures, in both adults and children. In light of these properties, melatonin has been administered to children undergoing diagnostic procedures requiring sedation or general anesthesia, such as magnetic resonance imaging, auditory brainstem response tests and electroencephalogram. Controversial data support the use of melatonin as anxiolytic and antinociceptive agents in pediatric patients undergoing surgery. The aim of this review was to evaluate available evidence relating to efficacy and safety of melatonin as an analgesic and as a sedative agent in children. Melatonin and its analogs may have a role in antinociceptive therapies and as an alternative to midazolam in premedication of adults and children, although its effectiveness is still controversial and available data are clearly incomplete.

  13. Comparison of Anxiolytic Effect of Matricaria Recutita in Male and Female Mice in the Presence and Absence of Gonads

    Directory of Open Access Journals (Sweden)

    Pourmehdi Rad Goli

    2009-06-01

    Full Text Available Background: Some studies indicated that the chamomile induces sedative and anxiolytic effects. It has been shown that this herbal drug contains some phytoestrogenic components. Concerning the different effects of sexual hormones on various physiological phenomena such as anxiety, it seems this herb has different effects on anxiety in males and females. So in this study we examined anxiolytic property of Iranian spicious of chamomile, Matricaria recutita (MR hydroalcholic extract in presence and absence of sexual glands in male and female animal models. Materials and Methods: This animal study was done in Shahid Chamran University in 2006. NMRI male and female mice were divided in 16 groups of seven mices including: intact, sham, gonadectomized, receiving hydroalcholic extract of MR (10, 30, 50 mg/kg, ip. Elevated plus maze was used to evaluate anxiety and locomotive activity in all groups. Statistical evaluation of data was performed using Student's t-test and analysis of variance (ANOVA with one factor followed by Tukey test. P<0.05 was considered significant. Results: MR induced anxiolytic effect (10, 30 mg/kg in intact (P<0.05 and gonadectomized male mice (P<0.05 while did not significant any effect on intact and gonadectomized females. Testectomized mice were more anxious than sham group (P<0.05. Ovariectomized mice had no difference in level of anxiety with sham group. MR had no effect on locomotive activity in male mice but decreased it in females only in dose of 50 mg/kg (P<0.05. Conclusion: It seems that the anxiolytic effect of MR is sex dependent and probably this different effect in two sexes is related to its phytoestrogenic components

  14. Citrus aurantium L. essential oil exhibits anxiolytic-like activity mediated by 5-HT(1A)-receptors and reduces cholesterol after repeated oral treatment.

    Science.gov (United States)

    Costa, Celso A R A; Cury, Thaís C; Cassettari, Bruna O; Takahira, Regina K; Flório, Jorge C; Costa, Mirtes

    2013-02-23

    The current treatments for anxiety disorders and depression have multiple adverse effects in addition to a delayed onset of action, which has prompted efforts to find new substances with potential activity in these disorders. Citrus aurantium was chosen based on ethnopharmacological data because traditional medicine refers to the Citrus genus as useful in diminishing the symptoms of anxiety or insomnia, and C. aurantium has more recently been proposed as an adjuvant for antidepressants. In the present work, we investigated the biological activity underlying the anxiolytic and antidepressant effects of C. aurantium essential oil (EO), the putative mechanism of the anxiolytic-like effect, and the neurochemical changes in specific brain structures of mice after acute treatment. We also monitored the mice for possible signs of toxicity after a 14-day treatment. The anxiolytic-like activity of the EO was investigated in a light/dark box, and the antidepressant activity was investigated in a forced swim test. Flumazenil, a competitive antagonist of benzodiazepine binding, and the selective 5-HT(1A) receptor antagonist WAY100635 were used in the experimental procedures to determine the mechanism of action of the EO. To exclude false positive results due to motor impairment, the mice were submitted to the rotarod test. The data suggest that the anxiolytic-like activity observed in the light/dark box procedure after acute (5 mg/kg) or 14-day repeated (1 mg/kg/day) dosing was mediated by the serotonergic system (5-HT(1A) receptors). Acute treatment with the EO showed no activity in the forced swim test, which is sensitive to antidepressants. A neurochemical evaluation showed no alterations in neurotransmitter levels in the cortex, the striatum, the pons, and the hypothalamus. Furthermore, no locomotor impairment or signs of toxicity or biochemical changes, except a reduction in cholesterol levels, were observed after treatment with the EO. This work contributes to a better

  15. Citrus aurantium L. essential oil exhibits anxiolytic-like activity mediated by 5-HT1A-receptors and reduces cholesterol after repeated oral treatment

    Science.gov (United States)

    2013-01-01

    Background The current treatments for anxiety disorders and depression have multiple adverse effects in addition to a delayed onset of action, which has prompted efforts to find new substances with potential activity in these disorders. Citrus aurantium was chosen based on ethnopharmacological data because traditional medicine refers to the Citrus genus as useful in diminishing the symptoms of anxiety or insomnia, and C. aurantium has more recently been proposed as an adjuvant for antidepressants. In the present work, we investigated the biological activity underlying the anxiolytic and antidepressant effects of C. aurantium essential oil (EO), the putative mechanism of the anxiolytic-like effect, and the neurochemical changes in specific brain structures of mice after acute treatment. We also monitored the mice for possible signs of toxicity after a 14-day treatment. Methods The anxiolytic-like activity of the EO was investigated in a light/dark box, and the antidepressant activity was investigated in a forced swim test. Flumazenil, a competitive antagonist of benzodiazepine binding, and the selective 5-HT1A receptor antagonist WAY100635 were used in the experimental procedures to determine the mechanism of action of the EO. To exclude false positive results due to motor impairment, the mice were submitted to the rotarod test. Results The data suggest that the anxiolytic-like activity observed in the light/dark box procedure after acute (5 mg/kg) or 14-day repeated (1 mg/kg/day) dosing was mediated by the serotonergic system (5-HT1A receptors). Acute treatment with the EO showed no activity in the forced swim test, which is sensitive to antidepressants. A neurochemical evaluation showed no alterations in neurotransmitter levels in the cortex, the striatum, the pons, and the hypothalamus. Furthermore, no locomotor impairment or signs of toxicity or biochemical changes, except a reduction in cholesterol levels, were observed after treatment with the EO. Conclusion

  16. Sedation in cardiac arrhythmias management.

    Science.gov (United States)

    Guerra, Federico; Stronati, Giulia; Capucci, Alessandro

    2018-03-01

    Procedural sedation is of paramount importance for a plethora of electrophysiological procedures. From electrical cardioversion to electrophysiology studies, device implantations, and catheter ablations, intraprocedural sedation and anesthesia have a pivotal role in allowing procedural success while ensuring patient safety and avoiding discomfort. Areas covered: The present review will discuss the current state-of-the-art in sedation and anesthesia during electrical cardioversion, cardiac implantable electronic device implantation, catheter ablation and electrophysiology studies. Specific information will be provided for each procedure in order to reach the core of this important clinical issue, and specific protocols will be compared. The main pro-arrhythmic and anti-arrhythmic effects of the most commonly used sedatives will also be discussed. Expert commentary: According to much recent evidence, the cardiologist can be the only person responsible for sedation administration in many settings, highlighting few safety issues associated with the absence of a dedicated anesthesiologist thus a concomitant reduction in costs. However, many concerns have been raised in allowing non-anesthesiologists to manage sedatives, as adverse events, while rare, could have catastrophic consequences. The present paper will highlight when a cardiologist-directed sedation is considered safe, how it should be performed, and the pros and cons related to this strategy.

  17. [Antidepressants in bipolar disorder].

    Science.gov (United States)

    Courtet, P; Samalin, L; Olié, E

    2011-12-01

    Whereas mania defines the bipolar disorder, depression is the major challenge of treatment. In general, depressions are more frequent, longer, with a major prognostic impact in terms of disability and suicide. How should we treat a patient with bipolar depression? Antidepressants are the treatment of choice for depression, but not in the bipolar disorder. In this context, we have traditionally accepted that antidepressants are effective but they were inducing a significant risk of destabilization of the bipolar disorder, because of the transitions to mania and rapid cycling. Current data reconsider both the two aspects of this risk-benefit ratio. The effectiveness of antidepressants finally seems very limited, especially after the more recent studies with a robust methodology. Manic switches and rapid cycling may not be increased, particularly with new antidepressants and mood stabilizer combinations. The current literature reminds us that these course's modalities are inherent to the disease, with numerous risk factors, and among them, exposure to antidepressants. Who are the bipolar patients who only get the benefits of antidepressant treatment? Research will tell. They are in any case limited. How to navigate in our treatment strategies ? By choosing first drugs that demonstrated efficacy in bipolar depression. When the situation is more complex, "primum non nocere" should lead to support the prescription of the antidepressant in association with mood stabilizer. Copyright © 2011 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

  18. [Determining factors for the use of anxiolytic and hypnotic drugs in the elderly].

    Science.gov (United States)

    Téllez-Lapeira, Juan M; López-Torres Hidalgo, Jesús; Gálvez-Alcaraz, Luis; Párraga-Martínez, Ignacio; Boix-Gras, Clotilde; García-Ruiz, Antonio

    To estimate the prevalence of self-reported anxiety/hypnotics use in adults 65 years and older and identify potential factors that determine the use of these drugs. Cross-sectional study conducted on a study population of 1,161 non-institutionalised adults 65 years old and older with enough ability to conduct a personal interview. Participants were randomly selected from health care registers. The main outcomes of interest included consumption of anxiolytics, hypnotics and other drugs (filed by ATC classification system), mood (based on the Yesavage geriatric depression scale), cognitive status (Pfeiffer questionnaire), physical-functional assessment of basic activities of daily living (Katz index), health problems (ICPC-2 classification WONCA), and sociodemographic variables. The prevalence of self-reported anxiety/hypnotics consumption was 16.6% (95% CI: 14.5 - 18.7), of which 90.5% were benzodiazepines (BZD), mainly lorazepam (39.4% of BZD). Long half-life BZD accounted for 24.7% of BZD. Hypnotics accounted for 27.5% of anxiolytics/hypnotics. The use of sedatives/hypnotics was independently associated with other drugs (non-psychotropics) consumption (OR 6.8, 95% CI: 2.1-22.0), presence of established depression (OR: 2.5; 95% CI: 1.0 -5.9), presence of 4 or more comorbidities (OR: 2.0; 95% CI: 1.4-2.9), being female (OR 2.1, 95% CI: 1.5-3.1) and being dependent for basic activities of daily living (OR: 1.8, 95% CI: 1.1-2.9). The prevalence of sedatives/hypnotics use in the elderly from Albacete is high. Several factors were identified as potential determinants of sedatives/hypnotics use in our study population. It will be important to evaluate the misuse of these drugs in order to develop effective, efficient and safe prescription strategies. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Use of Antidepressants

    Science.gov (United States)

    Kalali, Amir H.; Thase, Michael E.

    2007-01-01

    We investigated antidepressant prescriptions and reasons for use. According to our data, the top 10 molecules represent ∼95% of total antidepressant prescriptions for both primary care physicians (PCPs) and psychiatrists. The primary difference between PCPs and psychiatrists was the increased use of buproprion and tricyclics/tetracyclics by psychiatrists. The selective serotonin reuptake inhibitors (SSRIs) and other newer antidepressants such as venlafaxine (Effexor) and buproprion (Wellbutrin) are used to treat depression, anxiety, and bipolar disorders. The noted exception is duloxetine (Cymbalta), which looks like a blend between the newer agents and the tricyclics where there is use beyond the traditional central nervous system (CNS) disorders into pain and migraine. PMID:20436760

  20. Support for Natural Small-Molecule Phenols as Anxiolytics

    Directory of Open Access Journals (Sweden)

    Xiaohong Wang

    2017-12-01

    Full Text Available Natural small-molecule phenols (NSMPs share some bioactivities. The anxiolytic activity of NSMPs is attracting attention in the scientific community. This paper provides data supporting the hypothesis that NSMPs are generally anxiolytic. The anxiolytic activities of seven simple phenols, including phloroglucinol, eugenol, protocatechuic aldehyde, vanillin, thymol, ferulic acid, and caffeic acid, were assayed with the elevated plus maze (EPM test in mice. The oral doses were 5, 10 and 20 mg/kg, except for phloroglucinol for which the doses were 2.5, 5 and 10 mg/kg. All tested phenols had anxiolytic activity in mice. The phenolic hydroxyl group in 4-hydroxycinnamic acid (4-OH CA was essential for the anxiolytic activity in the EPM test in mice and rats compared to 4-chlorocinnamic acid (4-Cl CA. The in vivo spike recording of rats’ hippocampal neurons also showed significant differences between 4-OH CA and 4-Cl CA. Behavioral and neuronal spike recording results converged to indicate the hippocampal CA1 region might be a part of the anxiolytic pathways of 4-OH CA. Therefore, our study provides further experimental data supporting NSMPs sharing anxiolytic activity, which may have general implications for phytotherapy because small phenols occur extensively in herbal medicines.

  1. Intranasal sedatives in pediatric dentistry.

    Science.gov (United States)

    AlSarheed, Maha A

    2016-09-01

    To identify the intranasal (IN) sedatives used to achieve conscious sedation during dental procedures amongst children. A literature review was conducted by identifying relevant studies through searches on Medline. Search included IN of midazolam, ketamine, sufentanil, dexmedetomidine, clonidine, haloperidol, and loranzepam. Studies included were conducted amongst individuals below 18 years, published in English, and were not restricted by year. Exclusion criteria were articles that did not focus on pediatric dentistry.  Twenty studies were included. The most commonly used sedatives were midazolam, followed by ketamine and sufentanil. Onset of action for IN midazolam was 5-15 minutes (min), however, IN ketamine was faster (mean 5.74 min), while both IN sufentanil (mean 20 min) and IN dexmedetomidine (mean 25 min) were slow in comparison. Midazolam was effective for modifying behavior in mild to moderately anxious children, however, for more invasive or prolonged procedures, stronger sedatives, such as IN ketamine, IN sufentanil were recommended. In addition, ketamine fared better in overall success rate (89%) when compared with IN midazolam (69%). Intranasal dexmedetomidine was only used as pre-medication amongst children. While its' onset of action is longer when compared with IN midazolam, it produced deeper sedation at the time of separation from the parent and at the time of anesthesia induction. Intranasal midazolam, ketamine, and sufentanil are effective and safe for conscious sedation, while intranasal midazolam, dexmedetomidine, and sufentanil have proven to be effective premedications.

  2. Muscle power during intravenous sedation

    Directory of Open Access Journals (Sweden)

    Nobuyuki Matsuura

    2017-11-01

    Full Text Available Intravenous sedation is effective to reduce fear and anxiety in dental treatment. It also has been used for behavior modification technique in dental patients with special needs. Midazolam and propofol are commonly used for intravenous sedation. Although there have been many researches on the effects of midazolam and propofol on vital function and the recovery profile, little is known about muscle power. This review discusses the effects of intravenous sedation using midazolam and propofol on both grip strength and bite force. During light propofol sedation, grip strength increases slightly and bite force increases in a dose-dependent manner. Grip strength decreases while bite force increases during light midazolam sedation, and also during light sedation using a combination of midazolam and propofol. Flumazenil did not antagonise the increase in bite force by midazolam. These results may suggest following possibilities; (1 Activation of peripheral benzodiazepine receptors located within the temporomandibular joint region and masticatory muscles may be the cause of increasing bite force. (2 Propofol limited the long-latency exteroceptive suppression (ES2 period during jaw-opening reflex. Thus, control of masticatory muscle contraction, which is thought to have a negative feedback effect on excessive bite force, may be depressed by propofol.

  3. Intranasal sedatives in pediatric dentistry

    Science.gov (United States)

    AlSarheed, Maha A.

    2016-01-01

    Objectives: To identify the intranasal (IN) sedatives used to achieve conscious sedation during dental procedures amongst children. Methods: A literature review was conducted by identifying relevant studies through searches on Medline. Search included IN of midazolam, ketamine, sufentanil, dexmedetomidine, clonidine, haloperidol and loranzepam. Studies included were conducted amongst individuals below 18 years, published in English, and were not restricted by year. Exclusion criteria were articles that did not focus on pediatric dentistry. Results: Twenty studies were included. The most commonly used sedatives were midazolam, followed by ketamine and sufentanil. Onset of action for IN midazolam was 5-15 minutes (min), however, IN ketamine was faster (mean 5.74 min), while both IN sufentanil (mean 20 min) and IN dexmedetomidine (mean 25 min) were slow in comparison. Midazolam was effective for modifying behavior in mild to moderately anxious children, however, for more invasive or prolonged procedures, stronger sedatives, such as IN ketamine, IN sufentanil were recommended. In addition, ketamine fared better in overall success rate (89%) when compared with IN midazolam (69%). Intranasal dexmedetomidine was only used as pre-medication amongst children. While its’ onset of action is longer when compared with IN midazolam, it produced deeper sedation at the time of separation from the parent and at the time of anesthesia induction. Conclusion: Intranasal midazolam, ketamine and sufentanil are effective and safe for conscious sedation, while intranasal midazolam, dexmedetomidine and sufentanil have proven to be effective premedications. PMID:27570849

  4. Synthesis of Chlorinated Tetracyclic Compounds and Testing for Their Potential Antidepressant Effect in Mice

    Directory of Open Access Journals (Sweden)

    Usama Karama

    2016-01-01

    Full Text Available The synthesis of the tetracyclic compounds 1-(4,5-dichloro-9,10-dihydro-9,10-ethanoanthracen-11-yl-N-methylmethanamine (5 and 1-(1,8-dichloro-9,10-dihydro-9,10-ethanoanthracen-11-yl-N-methylmethanamine (6 as a homologue of the anxiolytic and antidepressant drugs benzoctamine and maprotiline were described. The key intermediate aldehydes (3 and (4 were successfully synthesized via a [4 + 2] cycloaddition between acrolein and 1,8-dichloroanthracene. The synthesized compounds were investigated for antidepressant activity using the forced swimming test. Compounds (5, (6 and (3 showed significant reduction in the mice immobility indicating significant antidepressant effects. These compounds significantly reduced the immobility times at a dose 80 mg/kg by 84.0%, 86.7% and 71.1% respectively.

  5. Anxiety in Children Undergoing VCUG: Sedation or No Sedation?

    Directory of Open Access Journals (Sweden)

    David W. Herd

    2008-01-01

    Full Text Available Background. Voiding cystourethrograms are distressing for children and parents. Nonpharmacological methods reduce distress. Pharmacological interventions for VCUG focus on sedation as well as analgesia, anxiolysis, and amnesia. Sedation has cost, time, and safety issues. Which agents and route should we use? Are we sure that sedation does not influence the ability to diagnose vesicoureteric reflux? Methods. Literature search of Medline, EMBASE, and the Cochrane Database. Review of comparative studies found. Results. Seven comparative studies including two randomised controlled trials were reviewed. Midazolam given orally (0.5-0.6 mg/kg or intranasally (0.2 mg/kg is effective with no apparent effect on voiding dynamics. Insufficient evidence to recommend other sedating agents was found. Deeper sedating agents may interfere with voiding dynamics. Conclusion. Midazolam reduces the VCUG distress, causes amnesia, and does not appear to interfere with voiding dynamics. Midazolam combined with simple analgesia is an effective method to reduce distress to children undergoing VCUG.

  6. Cognitive Effects and Sedation.

    Science.gov (United States)

    Dhingra, Lara; Ahmed, Ebtesam; Shin, Jae; Scharaga, Elyssa; Magun, Maximilian

    2015-10-01

    Cognitive effects and sedation (CES) are prevalent in chronic nonmalignant pain populations receiving long-term opioid therapy and are among the most common reasons patients discontinue opioid use. In this narrative review, we describe the phenomenology, epidemiology, mechanisms, assessment, and management of opioid-related CES. We reviewed the empirical and theoretical literature on CES in opioid-treated populations with chronic pain. Data on long-term opioid therapy (≥ 3 months in duration) in chronic nonmalignant pain patients were sought. The phenomenology of CES includes: inattention, concentration difficulties, memory deficits, psychomotor dysfunction, perceptual distortions, and executive dysfunction and somnolence, sleep disorders, and lethargy. Deficits may be caused by unrelieved pain or opioid therapy alone, or from a combination of these and other factors. Mechanisms include central nervous system effects, for example, direct toxic effects on neurons resulting in decreased consciousness; direct effects on processing and reaction resulting in cognitive or psychomotor impairment, and inhibitory effects on cholinergic activity. Pharmacological management approaches may include opioid dose reduction and rotation or psychostimulant use. Nonpharmacological approaches may include cognitive-behavioral therapy, mindfulness-based stress reduction, acupuncture, exercise, and yoga. The most prevalent CES include: memory deficits (73-81%), sleep disturbance (35-57%), and fatigue (10%). At its most severe, extreme cognitive dysfunction can result in frank delirium and decreased alertness can result in coma. Emotional distress, sleep disorders, and other comorbidities and treatments can worsen CES, particularly among the elderly. Conclusions about the neuropsychological domains affected by opioids are limited due to the heterogeneity of studies and methodological issues. Wiley Periodicals, Inc.

  7. Anxiolytic and antidepressive effects of electric stimulation of the paleocerebellar cortex in pentylenetetrazol kindled rats

    NARCIS (Netherlands)

    Godlevsky, L.S.; Muratova, T.N.; Kresyun, N.V.; Luijtelaar, E.L.J.M. van; Coenen, A.M.L.

    2014-01-01

    Anxiety and depression are component of interictal behavioral deteriorations that occur as a consequence of kindling, a procedure to induce chronic epilepsy. The aim of this study was to evaluate the possible effects of electrical stimulation (ES) of paleocerebellar cortex on anxiety and

  8. Examining the short-term anxiolytic and antidepressant effect of Floatation-REST.

    Directory of Open Access Journals (Sweden)

    Justin S Feinstein

    Full Text Available Floatation-REST (Reduced Environmental Stimulation Therapy reduces sensory input to the nervous system through the act of floating supine in a pool of water saturated with Epsom salt. The float experience is calibrated so that sensory signals from visual, auditory, olfactory, gustatory, thermal, tactile, vestibular, gravitational and proprioceptive channels are minimized, as is most movement and speech. This open-label study aimed to examine whether Floatation-REST would attenuate symptoms of anxiety, stress, and depression in a clinical sample. Fifty participants were recruited across a spectrum of anxiety and stress-related disorders (posttraumatic stress, generalized anxiety, panic, agoraphobia, and social anxiety, most (n = 46 with comorbid unipolar depression. Measures of self-reported affect were collected immediately before and after a 1-hour float session, with the primary outcome measure being the pre- to post-float change score on the Spielberger State Anxiety Inventory. Irrespective of diagnosis, Floatation-REST substantially reduced state anxiety (estimated Cohen's d > 2. Moreover, participants reported significant reductions in stress, muscle tension, pain, depression and negative affect, accompanied by a significant improvement in mood characterized by increases in serenity, relaxation, happiness and overall well-being (p < .0001 for all variables. In reference to a group of 30 non-anxious participants, the effects were found to be more robust in the anxious sample and approaching non-anxious levels during the post-float period. Further analysis revealed that the most severely anxious participants reported the largest effects. Overall, the procedure was well-tolerated, with no major safety concerns stemming from this single session. The findings from this initial study need to be replicated in larger controlled trials, but suggest that Floatation-REST may be a promising technique for transiently reducing the suffering in those with anxiety and depression.ClinicalTrials.gov NCT03051074.

  9. The potential of inhibitors of endocannabinoid metabolism as anxiolytic and antidepressive drugs--A practical view.

    Science.gov (United States)

    Fowler, Christopher J

    2015-06-01

    The endocannabinoid system, comprising cannabinoid CB1 and CB2 receptors, their endogenous ligands anandamide and 2-arachidonoylglyerol, and their synthetic and metabolic enzymes, are involved in many biological processes in the body, ranging from appetite to bone turnover. Compounds inhibiting the breakdown of anandamide and 2-arachidonoylglycerol increase brain levels of these lipids and thus modulate endocannabinoid signalling. In the present review, the preclinical evidence that these enzymes are good targets for development of novel therapies for anxiety and depression are discussed from a practical, rather than mechanistic, point of view. It is concluded that the preclinical data are promising, albeit tempered by problems of tolerance as well as effects upon learning and memory for irreversible monoacylglycerol lipase inhibitors, and limited by a focus upon male rodents alone. Clinical data so far has been restricted to safety studies with inhibitors of anandamide hydrolysis and a hitherto unpublished study on such a compound in elderly patients with major depressive disorders, but under the dose regimes used, they are well tolerated and show no signs of "cannabis-like" behaviours. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

  10. Anxiolytic Treatment Impairs Helping Behavior in Rats

    Science.gov (United States)

    Ben-Ami Bartal, Inbal; Shan, Haozhe; Molasky, Nora M. R.; Murray, Teresa M.; Williams, Jasper Z.; Decety, Jean; Mason, Peggy

    2016-01-01

    Despite decades of research with humans, the biological mechanisms that motivate an individual to help others remain poorly understood. In order to investigate the roots of pro-sociality in mammals, we established the helping behavior test, a paradigm in which rats are faced with a conspecific trapped in a restrainer that can only be opened from the outside. Over the course of repeated test sessions, rats exposed to a trapped cagemate learn to open the door to the restrainer, thereby helping the trapped rat to escape (Ben-Ami Bartal et al., 2011). The discovery of this natural behavior provides a unique opportunity to probe the motivation of rodent helping behavior, leading to a deeper understanding of biological influences on human pro-sociality. To determine if an affective response motivates door-opening, rats receiving midazolam, a benzodiazepine anxiolytic, were tested in the helping behavior test. Midazolam-treated rats showed less helping behavior than saline-treated rats or rats receiving no injection. Yet, midazolam-treated rats opened a restrainer containing chocolate, highlighting the socially specific effects of the anxiolytic. To determine if midazolam interferes with helping through a sympatholytic effect, the peripherally restricted beta-adrenergic receptor antagonist nadolol was administered; nadolol did not interfere with helping. The corticosterone response of rats exposed to a trapped cagemate was measured and compared to the rats’ subsequent helping behavior. Rats with the greatest corticosterone responses showed the least helping behavior and those with the smallest responses showed the most consistent helping at the shortest latency. These results are discussed in terms of their implications for the interaction between stress and pro-social behavior. Finally, we observed that door-opening appeared to be reinforcing. A novel analytical tool was designed to interrogate the pattern of door-opening for signs that a rat’s behavior on one

  11. Anxiolytic Treatment Impairs Helping Behavior in Rats.

    Science.gov (United States)

    Ben-Ami Bartal, Inbal; Shan, Haozhe; Molasky, Nora M R; Murray, Teresa M; Williams, Jasper Z; Decety, Jean; Mason, Peggy

    2016-01-01

    Despite decades of research with humans, the biological mechanisms that motivate an individual to help others remain poorly understood. In order to investigate the roots of pro-sociality in mammals, we established the helping behavior test, a paradigm in which rats are faced with a conspecific trapped in a restrainer that can only be opened from the outside. Over the course of repeated test sessions, rats exposed to a trapped cagemate learn to open the door to the restrainer, thereby helping the trapped rat to escape (Ben-Ami Bartal et al., 2011). The discovery of this natural behavior provides a unique opportunity to probe the motivation of rodent helping behavior, leading to a deeper understanding of biological influences on human pro-sociality. To determine if an affective response motivates door-opening, rats receiving midazolam, a benzodiazepine anxiolytic, were tested in the helping behavior test. Midazolam-treated rats showed less helping behavior than saline-treated rats or rats receiving no injection. Yet, midazolam-treated rats opened a restrainer containing chocolate, highlighting the socially specific effects of the anxiolytic. To determine if midazolam interferes with helping through a sympatholytic effect, the peripherally restricted beta-adrenergic receptor antagonist nadolol was administered; nadolol did not interfere with helping. The corticosterone response of rats exposed to a trapped cagemate was measured and compared to the rats' subsequent helping behavior. Rats with the greatest corticosterone responses showed the least helping behavior and those with the smallest responses showed the most consistent helping at the shortest latency. These results are discussed in terms of their implications for the interaction between stress and pro-social behavior. Finally, we observed that door-opening appeared to be reinforcing. A novel analytical tool was designed to interrogate the pattern of door-opening for signs that a rat's behavior on one session

  12. No-sedation during mechanical ventilation

    DEFF Research Database (Denmark)

    Laerkner, Eva; Stroem, Thomas; Toft, Palle

    2016-01-01

    patients with daily wake up, and also to estimate economic consequences of a no-sedation strategy. DESIGN AND METHODS: Data were collected during a prospective trial of 140 mechanically ventilated patients randomized to either no-sedation or to sedation with daily wake up. From day 1 to 7 in the intensive......BACKGROUND: Evidence is growing that less or no-sedation is possible and beneficial for patients during mechanical ventilation. AIM: To investigate if there was a difference in patient consciousness and nursing workload comparing a group of patients receiving no-sedation with a group of sedated...

  13. Sertraline: a new antidepressant.

    Science.gov (United States)

    Auster, R

    1993-08-01

    Sertraline is a serotonin reuptake inhibitor that has been approved for use in the treatment of depression. Its side-effect profile is similar to that of fluoxetine, a drug of the same class. The side effects of these drugs most often affect the gastrointestinal tract. Serotonin reuptake inhibitors are nonsedating and free of cardiac effects; they do not cause hypotension, urinary retention or blurred vision. Sertraline, like fluoxetine, appears to be safer than tricyclic antidepressants in overdose. However, no clinical studies comparing sertraline and fluoxetine have been published. The wholesale cost of a month's supply of sertraline is about $50, compared with about $5 for a generic tricyclic antidepressant. Despite their cost, serotonin uptake inhibitors may be the initial drugs of choice in depressed elderly patients, because these patients are at increased risk for suicide and have a low tolerance for the side effects of tricyclic antidepressants.

  14. [Multimodal serotonergic antidepressants].

    Science.gov (United States)

    Danilov, D S

    Based on the original literature, the author for the first time describes a history of selective serotonergic antidepressants simultaneously inhibiting the serotonin reuptake and directly interacting with serotonin receptors. A history of creation and introduction of their main representatives is presented. A history of investigation of their neurochemical activity is analyzed in details. The history of the evolution of their classifications is systemized. The data presented suggest the rationale for unifying all selective serotonergic antidepressants, simultaneously inhibiting the serotonin reuptake and directly interacting with serotonin receptors (trazodone, etoperidone, nefazodone, vilazodone, vortioxetine), in one group of 'multimodal serotonergic antidepressants'. The expediency to include this group in the modern neurochemical classification of nootropic drugs is substantiated.

  15. Ketamine: A New Antidepressant?

    Directory of Open Access Journals (Sweden)

    Feride Karacaer

    2015-03-01

    Full Text Available Standart antidepressants are needed for the many individuals with major depressive disorder. However they do not respond adequately to treatment and because of a delay of weeks before the emergence of therapeutic effects. Recent studies show that subanesthetic dose of ketamine is efficacy and safety for the treatment of depression. Antidepressant effects of ketamine have been found to be short-lived and its psychotomimetic properties may limit the use of ketamine to depressive patients. Future research studies should focus on identifying predictors of response (pharmalogical and clinical , investigating application of different doses and routes of administration and maintaining antidepressant effect. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(1: 30-40

  16. Cultural changes in ICU sedation management

    DEFF Research Database (Denmark)

    Egerod, Ingrid

    2009-01-01

    themes. The following themes emerged: a paradigm shift from sedated to more awake and comfortable patients, cultural changes toward intracollegial openness, increased interdisciplinary and staff/patient/family collaboration, patient and environmental normalization, and humanization. The study findings...... provide an understanding of contextual issues of sedation, safety, and comfort, and suggest that a cultural change in sedation strategies might reduce the duration of sedation and mechanical ventilation while containing cost and improving the well-being of the patients....

  17. A novel operant conflict procedure using incrementing shock intensities to assess the anxiolytic and anxiogenic effects of drugs.

    Science.gov (United States)

    Evenden, John; Ross, Laurie; Jonak, Gerald; Zhou, Jin

    2009-05-01

    There is a need for novel anxiolytics, which are effective, but do not cause sedation, tolerance, and rebound anxiety on discontinuation. To investigate a procedure that can be used to assess these characteristics preclinically, rats were initially trained to press a lever at a high rate to obtain food. Once trained, periods of punishment were introduced in which electric shocks were superimposed. The intensity of these electric shocks was increased every 90 s from very low (0.01 mA) to sufficiently high to stop most subjects responding (0.4 mA), so that a complete rate/intensity function was obtained during each punishment period. The benzodiazepine, chlordiazepoxide, and two novel subtype-selective gamma-aminobutyric acid-A agonists, TP003 and TPA023, significantly increased response rates mildly suppressed by intermediate levels of electric shock without any effect on unpunished response rate. Two clinically anxiogenic agents, yohimbine and flumazenil, reduced the rate of punished responding. Aripiprazole and amphetamine reduced both punished and unpunished responding. Repeated treatment with diazepam 2.5 mg/kg daily for 15 days, initially markedly reduced unpunished response rates, but also increased punished response rates, an effect which became greater with repeated treatment. Abrupt cessation of diazepam treatment produced a reduction in punished responding. Diazepam (5 mg/kg daily) produced a greater reduction in unpunished responding, a smaller increase in punished responding, and a larger and longer lasting reduction in punished rates on withdrawal. In conclusion, the procedure detected anxiolytic and anxiogenic effects of drugs, and the sedative side effects, development of tolerance, and rebound-anxiety on discontinuation of a benzodiazepine. This procedure should have utility in the characterization of novel treatments of anxiety.

  18. Inverted U-Shaped Dose-Response Curve of the Anxiolytic Effect of Cannabidiol during Public Speaking in Real Life

    Directory of Open Access Journals (Sweden)

    Antonio W. Zuardi

    2017-05-01

    Full Text Available The purpose of this study was to investigate whether the anxiolytic effect of cannabidiol (CBD in humans follows the same pattern of an inverted U-shaped dose-effect curve observed in many animal studies. Sixty healthy subjects of both sexes aged between 18 and 35 years were randomly assigned to five groups that received placebo, clonazepam (1 mg, and CBD (100, 300, and 900 mg. The subjects were underwent a test of public speaking in a real situation (TPSRS where each subject had to speak in front of a group formed by the remaining participants. Each subject completed the anxiety and sedation factors of the Visual Analog Mood Scale and had their blood pressure and heart rate recorded. These measures were obtained in five experimental sessions with 12 volunteers each. Each session had four steps at the following times (minutes after administration of the drug/placebo, as time 0: -5 (baseline, 80 (pre-test, 153 (speech, and 216 (post-speech. Repeated-measures analyses of variance showed that the TPSRS increased the subjective measures of anxiety, heart rate, and blood pressure. Student-Newman-Keuls test comparisons among the groups in each phase showed significant attenuation in anxiety scores relative to the placebo group in the group treated with clonazepam during the speech phase, and in the clonazepam and CBD 300 mg groups in the post-speech phase. Clonazepam was more sedative than CBD 300 and 900 mg and induced a smaller increase in systolic and diastolic blood pressure than CBD 300 mg. The results confirmed that the acute administration of CBD induced anxiolytic effects with a dose-dependent inverted U-shaped curve in healthy subjects, since the subjective anxiety measures were reduced with CBD 300 mg, but not with CBD 100 and 900 mg, in the post-speech phase.

  19. Inverted U-Shaped Dose-Response Curve of the Anxiolytic Effect of Cannabidiol during Public Speaking in Real Life.

    Science.gov (United States)

    Zuardi, Antonio W; Rodrigues, Natália P; Silva, Angélica L; Bernardo, Sandra A; Hallak, Jaime E C; Guimarães, Francisco S; Crippa, José A S

    2017-01-01

    The purpose of this study was to investigate whether the anxiolytic effect of cannabidiol (CBD) in humans follows the same pattern of an inverted U-shaped dose-effect curve observed in many animal studies. Sixty healthy subjects of both sexes aged between 18 and 35 years were randomly assigned to five groups that received placebo, clonazepam (1 mg), and CBD (100, 300, and 900 mg). The subjects were underwent a test of public speaking in a real situation (TPSRS) where each subject had to speak in front of a group formed by the remaining participants. Each subject completed the anxiety and sedation factors of the Visual Analog Mood Scale and had their blood pressure and heart rate recorded. These measures were obtained in five experimental sessions with 12 volunteers each. Each session had four steps at the following times (minutes) after administration of the drug/placebo, as time 0: -5 (baseline), 80 (pre-test), 153 (speech), and 216 (post-speech). Repeated-measures analyses of variance showed that the TPSRS increased the subjective measures of anxiety, heart rate, and blood pressure. Student-Newman-Keuls test comparisons among the groups in each phase showed significant attenuation in anxiety scores relative to the placebo group in the group treated with clonazepam during the speech phase, and in the clonazepam and CBD 300 mg groups in the post-speech phase. Clonazepam was more sedative than CBD 300 and 900 mg and induced a smaller increase in systolic and diastolic blood pressure than CBD 300 mg. The results confirmed that the acute administration of CBD induced anxiolytic effects with a dose-dependent inverted U-shaped curve in healthy subjects, since the subjective anxiety measures were reduced with CBD 300 mg, but not with CBD 100 and 900 mg, in the post-speech phase.

  20. Low Risk for Switch to Mania during Treatment with Sleep Promoting Antidepressants.

    Science.gov (United States)

    Wichniak, A; Jarkiewicz, M; Okruszek, Ł; Wierzbicka, A; Holka-Pokorska, J; Rybakowski, J K

    2015-05-01

    Sleep-promoting antidepressants are of interest because they are used not only as antidepressants, but also to promote sleep. We reviewed case reports describing the switch to mania during treatment with trazodone, mirtazapine, or agomelatine. Trazodone, mirtazapine, and agomelatine may induce manic symptoms. However, the risk of switching is related, first of all, to doses recommended for antidepressant treatment, administered without mood-stabilizer co-therapy. Low doses of these antidepressants, used for their hypnotic or sedative effects, were observed to cause mania only in patients with other risk factors for switching. There is no evidence for trazodone or mirtazapine and only sparse evidence for agomelatine, claiming that treatment with these antidepressants is related to an increased risk of switching to mania when administered in combination with a mood stabilizer. These findings suggest that low doses of trazodone and mirtazapine are safe in bipolar disorder, and should still be considered important alternatives to hypnotics when long-term pharmacological treatment of insomnia is necessary. It seems that these antidepressants and agomelatine can also be used safely in antidepressant doses when combined with a mood stabilizer. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Adverse event reporting tool for sedation

    African Journals Online (AJOL)

    SASA Refresher Text: Adverse event reporting tool for sedation. 60. 2012;18(1). South Afr J Anaesth Analg. Sedation practice today is experiencing revolutionary changes. One of them is a re-evaluation of what is defined as an adverse event during sedation. The World Health Organization (WHO) and the US Food and.

  2. Antidepressant drug therapy and suicide in severely depressed children and adults: A case-control study.

    Science.gov (United States)

    Olfson, Mark; Marcus, Steven C; Shaffer, David

    2006-08-01

    The Food and Drug Administration has issued a boxed warning concerning increased suicidal ideation and behavior associated with antidepressant drug treatment in children and adolescents. It is unknown whether antidepressant agents increase the risk of suicide death in children or adults. To estimate the relative risk of suicide attempt and suicide death in severely depressed children and adults treated with antidepressant drugs vs those not treated with antidepressant drugs. Matched case-control study. Outpatient treatment settings in the United States. Medicaid beneficiaries from all 50 states who received inpatient treatment for depression, excluding patients treated for pregnancy, bipolar disorder, schizophrenia or other psychoses, mental retardation, dementia, or delirium. Controls were matched to cases for age, sex, race or ethnicity, state of residence, substance use disorder, recent suicide attempt, number of days since hospital discharge, and recent treatment with antipsychotic, anxiolytic/hypnotic, mood stabilizer, and stimulant medications. Suicide attempts and suicide deaths. In adults (aged 19-64 years), antidepressant drug treatment was not significantly associated with suicide attempts (odds ratio [OR], 1.10; 95% confidence interval [CI], 0.86-1.39 [521 cases and 2394 controls]) or suicide deaths (OR, 0.90; 95% CI, 0.52-1.55 [86 cases and 396 controls]). However, in children and adolescents (aged 6-18 years), antidepressant drug treatment was significantly associated with suicide attempts (OR, 1.52; 95% CI, 1.12-2.07 [263 cases and 1241 controls]) and suicide deaths (OR, 15.62; 95% CI, 1.65-infinity [8 cases and 39 controls]). In these high-risk patients, antidepressant drug treatment does not seem to be related to suicide attempts and death in adults but might be related in children and adolescents. These findings support careful clinical monitoring during antidepressant drug treatment of severely depressed young people.

  3. Adherence to antidepressants

    Directory of Open Access Journals (Sweden)

    Abimbola Farinde

    2013-01-01

    Full Text Available While major depression is considered a frequent mental illness there are ongoing reports of high non-adherence to antidepressant medications which places suffers at high risk for relapse, recurrence, or greater impairment,. The World Health Organization (WHO defines adherence as the extent to which a person′s behavior (e.g. taking medications can align with the agreed recommendations of a health care provider. Unfortunately while patient may recognize the importance of adherence to antidepressant medications the majority of patients do not adhere to their prescribed antidepressants. Some of the factors that may contribute to or lead to non-adherence include knowingly or unknowingly missing doses, taking extra doses, delaying administration times, or taking drug holidays. Pharmacists have the unique ability to deter non-adherence through the performance of continuous assessment and monitoring of adherence in this population given these accessibility. Additionally, pharmacists are able to develop therapeutic alliances with patients that can help to increase the likelihood of achieving positive patient outcomes. Antidepressant non-adherence can be viewed as a significant public health concern so it is important for patients to be educated about the importance of adherence, and health care professionals should be aware of factors or patient characteristics that can serve as barriers to non-adherence.

  4. Antidepressant medications and osteoporosis

    DEFF Research Database (Denmark)

    Rizzoli, R; Cooper, C; Reginster, J-Y

    2012-01-01

    Use of antidepressant medications that act on the serotonin system has been linked to detrimental impacts on bone mineral density (BMD), and to osteoporosis. This article reviews current evidence for such effects, and identifies themes for future research. Serotonin receptors are found in all major...

  5. Cannabidiol, a Cannabis sativa constituent, as an anxiolytic drug.

    Science.gov (United States)

    Schier, Alexandre Rafael de Mello; Ribeiro, Natalia Pinho de Oliveira; Silva, Adriana Cardoso de Oliveira e; Hallak, Jaime Eduardo Cecílio; Crippa, José Alexandre S; Nardi, Antonio E; Zuardi, Antonio Waldo

    2012-06-01

    To review and describe studies of the non-psychotomimetic constituent of Cannabis sativa, cannabidiol (CBD), as an anxiolytic drug and discuss its possible mechanisms of action. The articles selected for the review were identified through searches in English, Portuguese, and Spanish in the electronic databases ISI Web of Knowledge, SciELO, PubMed, and PsycINFO, combining the search terms "cannabidiol and anxiolytic", "cannabidiol and anxiolytic-like", and "cannabidiol and anxiety". The reference lists of the publications included, review articles, and book chapters were handsearched for additional references. Experimental animal and human studies were included, with no time restraints. Studies using animal models of anxiety and involving healthy volunteers clearly suggest an anxiolytic-like effect of CBD. Moreover, CBD was shown to reduce anxiety in patients with social anxiety disorder. Future clinical trials involving patients with different anxiety disorders are warranted, especially of panic disorder, obsessive-compulsive disorder, social anxiety disorder, and post-traumatic stress disorders. The adequate therapeutic window of CBD and the precise mechanisms involved in its anxiolytic action remain to be determined.

  6. Terminal sedation: ethical implications in different situations.

    Science.gov (United States)

    Hallenbeck, J L

    2000-01-01

    Terminal sedation (TS) is a recently coined term that may apply to a variety of practices with differing ethical implications. Two hypothetical cases are presented and contrasted. The first presents the more common scenario in which sedation is used for severe distress in a patient very close to death, who has stopped eating and drinking. The second case is more problematic: a nonterminally ill spinal cord injury patient requests sedation because of psychic distress. Sedation is supported in the former, but not the latter case. Suggested principles guiding the ethical use of sedation are: (1) While respect for autonomy is important, we are not obliged under all circumstances to provide sedation. (2) Physician intent matters. In providing sedation the physician's primary intent should be to alleviate suffering. (3) Reasonable inferences of intent can be made from physician actions, providing safeguards to ensure proper care. Sedatives should be titrated to observable signs of distress. (4) Proximity to death is a more useful concept than terminality in weighing benefits and burdens of sedation. (5) The nature of physician action should depend upon the nature of the suffering. Not all suffering is appropriately treated with sedation. (6) In patients close to death who have already stopped eating and drinking, sedation cannot be said to hasten death through dehydration or starvation. (7) Where TS is otherwise appropriate and where dehydration may in fact hasten death, ethical concerns may be addressed through informed consent. If hydration is refused, TS cannot be considered synonymous with euthanasia.

  7. Anxiolytic-like effect of oxytocin in the simulated public speaking test.

    Science.gov (United States)

    de Oliveira, Danielle C G; Zuardi, Antonio W; Graeff, Frederico G; Queiroz, Regina H C; Crippa, José A S

    2012-04-01

    Oxytocin (OT) is known to be involved in anxiety, as well as cardiovascular and hormonal regulation. The objective of this study was to assess the acute effect of intranasally administered OT on subjective states, as well as cardiovascular and endocrine parameters, in healthy volunteers (n = 14) performing a simulated public speaking test. OT or placebo was administered intranasally 50 min before the test. Assessments were made across time during the experimental session: (1) baseline (-30 min); (2) pre-test (-15 min); (3) anticipation of the speech (50 min); (4) during the speech (1:03 h), post-test time 1 (1:26 h), and post-test time 2 (1:46 h). Subjective states were evaluated by self-assessment scales. Cortisol serum and plasma adrenocorticotropic hormone (ACTH) were measured. Additionally, heart rate, blood pressure, skin conductance, and the number of spontaneous fluctuations in skin conductance were measured. Compared with placebo, OT reduced the Visual Analogue Mood Scale (VAMS) anxiety index during the pre-test phase only, while increasing sedation at the pre-test, anticipation, and speech phases. OT also lowered the skin conductance level at the pre-test, anticipation, speech, and post-test 2 phases. Other parameters evaluated were not significantly affected by OT. The present results show that OT reduces anticipatory anxiety, but does not affect public speaking fear, suggesting that this hormone has anxiolytic properties.

  8. Prescription of antidepressants to patients on opioid maintenance therapy – a pharmacoepidemiological study

    Directory of Open Access Journals (Sweden)

    Ingeborg Hartz

    2011-12-01

    Full Text Available Background and aims: Depression and anxiety are commonly reported among patients in opioid maintenance treatment (OMT. The aim of the present study was to describe aspects of prescription of antidepresant drug therapy among patients on OMT. Our research questions were: 1 What is the prevalence of antidepressant use according to age and gender? 2 Which antidepressants are used? 3 How are antidepressants used in terms of reimbursement codes, dispensed dose and duration of therapy?Methods: Pharmacoepidemiological data were retrieved from the complete national Norwegian Prescription Database which contains information on all prescription drugs (such as Anatomical Theraputical Chemical (ATC-code, Defined Daily Dose (DDDs, dispensed at pharmacies to individual patients. Norwegian OMT-patients (N=4374, 3035 men and 1339 women who received methadone mixture, buprenorphine capsules or combined buprenorphine-naloxone capsules for at least 6 months in 2009 were included. Prevalence of antidepressant use in the studied patients was measured in terms of retrieval of prescriptions.Results: During 2009 21.7% of the studied patients filled at least one prescription for an antidepressant drugs (men: 21.2%; women: 22.9%. The subgroup of antidepressants most frequently dispensed was selective serotonin reuptake inhibitors (SSRIs (33%, followed by the sedative antidepressants mianserin and mirtazapin (22% and tricyclic antidepressants (TCAs (20%. Except for TCAs, prescriptions of all antidepressant subgroups were reimbursed for either anxiety or depression in 90% of the cases. Overall, 46.9% of the antidepressant users were prescribed antidepressants in the category < 1 DDD per day and/or treatment < 3 months, with no gender difference.Conclusions: About one out of five OMT-patients filled a prescription for an antidepressant drug in 2009. Above 90% had their prescriptions reimbursed for either depression or anxiety. Use at low doses and/or sporadic use among half

  9. High use of sedatives and hypnotics in ethnic minorities in Sweden.

    Science.gov (United States)

    Hjern, A

    2001-02-01

    To study use of analgesics, and psychotropic drugs in relation to health indicators in four ethnic minorities in Sweden in comparison with Swedish-born. Cross-sectional study based on data from the Survey of Living Conditions and Immigrant Survey of Living Conditions in Sweden in 1996. Random samples of 1890 Swedish residents, in the age range 27-60 years, born in Chile, Poland, Turkey and Iran and 2452 age-matched Swedish-born residents. A two fold higher use of prescribed analgesics and antidepressants and a five to sixfold higher use of hypnotic and sedative drugs was demonstrated in members of ethnic minorities in Sweden in comparison with Swedish-born. In a multivariate analysis the higher use of prescribed analgesics and antidepressants was explained almost entirely by a higher morbidity in the minority study groups. A twofold higher use of sedatives and hypnotics was demonstrated in the minority study populations compared to the Swedish-born sample even after adjustment for extensive indicators of psychiatric and physical health in the multivariate analysis. The higher use of sedatives and hypnotics in relation to health in the minority samples in the present study indicates a differential treatment of minor psychiatric disorders of members of ethnic minorities in Swedish health services. Further studies that yield more qualitative data regarding the interaction of Swedish physicians with migrant patients are needed to explain these differences and to create a basis for intervention.

  10. Screening of central functions of amino acids and their metabolites for sedative and hypnotic effects using chick models.

    Science.gov (United States)

    Furuse, Mitsuhiro

    2015-09-05

    The chick has a practical advantage in the screening process in that chicks require only small quantities of drugs. The chick separation stress paradigm has traditionally been recognized as a valid form of anxiolytic screening. Further, chick behavior involving standing motionless with eyes closed or sitting motionless with head drooped is nearly always associated with electrophysiological sleep. When centrally administered, some DNA-encoded L-α-amino acids, as well as some DNA-non-encoded amino acids, such as metabolites of L-α-amino acids, D-amino acid and β-amino acid, have shown sedative and/or hypnotic effects in chicks. The effects of some of these amino acids have subsequently been confirmed in humans. In conclusion, the chick model is convenient and useful for screening central functions of amino acids and their metabolites for hypnosis and sedation. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Society of Family Planning clinical guidelines pain control in surgical abortion part 1 - local anesthesia and minimal sedation.

    Science.gov (United States)

    Allen, Rebecca H; Singh, Rameet

    2018-01-31

    Satisfactory pain control for women undergoing surgical abortion is important for patient comfort and satisfaction. Clinicians ought to be aware of the safety and efficacy of different pain control regimens. This document will focus on nonpharmacologic modalities to reduce pain and pharmacologic interventions up to the level of minimal sedation. For surgical abortion without intravenous medications, a multimodal approach to pain control may combine a dedicated emotional-support person, visual or auditory distraction, administration of local anesthesia to the cervix with buffered lidocaine and a preoperative nonsteroidal anti-inflammatory drug. Oral opioids do not decrease procedural pain. Oral anxiolytics decrease anxiety but not the experience of pain. Further research is needed on alternative options to control pain short of moderate or deep sedation. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Adverse reactions to antidepressants

    DEFF Research Database (Denmark)

    Uher, Rudolf; Farmer, Anne; Henigsberg, Neven

    2009-01-01

    (74%), constipation (33%) and weight gain (15%) were associated with nortriptyline treatment. Diarrhoea (9%), insomnia (36%) and yawning (16%) were more common during treatment with escitalopram. Problems with urination and drowsiness predicted discontinuation of nortriptyline. Diarrhoea and decreased......Background: Adverse drug reactions are important determinants of non-adherence to antidepressant treatment, but their assessment is complicated by overlap with depressive symptoms and lack of reliable self-report measures. Aims: To evaluate a simple self-report measure and describe adverse...... comparing escitalopram and nortriptyline. Results: There was good agreement between self-report and psychiatrists' ratings. Most complaints listed as adverse reactions in people with depression were more common when they were medication-free rather than during their treatment with antidepressants. Dry mouth...

  13. Diving and antidepressants.

    Science.gov (United States)

    Querido, Abraham L

    2017-12-01

    Psychoactive drugs pose a risk to both the diver and his or her buddy. Little is known about the safety of diving with antidepressants. Amongst the potential interactions with the diving environment are: somnolence; convulsions; a bleeding tendency (potentially worsening decompression illness, DCI), alterations to glucose metabolism and psychiatric side effects. Fluoxetine may potentially reduce the inflammatory process associated with DCI. This article presents guidelines for recreational diving in combination with antidepressants. These guidelines were endorsed at a meeting of the Dutch Association for Diving Medicine in 2015 and are solely based on 'expert' opinion. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in printed and other forms.

  14. Milnacipran: a unique antidepressant?

    Directory of Open Access Journals (Sweden)

    Siegfried Kasper

    2010-08-01

    Full Text Available Siegfried Kasper, Gerald PailDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, AustriaAbstract: Tricyclic antidepressants (TCAs are among the most effective antidepressants available, although their poor tolerance at usual recommended doses and toxicity in ­overdose make them difficult to use. While selective serotonin reuptake inhibitors (SSRIs are ­better tolerated than TCAs, they have their own specific problems, such as the aggravation of sexual dysfunction, interaction with coadministered drugs, and for many, a discontinuation syndrome. In addition, some of them appear to be less effective than TCAs in more severely depressed patients. Increasing evidence of the importance of norepinephrine in the etiology of depression has led to the development of a new generation of antidepressants, the serotonin and ­norepinephrine reuptake inhibitors (SNRIs. Milnacipran, one of the pioneer SNRIs, was designed from theoretic considerations to be more effective than SSRIs and better tolerated than TCAs, and with a simple pharmacokinetic profile. Milnacipran has the most balanced potency ratio for reuptake inhibition of the two neurotransmitters compared with other SNRIs (1:1.6 for milnacipran, 1:10 for duloxetine, and 1:30 for venlafaxine, and in some studies milnacipran has been shown to inhibit norepinephrine uptake with greater potency than serotonin (2.2:1. Clinical studies have shown that milnacipran has efficacy comparable with the TCAs and is superior to SSRIs in severe depression. In addition, milnacipran is well tolerated, with a low potential for pharmacokinetic drug–drug interactions. Milnacipran is a first-line therapy suitable for most depressed patients. It is frequently successful when other treatments fail for reasons of efficacy or tolerability.Keywords: milnacipran, SNRI, antidepressant efficacy, tolerability

  15. Mechanisms of antidepressant resistance

    Directory of Open Access Journals (Sweden)

    Wissam eEl Hage

    2013-11-01

    Full Text Available Depression is one of the most frequent and severe mental disorder. Since the discovery of antidepressant properties of the imipramine and then after of other tricyclic compounds, several classes of psychotropic drugs have shown be effective in treating major depressive disorder. However, there is a wide range of variability in response to antidepressants that might lead to non response or partial response or in increased rate of relapse or recurrence. The mechanisms of response to antidepressant therapy are poorly understood, and few biomarkers are available than can predict response to pharmacotherapy. Here, we will first review markers that can be used to predict response to pharmacotherapy, such as markers of drug metabolism or blood-brain barrier function, the activity of specific brain areas or neurotransmitter systems, hormonal dysregulations or plasticity, and related molecular targets. We will describe both clinical and preclinical studies and describe factors that might affect the expression of these markers, including environmental or genetic factors and comorbidities. This information will permit us to suggest practical recommendations and innovative treatment strategies to improve therapeutic outcomes.

  16. Palliative sedation and ethical dilemma

    Directory of Open Access Journals (Sweden)

    Juri Salamah

    2018-01-01

    Full Text Available Palliative sedation is a unique concern for the patient as well as the family. It is a difficult serious ethical dilemma for the physicians to handle. The conflicting ethical principles of autonomy, beneficence and nonmaleficence in continuing versus discontinuing all supportive devices raise concerns among health professionals whether this is euthanasia (physician-assisted suicide or is just prolonging the patient's unnecessary suffering.

  17. Study of sedative, preanaesthetic and anti-anxiety effects of Rosa damascene herbal extract in comparison with diazepam in rat

    Directory of Open Access Journals (Sweden)

    Rezaie A

    2011-06-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Rosa damascene has a special role in the Iranian traditional medicine due to its sedative, anticonvulsant and analgesic effects. Regarding its alkaloid, flavonoid and other organic compounds, this plant has always been used to reduce nervousness and treat depression and chronic insomnia. In the present time, synthetic drugs with sedative and anxiolytic properties are used for such problems but due to their side-effects and economic issues, the significance of natural medicines with fewer side-effects is of interest. Considering the importance of sedative and anxiolytic effects of Rosa damascene, we decided to compare this plant with synthetic drugs of the same properties."n"nMethods: Two different groups of male Wistar rats received either Rosa damascene extract in doses of 150, 300, 450 mg/kg or Diazepam and dimethyl sulphoxide in doses of 1.2 mg/kg intraperitoneally 30 minutes before assessing the sleep duration, sedation and preanesthetic effects induced by intraperitoneal ketamine, 40 mg/kg. The anti-anxiety effect was evaluated by using an elevated plus maze and a rota rod."n"nResults: The results showed a meaningful increase in the period of sleep induced by Ketamine (P≤0.01 and also a meaningful

  18. Changes in head-dipping behavior in the hole-board test reflect the anxiogenic and/or anxiolytic state in mice.

    Science.gov (United States)

    Takeda, H; Tsuji, M; Matsumiya, T

    1998-05-29

    The effects of treatment with anxiogenic or anxiolytic agents and exposure to acute restraint stress on emotional behavior in mice were examined using an automatic hole-board apparatus. Changes in the emotional state of mice were evaluated in terms of changes in exploratory activity, i.e., total locomotor activity, numbers and duration of rearing and head-dipping, and latency to the first head-dipping. The typical benzodiazepine anxiolytics diazepam (0.05-0.5 mg/kg, i.p.) and chlordiazepoxide (0.5-4 mg/kg, i.p.) dose-dependently increased the number and duration of head-dips at doses that did not produce sedation. In contrast with these anxiolytics, the typical anxiogenic drugs N-methyl-beta-carboline-3-carboxamide (FG7142, 0.125-10 mg/kg, i.p.) and methyl-beta-carboline-3-carboxylate (beta-CCM, 0.1-2 mg/kg, i.p.) decreased both the number and duration of head-dips, and increased the latency to head-dipping. Moreover, decreases in the number and duration of head-dips, and an increase in the latency to head-dipping, were also observed in animals that were exposed to acute restraint stress. These effects of acute restraint stress were suppressed by treatment with diazepam at a dose that alone did not produce significant behavioral effects (0.1 mg/kg, i.p.). In addition, non-benzodiazepine anxiolytic flesinoxan (0.1 mg/kg, i.p.), a 5-HT1A receptor agonist, also had an effect on the restraint stress-induced decrease in head-dipping behavior. The present study shows that the changes in several exploratory behaviors could be objectively measured using our automatic hole-board apparatus. Therefore, this system can serve as a useful tool for evaluating the changes in various emotional states of animals. Moreover, we also found that treatment with anxiolytics or anxiogenics and exposure to acute restraint stress affected head-dipping behavior. These results suggest that changes in head-dipping behavior in the hole-board test may reflect the anxiogenic and/or anxiolytic

  19. Sedation and monitoring for gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-02-16

    The safe sedation of patients for diagnostic or therapeutic procedures requires a combination of properly trained physicians and suitable facilities. Additionally, appropriate selection and preparation of patients, suitable sedative technique, application of drugs, adequate monitoring, and proper recovery of patients is essential. The goal of procedural sedation is the safe and effective control of pain and anxiety as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation practices for gastrointestinal endoscopy (GIE) vary widely. The majority of GIE patients are ambulatory cases. Most of this procedure requires a short time. So, short acting, rapid onset drugs with little adverse effects and improved safety profiles are commonly used. The present review focuses on commonly used regimens and monitoring practices in GIE sedation. This article is to discuss the decision making process used to determine appropriate pre-sedation assessment, monitoring, drug selection, dose of sedative agents, sedation endpoint and post-sedation care. It also reviews the current status of sedation and monitoring for GIE procedures in Thailand.

  20. Withaferin-A displays enhanced anxiolytic efficacy without tolerance ...

    African Journals Online (AJOL)

    Withaferin-A dose-dependently (10 tob40 mg/kg) displayed anxiolytic activity, as measured by an increase in open arm exploration time in the elevated plus-maze (EPM), following intraperitoneal (i.p.) administration in rats. Acute administration of withaferin-A at 40.0 mg/kg significantly (P<0.05) increased open arm ...

  1. Evaluation of Lorazepam as an Anxiolytic Agent in Psychiatric Practice

    African Journals Online (AJOL)

    The efficacy of lorazepam, one of the newer benzodiazepines, as an anxiolytic agent is assessed in a study involving 35 non-hospitalised patients. No serious sideeffects were encountered and the drug, administered orally, was well tolerated. The patients exhibited anxiety as a primary symptom or in association with other ...

  2. Anxiolytic - like properties of Hallea ciliata in mice | Stephanie ...

    African Journals Online (AJOL)

    Background: The aim of the present study was to evaluate the anxiolytic properties of the decoction of stem bark of Hallea ciliate in mice. The decoction of Hallea ciliata is used in traditional medicine in Cameroon to treat diseases like anxiety disorders, fever, infantile convulsions and malaria. Materials and Methods: Stress ...

  3. Studies on the Anxiolytic Effect of Spondias mombin l ...

    African Journals Online (AJOL)

    These effects of the extracts were blocked by flumazenil, an antagonist of GABAA receptor. The results suggest that the extracts of Spondias mombin possess anxiolytic effect mediated by GABAergic transmission. Key Words: Spondias mombin, neurological, muricidal, swimming despair, GABA receptor antagonist.

  4. Withaferin-A displays enhanced anxiolytic efficacy without tolerance ...

    African Journals Online (AJOL)

    Jane

    2011-10-05

    Oct 5, 2011 ... anxiolytic efficacy and was devoid of tolerance. Key words: Withaferin-A, anxiety, benzodiazepines, nitric oxide, elevated plus-maze. INTRODUCTION. Withania somnifera Dunal (WS), known as Ashwagandha or Indian ginseng has been commonly used in Indian traditional medicines for over 3,000 years.

  5. The influence of antidepressants on restless legs syndrome and periodic limb movements: A systematic review.

    Science.gov (United States)

    Kolla, Bhanu Prakash; Mansukhani, Meghna P; Bostwick, J Michael

    2018-04-01

    Restless legs syndrome is commonly co-morbid with medical conditions that are treated with antidepressant medications, such as depression, anxiety, fibromyalgia, and chronic insomnia disorder. Evidence from case reports and cross-sectional studies suggests that antidepressants may induce or worsen restless legs syndrome and increase periodic limb movements. We undertook a systematic review of the literature to identify and collate all prospective studies that measured restless legs syndrome symptoms and/or periodic limb movements following the introduction of an antidepressant. Eighteen studies were eligible for inclusion. Current data indicate that onset or exacerbation of restless legs syndrome and rise in frequency of periodic limb movements are uncommon following the initiation of an antidepressant. Among the various antidepressants, mirtazapine may be associated with higher rates of restless legs syndrome and periodic limb movements. One small study of normal volunteers suggested that venlafaxine may be associated with an increase in restless legs syndrome symptoms and periodic limb movements. Sertraline, fluoxetine, and amitriptyline appear to increase periodic limb movements that do not disrupt sleep and are thus unlikely to be clinically significant. On the other hand, bupropion may reduce restless legs syndrome symptoms, at least in the short term. Sedating antidepressants such as trazodone, nefazodone, and doxepin do not seem to aggravate periodic limb movements. The current evidence is limited by poor study design, inadequate use of standardized questionnaires, and heterogeneous populations studied for variable lengths of time. Future research should attempt to remedy these shortcomings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Assessment of sedative effects of Passiflora edulis f. flavicarpa and Passiflora alata extracts in mice, measured by telemetry.

    Science.gov (United States)

    Klein, Nadine; Gazola, Andressa Córneo; de Lima, Thereza Christina Monteiro; Schenkel, Eloir; Nieber, Karen; Butterweck, Veronika

    2014-05-01

    Several Passiflora species have been used widely as a folk medicine due to their sedative and anxiolytic activities. In Brazil, a number of native plants of the genus Passiflora exist, but only Passiflora edulis f. flavicarpa (PE) and Passiflora alata (PA) are of commercial value. Thus, the aim of the present study was to investigate the sedative effects of aqueous extracts obtained from the pericarp as well as from the leaves of PE and PA in mice using radiotelemetry. Aqueous extracts from PE and PA were tested for effects on locomotion over 180 min in 300 mg/kg, 600 mg/kg and 1200 mg/kg, in male C57BL/6J mice after oral administration. For validation of the telemetry system, caffeine (negative control) and midazolam (positive control) were used. All tested extracts decreased locomotor activity in a dose-dependent manner in comparison to the control group. The two lower concentrations of each extract showed the highest decrease in locomotion after 24 min, while 1200 mg/kg had a significant sedative effect already after 18 min. Interestingly, aqueous extracts of PA were more active in comparison to aqueous extracts of PE and the pericarp extracts of both plants showed more pronounced effects on locomotor activity if compared to leaf extracts. In conclusion, the present study represents an innovative, objective approach to measure sedative effects of plant extracts with minimized handling-related stress and remote data collection. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Sedation-related complications in gastrointestinal endoscopy

    OpenAIRE

    Amornyotin, Somchai

    2013-01-01

    Sedation practices for gastrointestinal endoscopic (GIE) procedures vary widely in different countries depending on health system regulations and local circumstances. The goal of procedural sedation is the safe and effective control of pain and anxiety, as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation-related complications in gastrointestinal endoscopy, once occurred, can lead to significant morbidity and occasional mortality in patients. The risk fa...

  8. Sedation and monitoring for gastrointestinal endoscopy

    OpenAIRE

    Amornyotin, Somchai

    2013-01-01

    The safe sedation of patients for diagnostic or therapeutic procedures requires a combination of properly trained physicians and suitable facilities. Additionally, appropriate selection and preparation of patients, suitable sedative technique, application of drugs, adequate monitoring, and proper recovery of patients is essential. The goal of procedural sedation is the safe and effective control of pain and anxiety as well as to provide an appropriate degree of memory loss or decreased awaren...

  9. Sedation-related complications in gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-11-16

    Sedation practices for gastrointestinal endoscopic (GIE) procedures vary widely in different countries depending on health system regulations and local circumstances. The goal of procedural sedation is the safe and effective control of pain and anxiety, as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation-related complications in gastrointestinal endoscopy, once occurred, can lead to significant morbidity and occasional mortality in patients. The risk factors of these complications include the type, dose and mode of administration of sedative agents, as well as the patient's age and underlying medical diseases. Complications attributed to moderate and deep sedation levels are more often associated with cardiovascular and respiratory systems. However, sedation-related complications during GIE procedures are commonly transient and of a mild degree. The risk for these complications while providing any level of sedation is greatest when caring for patients already medically compromised. Significant unwanted complications can generally be prevented by careful pre-procedure assessment and preparation, appropriate monitoring and support, as well as post-procedure management. Additionally, physicians must be prepared to manage these complications. This article will review sedation-related complications during moderate and deep sedation for GIE procedures and also address their appropriate management.

  10. Tricyclic antidepressant radioreceptor assay

    International Nuclear Information System (INIS)

    Innis, R.B.; Tune, L.; Rock, R.; Depaulo, R.; U'Prichard, D.C.; Snyder, S.M.

    1979-01-01

    A receptor assay for tricyclic antidepressants described here is based on the ability of these drugs to compete with [ 3 H]-3-guinuclidnyl benzilate ( 3 H-QNB) for binding to muscarinic cholinergic receptors in rat brain membranes. The assay is sensitive, in that it can detect, for example, 2ng/ml nortriptyline in plasma. Seven plasma samples from depressed patients treated with nortriptyline were assayed with the radioreceptor and gas liquid chromatographic methods, and the results from these two methods were almost identical. This assay should be used cautiously, if at all, in patients treated with other drugs that have potent anticholinergic effects. (Auth.)

  11. Bitter acids from hydroethanolic extracts of Humulus lupulus L., Cannabaceae, used as anxiolytic

    Directory of Open Access Journals (Sweden)

    Giuseppina Negri

    2010-12-01

    Full Text Available Humulus lupulus L., Cannabaceae, is commonly used as light sedative and anxiolytics in folk medicine. HPLC-DAD-ESI-MSn represents a powerful tool for the analysis of natural products, since it can simultaneously provide a UV chromatogram and significant structural information about compounds in complex mixture. The aim of this work was characterize the constituents present in hydroethanolic extract. Compounds 1-9 were tentatively characterized on the basis of UV, MS/MS, after reversed phase separation, retention time and literature data. The main phenolic compounds (based on peak area were characterized as hulupinic acid (9, cohulupone (8, two oxidized hop alfa-bitter acids (principal constituents, one being a oxidized cohumulinone (5 and the other an oxidized humulinone (7 derivatives, together with a procyanidin dimer B (3, flavonoids rutin (4 and kaempferol-7-O-rutinoside (6. This plant known, due to anxiolytic property and beer flavoring, showed oxidized hop bitter acids, as principal constituents, in its hydroethanolic extract.Humulus lupulus L., Cannabaceae, é usada como sedativo e ansiolítico na medicina popular. O método de HPLC-DAD-ESI-MSn representa uma ferramenta poderosa para a análise de produtos naturais, desde que ela fornece o espectro de UV e informações estruturais sobre os constituintes da mistura. O objetivo deste trabalho foi o de caracterizar os constituintes encontrados no extrato hidroalcoólico. Os constituintes 1-9 foram tentativamente caracterizados através do UV/DAD e ionização por electrospray (MS/MS depois da separação usando fase reversa, tempo de retenção e dados da literatura. Os principais compostos fenólicos (baseados na área dos picos foram caracterizados como ácido hulupínico (9, coulupona (8, dois alfa-ácidos amargos oxidados (principais constituintes, um deles sendo um derivado da coumulinona oxidada (5 e o outro um derivado da humulinona oxidada (7, junto com uma procianidina B (3 e os

  12. Are sedatives and hypnotics associated with increased suicide risk of suicide in the elderly?

    Directory of Open Access Journals (Sweden)

    Waern Margda

    2009-06-01

    Full Text Available Abstract Background While antidepressant-induced suicidality is a concern in younger age groups, there is mounting evidence that these drugs may reduce suicidality in the elderly. Regarding a possible association between other types of psychoactive drugs and suicide, results are inconclusive. Sedatives and hypnotics are widely prescribed to elderly persons with symptoms of depression, anxiety, and sleep disturbance. The aim of this case-control study was to determine whether specific types of psychoactive drugs were associated with suicide risk in late life, after controlling for appropriate indications. Methods The study area included the city of Gothenburg and two adjacent counties (total 65+ population 210 703 at the start of the study. A case controlled study of elderly (65+ suicides was performed and close informants for 85 suicide cases (46 men, 39 women mean age 75 years were interviewed by a psychiatrist. A population based comparison group (n = 153 was created and interviewed face-to-face. Primary care and psychiatric records were reviewed for both suicide cases and comparison subjects. All available information was used to determine past-month mental disorders in accordance with DSM-IV. Results Antidepressants, antipsychotics, sedatives and hypnotics were associated with increased suicide risk in the crude analysis. After adjustment for affective and anxiety disorders neither antidepressants in general nor SSRIs showed an association with suicide. Antipsychotics had no association with suicide after adjustment for psychotic disorders. Sedative treatment was associated with an almost fourteen-fold increase of suicide risk in the crude analyses and remained an independent risk factor for suicide even after adjustment for any DSM-IV disorder. Having a current prescription for a hypnotic was associated with a four-fold increase in suicide risk in the adjusted model. Conclusion Sedatives and hypnotics were both associated with increased

  13. Sedation practice in Nordic and non-Nordic ICUs

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Albarran, John W; Ring, Mette

    2013-01-01

    A trend towards lighter sedation has been evident in many intensive care units (ICUs). The aims of the survey were to describe sedation practice in European ICUs and to compare sedation practice in Nordic and non-Nordic countries....

  14. Nurse-administered propofol sedation for endoscopy

    DEFF Research Database (Denmark)

    Jensen, J T; Vilmann, P; Horsted, T

    2011-01-01

    The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program.......The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program....

  15. Sedation practice among Nigerian radiology residents | Omisore ...

    African Journals Online (AJOL)

    Background: Providing safe and effective sedation to patients, especially those with multiple medical problems, can be challenging for radiology residents and fellows. This study aimed to determine knowledge, attitude and practice of Nigerian radiology residents concerning sedation. Keywords: anaesthetist, guidelines ...

  16. Pharmacodynamic considerations for moderate and deep sedation.

    Science.gov (United States)

    Becker, Daniel E

    2012-01-01

    Moderate and deep sedation can be provided using various classes of drugs, each having unique mechanisms of action. While drugs within a given classification share similar mechanisms and effects, certain classes demonstrate superior efficacy but added concern regarding safety. This continuing education article will highlight essential principles of pharmacodynamics and apply these to drugs commonly used to produce moderate and deep sedation.

  17. The sedative and analgesic potentials of dexmedtomidine ...

    African Journals Online (AJOL)

    Venous access was secured thirty minutes later, the fluid was connected to the cannula and was set to flow at daily fluid maintenance rate of 90mlkgday-1. Neither sedation nor analgesia was achieved with 20μgkg-1. Slight to moderate sedative effect was achieved at 40μg/kg with significant reduction in heart, pulse and ...

  18. Analgesia and sedation in paediatric intensive care

    African Journals Online (AJOL)

    Sedation in the PICU. Sedation is a broad term when used in the context of PICU. It may facilitate several goals, including: • Unconsciousness (virtual anaesthesia) or a reduction in the level of consciousness. • Reduced awareness. • Loss of explicit and implicit memory. • Compliance with the need to lie in a confined space,.

  19. Sedation in the ICU Less is more

    DEFF Research Database (Denmark)

    Strom, T.

    2012-01-01

    was days without mechanical ventilation, days in the ICU and total length of hospital stay. We conducted a post-hoc analysis of the data with kidney function expressed in urine output and RIFLE classification as the primary outcome. After hospital discharge all patients were invited to an interview......: A strategy of no sedation to critically ill patients undergoing mechanical ventilation resulted in fewer days in mechanical ventilation, shorter ICU and hospital length of stay compared to a standard strategy with sedation. Also the risk of acute renal impairment seems to be reduced with the use....... An increased urine output was seen in the group receiving no sedation compared to the sedated control group (1.15 ml/kg/hour vs. 0.88 ml/kg/hour, P=0.03), also more patients from the sedated control group was classified with renal impairment (41 (76 %)) according to the RIFLE classification compared...

  20. Anxiolytic-like effects of erythrinian alkaloids from Erythrina suberosa

    Energy Technology Data Exchange (ETDEWEB)

    Serrano, Maria Amelia R.; Batista, Andrea N. de L.; Bolzani, Vanderlan da S.; Santos, Luciana de A. [UNESP, Araraquara, SP (Brazil). Inst. de Quimica; Nogueira, Paulo J. de C.; Nunes-de-Souza, Ricardo L. [UNESP, Araraquara, SP (Brazil). Faculdade de Ciencias Farmaceuticas; Latif, Abdul; Arfan, Mohammad [University of Peshawar, Peshawar (Pakistan). Inst. of Chemical Sciences

    2011-07-01

    Two alkaloids, erysodine (1) and erysothrine (2) were isolated from the flowers of a Pakistani medicinal plant, Erythrina suberosa. These compounds were investigated for anxiolytic properties, and the results showed significant effect, in an acute oral treatment with 1-2, which were suspended in saline (NaCl 0.9%) plus DMSO 1%, and evaluated in 122 Swiss male mice exposed to two tests of anxiety - the elevated plus-maze (EPM) and the light/dark transition model (LDTM). (author)

  1. Anxiolytic-like effects of erythrinian alkaloids from Erythrina suberosa

    International Nuclear Information System (INIS)

    Serrano, Maria Amelia R.; Batista, Andrea N. de L.; Bolzani, Vanderlan da S.; Santos, Luciana de A.; Nogueira, Paulo J. de C.; Nunes-de-Souza, Ricardo L.; Latif, Abdul; Arfan, Mohammad

    2011-01-01

    Two alkaloids, erysodine (1) and erysothrine (2) were isolated from the flowers of a Pakistani medicinal plant, Erythrina suberosa. These compounds were investigated for anxiolytic properties, and the results showed significant effect, in an acute oral treatment with 1-2, which were suspended in saline (NaCl 0.9%) plus DMSO 1%, and evaluated in 122 Swiss male mice exposed to two tests of anxiety - the elevated plus-maze (EPM) and the light/dark transition model (LDTM). (author)

  2. Milk Collected at Night Induces Sedative and Anxiolytic-Like Effects and Augments Pentobarbital-Induced Sleeping Behavior in Mice

    OpenAIRE

    dela Peña, Irene Joy I.; Hong, Eunyoung; de la Peña, June Bryan; Kim, Hee Jin; Botanas, Chrislean Jun; Hong, Ye Seul; Hwang, Ye Seul; Moon, Byoung Seok; Cheong, Jae Hoon

    2015-01-01

    Milk has long been known and used to promote sleep. The sleep-promoting effect of milk has been attributed to its psychological associations (i.e., the memory of a mother giving milk at bedtime) and its rich store of sleep-promoting constituents (e.g., tryptophan). Studies have shown that milk harvested at night (Night milk) contains exceptionally high amounts of tryptophan and melatonin. In the present study, we evaluated the psychopharmacological properties of Night milk, particularly its p...

  3. Palliative sedation versus euthanasia: an ethical assessment.

    Science.gov (United States)

    ten Have, Henk; Welie, Jos V M

    2014-01-01

    The aim of this article was to review the ethical debate concerning palliative sedation. Although recent guidelines articulate the differences between palliative sedation and euthanasia, the ethical controversies remain. The dominant view is that euthanasia and palliative sedation are morally distinct practices. However, ambiguous moral experiences and considerable practice variation call this view into question. When heterogeneous sedative practices are all labeled as palliative sedation, there is the risk that palliative sedation is expanded to include practices that are actually intended to bring about the patients' death. This troublesome expansion is fostered by an expansive use of the concept of intention such that this decisive ethical concept is no longer restricted to signify the aim in guiding the action. In this article, it is argued that intention should be used in a restricted way. The significance of intention is related to other ethical parameters to demarcate the practice of palliative sedation: terminality, refractory symptoms, proportionality, and separation from other end-of-life decisions. These additional parameters, although not without ethical and practical problems, together formulate a framework to ethically distinguish a more narrowly defined practice of palliative sedation from practices that are tantamount to euthanasia. Finally, the article raises the question as to what impact palliative sedation might have on the practice of palliative care itself. The increasing interest in palliative sedation may reemphasize characteristics of health care that initially encouraged the emergence of palliative care in the first place: the focus on therapy rather than care, the physical dimension rather than the whole person, the individual rather than the community, and the primacy of intervention rather than receptiveness and presence. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  4. Our Sedation Experience on Mentally Retarded Patients

    Directory of Open Access Journals (Sweden)

    Metin Alkan

    2014-03-01

    Full Text Available Aim: The majority of dental treatments can be performed under local anesthesia. However, sedation or general anesthesia are often required for mentally retarded patients presenting a lack of cooperation. The aim of this study was to retrospectively evaluate the outcomes of mentally retarded patients treated under sedation. Material and Method: The records of the 214 mentally retarded patients that were treated under sedation between 2010-2012 were retrospectively evaluated. The retrospective data included demographic variables, duriation of anesthesia, anti-epileptic drugs used, level of sedation, anesthetic agents, the type of dental treatment and adverse events during and after sedation. Results: In this study the mean age of patients was 22,49±9,54. The female/male ratio was 109/105. The number of ASA I, II, III patients were 43, 157 and 14 respectively. 16.8% of the patiens (n=36 was on one anti-epileptic drug regimen, while 29.9% of the patiens (n=54 was on more than one anti-epileptic drug regimen. The sedation levels were determined as minimal sedation (6.5%, n=14, moderate sedation (35%, n=75 and deep sedation (58.4%, n=125 respectively. The midazolam-ketamine combination was the most preferred anesthetic regimen (41.1%, n=88. Single dental extraction was the most performed dental treatment (58.4%, n=125. Postoperative nausea and vomiting was encountered in 3.7% of patients (n=8. Respiratuar depression occurred in 2 patients. Two patients developed bronchospasm, while one patient developed postoperative agitation, deep bradycardia and allergic reaction respectively. Discussion: We are of the opinion that sedation can be performed safely by choosing the appropriate drug and method without depressing respiration and reflexes.

  5. Propofol sedation in children: sleep trumps amnesia☆

    Science.gov (United States)

    Veselis, Robert; Kelhoffer, Eric; Mehta, Meghana; Root, James C.; Robinson, Fay; Mason, Keira P.

    2017-01-01

    Objective Detailed assessments of the effects of propofol on memory in children are lacking. We assessed the feasibility of measuring memory during propofol infusion, as commonly performed in sedation for MRI scanning. In addition, we determined the onset of memory loss in relation to the onset of sedation measured by verbal responsiveness. Materials and methods Children scheduled for sedation for MRI received a 10-min infusion of propofol (3 mg/kg) as they viewed and named 100 simple line drawings, one shown every five seconds, until they were no longer responsive (encoding). A control group receiving no sedation for MRI underwent similar tasks. Sedation was measured as any verbal response, regardless of correctness. After recovery from sedation, recognition memory was tested, with correct yes/no recognitions matched to sedation responses during encoding (subsequent memory paradigm). Results Of the 48 children who received propofol, 30 could complete all study tasks (6.2 ± 1.6 years, 16 males). Individual responses could be modeled in all 30 children. On average, there was a 50% probability of no verbal response 3.1 min after the start of infusion, with 50% memory loss at 2.7 min. Children receiving propofol recognized 65 ± 16% of the pictures seen, whereas the control group recognized 93 ± 5%. Conclusion Measurement of memory and sedation is possible in verbal children receiving propofol by infusion in a clinical setting. Despite propofol being an amnestic agent, there was little or no amnestic effect of propofol while the child was verbally responsive. It is important for sedation providers to realize that propofol sedation does not always produce amnesia while the child is responsive. ClinicalTrials.gov number NCT02278003. PMID:27938911

  6. Propofol sedation in children: sleep trumps amnesia.

    Science.gov (United States)

    Veselis, Robert; Kelhoffer, Eric; Mehta, Meghana; Root, James C; Robinson, Fay; Mason, Keira P

    Detailed assessments of the effects of propofol on memory in children are lacking. We assessed the feasibility of measuring memory during propofol infusion, as commonly performed in sedation for MRI scanning. In addition, we determined the onset of memory loss in relation to the onset of sedation measured by verbal responsiveness. Children scheduled for sedation for MRI received a 10-min infusion of propofol (3 mg/kg) as they viewed and named 100 simple line drawings, one shown every five seconds, until they were no longer responsive (encoding). A control group receiving no sedation for MRI underwent similar tasks. Sedation was measured as any verbal response, regardless of correctness. After recovery from sedation, recognition memory was tested, with correct yes/no recognitions matched to sedation responses during encoding (subsequent memory paradigm). Of the 48 children who received propofol, 30 could complete all study tasks (6.2 ± 1.6 years, 16 males). Individual responses could be modeled in all 30 children. On average, there was a 50% probability of no verbal response 3.1 min after the start of infusion, with 50% memory loss at 2.7 min. Children receiving propofol recognized 65 ± 16% of the pictures seen, whereas the control group recognized 93 ± 5%. Measurement of memory and sedation is possible in verbal children receiving propofol by infusion in a clinical setting. Despite propofol being an amnestic agent, there was little or no amnestic effect of propofol while the child was verbally responsive. It is important for sedation providers to realize that propofol sedation does not always produce amnesia while the child is responsive. CLINICALTRIALS. NCT02278003. Copyright © 2016. Published by Elsevier B.V.

  7. The role of anxiolytic premedication in reducing preoperative anxiety.

    LENUS (Irish Health Repository)

    Carroll, Jennifer K

    2012-01-01

    Prevention of preoperative anxiety with anxiolytic premedication is associated with improved preoperative outcomes in surgical patients. The objective of the authors\\' study was to evaluate the percentage of surgical patients that are prescribed premedication for preoperative anxiety before their anticipated surgical procedure. A prospective study was carried out by theatre nursing staff in the theatre reception bay of a university teaching hospital. A questionnaire was designed to record the number of patients that described symptoms consistent with preoperative anxiety. The number of patients that had been offered anxiolytic premedication for preoperative anxiety was also recorded. Consent was obtained from 115 consecutive surgical patients (male, n=52; female, n=63). Of these, 66% (n=76) reported anxiety before their surgical procedure (male: n=27, female: n=49). Premedication with a low-dose benzodiazepine was prescribed by an anaesthetist in 4% of cases (n=5). Patients that received premedication preoperatively reported effective relief of their anxiety symptoms This study demonstrates that preoperative patient anxiety is highly prevalent. The authors\\' findings suggest that premedication with anxiolytic pharmacological therapy may be an underused therapeutic resource for managing preoperative patient anxiety.

  8. Psychotropic drug use and alcohol drinking in community-dwelling older Australian men: the CHAMP study.

    Science.gov (United States)

    Ilomäki, Jenni; Gnjidic, Danijela; Hilmer, Sarah N; Le Couteur, David G; Naganathan, Vasi; Cumming, Robert G; Waite, Louise M; Seibel, Markus J; Blyth, Fiona M; Handelsman, David J; Bell, J Simon

    2013-03-01

    To explore the association between psychotropic drug use and alcohol drinking in community-dwelling older Australian men. We conducted a cross-sectional population-based study using baseline data collected between 2005 and 2007 from 1705 participants in the Concord Health and Ageing in Men Project (CHAMP) conducted in Sydney, Australia. All participants were men aged ≥70 years. The prevalence of antidepressant and sedative or anxiolytic drug use was ascertained at clinical examinations and alcohol drinking was self-reported. Logistic regression models were used to compute the unadjusted and adjusted prevalence ratios and 95% confidence intervals for the association between sedative or anxiolytic use and antidepressant use with drinking patterns. In the study sample, 8.0% used an antidepressant, 5.7% used a sedative or anxiolytic, 33.7% were daily drinkers, 13.9% were binge drinkers, 19.2% were heavy drinkers and 11.0% were problem drinkers. Overall, 27.1% of antidepressant users were daily drinkers and 42.7% of sedative or anxiolytic users were daily drinkers. Sedative or anxiolytic use was associated with daily drinking (prevalence ratio = 1.42; 95% confidence intervals 1.09-1.76) but not with other drinking patterns. The associations between antidepressant use and alcohol drinking were not statistically significant. Potential psychotropic drug-alcohol interactions were common in older Australian men. Users of sedative or anxiolytic drugs were more likely to engage in daily drinking compared with non-users of sedative or anxiolytic drugs. Clinicians should monitor patients prescribed sedative or anxiolytic drugs for possible adverse events arising from concomitant use with alcohol. © 2012 Australasian Professional Society on Alcohol and other Drugs.

  9. [Antidepressants in the elderly].

    Science.gov (United States)

    Cortajarena García, M C; Ron Martin, S; Miranda Vicario, E; Ruiz de Vergara Eguino, A; Azpiazu Gomez, P J; Lopez Aldana, J

    2016-10-01

    Depression in the elderly is a changing, difficult and common disorder. At this age, there are more relapses and more long-life treatment is required. The pharmacology approach is a challenge because of concurrent factors that make their treatment more difficult. It is very important to have a basic antidepressant scheme, in order to help treat this disorder with efficiency and success from Primary Care. There are no drugs without side effects, and their characteristics have to be known in order to make the right selection depending on effectiveness, safety and tolerance. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Differing antidepressant maintenance methodologies.

    Science.gov (United States)

    Safer, Daniel J

    2017-10-01

    The principle evidence that antidepressant medication (ADM) is an effective maintenance treatment for adults with major depressive disorder (MDD) is from placebo substitution trials. These trials enter responders from ADM efficacy trials into randomized, double-blind placebo-controlled (RDBPC) effectiveness trials to measure the rate of MDD relapse over time. However, other randomized maintenance trial methodologies merit consideration and comparison. A systematic review of ADM randomized maintenance trials included research reports from multiple databases. Relapse rate was the main effectiveness outcome assessed. Five ADM randomized maintenance methodologies for MDD responders are described and compared for outcome. These effectiveness trials include: placebo-substitution, ADM/placebo extension, ADM extension, ADM vs. psychotherapy, and treatment as usual. The placebo-substitution trials for those abruptly switched to placebo resulted in unusually high (46%) rates of relapse over 6-12months, twice the continuing ADM rate. These trials were characterized by selective screening, high attrition, an anxious anticipation of a switch to placebo, and a risk of drug withdrawal symptoms. Selectively screened ADM efficacy responders who entered into 4-12month extension trials experienced relapse rates averaging ~10% with a low attrition rate. Non-industry sponsored randomized trials of adults with multiple prior MDD episodes who were treated with ADM maintenance for 1-2years experienced relapse rates averaging 40%. Placebo substitution trial methodology represents only one approach to assess ADM maintenance. Antidepressant maintenance research for adults with MDD should be evaluated for industry sponsorship, attrition, the impact of the switch to placebo, and major relapse differences in MDD subpopulations. Copyright © 2017. Published by Elsevier Inc.

  11. Antidepressant-selective gynecomastia.

    Science.gov (United States)

    Kaufman, Kenneth R; Podolsky, Dina; Greenman, Danielle; Madraswala, Rehman

    2013-01-01

    To describe what we believe is the first reported case of synergistic gynecomastia during treatment of depressive and anxiety disorders when sertraline was added to a stable medication regimen including duloxetine, rosuvastatin, and amlodipine. A 67-year-old male with major depression, dysthymia, obsessive-compulsive disorder, social anxiety, hypertension, diabetes, and hyperlipidemia presented with new-onset gynecomastia and breast tenderness. Mammography revealed bilateral gynecomastia (fibroglandular tissue posterior to the nipples bilaterally) without suspicious mass, calcification, or other abnormalities. These new symptoms developed after sertraline was added to his stable medication regimen (duloxetine, alprazolam, rosuvastatin, metoprolol, amlodipine, hydrochlorothiazide/triamterene, metformin, and sitagliptin). These symptoms were dose-dependent, with gynecomastia and breast tenderness more severe as sertraline was titrated from 25 mg/day to 50 mg/day and then to 75 mg/day. When sertraline was discontinued, gynecomastia and breast tenderness rapidly resolved. Mammoplasia and gynecomastia are associated with altered dopamine neurotransmission and/or perturbations in sexual hormones. These adverse effects may be medication induced. Selective serotonin reuptake inhibitors (sertraline), serotonin-norepinephrine reuptake inhibitors (duloxetine), rosuvastatin, and amlodipine have been reported to cause these adverse effects. This case was unique, since the patient had been on both sertraline and duloxetine previously as independent psychotropics without the development of gynecomastia. In the context of an additive drug adverse effect, the probability of sertraline as the precipitant drug was determined by both the Naranjo probability scale and the Horn drug interaction probability scale as probable. Gynecomastia is associated with antidepressants and other medications but is rarely addressed. Gynecomastia may be antidepressant selective or may be the result of

  12. Molecular Mechanisms Underlying the Anti-depressant Effects of Resveratrol: a Review.

    Science.gov (United States)

    de Oliveira, Marcos Roberto; Chenet, Aline Lukasievicz; Duarte, Adriane Ribeiro; Scaini, Giselli; Quevedo, João

    2017-07-10

    Major depression is a public health problem, affecting 121 million people worldwide. Patients suffering from depression present high rates of morbidity, causing profound economic and social impacts. Furthermore, patients with depression present cognitive impairments, which could influence on treatment adherence and long-term outcomes. The pathophysiology of major depression is not completely understood yet but involves reduced levels of monoamine neurotransmitters, bioenergetics, and redox disturbances, as well as inflammation and neuronal loss. Treatment with anti-depressants provides a complete remission of symptoms in approximately 50% of patients with major depression. However, these drugs may cause side effects, as sedation and weight gain. In this context, there is increasing interest in studies focusing on the anti-depressant effects of natural compounds found in the diet. Resveratrol is a polyphenolic phytoalexin (3,4',5-trihydroxystilbene; C 14 H 12 O 3 ; MW 228.247 g/mol) and has been found in peanuts, berries, grapes, and wine and induces anti-oxidant, anti-inflammatory, and anti-apoptotic effects in several mammalian cell types. Resveratrol also elicits anti-depressant effects, as observed in experimental models using animals. Therefore, resveratrol may be viewed as a potential anti-depressant agent, as well as may serve as a model of molecule to be modified aiming to ameliorate depressive symptoms in humans. In the present review, we describe and discuss the anti-depressant effects of resveratrol focusing on the mechanism of action of this phytoalexin in different experimental models.

  13. Sedation for pediatric radiological procedures: analysis of potential causes of sedation failure and paradoxical reactions

    Energy Technology Data Exchange (ETDEWEB)

    Karian, V.E.; Burrows, P.E.; Connor, L. [Dept. of Radiology, Children' s Hospital, Boston, MA (United States); Zurakowski, D. [Dept. of Biostatistics, Children' s Hospital, Boston, MA (United States); Mason, K.P. [Dept. of Anesthesiology, Children' s Hospital, Boston, MA (United States)

    1999-11-01

    Background. Sedation for diagnostic imaging and interventional radiologic procedures in pediatrics has greatly increased over the past decade. With appropriate patient selection and monitoring, serious adverse effects are infrequent, but failure to sedate and paradoxical reactions do occur. Objective. The purpose of this study was to determine, among patients undergoing sedation for radiologic procedures, the incidence of sedation failure and paradoxical reaction to pentobarbital and to identify potentially correctable causes. Materials and methods. Records of 1665 patients who were sedated in the radiology department from 1 November 1997 to 1 July 1998 were reviewed. Patients failing sedation or experiencing paradoxical reaction were compared with respect to sex, age group, diagnosis, scan type, time of day, NPO status, use of IV contrast and type of sedation agent using the Fisher exact test, Pearson chi-square, analysis of variance (ANOVA), the Student t-test, and logistic regression. Results. Data analysis revealed a sedation failure rate of 1 % and paradoxical reaction rate of 1.2 %. Stepwise multiple logistic regression revealed that the only significant independent multivariate predictor of failure was the need for the administration of a combination of pentobarbital, fentanyl, and midazolam IV. Conclusion. The low rate of sedation failure and paradoxical reactions to pentobarbital was near optimal and probably cannot be improved with the currently available sedatives. (orig.)

  14. Sedation for pediatric radiological procedures: analysis of potential causes of sedation failure and paradoxical reactions

    International Nuclear Information System (INIS)

    Karian, V.E.; Burrows, P.E.; Connor, L.; Zurakowski, D.; Mason, K.P.

    1999-01-01

    Background. Sedation for diagnostic imaging and interventional radiologic procedures in pediatrics has greatly increased over the past decade. With appropriate patient selection and monitoring, serious adverse effects are infrequent, but failure to sedate and paradoxical reactions do occur. Objective. The purpose of this study was to determine, among patients undergoing sedation for radiologic procedures, the incidence of sedation failure and paradoxical reaction to pentobarbital and to identify potentially correctable causes. Materials and methods. Records of 1665 patients who were sedated in the radiology department from 1 November 1997 to 1 July 1998 were reviewed. Patients failing sedation or experiencing paradoxical reaction were compared with respect to sex, age group, diagnosis, scan type, time of day, NPO status, use of IV contrast and type of sedation agent using the Fisher exact test, Pearson chi-square, analysis of variance (ANOVA), the Student t-test, and logistic regression. Results. Data analysis revealed a sedation failure rate of 1 % and paradoxical reaction rate of 1.2 %. Stepwise multiple logistic regression revealed that the only significant independent multivariate predictor of failure was the need for the administration of a combination of pentobarbital, fentanyl, and midazolam IV. Conclusion. The low rate of sedation failure and paradoxical reactions to pentobarbital was near optimal and probably cannot be improved with the currently available sedatives. (orig.)

  15. Antidepressants: Can They Lose Effectiveness?

    Science.gov (United States)

    ... be having the same effect. Can antidepressants lose effectiveness? Answers from Daniel K. Hall-Flavin, M.D. ... Policy Notice of Privacy Practices Notice of Nondiscrimination Advertising Mayo Clinic is a not-for-profit organization ...

  16. Dexmedetomidine for sedation of cardiosurgical patients

    Directory of Open Access Journals (Sweden)

    И. А. Козлов

    2015-10-01

    Full Text Available The problem of sedation in cardiosurgical intensive care units has obvious scientific and practical relevance. Many current studies deal with the implementation of novel medications for sedation, some features of their pharmacodynamic effects in different clinical settings, with advantages and disadvantages of their use in cardiosurgical patients. Recent years have seen an increase in the number of publications on the 2-adrenoceptor agonist dexmedetomidine used for sedation after open-heart surgery. The paper reviews current publications on 2-adrenoceptor agonists used in anesthesiology, considers their physiology and the mechanism of sedative action of dexmedetomidine, its pharmacokinetics and pharmacodynamics. The experience in using dexmedetomidine sedation in clinical practice is discussed in detail, by analyzing the data of current multicenter randomized trials in which this drug was compared with other sedative medications (propofol, midazolam, lorazepam. Some aspects of clinical pharmacology of dexmedetomidine, such as its effect on the sympathoadrenal system, hemodynamics, and respiratory system are analyzed. The clinical value of different receptor-dependent effects of the drug and the specific features of its application in different situations are also discussed. The authors share their own experience on delirium treatment and non-invasive ventilation in patients who receive dexmedetomidine sedation after heart transplantation and cardiac surgery.

  17. Deep sedation during pneumatic reduction of intussusception.

    Science.gov (United States)

    Ilivitzki, Anat; Shtark, Luda Glozman; Arish, Karin; Engel, Ahuva

    2012-05-01

    Pneumatic reduction of intussusception under fluoroscopic guidance is a routine procedure. The unsedated child may resist the procedure, which may lengthen its duration and increase the radiation dose. We use deep sedation during the procedure to overcome these difficulties. The purpose of this study was to summarize our experience with deep sedation during fluoroscopic reduction of intussusception and assess the added value and complication rate of deep sedation. All children with intussusception who underwent pneumatic reduction in our hospital between January 2004 and June 2011 were included in this retrospective study. Anesthetists sedated the children using propofol. The fluoroscopic studies, ultrasound (US) studies and the childrens' charts were reviewed. One hundred thirty-one attempted reductions were performed in 119 children, of which 121 (92%) were successful and 10 (8%) failed. Two perforations (1.5%) occurred during attempted reduction. Average fluoroscopic time was 1.5 minutes. No complication to sedation was recorded. Deep sedation with propofol did not add any complication to the pneumatic reduction. The fluoroscopic time was short. The success rate of reduction was high,raising the possibility that sedation is beneficial, possibly by smooth muscle relaxation.

  18. [Sedation with midazolam for ambulatory pediatric dentistry].

    Science.gov (United States)

    Shavlokhova, E A; Ostreĭkov, I F; Korolenkova, M V

    2014-01-01

    To improve the quality of dental treatment in children by using combined anaesthesia technique including local anaesthesia and conscious sedation, and to assess the effectiveness of conscious sedation for younger children undergoing dental treatment. The study included 208 children aged 14-88 months who received dental treatment for tooth decay and its complication under combined anaesthesia. Midazolam was used as sedative medication. Sedation level was assessed by visual scale and BIS-monitoring. ANI-monitoring was also used for pain sensitiveness evaluation. Results All 208 children were successfully treated under combined anaesthesia which showed satisfactory sedation rates both by visual scale and and BIS-monitoring values. While mean patient age was 39 months 20.6% were younger than 24 months. These data are extremely valuable as according to literature review conscious sedation in early infancy remains controversial. Our results proved conscious sedation to be effective in younger children undergoing dental treatment thus representing important alternative for general anaesthesia and providing a basis for later behavior management.

  19. Antidepressant-induced liver injury.

    Science.gov (United States)

    DeSanty, Kevin P; Amabile, Celene M

    2007-07-01

    To review principles of drug-induced liver injury (DILI), summarize characteristics of antidepressant-mediated liver injury, and provide recommendations for monitoring and management. A search relating to antidepressant-induced liver injury was performed using MEDLINE (1966-March 2007). Search terms included antidepressant, cholestasis, hepatotoxicity, jaundice, liver injury, toxic hepatitis, and transaminases. Reference citations not identified in the initial database search were also utilized. All English-language case reports, letters, and review articles identified from the data sources were used. Case reports and letters relating to hepatotoxicity from antidepressant overdose were excluded. Antidepressant-induced liver injury described in published cases were of the idiopathic type and, by definition, cannot be predicted based on dose or specific risk factors. Paroxetine had the largest number of cases within the selective serotonin-reuptake inhibitor class. Nefazodone, a serotonin-norepinephrine reuptake inhibitor, appeared to have the most serious cases and is the only antidepressant agent that carries a Food and Drug Administration Black Box Warning regarding hepatotoxicity. The tricyclic antidepressants and monoamine oxidase inhibitors are capable of producing hepatotoxicity, but fewer cases with these agents have been reported in the past 15 years, possibly due to a decline in their use. Causality has not been well established in all reports due to the concurrent use of other drugs and/or underlying liver disease. Most antidepressant agents have the potential to produce idiopathic liver injury. There is no way to prevent idiopathic DILI, but the severity of the reaction may be minimized with prompt recognition and early withdrawal of the agent. The clinician must be careful to provide ongoing therapy of the underlying depressive disorder and be aware of possible drug discontinuation syndromes should potential hepatotoxicity be suspected.

  20. Conscious Sedation: Emerging Trends in Pediatric Dentistry.

    Science.gov (United States)

    Attri, Joginder Pal; Sharan, Radhe; Makkar, Vega; Gupta, Kewal Krishan; Khetarpal, Ranjana; Kataria, Amar Parkash

    2017-01-01

    Dental fear and anxiety is a common problem in pediatric patients. There is considerable variation in techniques used to manage them. Various sedation techniques using many different anesthetic agents have gained considerable popularity over the past few years. Children are not little adults; they differ physically, psychologically, and emotionally. The purpose of this review is to survey recent trends and concerning issues in the rapidly changing field of pediatric sedation. We will study the topic from the perspective of an anesthesiologist. It will also provide information to practitioners on the practice of conscious sedation in dentistry and will also outline the route of administration, pharmacokinetics, and pharmacodynamics of various drugs used.

  1. Mechanistic evidence of Passiflora edulis (Passifloraceae) anxiolytic activity in relation to its metabolite fingerprint as revealed via LC-MS and chemometrics.

    Science.gov (United States)

    Otify, Asmaa; George, Camilia; Elsayed, Aly; Farag, Mohamed A

    2015-12-01

    Passiflora edulis Sims F. flavicarpa along with several other plants belonging to the genus Passiflora have been reported as sedatives and for treatment or prevention of central disorders. This study evaluated the anxiolytic effect of P. edulis ethanol extract and its fractions (viz. chloroform, ethyl acetate and butanol) using the elevated plus-maze model of anxiety and assessment of γ-aminobutyric acid levels. The results revealed that butanol and chloroform extracts exhibit the strongest effect followed by ethyl acetate suggesting that a combination of different classes of metabolites is likely to mediate for P. edulis anxiolytic effect in these fractions. To further pinpoint bioactive agents in fractions, ultra-performance liquid chromatography (UPLC) coupled to high resolution qTOF-MS was used for secondary metabolite profiling. A total of 65 metabolites were characterized including O-flavonoids, C-flavonoids, cyanogenic glycosides and fatty acids. Harman type alkaloids found in P. incarnata were not detected in P. edulis ethanol extract or any of its fractions suggesting that they do not mediate for its CNS modulating effects. Multivariate data analysis (PCA) was further applied to identify metabolite markers for fractions and revealed that enrichment of C-glycoside type flavonoids in chloroform/ethyl acetate fractions versus the exclusive presence of cyanogenic glycosides in its butanol fraction.

  2. Effect of an analgo-sedation protocol for neurointensive patients

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Jensen, Malene Brorson; Herling, Suzanne Forsyth

    2010-01-01

    Sedation protocols are needed for neurointensive patients. The aim of this pilot study was to describe sedation practice at a neurointensive care unit and to assess the feasibility and efficacy of a new sedation protocol. The primary outcomes were a shift from sedation-based to analgesia...

  3. Sedation Monitoring and Management during Percutaneous Endoscopic Lumbar Discectomy

    Directory of Open Access Journals (Sweden)

    Menekse Oksar

    2016-01-01

    Full Text Available Percutaneous endoscopic laser discectomy (PELD is a painful intervention that requires deep sedation and analgesia. However, sedation should be light at some point because cooperation by the patient during the procedure is required for successful surgical treatment. Light sedation poses a problem for endotracheal intubation, while patients placed in the prone position during percutaneous endoscopic discectomy pose a problem for airway management. Therefore, under these conditions, sedation should be not deeper than required. Here we report the sedation management of three cases that underwent PELD, with a focus on deep and safe sedation that was monitored using bispectral index score and observer’s assessment of alertness/sedation score.

  4. Sedation for procedures outside the operating room in children

    International Nuclear Information System (INIS)

    Molina Rodriguez, Ericka

    2014-01-01

    Sedation is defined in the pediatric population. An adequate preoperative assessment is established in patients subjected to a sedation. Fundamental characteristics of drugs used during a sedation are determined. Recommendations about surveillance and monitoring are established in a patient sedated. Principal characteristics of sedation are defined in patients exposed to radiological diagnostic and therapeutic procedures. Considerations in sedation are identified for procedures in the laboratory of digestive endoscopy. Alternatives of sedation are mentioned for oncological patients subjected to invasive procedures. Working conditions and specifications of anesthesia are determined in the cardiac catheterization room [es

  5. Diverse antidepressants increase CDP-diacylglycerol production and phosphatidylinositide resynthesis in depression-relevant regions of the rat brain

    Directory of Open Access Journals (Sweden)

    Undieh Ashiwel S

    2008-01-01

    Full Text Available Abstract Background Major depression is a serious mood disorder affecting millions of adults and children worldwide. While the etiopathology of depression remains obscure, antidepressant medications increase synaptic levels of monoamine neurotransmitters in brain regions associated with the disease. Monoamine transmitters activate multiple signaling cascades some of which have been investigated as potential mediators of depression or antidepressant drug action. However, the diacylglycerol arm of phosphoinositide signaling cascades has not been systematically investigated, even though downstream targets of this cascade have been implicated in depression. With the ultimate goal of uncovering the primary postsynaptic actions that may initiate cellular antidepressive signaling, we have examined the antidepressant-induced production of CDP-diacylglycerol which is both a product of diacylglycerol phosphorylation and a precursor for the synthesis of physiologically critical glycerophospholipids such as the phosphatidylinositides. For this, drug effects on [3H]cytidine-labeled CDP-diacylglycerol and [3H]inositol-labeled phosphatidylinositides were measured in response to the tricyclics desipramine and imipramine, the selective serotonin reuptake inhibitors fluoxetine and paroxetine, the atypical antidepressants maprotiline and nomifensine, and several monoamine oxidase inhibitors. Results Multiple compounds from each antidepressant category significantly stimulated [3H]CDP-diacylglycerol accumulation in cerebrocortical, hippocampal, and striatal tissues, and also enhanced the resynthesis of inositol phospholipids. Conversely, various antipsychotics, anxiolytics, and non-antidepressant psychotropic agents failed to significantly induce CDP-diacylglycerol or phosphoinositide synthesis. Drug-induced CDP-diacylglycerol accumulation was independent of lithium and only partially dependent on phosphoinositide hydrolysis, thus indicating that antidepressants

  6. Sedation with nitrous oxide compared with no sedation during catheterization for urologic imaging in children

    International Nuclear Information System (INIS)

    Zier, Judith L.; Kvam, Kathryn A.; Kurachek, Stephen C.; Finkelstein, Marsha

    2007-01-01

    Various strategies to mitigate children's distress during voiding cystourethrography (VCUG) have been described. Sedation with nitrous oxide is comparable to that with oral midazolam for VCUG, but a side-by-side comparison of nitrous oxide sedation and routine care is lacking. The effects of sedation/analgesia using 70% nitrous oxide and routine care for VCUG and radionuclide cystography (RNC) were compared. A sample of 204 children 4-18 years of age scheduled for VCUG or RNC with sedation or routine care were enrolled in this prospective study. Nitrous oxide/oxygen (70%/30%) was administered during urethral catheterization to children in the sedated group. The outcomes recorded included observed distress using the Brief Behavioral Distress Score, self-reported pain, and time in department. The study included 204 patients (99 nonsedated, 105 sedated) with a median age of 6.3 years (range 4.0-15.2 years). Distress and pain scores were greater in nonsedated than in sedated patients (P < 0.001). Time in department was longer in the sedated group (90 min vs. 30 min); however, time from entry to catheterization in a non-imaging area accounted for most of the difference. There was no difference in radiologic imaging time. Sedation with nitrous oxide is effective in reducing distress and pain during catheterization for VCUG or RNC in children. (orig.)

  7. Sedative effect of detomidine in infant calves.

    Science.gov (United States)

    Peshin, P K; Singh, A P; Singh, J; Patil, D B; Sharifi, D

    1991-01-01

    Detomidine administered intramuscularly at a dose of 10, 20 or 40 micrograms/kg body mass was evaluated for its sedative effects in 15 unfasted infant calves (age: 15-20 days; body mass: 18-33 kg). The drug produced dose-dependent sedation. At a dose of 10 micrograms/kg detomidine produced effective sedation for 30 to 45 min without any observable analgesia. At doses of 20 or 40 micrograms/kg it caused deep sedation, sternal recumbency, and moderate analgesia of the trunk. Hyperglycaemia was recorded at all dose levels. The changes in respiratory rate, rectal temperature, haemoglobin, packed cell volume, total erythrocyte count and plasma concentration of total protein were not significant.

  8. Sedation practice among Nigerian radiology residents

    African Journals Online (AJOL)

    . This will form the basis for ... the respondents having had formal training in sedation. A subgroup analysis of these 55 respondents showed ..... 12. Rowe R, Cohen RA. An evaluation of a virtual reality airway simulator. Anesth. Analg. 2002 ...

  9. Ketamine Sedation in Gastrointestinal Endoscopy in Children

    Directory of Open Access Journals (Sweden)

    Ayman E. Eskander

    2016-07-01

    CONCLUSION: Ketamine sedation found to be safe for paediatric gastrointestinal endoscopy in Egyptian children without co-morbidities. Transient Hypoxia (13% may occur but easily reversed by nasal oxygen therapy.

  10. Effect of methanol extract of Trigonella foenum-graecum L. seeds on anxiety, sedation and motor coordination.

    Science.gov (United States)

    Assad, Tahira; Khan, Rafeeq Alam

    2017-04-01

    Currently available anxiolytics cause numerous adverse effects and show craving and tolerance during long term treatment. Currently traditional medicines have been re-evaluated widely through work on various plant species. Numerous plants in traditional system show pharmacological activity with unlimited prospective for therapeutic use. Hence we planned to evaluate the effect of methanol extract of T. foenum-graecum L. seeds on anxiety, sedation and motor coordination in mice at different doses following 15 days of oral feeding. Effect on anxiety was assessed by Hole board test and Light and Dark transition models.Phenobarbitone induced sleeping time and Rota rod test were performed to assess effect on sedation and motor coordination. In Hole board test, T. foenum-graecum L. seeds decreased the number of head dips in mice at all the three doses. In Light and Dark transition model, T. foenum-graecum L. seeds increased the period spent in the light box and the number of moves among the two compartments at 100 and 200 mg/kg as compared to control animals. In phenobarbitone induced sleeping time, T. foenum-graecum L. seeds did not reveal any sedative effect. In Rota rod test, extract exhibited significant skeletal muscle relaxant effect at 200 mg/kg (at 90 min) as compared to the control animals. Results of our study shows significant antianxiety effects of T. foenum-graecum L. seeds and may also recommend improved adverse effect profile as compared to diazepam.

  11. Sedative effect of central administration of Coriandrum sativum essential oil and its major component linalool in neonatal chicks.

    Science.gov (United States)

    Gastón, María Soledad; Cid, Mariana Paula; Vázquez, Ana María; Decarlini, María Florencia; Demmel, Gabriela I; Rossi, Laura I; Aimar, Mario Leandro; Salvatierra, Nancy Alicia

    2016-10-01

    Context Coriandrum sativum L. (Apiaceae) (coriander) is an herb grown throughout the world as a culinary, medicinal or essential crop. In traditional medicine, it is used for the relief of anxiety and insomnia. Systemic hydro-alcoholic and aqueous extract from aerial parts and seeds had anxiolytic and sedative action in rodents, but little is known about its central effect in chicks. Objective To study the effects of intracerebroventricular administration of essential oil from coriander seeds and its major component linalool on locomotor activity and emotionality of neonatal chicks. Materials and methods The chemical composition of coriander essential oil was determined by a gas-chromatographic analysis (> 80% linalool). Behavioural effects of central administration of coriander oil and linalool (both at doses of 0.86, 8.6 and 86 μg/chick) versus saline and a sedative diazepam dose (17.5 μg/chick, standard drug) in an open field test for 10 min were observed. Results Doses of 8.6 and 86 μg from coriander oil and linalool significantly decreased (p linalool, which also induced a similar sedative effect, and, therefore, could be considered as a potential therapeutic agent similar to diazepam.

  12. Anxiolytic effects of muscarinic acetylcholine receptors agonist oxotremorine in chronically stressed rats and related changes in BDNF and FGF2 levels in the hippocampus and prefrontal cortex.

    Science.gov (United States)

    Di Liberto, Valentina; Frinchi, Monica; Verdi, Vincenzo; Vitale, Angela; Plescia, Fulvio; Cannizzaro, Carla; Massenti, Maria F; Belluardo, Natale; Mudò, Giuseppa

    2017-02-01

    In depressive disorders, one of the mechanisms proposed for antidepressant drugs is the enhancement of synaptic plasticity in the hippocampus and cerebral cortex. Previously, we showed that the muscarinic acetylcholine receptor (mAChR) agonist oxotremorine (Oxo) increases neuronal plasticity in hippocampal neurons via FGFR1 transactivation. Here, we aimed to explore (a) whether Oxo exerts anxiolytic effect in the rat model of anxiety-depression-like behavior induced by chronic restraint stress (CRS), and (b) if the anxiolytic effect of Oxo is associated with the modulation of neurotrophic factors, brain-derived neurotrophic factor (BDNF) and fibroblast growth factor-2 (FGF2), and phosphorylated Erk1/2 (p-Erk1/2) levels in the dorsal or ventral hippocampus and in the medial prefrontal cortex. The rats were randomly divided into four groups: control unstressed, CRS group, CRS group treated with 0.2 mg/kg Oxo, and unstressed group treated with Oxo. After 21 days of CRS, the groups were treated for 10 days with Oxo or saline. The anxiolytic role of Oxo was tested by using the following: forced swimming test, novelty suppressed feeding test, elevated plus maze test, and light/dark box test. The hippocampi and prefrontal cortex were used to evaluate BDNF and FGF2 protein levels and p-Erk1/2 levels. Oxo treatment significantly attenuated anxiety induced by CRS. Moreover, Oxo treatment counteracted the CRS-induced reduction of BDNF and FGF2 levels in the ventral hippocampus and medial prefrontal cerebral cortex CONCLUSIONS: The present study showed that Oxo treatment ameliorates the stress-induced anxiety-like behavior and rescues FGF2 and BDNF levels in two brain regions involved in CRS-induced anxiety, ventral hippocampal formation, and medial prefrontal cortex.

  13. Anxiolytic and nootropic activity of Vetiveria zizanioides roots in mice

    Directory of Open Access Journals (Sweden)

    Abhijit M Nirwane

    2015-01-01

    Full Text Available Background: Vetiveria zizanioides (VZ (family: Poaceae, an aromatic plant commonly known as “Vetiver“ has been used for various ailments. Concerning the various ailments being listed as the traditional uses of VZ, no mention about anxiety and memory was found. Objective: The present study examined the anxiolytic and memory enhancing activity of ethanolic extract of V. zizanioides (EEVZ dried roots in mice. Materials and Methods: Activity of EEVZ was assessed using models of anxiety (elevated plus-maze [EPM], light/dark test, hole board test, marble-burying test and learning and memory (EPM, passive shock avoidance paradigm. Results: EEVZ at doses of 100, 200, and 300 mg/kg b.w. illustrated significant anxiolytic activity indicated by increase in time spent and number of entries in open arm, time spent in lightened area, number of head poking and number marble buried when compared to that of diazepam (1 mg/kg b.w., a reference standard. The same treatment showed a significant decrease in transfer latency to reach open arm, shock-free zone, and number of mistakes when compared to that of scopolamine (0.3 mg/kg b.w.. EEVZ in all the doses (100, 200, and 300 mg/kg b.w. significantly decreased mortality in sodium nitrite (250 mg/kg b.w. induced hypoxia and also significantly increases contraction induced by acetylcholine on rat ileum preparation. Conclusion: The result emanated in the present investigation revealed EEVZ possesses significant anxiolytic and nootropic activity by possibly interplaying with neurotransmitters implicated in anxiety and learning and memory.

  14. Clonidine Sedation Effects in Children During Electroencephalography

    Directory of Open Access Journals (Sweden)

    Mohammad Barzegar

    2017-10-01

    Full Text Available It is very important to have proper management in children with Seizure. Electroencephalography (EEG as a diagnostic instrument has a key role in determining the management method of seizure in children. Because of poor cooperation of some children (especially children with attention deficit hyperactivity disorders and developmental disorders in performing EEG, it is the best choice to sedate children before EEG. The aim of present study is to evaluate the sedation efficacy of clonidine in children before EEG. In a randomized clinical trial, 45 children age 2 to 12 with seizure, who referred to Children Hospital of Tabriz University of Medical Sciences and candidate for EEG, were studied. Sedation before EEG induced by 0.5 to 2.0 mg clonidine orally. Sedation score (0 to 5 measured by using eyes condition, response to voice, and response to touch. Successful sedation, EEG performing, and hemodynamic stability were evaluated during sedation. Of all patients, 40 patients (88.88% were sedated successfully, and EEG was performed for all of the children. Mean onset time of clonidine effect was 35.47±13.56 minutes and mean time of that the patients’ level of consciousness back to the level before administrating of clonidine was 77.55±26.87 minutes. Hemodynamic states of all patients were stable during the study, and there were no significant changes in vital sign of patients. In conclusion, clonidine can be considered as a safe alternative medication for sedation for EEG, which is fortunately associated with no significant change in vital signs, which may complicate overall status of patients.

  15. Mirtazapine exerts an anxiolytic-like effect through activation of the median raphe nucleus-dorsal hippocampal 5-HT pathway in contextual fear conditioning in rats.

    Science.gov (United States)

    An, Yan; Chen, Chong; Inoue, Takeshi; Nakagawa, Shin; Kitaichi, Yuji; Wang, Ce; Izumi, Takeshi; Kusumi, Ichiro

    2016-10-03

    The functional role of serotonergic projections from the median raphe nucleus (MRN) to the dorsal hippocampus (DH) in anxiety remains understood poorly. The purpose of the present research was to examine the functional role of this pathway, using the contextual fear conditioning (CFC) model of anxiety. We show that intra-MRN microinjection of mirtazapine, a noradrenergic and specific serotonergic antidepressant, reduced freezing in CFC without affecting general motor activity dose-dependently, suggesting an anxiolytic-like effect. In addition, intra-MRN microinjection of mirtazapine dose-dependently increased extracellular concentrations of serotonin (5-HT) but not dopamine in the DH. Importantly, intra-DH pre-microinjection of WAY-100635, a 5-HT1A antagonist, significantly attenuated the effect of mirtazapine on freezing. These results, for the first time, suggest that activation of the MRN-DH 5-HT1A pathway exerts an anxiolytic-like effect in CFC. This is consistent with the literature that the hippocampus is essential for retrieval of contextual memory and that 5-HT1A receptor activation in the hippocampus primarily exerts an inhibitory effect on the neuronal activity. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Safety of Conscious Sedation In Interventional Radiology

    International Nuclear Information System (INIS)

    Arepally, Aravind; Oechsle, Denise; Kirkwood, Sharon; Savader, Scott J.

    2001-01-01

    Purpose: To identify rates of adverse events associated with the use of conscious sedation in interventional radiology.Methods: In a 5-month period, prospective data were collected on patients undergoing conscious sedation for interventional radiology procedures (n = 594). Adverse events were categorized as respiratory, sedative, or major adverse events. Respiratory adverse events were those that required oral airway placement, ambu bag, or jaw thrust. Sedation adverse events were unresponsiveness, oxygen saturation less than 90%, use of flumazenil/naloxone, or agitation. Major adverse events were hypotension, intubation, CPR, or cardiac arrest. The frequency of adverse events for the five most common radiology procedures were determined.Results: The five most common procedures (total n = 541) were biliary tube placement/exchange (n = 182), tunneled catheter placement (n 135), diagnostic arteriography (n = 125), vascular interventions (n = 52), and other catheter insertions (n = 46). Rates for respiratory, sedation, and major adverse events were 4.7%, 4.2%, and 2.0%, respectively. The most frequent major adverse event was hypotension (2.0%). Biliary procedures had the highest rate of total adverse events (p < .05) and respiratory adverse events (p < .05).Conclusion: The frequency of adverse events is low with the use of conscious sedation during interventional procedures. The highest rates occurred during biliary interventions

  17. Analgesia, sedation, and memory of intensive care.

    Science.gov (United States)

    Capuzzo, M; Pinamonti, A; Cingolani, E; Grassi, L; Bianconi, M; Contu, P; Gritti, G; Alvisi, R

    2001-09-01

    The purpose of this article was to investigate the relationship between analgesia, sedation, and memory of intensive care. One hundred fifty-two adult, cooperative intensive care unit (ICU) patients were interviewed 6 months after hospital discharge about their memory of intensive care. The patient was considered to be cooperative when he/she was aware of self and environment at the interview. The patients were grouped as follows: A (45 patients) substantially no sedation, B (85) morphine, and C (22) morphine and other sedatives. The patients having no memory of intensive care were 38%, 34%, and 23% respectively, in the three groups. They were less ill, according to SAPS II (P memories was not different among the three groups. Females reported at least one emotional memory more frequently than males (odds ratio 4.17; 95% CI 10.97-1.59). The patients receiving sedatives in the ICU are not comparable with those receiving only opiates or nothing, due to the different clinical condition. The lack of memory of intensive care is present in one third of patients and is influenced more by length of stay in ICU than by the sedation received. Sedation does not influence the incidence of factual, sensation, and emotional memories of ICU admitted patients. Females have higher incidences of emotional memories than males. Copyright 2001 by W.B. Saunders Company

  18. Patient attitudes toward undergoing colonoscopy without sedation.

    Science.gov (United States)

    Early, D S; Saifuddin, T; Johnson, J C; King, P D; Marshall, J B

    1999-07-01

    The vast majority of patients undergoing colonoscopy in the United States are given sedation. There are a number of potential advantages to performing colonoscopy without sedation. We sought to determine the attitude of patients toward unsedated colonoscopy in our three practice settings (a university medical center, a cancer center, and a Veterans Affairs medical center), and to see if there were factors that predicted willingness to try it. Four-hundred thirty-four adult patients undergoing outpatient colonoscopy completed questionnaires before and after their procedures providing demographic information and assessing willingness to undergo colonoscopy without sedation. Patients were routinely given meperidine and midazolam for their procedures unless they specifically requested that they be unsedated (10 patients). Only 16.9% of our patients were willing to undergo colonoscopy on their preprocedure questionnaire. Willingness increased modestly on the postprocedure questionnaire to 22.6% (p = 0.01). Logistic regression analysis disclosed that male gender, having a college degree, low anxiety based on preprocedure anxiety scales, and lower doses of sedative drugs used during colonoscopy were the best predictors of willingness to undergo colonoscopy without sedation in the future. Only about a fifth of patients undergoing colonoscopy in our three practice settings expressed a willingness to try colonoscopy unsedated. Male gender, higher levels of education, and low anxiety scores on simple scales of preprocedure anxiety may help to predict willingness. Efforts to substantially increase the frequency of patients willing to undergo colonoscopy without sedation will likely require increased patient counseling and education.

  19. Safe Driving After Propofol Sedation.

    Science.gov (United States)

    Summerlin-Grady, Lee; Austin, Paul N; Gabaldon, Dion A

    2017-10-01

    Propofol is a short-acting medication with fast cognitive and psychomotor recovery. However, patients are usually instructed not to drive a motor vehicle for 24 hours after receiving propofol. The purpose of this article was to review the evidence examining when it is safe to drive after receiving propofol for sedation for diagnostic and surgical procedures. This is a systematic review of the literature. A search of the literature was conducted using Google Scholar, PubMed, and the Cochrane Library for the time period 1990 to 2015. Two randomized controlled trials and two observational studies met the inclusion criteria. Using a simulator, investigators examined driving ability of subjects who received modest doses (about 100 mg) of propofol for endoscopic procedures and surveyed subjects who drove immediately after discharge. There were methodological concerns with the studies such as small sample sizes, modest doses of propofol, and three of the four studies were done in Japan by the same group of investigators limiting generalizability. This limited research suggests that it may be safe for patients to drive sooner than 24 hours after receiving propofol. However, large multicenter trials using heterogenous samples using a range of propofol doses are needed to support an evidence-based revision to the current discharge guidelines for patients receiving propofol. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  20. Road traffic crash risk associated with prescription of hydroxyzine and other sedating H1-antihistamines: A responsibility and case-crossover study.

    Science.gov (United States)

    Orriols, Ludivine; Luxcey, Audrey; Contrand, Benjamin; Bénard-Laribière, Anne; Pariente, Antoine; Gadegbeku, Blandine; Lagarde, Emmanuel

    2017-09-01

    H1 antihistamines differ from each other by their ability to cross the blood-brain barrier. The resulting sedating effect can be sought in therapy but may be a driving hazard. The aim of this study was to estimate the impact of sedating H1-antihistamines on the risk of road traffic crash, with a particular focus on hydroxyzine which is also indicated as an anxiolytic in France. The study consisted in extracting and matching data from three French nationwide databases: the national healthcare insurance database, police reports and the police national database of injurious crashes. All sedating H1-antihistamines, including hydroxyzine, were considered in the study. A case-control analysis, in which responsible drivers were cases and non-responsible were controls was performed. A case-crossover analysis, comparing for the same subject exposure during a period immediately before the crash with exposure during an earlier period, was also conducted. The extraction and matching procedures over the July 2005-December 2011 period led to the inclusion of 142,771 drivers involved in an injurious road traffic crash. The responsibility study found an increased risk of being responsible for an injurious road traffic crash in hydroxyzine users who were registered with a long-term chronic disease (mostly psychiatric disorders) on the day of the crash (OR=1.67 [1.22-2.30]). Among them, the risk was even higher in drivers with highest exposure levels (OR=2.60 [1.23-5.50]). There was no impact of sedating H1 antihistamine treatment initiation on the risk of crash. Even if it is difficult to disentangle the part of the increased risk that would be causally related to hydroxyzine and the part related to behaviours of patients with a heavy psychiatric disorder, our study raises the alarm on the crash risk linked to hydroxyzine utilization in countries in which the anxiolytic indication is widespread. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. The feasibility of office-based propofol sedation for dental care in patients with intellectual disability by sedation practitioners.

    Science.gov (United States)

    Vaessen, Hermanus H B; Schouten, Antonius N J; van der Hoeve, Henriette; Knape, Johannes T A

    2017-03-01

    The quality of oral health care for intellectually disabled patients is a significant challenge due to behavioral issues. Intravenous propofol sedation may be useful to relieve the anxiety and fear, and make dental procedures more acceptable. The aim of this study was to evaluate the safety and effectiveness of propofol sedation, by trained nonmedical sedation practitioners, during dental treatments in an office-based setting. Intellectually disabled patients (124) were subjected to restorative dental procedures and moderately sedated using intravenous propofol. Vital signs, cooperation of the patient, and sedation depth were continuously assessed. Propofol sedation was effective for dental treatment. All procedures resulted in a sufficient level of sedation without moderate or severe complications. Propofol sedation can be safely and effectively performed in an office-based setting by sedation practitioners, who have experience in propofol sedation and are trained in the care of patients with disabilities. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

  2. Variation in Procedural Sedation Practices Among Children's Hospitals.

    Science.gov (United States)

    Srinivasan, Mythili; Bhaskar, Shobha; Carlson, Douglas W

    2015-03-01

    Children often need procedural sedation for painful procedures. There are few data on type of provider, site of sedation, and agents used for procedural sedation in hospitals across the nation. The objective was to determine procedural sedation practices for hospitalized children outside the PICU and emergency department. Surveys were sent to 89 pediatric hospitalist (PH) leaders in hospitals belonging to the Child Health Corporation of America or the National Association of Children's Hospitals and Related Institutions. We received responses from 56 PHs (63%), of whom 49 (55%) completed the survey. PHs provided sedation in 18 hospitals. Provider, setting, and agents used for procedural sedation varied. The primary providers of procedural sedation for abscess incision and drainage, renal biopsy, joint aspiration, computed tomography, and MRI were anesthesiologists. A significantly greater percentage of hospitals where PHs did not provide procedural sedation used the operating room for abscess incision and drainage compared with hospitals where PHs provided procedural sedation (63% vs 28%, respectively). Postoperative/abscess dressing change, vesicocystourethrogram, and ≥1 painful procedure were performed without sedation in significantly greater percentage of hospitals where PHs did not provide procedural sedation compared with hospitals where PHs provided procedural sedation. There is variability in sedation practices in hospitals across the nation, which affects patient care and use of resources such as the operating room. In hospitals where PHs provide procedural sedation, there is less operating room use and fewer painful procedures for which no sedation is provided. Copyright © 2015 by the American Academy of Pediatrics.

  3. Development and validation of the PROcedural Sedation Assessment Survey (PROSAS) for assessment of procedural sedation quality.

    Science.gov (United States)

    Leffler, Daniel A; Bukoye, Bolanle; Sawhney, Mandeep; Berzin, Tyler; Sands, Kenneth; Chowdary, Sona; Shah, Anita; Barnett, Sheila

    2015-01-01

    More than 20 million invasive procedures are performed annually in the United States. The vast majority are performed with moderate sedation or deep sedation, yet there is limited understanding of the drivers of sedation quality and patient satisfaction. Currently, the major gap in quality assurance for invasive procedures is the lack of procedural sedation quality measures. To develop and validate a robust, patient-centered measure of procedural sedation quality, the PROcedural Sedation Assessment Survey (PROSAS). Through a series of interviews with patients, proceduralists, nurses, anesthesiologists, and an interactive patient focus group, major domains influencing procedural sedation quality were used to create a multipart survey. The pilot survey was administered and revised in sequential cohorts of adults receiving moderate sedation for GI endoscopy. After revision, the PROSAS was administered to a validation cohort. GI endoscopy unit. A expert panel of proceduralists, nurses, and anesthesiologists, an initial survey development cohort of 40 patients, and a validation cohort of 858 patients undergoing sedation for outpatient GI endoscopy with additional surveys completed by the gastroenterologist, procedure nurse, and recovery nurse. Survey characteristics of the PROSAS. Patients were able to independently complete the PROSAS after procedural sedation before discharge. Of the patients, 91.6% reported minimal discomfort; however, 8.4% of patients reported significant discomfort and 2.4% of patients experienced hemodynamic and/or respiratory instability. There was a high correlation between patient-reported intraprocedure discomfort and both clinician assessments of procedural discomfort and patient recall of procedural pain 24 to 48 hours post procedure (P procedural sedation quality. The PROSAS may be useful in both research and clinical settings. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  4. Antidepressant-like effects of a water-soluble extract from the culture medium of Ganoderma lucidum mycelia in rats.

    Science.gov (United States)

    Matsuzaki, Hirokazu; Shimizu, Yuta; Iwata, Naohiro; Kamiuchi, Shinya; Suzuki, Fumiko; Iizuka, Hiroshi; Hibino, Yasuhide; Okazaki, Mari

    2013-12-26

    Ganoderma lucidum is a popular medicinal mushroom used for promoting health and longevity in Asian countries. Previously, we reported that a water-soluble extract from a culture medium of Ganoderma lucidum mycelia (MAK) exerts antioxidative and cerebroprotective effects against ischemia-reperfusion injury in vivo. Here, we evaluated the antidepressant and anxiolytic activities of MAK in rats. MAK (0.3 or 1 g/kg, p.o.) was administered in the experimental animals 60 min before the forced swimming, open-field, elevated plus-maze, contextual fear-conditioning, and head twitch tests. Additionally, the mechanisms involved in the antidepressant-like action of MAK were investigated by the serotonin precursor 5-hydroxy-L-tryptophan (5-HTP)- or 5-HT2A agonist (±)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane hydrochloride (DOI)-induced head twitch responses. Treatment with MAK (1 g/kg) exhibited antidepressant-like effects in the forced swimming test, attenuated freezing behavior in the contextual fear-conditioning test, and decreased the number of head twitches induced by DOI, but not with 5-HTP. No significant response was observed in locomotion or anxiety-like behavior, when the animals were evaluated in the open-field or elevated plus-maze test, respectively. These data suggest that MAK has antidepressant-like potential, which is most likely due to the antagonism of 5-HT2A receptors, and possesses anxiolytic-like effects toward memory-dependent and/or stress-induced anxiety in rats.

  5. [Antidepressive agents and breast feeding].

    Science.gov (United States)

    Håberg, M; Matheson, I

    1997-11-10

    Postpartum blues occurs in 50-80% of women. A few percent of the cases are classified as serious postpartum depression, requiring antidepressant treatment. There is a growing understanding that women should continue to breast-feed in this situation. Data concerning the transfer of antidepressants into breast milk has been researched. Calculations of the infant relative dose via breast milk were done for the drugs concerned. Few antidepressants have been studied at steady state conditions in nursing mothers. Nortriptyline and amitriptyline have minimal relative doses and can be used when breast-feeding. Doxepine should be avoided, as should lithium, which has a significant transfer. Among the serotonine-reuptake inhibitors fluoxetine has been well studied in breast milk. Since fluoxetine has a long half life and a high transfer, sertraline and possibly paroxetine are better alternatives, but the latter has not yet been studied in repeated doses. Moclobemide also lacks data from multiple dose studies, but extrapolation to steady state indicates that the relative dose is small. More observational studies should be carried out in infants breast-fed by mothers using antidepressants. In the meantime, doctors prescribing antidepressant drugs to nursing mothers should see that the infants are monitored for side effects.

  6. Neuroimmune endocrine effects of antidepressants

    Directory of Open Access Journals (Sweden)

    Antonioli M

    2012-02-01

    Full Text Available Marco Antonioli, Joanna Rybka, LA CarvalhoPsychoimmunology Translational Laboratory, Health Science Research Centre, Roehampton University, London, UKAbstract: Antidepressant pharmacotherapy is to date the most often used treatment for depression, but the exact mechanism of action underlying its therapeutic effect is still unclear. Many theories have been put forward to account for depression, as well as antidepressant activity, but none of them is exhaustive. Neuroimmune endocrine impairment is found in depressed patients; high levels of circulating corticosteroids along with hyperactivation of the immune system, high levels of proinflammatory cytokines, low levels of melatonin in plasma and urine, and disentrainment of circadian rhythms have been demonstrated. Moreover, antidepressant treatment seems to correct or at least to interfere with these alterations. In this review, we summarize the complex neuroimmune endocrine and chronobiological alterations found in patients with depression and how these systems interact with each other. We also explain how antidepressant therapy can modify these systems, along with some possible mechanisms of action shown in animal and human models.Keywords: antidepressant agents, biological markers, human, cytokines, neuroinflammation, psychoneuroimmunology, endophenotype

  7. Chamomile (Matricaria recutita) May Have Antidepressant Activity in Anxious Depressed Humans - An Exploratory Study

    Science.gov (United States)

    Amsterdam, Jay D.; Shults, Justine; Soeller, Irene; Mao, Jun James; Rockwell, Kenneth; Newberg, Andrew B.

    2013-01-01

    Objective As part of a randomized, double-blind, placebo-controlled study, we examined the antidepressant action of oral chamomile (Matricaria recutita) extract in subjects with co-morbid anxiety and depression symptoms. We hypothesized that chamomile may demonstrate a clinically meaningful antidepressant activity versus placebo. Methods 57 subjects received either chamomile extract or placebo therapy. Nineteen subjects had anxiety with co-morbid depression, 16 had anxiety with past history of depression, and 22 had anxiety with no current or past depression. Generalized estimating equations analysis was used to identify clinically meaningful changes over time in Hamilton Depression Rating (HAM-D) rating outcome measures among treatment groups. Results We observed a significantly greater reduction in mean total HAM-D scores (pchamomile versus placebo in all subjects, and a non-significant trend for a greater reduction in HAM-D core depression score for chamomile versus placebo in subjects with anxiety with current co-morbid depression (p=0.062). Conclusion Chamomile may have clinically meaningful antidepressant activity that occurs in addition to its previously observed anxiolytic activity. PMID:22894890

  8. Functional Selectivity and Antidepressant Activity of Serotonin 1A Receptor Ligands.

    Science.gov (United States)

    Chilmonczyk, Zdzisław; Bojarski, Andrzej Jacek; Pilc, Andrzej; Sylte, Ingebrigt

    2015-08-07

    Serotonin (5-HT) is a monoamine neurotransmitter that plays an important role in physiological functions. 5-HT has been implicated in sleep, feeding, sexual behavior, temperature regulation, pain, and cognition as well as in pathological states including disorders connected to mood, anxiety, psychosis and pain. 5-HT1A receptors have for a long time been considered as an interesting target for the action of antidepressant drugs. It was postulated that postsynaptic 5-HT1A agonists could form a new class of antidepressant drugs, and mixed 5-HT1A receptor ligands/serotonin transporter (SERT) inhibitors seem to possess an interesting pharmacological profile. It should, however, be noted that 5-HT1A receptors can activate several different biochemical pathways and signal through both G protein-dependent and G protein-independent pathways. The variables that affect the multiplicity of 5-HT1A receptor signaling pathways would thus result from the summation of effects specific to the host cell milieu. Moreover, receptor trafficking appears different at pre- and postsynaptic sites. It should also be noted that the 5-HT1A receptor cooperates with other signal transduction systems (like the 5-HT1B or 5-HT2A/2B/2C receptors, the GABAergic and the glutaminergic systems), which also contribute to its antidepressant and/or anxiolytic activity. Thus identifying brain specific molecular targets for 5-HT1A receptor ligands may result in a better targeting, raising a hope for more effective medicines for various pathologies.

  9. Migraine Medications and Antidepressants: A Risky Mix?

    Science.gov (United States)

    ... health risks associated with taking migraine medications and antidepressants at the same time? Answers from Jerry W. ... that combining migraine medications called triptans with certain antidepressants — including selective serotonin reuptake inhibitors (SSRIs) and serotonin ...

  10. Anxiolytic Effect of Citrus aurantium L. in Crack Users

    Directory of Open Access Journals (Sweden)

    Gabriel Chaves Neto

    2017-01-01

    Full Text Available The objective of this study was to investigate the anxiolytic effects of the essential oil (EO of Citrus aurantium L. in patients experiencing crack withdrawal. This was developed with internal users in therapeutic communities in Paraíba, Brazil. The test population consisted of 51 volunteers, subdivided into three groups. To elicit anxiety, the Simulated Public Speaking (SPS method was used. Physiological measures were assessed at specific phases during the experiment using appropriate equipment. Psychological measures of anxiety were assessed using the Trait-State Anxiety Inventory (IDATE and the Analog Smoke Scale (HAS. EO was administered by nebulization. The experiment was developed in individual sessions and consolidated to four phases. The results demonstrated that the test subjects in the groups that were given the EO maintained controlled anxiety levels during SPS, when compared to the Control Group (no treatment. Subjects who used the EO also maintained levels of “discomfort” and “cognitive impairment” during SPS. It was concluded that individuals who are experiencing internal crack cocaine withdrawal present high anxiety traits and that nebulization of the EO of Citrus aurantium L. provided an acute anxiolytic effect in crack cocaine users exposed to SPS.

  11. Anxiolytic Effect of Citrus aurantium L. in Crack Users

    Science.gov (United States)

    Chaves Neto, Gabriel; Braga, João Euclides Fernandes; de Morais Pordeus, Liana Clébia; dos Santos, Sócrates Golzio; Almeida, Reinaldo N.; Diniz, Margareth de Fátima Formiga Melo

    2017-01-01

    The objective of this study was to investigate the anxiolytic effects of the essential oil (EO) of Citrus aurantium L. in patients experiencing crack withdrawal. This was developed with internal users in therapeutic communities in Paraíba, Brazil. The test population consisted of 51 volunteers, subdivided into three groups. To elicit anxiety, the Simulated Public Speaking (SPS) method was used. Physiological measures were assessed at specific phases during the experiment using appropriate equipment. Psychological measures of anxiety were assessed using the Trait-State Anxiety Inventory (IDATE) and the Analog Smoke Scale (HAS). EO was administered by nebulization. The experiment was developed in individual sessions and consolidated to four phases. The results demonstrated that the test subjects in the groups that were given the EO maintained controlled anxiety levels during SPS, when compared to the Control Group (no treatment). Subjects who used the EO also maintained levels of “discomfort” and “cognitive impairment” during SPS. It was concluded that individuals who are experiencing internal crack cocaine withdrawal present high anxiety traits and that nebulization of the EO of Citrus aurantium L. provided an acute anxiolytic effect in crack cocaine users exposed to SPS. PMID:29234424

  12. A Systematic Review of the Anxiolytic-Like Effects of Essential Oils in Animal Models

    Directory of Open Access Journals (Sweden)

    Damião Pergentino de Sousa

    2015-10-01

    Full Text Available The clinical efficacy of standardized essential oils (such as Lavender officinalis, in treating anxiety disorders strongly suggests that these natural products are an important candidate source for new anxiolytic drugs. A systematic review of essential oils, their bioactive constituents, and anxiolytic-like activity is conducted. The essential oil with the best profile is Lavendula angustifolia, which has already been tested in controlled clinical trials with positive results. Citrus aurantium using different routes of administration also showed significant effects in several animal models, and was corroborated by different research groups. Other promising essential oils are Citrus sinensis and bergamot oil, which showed certain clinical anxiolytic actions; along with Achillea wilhemsii, Alpinia zerumbet, Citrus aurantium, and Spiranthera odoratissima, which, like Lavendula angustifolia, appear to exert anxiolytic-like effects without GABA/benzodiazepine activity, thus differing in their mechanisms of action from the benzodiazepines. The anxiolytic activity of 25 compounds commonly found in essential oils is also discussed.

  13. Sedative medications outside the operating room and the pharmacology of sedatives

    DEFF Research Database (Denmark)

    Hansen, Tom G

    2015-01-01

    available.Newer drugs are on the horizon (e.g., remimazolam, fospropofol, and etomidate analogues) with a theoretical more predictable onset and offset; whether these will revolutionize the sedational practice sedation remains unknown. SUMMARY: Clinicians should be aware of the pharmacokinetic...

  14. Antidepressant-Resistant Depression and Antidepressant-Associated Suicidal Behaviour: The Role of Underlying Bipolarity

    Directory of Open Access Journals (Sweden)

    Zoltan Rihmer

    2011-01-01

    Full Text Available The complex relationship between the use of antidepressants and suicidal behaviour is one of the hottest topics of our contemporary psychiatry. Based on the literature, this paper summarizes the author's view on antidepressant-resistant depression and antidepressant-associated suicidal behaviour. Antidepressant-resistance, antidepressant-induced worsening of depression, antidepressant-associated (hypomanic switches, mixed depressive episode, and antidepressant-associated suicidality among depressed patients are relatively most frequent in bipolar/bipolar spectrum depression and in children and adolescents. As early age at onset of major depressive episode and mixed depression are powerful clinical markers of bipolarity and the manic component of bipolar disorder (and possible its biological background shows a declining tendency with age antidepressant-resistance/worsening, antidepressant-induced (hypomanic switches and “suicide-inducing” potential of antidepressants seem to be related to the underlying bipolarity.

  15. CNS effects of citalopram, a new serotonin inhibitor antidepressant (a quantitative pharmaco-electroencephalography study).

    Science.gov (United States)

    Itil, T M; Menon, G N; Bozak, M M; Itil, K Z

    1984-01-01

    Citalopram, a new phthalane derivative and a specific serotonin re-uptake inhibitor in animal pharmacological tests, was evaluated in a double-blind, crossover, quantitative pharmaco-EEG (QPEEGTM) study in healthy human volunteers. The CNS effects of citalopram are linear, dose- and time-related, can statistically be differentiated from placebo, and indicate a rapid onset of effects with short duration. According to the Computer Data Bank, citalopram has a mode of action similar to mood elevators (antidepressants) with fewer sedative properties. Thus the therapeutic action of citalopram is predicted to be similar to desipramine and protriptyline from the tricyclics, and fluvoxamine from non-tricyclics. According to data bank assessment, it is hypothesized that the single antidepressant dose of citalopram is to be more than 25 mg, which should be given t.i.d. in clinical trials.

  16. The role of sedation tests in identifying sedative drug effects in healthy volunteers and their power to dissociate sedative-related impairments from memory dysfunctions

    NARCIS (Netherlands)

    Wezenberg, E.; Sabbe, B.G.C.; Hulstijn, W.; Ruigt, G.S.F.; Verkes, R.J.

    2007-01-01

    The study investigated whether four specified drugs would show similar patterns on tests considered to measure sedation. In addition, their drug-effect patterns on sedation and memory performance were compared to determine whether the sedative effects could be differentiated from the memory effects.

  17. The role of sedation tests in identifying sedative drug effects in healthy volunteers and their power to dissociate sedative-related impairments from memory dysfunctions.

    NARCIS (Netherlands)

    Wezenberg, E.; Sabbe, B.G.C.; Hulstijn, W.; Ruigt, G.S.F.; Verkes, R.J.

    2007-01-01

    The study investigated whether four specified drugs would show similar patterns on tests considered to measure sedation. In addition, their drug-effect patterns on sedation and memory performance were compared to determine whether the sedative effects could be differentiated from the memory

  18. Procedural sedation: A review of sedative agents, monitoring, and management of complications

    Directory of Open Access Journals (Sweden)

    Joseph D Tobias

    2011-01-01

    Full Text Available Given the continued increase in the complexity of invasive and noninvasive procedures, healthcare practitioners are faced with a larger number of patients requiring procedural sedation. Effective sedation and analgesia during procedures not only provides relief of suffering, but also frequently facilitates the successful and timely completion of the procedure. However, any of the agents used for sedation and/or analgesia may result in adverse effects. These adverse effects most often affect upper airway patency, ventilatory function or the cardiovascular system. This manuscript reviews the pharmacology of the most commonly used agents for sedation and outlines their primary effects on respiratory and cardiovascular function. Suggested guidelines for the avoidance of adverse effects through appropriate pre-sedation evaluation, early identification of changes in respiratory and cardiovascular function, and their treatment are outlined.

  19. Ketamine-propofol sedation in circumcision

    Directory of Open Access Journals (Sweden)

    Handan Gulec

    2015-10-01

    Full Text Available ABSTRACTBACKGROUND AND OBJECTIVE: To compare the therapeutic effects of ketamine alone or ketamine plus propofol on analgesia, sedation, recovery time, side effects in premedicated children with midazolam-ketamine-atropin who are prepared circumcision operation.METHODS: 60 American Society of Anaesthesiologists physical status I-II children, aged between 3 and 9 years, undergoing circumcision operations under sedation were recruited according to a randomize and double-blind institutional review board-approved protocol. Patients were randomized into two groups via sealed envelope assignment. Both groups were administered a mixture of midazolam 0.05 mg/kg + ketamine 3 mg/kg + atropine 0.02 mg/kg intramuscularly in the presence of parents in the pre-operative holding area. Patients were induced with propofol-ketamine in Group I or ketamine alone in Group II.RESULTS: In the between-group comparisons, age, weight, initial systolic blood pressure, a difference in terms of the initial pulse rate was observed (p > 0.050. Initial diastolic blood pressure and subsequent serial measurements of 5, 10, 15, 20th min, systolic blood pressure, diastolic blood pressure and pulse rate in ketamine group were significantly higher (p < 0.050.CONCLUSION: Propofol-ketamine (Ketofol provided better sedation quality and hemodynamy than ketamine alone in pediatric circumcision operations. We did not observe significant complications during sedation in these two groups. Therefore, ketofol appears to be an effective and safe sedation method for circumcision operation.

  20. Sedation for pediatric diagnostic imaging: use of pediatric and nursing resources as an alternative to a radiology department sedation team

    International Nuclear Information System (INIS)

    Ruess, Lynne; O'Connor, Stephen C.; Mikita, Cecilia P.; Creamer, Kevin M.

    2002-01-01

    Objective. To develop a pathway to provide safe, effective, and efficient sedation for pediatric diagnostic imaging studies using non-radiology personnel. Materials and methods. A multidisciplinary team considered manpower and training requirements and national sedation standards before designing a sedation pathway, which included scheduling, pre-sedation history and physical, medication protocols, and monitoring. Oral and IV medication protocols were developed based on patient age and weight. Sedation delays were defined as >15 min (IV) or >30 min (PO) from start of sedation to start of imaging. A sedation failure resulted in an incomplete diagnostic imaging study. Failure rates of 124 sedations before and 388 sedations after the pathway were compared.Results. The sedation failure rate for 7 months prior to pathway initiation was 15% (19/124). In the first 25 months after pathway initiation, failures were significantly reduced to 1.5% (6/388) (P 55 min). Deviation from the recommended medication protocol accounted for most of the 115 delays. Only minor adverse events were seen (12/388, 3.1%).Conclusion. Implementing a pediatric sedation pathway significantly decreases the sedation failure rate. Pediatric residents and nurses can safely, effectively and efficiently sedate pediatric patients for routine diagnostic imaging procedures without the need for a radiology department sedation team in a department with a small-to-moderate volume of pediatric patients. (orig.)

  1. Conscious sedation with inhaled 50% nitrous oxide/oxygen premix in photodynamic therapy sessions for vulvar lichen sclerosus treatment.

    Science.gov (United States)

    Cabete, Joana; Campos, Sara; Lestre, Sara

    2015-01-01

    Photodynamic therapy has been described as an effective therapeutic option in selected cases of anogenital lichen sclerosus that are refractory to first-line treatments. However, procedure-related pain is a limiting factor in patient adherence to treatment. The authors report the case of a 75-year-old woman with highly symptomatic vulvar lichen sclerosus, successfully treated with photodynamic therapy. An inhaled 50% nitrous oxide/oxygen premix was administered during sessions, producing a pain-relieving, anxiolytic, and sedative effect without loss of consciousness. This ready-to-use gas mixture may be a well-tolerated and accepted alternative to classical anesthetics in Photodynamic therapy, facilitating patients' adherence to illumination of pain-prone areas.

  2. Antidepressants and the risk of hyponatremia

    DEFF Research Database (Denmark)

    Leth-Møller, Katja Biering; Hansen, Annette Højmann; Torstensson, Maia

    2016-01-01

    OBJECTIVE: To examine the association between classes of antidepressants and hyponatremia, and between specific antidepressants and hyponatremia. DESIGN: Retrospective register-based cohort study using nationwide registers from 1998 to 2012. SETTING: The North Denmark Region. PARTICIPANTS: In total....../L. The association between use of specific antidepressants and hyponatremia was analysed using multivariable Poisson regression models. RESULTS: An event of hyponatremia occurred in 72 509 individuals and 11.36% (n=6476) of these events happened during treatment with antidepressants. Incidence rate ratios and CIs.......14). CONCLUSIONS: All antidepressants except mianserin are associated with hyponatremia. The association is strongest with citalopram and lowest with duloxetine, venlafaxine and mirtazapine....

  3. [Interactions between metoprolol and antidepressants].

    Science.gov (United States)

    Molden, Espen; Spigset, Olav

    2011-09-20

    Metoprolol, the most commonly used beta-receptor antagonist in Norway, is eliminated mainly via the enzyme cytochrome P450 (CYP) 2D6. This enzyme is inhibited to a varying extent by antidepressants. The aim of this article is to provide an overview of the interactions between metoprolol and antidepressants with an emphasis on CYP2D6 inhibition. Relevant literature was identified by a PubMed search using the word "metoprolol" combined with generic names of antidepressant drugs. The potent CYP2D6 inhibitor paroxetine has been shown to increase the biologically available dose of metoprolol about 4- to 6-fold. The same degree of increase is expected for the two other potent CYP2D6 inhibitors in the class, fluoxetine and bupropion. Severe bradycardia and atroventricular block has been reported in patients who have taken metoprolol in combination with these three drugs. Escitalopram, citalopram and duloxetine are less potent CYP2D6 inhibitors, and have been shown to cause 2- to 3-fold increases in biologically available dose of metoprolol. Other antidepressants, such as sertraline, venlafaxine, mianserin and mirtazapine, inhibit CYP2D6 to little or no extent, and are not expected to cause clinically relevant interactions with metoprolol. Metoprolol should not be used concomitantly with paroxetine, fluoxetine or bupropion due to extensive interactions and the risk of serious adverse effects. Dose reductions of metoprolol should be considered for combined treatment with citalopram, escitalopram or duloxetine, while concurrent use with sertraline, venlafaxine, mianserin and mirtazapine should be safe.

  4. Is testing the voice under sedation reliable in medialization thyroplasty?

    Science.gov (United States)

    Oishi, Natsuki; Herrero, Ricard; Martin, Ana; Basterra, Jorge; Zapater, Enrique

    2016-12-01

    Medialization thyroplasty is an accepted method for improving non-compensated unilateral vocal cord palsy. Most surgeons decide the depth of penetration of the prosthesis by monitoring the voice changes in the patient during the surgical procedure. General anesthesia with intubation is incompatible with this procedure. Sedation is recommended. In this study we want to objectivize and quantify the influence of sedation and position on voice in order to know if this anesthetic procedure is justified in medialization thyroplasties. A prospective study. This study involved 15 adult patients who underwent sedation. Voice recordings were performed in each patient in three different positions and conditions: the seated position without sedation, the supine position without sedation, and the supine position under the effects of sedation. The sedation drugs used were midazolam, fentanyl, and propofol. The level of sedation was monitored using the observational scale and the bispectral index. The acoustic data obtained from sustained vowel sounds from patient recordings showed that sedation significantly affected the values of pitch. Compared to recordings from patients without sedation, pitch values in patients under sedation were significantly higher for jitter local and shimmer local recordings and significantly lower for pitch and harmonics-to-noise ratio. The supine position was shown not to influence on the voice. Sedation exerts an important influence on voice quality. General anesthesia could be an alternative, focusing our attention on monitoring the glottis with a fibrolaryngoscope during the surgical procedure. No sedation at all can also be an alternative.

  5. An audit of the sedation activity of participants following their attendance on SAAD conscious sedation courses.

    Science.gov (United States)

    Walker, Peter

    2013-01-01

    The aim of this study was to analyse the results of a questionnaire given directly to participants of SAAD courses in 2011, and posted to previous participants, on their own use of conscious sedation. Apart from general interest, such data will help the SAAD Faculty to tailor the courses in future better to meet the needs of participants by providing insights into the attitudes and level of experience in sedation of course participants. Questionnaires were distributed to participants on all the 2011 SAAD courses and to all members of the dental team. In addition, the same questionnaire was posted to dentists who had attended courses in 2010 and 2007. In total 71% of the 157 dentists who completed questionnaires were providing conscious sedation in their practices. The most common technique used was intravenous sedation. Only 3% carried out any advanced techniques. 14% (n = 81) of dentists who had completed a SAAD course previously did not go on to use conscious sedation, and possible reasons for this are discussed. Participants' overall confidence in specific areas of sedation training were rated from 'good' to 'excellent' after completion of a SAAD course. Participants completing SAAD courses believe they have gained in confidence and in knowledge, and obtained the skills required to provide conscious sedation although some identify barriers which prevent them from putting these new skills into practice.

  6. Anxiolytic effects of aniracetam in three different mouse models of anxiety and the underlying mechanism.

    Science.gov (United States)

    Nakamura, K; Kurasawa, M

    2001-05-18

    The anxiolytic effects of aniracetam have not been proven in animals despite its clinical usefulness for post-stroke anxiety. This study, therefore, aimed to characterize the anxiolytic effects of aniracetam in different anxiety models using mice and to examine the mode of action. In a social interaction test in which all classes (serotonergic, cholinergic and dopaminergic) of compounds were effective, aniracetam (10-100 mg/kg) increased total social interaction scores (time and frequency), and the increase in the total social interaction time mainly reflected an increase in trunk sniffing and following. The anxiolytic effects were completely blocked by haloperidol and nearly completely by mecamylamine or ketanserin, suggesting an involvement of nicotinic acetylcholine, 5-HT2A and dopamine D2 receptors in the anxiolytic mechanism. Aniracetam also showed anti-anxiety effects in two other anxiety models (elevated plus-maze and conditioned fear stress tests), whereas diazepam as a positive control was anxiolytic only in the elevated plus-maze and social interaction tests. The anxiolytic effects of aniracetam in each model were mimicked by different metabolites (i.e., p-anisic acid in the elevated plus-maze test) or specific combinations of metabolites. These results indicate that aniracetam possesses a wide range of anxiolytic properties, which may be mediated by an interaction between cholinergic, dopaminergic and serotonergic systems. Thus, our findings suggest the potential usefulness of aniracetam against various types of anxiety-related disorders and social failure/impairments.

  7. Influence of antidepressants on hemostasis

    Science.gov (United States)

    Halperin, Demian; Reber, Guido

    2007-01-01

    Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are widely used for the treatment of depression and anxious disorders. The observation that depression is an independent risk factor for cardiovascular mortality and morbidity in patients with ischemic heart disease, the assessment of the central role of serotonin in pathophysiological mechanisms of depression, and reports of cases of abnormal bleeding associated with antidepressant therapy have led to investigations of the influence of antidepressants on hemostasis markers. In this review, we summarize data regarding modifications of these markers, drawn from clinical studies and case reports. We observed an association between the type of antidepressant drug and the number of abnormal bleeding case reports, with or without modifications of hemostasis markers. Drugs with the highest degree of serotonin reuptake inhibition - fluoxetine, paroxetine, and sertraline - are more frequently associated with abnormal bleeding and modifications of hemostasis markers. The most frequent hemostatic abnormalities are decreased platelet aggregability and activity, and prolongation of bleeding time. Patients with a history of coagulation disorders, especially suspected or documented thrombocytopenia or platelet disorder, should be monitored in case of prescription of any serotonin reuptake inhibitor (SRI). Platelet dysfunction, coagulation disorder, and von Willebrand disease should be sought in any case of abnormal bleeding occurring during treatment with an SRI. Also, a non-SSRI antidepressant should be favored over an SSRI or an SRI in such a context. Considering the difficulty in performing platelet aggregation tests, which are the most sensitive in SRI-associated bleeding, and the low sensitivity of hemostasis tests when performed in case of uncomplicated bleeding in the general population, establishing guidelines for the assessment of SRI-associated bleeding complications remains a challenge

  8. Anxiolytic Effect of Aromatherapy Massage in Patients with Breast Cancer

    Science.gov (United States)

    Kuriyama, Hiroko; Shigemori, Ichiro; Watanabe, Satoko; Aihara, Yuka; Kita, Masakazu; Sawai, Kiyoshi; Nakajima, Hiroo; Yoshida, Noriko; Kunisawa, Masahiro; Kawase, Masanori; Fukui, Kenji

    2009-01-01

    We examined how aromatherapy massage influenced psychologic and immunologic parameters in 12 breast cancer patients in an open semi-comparative trial. We compared the results 1 month before aromatherapy massage as a waiting control period with those during aromatherapy massage treatment and 1 month after the completion of aromatherapy sessions. The patients received a 30 min aromatherapy massage twice a week for 4 weeks (eight times in total). The results showed that anxiety was reduced in one 30 min aromatherapy massage in State-Trait Anxiety Inventory (STAI) test and also reduced in eight sequential aromatherapy massage sessions in the Hospital Anxiety and Depression Scale (HADS) test. Our results further suggested that aromatherapy massage ameliorated the immunologic state. Further investigations are required to confirm the anxiolytic effect of aromatherapy in breast cancer patients. PMID:18955225

  9. Anxiolytic Effect of Aromatherapy Massage in Patients with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Jiro Imanishi

    2009-01-01

    Full Text Available We examined how aromatherapy massage influenced psychologic and immunologic parameters in 12 breast cancer patients in an open semi-comparative trial. We compared the results 1 month before aromatherapy massage as a waiting control period with those during aromatherapy massage treatment and 1 month after the completion of aromatherapy sessions. The patients received a 30 min aromatherapy massage twice a week for 4 weeks (eight times in total. The results showed that anxiety was reduced in one 30 min aromatherapy massage in State-Trait Anxiety Inventory (STAI test and also reduced in eight sequential aromatherapy massage sessions in the Hospital Anxiety and Depression Scale (HADS test. Our results further suggested that aromatherapy massage ameliorated the immunologic state. Further investigations are required to confirm the anxiolytic effect of aromatherapy in breast cancer patients.

  10. The anxiolytic effect of aqua aerobics in elderly women.

    Science.gov (United States)

    Wininger, Steven R

    2002-02-01

    This study examined the anxiolytic (anxiety reducing) effects of exercise for elderly women engaging in a single bout of aqua aerobics. Volunteers (N=29) completed questionnaires immediately before and after participating in an aqua aerobics class. The average age of participants was 66.4 yr. A brief form of Spielberger's State Anxiety Inventory and a questionnaire on demographic items were administered prior to engagement in exercise, and the brief form of the State Anxiety Inventory was administered again immediately after the exercise session. There was a significant difference on a t test between participants' ratings of anxiety before exercise (M = 16.8) compared to after exercise (M= 13.9); participants' ratings of state anxiety were somewhat lower after exercising. Weaknesses of the present study and suggestions for research are presented.

  11. Sedation and analgesia to facilitate mechanical ventilation.

    Science.gov (United States)

    Nemergut, Michael E; Yaster, Myron; Colby, Christopher E

    2013-09-01

    Regardless of age, health care professionals have a professional and ethical obligation to provide safe and effective analgesia to patients undergoing painful procedures. Historically, newborns, particularly premature and sick infants, have been undertreated for pain. Intubation of the trachea and mechanical ventilation are ubiquitous painful procedures in the neonatal intensive care unit that are poorly assessed and treated. The authors review the use of sedation and analgesia to facilitate endotracheal tube placement and mechanical ventilation. Controversies regarding possible adverse neurodevelopmental outcomes after sedative and anesthetic exposure and in the failure to treat pain is also discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction.

    Science.gov (United States)

    Inverso, Gino; Dodson, Thomas B; Gonzalez, Martin L; Chuang, Sung-Kiang

    2016-03-01

    To examine the complications resulting from moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing third molar extraction and determine whether any differences in complication risks exist between the 2 levels of sedation. We performed a prospective study of the Oral and Maxillofacial Surgery Outcomes System from January 2001 to December 2010. The primary predictor variable was the level of sedation, divided into 2 groups: moderate sedation versus deep sedation/general anesthesia. The primary outcome was the incidence of adverse complications resulting from the sedation level. Differences in the cohort characteristics were analyzed using the independent samples t test, χ(2) test, and analysis of variance, as appropriate. Multivariable logistic regression was used to measure the effect the level of sedation had on the adverse complication rate. Patients in the moderate sedation group had a complication rate of 0.5%, and patients in the deep sedation/general anesthesia group had a complication rate of 0.9%. Compared with moderate sedation, deep sedation/general anesthesia did not pose a significantly increased risk of adverse anesthesia complications (adjusted odds ratio 1.63, 95% confidence interval 0.95 to 2.81; P = .077). The results of our study have shown that the risk of adverse anesthesia complications is not increased when choosing between moderate and deep sedation/general anesthesia for adolescent patients undergoing third molar extraction. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Antidepressant-like effects of cannabidiol in mice: possible involvement of 5-HT1A receptors

    Science.gov (United States)

    Zanelati, TV; Biojone, C; Moreira, FA; Guimarães, FS; Joca, SRL

    2010-01-01

    Background and purpose: Cannabidiol (CBD) is a non-psychotomimetic compound from Cannabis sativa that induces anxiolytic- and antipsychotic-like effects in animal models. Effects of CBD may be mediated by the activation of 5-HT1A receptors. As 5-HT1A receptor activation may induce antidepressant-like effects, the aim of this work was to test the hypothesis that CBD would have antidepressant-like activity in mice as assessed by the forced swimming test. We also investigated if these responses depended on the activation of 5-HT1A receptors and on hippocampal expression of brain-derived neurotrophic factor (BDNF). Experimental approach: Male Swiss mice were given (i.p.) CBD (3, 10, 30, 100 mg·kg−1), imipramine (30 mg·kg−1) or vehicle and were submitted to the forced swimming test or to an open field arena, 30 min later. An additional group received WAY100635 (0.1 mg·kg−1, i.p.), a 5-HT1A receptor antagonist, before CBD (30 mg·kg−1) and assessment by the forced swimming test. BDNF protein levels were measured in the hippocampus of another group of mice treated with CBD (30 mg·kg−1) and submitted to the forced swimming test. Key results: CBD (30 mg·kg−1) treatment reduced immobility time in the forced swimming test, as did the prototype antidepressant imipramine, without changing exploratory behaviour in the open field arena. WAY100635 pretreatment blocked CBD-induced effect in the forced swimming test. CBD (30 mg·kg−1) treatment did not change hippocampal BDNF levels. Conclusion and implications: CBD induces antidepressant-like effects comparable to those of imipramine. These effects of CBD were probably mediated by activation of 5-HT1A receptors. PMID:20002102

  14. Auditory processing during deep propofol sedation and recovery from unconsciousness

    OpenAIRE

    Koelsch, Stefan; Heinke, Wolfgang; Sammler, Daniela; Olthoff, Derk

    2006-01-01

    Objective Using evoked potentials, this study investigated effects of deep propofol sedation, and effects of recovery from unconsciousness, on the processing of auditory information with stimuli suited to elicit a physical MMN, and a (music-syntactic) ERAN. Methods Levels of sedation were assessed using the Bispectral Index (BIS) and the Modified Observer's Assessment of Alertness and Sedation Scale (MOAAS). EEG-measurements were performed during wakefulness, deep propofol sedation (MOAAS 2–3...

  15. Antidepressant treatment for postnatal depression.

    Science.gov (United States)

    Molyneaux, Emma; Howard, Louise M; McGeown, Helen R; Karia, Amar M; Trevillion, Kylee

    2014-09-11

    Postnatal depression is a common disorder that can have adverse short- and long-term effects on maternal morbidity, the new infant and the family as a whole. Treatment is often largely by social support and psychological interventions. It is not known whether antidepressants are an effective and safe choice for treatment of this disorder. This review was undertaken to evaluate the effectiveness of different antidepressants and to compare their effectiveness with other forms of treatment, placebo or treatment as usual. It is an update of a review first published in 2001. To assess the effectiveness of antidepressant drugs in comparison with any other treatment (psychological, psychosocial or pharmacological), placebo or treatment as usual for postnatal depression. We searched the Cochrane Depression, Anxiety and Neurosis Group's Specialized Register (CCDANCTR) to 11 July 2014. This register contains reports of relevant randomised controlled trials (RCTs) from the following bibliographic databases: The Cochrane Library (all years), MEDLINE (1950 to date), EMBASE, (1974 to date) and PsycINFO (1967 to date). We also searched international trial registries and contacted pharmaceutical companies and experts in the field. We included RCTs of women with depression with onset up to six months postpartum that compared antidepressant treatment (alone or in combination with another treatment) with any other treatment, placebo or treatment as usual. Two review authors independently extracted data from the trial reports. We requested missing information from investigators wherever possible. We sought data to allow an intention-to-treat analysis. Random effects meta-analyses were conducted to pool data where sufficient comparable studies were identified. We included six trials with 596 participants in this review. All studies had a randomised controlled parallel group design, with two conducted in the UK, three in the US and one in Israel. Meta-analyses were performed to pool

  16. Sedation for paediatric auditory electrophysiology in South Africa

    African Journals Online (AJOL)

    Background: The sedation of children in the medical and allied professional fields has been a topic of controversy and debate internationally. Limited information is available on the use of sedation for auditory electrophysiology testing in South Africa. Objectives: The aim of this study was to determine how sedation ...

  17. Færre indikationer for sedation ved respiratorbehandling

    DEFF Research Database (Denmark)

    Strøm, Thomas; Rian, Omar; Toft, Palle

    2012-01-01

    Critically ill patients undergoing mechanical ventilation have traditionally been deeply sedated. In the latest decade growing evidence supports less sedation as being beneficial for the patients. A daily interruption of sedation has been shown to reduce the length of mechanical ventilation and t...

  18. Sedation for paediatric auditory electrophysiology in South Africa ...

    African Journals Online (AJOL)

    Background: The sedation of children in the medical and allied professional fields has been a topic of controversy and debate internationally. Limited information is available on the use of sedation for auditory electrophysiology testing in South Africa. Objectives: The aim of this study was to determine how sedation ...

  19. Pediatric Gastrointestinal Endoscopic Sedation: A 2010 Nationwide Survey in Taiwan

    Directory of Open Access Journals (Sweden)

    Po-Hon Chen

    2012-06-01

    Conclusion: A majority of pediatric EGD in Taiwan was performed under sedation and applied more often to younger children. Endoscopists were more satisfied during EGD when practicing sedation. This survey should help formulate updated practice guidelines and policies regarding endoscopic sedation.

  20. Nurse-administered propofol sedation for endoscopy

    DEFF Research Database (Denmark)

    Jensen, J T; Vilmann, P; Horsted, T

    2011-01-01

    BACKGROUND AND STUDY AIMS: The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program. PATIENTS AND METHODS: A structured training program was developed both for endosco......BACKGROUND AND STUDY AIMS: The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program. PATIENTS AND METHODS: A structured training program was developed both...... for endoscopists and for endoscopy nurses who were administering propofol sedation. The nurses' program comprised a 6-week course including theoretical and practical training in airway management, and the endoscopists' program consisted of 2.5 h of theory and a short course in practical airway management....... In the implementation phase, data from 1822 endoscopic procedures in 1764 patients were prospectively collected. All adverse events related to sedation were recorded (defined as oxygen saturation change in blood pressure > 20 mmHg). RESULTS: 78 cases...

  1. Effects of music on sedation depth and sedative use during pediatric dental procedures.

    Science.gov (United States)

    Ozkalayci, Ozlem; Araz, Coskun; Cehreli, Sevi Burcak; Tirali, Resmiye Ebru; Kayhan, Zeynep

    2016-11-01

    The study aimed to investigate the effects of listening to music or providing sound isolation on the depth of sedation and need for sedatives in pediatric dental patients. Prospective, randomized, and controlled study. Tertiary, university hospital. In total, 180 pediatric patients, American Society of Anesthesiologists physical status I and II, who were scheduled for dental procedures of tooth extraction, filling, amputation, and root treatment. Patients were categorized into 3 groups: music, isolation, and control. During the procedures, the patients in the music group listened to Vivaldi's The Four Seasons violin concertos by sound-isolating headphones, whereas the patients in the isolation group wore the headphones but did not listen to music. All patients were sedated by 0.1 mg/kg midazolam and 1 mg/kg propofol. During the procedure, an additional 0.5 mg/kg propofol was administered as required. Bispectral index was used for quantifying the depth of sedation, and total dosage of the propofol was used for sedative requirements. The patients' heart rates, oxygen saturations, and Observer's Assessment of Alertness and Sedation Scale and bispectral index scores, which were monitored during the operation, were similar among the groups. In terms of the amount of propofol used, the groups were similar. Prolonged postoperative recovery cases were found to be significantly frequent in the control group, according to the recovery duration measurements (P = .004). Listening to music or providing sound isolation during pediatric dental interventions did not alter the sedation level, amount of medication, and hemodynamic variables significantly. This result might be due to the deep sedation levels reached during the procedures. However, listening to music and providing sound isolation might have contributed in shortening the postoperative recovery duration of the patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Pregnanolone glutamate, a novel use-dependent NMDA receptor inhibitor, exerts antidepressant-like properties in animal models.

    Directory of Open Access Journals (Sweden)

    Karel eVales

    2014-04-01

    Full Text Available A number of studies demonstrated a rapid onset of an antidepressant effect of non-competitive NMDA receptor antagonists. Nonetheless, its therapeutic potential is rather limited, due to a high coincidence of negative side-effects. Therefore, the challenge seems to be in the development of NMDA receptor (NMDAR antagonists displaying antidepressant properties, and at the same time maintaining regular physiological function of the NMDAR. Previous results demonstrated that naturally occurring neurosteroid 3α5β-pregnanolone sulfate shows pronounced inhibitory action by a use-dependent mechanism on the tonically active NMDAR. The aim of the present experiments is to find out whether the treatment with pregnanolone 3αC derivatives affects behavioral response to chronic and acute stress in an animal model of depression. Adult male mice were used throughout the study. Repeated social defeat and forced swimming tests were used as animal models of depression. The effect of the drugs on the locomotor/exploratory activity in the open-field test was also tested together with an effect on anxiety in the elevated plus maze. Results showed that pregnanolone glutamate (PG did not induce hyperlocomotion, whereas both dizocilpine and ketamine significantly increased spontaneous locomotor activity in the open field. In the elevated plus maze PG displayed anxiolytic-like properties. In forced swimming PG prolonged time to the first floating. Acute treatment of PG disinhibited suppressed locomotor activity in the repeatedly defeated group-housed mice. Aggressive behavior of isolated mice was reduced after the chronic 30-day administration of PG. PG showed antidepressant-like and anxiolytic-like properties in the used tests, with minimal side-effects. Since PG combines GABAA receptor potentiation and use-dependent NMDAR inhibition, synthetic derivatives of neuroactive steroids present a promising strategy for the treatment of mood disorders.

  3. Evaluation of anxiolytic and hypoglycemic activity of methanolic extract of Ixora cuneifolia in an animal model

    Directory of Open Access Journals (Sweden)

    Abdullah Al Mahmud

    2017-10-01

    Full Text Available Objective: To investigate anxiolytic and hypoglycemic activity of Ixora cuneifolia (Family: Rubiaceae in an experimental animal model. Methods: Anxiolytic test was performed by elevated plus maze (EPM and hole-board method. Hypoglycemic activity was measured in glucose-loaded Swiss albino mice by glucose tolerance test. Results: The methanol extract of Ixora cuneifolia exhibited dose-dependent and statistically significant (P < 0.05 anxiolytic activity at doses of 200 and 400 mg/kg. Reduction of glucose level was observed with the highest dose 400 mg/kg of the extract in glucose tolerance test. Conclusions: The better anxiolytic and hypoglycemic activities in the present study could be due to the presence of different chemical constituents like alkaloids, flavonoids, saponin, phenols and tannins in this methanolic extract.

  4. Treatment of Fibromyalgia with Antidepressants

    Science.gov (United States)

    O'Malley, Patrick G; Balden, Erin; Tomkins, Glen; Santoro, James; Kroenke, Kurt; Jackson, Jeffrey L

    2000-01-01

    BACKGROUND Fibromyalgia is a common, poorly understood musculoskeletal pain syndrome with limited therapeutic options. OBJECTIVE To systematically review the efficacy of antidepressants in the treatment of fibromyalgia and examine whether this effect was independent of depression. DESIGN Meta-analysis of English-language, randomized, placebo-controlled trials. Studies were obtained from searching medline, embase, and psyclit(1966-1999), the Cochrane Library, unpublished literature, and bibliographies. We performed independent duplicate review of each study for both inclusion and data extraction. MAIN RESULTS Sixteen randomized, placebo-controlled trials were identified, of which 13 were appropriate for data extraction. There were 3 classes of antidepressants evaluated: tricyclics (9 trials), selective serotonin reuptake inhibitors (3 trials), and S-adenosylmethionine (2 trials). Overall, the quality of the studies was good (mean score 5.6, scale 0-8). The odds ratio for improvement with therapy was 4.2 (95% confidence interval [95% CI], 2.6 to 6.8). The pooled risk difference for these studies was 0.25 (95% CI, 0.16 to 0.34), which calculates to 4 (95% CI, 2.9 to 6.3) individuals needing treatment for 1 patient to experience symptom improvement. When the effect on individual symptoms was combined, antidepressants improved sleep, fatigue, pain, and well-being, but not trigger points. In the 5 studies where there was adequate assessment for an effect independent of depression, only 1 study found a correlation between symptom improvement and depression scores. Outcomes were not affected by class of agent or quality score using meta-regression. CONCLUSION Antidepressants are efficacious in treating many of the symptoms of fibromyalgia. Patients were more than 4 times as likely to report overall improvement, and reported moderate reductions in individual symptoms, particularly pain. Whether this effect is independent of depression needs further study. PMID:11029681

  5. Leptocarpus disjunctus prolongs sleeping time and increases nonrapid eye movement sleep with additional anxiolytic capacity

    OpenAIRE

    Watchara Damjuti; Thanes Fuangfoo; Chanida Palanuvej; Tingli Li; Nijsiri Ruangrungsi

    2017-01-01

    Leptocarpus disjunctus Mast. (Restionaceae) is an edible plant which has indigenous warnings regarding its side effects which can manifest as dizziness. This study investigated hypnotic and anxiolytic properties using several animal models. Anxiolytic activities were evaluated using locomotor determination by elevated plus-maze test, open-field test, and rotarod performance test. Hypnotic activities were performed using pentobarbital sodium-induced sleeping time test. Sleep architecture and q...

  6. [Antidepressive agents and suicidal tendencies].

    Science.gov (United States)

    Gründer, G; Veselinović, T; Paulzen, M

    2014-09-01

    In the last 2 years the discussions on the question whether antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) can lead to suicidality, aggression and violence, flared up again. The available data on the problem, which has been discussed since the introduction of this substance group in the late 1980s, is presented in this article. A systematic literature search showed that a scientific consensus exists that the benefits of antidepressant pharmacotherapy in general, and of treatment with SSRIs and selective serotonin/norepinephrine reuptake inhibitors (SSNRIs) in particular, outweigh the risks of their use. This also applies to the treatment of children, adolescents and young adults. The agitation occasionally occurring at the beginning of treatment, which can be experienced as aversive in susceptible patients, can intensify or even trigger suicidal thoughts or impulses. This has to be paid particular attention to especially at the beginning of treatment. It is recommended that the indications for antidepressant pharmacotherapy of children, adolescents and young adults are assessed by a specialist.

  7. Combination antidepressants - use by GPs and psychiatrists.

    Science.gov (United States)

    Horgan, David; Dodd, Seetal

    2011-06-01

    Current treatment of depression fails to achieve remission in 50% of patients. Combinations of two antidepressants are used by some Australian psychiatrists. This article investigates the pros and cons of combination antidepressant therapy and provides suggestions for when to consider their use, which combinations to choose, and how to introduce combination antidepressant therapies. Combining two antidepressants is a controversial strategy, with supporters and critics arguing its efficacy and safety from opposing perspectives. The use of combination antidepressant therapies may facilitate remission from depression. However, there is limited evidence supporting these treatments, and safety concerns are often cited. There is some support for combination therapies in selected cases from international bodies. After considering risks and benefits on a case-by-case basis, careful use of selected combination antidepressant therapy may be one of a range of effective treatments for some individuals suffering from depression.

  8. Anxiolytic effect of clonazepam in female rats: grooming microstructure and elevated plus maze tests.

    Science.gov (United States)

    Nin, Maurício S; Couto-Pereira, Natividade S; Souza, Marilise F; Azeredo, Lucas A; Ferri, Marcelo K; Dalprá, Walesca L; Gomez, Rosane; Barros, Helena M T

    2012-06-05

    Grooming behavior is an adaptation to a stressful environment that can vary in accordance with stress intensity. Direct and indirect GABA(A) receptor agonists decrease duration, frequency, incorrect transitions and uninterrupted bouts of grooming. Hormonal variation during the different phases of the estrous cycle of female rats also changes the grooming behavior. It is known that GABA(A) agonists and endogenous hormones change anxiety-like behaviors observed in the elevated plus maze test, a classical animal model of anxiety. This study was designed to determine the anxiolytic effect of clonazepam in female rats in different estrous phases and to correlate anxiety behaviors in the elevated plus maze and grooming microstructure tests. Our results show that female rats displayed higher anxiety-like behavior scores during the estrus and proestrus phases in the elevated plus maze and that clonazepam (0.25 mg/kg; i.p.) had an anxiolytic effect that was independent of the estrous phase. Grooming behaviors were higher in the proestrus phase but were decreased by clonazepam administration, independent of the estrous phase, demonstrating the anxiolytic effect of this drug in both animal models. Grooming behaviors were moderately associated with anxiolytic-like behaviors in the elevated plus maze test. Here, we describe the anxiolytic effect of clonazepam and the influence of estrous phase on anxiety. Moreover, we show that the grooming microstructure test is a useful tool for detecting anxiolytic-like behaviors in rats. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Prenatal Antidepressants and Autism Spectrum Disorder

    Science.gov (United States)

    2014-09-01

    1 AWARD NUMBER: W81XWH-13-1-0306 TITLE: Prenatal Antidepressants and Autism Spectrum Disorder PRINCIPAL INVESTIGATOR...TYPE Annual 3. DATES COVERED 1Sept 2013-31Aug2014 4. TITLE AND SUBTITLE Prenatal Antidepressants and Autism Spectrum Disorder 5a... antidepressants (ADs) during pregnancy. We are testing this hypothesis in rodents. The study is a 2-year long experiment to be decoded and

  10. Antidepressants and gastrointestinal symptoms in the general Dutch adult population

    NARCIS (Netherlands)

    Schurink, B.; Tielemans, M.M.; Aaldering, B.R.; Eikendal, T.; Jaspers Focks, J.; Laheij, R.J.F.; Jansen, J.B.M.J.; Rossum, L.G.M. van; Oijen, M.G.H. van

    2014-01-01

    BACKGROUND: Gastrointestinal symptoms are frequently reported adverse effects of antidepressants, but antidepressants are also a treatment modality in functional gastrointestinal disorders. We aimed to assess the association between antidepressant use and gastrointestinal symptoms in the general

  11. The endocannabinoid system as a target for novel anxiolytic drugs.

    Science.gov (United States)

    Patel, Sachin; Hill, Mathew N; Cheer, Joseph F; Wotjak, Carsten T; Holmes, Andrew

    2017-05-01

    The endocannabinoid (eCB) system has attracted attention for its role in various behavioral and brain functions, and as a therapeutic target in neuropsychiatric disease states, including anxiety disorders and other conditions resulting from dysfunctional responses to stress. In this mini-review, we highlight components of the eCB system that offer potential 'druggable' targets for new anxiolytic medications, emphasizing some of the less well-discussed options. We discuss how selectively amplifying eCBs recruitment by interfering with eCB-degradation, via fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL), has been linked to reductions in anxiety-like behaviors in rodents and variation in human anxiety symptoms. We also discuss a non-canonical route to regulate eCB degradation that involves interfering with cyclooxygenase-2 (COX-2). Next, we discuss approaches to targeting eCB receptor-signaling in ways that do not involve the cannabinoid receptor subtype 1 (CB1R); by targeting the CB2R subtype and the transient receptor potential vanilloid type 1 (TRPV1). Finally, we review evidence that cannabidiol (CBD), while representing a less specific pharmacological approach, may be another way to modulate eCBs and interacting neurotransmitter systems to alleviate anxiety. Taken together, these various approaches provide a range of plausible paths to developing novel compounds that could prove useful for treating trauma-related and anxiety disorders. Published by Elsevier Ltd.

  12. Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report

    Directory of Open Access Journals (Sweden)

    Flávia de L. Osório

    2015-03-01

    Full Text Available Objectives: Ayahuasca (AYA, a natural psychedelic brew prepared from Amazonian plants and rich in dimethyltryptamine (DMT and harmine, causes effects of subjective well-being and may therefore have antidepressant actions. This study sought to evaluate the effects of a single dose of AYA in six volunteers with a current depressive episode. Methods: Open-label trial conducted in an inpatient psychiatric unit. Results: Statistically significant reductions of up to 82% in depressive scores were observed between baseline and 1, 7, and 21 days after AYA administration, as measured on the Hamilton Rating Scale for Depression (HAM-D, the Montgomery-Åsberg Depression Rating Scale (MADRS, and the Anxious-Depression subscale of the Brief Psychiatric Rating Scale (BPRS. AYA administration resulted in nonsignificant changes in Young Mania Rating Scale (YMRS scores and in the thinking disorder subscale of the BPRS, suggesting that AYA does not induce episodes of mania and/or hypomania in patients with mood disorders and that modifications in thought content, which could indicate psychedelic effects, are not essential for mood improvement. Conclusions: These results suggest that AYA has fast-acting anxiolytic and antidepressant effects in patients with a depressive disorder.

  13. Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report.

    Science.gov (United States)

    Osório, Flávia de L; Sanches, Rafael F; Macedo, Ligia R; Santos, Rafael G dos; Maia-de-Oliveira, João P; Wichert-Ana, Lauro; Araujo, Draulio B de; Riba, Jordi; Crippa, José A; Hallak, Jaime E

    2015-01-01

    Ayahuasca (AYA), a natural psychedelic brew prepared from Amazonian plants and rich in dimethyltryptamine (DMT) and harmine, causes effects of subjective well-being and may therefore have antidepressant actions. This study sought to evaluate the effects of a single dose of AYA in six volunteers with a current depressive episode. Open-label trial conducted in an inpatient psychiatric unit. Statistically significant reductions of up to 82% in depressive scores were observed between baseline and 1, 7, and 21 days after AYA administration, as measured on the Hamilton Rating Scale for Depression (HAM-D), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Anxious-Depression subscale of the Brief Psychiatric Rating Scale (BPRS). AYA administration resulted in nonsignificant changes in Young Mania Rating Scale (YMRS) scores and in the thinking disorder subscale of the BPRS, suggesting that AYA does not induce episodes of mania and/or hypomania in patients with mood disorders and that modifications in thought content, which could indicate psychedelic effects, are not essential for mood improvement. These results suggest that AYA has fast-acting anxiolytic and antidepressant effects in patients with a depressive disorder.

  14. Increased precuneus connectivity during propofol sedation.

    Science.gov (United States)

    Liu, Xiaolin; Li, Shi-Jiang; Hudetz, Anthony G

    2014-02-21

    Using functional magnetic resonance imaging in human participants, we show that sedation by propofol to the point of lost overt responsiveness during the performance of an auditory verbal memory task unexpectedly increases functional connectivity of the precuneus with cortical regions, particularly the dorsal prefrontal and visual cortices. After recovery of consciousness, functional connectivity returns to a pattern similar to that observed during the wakeful baseline. In the context of a recent proposal that highlights the uncoupling of consciousness, connectedness, and responsiveness in general anesthesia, the increased precuneus functional connectivity under propofol sedation may reflect disconnected endogenous mentation or dreaming that continues at a reduced level of metabolic activity. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Antidepressant prescribing in five European countries

    DEFF Research Database (Denmark)

    Abbing-Karahagopian, V; Huerta, C; Souverein, P C

    2014-01-01

    , sex, antidepressant type (selective serotonin re-uptake inhibitors [SSRIs] or tricyclic antidepressants [TCAs]) and major indications. RESULTS: The age- and sex-standardized prevalence was lowest in the two Dutch (391 and 429 users per 10,000 PYs) and highest in the two UK (913 and 936 users per 10...

  16. Antidepressant induced sexual dysfunction, part 1: epidemiology ...

    African Journals Online (AJOL)

    ... their compliance with medication and ultimately the prognosis of their illness. This review will be presented in two parts. The first part focuses on the prevalence of antidepressant induced sexual dysfunction and its clinical presentation both generally and in the case of individual classes of antidepressants. The second part ...

  17. Antidepressants in the treatment of neuropathic pain

    DEFF Research Database (Denmark)

    Sindrup, Søren H.; Otto, Marit; Finnerup, Nanna Brix

    2005-01-01

    Neuropathic pain is due to lesion or dysfunction of the peripheral or central nervous system. Tricyclic antidepressants and anticonvulsants have long been the mainstay of treatment of this type of pain. Tricyclic antidepressants may relieve neuropathic pain by their unique ability to inhibit...... presynaptic reuptake of the biogenic amines serotonin and noradrenaline, but other mechanisms such as N-methyl-D-aspartate receptor and ion channel blockade probably also play a role in their pain-relieving effect. The effect of tricyclic antidepressants in neuropathic pain in man has been demonstrated...... in numerous randomised, controlled trials, and a few trials have shown that serotonin noradrenaline and selective serotonin reuptake inhibitor antidepressants also relieve neuropathic pain although with lower efficacy. Tricyclic antidepressants will relieve one in every 2-3 patients with peripheral...

  18. Should patients with schizophrenia receive antidepressants?

    Science.gov (United States)

    Terevnikov, Viacheslav; Stenberg, Jan-Henry; Joffe, Grigori

    Antipsychotics play a key role in the pharmacological treatment of schizophrenia, and monotherapy is effective for most patients. Achieving an optimal treatment response is, however, often difficult. Combining an antidepressant drug to the antipsychotic regimen could potentially improve treatment outcomes, although the evidence supporting the use of such combinations is limited and contradictory. Positive evidence has mostly been obtained from the efficacy of antidepressants acting on monoamine receptors on the negative symptoms of schizophrenia. These receptor-active drugs may also improve cognition in schizophrenic patients. In the light of current knowledge, antidepressants do not appear to potentiate the psychotic symptoms of schizophrenic patients. However, there is no robust evidence of the efficacy of antidepressants in the treatment of schizophrenia-related depression, and thus monotherapy with an antipsychotic drug is recommended for treating it. If using antidepressants in addition to antipsychotics is deemed necessary, the risk of pharmacodynamic and pharmacokinetic interactions should be kept in mind.

  19. Functional Selectivity and Antidepressant Activity of Serotonin 1A Receptor Ligands

    Directory of Open Access Journals (Sweden)

    Zdzisław Chilmonczyk

    2015-08-01

    Full Text Available Serotonin (5-HT is a monoamine neurotransmitter that plays an important role in physiological functions. 5-HT has been implicated in sleep, feeding, sexual behavior, temperature regulation, pain, and cognition as well as in pathological states including disorders connected to mood, anxiety, psychosis and pain. 5-HT1A receptors have for a long time been considered as an interesting target for the action of antidepressant drugs. It was postulated that postsynaptic 5-HT1A agonists could form a new class of antidepressant drugs, and mixed 5-HT1A receptor ligands/serotonin transporter (SERT inhibitors seem to possess an interesting pharmacological profile. It should, however, be noted that 5-HT1A receptors can activate several different biochemical pathways and signal through both G protein-dependent and G protein-independent pathways. The variables that affect the multiplicity of 5-HT1A receptor signaling pathways would thus result from the summation of effects specific to the host cell milieu. Moreover, receptor trafficking appears different at pre- and postsynaptic sites. It should also be noted that the 5-HT1A receptor cooperates with other signal transduction systems (like the 5-HT1B or 5-HT2A/2B/2C receptors, the GABAergic and the glutaminergic systems, which also contribute to its antidepressant and/or anxiolytic activity. Thus identifying brain specific molecular targets for 5-HT1A receptor ligands may result in a better targeting, raising a hope for more effective medicines for various pathologies.

  20. GLYX-13, a NMDA receptor glycine-site functional partial agonist, induces antidepressant-like effects without ketamine-like side effects.

    Science.gov (United States)

    Burgdorf, Jeffrey; Zhang, Xiao-lei; Nicholson, Katherine L; Balster, Robert L; Leander, J David; Stanton, Patric K; Gross, Amanda L; Kroes, Roger A; Moskal, Joseph R

    2013-04-01

    Recent human clinical studies with the NMDA receptor (NMDAR) antagonist ketamine have revealed profound and long-lasting antidepressant effects with rapid onset in several clinical trials, but antidepressant effects were preceded by dissociative side effects. Here we show that GLYX-13, a novel NMDAR glycine-site functional partial agonist, produces an antidepressant-like effect in the Porsolt, novelty induced hypophagia, and learned helplessness tests in rats without exhibiting substance abuse-related, gating, and sedative side effects of ketamine in the drug discrimination, conditioned place preference, pre-pulse inhibition and open-field tests. Like ketamine, the GLYX-13-induced antidepressant-like effects required AMPA/kainate receptor activation, as evidenced by the ability of NBQX to abolish the antidepressant-like effect. Both GLYX-13 and ketamine persistently (24 h) enhanced the induction of long-term potentiation of synaptic transmission and the magnitude of NMDAR-NR2B conductance at rat Schaffer collateral-CA1 synapses in vitro. Cell surface biotinylation studies showed that both GLYX-13 and ketamine led to increases in both NR2B and GluR1 protein levels, as measured by Western analysis, whereas no changes were seen in mRNA expression (microarray and qRT-PCR). GLYX-13, unlike ketamine, produced its antidepressant-like effect when injected directly into the medial prefrontal cortex (MPFC). These results suggest that GLYX-13 produces an antidepressant-like effect without the side effects seen with ketamine at least in part by directly modulating NR2B-containing NMDARs in the MPFC. Furthermore, the enhancement of 'metaplasticity' by both GLYX-13 and ketamine may help explain the long-lasting antidepressant effects of these NMDAR modulators. GLYX-13 is currently in a Phase II clinical development program for treatment-resistant depression.

  1. Moderate and deep nurse-administered propofol sedation is safe

    DEFF Research Database (Denmark)

    Jensen, Jeppe Thue; Møller, Ann; Hornslet, Pernille

    2015-01-01

    INTRODUCTION: Non-anaesthesiologist-administered propofol sedation (NAPS/NAAP) is increasingly used in many countries. Most regimens aim for light or moderate sedation. Little evidence on safety of deep NAPS sedation is available. The aim of this study was to explore the safety of intermittent deep...... sedation with NAPS in patients undergoing gastroenterologic endoscopic procedures. METHODS: This was a retrospective case-control study. All patients sedated with NAPS for colonoscopies, sigmoidoscopies and oesophagogastroduodenoscopies from May 2007 through December 2012 were included. Cases were defined...... with a higher rate of adverse events. CONCLUSION: Safety during intermittent deep sedation with NAPS was good. Age, ASA class 3 and total propofol dose were correlated with a higher rate of adverse events. Patients aged 60 years or more needed more handling during adverse events. FUNDING: Arvid Nilsson...

  2. Techniques to administer oral, inhalational, and IV sedation in dentistry

    Directory of Open Access Journals (Sweden)

    Diana Krystyna Harbuz

    2016-02-01

    Full Text Available Background Sedation in dentistry is a controversial topic given the variety of opinions regarding its safe practice. Aims This article evaluates the various techniques used to administer sedation in dentistry and specific methods practiced to form a recommendation for clinicians. Methods An extensive literature search was performed using PubMed, Medline, Google Scholar, Google, and local library resources. Results Most of the literature revealed a consensus that light sedation on low-risk American Society of Anesthesiologists (ASA groups, that is ASA I, and possibly II, is the safest method for sedation in a dental outpatient setting. Conclusion Formal training is essential to achieve the safe practice of sedation in dentistry or medicine. The appropriate setting for sedation should be determined as there is an increased risk outside the hospital setting. Patients should be adequately assessed and medication titrated appropriately, based on individual requirements.

  3. Sedation versus general anaesthesia in paediatric patients undergoing chest CT

    International Nuclear Information System (INIS)

    Lam, W.W.M.; So, N.M.C.; Metreweli, C.; Chen, P.P.

    1998-01-01

    Objective: CT of the chest in paediatric patients often requires sedation or general anaesthesia to minimize motion artefacts. Both sedation and general anaesthesia are associated with atelectasis which obscures the underlying pulmonary pathology. We conducted a prospective study to compare these two methods with respect to degree of motion artefacts and extent of atelectasis. Material and Methods: Nineteen patients undergoing 22 chest CT examinations were randomly selected for either sedation or general anaesthesia. The total area of atelectasis and the degree of motion artefacts were measured. Results: The mean percentage of atelectasis was 6.67% for general anaesthesia and 0.01% for sedation (p=0.01). There was no significant difference in the quality of the images between the sedation patients and the general anaesthesia patients. Conclusion: Whenever the clinical condition permits it, sedation rather than general anaesthesia should be given to paediatric patients undergoing chest CT. (orig.)

  4. Pediatric CT sedation: comparison of dexmedetomidine and pentobarbital.

    Science.gov (United States)

    Mason, Keira P; Prescilla, Randy; Fontaine, Paulette J; Zurakowski, David

    2011-02-01

    Our institution replaced pentobarbital with dexmedetomidine for pediatric CT sedation. The purpose of this study was to compare the efficacy, incidence of adverse events, and cardiovascular and respiratory profiles of these two sedatives. Quality assurance data were accessed for a review of demographics, outcome parameters, and adverse events among all children who received either pentobarbital or dexmedetomidine. From January 2004 through June 2009 there were 388 pentobarbital sedations and 1,274 dexmedetomidine sedations. Age, sex, weight, and duration of imaging study were similar in the two groups. Average time to achieve sedation was 12 ± 4 minutes with dexmedetomidine and 6 ± 3 minutes with pentobarbital (p pentobarbital (p pentobarbital than with dexmedetomidine (odds ratio, 4.0; 95% CI, 2.0-8.4; p pentobarbital for pediatric CT, being associated with a much shorter recovery time and less need for adjuvant sedatives.

  5. The role of sedation tests in identifying sedative drug effects in healthy volunteers and their power to dissociate sedative-related impairments from memory dysfunctions.

    Science.gov (United States)

    Wezenberg, E; Sabbe, B G C; Hulstijn, W; Ruigt, G S F; Verkes, R J

    2007-08-01

    The study investigated whether four specified drugs would show similar patterns on tests considered to measure sedation. In addition, their drug-effect patterns on sedation and memory performance were compared to determine whether the sedative effects could be differentiated from the memory effects. Two double-blind, placebo-controlled, crossover studies, each with 16 healthy volunteers, were performed, one testing lorazepam (2.5 mg) and mirtazapine (15 mg) and the other olanzapine (10 mg) and haloperidol (2.5 mg). Subjective sedation was assessed by means of visual analogue scales (VAS) and objective sedation using a simple-reaction-time (SRT) task and a choice-reaction-time (CRT) task, code substitution (symbol digit substitution test (SDST)) and the peak velocity of saccadic eye movements (SEM). A verbal memory test (VMT) was administered to evaluate memory capacity. Apart from haloperidol, all drugs proved to impair performance on all five sedation indices. Contrary to the VAS, the objective measures yielded different response profiles. Two types of drug-effect patterns emerged: one for greater impairments in response speed (SRT, SEM) and one for greater impairments in information processing (CRT, SDST). Lorazepam and olanzapine impeded memory performance, whereas mirtazapine did not. With the use of standardized scores it proved possible to differentiate between the size of the effects of the drugs on the sedation and memory tests. To accurately assess the level and nature of sedation and to differentiate sedation from memory impairments different types of sedation measures are required. Besides studying the subjective effects, it is recommended to also test psychomotor responses and information processing speed.

  6. Anxiolytic effects of standardized extract of Centella asiatica (ECa 233) after chronic immobilization stress in mice.

    Science.gov (United States)

    Wanasuntronwong, Aree; Tantisira, Mayuree H; Tantisira, Boonyong; Watanabe, Hiroshi

    2012-09-28

    Centella asiatica has long been used for various neurological disturbances in Southeast Asian countries. The present study aims to demonstrate the anxiolytic effect of ECa 233, a standardized extract of C. asiatica containing triterpenoids not less than 80%, in comparison to diazepam. The test compound was given orally to non-stressed mice and mice subjected to chronic immobilization stress. Anxiolytic effect was assessed by an elevated plus maze (EPM), a dark-light box and an open-field tests. Anxiolytic effect of ECa 233 was clearly demonstrated in non-stressed mice subjected to acute stress in all behavioral tests employed. In the EPM test, chronically stressed mice showed significant decrease in the number of open arm entries, shortening the time spent in open arms and an increase of the latency to leave the central area, suggesting their release from the stress. In addition, ameliorating effect of ECa 233 was observed on the body weight and serum corticosterone which were adversely affected by immobilization stress. Madecassoside and asiaticoside, equal to their respective contents of the effective doses of ECa 233, exclusively presented anxiolytic effects in EPM, while no distinct effect was observed on the body weight and serum corticosterone. The present study demonstrated anxiolytic effect of ECa 233 in both acutely and chronically stressed animals. These effects could be mainly accounted by madecassoside and asiaticoside, suggesting a possible use of ECa 233 for the treatment of both acute and chronic anxiety in the pathological state. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  7. The failure of anxiolytic therapies in early clinical trials: what needs to be done.

    Science.gov (United States)

    Stewart, Adam Michael; Nguyen, Michael; Poudel, Manoj K; Warnick, Jason E; Echevarria, David J; Beaton, Elliott A; Song, Cai; Kalueff, Allan V

    2015-04-01

    Anxiety spectrum disorders (ASDs) are highly prevalent psychiatric illnesses that affect millions of people worldwide. Strongly associated with stress, common ASDs include generalized anxiety disorder, panic, social anxiety, phobias and drug-abuse-related anxiety. In addition to ASDs, several other prevalent psychiatric illnesses represent trauma/stressor-related disorders, such as post-traumatic stress disorder and acute stress disorder. Anxiolytic drugs, commonly prescribed to treat ASDs and trauma/stressor-related disorders, form a highly heterogenous group, modulating multiple neurotransmitters and physiological mechanisms. However, overt individual differences in efficacy and the potential for serious side-effects (including addiction and drug interaction) indicate a need for further drug development. Yet, over the past 50 years, there has been relatively little progress in the development of novel anxiolytic medications, especially when promising candidate drugs often fail in early clinical trials. Herein, the authors present recommendations of the Task Force on Anxiolytic Drugs of the International Stress and Behavior Society on how to improve anxiolytic drug discovery. These recommendations cover a wide spectrum of aspects, ranging from methodological improvements to conceptual insights and innovation. In order to improve the success of anxiolytic drugs in early clinical trials, the goals of preclinical trials may need to be adjusted from a clinical perspective and better synchronized with those of clinical studies. Indeed, it is important to realize that the strategic goals and approaches must be similar if we want to have a smoother transition between phases.

  8. Sedation levels during propofol administration for outpatient colonoscopies

    OpenAIRE

    Ramsay, Michael A. E.; Newman, Kate B.; Jacobson, Robert M.; Richardson, Charles T.; Rogers, Lindsay; Brown, Bertrand J.; Hein, H. A. Tillmann; De Vol, Edward B.; Daoud, Yahya A.

    2014-01-01

    The levels of sedation required for patients to comfortably undergo colonoscopy with propofol were examined. One hundred patients undergoing colonoscopy with propofol were enrolled. In addition to standard-of-care monitoring, sedation level was monitored with the Patient State Index (PSI) obtained from a brain function monitor, transcutaneous carbon dioxide (tcpCO2) was monitored with the TCM TOSCA monitor, and end-tidal carbon dioxide was monitored via nasal cannula. The Ramsay Sedation Scor...

  9. Clinically significant drug interactions with newer antidepressants.

    Science.gov (United States)

    Spina, Edoardo; Trifirò, Gianluca; Caraci, Filippo

    2012-01-01

    After the introduction of selective serotonin reuptake inhibitors (SSRIs), other newer antidepressants with different mechanisms of action have been introduced in clinical practice. Because antidepressants are commonly prescribed in combination with other medications used to treat co-morbid psychiatric or somatic disorders, they are likely to be involved in clinically significant drug interactions. This review examines the drug interaction profiles of the following newer antidepressants: escitalopram, venlafaxine, desvenlafaxine, duloxetine, milnacipran, mirtazapine, reboxetine, bupropion, agomelatine and vilazodone. In general, by virtue of a more selective mechanism of action and receptor profile, newer antidepressants carry a relatively low risk for pharmacodynamic drug interactions, at least as compared with first-generation antidepressants, i.e. monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs). On the other hand, they are susceptible to pharmacokinetic drug interactions. All new antidepressants are extensively metabolized in the liver by cytochrome P450 (CYP) isoenzymes, and therefore may be the target of metabolically based drug interactions. Concomitant administration of inhibitors or inducers of the CYP isoenzymes involved in the biotransformation of specific antidepressants may cause changes in their plasma concentrations. However, due to their relatively wide margin of safety, the consequences of such kinetic modifications are usually not clinically relevant. Conversely, some newer antidepressants may cause pharmacokinetic interactions through their ability to inhibit specific CYPs. With regard to this, duloxetine and bupropion are moderate inhibitors of CYP2D6. Therefore, potentially harmful drug interactions may occur when they are coadministered with substrates of these isoforms, especially compounds with a narrow therapeutic index. The other new antidepressants are only weak inhibitors or are not inhibitors of CYP isoforms at

  10. Complications of three deep sedation methods for magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Solina Tith

    2012-01-01

    Conclusions: DS with a pentobarbital technique was associated with decreased odds for complications when compared to a propofol-based technique or a pentobarbital technique requiring supplemental sedation.

  11. Relabeling the Medications We Call Antidepressants

    Directory of Open Access Journals (Sweden)

    David Antonuccio

    2012-01-01

    Full Text Available This paper raises the question about whether the data on the medications we call antidepressants justify the label of antidepressant. The authors argue that a true antidepressant should be clearly superior to placebo, should offer a risk/benefit balance that exceeds that of alternative treatments, should not increase suicidality, should not increase anxiety and agitation, should not interfere with sexual functioning, and should not increase depression chronicity. Unfortunately, these medications appear to fall short on all of these dimensions. Many of the “side effects” of these medications have larger effect sizes than the antidepressant effect size. To call these medications antidepressants may make sense from a marketing standpoint but may be misleading from a scientific perspective. Consumers deserve a label that more accurately reflects the data on the largest effects and helps them understand the range of effects from these medications. In other words, it may make just as much sense to call these medications antiaphrodisiacs as antidepressants because the negative effects on libido and sexual functioning are so common. It can be argued that a misleading label may interfere with our commitment to informed consent. Therefore, it may be time to stop calling these medications antidepressants.

  12. Anxiolytic activity of a phytochemically characterized Passiflora incarnata extract is mediated via the GABAergic system.

    Science.gov (United States)

    Grundmann, Oliver; Wang, Jie; McGregor, Gerard P; Butterweck, Veronika

    2008-12-01

    The purpose of this research was to assess the anxiolytic properties of a phytochemically characterized commercial extract from Passiflora incarnata (PI; Passifloraceae) in the elevated plus maze test in mice. Using an HPLC method, the flavonoids homoorientin, orientin, vitexin, and isovitexin were identified as major compounds. Following oral administration, the extract exerted an anxiolytic effect that was comparable to diazepam (1.5 mg/kg) at a dose of 375 mg/kg and exhibited a U-shaped dose-response curve. In addition, antagonism studies using the GABA (A)/benzodiazepine receptor antagonist flumazenil and the 5-HT (1A)-receptor antagonist WAY-100 635 were conducted. The active dose was effectively antagonized by flumazenil, but not by WAY-100 635. This study is the first demonstration of the IN VIVO, GABA-mediated anxiolytic activity of an HPLC- characterized extract of Passiflora incarnata.

  13. Dexmedetomidine sedation in painful posterior segment surgery

    Directory of Open Access Journals (Sweden)

    Mansour A

    2012-12-01

    Full Text Available Ahmad Mansour,1,2 Samar Taha31Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; 2Rafik Hariri University Hospital, Beirut, Lebanon; 3Department of Anesthesiology, American University of Beirut, Beirut, LebanonPurpose: To present a case series on the use of dexmedetomidine (Precedex sedation in painful posterior segment surgery performed under topical anesthesia, similar to its use in cataract surgery.Methods: A prospective review of cases that had posterior segment surgery under topical anesthesia and that needed sedation. Dexmedetomidine-loading infusion was 1 mcg/kg over 10 minutes, followed by a maintenance infusion (0.5 mcg/kg/h.Results: Nine patients were operated on under topical anesthesia: two scleral buckle, five cryopexy, one scleral laceration, and one pars plana vitrectomy with very dense laser therapy in an albinotic fundus; six patients had retinal detachment. General or local anesthesia were not possible due to medical or ocular morbidities, use of anticoagulants, or the surgery plan changed intraoperatively when new pathologies were discovered. The surgeon achieved good surgical control in eight of nine cases, with one patient having ocular and bodily movements that were disturbing. Six patients had no pain, while three patients reported mild pain. No adverse effects were noted and all patients had successful surgical outcomes. Heart rate, blood pressure, and oxygen saturation were well controlled throughout the procedures. The most frequent adverse reactions of dexmedetomidine reported in the literature in less than 5% (hypotension, bradycardia, and dry mouth were not recorded in the present study.Conclusion: When a surgeon has planned to do a pars plana vitrectomy under topical anesthesia and the surgical situation dictates the addition of cryopexy, scleral buckle, or intense laser retinopexy, then sedation with dexmedetomidine can help in the control of ocular pain in the majority of cases, with good

  14. Antidepressant medication use and breast cancer risk.

    Science.gov (United States)

    Wernli, Karen J; Hampton, John M; Trentham-Dietz, Amy; Newcomb, Polly A

    2009-04-01

    Most epidemiologic studies have detected no association between prior use of antidepressant medications and breast cancer risk. Despite the uniform conclusion, there is a continuous rise in the proportion of women using antidepressants, lending support to further monitoring of disease effects. We conducted a population-based case-control study among 2908 incident breast cancer cases diagnosed from 2003 to 2006, and 2927 control women from Wisconsin. Associations between antidepressant use and breast cancer risk were evaluated using multivariable logistic regression. The association between use of antidepressant medications and breast cancer risk was null (OR = 0.89, 95%CI 0.78-1.01). When stratified by type of antidepressant, use of selective-serotonin reuptake inhibitors (SSRIs) resulted in a similar risk overall (OR = 0.85, 95%CI 0.72-1.00) and among former and currents users. There were no associations between other types of antidepressant classes and breast cancer risk. In assessing risks among the five most commonly used antidepressants, we detected no association with fluoxetine, sertraline, venlafaxine, or buproprion hydrochloride. There was a reduction in breast cancer risk of 36% (OR = 0.64, 95%CI 0.45-0.92) among users of paroxetine hydrochloride. When stratified by body mass index, there was a reduction in risk associated with antidepressant users who were not overweight (OR = 0.73, 95% CI 0.60-0.90), but this association was null in overweight women (p-interaction = 0.04). Surveillance of health risks associated with antidepressant medications continues to be of public health importance, though these medications are not likely to be associated with breast cancer risk.

  15. Recall of intensive care unit stay in patients managed with a sedation protocol or a sedation protocol with daily sedative interruption: a pilot study.

    Science.gov (United States)

    Ethier, Cheryl; Burry, Lisa; Martinez-Motta, Carlos; Tirgari, Sam; Jiang, Depeng; McDonald, Ellen; Granton, John; Cook, Deborah; Mehta, Sangeeta

    2011-04-01

    Analgesics and sedatives are integral for the relief of pain and anxiety in critically ill patients. However, these agents may contribute to amnesia for intensive care unit (ICU) events; which has been associated with development of posttraumatic stress disorder. Drug administration strategies that minimize sedative use have been associated with less amnesia. The objective of this pilot study was to evaluate recall of ICU stay in patients managed with 2 sedation strategies: a sedation protocol or a combination of sedation protocol and daily sedative/analgesic interruption. A questionnaire was administered on day 3 following ICU discharge to evaluate patients' recollections of pain, anxiety, fear, and sleep, as well as memories for specific ICU procedures. Participants were ICU survivors who had been enrolled in SLEAP - a randomized pilot trial comparing two sedation strategies, at 3 university-affiliated medical/surgical ICUs. Twenty-one patients who regained orientation within 72 hours of ICU discharge completed the questionnaire. More than 50% of patients recalled experiencing pain, anxiety, and fear to a moderate or extreme extent; and 57% reported inadequate sleep while in the ICU. Of the 21 patients, 48%, 33%, and 29% had no memories of endotracheal tube suctioning, being on a "breathing machine," and being bathed, respectively. A notable percentage of patients discharged from the ICU report moderate to extreme pain, anxiety, and fear, and inability to sleep during their ICU stay; and 29% to 48% have no recall of specific ICU events. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. "Sedation is tricky": A qualitative content analysis of nurses' perceptions of sedation administration in mechanically ventilated intensive care unit patients.

    Science.gov (United States)

    Hetland, Breanna; Guttormson, Jill; Tracy, Mary Fran; Chlan, Linda

    2018-03-20

    Critical care nurses are responsible for administering sedative medications to mechanically ventilated patients. With significant advancements in the understanding of the impact of sedative exposure on physiological and psychological outcomes of ventilated patients, updated practice guidelines for assessment and management of pain, agitation, and delirium in the intensive care unit were released in 2013. The primary aim of this qualitative study was to identify and describe themes derived from critical care nurses' comments regarding sedation administration practices with mechanically ventilated patients. This is a qualitative content analysis of secondary text data captured through a national electronic survey of members of the American Association of Critical-Care Nurses. A subsample (n = 67) of nurses responded to a single, open-ended item at the end of a survey that evaluated nurses' perceptions of current sedation administration practices. Multiple factors guided sedation administration practices, including individual patient needs, nurses' synthesis of clinical evidence, application of best practices, and various personal and professional practice perspectives. Our results also indicated nurses desire additional resources to improve their sedation administration practices including more training, better communication tools, and adequate staffing. Critical care nurses endorse recommendations to minimise sedation administration when possible, but a variety of factors, including personal perspectives, impact sedation administration in the intensive care unit and need to be considered. Critical care nurses continue to encounter numerous challenges when assessing and managing sedation of mechanically ventilated patients. Copyright © 2018 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  17. The anxiolytic effect of Juniperus virginiana L. essential oil and determination of its active constituents.

    Science.gov (United States)

    Zhang, Kai; Yao, Lei

    2018-01-08

    Essential oil from Juniperus virginiana L. (eastern red cedarwood essential oil, CWO) has been used to relax mind and enhance comfort for medical purposes. Few reports showed its effect on anxiety behaviors in animal models. The present study investigated the anxiolytic effect of CWO using two anxiety tests in mice, then determined the major active constituents, examined the change of neurotransmitters after intraperitoneal (i.p.) administration. Analysis using GC/MS revealed that the CWO contained (-)-α-cedrene (28.11%), (+)-β-cedrene (7.81%), (-)-thujopsene (17.71%) and (+)-cedrol (24.58%). CWO at 400-800mg/kg increased the percentage of open arm entries and the percentage of the time spent in open arms in the elevated plus maze (EPM), suggesting that the oil has anxiolytic effect. However, it didn't show anxiolytic effect in the light-dark box (LDB) test. Tests of the cedrene did not show anxiolytic effect in either test, but rather induced anxiety-related behaviors and inhibited the locomotor activity in EPM and LDB. Cedrol produced significant anxiolytic effect in both EPM and LDB tests at 400-1600mg/kg and 800-1600mg/kg, respectively. A more significant increase in locomotor activity was observed in cedrol at 200-1600mg/kg administration than CWO. CWO increased the 5-hydroxytryptamine (5-HT) concentration at 800mg/kg, whereas it didn't affect the dopamine (DA) concentration. Cedrol significantly reduced the DA level at 100-200mg/kg and elevated the 5-HT level at 1200-1600mg/kg. Moreover, it changed the ratio of 5-hydroxyindoleacetic acid/5-HT and 3, 4-dihydroxyphenyl acetic acid/DA at 1200-1600mg/kg. CWO and cedrol, in particular might act in an anxiolytic effect through the 5-HTnergic and DAnergic pathways. Copyright © 2018. Published by Elsevier Inc.

  18. Anxiolytic-like effects of alverine citrate in experimental mouse models of anxiety.

    Science.gov (United States)

    Gupta, Deepali; Radhakrishnan, Mahesh; Kurhe, Yeshwant

    2014-11-05

    Anxiety disorders are widely spread psychiatric illnesses that are a cause of major concern. Despite a consistent increase in anxiolytics, the prevalence of anxiety is static; this necessitates the development of new compounds with potential activity and minimum unwanted effects. A serotonergic (5HT) system plays an important role in pathogenesis of anxiety and predominantly involves 5HT1A receptor action in mediating anxiety-like behavior; the antagonism of 5HT1A receptor has demonstrated to produce anxiolytic-like effects. Alverine citrate (AVC) is reported as a 5HT1A antagonist; however, its effects on anxiety-like behavior are not investigated. Thus, the present study, by utilizing a neurobehavioral approach, examined the anxiolytic-like effects of AVC in experimental mouse models of anxiety. Mice were acutely treated with AVC (5-20mg/kg, i.p.)/diazepam (DIA, 2mg/kg, i.p.) and subjected to four validated anxiety models viz. elevated plus-maze (EPM), light/dark (L/D), hole-board (HB) and marble burying (MB) tests. AVC (15-20mg/kg) and DIA significantly increased open arm activity in EPM, exploration in light chamber in L/D test, exploratory behavior in HB and reduced MB behavior in marble burying test. AVC (5mg/kg) had no effect on all behavioral tests, while AVC (10mg/kg) produced partial effects. It revealed anxiolytic-like effects of AVC. Furthermore, anxiolytic-like effects of AVC at higher doses (15-20mg/kg) were more pronounced than lower doses (10mg/kg) and were quite similar to the standard drug DIA. The present finding demonstrates, for the first time, the anxiolytic-like effects of AVC, which may be an alternative approach for management of anxiety-related disorders. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Treatment with antiparkinson and antidepressant drugs

    DEFF Research Database (Denmark)

    Brandt-Christensen, Mette; Kvist, Kajsa; Nilsson, Flemming Mørkeberg

    2007-01-01

    Depressive symptoms and major depression are frequent in patients with Parkinson's disease (PD). However, a systematic knowledge about the treatment with antidepressant drugs among PD patients is missing. We estimated the frequency of antidepressant drug treatment in a national sample of persons......,029,737 persons were included. Persons who got APDs had significantly increased rate ratios (RR) of subsequent antidepressant drug treatment compared with an unexposed control group (RR: 2.10 (95% CI: 2.04-2.16)) and with persons who got anti-diabetic drugs [RR: 1.58 (95% CI: 1.51-1.65)]. Persons treated...... and depression....

  20. Placebo and antidepressant treatment for major depression

    DEFF Research Database (Denmark)

    Hougaard, Esben

    2010-01-01

    Antidepressant medication is generally considered the primary treatment for major depressive disorders (MDD), but antidepressant treatment has recently approached a crisis with shrinking specific effects and growing placebo responses in current trials. The aim of the paper is to review the placebo...... problem within antidepressant treatment for MDD, and to draw lines to similar problems within the field of psychotherapy. Although clinicians might profit from the large placebo response in their treatment of MDD, the small differences between active treatment and placebo groups found in controlled...

  1. Moderate sedation for MRI in young children with autism

    International Nuclear Information System (INIS)

    Ross, Allison Kinder; Hazlett, Heather Cody; Garrett, Nancy T.; Wilkerson, Christy; Piven, Joseph

    2005-01-01

    Autism is a pervasive neurodevelopmental disorder. Because of the deficits associated with the condition, sedation of children with autism has been considered more challenging than sedation of other children. To test this hypothesis, we compared children with autism against clinical controls to determine differences in requirements for moderate sedation for MRI. Children ages 18-36 months with autism (group 1, n = 41) and children with no autistic behavior (group 2, n = 42) were sedated with a combination of pentobarbital and fentanyl per sedation service protocol. The sedation nurse was consistent for all patients, and all were sedated to achieve a Modified Ramsay Score of 4. Demographics and doses of sedatives were recorded and compared. There were no sedation failures in either group. Children in group 1 (autism) were significantly older than group 2 (32.02±3.6 months vs 28.16±6.7 months) and weighed significantly more (14.87±2.1 kg vs 13.42±2.2 kg). When compared on a per-kilogram basis, however, group 1 had a significantly lower fentanyl requirement than group 2 (1.25±0.55 mcg/kg vs 1.57±0.81 mcg/kg), but no significant difference was found in pentobarbital dosing between groups 1 and 2, respectively (4.92±0.92 mg/kg vs 5.21±1.6 mg/kg). Autistic children in this age range are not more difficult to sedate and do not require higher doses of sedative agents for noninvasive imaging studies. (orig.)

  2. Moderate sedation for MRI in young children with autism

    Energy Technology Data Exchange (ETDEWEB)

    Ross, Allison Kinder [Duke University Medical Center, Division of Pediatric Anesthesia, Durham (United States); Hazlett, Heather Cody; Garrett, Nancy T. [University of North Carolina School of Medicine, Department of Psychiatry, Chapel Hill, NC (United States); Wilkerson, Christy [Duke University Medical Center, Department of Radiology, Durham, NC (United States); Piven, Joseph [University of North Carolina School of Medicine, Departments of Psychiatry and Pediatrics, Chapel Hill, NC (United States)

    2005-09-01

    Autism is a pervasive neurodevelopmental disorder. Because of the deficits associated with the condition, sedation of children with autism has been considered more challenging than sedation of other children. To test this hypothesis, we compared children with autism against clinical controls to determine differences in requirements for moderate sedation for MRI. Children ages 18-36 months with autism (group 1, n = 41) and children with no autistic behavior (group 2, n = 42) were sedated with a combination of pentobarbital and fentanyl per sedation service protocol. The sedation nurse was consistent for all patients, and all were sedated to achieve a Modified Ramsay Score of 4. Demographics and doses of sedatives were recorded and compared. There were no sedation failures in either group. Children in group 1 (autism) were significantly older than group 2 (32.02{+-}3.6 months vs 28.16{+-}6.7 months) and weighed significantly more (14.87{+-}2.1 kg vs 13.42{+-}2.2 kg). When compared on a per-kilogram basis, however, group 1 had a significantly lower fentanyl requirement than group 2 (1.25{+-}0.55 mcg/kg vs 1.57{+-}0.81 mcg/kg), but no significant difference was found in pentobarbital dosing between groups 1 and 2, respectively (4.92{+-}0.92 mg/kg vs 5.21{+-}1.6 mg/kg). Autistic children in this age range are not more difficult to sedate and do not require higher doses of sedative agents for noninvasive imaging studies. (orig.)

  3. Anti-depressants and suicide.

    Science.gov (United States)

    Ludwig, Jens; Marcotte, Dave E; Norberg, Karen

    2009-05-01

    Suicide takes the lives of around a million people each year, most of whom suffer from depression. In recent years there has been growing controversy about whether one of the best-selling anti-depressants - selective serotonin reuptake inhibitors (SSRIs) - increases or decreases the risk of completed suicide. Randomized clinical trials are not informative in this application because of small samples and other problems. We present what we believe are the most scientifically credible estimates to date on how SSRI sales affect suicide mortality using data from 26 countries for up to 25 years. We exploit just the variation in SSRI sales that can be explained by institutional differences in how drugs are regulated, priced, and distributed, as reflected by the sales growth of new drugs more generally. We find an increase in SSRI sales of 1 pill per capita (12% of 2000 sales levels) reduces suicide by 5%.

  4. Green synthesis and anxiolytic activity of some new dibenz-[1,4] diazepine-1-one analogues

    Directory of Open Access Journals (Sweden)

    Jaiprakash N. Sangshetti

    2017-02-01

    Full Text Available A facile, green approach for the synthesis of some new dibenz[1,4]-diazepine-1-one by a three component reaction of Diamine, 1,3 diketone and aromatic aldehyde using oxalic acid as catalyst in water is described. The products are formed in good yields (92–94%. Newly synthesized dibenz [1,4]-diazepine-1-one analogues were evaluated for the anxiolytic activity by the elevated plus maze method. From the activity data it is observed that compounds, 4g, 4h and 4k show promising anxiolytic activity.

  5. A randomized controlled trial of daily sedation interruption in critically ill children

    NARCIS (Netherlands)

    Vet, N.J.; Wildt, S.N. de; Verlaat, C.W.; Knibbe, C.A.; Mooij, M.G.; Woensel, J.B. van; Rosmalen, J. van; Tibboel, D.; Hoog, M. de

    2016-01-01

    PURPOSE: To compare daily sedation interruption plus protocolized sedation (DSI + PS) to protocolized sedation only (PS) in critically ill children. METHODS: In this multicenter randomized controlled trial in three pediatric intensive care units in the Netherlands, mechanically ventilated critically

  6. A randomized controlled trial of daily sedation interruption in critically ill children

    NARCIS (Netherlands)

    Vet, Nienke J.; de Wildt, Saskia N.; Verlaat, Carin W. M.; Knibbe, Catherijne A. J.; Mooij, Miriam G.; van Woensel, Job B. M.; van Rosmalen, Joost; Tibboel, Dick; de Hoog, Matthijs

    2016-01-01

    To compare daily sedation interruption plus protocolized sedation (DSI + PS) to protocolized sedation only (PS) in critically ill children. In this multicenter randomized controlled trial in three pediatric intensive care units in the Netherlands, mechanically ventilated critically ill children with

  7. 'In my life antidepressants have been…': a qualitative analysis of users' diverse experiences with antidepressants.

    Science.gov (United States)

    Gibson, Kerry; Cartwright, Claire; Read, John

    2016-05-11

    While mental health professionals have focused on concerns about whether antidepressants work on a neurochemical level it is important to understand the meaning this medication holds in the lives of people who use it. This study explores diversity in the experience of antidepressant users. One thousand seven hundred forty-seven New Zealand antidepressant users responded to an open-ended question about their experience of antidepressants. This was analysed using content and thematic analysis. There was considerable diversity in participants' responses including positive (54 %), negative (16 %) and mixed (28 %) experiences with antidepressants. Those with positive experiences saw antidepressants as a necessary treatment for a 'disease', a life saver, a way of meeting social obligations, dealing with difficult circumstances or a stepping stone to further help. Negative themes described antidepressants as being ineffective, having unbearable side effects, undermining emotional authenticity, masking real problems and reducing the experience of control. Mixed experience themes showed how participants weighed up the unpleasant side effects against the benefits, felt calmer but less like themselves, struggled to find the one or dosage and felt stuck with continuing on antidepressants when they wished to stop. Mental health professions need to recognize that antidepressants are not a 'one size fits all' solution.

  8. Sedative properties of Mitracarpus villosus leaves in mice | John ...

    African Journals Online (AJOL)

    Our results revealed that the ethylacetate extract of Mitracarpus villosus leaves may contain psychoactive principles that are sedative in nature, thus supporting further development of the psychoactive components of this plant for management of stress-related diseases. Keywords: Mitracarpus villosus, sedation, diazepam, ...

  9. Recording EEG In Young Children Without Sedation | Curuneaux ...

    African Journals Online (AJOL)

    Background Although it has been considered that sedation in children undergoing EEG tests is effective and safe and complications are infrequent, occasionally adverse sedation-related events are presented. Objective The aim of this work was to determine if it is possible to carry out EEG in children up to 4 years old ...

  10. Atelectasis on pediatric chest CT: comparison of sedation techniques

    International Nuclear Information System (INIS)

    Sargent, M.A.; McEachern, A.M.; Jamieson, D.H.

    1999-01-01

    Background. A change in practice at our institution resulted in increased use of anesthesia for CT scan of the chest in children who required sedation. Objective. To determine whether there is a difference in the frequency or severity of pulmonary atelectasis on CT scan in children sedated by anesthesiologists compared with children sedated by radiologists using intravenous pentobarbital. Materials and methods. Retrospective blinded review of 60 CT scans of the chest performed in 41 children. Forty-one studies in children sedated by radiologists (median age 29 months) were compared with 19 studies in children sedated by anesthesiologists (median age 25 months). Results. Atelectasis sufficient to obscure pulmonary metastases was shown in 5 of 41 (12 %) radiology sedations and 13 of 19 (68 %) anesthesiology sedations (P < 0.01). Higher grades of atelectasis were recorded in children under anesthesia (P < 0.01). Conclusion. Atelectasis is more frequent and more severe in children undergoing general anesthesia compared with intravenous pentobarbital sedation. Consideration should be given to the use of forced inspiration in children anesthetized for CT scan of the chest. (orig.)

  11. Improving prescription in palliative sedation: compliance with dutch guidelines.

    NARCIS (Netherlands)

    Hasselaar, J.G.J.; Reuzel, R.P.B.; Verhagen, C.A.H.H.V.M.; Graeff, A. de; Vissers, K.C.P.; Crul, B.J.P.

    2007-01-01

    BACKGROUND: Two guidelines addressing palliative sedation have been published in the Netherlands in 2002 and 2003. The objective of the present study is to determine adherence to the guidelines for palliative sedation with regard to prescription. The study is restricted to the practice of continuous

  12. [Psychomotor agitation, pharmaceutical sedation and psychiatric emergency in psychotic patients].

    Science.gov (United States)

    Passamar, M; Tellier, O; Vilamot, B

    2011-12-01

    Psychomotor agitation, very common among psychiatric emergencies, raises the question of pharmaceutical sedation, its indications, and its issues, notably with regard to the observance in postemergency. A new approach to sedation places it within its therapeutic aim and also takes into account the sometimes harmful impact on the course of the patient's care. A pretherapeutical, analysis both clinical and environmental is crucial. The time spent on the initial meeting and assessment is essential. The evolution of professional practices in mental health allows us to distinguish three kinds of sedation (vigilance, behaviour and psychical) that guide the choice and the mode of psychotropic drug use. The harmful effects of an ever-increasing use of sedation is debated. The use of atypical antipsychotics and injectable forms is argued. Early psychical sedation is preferable to the obsolete practice of vigilance sedation and to behavioural sedation with its limited indications. The use of excessive or prolonged sedation might have a detrimental effect on the care offered after psychiatric emergency treatment. Copyright © 2011. Published by Elsevier Masson SAS.

  13. Attitude and Practices of Sedation amongst Critical Care Nurses ...

    African Journals Online (AJOL)

    Summary: Sedation is necessary for the alleviation of anxiety so as to improve patient comfort and facilitate medical interventions and invasive procedures in the Intensive Care Unit (ICU). Methods: A cross-sectional survey of the attitudes and practice of sedation amongst all nurses working in the Kenyatta National Hospital ...

  14. Sedative and Anticonvulsant Activities of the Ethanol Root Extract of ...

    African Journals Online (AJOL)

    Purpose: To investigate the sedative, hypnotic and anticonvulsant activities of the ethanol extract of the roots of the Flemingia chappar (ERFC) on the central nervous system (CNS) of mice. Methods: The ethanol extract of the roots of F. chappar in doses of 200, 400 and 600 mg/kg, p.o., was studied in mice for its sedative ...

  15. Ketamine for continuous sedation of mechanically ventilated patients

    Directory of Open Access Journals (Sweden)

    Ben-Paul Umunna

    2015-01-01

    Full Text Available Context: Long-term sedation with midazolam or propofol has been demonstrated to have serious adverse side effects, such as toxic accumulation or propofol infusion syndrome. Ketamine remains a viable alternative for continuous sedation as it is inexpensive and widely available, however, there are few analyses regarding its safety in this clinical setting. Objective: To review the data related to safety and efficacy of ketamine as a potential sedative agent in mechanically ventilated patients admitted to the intensive care unit (ICU. Materials and Methods: This was a single-center retrospective study from September 2011 to March 2012 of patients who required sedation for greater than 24 hours, in whom ketamine was selected as the primary sedative agent. All patients greater than 18 years of age, regardless of admitting diagnosis, were eligible for inclusion. Patients that received ketamine for continuous infusion but died prior to receiving it for 24 hours were not included. Results: Thirty patients received ketamine for continuous sedation. In four patients, ketamine was switched to another sedative agent due to possible adverse side effects. Of these, two patients had tachydysrhythmias, both with new onset atrial fibrillation and two patients had agitation believed to be caused by ketamine. The adverse event rate in our patient population was 13% (4/30. Conclusions: Among ICU patients receiving prolonged mechanical ventilation, the use of ketamine appeared to have a frequency of adverse events similar to more common sedative agents, like propofol and benzodiazepines.

  16. Sedation with alfentanil and propofol for rhizotomies | Jansen van ...

    African Journals Online (AJOL)

    Background: Patient safety during sedation for closed rhizotomies is improved when analgesia is optimised, rather than relying on deep sedation for patient comfort. This retrospective study determined the appropriate effect-site concentration (Ce) for alfentanil, in combination with a constant propofol infusion, for optimal ...

  17. [Sedation and analgesia practices among Spanish neonatal intensive care units].

    Science.gov (United States)

    Avila-Alvarez, A; Carbajal, R; Courtois, E; Pertega-Diaz, S; Muñiz-Garcia, J; Anand, K J S

    2015-08-01

    Pain management and sedation is a priority in neonatal intensive care units. A study was designed with the aim of determining current clinical practice as regards sedation and analgesia in neonatal intensive care units in Spain, as well as to identify factors associated with the use of sedative and analgesic drugs. A multicenter, observational, longitudinal and prospective study. Thirty neonatal units participated and included 468 neonates. Of these, 198 (42,3%) received sedatives or analgesics. A total of 19 different drugs were used during the study period, and the most used was fentanyl. Only fentanyl, midazolam, morphine and paracetamol were used in at least 20% of the neonates who received sedatives and/or analgesics. In infusions, 14 different drug prescriptions were used, with the most frequent being fentanyl and the combination of fentanyl and midazolam. The variables associated with receiving sedation and/or analgesia were, to have required invasive ventilation (P3 (P=.023; OR=2.26), the existence of pain evaluation guides in the unit (Pneonates admitted to intensive care units receive sedatives or analgesics. There is significant variation between Spanish neonatal units as regards sedation and analgesia prescribing. Our results provide evidence on the "state of the art", and could serve as the basis of preparing clinical practice guidelines at a national level. Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  18. Comfort and patient-centred care without excessive sedation

    DEFF Research Database (Denmark)

    Vincent, Jean-Louis; Shehabi, Yahya; Walsh, Timothy S

    2016-01-01

    and Delirium guidelines, is conveyed in the mnemonic eCASH-early Comfort using Analgesia, minimal Sedatives and maximal Humane care. eCASH aims to establish optimal patient comfort with minimal sedation as the default presumption for intensive care unit (ICU) patients in the absence of recognised medical...

  19. The clinical pharmacology of non-sedating antihistamines

    NARCIS (Netherlands)

    Yanai, Kazuhiko; Yoshikawa, Takeo; Yanai, Ai; Nakamura, Tadaho; Iida, Tomomitsu; Leurs, Rob; Tashiro, Manabu

    2017-01-01

    We previously reported on brain H1 receptor occupancy measurements of antihistamines in human brain using [11C]doxepin and positron emission tomography (PET). We proposed the use of brain H1 receptor occupancy to classify antihistamines objectively into three categories of sedating, less-sedating,

  20. Use of sedation to relieve refractory symptoms in dying patients ...

    African Journals Online (AJOL)

    Indications. Agitated delirium was the most common reason (45%) for using sedation, followed by intractable vomiting due to inoperable malignant intestinal obstruction in 25% of patients. Three patients with persistent convulsions or myoclonic jerking and 2 patients with severe refractory dyspnoea required some sedation.

  1. Experience with Conscious sedation for Oocyte Retrieval in Nigeria

    African Journals Online (AJOL)

    elearning

    The aim of this study was to assess clients' pain experience, acceptance of conscious sedation and correlates of pain during oocyte retrieval ... Conscious sedation and analgesia are one of several methods used to relieve pain during oocyte retrieval in. IVF procedures. .... relieves anxiety and reduces the patient's memory.

  2. Atelectasis on pediatric chest CT: comparison of sedation techniques

    Energy Technology Data Exchange (ETDEWEB)

    Sargent, M.A.; McEachern, A.M.; Jamieson, D.H. [Department of Radiology, Children`s and Women`s Health Centre of British Columbia, Vancouver (Canada).; Kahwaji, R. [Department of Anaesthesia, University of British Columbia, Vancouver (Canada)

    1999-07-01

    Background. A change in practice at our institution resulted in increased use of anesthesia for CT scan of the chest in children who required sedation. Objective. To determine whether there is a difference in the frequency or severity of pulmonary atelectasis on CT scan in children sedated by anesthesiologists compared with children sedated by radiologists using intravenous pentobarbital. Materials and methods. Retrospective blinded review of 60 CT scans of the chest performed in 41 children. Forty-one studies in children sedated by radiologists (median age 29 months) were compared with 19 studies in children sedated by anesthesiologists (median age 25 months). Results. Atelectasis sufficient to obscure pulmonary metastases was shown in 5 of 41 (12 %) radiology sedations and 13 of 19 (68 %) anesthesiology sedations (P < 0.01). Higher grades of atelectasis were recorded in children under anesthesia (P < 0.01). Conclusion. Atelectasis is more frequent and more severe in children undergoing general anesthesia compared with intravenous pentobarbital sedation. Consideration should be given to the use of forced inspiration in children anesthetized for CT scan of the chest. (orig.) With 4 figs., 2 tabs., 13 refs.

  3. New generation of antidepressants in pregnant women

    Directory of Open Access Journals (Sweden)

    Ladan Kashani

    2007-03-01

    Full Text Available Although pregnancy was once thought to protect against psychiatric disorders, gravid and non gravid women have similar risks for major depression, at 10% to 15%. Both depression and antidepressant treatment during pregnancy have been associated with risks. Few medications have been proved unequivocally safe during pregnancy. Although certain antidepressants have not been linked with an increased risk of birth defects or impaired development including bupropion, citalopram, escitalopram and venlafaxine, the latest studies aren't necessarily reassuring. As researchers continue to learn more about antidepressants, the risks and benefits of taking the drugs during pregnancy must be weighed carefully on a case-by-case basis. This review discusses about the use of new generation of antidepressants in pregnancy

  4. Capgras syndrome responding to the antidepressant mirtazapine.

    Science.gov (United States)

    Khouzam, Hani Raoul

    2002-01-01

    A new onset of Capgras syndrome, delusional misidentification, developed in an elderly gentleman. Treatment with the antidepressant mirtazapine led to the remission. Suggestions are made for both dynamic and medical bases for Capgras syndrome and possible antipsychotic effects of mirtazapine.

  5. The effects of antidepressants on gastric ulcer

    Directory of Open Access Journals (Sweden)

    Mehmet Latif Güneş

    2013-12-01

    Full Text Available In their daily practice, psychiatrists often experience gastriccomplaints in patients beside psychiatric disorders.Peptic ulcer is one of the diseases, which accompanyto psychiatric disorders including mainly depression. Itis shown that antidepressants can inflame the bleedingsincluding gastrointestinal (GI bleedings, while they havepositive effect on ulcer healing. In this review, studies,which conducted about the positive or negative effects ofantidepressant drugs on ulcer treatment were examined.Accordingly; it was found that opipramol, amitriptyline,imipramine that of tricyclic antidepressants was found tobe helpful in healing of the ulcer. It was stated that SelectiveSerotonin Reuptake Inhibitors generally inflamedulcers, exceptionally fluvoxamine and fluoxetine reducedulcer; moclobemide that of monoamine-oxidase inhibitorand tianeptine and mirtazapine that of atypical antidepressantshad positive effect in ulcer healing. To be carefulin choosing the appropriate antidepressant in psychiatricpatients with gastric ulcer is important in the prognosisof both ulcer and depression.Key words: peptic ulcer; depression; antidepressant drugs

  6. Antidepressants: MedlinePlus Health Topic

    Science.gov (United States)

    ... Medical Education and Research) Genetics Genetics Home Reference: depression (National Library of Medicine) Statistics and Research Antidepressant Use in Persons Aged 12 and Over: United States, 2005-2008 (National Center for Health Statistics) Clinical ...

  7. Laryngospasm With Apparent Aspiration During Sedation With Nitrous Oxide.

    Science.gov (United States)

    Babl, Franz E; Grindlay, Joanne; Barrett, Michael Joseph

    2015-11-01

    Nitrous oxide and oxygen mixture has become increasingly popular for the procedural sedation and analgesia of children in the emergency department. In general, nitrous oxide is regarded as a very safe agent according to large case series. We report a case of single-agent nitrous oxide sedation of a child, complicated by laryngospasm and radiographically confirmed bilateral upper lobe pulmonary opacities. Although rarely reported with parenteral sedative agents, laryngospasm and apparent aspiration has not been previously reported in isolated nitrous oxide sedation. This case highlights that, similar to other sedative agents, nitrous oxide administration also needs to be conducted by staff and in settings in which airway emergencies can be appropriately managed. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  8. Moderate and deep nurse-administered propofol sedation is safe

    DEFF Research Database (Denmark)

    Jensen, Jeppe Thue; Møller, Ann; Hornslet, Pernille

    2015-01-01

    sedation with NAPS in patients undergoing gastroenterologic endoscopic procedures. METHODS: This was a retrospective case-control study. All patients sedated with NAPS for colonoscopies, sigmoidoscopies and oesophagogastroduodenoscopies from May 2007 through December 2012 were included. Cases were defined......INTRODUCTION: Non-anaesthesiologist-administered propofol sedation (NAPS/NAAP) is increasingly used in many countries. Most regimens aim for light or moderate sedation. Little evidence on safety of deep NAPS sedation is available. The aim of this study was to explore the safety of intermittent deep......'s Foundation provided funding for this study. The founders did not have any influence on the design or the presentation of the study. TRIAL REGISTRATION: not relevant....

  9. Auditory processing during deep propofol sedation and recovery from unconsciousness.

    Science.gov (United States)

    Koelsch, Stefan; Heinke, Wolfgang; Sammler, Daniela; Olthoff, Derk

    2006-08-01

    Using evoked potentials, this study investigated effects of deep propofol sedation, and effects of recovery from unconsciousness, on the processing of auditory information with stimuli suited to elicit a physical MMN, and a (music-syntactic) ERAN. Levels of sedation were assessed using the Bispectral Index (BIS) and the Modified Observer's Assessment of Alertness and Sedation Scale (MOAAS). EEG-measurements were performed during wakefulness, deep propofol sedation (MOAAS 2-3, mean BIS=68), and a recovery period. Between deep sedation and recovery period, the infusion rate of propofol was increased to achieve unconsciousness (MOAAS 0-1, mean BIS=35); EEG measurements of recovery period were performed after subjects regained consciousness. During deep sedation, the physical MMN was markedly reduced, but still significant. No ERAN was observed in this level. A clear P3a was elicited during deep sedation by those deviants, which were task-relevant during the awake state. As soon as subjects regained consciousness during the recovery period, a normal MMN was elicited. By contrast, the P3a was absent in the recovery period, and the P3b was markedly reduced. Results indicate that the auditory sensory memory (as indexed by the physical MMN) is still active, although strongly reduced, during deep sedation (MOAAS 2-3). The presence of the P3a indicates that attention-related processes are still operating during this level. Processes of syntactic analysis appear to be abolished during deep sedation. After propofol-induced anesthesia, the auditory sensory memory appears to operate normal as soon as subjects regain consciousness, whereas the attention-related processes indexed by P3a and P3b are markedly impaired. Results inform about effects of sedative drugs on auditory and attention-related mechanisms. The findings are important because these mechanisms are prerequisites for auditory awareness, auditory learning and memory, as well as language perception during anesthesia.

  10. Pharmacogenetics of antidepressant response: An update

    Directory of Open Access Journals (Sweden)

    Drago Antonio

    2009-04-01

    Full Text Available Abstract The past few decades have witnessed much progress in the field of pharmacogenetics. The identification of the genetic background that regulates the antidepressant response has benefited from these advances. This review focuses on the pharmacogenetics of the antidepressant response through the analysis and discussion of the most compelling evidence in this line of research. Online databases (Medline and PsycINFO have been searched and the most replicated association findings relating to the genetics of the antidepressant response have been reported and discussed. Some replicated findings in the literature have suggested the serotonin transporter promoter (5-HTTLPR, serotonin receptor 1A (HTR1A, serotonin receptor 2A (HTR2A, brain derived neurotrophic factor (BDNF, corticotropin releasing hormone receptor 1 (CRHR1 and FK506 binding protein 5 (FKBP5 as putative regulators of the antidepressant response. A high rate of failure of replication has also been reported. Pharmacogenetics will hopefully provide the basis for personalised antidepressant treatment that is able to maximise the probability of a good response and to minimise side effects; however, this goal is not achievable at the moment. The extent of the validity of the replicated findings and the reasons for the poor results obtained from studies of the pharmacogenetics of the antidepressant response are discussed.

  11. Myristic Acid Produces Anxiolytic-Like Effects in Wistar Rats in the Elevated Plus Maze

    Directory of Open Access Journals (Sweden)

    Carlos M. Contreras

    2014-01-01

    Full Text Available A mixture of eight fatty acids (linoleic, palmitic, stearic, myristic, elaidic, lauric, oleic, and palmitoleic acids at similar concentrations identified in human amniotic fluid produces anxiolytic-like effects comparable to diazepam in Wistar rats. However, individual effects of each fatty acid remain unexplored. In Wistar rats, we evaluated the separate action of each fatty acid at the corresponding concentrations previously found in human amniotic fluid on anxiety-like behaviour. Individual effects were compared with vehicle, an artificial mixture of the same eight fatty acids, and a reference anxiolytic drug (diazepam, 2 mg/kg. Myristic acid, the fatty acid mixture, and diazepam increased the time spent in the open arms of the elevated plus maze and reduced the anxiety index compared with vehicle, without altering general locomotor activity. The other fatty acids had no effect on anxiety-like behaviour, but oleic acid reduced locomotor activity. Additionally, myristic acid produced anxiolytic-like effects only when the concentration corresponded to the one identified in human amniotic fluid (30 g/mL but did not alter locomotor activity. We conclude that of the eight fatty acids contained in the fatty acid mixture, only myristic acid produces anxiolytic-like effects when administered individually at a similar concentration detected in human amniotic fluid.

  12. Nonmedical Use of Antihistaminergic Anxiolytics and Other Prescription Drugs among Persons with Opioid Dependence.

    Science.gov (United States)

    Dahlman, Disa; Abrahamsson, Tove; Kral, Alex H; Hakansson, Anders

    2016-01-01

    Background . Nonmedical prescription drug use (NMPDU) is an increasing problem, insufficiently studied among people in opioid maintenance treatment (OMT). This study investigates the prevalence of and factors associated with NMPDU for drug classes insufficiently described in opioid-dependent populations, including antihistaminergic anxiolytics and central stimulants. Methods . Study participants were recruited at two OMT clinics in Malmo, Sweden, between October 2014 and December 2015 ( N = 73) and interviewed about their use, motivations for use, and acquisition and administration of prescription drugs. Results . The majority of the sample reported lifetime NMPDU: 60% for benzodiazepine-like hypnotics (z-drugs), 21% for pregabalin, 19% for stimulants, and 12%-15% for antihistaminergic anxiolytics. Lower age was associated with nonmedical benzodiazepine use (Adjusted Odds Ratio = 0.89; 95% Confidence Interval = 0.82-0.97). Illicit acquisition was reported by 61% of people using z-drugs, 46% of people using pregabalin, and 38% of people using prescription stimulants, but only by 6-10% of people using antihistaminergic anxiolytics. Conclusions . The substantial nonmedical use of pregabalin, z-drugs, and prescription stimulants found in this study suggests that clinicians should prescribe these drugs with great caution. Nonmedical use of antihistaminergic anxiolytics does not seem to be a clinical issue among people in OMT in a Swedish setting, but we propose future studies to monitor their use.

  13. The anxiolytic effects of a Valerian extract is based on valerenic acid.

    Science.gov (United States)

    Becker, Axel; Felgentreff, Falko; Schröder, Helmut; Meier, Beat; Brattström, Axel

    2014-07-28

    Valerian is commonly used for the treatment of insomnia and anxiety. Valerian extracts allosterically modulate GABA-A receptors and induced an anxiolytic activity. This activity is closely related to valerenic acid. In the present experiments it was investigated whether acetoxy valerenic acid may interfere with the anxiolytic action of valerenic acid. Situational anxiety was measured using male CD-1 mice in the elevated plus maze test after oral administration of the test substances. In addition the body core temperature was measured. For the 3H-GABA binding assay dissected tissue from frontal cortex of male RjHan:WI rats were used. Statistical evaluation was performed by means of the non-parametric Kruskal-Wallies H-test, followed by the two-tailed Mann-Whitney U-test. Adding of acetoxy valerenic acid abolished the anxiolytic action of valerenic acid. There was no effect on body core temperature. Moreover, the valerian extract did not show any affinity to benzodiazepine binding sites. The determining compound for the observed anxiolytic effect of the valerian extract is its content of valerenic acid.

  14. Prescription pattern of anxiolytic drugs in burn patients: a case study ...

    African Journals Online (AJOL)

    Anxiolytic drugs are essential in the management of cases where anxiety and insomnia are likely to be found. This study was therefore carried out to determine the prescription pattern of these drugs on burn patients and to ascertain their relevance in burn therapy. The study was carried out retrospectively by evaluating ...

  15. Preclinical anxiolytic profiles of 7189 and 8319, novel non-competitive NMDA antagonists

    International Nuclear Information System (INIS)

    Dunn, R.W.; Corbett, R.; Martin, L.L.; Payack, J.F.; Laws-Ricker, L.; Wilmot, C.A.; Rush, D.K.; Cornfeldt, M.L.; Fielding, S.

    1990-01-01

    Antagonists at excitatory amino acid receptors, especially the N-methyl-d-aspartate (NMDA) subtype, have been shown to possess anticonvulsant and anxiolytic properties. Two closely related benzeneethanamines, are potential novel anxiolytic agents which bind with high affinity to the NMDA receptor at the non-competitive site and are relatively non-toxic (LD50's-160 mg/kg, ip). 7189 and 8319 showed anxiolytic effects in schedule controlled conflict assays as well as in the social interaction (SI) and elevated plus maze (EPM) procedures in rats. Following intraperitoneal administration of 7189 at 20 to 60 mg/kg, conflict responding was increased from 2- to 7-fold in the modified Cook and Davidson and Geller conflict paradigms. 8319, at 2.5 to 5 mg/kg, produced a two fold increase in conflict responding. In the non-schedule controlled procedures, 7189 at 20 mg/kg increased SI time by 23% while in the EPM at 10 to 20 mg/kg, open arm exploration time increased by 41 to 77%. Likewise, 8319 at 2.5 and 5 mg/kg increased open arm exploration and SI time by 50 and 37%, respectively. In summary, 7189 and 8319 were efficacious in four behavioral procedures predictive of potential anxiolytic agents. Although these compounds have not been submitted for clinical evaluation, they may represent a new class of beneficial compounds for the treatment of anxiety

  16. Sexual dysfunction related to psychotropic drugs: a critical review. Part III: mood stabilizers and anxiolytic drugs.

    Science.gov (United States)

    La Torre, A; Giupponi, G; Duffy, D M; Pompili, M; Grözinger, M; Kapfhammer, H P; Conca, A

    2014-01-01

    Sexual dysfunction is a potential side effect of mood stabilizers and anxiolytic drugs: this article presents a critical review of the current literature. Although many studies have been published on sexual side effects of psychopharmacological treatment, only a minority relate to mood stabilizers and anxiolytic drugs. Most of these studies are not methodologically robust, few are RCTs and most did not use a validated rating scale to evaluate sexual functioning. In addition, many of the studies on sexual dysfunction associated with mood stabilizers and anxiolytic drugs are limited by other methodological flaws. While there is evidence to suggest that mood stabilizers, with some exceptions, negatively affect sexual functioning, there is still insufficient evidence to draw any clear conclusions about the effects of anxiolytic drugs on sexual function. There is some weak evidence to indicate that switching from enzyme-inducing to non-enzyme-inducing anticonvulsant drugs, could be clinically useful. Some researchers recommend that sexual dysfunction in patients taking antiepileptic drugs should in general be treated according to standard guidelines for the management of sexual dysfunction, since reliable data on special populations is not available. However, specific approaches may be useful, but cannot yet be recommended until further validating research has been conducted. We did not find evidence supporting the use of any specific treatment strategy for sexual dysfunction associated with anxiolytic treatment. This study was conducted in 2013 using the paper and electronic resources of the library of the Azienda Provinciale per i Servizi Sanitari (APSS) in Trento, Italy (http://atoz.ebsco.com/Titles/2793). The library has access to a wide range of databases including DYNAMED, MEDLINE Full Text, CINAHL Plus Full Text, The Cochrane Library, Micromedex healthcare series, BMJ Clinical Evidence. The full list of available journals can be viewed at http

  17. The effect of antidepressants on fertility.

    Science.gov (United States)

    Casilla-Lennon, Marianne M; Meltzer-Brody, Samantha; Steiner, Anne Z

    2016-09-01

    Information on the effects of different pharmaceuticals on fertility is sparse. Human and animal models indicate that antidepressant use could have a negative effect on fertility through alteration of levels of the neurosteroid, allopregnanolone. The objective of this study is to assess the effects of antidepressants on the natural fertility in women. A secondary analysis of data from Time to Conceive, a prospective cohort study, was conducted. Women ages 30 to 44 years without a history of infertility, early in their attempts to conceive, were followed with standardized pregnancy testing until pregnancy was detected. Medication use was assessed at enrollment, daily for up to 4 months, and then monthly. For this analysis, discrete time regression models were created to calculate the association between antidepressant use and fecundability. Potential confounders-age, body mass index, caffeine, alcohol use, and education-were included in all models. Ninety-two (9.6%) of 957 women reported antidepressant use while attempting to conceive. Women taking antidepressants were more likely to be non-Hispanic Caucasian (91% vs 75%, P Antidepressant use at enrollment had an adjusted fecundability ratio (FR) of 0.86 (95% confidence interval [CI], 0.63-1.20). However, time-varying analyses suggested that antidepressant use in a given cycle is associated with a reduced probability of conceiving in that cycle (adjusted FR, 0.75; 95% CI, 0.53-1.06). After adjusting for history of depression or restricting the analysis to women who reported a history of depression, the association between antidepressant use and decreased fecundability remained [adjusted FR, 0.66 (95% CI, 0.45-0.97) and (adjusted FR, 0.64; 95% CI, 0.43-0.94), respectively]. Our data suggest that antidepressants may reduce the probability of a woman with a history of depression to conceive naturally. Future studies are needed to differentiate the extent to which this association is due to the antidepressant itself

  18. An assessment of quality of sleep and the use of drugs with sedating properties in hospitalized adult patients

    Directory of Open Access Journals (Sweden)

    Naumann Terryn

    2004-03-01

    Full Text Available Abstract Background Hospitalization can significantly disrupt sleeping patterns. In consideration of the previous reports of insomnia and apparent widespread use of benzodiazepines and other hypnotics in hospitalized patients, we conducted a study to assess quality of sleep and hypnotic drug use in our acute care adult patient population. The primary objectives of this study were to assess sleep disturbance and its determinants including the use of drugs with sedating properties. Methods This single-centre prospective study involved an assessment of sleep quality for consenting patients admitted to the general medicine and family practice units of an acute care Canadian hospital. A validated Verran and Snyder-Halpern (VSH Sleep Scale measuring sleep disturbance, sleep effectiveness, and sleep supplementation was completed daily by patients and scores were compared to population statistics. Patients were also asked to identify factors influencing sleep while in hospital, and sedating drug use prior to and during hospitalization was also assessed. Results During the 70-day study period, 100 patients completed at least one sleep questionnaire. There was a relatively even distribution of males versus females, most patients were in their 8th decade of life, retired, and suffered from multiple chronic diseases. The median self-reported pre-admission sleep duration for participants was 8 hours and our review of PharmaNetR profiles revealed that 35 (35% patients had received a dispensed prescription for a hypnotic or antidepressant drug in the 3-month period prior to admission. Benzodiazepines were the most common sedating drugs prescribed. Over 300 sleep disturbance, effective and supplementation scores were completed. Sleep disturbance scores across all study days ranged 16–681, sleep effectiveness scores ranged 54–402, while sleep supplementation scores ranged between 0–358. Patients tended to have worse sleep scores as compared to healthy non

  19. Sedation during bronchoscopy: data from a nationwide sedation and monitoring survey.

    Science.gov (United States)

    Gaisl, Thomas; Bratton, Daniel J; Heuss, Ludwig T; Kohler, Malcolm; Schlatzer, Christian; Zalunardo, Marco P; Frey, Martin; Franzen, Daniel

    2016-08-05

    There is limited knowledge on practice patterns in procedural sedation and analgesia (PSA), the use of propofol, and monitoring during flexible bronchoscopy (FB). The purpose of this study was to assess the current practice patterns of FBs and to focus on the use of propofol, the education of the proceduralist, and the involvement of anaesthesiologists during FB. An anonymous questionnaire was sent to 299 pulmonologists. Only respondents who were active physicians in adult respiratory medicine performing FB were subsequently analysed. The response rate was 78 % and 27,149 FB in the previous 12 months were analysed. The overall sedation-related morbidity rate was 0.02 % and mortality was 7/100'000 FB. Sedation was used in 95 % of bronchoscopies. The main drugs used for PSA were propofol (77 %) and midazolam (46 %). In 84 % of PSAs propofol was used without the attendance of an anaesthesiologist. The use of propofol was associated with high volume bronchoscopists (p vital parameters has become standard practice, pulmonologists reported a very low rate of systematic basic education and training in the field of PSA (50 %). In Switzerland, PSA during FB is mostly performed with propofol without the attendance of an anaesthesiologist and the use of this drug is expected to increase in the future. While monitoring standards are very high there is need for policies to improve education, systematic training, and support for pulmonologists for PSA during FB.

  20. Anxiolytic-Like Effects of Increased Ghrelin Receptor Signaling in the Amygdala.

    Science.gov (United States)

    Jensen, Morten; Ratner, Cecilia; Rudenko, Olga; Christiansen, Søren H; Skov, Louise J; Hundahl, Cecilie; Woldbye, David P D; Holst, Birgitte

    2016-05-01

    Besides the well-known effects of ghrelin on adiposity and food intake regulation, the ghrelin system has been shown to regulate aspects of behavior including anxiety and stress. However, the effect of virus-mediated overexpression of the ghrelin receptor in the amygdala has not previously been addressed directly. First, we examined the acute effect of peripheral ghrelin administration on anxiety- and depression-like behavior using the open field, elevated plus maze, forced swim, and tail suspension tests. Next, we examined the effect of peripheral ghrelin administration and ghrelin receptor deficiency on stress in a familiar and social environment using the Intellicage system. Importantly, we also used a novel approach to study ghrelin receptor signaling in the brain by overexpressing the ghrelin receptor in the amygdala. We examined the effect of ghrelin receptor overexpression on anxiety-related behavior before and after acute stress and measured the modulation of serotonin receptor expression. We found that ghrelin caused an anxiolytic-like effect in both the open field and elevated plus maze tests. Additionally, it attenuated air-puff-induced stress in the social environment, while the opposite was shown in ghrelin receptor deficient mice. Finally, we found that overexpression of the ghrelin receptor in the basolateral division of the amygdala caused an anxiolytic-like effect and decreased the 5HT1a receptor expression. Ghrelin administration and overexpression of the ghrelin receptor in the amygdala induces anxiolytic-like behavior. Since the ghrelin receptor has high constitutive activity, ligand-independent signaling in vivo may be important for the observed anxiolytic-like effects. The anxiolytic effects seem to be mediated independently from the HPA axis, potentially engaging the central serotonin system. © The Author 2015. Published by Oxford University Press on behalf of CINP.

  1. Involvement of Nitric Oxide System on Anxiolytic-Like Behaviors Induced by Cholestasiss

    Directory of Open Access Journals (Sweden)

    Mohammad Nasehi

    2012-09-01

    Full Text Available Introduction: The mechanisms of hepatic encephalopathy are not fully understood. Moreover, there is no comprehensive data concerning the effects of nitric oxide (NO system on anxiolytic-like behaviors induced by bile duct ligation (BDL. Methods: Male mice weighing 25-30 g were used and anxiety-like behaviors were tested using hole-board task. Results: The data indicated that cholestasis increased the number of head-dipping but did not alter other aspects of behavior, 7 days after BDL, suggesting an anxiolytic-like response. Furthermore, the results showed that intraperitoneal (i.p. injection of L-arginine (200 and 250 mg/kg 15 min before testing induced anxiolytic-like behaviors in the normal animals, 4 and 7 days after BDL (considering that the dose of 200 mg in the normal mice is ineffective but is effective in the BDL mice. On the other hand, injection of L-NAME (35 and 45 mg/kg, i.p. 15 min before testing induced anxiogenic-like behaviors in the normal animals, 4 and 7 days after BDL (the dose of 35 mg/kg in the normal mice is ineffective but is effective in the BDL mice . Moreover, injection of ineffective doses of L-NAME (25 and 35 mg/kg, i.p. 15 min before administration of L-arginine (250 mg/kg, i.p. and 7 days after BDL, decreased anxiolytic-like behaviors, signi.cantly. Discussion: Cholestatic mice show anxiolytic-like behaviors suggesting the involvement of the nitric oxide system.

  2. [Recommendations for analgesia and sedation in neonatal intensive care].

    Science.gov (United States)

    Rawicz, Marcin

    2008-01-01

    The purpose of the study was to present recommendations, relevant to the management of neonates and infants aged 0-1 years, treated in intensive care settings. They include general principles and recommendations for pain and sedation assessment, sedation and pain management and advice on the use of pharmacological strategies. The bolus (on demand) administration of sedative agents should be avoided because of increased risk of cardiovascular depression and/or neurological complications. Midazolam administration time should be limited to 72 hours because of tachyphylaxis, and the possibility of development of a withdrawal syndrome and neurological complications (grade A, LOE 1b). The level of sedation and pain should be regularly assessed and documented, using presented scales; the COMFORT scale is preferred. Opioids, given in continuous infusion, are the drugs of choice for neonatal sedation. To avoid withdrawal syndrome, the total doses and time of administration of sedative agents should be limited. Methadone is a drug of choice in the treatment of a withdrawal (Grade B, LOE 2). Intravenous ketamine is recommended, when short-term sedation/anaesthesia is required (Grade C, LOE 3) for painful and/or stressful intensive care procedures. (Grade C, LOE 2). Muscle relaxants should be used for endotracheal intubation and in the situations when mechanical ventilation is not possible due to maximal respiratory effort of the patient.

  3. Patient satisfaction with procedural sedation in the emergency department.

    Science.gov (United States)

    Johnson, Olivia G; Taylor, David McD; Lee, Marina; Ding, Juen-Li; Ashok, Aadith; Johnson, Damian; Peck, Daniel; Knott, Jonathan; Weinberg, Laurence

    2017-06-01

    The aim of this study was to determine patient satisfaction with procedural sedation as a function of nature of the procedure and depth of sedation. We undertook a prospective observational study of adult patients who received procedural sedation in two EDs (20 month period). The level of sedation was determined by an investigator, using the Observers Assessment of Anaesthesia/Sedation Scale (1 = awake to 6 = no response to noxious stimuli). Patient satisfaction was measured with the Iowa Satisfaction with Anaesthesia Scale after full recovery. This was self-administered, comprised 11 items (e.g. 'I felt pain') and has a score range of -3 (poor satisfaction) to +3 (very satisfied). A total of 163 patients were enrolled (51.2% men, mean age 50.7 years). The median (interquartile range) satisfaction score was 2.7 (0.7). Patient satisfaction was lower among patients who had orthopaedic procedures (median 2.6 vs 2.8, P patient satisfaction is high. Greater satisfaction is associated with deeper sedation, sedation with propofol and non-orthopaedic procedures. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  4. Polypharmacy with antidepressants in children and adolescents.

    Science.gov (United States)

    Díaz-Caneja, Covadonga M; Espliego, Ana; Parellada, Mara; Arango, Celso; Moreno, Carmen

    2014-07-01

    The aim of this study was to review current epidemiological data on the use of antidepressants in co-prescription with other psychotropic drugs in children and adolescents, as well as available efficacy and safety information. A Medline search from inception until February 2012 was performed to identify epidemiological and clinical studies, reviews and reports containing potentially relevant information on polypharmacy with antidepressants in young people. There has been an increase in polypharmacy in children and adolescents involving antidepressants in recent years. Antidepressants have become one of the drug classes most frequently prescribed in combination and are commonly co-prescribed with stimulants and antipsychotics. Most information regarding efficacy and safety of polypharmacy patterns was provided by case series and open-label studies. Efficacy studies gave some support for the use of a combination of antidepressants and antipsychotics in the management of refractory obsessive-compulsive disorder and some residual symptoms in major depressive disorder. Even less empirical support was found for a combination of stimulants and antidepressants in co-morbid attention deficit hyperactivity disorder and mood or anxiety disorders. Adverse events were similar to those found with individual medication groups, with severe adverse events mostly reported by individual case reports. The use of polypharmacy with antidepressants has become a regular practice in clinical settings. Although there is still little efficacy and safety information, preliminary evidence points to the potential clinical usefulness of some polypharmacy patterns. Further research on patients with co-morbidities or more severe conditions is needed, in order to improve knowledge of this issue.

  5. Antidepressant use and risk for preeclampsia.

    Science.gov (United States)

    Palmsten, Kristin; Huybrechts, Krista F; Michels, Karin B; Williams, Paige L; Mogun, Helen; Setoguchi, Soko; Hernández-Díaz, Sonia

    2013-09-01

    Prior studies suggest that women who use antidepressants during pregnancy have an increased risk for preeclampsia, yet the comparative safety of specific antidepressants remains unclear. US nationwide Medicaid Analytic eXtract (MAX) data have not been used to study medication safety during pregnancy. We identified 100,942 pregnant women with depression from 2000 to 2007 MAX data. We used pharmacy dispensing records to ascertain exposure to selective serotonin reuptake inhibitor (SSRI), serotonin-norepenephrine reuptake inhibitor (SNRI), tricyclic, bupropion, other antidepressant monotherapy or polytherapy, and specific antidepressants, during the second trimester and first half of the third trimester. Relative risks (RRs) and 95% confidence intervals (CIs) were adjusted for delivery year, preeclampsia risk factors, depression severity proxies, other antidepressant indications, other medications, and healthcare utilization. The risk of preeclampsia was 5.4% among women with depression and no antidepressant exposure. Compared with these women, the risk for preeclampsia was higher among those receiving SNRI (RR: 1.52, 95% CI = 1.26-1.83) and tricyclic monotherapy (RR: 1.62, 95% CI = 1.23-2.12), but not SSRI monotherapy (RR: 1.00, 95% CI = 0.93-1.07) or other antidepressants. Compared with women receiving SSRI monotherapy, preeclampsia risk was higher among women with SNRI (RR: 1.54, 95% CI = 1.28-1.86) and tricyclic (RR: 1.64, 95% CI = 1.25-2.16) monotherapy. None of the specific SSRIs was associated with preeclampsia. The RR with venlafaxine was 1.57 (95% CI = 1.29-1.91) and with amitriptyline 1.72 (95% CI = 1.24-2.40). In this population, SNRIs and tricyclics were associated with a higher risk of preeclampsia than SSRIs.

  6. Antidepressant effects of ketamine: mechanisms underlying fast-acting novel antidepressants

    Directory of Open Access Journals (Sweden)

    Caroline Ann Browne

    2013-12-01

    Full Text Available Newer antidepressants are needed for the many individuals with major depressive disorder that do not respond adequately to treatment and because of a delay of weeks before the emergence of therapeutic effects. Recent evidence from clinical trials shows that the NMDA antagonist ketamine is a revolutionary novel antidepressant because it acts rapidly and is effective for treatment-resistant patients. A single infusion of ketamine alleviates depressive symptoms in treatment-resistant depressed patients within hours and these effects may be sustained for up to 2 weeks. Although the discovery of ketamine’s effects has reshaped drug discovery for antidepressants, the psychotomimetic properties of this compound limit the use of this therapy to the most severely ill patients. In order to develop additional antidepressants like ketamine, adequate preclinical behavioral screening paradigms for fast-acting antidepressants need to be established and used to identify the underlying neural mechanisms. This review examines the preclinical literature attempting to model the antidepressant-like effects of ketamine. Acute administration of ketamine has produced effects in behavioral screens for antidepressants like the forced swim test, novelty suppression of feeding and in rodent models for depression. Protracted behavioral effects of ketamine have been reported to appear after a single treatment that last for days. This temporal pattern is similar to its clinical effects and may serve as a new animal paradigm for rapid antidepressant effects in humans. In addition, protracted changes in molecules mediating synaptic plasticity have been implicated in mediating the antidepressant-like behavioral effects of ketamine. Current preclinical studies are examining compounds with more specific pharmacological effects at glutamate receptors and synapses in order to develop additional rapidly acting antidepressants without the hallucinogenic side effects or abuse

  7. Escitalopram versus other antidepressive agents for depression

    Science.gov (United States)

    Cipriani, Andrea; Santilli, Claudio; Furukawa, Toshi A; Signoretti, Alessandra; Nakagawa, Atsuo; McGuire, Hugh; Churchill, Rachel; Barbui, Corrado

    2014-01-01

    Background Although pharmacological and psychological interventions are both effective for major depression, antidepressant drugs remain the mainstay of treatment in primary and secondary care settings. During the last 20 years, antidepressant prescribing has risen dramatically in western countries, mainly because of the increasing consumption of selective serotonin reuptake inhibitors (SSRIs) and newer antidepressants, which have progressively become the most commonly prescribed antidepressants. Escitalopram is the pure S-enantiomer of the racemic citalopram. Objectives To assess the evidence for the efficacy, acceptability and tolerability of escitalopram in comparison with tricyclics, other SSRIs, heterocyclics and newer agents in the acute-phase treatment of major depression. Search methods Electronic databases were searched up to July 2008. Trial databases of drug-approving agencies were hand-searched for published, unpublished and ongoing controlled trials. Selection criteria All randomised controlled trials comparing escitalopram against any other antidepressant (including non-conventional agents such as hypericum) for patients with major depressive disorder (regardless of the diagnostic criteria used). Data collection and analysis Data were entered by two review authors (double data entry). Responders and remitters to treatment were calculated on an intention-to-treat basis. For dichotomous data, odds ratios (ORs) were calculated with 95% confidence intervals (CI). Continuous data were analysed using standardised mean differences (with 95% CI) using the random effects model. Main results Fourteen trials compared escitalopram with another SSRI and eight compared escitalopram with a newer antidepressive agent (venlafaxine, bupropion and duloxetine). Escitalopram was shown to be significantly more effective than citalopram in achieving acute response (OR 0.67, 95% CI 0.50 to 0.87). Escitalopram was also more effective than citalopram in terms of remission (OR

  8. Nurse administered propofol sedation for pulmonary endoscopies requires a specific protocol

    DEFF Research Database (Denmark)

    Jensen, Jeppe Thue; Banning, Anne-Marie; Clementsen, Paul

    2012-01-01

    This study provides an evaluation and risk analysis of propofol sedation for endoscopic pulmonary procedures according to our unit's "gastroenterologic nurse-administered propofol sedation (NAPS) guideline".......This study provides an evaluation and risk analysis of propofol sedation for endoscopic pulmonary procedures according to our unit's "gastroenterologic nurse-administered propofol sedation (NAPS) guideline"....

  9. Propofol vs pentobarbital for sedation of children undergoing magnetic resonance imaging: results from the Pediatric Sedation Research Consortium.

    Science.gov (United States)

    Mallory, Michael D; Baxter, Amy L; Kost, Susanne I

    2009-06-01

    Pentobarbital and propofol are commonly used to sedate children undergoing magnetic resonance imaging (MRI). The Pediatric Sedation Research Consortium (PSRC) was created in 2003 to improve pediatric sedation process and outcomes. To use PSRC records to compare the effectiveness, efficiency and adverse events of propofol vs pentobarbital for sedation of children undergoing MRI. Pediatric Sedation Research Consortium records of children aged 6 months to 6 years who were primarily sedated with either i.v. pentobarbital or propofol were included. Participating PSRC investigators obtained institutional review board approval before data collection. Of 11 846 sedations for MRI, 7079 met inclusion criteria (propofol: n = 5072; pentobarbital: n = 2007). Demographic details were similar between the two groups. Ideal sedation was produced in 96.45% of the pentobarbital group and in 96.8% of the propofol group (P = 0.478), but pentobarbital was more likely to result in poor sedation cancelling the procedure (OR 5.88; CI 2.24, 15.40). Propofol resulted in physiologic changes more frequently than did pentobarbital (OR 5.69; CI 1.35, 23.97). Pentobarbital was associated with prolonged recovery (OR 16.82; CI 4.98, 56.8), unplanned admission (OR 5.60; CI 1.02, 30.82), vomiting (OR 36.76; CI 4.84, 279.2) and allergic complication (OR 9.15; CI 1.02, 82.34). The incidence of airway complications was not significantly different between the two. The median recovery time for patients receiving propofol was 30 min, whereas for pentobarbital it was 75 min (P pentobarbital for children undergoing MRI. Although apnea occurred with a greater frequency in patients who received propofol, the rate of apnea and airway complications for propofol was not statistically different from that seen in patients who received pentobarbital.

  10. Antidepressant medication and the risk of pregnancy-induced hypertension

    NARCIS (Netherlands)

    Ter Heijne, Loes F.; Zakiyah, Neily; Bos, Jens H.J.; Hak, Eelko; Schuiling-Veninga, Catharina C.M.

    2016-01-01

    Background: Increased activity of the sympatic nervous system could possibly cause pregnancy-induced hypertension (PIH). Previous studies have suggested that antidepressants could contribute to this increased activity. Objectives: To examine whether the use of antidepressants during pregnancy

  11. Coumarin Compounds of Biebersteinia Multifida Roots Show Potential Anxiolytic Effects In Mice

    Directory of Open Access Journals (Sweden)

    Hamid Reza Monsef-Esfahani

    2013-06-01

    Full Text Available Background:Traditional preparations of the root of Biebersteinia multifida DC (Geraniaceae, a native medicinal plant of Irano-Turanian floristic region, have been used for the treatment of phobias as anxiolytic herbal preparation.Methods:We utilized the phobic behavior of mice in an elevated plus-maze as a model to evaluate the anxiolytic effect of the plant extract and bio-guided fractionation was applied to isolate the active compounds. Total root extract, alkaline and ether fraction were administered to mice at different doses 30 and 90 min prior to the maze test. Saline and diazepam were administered as negative and positive controls, respectively. The time spent in open and closed arms, an index of anxiety behavior and entry time, was measured as an index of animal activity.Results:The total root extract exhibited anxiolytic effect which was comparable to diazepam but with longer duration. This sustained effect of the crude extract was sustained for 90 min and was even more after injection of 45 mg/kg while the effect of diazepam had been reduced by 90 min. The anxiolytic effect factor was only present in the alkaline fraction and displayed its effect at lower doses than diazepam while pure vasicinone as the previously known alkaloid did not shown anxiolytic effect. The effect of the alkaline fraction was in a dose dependent manner starting at 0.2 mg/kg with a maximum at 1.0 mg/kg. Bio-guided fractionation using a variety of chromatographic methods led to isolation and purification of three coumarin derivatives from the bioactive fraction, including umbelliferone, scopoletin, and ferulic acid.Conclusion:For the first time, bio-guided fractionation of the root extract of B. multifida indicates significant sustained anxiolytic effects which led to isolation of three coumarin derivatives with well-known potent MAO inhibitory and anti-anxiety effects. These data contribute to evidence-based traditional use of B. multifida root for anxiety

  12. Could conscious sedation with midazolam for dental procedures be ...

    African Journals Online (AJOL)

    2012-04-25

    Wilk test. As the data ... recovery, whereas patients under GA experienced a more tranquil phase during recovery. .... Evaluation of SEDline to improve the safety and efficiency of conscious sedation. Proc (Bayl Univ Med Cent) ...

  13. Hypnosis for sedation in transesophageal echocardiography: a comparison with midazolam.

    Science.gov (United States)

    Eren, Gulay; Dogan, Yuksel; Demir, Guray; Tulubas, Evrim; Hergunsel, Oya; Tekdos, Yasemin; Dogan, Murat; Bilgi, Deniz; Abut, Yesim

    2015-01-01

    Transesophageal echocardiography (TEE), being a displeasing intervention, usually entails sedation. We aimed to compare the effects of hypnosis and midazolam for sedation in TEE. A prospective single-blinded study conducted on patients scheduled for TEE between April 2011 and July 2011 at a university in Istanbul, Turkey. A total of 41 patients underwent sedation using midazolam and 45 patients underwent hypnosis. Patients were given the State-Trait Anxiety Inventory (STAI) test for anxiety and continuous performance test (CPT) for alertness before and after the procedure. The difficulty of probing and the overall procedure rated by the cardiologist and satisfaction scores of the patients were also documented. Anxiety was found to be less and attention more in the hypnosis group, as revealed by STAI and CPT test scores (P Hypnosis proved to be associated with positive therapeutic outcomes for TEE with regard to alleviation of anxiety and maintenance of vigilance, thus providing more satisfaction compared to sedation with midazolam.

  14. Sedation of Pediatric Patients in Magnetic Resonance Imaging

    National Research Council Canada - National Science Library

    Ricks, Alesia

    2000-01-01

    .... The purpose of this study was to explore the combination sedative of ketamine, midazolam, and atropine administered intramuscularly and determine if it is safe and effective for pediatric patients...

  15. Assessment of buccal aerosolized midazolam for pediatric conscious sedation.

    Science.gov (United States)

    Chopra, Radhika; Marwaha, Mohita

    2015-02-01

    To assess the acceptance and efficacy of aerosolized midazolam through buccal mucosa for conscious sedation. Thirty-five children aged 2-6 years with Grade I and II Frankl behavior rating scale were selected for various dental procedures under local anesthesia. Initially behavior-shaping procedures were used and Houpt behavior scoring was recorded. Thereafter, midazolam was administered using a spray through buccal mucosa and scores for acceptance of drug and behavior after sedation were recorded. The data were compiled and a Wilcoxon signed ranks test was used to assess the difference in behavior before and after the sedation. Eighty-three percent of the patients accepted the drug without any complaint. A statistically significant improvement was seen in the Houpt scores before and after drug administration (P < 0.001). Buccal aerosolized midazolam can be used successfully for pediatric conscious sedation. © 2013 Wiley Publishing Asia Pty Ltd.

  16. Positron emission tomography evaluation of sedative properties of antihistamines.

    Science.gov (United States)

    Yanai, Kazuhiko; Zhang, Dongying; Tashiro, Manabu; Yoshikawa, Takeo; Naganuma, Fumito; Harada, Ryuichi; Nakamura, Tadaho; Shibuya, Katsuhiko; Okamura, Nobuyuki

    2011-07-01

    H(1) antihistamines are often used in the medication for allergic diseases, coughs and colds, and insomnia, with or without prescription, even though their sedative properties are a potentially dangerous unwanted side effect that is not properly recognized. These sedative properties have been evaluated using the incidence of subjective sleepiness, objective cognitive and psychomotor functions, and positron emission tomography (PET) measurement of H(1) receptor occupancy. This article reviews the current updated literature on the sedative properties of antihistamines examined by PET measurement of H(1) receptor occupancy. The use of PET to examine antihistamine penetration in the human brain in relation to psychometric and other functional measures of CNS effects is a major breakthrough and provides a new standard by which the functional CNS effects of antihistamines can be related directly to H(1) receptor occupancy. Therapy with antihistamines can be better guided by considering histamine H(1) receptor occupancy from the view of their sedative properties.

  17. Chirality of Modern Antidepressants: An Overview

    Directory of Open Access Journals (Sweden)

    Monica Budău

    2017-12-01

    Full Text Available The majority of modern antidepressants (selective serotonin reuptake inhibitors and selective serotonin and norepinephrine reuptake inhibitors have one or two centers of asymmetry in their structure; resulting in the formation of enantiomers which may exhibit different pharmacodynamic and pharmacokinetic properties. Recent developments in drug stereochemistry has led to understanding the role of chirality in modern therapy correlated with increased knowledge regarding the molecular structure of specific drug targets and towards the possible advantages of using pure enantiomers instead of racemic mixtures. The current review deals with chiral antidepressant drugs; presenting examples of stereoselectivity in the pharmacological actions of certain antidepressants and their metabolites and emphasizing the differences between pharmacological actions of the racemates and pure enantiomers.

  18. Hippocampal Neurogenesis, Depressive Disorders, and Antidepressant Therapy

    Directory of Open Access Journals (Sweden)

    Eleni Paizanis

    2007-01-01

    Full Text Available There is a growing body of evidence that neural stem cells reside in the adult central nervous system where neurogenesis occurs throughout lifespan. Neurogenesis concerns mainly two areas in the brain: the subgranular zone of the dentate gyrus in the hippocampus and the subventricular zone, where it is controlled by several trophic factors and neuroactive molecules. Neurogenesis is involved in processes such as learning and memory and accumulating evidence implicates hippocampal neurogenesis in the physiopathology of depression. We herein review experimental and clinical data demonstrating that stress and antidepressant treatments affect neurogenesis in opposite direction in rodents. In particular, the stimulation of hippocampal neurogenesis by all types of antidepressant drugs supports the view that neuroplastic phenomena are involved in the physiopathology of depression and underlie—at least partly—antidepressant therapy.

  19. [Modification of sexual functions by antidepressants].

    Science.gov (United States)

    Baier, D; Philipp, M

    1994-01-01

    Sexual dysfunctions appear to be frequently occurring adverse events in treatment with antidepressants. Due to methodological reasons, a reliable estimation of the frequency of such events is currently not yet possible. There is evidence, that antidepressants could be differentiated with respect to their potency and specificity for disturbances of certain sexual subfunctions according to their pharmacological profile. With SSRIs in particular impaired functions of orgasm and ejaculation can be observed. No deteriorations are reported for buproprion and an improvement of sexual dysfunctions within the course of treatment for moclobemide. Viloxazine and trazodone appear to possess marked stimulating effects on libido and erectile functions. Generally the incidence of sexual adverse events is underestimated, although there is a pronounced impact on patient compliance. Taking into account this well documented side effect, sexual impairments should be monitored carefully within antidepressive treatment.

  20. [Depression and treatment. Apoptosis, neuroplasticity and antidepressants].

    Science.gov (United States)

    Arantes-Gonçalves, Filipe; Coelho, Rui

    2006-01-01

    Depression's neurobiology begins to be better understood. The last decade data considers neuroplasticity and stress as implicated factors on the pathophisiology of depression. Because antidepressants have a lag-time on their action it is possible that inhibition of neurotransmitters recaptation is not sufficient to explain long term changes. For that purpose, neurogenesis increase, nervous fibers sprouting, new synapses and stabilization of the old ones can be responsible for those changes. AMPc-MAPcinases-CREB-BDNF cellular cascade can play a significant role in the mechanisms of dendritic restructuration, hippocampal neurogenesis increase and nervous cells survival. The aim of this article is to discuss if apoptosis could play a key role as an ethiopathogenic factor on the patogenesis of depression. It was done a medline search for references with apoptosis, stress, neuroplasticity, depression and antidepressants key-words. It were found 101 original or review references about these subjects. Stress plays a key role in the etiopathogeny of depression. Its deletery effects on apoptosis and neuroplasticity can be changed by antidepressants. Neurogenesis' increase is necessary for their action. This increase is reached with chronic antidepressant treatment and not with other psychotropic drugs which means some pharmacological specificity of antidepressants. AMPc, CREB, BDNF and Bcl-2 can be considered as target genes in antidepressant synthesis. At the level of this neurotrophic factors apoptosis might be included in the neuroplastic model of depression and play a prominent role in etiopathogeny of depression. To confirm that, we need more research on the field to know which are the mechanisms that trigger apoptosis and its biological significance. In relation to the last one, we can say that is possible to be physiological apoptosis in deteriorated neurons death which cannot make strong connections and pathological apoptosis because of stress via, namely, HPA axis.

  1. Cardiovascular Effects of Antidepressants and Mood Stabilizers

    Directory of Open Access Journals (Sweden)

    Javad Maleki

    2007-09-01

    Full Text Available  Depression is a serious disorder in today’s society, with the estimates of lifetime prevalence being as high as 21% of the general population in some developed countries. As defined by the American Psychiatric Association, depression is a heterogeneous disorder often manifested with symptoms at the psychological, behavioral, and physiological levels. Such patients are often reluctant to take synthetic antidepressants in their appropriate doses due to their anticipated side effects including inability to drive a car, dry mouth, constipation, and sexual dysfunction. As a therapeutic alternative, effective herbal drugs may offer advantages in terms of safety and tolerability, possibly also improving patient compliance. The advent of the first antidepressants, Monoamine Oxidase Inhibitors (MAOIs and Tricyclic Antidepressants (TCAs, in the 1950s and 1960s represented a dramatic leap forward in the clinical management of depression. The subsequent development of the Selective Serotonin Reuptake Inhibitors (SSRIs and the Serotonin Norepinephrine Reuptake Inhibitor (SNRI venlafaxine in the past decade and a half has greatly enhanced the treatment of depression by offering patients medications that are as effective as the older agents but are generally more tolerable and safer in an overdose. The introduction of atypical antidepressants, such as bupropion, nefazadone, and mirtazapine, has added substantially to the available pharmacopoeia for depression. Nonetheless, rates of remission tend to be low and the risk of relapse and recurrence remains high. One of the concerns regarding the safety of antidepressant is its potential risk of cardiotoxicity and cardiovascular side effects. In this review, we will focus on the cardiovascular side effects of different types of antidepressants.

  2. Cardiovascular Effects of Antidepressants and Mood Stabilizers

    Directory of Open Access Journals (Sweden)

    Shahin Akhondzadeh

    2007-08-01

    Full Text Available Depression is a serious disorder in today’s society, with the estimates of lifetime prevalence being as high as 21% of the general population in some developed countries. As defined by the American Psychiatric Association, depression is a heterogeneous disorder often manifested with symptoms at the psychological, behavioral, and physiological levels. Such patients are often reluctant to take synthetic antidepressants in their appropriate doses due to their anticipated side effects including inability to drive a car, dry mouth, constipation, and sexual dysfunction. As a therapeutic alternative, effective herbal drugs may offer advantages in terms of safety and tolerability, possibly also improving patient compliance. The advent of the first antidepressants, Monoamine Oxidase Inhibitors (MAOIs and Tricyclic Antidepressants (TCAs, in the 1950s and 1960s represented a dramatic leap forward in the clinical management of depression. The subsequent development of the Selective Serotonin Reuptake Inhibitors (SSRIs and the Serotonin Norepinephrine Reuptake Inhibitor (SNRI venlafaxine in the past decade and a half has greatly enhanced the treatment of depression by offering patients medications that are as effective as the older agents but are generally more tolerable and safer in an overdose. The introduction of atypical antidepressants, such as bupropion, nefazadone, and mirtazapine, has added substantially to the available pharmacopoeia for depression. Nonetheless, rates of remission tend to be low and the risk of relapse and recurrence remains high. One of the concerns regarding the safety of antidepressant is its potential risk of cardiotoxicity and cardiovascular side effects. In this review, we will focus on the cardiovascular side effects of different types of antidepressants.

  3. Balanced propofol sedation administered by nonanesthesiologists: The first Italian experience

    Science.gov (United States)

    Repici, Alessandro; Pagano, Nico; Hassan, Cesare; Carlino, Alessandra; Rando, Giacomo; Strangio, Giuseppe; Romeo, Fabio; Zullo, Angelo; Ferrara, Elisa; Vitetta, Eva; Ferreira, Daniel de Paula Pessoa; Danese, Silvio; Arosio, Massimo; Malesci, Alberto

    2011-01-01

    AIM: To assess the efficacy and safety of a balanced approach using midazolam in combination with propofol, administered by non-anesthesiologists, in a large series of diagnostic colonoscopies. METHODS: Consecutive patients undergoing diagnostic colonoscopy were sedated with a single dose of midazolam (0.05 mg/kg) and low-dose propofol (starter bolus of 0.5 mg/kg and repeated boluses of 10 to 20 mg). Induction time and deepest level of sedation, adverse and serious adverse events, as well as recovery times, were prospectively assessed. Cecal intubation and adenoma detection rates were also collected. RESULTS: Overall, 1593 eligible patients were included. The median dose of propofol administered was 70 mg (range: 40-120 mg), and the median dose of midazolam was 2.3 mg (range: 2-4 mg). Median induction time of sedation was 3 min (range: 1-4 min), and median recovery time was 23 min (range: 10-40 min). A moderate level of sedation was achieved in 1561 (98%) patients, whilst a deep sedation occurred in 32 (2%) cases. Transient oxygen desaturation requiring further oxygen supplementation occurred in 8 (0.46%; 95% CI: 0.2%-0.8%) patients. No serious adverse event was observed. Cecal intubation and adenoma detection rates were 93.5% and 23.4% (27.8% for male and 18.5% for female, subjects), respectively. CONCLUSION: A balanced sedation protocol provided a minimalization of the dose of propofol needed to target a moderate sedation for colonoscopy, resulting in a high safety profile for non-anesthesiologist propofol sedation. PMID:21987624

  4. Techniques to administer oral, inhalational, and IV sedation in dentistry

    OpenAIRE

    Diana Krystyna Harbuz; Michael O’Halloran

    2016-01-01

    Background Sedation in dentistry is a controversial topic given the variety of opinions regarding its safe practice. Aims This article evaluates the various techniques used to administer sedation in dentistry and specific methods practiced to form a recommendation for clinicians. Methods An extensive literature search was performed using PubMed, Medline, Google Scholar, Google, and local library resources. Results Most of the literature revealed a consensus that li...

  5. Pharmaco-Epidemiological Studies on Antidepressant Use in Older Adults

    NARCIS (Netherlands)

    R. Noordam (Raymond)

    2015-01-01

    markdownabstract__Abstract__ With the increasing number of patients using antidepressants, the number of patients at risk to develop antidepressant-associated adverse drug reactions is also increasing. However, there were not much studies conducted on antidepressant safety in older adults,

  6. Dealing With Depression: Antidepressant Skills for Teens

    OpenAIRE

    Bilsker, Dan; Gilbert, Merv; Worling, David; Garland, Jane

    2005-01-01

      Dealing with Depression is a workbook for teens that explains depression and teaches three main antidepressant skills you can use to help overcome or prevent it. The skills are presented in a step-by-step way so that you may learn them easily and apply them to your life. Sometimes these antidepressant skills can be used on their own, when the mood problem isn't too severe, and sometimes they have to be used along with treatments prescribed by professionals. Either way, practicing th...

  7. Poisoining with Tricyclic Antidepressants and Current Treatment

    Directory of Open Access Journals (Sweden)

    Muge Gulen

    2016-12-01

    Full Text Available Poisoning with tricyclic antidepressants is one of the main causes of morbidity and mortality compared to all the antidepressants. Main toxic effects are on the cardiovascular system and central nervous system and manifests itself as anticholinergic symptoms. There is no antidote known to be used in the treatment. But sodium bicarbonate treatment is effective in preventing ventricular arrhythmias and hypotension, and resolving metabolic acidosis. There are some treatments that has been used for relief of symptoms and some of them still are in research stage. The drugs that are used can be customized according to the patients symptoms. [Archives Medical Review Journal 2016; 25(4.000: 608-621

  8. Fospropofol Disodium for Sedation in Elderly Patients Undergoing Flexible Bronchoscopy.

    Science.gov (United States)

    Silvestri, Gerard A; Vincent, Brad D; Wahidi, Momen M

    2011-01-01

    BACKGROUND: Fospropofol disodium is a water-soluble prodrug of propofol. A subset analysis was undertaken of elderly patients (≥65 y) undergoing flexible bronchoscopy, who were part of a larger multicenter, randomized, double-blind study. METHODS: Patients received fentanyl citrate (50 mcg) followed by fospropofol at initial (4.88mg/kg) and supplemental (1.63mg/kg) doses. The primary end point was sedation success (3 consecutive Modified Observer's Assessment of Alertness/Sedation scores of ≤4 and procedure completion without alternative sedative or assisted ventilation). Treatment success, time to fully alert, patient and physician satisfaction, and safety/tolerability were also evaluated. RESULTS: In the elderly patients subset (n=61), sedation success was 92%, the mean time to fully alert was 8.0±10.9 min, and memory retention was 72% during recovery, and these were comparable with the younger patients subgroup (age, Sedation-related adverse events occurred in 23% of the elderly and 18% of the younger patients (age, sedation, rapid time to fully alert, and high satisfaction in this elderly subset undergoing flexible bronchoscopy, which was comparable with outcomes in younger patients.

  9. Anxiolytic activity of methanol leaf extract of Achyranthes aspera Linn in mice using experimental models of anxiety

    OpenAIRE

    Barua, Chandana C.; Talukdar, Archana; Begum, Shameem Ara; Borah, Prabodh; Lahkar, Mangala

    2012-01-01

    Objective: To study the anxiolytic activity of methanol extract of Achyranthes aspera Linn (Amaranthaceae). Materials and Methods: Male Swiss albino mice were used. Methanolic extract of Achyranthes aspera (MEAA) was administered in the doses of 100, 300 and 600 mg/kg p.o. Hole board (HB), open field (OF), elevated plus maze (EPM) and light/dark exploration (LDE) tests were used for determination of anxiolytic activity. Results: The methanolic extract of Achyranthes aspera significa...

  10. Participation of GABAA Chloride Channels in the Anxiolytic-Like Effects of a Fatty Acid Mixture

    Directory of Open Access Journals (Sweden)

    Juan Francisco Rodríguez-Landa

    2013-01-01

    Full Text Available Human amniotic fluid and a mixture of eight fatty acids (FAT-M identified in this maternal fluid (C12:0, lauric acid, 0.9 μg%; C14:0, myristic acid, 6.9 μg%; C16:0, palmitic acid, 35.3 μg%; C16:1, palmitoleic acid, 16.4 μg%; C18:0, stearic acid, 8.5 μg%; C18:1cis, oleic acid, 18.4 μg%; C18:1trans, elaidic acid, 3.5 μg%; C18:2, linoleic acid, 10.1 μg% produce anxiolytic-like effects that are comparable to diazepam in Wistar rats, suggesting the involvement of γ-aminobutyric acid-A (GABAA receptors, a possibility not yet explored. Wistar rats were subjected to the defensive burying test, elevated plus maze, and open field test. In different groups, three GABAA receptor antagonists were administered 30 min before FAT-M administration, including the competitive GABA binding antagonist bicuculline (1 mg/kg, GABAA benzodiazepine antagonist flumazenil (5 mg/kg, and noncompetitive GABAA chloride channel antagonist picrotoxin (1 mg/kg. The FAT-M exerted anxiolytic-like effects in the defensive burying test and elevated plus maze, without affecting locomotor activity in the open field test. The GABAA antagonists alone did not produce significant changes in the behavioral tests. Picrotoxin but not bicuculline or flumazenil blocked the anxiolytic-like effect of the FAT-M. Based on the specific blocking action of picrotoxin on the effects of the FAT-M, we conclude that the FAT-M exerted its anxiolytic-like effects through GABAA receptor chloride channels.

  11. The Anxiolytic Effects of Valtrate in Rats Involves Changes of Corticosterone Levels

    Directory of Open Access Journals (Sweden)

    Shu-Ning Shi

    2014-01-01

    Full Text Available Valtrate is a principle compound isolated from Valeriana jatamansi Jones, which is a Traditional Chinese Medicine used to treat various mood disorders. The aim of the present study was to investigate the anxiolytic effects of valtrate in rats. The animals were orally administered valtrate (5, 10, and 20 g/kg daily for 10 days and exposed to open field test (OFT and elevated plus-maze (EPM. Then the corticosterone levels in the rat serum were measured by enzyme-linked immunosorbent assay (ELISA. The valtrate (10 mg/kg, p.o. exhibited the anxiolytic effect in rats by increasing the time and entry percentage into the open arms in the EPM and the number of central entries in the OFT. Valtrate (10 mg/kg, p.o. significantly reduced the corticosterone level in the rat serum. Taken together, these results suggest that the valtrate has anxiolytic activity in behavioral models that might be mediated via the function of hypothalamus-pituitary-adrenal axis.

  12. Chemical composition of hydroethanolic extracts from Siparuna guianensis, medicinal plant used as anxiolytics in Amazon region

    Directory of Open Access Journals (Sweden)

    Giuseppina Negri

    2012-10-01

    Full Text Available Siparuna guianensis Aubl., Siparunaceae, is used as anxiolytic plants in folk medicine by South-American indians, "caboclos" and river-dwellers. This work focused the evaluation of phenolic composition of hydroethanolic extract of S. guianensis through HPLC-DAD-ESI/MS/MS. The constituents exhibited protonated, deprotonated and sodiated molecules and the MS/MS fragmentation of protonated, deprotonated and sodiated molecules provided product ions with rich structural information. Vicenin-2 (apigenin-6,8-di-C-glucoside was the main constituent found in S. guianensis together quercetin-3,7-di-O-rhamnoside and kaempferol-3,7di-O-rhamnoside. A commercial extract of Passiflora incarnata (Phytomedicine was used as surrogate standard and also was analyzed through HPLC-DAD-ESI/ MS/MS, showing flavones C-glycosides as constituents, among them, vicenin-2 and vitexin. The main constituent was vitexin. Flavonols triglycosides was also found in low content in S. guianensis and were tentatively characterized as quercetin-3O-rutinoside-7-O-rhamnoside, quercetin-3-O-pentosyl-pentoside-7-O-rhamnoside and kaempferol-3-O-pentosyl-pentoside-7-O-rhamnoside. Apigenin and kaempferol derivatives had been reported as anxiolytic agents. Flavonoids present in this extract were correlated with flavonoids reported as anxiolytics.

  13. Chemical composition of hydroethanolic extracts from Siparuna guianensis, medicinal plant used as anxiolytics in Amazon region

    Directory of Open Access Journals (Sweden)

    Giuseppina Negri

    2012-03-01

    Full Text Available Siparuna guianensis Aubl., Siparunaceae, is used as anxiolytic plants in folk medicine by South-American indians, "caboclos" and river-dwellers. This work focused the evaluation of phenolic composition of hydroethanolic extract of S. guianensis through HPLC-DAD-ESI/MS/MS. The constituents exhibited protonated, deprotonated and sodiated molecules and the MS/MS fragmentation of protonated, deprotonated and sodiated molecules provided product ions with rich structural information. Vicenin-2 (apigenin-6,8-di-C-glucoside was the main constituent found in S. guianensis together quercetin-3,7-di-O-rhamnoside and kaempferol-3,7di-O-rhamnoside. A commercial extract of Passiflora incarnata (Phytomedicine was used as surrogate standard and also was analyzed through HPLC-DAD-ESI/ MS/MS, showing flavones C-glycosides as constituents, among them, vicenin-2 and vitexin. The main constituent was vitexin. Flavonols triglycosides was also found in low content in S. guianensis and were tentatively characterized as quercetin-3O-rutinoside-7-O-rhamnoside, quercetin-3-O-pentosyl-pentoside-7-O-rhamnoside and kaempferol-3-O-pentosyl-pentoside-7-O-rhamnoside. Apigenin and kaempferol derivatives had been reported as anxiolytic agents. Flavonoids present in this extract were correlated with flavonoids reported as anxiolytics.

  14. Inhibition of endocannabinoid neuronal uptake and hydrolysis as strategies for developing anxiolytic drugs.

    Science.gov (United States)

    Batista, Luara A; Gobira, Pedro H; Viana, Thercia G; Aguiar, Daniele C; Moreira, Fabricio A

    2014-09-01

    The endocannabinoid system comprises the CB1 and CB2 receptors (the targets of the Cannabis sativa compound delta-9-tetrahydrocannabinol), the endogenous ligands (endocannabinoids) arachidonoyl ethanolamide (anandamide) and 2-arachidonoyl glycerol, their synthesizing machinery and membrane transport system, and the hydrolyzing enzymes fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL), respectively. The endocannabinoids may act on demand to confer protection against aversive stimuli, which suggests that increasing their brain levels may represent an approach for treatment of anxiety-related disorders. Thus, this article reviews the profile of endocannabinoid reuptake and hydrolysis inhibitors in experimental tests predictive of anxiolytic activity. The FAAH inhibitors and the blockers of anandamide transport, in contrast to direct CB1 receptor agonists, induce anxiolytic effects at doses that do not interfere with motor activity. MAGL inhibitors also reduce anxiety-like behavior, although they are more likely to impair motor activity. Regarding their mechanisms, increasing anandamide levels induce responses mediated by the CB1 receptor and occluded by the transient receptor potential vanilloid type-1 channels, whereas the effects of increasing 2-arachidonoyl glycerol depend on both CB1 and CB2 receptors. Their neuroanatomical targets include various structures related to anxiety and fear responses. Understanding the pharmacological properties of FAAH and MAGL inhibitors may contribute toward the development of new anxiolytic interventions based on the endocannabinoid system.

  15. Leptocarpus disjunctus prolongs sleeping time and increases nonrapid eye movement sleep with additional anxiolytic capacity

    Directory of Open Access Journals (Sweden)

    Watchara Damjuti

    2017-01-01

    Full Text Available Leptocarpus disjunctus Mast. (Restionaceae is an edible plant which has indigenous warnings regarding its side effects which can manifest as dizziness. This study investigated hypnotic and anxiolytic properties using several animal models. Anxiolytic activities were evaluated using locomotor determination by elevated plus-maze test, open-field test, and rotarod performance test. Hypnotic activities were performed using pentobarbital sodium-induced sleeping time test. Sleep architecture and quality were obtained from sleep–wake analysis and nonrapid eye movement (NREM delta activity using electroencephalography. An ethanolic extract of L. disjunctus indicated effective potencies for hypnotic test, locomotor activities, and sleep–wake analysis. Ethanolic extract showed a dose relationship with sleeping time for pentobarbital-induced sleeping time test (P < 0.01 and also an antagonistic effect on shortening in sleep time induced by flumazenil. The consort significantly decreased locomotor activities among animals undergoing elevated plus-maze test, open-field test, and rotarod performance test, whereas sleep–wake analysis showed that sleeping time and NREM sleep increased. Ethanolic extract of L. disjunctus was shown to be anxiolytic, with the possibly of benzodiazepine-like hypnotic activity.

  16. Leptocarpus disjunctus prolongs sleeping time and increases nonrapid eye movement sleep with additional anxiolytic capacity.

    Science.gov (United States)

    Damjuti, Watchara; Fuangfoo, Thanes; Palanuvej, Chanida; Li, Tingli; Ruangrungsi, Nijsiri

    2017-01-01

    Leptocarpus disjunctus Mast. (Restionaceae) is an edible plant which has indigenous warnings regarding its side effects which can manifest as dizziness. This study investigated hypnotic and anxiolytic properties using several animal models. Anxiolytic activities were evaluated using locomotor determination by elevated plus-maze test, open-field test, and rotarod performance test. Hypnotic activities were performed using pentobarbital sodium-induced sleeping time test. Sleep architecture and quality were obtained from sleep-wake analysis and nonrapid eye movement (NREM) delta activity using electroencephalography. An ethanolic extract of L. disjunctus indicated effective potencies for hypnotic test, locomotor activities, and sleep-wake analysis. Ethanolic extract showed a dose relationship with sleeping time for pentobarbital-induced sleeping time test ( P sleep time induced by flumazenil. The consort significantly decreased locomotor activities among animals undergoing elevated plus-maze test, open-field test, and rotarod performance test, whereas sleep-wake analysis showed that sleeping time and NREM sleep increased. Ethanolic extract of L. disjunctus was shown to be anxiolytic, with the possibly of benzodiazepine-like hypnotic activity.

  17. Is the antidepressive effect of second-generation antidepressants a myth?

    DEFF Research Database (Denmark)

    Bech, P

    2010-01-01

    Two recent meta-analyses on second-generation antidepressants versus placebo in mild to moderate forms of major depression, based on data on all randomized clinical trials using the Hamilton Depression Scale (HAMD) submitted to FDA, have shown an effect size of approximately 0.30 in favour...... of antidepressants in the acute therapy of major depression. The clinical significance of an effect size at this level was found to be so poor that these meta-analyses have subscribed to the myth of an exclusively placebo-like effect of second-generation antidepressants. A re-allocation of HAMD items focusing...... on those items measuring severity of clinical depression, the HAMD6, has identified effect sizes of >or=0.40 for second-generation antidepressants in placebo-controlled trials for which even a dose-response relationship can be demonstrated. In the relapse-prevention phase during continuation therapy...

  18. Antidepressant properties of aqueous acerate from Gladiolus ...

    African Journals Online (AJOL)

    Materials and Methods: We assessed the antidepressant properties of G. dalenii corm aqueous extract in mice, using the open field, forced swimming, and tail suspension tests. Spontaneous locomotor activity of mice given various doses of G. dalenii extract (per os) was determined in the open field, whereas immobility was ...

  19. Physiological Bases of Bulimia, and Antidepressant Treatment.

    Science.gov (United States)

    Getzfeld, Andrew R.

    This paper reviews the literature on the physiological causes of bulimia and investigates the rationale behind the usage of antidepressant medication in the treatment of bulimia nervosa. No definite conclusions can be stated regarding the physiology of bulimia, but a number of hypotheses are suggested. It appears that the hypothalamus is involved…

  20. Tricyclic antidepressant overdose necessitating ICU admission ...

    African Journals Online (AJOL)

    Tricyclic antidepressant (TCA) overdose necessitating intensive care unit (ICU) admission remains a significant problem in the Western Cape. In this retrospective study, we reviewed the course of life-threatening TCA overdose in our centre to identify potential prognostic indicators. TCA levels >1 000 ng/ml were associated ...

  1. Mind your state: Insights into antidepressant nonadherence ...

    African Journals Online (AJOL)

    Major depressive disorder (MDD) is an insidious disease and affects up to 15% of the global population. Although MDD responds to a wide range of pharmacological treatment options, a number of factors, i.e. not adhering to treatment for at least 4–12 months, contribute to antidepressants not being highly effective.

  2. Effects of antidepressant drugs on sexual function.

    Science.gov (United States)

    Baldwin, D S; Thomas, S C; Birtwistle, J

    1997-01-01

    Adequate sexual expression is an essential part of human relationships, enhancing quality of life and providing a sense of physical, psychological and social well-being. Unfortunately, depression is associated with impairments of sexual function and satisfaction. These problems can worsen a quality of life that is already reduced by the effects of depressive illness. The existing antidepressant drugs are far from ideal, most having adverse effects on sexual function. Unfortunately, the exact incidence of sexual dysfunction during treatment with many antidepressants is not known. Disturbances of sexual interest and performance will only be detected in a reliable fashion when systematic enquiries are made during the course of the standard clinical interview. Growing awareness of the adverse effects of many antidepressants on sexual function has led to some re-evaluation of the earlier claims for the good tolerability of many of the newer drugs. There is a clear need for further well-designed controlled studies of the effects of antidepressants on sexual function, so that this aspect of the tolerability of differing drugs can be assessed more reliably. (IntJ Psych Clin Pract 1997; 1: 47-58).

  3. Anti-Depressants, Suicide, and Drug Regulation

    Science.gov (United States)

    Ludwig, Jens; Marcotte, Dave E.

    2005-01-01

    Policymakers are increasingly concerned that a relatively new class of anti-depressant drugs, selective serotonin re-uptake inhibitors (SSRI), may increase the risk of suicide for at least some patients, particularly children. Prior randomized trials are not informative on this question because of small sample sizes and other limitations. Using…

  4. Antidepressant screening and flavonoids isolation from ...

    African Journals Online (AJOL)

    Eremostachys laciniata (L) Bunge (Lamiaceae), a rich source of flavonoids, has been investigated for chemical constituents and in vivo antidepressant property using forced swim test (FST) model. Five important compounds were isolated, including luteolin (1), apigenin (2), 5,8-dihydroxy-6,7- dimethoxyflavone (3), 5 ...

  5. Antidepressant utilization after hospitalization with depression

    DEFF Research Database (Denmark)

    Wallach-Kildemoes, Helle; Thomsen, Louise Thirstrup; Kriegbaum, Margit

    2014-01-01

    Background: Antidepressant (AD) therapy is recommended for patients 4-12months after remission from depression. The aim was to examine whether immigrants (refugees or family reunited immigrants) from non-Western countries are at greater risk than Danish-born residents of 1) not initiating AD ther...

  6. Hyperforin: A lead for antidepressants | Hussain | International ...

    African Journals Online (AJOL)

    Hyperforin: A lead for antidepressants. S Hussain, Z Ansari, M Arif. Abstract. Depression is a complex but treatable disorder if diagnosed appropriately. However, despite the advances in the understanding of the molecular basis of this disorder and the vast range of medication, psychotherapy and electroconvulsive therapy, ...

  7. Tritiation of unsaturated tricyclic antidepressants for radioimmunoassay

    International Nuclear Information System (INIS)

    Buchman, O.; Azran, J.; Shimoni, M.

    1983-01-01

    A rapid and convenient method to obtain specific an high activity tritium labelling of tricyclic antidepressants which have a double bond, is described. The procedure is based on the halogenation of the active benzylic positions of the unlabelled material and the selective catalytic removal of the halogen atom by tritium in the presence of a base which inhibits the attack on the olefin bond

  8. Antidepressant induced sexual dysfunction Part 1: epidemiology ...

    African Journals Online (AJOL)

    Adele

    Part 2 will focus on the assessment and management of AISD. Antidepressant induced sexual dysfunction Part 1: epidemiology and clinical presentation .... Poor self esteem. SOCIAL. Cultural issues. Religious issues. Environmental issues. Interpersonal conflicts. Partner specific. Sexual activity specific. Pregnancy and ...

  9. Response to tricyclic antidepressants: independent of gender?

    NARCIS (Netherlands)

    Wohlfarth, Tamar; Storosum, Jitschak G.; Elferink, André J. A.; van Zwieten, Barbara J.; Fouwels, Annemarie; van den Brink, Wim

    2004-01-01

    OBJECTIVE: The authors examined gender differences in response to tricyclic antidepressants. METHOD: A total of 30 randomized, placebo-controlled trials that included 3,886 patients (1,555 men and 2,331 women), submitted between 1979 and 1991 in order to obtain marketing authorization, were

  10. Jieyuanshen decoction exerts antidepressant effects on depressive ...

    African Journals Online (AJOL)

    Conclusion: JYAS-D had a significant antidepressant-like effect on rat model through regulating serum concentration of CORT, ACTH and CRH, increasing the content of hippocampus GR and regulating the equilibrium of amino acids neurotransmitter. Keywords: Hypothalamic-pituitary-adrenal (HPA) axis; Glucocorticoid/ ...

  11. Chamomile (Matricaria recutita) may provide antidepressant activity in anxious, depressed humans: an exploratory study.

    Science.gov (United States)

    Amsterdam, Jay D; Shults, Justine; Soeller, Irene; Mao, Jun James; Rockwell, Kenneth; Newberg, Andrew B

    2012-01-01

    placebo in all participants (P chamomile vs placebo in participants with current comorbid depression (P = .062). When the team examined the HAM-D core mood item scores, it observed a significantly greater reduction over time for chamomile vs placebo in all participants (P chamomile vs placebo in participants without current or past depression (P = .06). Chamomile may provide clinically meaningful antidepressant activity that occurs in addition to its previously observed anxiolytic activity.

  12. Performance in anxiety and spatial memory tests following bilateral vestibular loss in the rat and effects of anxiolytic and anxiogenic drugs.

    Science.gov (United States)

    Zheng, Yiwen; Cheung, Irene; Smith, Paul F

    2012-11-01

    Vestibular dysfunction in humans is associated with anxiety and cognitive disorders. However, various animal studies of the effects of vestibular loss have yielded conflicting results, from reduced anxiety to increased anxiety, depending on the particular model of vestibular dysfunction and the anxiety test used. In this study we revisited the question of whether rats with surgical bilateral vestibular deafferentation (BVD) exhibit changes in anxiety-related behaviour by testing them in the open field maze (OFM), elevated plus maze (EPM) and elevated T maze (ETM) in the presence of a non-sedating anxiolytic drug, buspirone, or an anxiogenic drug, FG-7142. We also tested the animals in a spatial T maze (STM) in order to evaluate their cognitive function under the same set of conditions. We found that BVD animals exhibited increased locomotor activity (P≤0.003), reduced supported and unsupported rearing (P≤0.02 and P≤0.000, respectively) and reduced thigmotaxis (P≤0.000) in the OFM, which for the most part the drugs did not modify. By contrast, there were no significant differences between BVD and sham control animals in the EPM and the BVD animals exhibited a marginally longer escape latency in the ETM (P≤0.03), with no change in avoidance latency. In the STM, the BVD animals demonstrated a large and significant decrease in accuracy compared to the sham control animals (P≤0.000), which was not affected by drug treatment. These results have replicated previous findings regarding increased locomotor activity, reduced rearing and thigmotaxis in the OFM, and impaired performance in the STM. However, they failed to replicate some previous results obtained using the EPM and ETM. Overall, they do not support the hypothesis that BVD animals exhibit increased anxiety-like behaviour and suggest that the cognitive deficits may be independent of the emotional effects of vestibular loss. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Antidepressants, antimicrobials or both? Gut microbiota dysbiosis in depression and possible implications of the antimicrobial effects of antidepressant drugs for antidepressant effectiveness.

    Science.gov (United States)

    Macedo, Danielle; Filho, Adriano José Maia Chaves; Soares de Sousa, Caren Nádia; Quevedo, João; Barichello, Tatiana; Júnior, Hélio Vitoriano Nobre; Freitas de Lucena, David

    2017-01-15

    The first drug repurposed for the treatment of depression was the tuberculostatic iproniazid. At present, drugs belonging to new classes of antidepressants still have antimicrobial effects. Dysbiosis of gut microbiota was implicated in the development or exacerbation of mental disorders, such as major depressive disorder (MDD). Based on the current interest in the gut-brain axis, the focus of this narrative review is to compile the available studies regarding the influences of gut microbiota in behavior and depression and to show the antimicrobial effect of antidepressant drugs. A discussion regarding the possible contribution of the antimicrobial effect of antidepressant drugs to its effectiveness/resistance is included. The search included relevant articles from PubMed, SciELO, LILACS, PsycINFO, and ISI Web of Knowledge. MDD is associated with changes in gut permeability and microbiota composition. In this respect, antidepressant drugs present antimicrobial effects that could also be related to the effectiveness of these drugs for MDD treatment. Conversely, some antimicrobials present antidepressant effects. Both antidepressants and antimicrobials present neuroprotective/antidepressant and antimicrobial effects. Further studies are needed to evaluate the participation of antimicrobial mechanisms of antidepressants in MDD treatment as well as to determine the contribution of this effect to antidepressant resistance. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Cannabidiol induces rapid-acting antidepressant-like effects and enhances cortical 5-HT/glutamate neurotransmission: role of 5-HT1A receptors.

    Science.gov (United States)

    Linge, Raquel; Jiménez-Sánchez, Laura; Campa, Leticia; Pilar-Cuéllar, Fuencisla; Vidal, Rebeca; Pazos, Angel; Adell, Albert; Díaz, Álvaro

    2016-04-01

    Cannabidiol (CBD), the main non-psychotomimetic component of marihuana, exhibits anxiolytic-like properties in many behavioural tests, although its potential for treating major depression has been poorly explored. Moreover, the mechanism of action of CBD remains unclear. Herein, we have evaluated the effects of CBD following acute and chronic administration in the olfactory bulbectomy mouse model of depression (OBX), and investigated the underlying mechanism. For this purpose, we conducted behavioural (open field and sucrose preference tests) and neurochemical (microdialysis and autoradiography of 5-HT1A receptor functionality) studies following treatment with CBD. We also assayed the pharmacological antagonism of the effects of CBD to dissect out the mechanism of action. Our results demonstrate that CBD exerts fast and maintained antidepressant-like effects as evidenced by the reversal of the OBX-induced hyperactivity and anhedonia. In vivo microdialysis revealed that the administration of CBD significantly enhanced serotonin and glutamate levels in vmPFCx in a different manner depending on the emotional state and the duration of the treatment. The potentiating effect upon neurotransmitters levels occurring immediately after the first injection of CBD might underlie the fast antidepressant-like actions in OBX mice. Both antidepressant-like effect and enhanced cortical 5-HT/glutamate neurotransmission induced by CBD were prevented by 5-HT1A receptor blockade. Moreover, adaptive changes in pre- and post-synaptic 5-HT1A receptor functionality were also found after chronic CBD. In conclusion, our findings indicate that CBD could represent a novel fast antidepressant drug, via enhancing both serotonergic and glutamate cortical signalling through a 5-HT1A receptor-dependent mechanism. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Recall of ICU Stay in Patients Managed With a Sedation Protocol or a Sedation Protocol With Daily Interruption.

    Science.gov (United States)

    Burry, Lisa; Cook, Deborah; Herridge, Margaret; Devlin, John W; Fergusson, Dean; Meade, Maureen; Steinberg, Marilyn; Skrobik, Yoanna; Olafson, Kendiss; Burns, Karen; Dodek, Peter; Granton, John; Ferguson, Niall; Jacka, Michael; Tanios, Maged; Fowler, Robert; Reynolds, Steven; Keenan, Sean; Mallick, Ranjeeta; Mehta, Sangeeta

    2015-10-01

    To 1) describe factual, emotional, and delusional memories of ICU stay for patients enrolled in the SLEAP (Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol) trial; 2) compare characteristics of patients with and without ICU recall, and patients with and without delusional memories; and 3) determine factors associated with delusional memories 28 days after ICU discharge. Prospective cohort. Sixteen North American medical and surgical ICUs. Critically ill, mechanically ventilated adults randomized in the SLEAP trial. Post-ICU interviews on days 3, 28, and 90 using the validated ICU Memory Tool. Overall, 289 of 297 ICU survivors (97%) (146 protocolized sedation and 143 protocolized sedation plus daily interruption patients) were interviewed at least once. Because there were no differences in recall status or types of memories between the two sedation groups, we present the findings for all patients rather than by study group. On days 3, 28, and 90, 28%, 26%, and 36% of patients, respectively, reported no recall of being in the ICU (overall perception, self-reported) (p = 0.75). Mean daily doses of benzodiazepines and opioids were lower in patients with no ICU recall than those with recall (p memory from ICU, respectively. Emotional memories declined with time after ICU discharge, particularly panic and confusion. Delusional memories 28 days after discharge were common (70%) yet unrelated to delirium (p = 0.84), recall status (p = 0.15), total dose of benzodiazepine (p = 0.78), or opioid (p = 0.21). Delusional memories were less likely with longer duration of mechanical ventilation (odds ratio, 0.955; 95% CI, 0.91-1.00; p = 0.04). Recall of ICU stay and types of memories reported were not influenced by the trial sedation strategy. Lack of ICU recall and delusional memories were common after ICU discharge despite the use of sedation strategies that promoted wakefulness.

  16. [Patient safety recommendations for out of operating room procedure sedation].

    Science.gov (United States)

    Arnal Velasco, D; Romero García, E; Martínez Palli, G; Muñoz Corsini, L; Rey Martínez, M; Postigo Morales, S

    There is an increasing and more complex demand for sedation for procedures out of the operating room. For different reasons, nowadays the administration of sedation varies considerably. We believe that a patient safety approach rather an approach out of corporate or economic interests is desirable. We created a working group of experts within the Spanish Anaesthesia and Reanimation Incident Reporting System (SENSAR) to prepare a series of recommendations through a non-systematic review. These recommendations were validated by an expert panel of 31 anaesthesiologists through two rounds of an adaptation of the Delphi Method where more than 70% agreement was required. The resulting recommendations include previous evaluation, material and staffing needs for sedation for procedures, post-sedation recommendations and activity and quality control advice. We present patient centred recommendations for the safe use of sedation for out of the operating room procedures from the point of view of the professionals with the most experience in its administration. We believe that these can be used as a guide to reduce variability and increase patient safety in the organisation of healthcare. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Patient safety recommendations for out of operating room procedure sedation.

    Science.gov (United States)

    Arnal Velasco, D; Romero García, E; Martínez Palli, G; Muñoz Corsini, L; Rey Martínez, M; Postigo Morales, S

    2016-12-01

    There is an increasing and more complex demand for sedation for procedures out of the operating room. For different reasons, nowadays the administration of sedation varies considerably. We believe that a patient safety approach rather an approach out of corporate or economic interests is desirable. We created a working group of experts within the Spanish Anaesthesia and Reanimation Incident Reporting System (SENSAR) to prepare a series of recommendations through a non-systematic review. These recommendations were validated by an expert panel of 31 anaesthesiologists through two rounds of an adaptation of the Delphi Method where more than 70% agreement was required. The resulting recommendations include previous evaluation, material and staffing needs for sedation for procedures, post-sedation recommendations and activity and quality control advice. We present patient centred recommendations for the safe use of sedation for out of the operating room procedures from the point of view of the professionals with the most experience in its administration. We believe that these can be used as a guide to reduce variability and increase patient safety in the organisation of healthcare. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Survey on sedation in paediatric dentistry: a global perspective.

    Science.gov (United States)

    Wilson, Stephen; Alcaino, Eduardo A

    2011-09-01

    Paediatric dentists receive training in sedation during their advanced education training, but evidence suggests that this training varies widely. The purpose of this study was to survey members of the International Association of Paediatric Dentistry (IAPD) and the European Academy of Paediatric Dentistry (EAPD) on their opinion on pharmacological and other behavioural management techniques and their training related to provision of oral health care of paediatric patients in the dental setting. A request was made for access to the IAPD and EAPD membership email addresses. The responses were recorded anonymously and data uploaded into spss (version 9) and analysed using descriptive analysis and chi-square with and without tabulation processes. A total of 311 respondents of 1973 targeted individuals answered the survey. The response rate was 16%. The majority of the respondents came from the continent of Europe, Asia, and the Americas. The most frequent type of sedation was general anaesthesia (52% of the respondents), followed by nitrous oxide (46%) and then oral sedation (44%). At least 91% of the respondents indicated that they were interested in the development of continuing education on the topic of sedation. Paediatric dentists around the world use relatively few behaviour management techniques, including pharmacological management. There is a definite interest in continuing education in the area of sedation. The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.

  19. The efficacy of primary care chaplaincy compared with antidepressants: a retrospective study comparing chaplaincy with antidepressants.

    Science.gov (United States)

    Macdonald, Gordon

    2017-07-01

    Aim To determine the effectiveness of primary care chaplaincy (PCC) when used as the sole intervention, with outcomes being compared directly with those of antidepressants. This was to be carried out in a homogenous study population reflective of certain demographics in the United Kingdom. Increasing numbers of patients are living with long-term conditions and 'modern maladies' and are experiencing loss of well-being and depression. There is an increasing move to utilise non-pharmacological interventions such as 'talking therapies' within this context. Chaplaincy is one such 'talking therapy' but within primary care its evidence base is sparse with only one quantitative study to date. There is therefore a need to evaluate PCC excluding those co-prescribed antidepressants, as this is not evidenced in the literature as yet. PCC also needs to be directly compared with the use of antidepressants to justify its use as a valid alternative treatment for loss of well-being and depression. This was a retrospective observational study based on routinely collected data. There were 107 patients in the PCC group and 106 in the antidepressant group. Socio-demographic data were collected. Their pre- and post-intervention (either chaplaincy or antidepressant) well-being was assessed, by the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) which is a validated Likert scale. Findings The majority of both groups were female with both groups showing marked ethnic homogeneity. PCC was associated with a significant and clinically meaningful improvement in well-being at a mean follow-up of 80 days. This treatment effect was maintained after those co-prescribed antidepressants were removed. PCC was associated with an improvement in well-being similar to that of antidepressants with no significant difference between the two groups.

  20. Use of Antidepressants During Pregnancy?: What to Consider when Weighing Treatment with Antidepressants Against Untreated Depression.

    Science.gov (United States)

    Muzik, Maria; Hamilton, Susan E

    2016-11-01

    Introduction Mood disorders impact many pregnant women, particularly those who have experienced symptoms prior to conception, and there are significant barriers, including stigma and access, to seeking and receiving appropriate treatments. Antidepressants are a helpful option in treating perinatal depression, but research on risks and benefits of antidepressant use in pregnancy is difficult given lack of "gold standard" comparative trials. Methods This paper summarizes current state of knowledge on the safety of antidepressants during pregnancy by providing a summary of the literature published in the past 3 years (January 2013-October 2015). We identified 21 reviews and meta-analyses that were included in this summary report. This report is meant to provide a user-friendly, yet comprehensive guide summarizing the abundant, and in part contradicting, literature on risks and benefits of antidepressants during pregnancy, in order to assist busy primary care prescribers in educating their patients. Our goal is also to contrast the risks/benefits of untreated depression in pregnancy versus treatment with antidepressant medication in pregnancy, and in such support prescribers in their decision-making. Results The past 3 years have yielded an abundance of publications on the topic, in part, with conflicting findings adding to confusion and concern among providers, patients, and their families. Many reported studies have methodological problems limiting their impact. Data on adverse effects of medications on pregnancy and fetal outcomes have to be weighed against the impact of untreated illness and poor health habits associated with untreated illness on the same outcomes. Discussion Medical-decision making is often complex and seldom free of risks. Obviously, as providers we cannot guarantee that fetal exposure to antidepressants is totally free of risk, yet this is true for any medicine taken in pregnancy. However, to date, perinatal psychiatry has collected enough

  1. [Effect of the economic crisis on consumption of psychotropic drugs in Asturias (Spain)].

    Science.gov (United States)

    Nicieza-García, María Luisa; Alonso-Lorenzo, Julio C; Suárez-Gil, Patricio; Rilla-Villar, Natalia

    To assess whether the economic crisis of 2008 has changed the consumption of anxiolytics, hypnotics-sedatives and antidepressants in Asturias (Spain). We conducted a descriptive study of drug use from 2003 -2013. The defined daily doses of 1000 inhabitants per day (DHD) were calculated for anxiolytics, hypnotics-sedatives and antidepressants. Linear regression coefficients (b) of the DHD were obtained for the pre-crisis period (2003-2008) and the crisis period (2009-2013). The consumption of anxiolytics increased by 40.25%, that of hypnotics by 88.11% and that of antidepressants by 80.93%. For anxiolytics: b-(2003-2008)=4.38 DDI/year and b-(2009-2013)=1.08 DDI/year. For hypnotics-sedatives: b-(2003-2008)=2.30 DDI/year and b-(2009-2013)=0.40 DDI/year. For antidepressants: b-(2003-2008)=5.79 DDI/year and b-(2009-2013)=2.83 DDI/year. The rise in consumption of the three subgroups during the crisis period was lower than that of the pre-crisis period. This study does not confirm the influence of the economic crisis on the rise in consumption of these drugs. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. H1-histamine receptor affinity predicts weight gain with antidepressants.

    Science.gov (United States)

    Salvi, Virginio; Mencacci, Claudio; Barone-Adesi, Francesco

    2016-10-01

    Weight gain and metabolic abnormalities are extensively found in patients taking psychotropic medications. Although mainly antipsychotics have been implicated, also antidepressants carry the potential to induce weight gain, with tricyclics and mirtazapine being associated with the greatest weight gain. It has been suggested that this could be due to the different ability of antidepressants to block adrenergic, cholinergic, and histaminergic postsynaptic receptors. To date, however, the link between antidepressant-induced weight gain and their receptor affinity profile has not been established. We reanalysed data from a previous meta-analysis to evaluate whether weight change is associated with specific receptor affinity of antidepressants. We retrieved data from the only meta-analysis that assessed weight change with antidepressants. We searched in the Psychoactive Drug Screening Program (PDSP) Ki database data on the affinities of antidepressants to receptors hypothetically linked with weight change: H1-histamine, 5HT2c, M3-muscarinic, and α1A-adrenergic receptors. The association between weight change and receptor affinities was estimated using meta-regression. We found a significant association between the affinity of antidepressants to H1-receptor and weight gain (p value: antidepressants. These results further stress a reclassification of antidepressants according to their pharmacodynamic properties, and suggest avoiding prescribing antidepressants with an anti-histaminergic profile to patients at risk for cardio-metabolic disturbances. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

  3. Evaluation of detomidine as a sedative in goats.

    Science.gov (United States)

    Singh, A P; Peshin, P K; Singh, J; Sharifi, D; Patil, D B

    1991-01-01

    Intramuscular (i.m.) and intravenous (i.v.) administration of detomidine at doses of 10, 20 and 40 micrograms/kg body mass was evaluated for its sedative and analgesic properties in 15 goats (Capra hircus). The drug produced dose- and route-dependent sedation. The 10 micrograms/kg dose was effective only when administered i.v. There was no observable analgesia at this dose. Higher doses produced effective sedation and moderate analgesia of the body with either route of administration. Severe ataxia and sternal recumbency were seen in all the animals after the dose of 40 micrograms/kg. Other effects of detomidine in these goats included mild to moderate salivation, depressed respiratory rate, decreased rectal temperature, bradycardia and hyperglycaemia. Plasma concentrations of total protein, sodium, potassium and chloride were not affected.

  4. Impact of office-based intravenous deep sedation providers upon traditional sedation practices employed in pediatric dentistry.

    Science.gov (United States)

    Tarver, Michael; Guelmann, Marcio; Primosch, Robert

    2012-01-01

    This survey intended to determine how the implementation of office-based IV deep sedation by a third party provider (OIVSED) impacted the traditional sedation practices employed in pediatric dentistry private practice settings. A digital survey was e-mailed to 924 members of the American Academy of Pediatric Dentistry practicing in California, Florida, and New York, chosen because these states had large samples of practicing pediatric dentists in geographically disparate locations. 151 pediatric dentists using OIVSED responded to the survey. Improved efficiency, safety and quality of care provided, and increased parental acceptance were reported advantages of this service. Although less costly than hospital-based general anesthesia, the average fee for this service was a deterrent to some parents considering this option. Sixty-four percent of respondents continued to provide traditional sedation modalities, mostly oral sedation, in their offices, as parenteral routes taught in their training programs were less often selected. OIVSED users reported both a reduction in the use of traditional sedation modalities in their offices and use of hospital-based GA services in exchange for perceived improvements in efficiency, safety and quality of care delivered. Patient costs, in the absence of available health insurance coverage, inhibited accessing this service by some parents.

  5. Antidepressant Use and Cognitive Decline: The Health and Retirement Study.

    Science.gov (United States)

    Saczynski, Jane S; Rosen, Allison B; McCammon, Ryan J; Zivin, Kara; Andrade, Susan E; Langa, Kenneth M; Vijan, Sandeep; Pirraglia, Paul A; Briesacher, Becky A

    2015-07-01

    Depression is associated with cognitive impairment and dementia, but whether treatment for depression with antidepressants reduces the risk for cognitive decline is unclear. We assessed the association between antidepressant use and cognitive decline over 6 years. Participants were 3714 adults aged 50 years or more who were enrolled in the nationally representative Health and Retirement Study and had self-reported antidepressant use. Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies Depression Scale. Cognitive function was assessed at 4 time points (2004, 2006, 2008, 2010) using a validated 27-point scale. Change in cognitive function over the 6-year follow-up period was examined using linear growth models, adjusted for demographics, depressive symptoms, comorbidities, functional limitations, and antidepressant anticholinergic activity load. At baseline, cognitive function did not differ significantly between the 445 (12.1%) participants taking antidepressants and those not taking antidepressants (mean, 14.9%; 95% confidence interval, 14.3-15.4 vs mean, 15.1%; 95% confidence interval, 14.9-15.3). During the 6-year follow up period, cognition declined in both users and nonusers of antidepressants, ranging from -1.4 change in mean score in those with high depressive symptoms and taking antidepressants to -0.5 change in mean score in those with high depressive symptoms and not taking antidepressants. In adjusted models, cognition declined in people taking antidepressants at the same rate as those not taking antidepressants. Results remained consistent across different levels of baseline cognitive function, age, and duration of antidepressant use (prolonged vs short-term). Antidepressant use did not modify the course of 6-year cognitive change in this nationally representative sample. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. The use of dexmedetomidine in intensive care sedation

    Directory of Open Access Journals (Sweden)

    Massimo Antonelli

    2013-05-01

    Full Text Available The goals and recommendations for ICU (Intensive Care Unit patients’ sedation and analgesia should be to have adequately sedated patients who are calm and arousal, so that they can guarantee a proper evaluation and an adequate control of pain. This way, it is also possible to perform their neurological evaluation, preserving intellectual faculties and helping them in actively participating to their care. Dexmedetomidine is a selective alpha-2 receptor agonist, member of theraputical cathegory: “other hypnotics and sedatives” (ATC: N05CM18. Dexmedetomidine is recommended for the sedation of adult ICU patients who need a sedation level not deeper than arousal in response to verbal stimulation (corresponding to Richmond Agitation-Sedation Scale 0 to -3. After the EMA approval, some European government authorities have elaborated HTA on dexmedetomidine, based on clinical evidence derived from Prodex and Midex trials. Dexmedetomidine resulted to be as effective as propofol and midazolam in maintaining the target depth of sedation in ICU patients. The mean duration of mechanical ventilation with dexmedetomidine was numerically shorter than with propofol and significantly shorter than with midazolam. The resulting favourable economic profile of dexmedetomidine supported the clinical use in ICU. Dexmedetomidine seems to provide clinical benefits due to the reduction of mechanical ventilation and ventilator weaning duration. Within the present review, an economic analysis of costs associated to the use of dexmedetomidine was therefore performed also in the Italian care setting. Thus, four different analyses were carried out based on the quantification of the total number of days in ICU, the time spent on mechanical ventilation, the weighted average number of days with mechanical ventilation or not and TISS points (Therapeutic Intervention Scoring System. Despite the incremental cost for drug therapy associated with dexmedetomidine, a reduction of

  7. Evaluation of anxiolytic potency of essential oil and S-(+-linalool from Cinnamomum osmophloeum ct. linalool leaves in mice

    Directory of Open Access Journals (Sweden)

    Bing-Ho Cheng

    2015-01-01

    Full Text Available Cinnamomum osmophloeum ct. linalool (土肉桂 tǔ ròu guì is one chemotype of the indigenous cinnamons in Taiwan. This study examined the anxiolytic potency of leaf essential oil (LEO from C. osmophloeum ct. linalool and its main constituent on 4-week ICR mice using an open field test (OFT, a light–dark test (LDT and an elevated plus maze test (EPT. After oral administration of corn oil, LEO (250 mg/kg and 500 mg/kg, S-(+-linalool (500 mg/kg, R-(−-linalool (500 mg/kg, and trazodone hydrochloride (75 mg/kg for 14 days, the anxiolytic effects on mice behavior were evaluated. The results showed that LEO from C. osmophloeum ct. linalool leaves and S-(+-linalool can significantly increase the time mice remained in the center area of the OFT, the illuminated area of the LDT and the open arms of the EPT without any side effects affecting motor activity, indicating excellent anxiolytic responses. Furthermore, results from the measurements of monoamines in mice brain revealed decreases in serotonin, dopamine, and norepinephrine, which are consistent with their anxiolytic effects in animal models. The findings obtained suggest that LEO from C. osmophloeum ct. linalool and its major compound, S-(+-linalool, possess anxiolytic properties without any side effects and thus support their potential use in treatment of anxiety disorders.

  8. Anxiolytic effects of Dolichandrone falcata Seem., Bignoniaceae, stem-bark in elevated plus maze and marble burying test on mice

    Directory of Open Access Journals (Sweden)

    Vishal B Badgujar

    2010-10-01

    Full Text Available Dolichandrone falcata Seem., Bignoniaceae, is a deciduous tree commonly known as Medshingi in local areas of Toranmal region of Maharashtra, India. Its bark paste is applied on fractured or dislocated bones, used as a fish poison; bark juice is used in cases of menorragia and leucorrhoea. The leaves of the plant have afforded chrysin-7-rutinoside. The present study was carried out to investigate the anxiolytic effects of methanol extract (DFBM, ethyl acetate extract (DFBEA and isolated compound DFB (V+VI of D. falcata stem-bark using animal models. Anxiolytic effects were studied by elevated plus maze (EPM and marble burying test (MBT assay. The crude dried DFBM and DFBEA extract was prepared in doses of 100, 200 and 400 mg/kg whereas DFB (V+VI compound was prepared in doses of 50, 100 and 200 mg/kg and were administered orally to mice for evaluation of anxiolytic activity. DFBEA 400 and DFB (V+VI 200 mg/kg produced highly significant (p <0.01 anxiolytic effects in dose dependent manner by increasing the time spent on and the number of entries into the open arms of the EPM and by decreasing the number of marbles buried by mice in MBT test. This study showed that the DFBM, DFBEA extracts and DFB (V+VI isolated compound possesses potential pharmacological active constituents flavonoids (like chrysin which may be responsible for the anxiolytic activity.

  9. Evaluation of anxiolytic potency of essential oil and S-(+)-linalool from Cinnamomum osmophloeum ct. linalool leaves in mice.

    Science.gov (United States)

    Cheng, Bing-Ho; Sheen, Lee-Yan; Chang, Shang-Tzen

    2015-01-01

    Cinnamomum osmophloeum ct. linalool ( tǔ ròu guì) is one chemotype of the indigenous cinnamons in Taiwan. This study examined the anxiolytic potency of leaf essential oil (LEO) from C. osmophloeum ct. linalool and its main constituent on 4-week ICR mice using an open field test (OFT), a light-dark test (LDT) and an elevated plus maze test (EPT). After oral administration of corn oil, LEO (250 mg/kg and 500 mg/kg), S-(+)-linalool (500 mg/kg), R-(-)-linalool (500 mg/kg), and trazodone hydrochloride (75 mg/kg) for 14 days, the anxiolytic effects on mice behavior were evaluated. The results showed that LEO from C. osmophloeum ct. linalool leaves and S-(+)-linalool can significantly increase the time mice remained in the center area of the OFT, the illuminated area of the LDT and the open arms of the EPT without any side effects affecting motor activity, indicating excellent anxiolytic responses. Furthermore, results from the measurements of monoamines in mice brain revealed decreases in serotonin, dopamine, and norepinephrine, which are consistent with their anxiolytic effects in animal models. The findings obtained suggest that LEO from C. osmophloeum ct. linalool and its major compound, S-(+)-linalool, possess anxiolytic properties without any side effects and thus support their potential use in treatment of anxiety disorders.

  10. Is the antidepressive effect of second-generation antidepressants a myth?

    Science.gov (United States)

    Bech, P

    2010-02-01

    Two recent meta-analyses on second-generation antidepressants versus placebo in mild to moderate forms of major depression, based on data on all randomized clinical trials using the Hamilton Depression Scale (HAMD) submitted to FDA, have shown an effect size of approximately 0.30 in favour of antidepressants in the acute therapy of major depression. The clinical significance of an effect size at this level was found to be so poor that these meta-analyses have subscribed to the myth of an exclusively placebo-like effect of second-generation antidepressants. A re-allocation of HAMD items focusing on those items measuring severity of clinical depression, the HAMD6, has identified effect sizes of >or=0.40 for second-generation antidepressants in placebo-controlled trials for which even a dose-response relationship can be demonstrated. In the relapse-prevention phase during continuation therapy of patients with major depression, the advantage of second-generation antidepressants over placebo was as significant as in the acute therapy phase. To explore a myth is not to deny the facts but rather to re-allocate them.

  11. Antidepressant-Induced Female Sexual Dysfunction.

    Science.gov (United States)

    Lorenz, Tierney; Rullo, Jordan; Faubion, Stephanie

    2016-09-01

    Because 1 in 6 women in the United States takes antidepressants and a substantial proportion of patients report some disturbance of sexual function while taking these medications, it is a near certainty that the practicing clinician will need to know how to assess and manage antidepressant-related female sexual dysfunction. Adverse sexual effects can be complex because there are several potentially overlapping etiologies, including sexual dysfunction associated with the underlying mood disorder. As such, careful assessment of sexual function at the premedication visit followed by monitoring at subsequent visits is critical. Treatment of adverse sexual effects can be pharmacological (dose reduction, drug discontinuation or switching, augmentation, or using medications with lower adverse effect profiles), behavioral (exercising before sexual activity, scheduling sexual activity, vibratory stimulation, psychotherapy), complementary and integrative (acupuncture, nutraceuticals), or some combination of these modalities. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  12. Neurogenesis and the Effect of Antidepressants

    Directory of Open Access Journals (Sweden)

    Philippe Taupin

    2006-01-01

    Full Text Available The recent evidence that neurogenesis occurs throughout adulthood and neural stem cells (NSCs reside in the adult central nervous system (CNS suggests that the CNS has the potential for self-repair. Beside this potential, the function of newly generated neuronal cells in the adult brain remains the focus of intense research. The hippocampus of patients with depression show signs of atrophy and neuronal loss. This suggests that adult neurogenesis may contribute to the biology of depression. The observations that antidepressants, like fluoxetine, increase neurogenesis in the dentate gyrus (DG and neurogenesis is required for the behavioral effect of antidepressants, lead to a new theory for depression and the design of new strategies and drugs for the treatment of depression. However, the role of adult neurogenesis in the etiology of depression remains the source of controversies and debates.

  13. Neurogenesis and The Effect of Antidepressants

    Directory of Open Access Journals (Sweden)

    Philippe Taupin

    2006-01-01

    Full Text Available The recent evidence that neurogenesis occurs throughout adulthood and neural stem cells (NSCs reside in the adult central nervous system (CNS suggests that the CNS has the potential for self-repair. Beside this potential, the function of newly generated neuronal cells in the adult brain remains the focus of intense research. The hippocampus of patients with depression show signs of atrophy and neuronal loss. This suggests that adult neurogenesis may contribute to the biology of depression. The observations that antidepressants, like fluoxetine, increase neurogenesis in the dentate gyrus (DG and neurogenesis is required for the behavioral effect of antidepressants, lead to a new theory for depression and the design of new strategies and drugs for the treatment of depression. However, the role of adult neurogenesis in the etiology of depression remains the source of controversies and debates.

  14. Antidepressant effects of Mentha pulegium in mice

    Directory of Open Access Journals (Sweden)

    Zahra Rabiei

    2016-09-01

    Full Text Available The aim of this study is to investigate the antidepressant effects of Mentha pulegium essential oil in BALB/c mice. Six experimental groups (7 mice each were used. Forced swim test was performed 30 min after essential oil injection. In the groups receiving M. pulegium essential oil (50, 75 and 100 mg/kg, immobility duration significantly decreased compared to the control group. M. pulegium (50 and 75 mg/kg resulted in significant decrease in nitrate/nitrite content in serum compared to the control group. M. pulegium essential oil antidepressant effect that may be due to the inhibition of oxidative stress. The results showed that decrease in nitrate/nitrite content in serum and high anti-oxidant effects of M. pulegium essential oil.

  15. New Generation Antidepressants in Painful Diabetic Neuropathy

    OpenAIRE

    Gutiérrez-Álvarez, Ángela-María; Moreno, Carlos B

    2011-01-01

    The incidence of diabetic neuropathy increases with the duration of diabetes and the degree of hyperglycaemia. Pain is one of the most common and incapacitating symptoms of diabetic neuropathy and its pharmacological control is complex. The effectiveness of antidepressive agents has been described in different types of neuropathic pain, but their effectiveness, when used as analgesics in painful diabetic neuropathy, still remains controversial. Objective: To review the possible role of new-ge...

  16. Antidepressants are not overprescribed for mild depression.

    Science.gov (United States)

    Simon, Gregory E; Rossom, Rebecca C; Beck, Arne; Waitzfelder, Beth E; Coleman, Karen J; Stewart, Christine; Operskalski, Belinda; Penfold, Robert B; Shortreed, Susan M

    2015-12-01

    To evaluate overprescribing of antidepressant medication for minimal or mild depression. Electronic records data from 4 large health care systems identified outpatients aged 18 years or older starting a new episode of antidepressant treatment in 2011 with an ICD-9 diagnosis of depressive disorder (296.2, 296.3, 311, or 300.4). Patient Health Questionnaire-9 (PHQ-9) depression severity scores at time of treatment initiation were used to examine the distribution of baseline severity and the association between baseline severity and patients' demographic and clinical characteristics. Of 19,751 adults beginning treatment in 2011, baseline PHQ-9 scores were available for 7,051. In those with a baseline score, 85% reported moderate or severe symptoms (PHQ-9 score of 10 or more), 12% reported mild symptoms (PHQ-9 score of 5 to 9), and 3% reported minimal symptoms (PHQ-9 score of less than 5). The proportion reporting minimal or mild symptoms when starting treatment increased with age, ranging from 11% in those under age 65 years to 26% in those aged 65 and older. The proportion with minimal or mild symptoms was also moderately higher among patients living in wealthier neighborhoods and those treated by psychiatrists. Nevertheless, across all subgroups defined by sex, race/ethnicity, prescriber specialty, and treatment history, the proportions with minimal or mild symptoms did not exceed 18%. Secondary analyses, including weighting and subgroup analyses, found no evidence that estimates of baseline severity were biased by missing PHQ-9 scores. In these health systems, prescribing of antidepressant medication for minimal or mild depression is much less common than suggested by previous reports. Given that this practice may sometimes be clinically appropriate, our findings indicate that overprescribing of antidepressants for mild depression is not a significant public health concern. © Copyright 2015 Physicians Postgraduate Press, Inc.

  17. Pediatric Tricyclic Antidepressant Poisoning: Approach and Management

    OpenAIRE

    Roldán Ovalle, Tatiana; Hospital Universitario de San Ignacio; López Millán, Angelo; Hospital Universitario de San Ignacio

    2016-01-01

    Antidepressants are agents that cause significant morbidity and mortality with important toxicity particularly on cardiovascular and neurological systems, which is mainly based on their pharmacology and is that determines specific treatment. Unfortunately, children are vulnerable population because the increase in psychiatric disorders which are treated with these drugs. The purpose of this article is to review the pharmacokinetics, clinical presentation and treatment of acute poisoning with ...

  18. Anxiolytic-like effect of Bifidobacterium adolescentis IM38 in mice with or without immobilisation stress.

    Science.gov (United States)

    Jang, H M; Jang, S-E; Han, M J; Kim, D-H

    2018-01-29

    To better understand the role of gut microbiota in the anxiety, we isolated bifidobacteria and lactobacilli from the human faecal microbiota, investigated their inhibitory effects on the expression of interleukin (IL)-6 and tumour necrosis factor (TNF)-α in lipopolysaccharide-stimulated macrophages, and examined the anxiolytic-like effect of Bifidobacterium adolescentis IM38 in mice treated with or without immobilisation stress using the elevated plus maze (EPM) task. Oral administration of IM38 at a dose of 1×10 9 cfu/mouse showed a significant anxiolytic-like effect both in mice exposed to immobilisation stress and in control mice using the EPM test (Peffect of IM38 was comparable to that of buspirone (1 mg/kg). Moreover, this anxiolytic-like effect was blocked by treatment with flumazenil (3 mg/kg, i.p.), a benzodiazepine receptor antagonist, but was not affected by treatment with bicuculine or WAY-100635. IM38 treatment also reduced the blood levels of corticosterone and IL-6 in mice with or without immobilisation stress, whereas this effect was abolished by treatment with flumazenil. IM38 treatment also reduced the blood TNF-α level in mice subjected to immobilisation stress but not in normal control mice. Treatment with flumazenil also significantly increased TNF-α and IL-6 levels in immobilisation stress-free mice treated with IM38. These findings suggest that IM38 may attenuate anxiety through modulation of the benzodiazepine site on the GABA A receptor and modulate stress-related cytokine expression.

  19. Relationships of beta-blockers and anxiolytics intake and salivary secretion, masticatory performance and taste perception.

    Science.gov (United States)

    de Matos, Leandro Faria; Pereira, Stela Márcia; Kaminagakura, Estela; Marques, Leandro Silva; Pereira, Cássio Vicente; van der Bilt, Andries; Pereira, Luciano José

    2010-02-01

    Assess the influence of salivary flow on physiological parameters of the stomatognathic system in patients who take beta-blockers or anxiolytic medications. Sixty patients were divided into three groups based on the following criteria: Group 1, control (n=20; no use of medication); Group 2, use of antihypertensive beta-blockers (n=20); and Group 3, use of benzodiazepine anxiolytics (n=20). Salivary flow was assessed by determining stimulated and non-stimulated flow/minute. The quantification of the sense of taste was determined on a visual analogue scale (VAS) using solutions of 0.9% NaCl (salty), 50% sucrose (sweet), 20% unsweetened coffee (bitter) and 4.2% vinegar (sour). The DMFT index (number of decayed/missing/filled teeth) was determined by a calibrated examination, following the criteria of the World Health Organization (WHO). Masticatory performance was assessed with an Optosil comminution test and Rosim-Ramler equation. The results did not reveal a significant correlation between salivary flow and masticatory performance (p>0.05). We observed significant decreased non-stimulated salivary flow for Group 2 (p=0.05) when compared to controls. However, taste perception was not influenced by salivary secretion amongst groups. Furthermore, we observed a significant negative correlation between non-stimulated salivary flow and DMFT in Group 1 (p=0.02; r=-0.52). Patients under beta-blockers therapy presented reduced non-stimulated salivary flow when compared to controls, without influencing the sense of taste or masticatory performance. The use of anxiolytics did not affect salivary flow and taste perception in the studied sample. Copyright 2009 Elsevier Ltd. All rights reserved.

  20. Evaluation of the anxiolytic effect of the methanol stem extracts of Cissus quadrangularis

    Directory of Open Access Journals (Sweden)

    Naina Raghavjibhai Ghadiya

    2013-11-01

    Full Text Available Objective: To investigate the potentials of the stem of Cissus quadrangularis (C. quadrangularis in the control of anxiety and related motor coordination effects in mice using experimental models. Methods: The methanol extract of the stem of C. quadrangularis was studied in mice using elevated plus maze, hole board, open field and stair case tests. Acute toxicity and phytochemical analysis were also carried out. Results: The methanol extract (100, 200, 300 and 400 mg/kg exhibited significant anxiolytic effects, as evident by significant (P<0.05 increase in the number of crossings at 100, 200 and 300 mg/kg dose and number of rearing at 200, 300 and 400 mg/kg dose in open field behavior test. Time spent in the open arms and number of entrances in the open arms increased significantly (P<0.05, P<0.01 at the dose of 200 and 300 mg/kg in elevated plus maze test. Post hoc analysis showed that C. quadrangularis at the dose of 200 and 300 mg/kg significantly (P<0.05 increased the number of steps taken and number of head dips. Significant (P<0.05 reduction in time duration on the bar and number of rearing were observed at the dose of 200, 300 and 400 mg/kg. The acute toxicity test revealed an oral LD50 above 5 000 mg/kg, while phytochemical studies showed the presence of phytosterols, terpenoids, saponins, flavanoids, tannins, carbohydrates and aminoacids. Conclusions: The stem extracts of C. quadrangularis is anxiolytic in nature, which contribute to its use in traditional medicine as anxiolytic.

  1. Continuous Deep Sedation Until Death in Nursing Home Residents with Dementia: A Case Series

    NARCIS (Netherlands)

    Anquinet, L.; Rietjens, J.A.C.; Vandervoort, A.; van der Steen, J.T.; van der Stichele, R.; Deliens, L.; Block, L.

    2013-01-01

    Objectives To describe the characteristics of continuous deep sedation until death and the prior decision-making process of nursing home residents dying with dementia and to evaluate this practice according to features reflecting sedation guideline recommendations. Design Epidemiological

  2. Patient safety during procedural sedation using capnography monitoring : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Saunders, Rhodri; Struys, Michel M. R. F.; Pollock, Richard F.; Mestek, Michael; Lightdale, Jenifer R.

    2017-01-01

    Objective: To evaluate the effect of capnography monitoring on sedation-related adverse events during procedural sedation and analgesia (PSA) administered for ambulatory surgery relative to visual assessment and pulse oximetry alone. Design and setting: Systematic literature review and random

  3. Antidepressant induced excessive yawning and indifference

    Directory of Open Access Journals (Sweden)

    Bruno Palazzo Nazar

    2015-03-01

    Full Text Available Introduction Antidepressant induced excessive yawning has been described as a possible side effect of pharmacotherapy. A syndrome of indifference has also been described as another possible side effect. The frequency of those phenomena and their physiopathology are unknown. They are both considered benign and reversible after antidepressant discontinuation but severe cases with complications as temporomandibular lesions, have been described. Methods We report two unprecedented cases in which excessive yawning and indifference occurred simultaneously as side effects of antidepressant therapy, discussing possible physiopathological mechanisms for this co-occurrence. Case 1: A male patient presented excessive yawning (approximately 80/day and apathy after venlafaxine XR treatment. Symptoms reduced after a switch to escitalopram, with a reduction to 50 yawns/day. Case 2: A female patient presented excessive yawning (approximately 25/day and inability to react to environmental stressors with desvenlafaxine. Conclusion Induction of indifference and excessive yawning may be modulated by serotonergic and noradrenergic mechanisms. One proposal to unify these side effects would be enhancement of serotonin in midbrain, especially paraventricular and raphe nucleus.

  4. Antidepressants and Suicide Risk: A Comprehensive Overview

    Directory of Open Access Journals (Sweden)

    Roberto Tatarelli

    2010-08-01

    Full Text Available The annual worldwide suicide rate currently averages approximately 13 per 100,000 individuals per year (0.013% per year, with higher average rates for men than for women in all but a few countries, very low rates in children, and relatively high rates in elderly men. Suicide rates vary markedly between countries, reflecting in part differences in case-identification and reporting procedures. Rates of attempted suicide in the general population average 20–30 times higher than rates of completed suicide, but are probably under-reported. Research on the relationship between pharmacotherapy and suicidal behavior was rare until a decade ago. Most ecological studies and large clinical studies have found that a general reduction in suicide rates is significantly correlated with higher rates of prescribing modern antidepressants. However, ecological, cohort and case-control studies and data from brief, randomized, controlled trials in patients with acute affective disorders have found increases, particularly in young patients and particularly for the risk of suicide attempts, as well as increases in suicidal ideation in young patients. whether antidepressants are associated with specific aspects of suicidality (e.g., higher rates of completed suicide, attempted suicide and suicidal ideation in younger patients with major affective disorders remains a highly controversial question. In light of this gap this paper analyzes research on the relationship between suicidality and antidepressant treatment.

  5. Molecular and cellular mechanisms of antidepressant action.

    Science.gov (United States)

    Sharp, Trevor

    2013-01-01

    A long-standing theory is that brain monoamine signalling is critically involved in the mechanisms of antidepressant drug treatment. Theories on the nature of these mechanisms commenced with ideas developed in the 1960s that the drugs act simply by increasing monoamine availability in the synapse. However, this thinking has advanced remarkably in the last decade to concepts which position that antidepressant drug action on monoamine signalling is just the starting point for a complex sequence of neuroadaptive molecular and cellular changes that bring about the therapeutic effect. These changes include activation of one or more programmes of gene expression that leads to the strengthening of synaptic efficacy and connectivity, and even switching neural networks into a more immature developmental state. It is thought that through this increase in plasticity, key neural circuits within the limbic system are more easily remodelled by incoming emotionally relevant stimuli. This article attempts to bring together previous and current knowledge of antidepressant drug action on monoamine signalling at molecular and cellular levels, and introduces current thinking that these changes interact with neuropsychological processes ultimately to elevate mood.

  6. Anxiolytic and free radical scavenging potential of Chinese celery (Apium graveolens) extract in mice

    OpenAIRE

    Tanasawet, Supita; Boonruamkaew, Phetcharat; Sukketsiri, Wanida; Chonpathompikunlert, Pennapa

    2017-01-01

    Objective: To elucidate the anxiolytic and free radical scavenging effect of methanolic extract of Apium graveolens (A. graveolens) in adult C57BL/6 mice. Methods: Sixty male mice were divided into 6 groups: control, vehicle, positive control and A. graveolens (125, 250 and 500 mg/kg). Different behavioral models of elevated plus maze, open field, light/dark, hole-board and pentobarbital-induced sleep were used to assess anxiety-like behavior. Biochemical parameters including monoamine oxi...

  7. The Novel Dipeptide Translocator Protein Ligand, Referred to As GD-23, Exerts Anxiolytic and Nootropic Activities

    OpenAIRE

    Povarnina, P. Yu.; Yarkov, S. A.; Gudasheva, T. A.; Yarkova, M. A.; Seredenin, S. B.

    2015-01-01

    The translocator protein (TSPO) promotes the translocation of cholesterol to the inner mitochondrial membrane and mediates steroid formation. In this study, we first report on a biological evaluation of the dipeptide GD-23 (N-carbobenzoxy-L tryptophanyl-L isoleucine amide), a structural analogue of Alpidem, the principal TSPO ligand. We show that GD-23 in a dose range of 0.05 to 0.5 mg/kg (i.p.) exhibits anxiolytic activity in the elevated plus maze test and nootropic activity in the object r...

  8. Chronic consumption of distilled sugarcane spirit induces anxiolytic-like effects in mice

    OpenAIRE

    Sena, Maria Clécia P; Nunes, Fabíola C; Stiebbe Salvadori, Mirian G S; Carvalho, Cleyton Charles D; Morais, Liana Clébia S L; Braga, Valdir A

    2011-01-01

    OBJECTIVE: Chronic ethanol consumption is a major public health problem throughout the world. We investigated the anxiolytic-like effects and the possible ever injury induced by the chronic consumption of ethanol or sugarcane spirit in mice. METHOD: Adult mice were exposed to a two-bottle free-choice paradigm for 6 weeks. The mice in Group A (n  =  16) had access to sugarcane spirit + distilled water, the mice in Group B (n  =  15) had access to ethanol + distilled water, and the mice in Grou...

  9. Sexual dysfunction, depression, and the impact of antidepressants.

    Science.gov (United States)

    Kennedy, Sidney H; Rizvi, Sakina

    2009-04-01

    Sexual dysfunction is a common symptom of depression. Although decreased libido is most often reported, difficulties with arousal, resulting in vaginal dryness in women and erectile dysfunction in men, and absent or delayed orgasm are also prevalent. Sexual dysfunction is also a frequent adverse effect of treatment with most antidepressants and is one of the predominant reasons for premature drug discontinuation. Selective serotonin reuptake inhibitors are the most widely prescribed antidepressants and have significant effects on arousal and orgasm compared with antidepressants that target norepinephrine, dopamine, and melatonin systems. The availability of an antidepressant that does not cause or exacerbate sexual dysfunction represents an advance in pharmacotherapy for mood disorders and should reduce treatment noncompliance and decrease the need for switching antidepressants or adding antidotes. The purpose of this review was to provide an update on the prevalence, psychobiology, and relative adverse effect burden of sexual dysfunction associated with different antidepressants.

  10. 13C NMR studies of the molecular flexibility of antidepressants

    International Nuclear Information System (INIS)

    Munro, S.L.; Andrews, P.R.; Craik, D.J.; Gale, D.J.

    1986-01-01

    The solution dynamics of a series of clinically potent antidepressants have been investigated by measuring 13 C NMR relaxation parameters. Correlation times and internal motional rates were calculated from spin-lattice relaxation times and nuclear Overhauser effects for the protonated carbons in mianserin, imipramine-like antidepressants, and amitriptyline-like antidepressants. These data were interpreted in terms of overall molecular tumbling, internal rotations, and inherent flexibility of these structures. Of particular interest was the conformational variability of the tricyclic nucleus of the tricyclic antidepressants, where the data indicated a fivefold difference in mobility of the dimethylene bridge of imipramine-like antidepressants relative to amitriptyline-like compounds. The implications of such a difference in internal motions is discussed in relation to previous NMR studies and to the reported differences in pharmacological activity of these antidepressants

  11. Antidepressants and Driving in Older Adults: A Systematic Review.

    Science.gov (United States)

    Cameron, Duncan H; Rapoport, Mark J

    2016-06-01

    With an increasing number of older drivers who are prescribed antidepressants, the potential consequences of antidepressant use on driving skills in an aging population are becoming a pressing issue. We conducted a systematic review using MEDLINE, targeting articles specifically pertaining to antidepressants and driving in a population or subgroup of older adults (≥ 55 years of age). The search yielded 267 references, nine of which pertained to the effects of antidepressants on driving in older adults. The single experimental study found imipramine to have detrimental effects on highway driving, whereas nefazodone did not. Seven of eight population-based studies reported a significant increased risk of involvement in a collision associated with antidepressant use. Although the studies indicated a negative effect of antidepressants on driving, the epidemiological designs cannot exclude the possibility that the underlying illness, generally major depression, is the culprit.

  12. The PediSedate device, a novel approach to pediatric sedation that provides distraction and inhaled nitrous oxide: clinical evaluation in a large case series.

    Science.gov (United States)

    Denman, William T; Tuason, Pacifico M; Ahmed, Mohammed I; Brennen, Loralie M; Cepeda, M Soledad; Carr, Daniel B

    2007-02-01

    Pediatric sedation is of paramount importance but can be challenging. Fear and anticipatory anxiety before invasive procedures often lead to uncooperativeness. A novel device (PediSedate) provides sedation through a combination of inhaled nitrous oxide and distraction (video game). We evaluated the acceptability and safety of the PediSedate device in children. We enrolled children between 3 and 9 years old who were scheduled to undergo surgical procedures that required general inhalational anesthesia. After the device was applied, he/she played a video game while listening to the audio portion of the game through the earphones. Nitrous oxide in oxygen was administered via the nasal piece of the headset starting at 50% and increasing to 70%, in 10% increments every 8 min. Treatment failures, vital signs, arterial oxygen saturation, depth of sedation, airway patency, side effects, acceptance of the device and parental satisfaction were all evaluated. Of 100 children included, treatment failure occurred in 18% mainly because of poor tolerance of the device. At least 96% of the children who completed the study exhibited an excellent degree of sedation, 22% had side effects, and none experienced serious airway obstruction. Nausea and vomiting were the most common side effects and no patients had hemodynamic instability. The PediSedate device combines nonpharmacologic with pharmacologic methods of sedation. Most of the children we evaluated were able to tolerate the PediSedate device and achieved an adequate degree of sedation.

  13. A retrospective study of deep sedation with concomitant administration of sedative agents in children undergoing surgical removal of a mesiodens.

    Science.gov (United States)

    Lee, Soo Jeong; Baek, Kwangwoo

    2015-12-01

    Pediatric dentists face challenges when young patients require a mesiodens extraction. General anesthesia may be a burden to the child as well as the parent due to dental fears and costs. The aim of this study was to evaluate oral and intravenous sedation in the outpatient setting as a safe and effective means of managing patients who require a mesiodens extraction. Records were reviewed retrospectively to find patients who underwent a mesiodens removal procedure from January 2013 to September 2014 in the Department of Pediatric Dentistry at Ajou University Hospital (Suwon, Gyeonggi-do, Republic of Korea). A total of 81 patients (62 male and 19 female) between 4 and 11 years of age (mean [± SD] 81.6 ± 14.1 months) were studied, with a mean weight of 22.9 ± 3.3 kg (16 kg to 30 kg). Vital signs, sedation drug dosage, and sedation time were studied. Mean doses of 63.7 ± 2.5 mg/kg chloral hydrate and 1.36 ± 0.22 mg/kg hydroxyzine were used for oral sedation. Nitrous oxide/oxygen was administrated for 40.0 ± 2.1 min. The mean dose of midazolam administered intravenously was 0.14 ± 0.06 mg/kg (2.38 ± 0.97 times). In all cases, the mesiodens was removed successfully. Intravenous sedation combined with oral sedation and nitrous oxide/oxygen inhalation can be an alternative to general anesthesia when administrated and monitored properly.

  14. The impact of obesity on pediatric procedural sedation-related outcomes: results from the Pediatric Sedation Research Consortium.

    Science.gov (United States)

    Scherrer, Patricia D; Mallory, Michael D; Cravero, Joseph P; Lowrie, Lia; Hertzog, James H; Berkenbosch, John W

    2015-07-01

    To evaluate the impact of obesity on adverse events and required interventions during pediatric procedural sedation. The Pediatric Sedation Research Consortium database of prospectively collected procedural sedation encounters was queried to identify patients for whom body mass index (BMI) could be calculated. Obesity was defined as BMI ≥95th percentile for age and gender. Sedation-related outcomes, adverse events, and therapeutic interventions were compared between obese and nonobese patients. For analysis, 28,792 records were eligible. A total of 5,153 patients (17.9%) were obese; they were predominantly male and older and had a higher median American Society of Anesthesiologists Physical Status classification (P obese patients (odds ratio [OR] 1.49, 95% confidence interval [1.31, 1.70]). Respiratory events (airway obstruction OR 1.94 [1.54, 2.44], oxygen desaturation OR 1.99 [1.50, 2.63], secretions OR 1.48 [1.01, 2.15], laryngospasm OR 2.30 [1.30, 4.05]), inability to complete the associated procedure (OR 1.96 [1.16, 3.30]), and prolonged recovery (OR 2.66 [1.26, 5.59]) were increased in obese patients. Obese patients more frequently required airway intervention including repositioning, suctioning, jaw thrust, airway adjuncts, and bag-valve-mask ventilation. Multivariate regression analysis demonstrated obesity to be independently associated with minor and moderate but not major adverse events. Obesity is an independent risk factor for adverse respiratory events during procedural sedation and is associated with an increased frequency of airway interventions, suggesting that additional vigilance and expertise are required when sedating these patients. © 2015 John Wiley & Sons Ltd.

  15. Mothers' perceptions about pediatric dental sedation as an alternative to dental general anesthesia

    OpenAIRE

    LIMA, Alessandra Rodrigues de Almeida; MEDEIROS, Marcelo; COSTA, Luciane Rezende

    2015-01-01

    OBJECTIVE: Moderate sedation has limits in managing children's behavior. Existing literature lacks insight into parental perceptions about the topic. This study aimed to understand mothers' perceptions concerning sedation after their children undergone dental treatment under sedation.METHODS: Twelve mothers and one godmother of 1.3-8.4 year-old children with definitely negative behavior in the dental chair, who had dental treatment under oral sedation, were in depth interviewed according to a...

  16. Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy

    OpenAIRE

    Yen-Hsuan Hsu; Feng-Sheng Lin; Chi-Cheng Yang; Chih-Peng Lin; Mau-Sun Hua; Wei-Zen Sun

    2015-01-01

    Midazolam is a widely used sedative agent during colonoscopy, with cognitive toxicity. However, the potential cognitive hazard of midazolam-based light sedation has not been sufficiently examined. We aimed to examine the cognitive safety and vulnerability profile under midazolam light sedation, with a particular focus on individual variations. Methods: We conducted a prospective case-controlled study in an academic hospital. In total, 30 patients undergoing sedative colonoscopy as part of ...

  17. Use of Antidepressants: Expansion Beyond Depression and Anxiety

    OpenAIRE

    Cascade, Elisa F.; Kalali, Amir H.; Thase, Michael E.

    2007-01-01

    We investigated antidepressant prescriptions and reasons for use. According to our data, the top 10 molecules represent ∼95% of total antidepressant prescriptions for both primary care physicians (PCPs) and psychiatrists. The primary difference between PCPs and psychiatrists was the increased use of buproprion and tricyclics/tetracyclics by psychiatrists. The selective serotonin reuptake inhibitors (SSRIs) and other newer antidepressants such as venlafaxine (Effexor) and buproprion (Wellbutri...

  18. Increase in palliative sedation and reasons in cancer patients in Dutch general practice 2005–2014.

    NARCIS (Netherlands)

    Donker, G.A.; Dijk, C.E. van

    2015-01-01

    Background: Little is known about the quantity and reasons for use of palliative sedation in cancer patients in general practice and the reason to apply palliative sedation when a request for euthanasia was pending. Aim: To gain more insight into the reasons for palliative sedation at the end of

  19. A randomized controlled trial of daily sedation interruption in critically ill children

    NARCIS (Netherlands)

    N.J. Vet (Nienke); S.N. de Wildt (Saskia); C.W.M. Verlaat (Carin); C.A.J. Knibbe (Catherijne); M.G. Mooij (Miriam); J.B. van Woensel (Job); J.M. van Rosmalen (Joost); D. Tibboel (Dick); M. de Hoog (Matthijs)

    2016-01-01

    textabstractPurpose: To compare daily sedation interruption plus protocolized sedation (DSI + PS) to protocolized sedation only (PS) in critically ill children. Methods: In this multicenter randomized controlled trial in three pediatric intensive care units in the Netherlands, mechanically

  20. [Technology of nitrous oxide/oxygen inhalation sedation and its clinical application in pediatric dentistry].

    Science.gov (United States)

    Zhong, Tian; Hu, Daoyong

    2014-02-01

    Dental fear is a common problem in pediatric dentistry. Therefore, sedation for pediatric patients is an essential tool for anxiety management. Nitrous oxide/oxygen inhalation sedation is a safe, convenient, effective way to calm children. The review is about the technology of nitrous oxide/oxygen inhalation sedation and its clinical application in pediatric dentistry.

  1. Feasibility of measuring memory response to increasing dexmedetomidine sedation in children

    OpenAIRE

    Mason, K. P.; Kelhoffer, E. R.; Prescilla, R.; Mehta, M.; Root, J. C.; Young, V. J.; Robinson, F.; Veselis, R. A.

    2017-01-01

    Background. The memory effect of dexmedetomidine has not been prospectively evaluated in children. We evaluated the feasibility of measuring memory and sedation responses in children during dexmedetomidine sedation for non-painful radiological imaging studies. Secondarily, we quantified changes in memory in relation to the onset of sedation.

  2. Continued antidepressant treatment and suicide in patients with depressive disorder

    DEFF Research Database (Denmark)

    Søndergård, Lars; Lopez, Ana Garcia; Andersen, Per Kragh

    2007-01-01

    1995 to 2000, we investigated the relation between continued treatment with antidepressants and suicide in a population of all patients discharged from hospital psychiatry with a diagnosis of depressive disorder. Patients discharged from hospital psychiatry with a diagnosis of depressive disorder had...... of prescriptions. On individualized data from a cohort of patients with a known history of depressive disorder, continued antidepressant treatment was associated with reduced risk of suicide.......Antidepressant use in Denmark, as in many developed countries, has substantially increased during recent years, coinciding with a decreasing suicide rate. In a nationwide observational cohort study with linkage of registers of all prescribed antidepressants and recorded suicides in Denmark from...

  3. Comparison of sedation strategies for critically ill patients

    DEFF Research Database (Denmark)

    Hutton, Brian; Burry, Lisa D.; Kanji, Salmaan

    2016-01-01

    of interest include duration of mechanical ventilation, time to first extubation, ICU and hospital length of stay, re-intubation, tracheostomy, mortality, total sedative and opioid exposure, health-related quality of life, and adverse events. To inform our NMA, we will first conduct conventional pair...

  4. Reflexology: its effects on physiological anxiety signs and sedation needs.

    Science.gov (United States)

    Akin Korhan, Esra; Khorshid, Leyla; Uyar, Mehmet

    2014-01-01

    To investigate whether reflexology has an effect on the physiological signs of anxiety and level of sedation in patients receiving mechanically ventilated support, a single blinded, randomized controlled design with repeated measures was used in the intensive care unit of a university hospital in Turkey. Patients (n = 60) aged between 18 and 70 years and were hospitalized in the intensive care unit and receiving mechanically ventilated support. Participants were randomized to a control group or an intervention group. The latter received 30 minutes of reflexology therapy on their feet, hands, and ears for 5 days. Subjects had vital signs taken immediately before the intervention and at the 10th, 20th, and 30th minutes of the intervention. In the collection of the data, "American Association of Critical-Care Nurses Sedation Assessment Scale" was used. The reflexology therapy group had a significantly lower heart rate, systolic blood pressure, diastolic blood pressure, and respiratory rate than the control group. A statistically significant difference was found between the averages of the scores that the patients included in the experimental and control groups received from the agitation, anxiety, sleep, and patient-ventilator synchrony subscales of the American Association of Critical-Care Nurses Sedation Assessment Scale. Reflexology can serve as an effective method of decreasing the physiological signs of anxiety and the required level of sedation in patients receiving mechanically ventilated support. Nurses who have appropriate training and certification may include reflexology in routine care to reduce the physiological signs of anxiety of patients receiving mechanical ventilation.

  5. Anticonvulsant and sedative effect of Fufang Changniu pills and ...

    African Journals Online (AJOL)

    Results: Gallic acid, liquiritin, cinnamyl alcohol, cinnamic acid and glycyrrhizic acid were detected in. FCP decoction. FCP (50, 100 and 200 mg/kg) showed significant anticonvulsant and sedative effects on epileptic mice induced by MES (p < 0.05) and PTZ (p < 0.05). Moreover, pentobarbital sodium-induced sleeping time ...

  6. Intravenous Sedation for Dental Patients with Intellectual Disability

    Science.gov (United States)

    Miyawaki, T.; Kohjitani, A.; Maeda, S.; Egusa, M.; Mori, T.; Higuchi, H.; Kita, F.; Shimada, M.

    2004-01-01

    The poor quality of oral health care for people with intellectual disability (ID) has been recognized, and the strong fears about dental treatment suggested as a major reason for disturbances of visits to dentists by such patients. Intravenous sedation is a useful method for relieving the anxiety and fear of such patients about dental treatment,…

  7. Evaluation of the Sedative and Anticonvulsant Properties of Three ...

    African Journals Online (AJOL)

    The total sleep time of the control groups was multiplied by a factor of 3 at least by each extract. The presence of sedative and anticonvulsant activity in the three plants could explain their use in traditional medicine in the treatment of epilepsy and insomnia in Cameroon. Keywords: Epilepsy; Insomnia; Traditional medicine.

  8. Breast Surgery Using Thoracic Paravertebral Blockade and Sedation Alone

    Directory of Open Access Journals (Sweden)

    James Simpson

    2014-01-01

    Full Text Available Introduction. Thoracic paravertebral block (TPVB provides superior analgesia for breast surgery when used in conjunction with general anesthesia (GA. Although TPVB and GA are often combined, for some patients GA is either contraindicated or undesirable. We present a series of 28 patients who received a TPVB with sedation alone for breast cancer surgery. Methods. A target controlled infusion of propofol or remifentanil was used for conscious sedation. Ultrasound guided TPVB was performed at one, two, or three thoracic levels, using up to 30 mL of local anesthetic. If required, top-up local infiltration analgesia with prilocaine 0.5% was performed by the surgeon. Results. Most patients were elderly with significant comorbidities and had TPVB injections at just one level (54%. Patient choice and anxiety about GA were indications for TVPB in 9 patients (32%. Prilocaine top-up was required in four (14% cases and rescue opiate analgesia in six (21%. Conclusions. Based on our technique and the outcome of the 28 patients studied, TPVB with sedation and ultrasound guidance appears to be an effective and reliable form of anesthesia for breast surgery. TPVB with sedation is a useful anesthetic technique for patients in which GA is undesirable or poses an unacceptable risk.

  9. Changes in resting neural connectivity during propofol sedation.

    Directory of Open Access Journals (Sweden)

    Emmanuel A Stamatakis

    2010-12-01

    Full Text Available The default mode network consists of a set of functionally connected brain regions (posterior cingulate, medial prefrontal cortex and bilateral parietal cortex maximally active in functional imaging studies under "no task" conditions. It has been argued that the posterior cingulate is important in consciousness/awareness, but previous investigations of resting interactions between the posterior cingulate cortex and other brain regions during sedation and anesthesia have produced inconsistent results.We examined the connectivity of the posterior cingulate at different levels of consciousness. "No task" fMRI (BOLD data were collected from healthy volunteers while awake and at low and moderate levels of sedation, induced by the anesthetic agent propofol. Our data show that connectivity of the posterior cingulate changes during sedation to include areas that are not traditionally considered to be part of the default mode network, such as the motor/somatosensory cortices, the anterior thalamic nuclei, and the reticular activating system.This neuroanatomical signature resembles that of non-REM sleep, and may be evidence for a system that reduces its discriminable states and switches into more stereotypic patterns of firing under sedation.

  10. Continuous Palliative Sedation: Not Only a Response to Physical Suffering

    NARCIS (Netherlands)

    Swart, S.J.; Heide, A.; van Zuylen, L.; Perez, R.S.G.M.; Zuurmond, W.W.A.; van der Maas, P.J.; van Delden, J.J.M.; Rietjens, J.A.C.

    2014-01-01

    Background: Palliative sedation is a medical intervention aimed at relieving symptoms that can no longer be controlled by conventional treatment. Ample knowledge is available regarding the nature of such symptoms, but there is no in-depth information regarding how health care workers decide about

  11. Effect of xylazine sedation on some clinico-physiological and ...

    African Journals Online (AJOL)

    Xylazine is classified pharmacologically as an effective sedative, analgesic, muscle relaxant, immobilizing and hypnotic agent in domestic animals (Torre and Erausquine, 1988; Ewing, 1990; Adams, 2001). Xylazine is also known to significantly ameliorate the effects induced by stress stimuli (Ali et al., 2006). It does not ...

  12. Sedative and Anticonvulsant Activities of the Ethanol Root Extract of ...

    African Journals Online (AJOL)

    ... the onset of tonic seizures. Conclusion: The results indicate that the ethanol root extract of F. chappar has sedative and anticonvulsant activities, thus justifying its use in traditional medicine for epilepsy. Keywords: Flemingia chappar, Anticonvulsant activity, Pentylenetetrazole , Electroshock seizure, CNS depressant.

  13. Safety and efficacy of procedural sedation and analgesia (PSA ...

    African Journals Online (AJOL)

    Safety and efficacy of procedural sedation and analgesia (PSA) conducted by medical officers in a level 1 hospital in Cape Town. ... Respiratory complications were treated with simple airway manoeuvres; no patient required intubation or experienced respiratory problems after waking up. There was no significant difference ...

  14. The impact of sedation on pulse pressure variation

    Czech Academy of Sciences Publication Activity Database

    Zvoníček, V.; Jurák, Pavel; Halámek, Josef; Kružliak, P.; Vondra, Vlastimil; Leinveber, P.; Cundrle, I.; Pavlík, M.; Suk, P.; Šrámek, V.

    2015-01-01

    Roč. 28, č. 4 (2015), s. 203-207 ISSN 1036-7314 R&D Projects: GA MŠk(CZ) LO1212 Institutional support: RVO:68081731 Keywords : pulse pressure variation * sedation * heart lung interactions * mechanical ventilation * brain death * oesophageal pressure Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 1.479, year: 2015

  15. Sedative, hypothermic and muscle relaxant effects of the essential ...

    African Journals Online (AJOL)

    The sedative effect was assessed by sodium pentobarbitone (50 mg/kg, i.p.) - induced sleeping time, while hypothermic effect was evaluated by estimating rectal temperature variation after administration of various doses of the oil using digital thermometer. The muscle relaxant effect was determined using the hind limb-grip ...

  16. Sedative and cardiopulmonary effects of buprenorphine and xylazine in horses.

    Science.gov (United States)

    Cruz, Fernando S F; Carregaro, Adriano B; Machado, Melissa; Antonow, Rômulo R

    2011-01-01

    This study investigated the sedative, cardiopulmonary, and gastrointestinal effects produced by buprenorphine and xylazine given in combination to horses. Six healthy adult horses underwent 4 randomized treatments, with an interval of 1 wk between treatments. A control group was given a saline solution intravenously (IV) and the experimental groups received buprenorphine [10 μg/kg bodyweight (BW)] in combination with 1 of 3 different doses of xylazine: 0.25 mg/kg BW (BX25), 0.50 mg/kg BW (BX50), or 0.75 mg/kg BW (BX75), all of them by IV. Cardiopulmonary parameters were evaluated for 120 min after the drugs were administered and intestinal motility was observed for 12 h after treatment. Sedation was found to be dose-dependent in all groups receiving buprenorphine and xylazine and it was observed that the heart rate decreased in the first 5 min and increased at the end of the sedation period. Arterial blood gas tension analyses showed minimal alterations during the experiment. Gastrointestinal hypomotility was observed for up to 8 h. The combination of buprenorphine and 0.50 mg/kg BW of xylazine (BX50) provided a 30-minute period of sedation without intense ataxia and maintained cardiopulmonary parameters within acceptable limits for the species.

  17. Patient satisfaction during and following procedural sedation for ...

    African Journals Online (AJOL)

    Conclusion: Our study population showed a high level of satisfaction with their sedation experience. It is suggested that the devised questionnaire could ... Patients are viewed as customers who expect a certain standard of care in a service delivery-driven world.4 ... Feel cold at any stage? • Have any problems breathing?

  18. Effect of Xylazine Sedation on some Clinicophysiological and ...

    African Journals Online (AJOL)

    UP Employee

    The objective of this research was to evaluate the sedative effect of xylazine in Sokoto red ... Gweba et al: Effects of xylazine on some parameters in goats. 178 .... Disposition of anaesthesia and anaesthetic related agents in ruminants. Vet. Clin. North Am. (Food Anim. Pract.), 2:527-552. EWING, K. K. (1990): Anaesthesia.

  19. Allergic Reaction to Ketamine as Monotherapy for Procedural Sedation.

    Science.gov (United States)

    Nguyen, Tammy T; Baker, Bethany; Ferguson, Jeffrey D

    2017-04-01

    Ketamine is a cyclohexamine derivative that acts as a noncompetitive N-methyl D-aspartate receptor antagonist. Its use for procedural sedation is recommended by national clinical policy. However, its immunogenic potential is not well documented. We report a case of allergic reaction associated with the administration of intravenous ketamine for procedural sedation in a 16-year-old male. Minutes after administration, the patient developed a morbilliform, erythematous rash that extended to the upper and lower torso and resolved with intravenous diphenhydramine. It is most likely that this allergic reaction was caused by a ketamine-induced histamine release that has been described in vitro. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This is the first case report in which ketamine was used as monotherapy in the emergency department for the facilitation of procedural sedation that resulted in an allergic reaction. Supportive measures, including advanced airway procedures and hemodynamic support, may be necessary in more severe anaphylactic cases. Providers should be aware of this potential adverse effect when using ketamine for procedural sedation. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Haematological effects of azaperone sedation in pigs | Adetunjia ...

    African Journals Online (AJOL)

    The short-term effect of azaperone sedation on packed cell volume (PCV), haemoglobin (Hb) level, red blood cell (RBC) and white blood cell (WBC) counts was investigated at 15 - minute intervals over a 1 - hour period in 5 pigs. The haematological values were tabulated. The PCV, Hb and RBC values were below the ...

  1. Pharmacological therapy for analgesia and sedation in the newborn.

    Science.gov (United States)

    Anand, K J S; Hall, R W

    2006-11-01

    Rapid advances have been made in the use of pharmacological analgesia and sedation for newborns requiring neonatal intensive care. Practical considerations for the use of systemic analgesics (opioids, non-steroidal anti-inflammatory agents, other drugs), local and topical anaesthetics, and sedative or anaesthetic agents (benzodiazepines, barbiturates, other drugs) are summarised using an evidence-based medicine approach, while avoiding mention of the underlying basic physiology or pharmacology. These developments have inspired more humane approaches to neonatal intensive care. Despite these advances, little is known about the clinical effectiveness, immediate toxicity, effects on special patient populations, or long-term effects after neonatal exposure to analgesics or sedatives. The desired or adverse effects of drug combinations, interactions with non-pharmacological interventions or use for specific conditions also remain unknown. Despite the huge gaps in our knowledge, preliminary evidence for the use of neonatal analgesia and sedation is available, but must be combined with a clear definition of clinical goals, continuous physiological monitoring, evaluation of side effects or tolerance, and consideration of long-term clinical outcomes.

  2. Non-sedation versus sedation with a daily wake-up trial in critically ill patients receiving mechanical ventilation-effects on physical function

    DEFF Research Database (Denmark)

    Nedergaard, Helene Korvenius; Jensen, Hanne Irene; Lauridsen, Jørgen T

    2015-01-01

    BACKGROUND: Critically ill patients rapidly loose much of their muscle mass and strength. This can be attributed to prolonged admission, prolonged mechanical ventilation and increased mortality, and it can have a negative impact on the degree of independence and quality of life. In the NONSEDA...... trial we randomize critically ill patients to non-sedation or sedation with a daily wake-up trial during mechanical ventilation in the intensive care unit. It has never been assessed whether non-sedation affects physical function. The aim of this study is to assess the effects of non-sedation versus...... to ensure sufficient oxygenation or placing the patient in a prone position. The experimental intervention will be non-sedation supplemented with pain management during mechanical ventilation. The control intervention will be sedation with a daily wake-up trial. The co-primary outcome will be quality...

  3. Non-sedation versus sedation with a daily wake-up trial in critically ill patients recieving mechanical ventilation - effects on long-term cognitive function

    DEFF Research Database (Denmark)

    Nedergaard, Helene Korvenius; Jensen, Hanne Irene; Stylsvig, Mette

    2016-01-01

    and long-term cognitive function. DISCUSSION: If non-sedation can improve long-term cognitive function, it could be an approach worth considering for a larger group of critically ill patients. TRIAL REGISTRATION: The study has been approved by the relevant scientific ethics committee and is registered......BACKGROUND: The effects of non-sedation on cognitive function in critically ill patients on mechanical ventilation are not yet certain. This trial is a substudy of the NONSEDA trial where critically ill patients are randomized to non-sedation or to sedation with a daily wake-up attempt during...... trauma, status epilepticus, patients treated with therapeutic hypothermia and patients with severe hypoxia). The experimental intervention will be non-sedation supplemented with pain management during mechanical ventilation. The control intervention will be sedation with a daily wake-up attempt...

  4. Evaluation of Anxiolytic-Like Effect of Aqueous Extract of Asparagus Stem in Mice

    Science.gov (United States)

    Cheng, Long; Pan, Guo-feng; Sun, Xiao-bo; Huang, Yun-xiang; Peng, You-shun; Zhou, Lin-yan

    2013-01-01

    There are few studies on the neuropharmacological properties of asparagus, which was applied in Chinese traditional medicine as a tonic and heat-clearing agent. The present study was designed to investigate the anxiolytic-like activity of the aqueous extract of asparagus stem (AEAS) using elevated plus maze (EPM) and Vogel conflict tests (VCT) in mice. AEAS significantly increased the percentage of time spent in open arms in EPM, when compared with control group. In the Vogel conflict drinking test, the numbers of punished licks increased to 177% and 174% by the treatment of AEAS at the doses of 1.5 and 3.0 g/kg (250 and 500 mg sarsasapogenin per kilogram of body weight), compared with control group. The serum cortisol level decreased significantly, at the same time. In conclusion, these findings indicated that the aqueous extract of asparagus stem exhibited a strong anxiolytic-like effect at dose of 1.5 and 3.0 g/kg (250 and 500 mg sarsasapogenin per kilogram of body weight) in experimental models of anxiety and may be considered an alternative approach for the management of anxiety disorder. PMID:24348707

  5. Anxiolytic effect of music exposure on BDNFMet/Met transgenic mice.

    Science.gov (United States)

    Li, Wen-Jing; Yu, Hui; Yang, Jian-Min; Gao, Jing; Jiang, Hong; Feng, Min; Zhao, Yu-Xia; Chen, Zhe-Yu

    2010-08-06

    Brain-derived neurotrophic factor (BDNF) has been reported to play important roles in the modulation of anxiety, mood stabilizers, and pathophysiology of affective disorders. Recently, a single nucleotide polymorphism (SNP) in the BDNF gene (Val66Met) has been found to be associated with depression and anxiety disorders. The humanized BDNF(Met/Met) knock-in transgenic mice exhibited increased anxiety-related behaviors that were unresponsive to serotonin reuptake inhibitors, fluoxetine. Music is known to be able to elicit emotional changes, including anxiolytic effects. In this study, we found that music treatment could significantly decrease anxiety state in BDNF(Met/Met) mice, but not in BDNF(+/)(-), mice compared with white noise exposure in open field and elevated plus maze test. Moreover, in contrast to white noise exposure, BDNF expression levels in the prefrontal cortex (PFC), amygdala and hippocampus were significantly increased in music-exposed adult BDNF(Met/Met) mice. However, music treatment could not upregulate BDNF levels in the PFC, amygdala, and hippocampus in BDNF(+/)(-) mice, which suggests the essential role of BDNF in the anxiolytic effect of music. Together, our results imply that music may provide an effective therapeutic intervention for anxiety disorders in humans with this genetic BDNF(Met) variant. Copyright 2010 Elsevier B.V. All rights reserved.

  6. Anxiolytic-like effect of Carvacrol (5-isopropyl-2-methylphenol) in mice: involvement with GABAergic transmission.

    Science.gov (United States)

    Melo, Francisca Helvira Cavalcante; Venâncio, Edith Teles; de Sousa, Damião Pergentino; de França Fonteles, Marta Maria; de Vasconcelos, Silvânia Maria Mendes; Viana, Glauce Socorro Barros; de Sousa, Francisca Cléa Florenço

    2010-08-01

    Carvacrol (5-isopropyl-2-methylphenol) is a monoterpenic phenol present in the essencial oil of many plants. It is the major component of the essential oil fraction of oregano and thyme. This work presents the behavioral effects of carvacrol in animal models of elevated plus maze (EPM), open field, Rotarod and barbiturate-induced sleeping time tests in mice. Carvacrol (CVC) was administered orally, in male mice, at single doses of 12.5; 25 and 50 mg/kg while diazepam 1 or 2 mg/kg was used as standard drug and flumazenil (2.5 mg/kg) was used to elucidate the possible anxiolytic mechanism of CVC on the plus maze test. The results showed that CVC, at three doses, had no effect on the spontaneous motor activity in the Rotarod test nor in the number of squares crossed in the open-field test. However, CVC decreased the number of groomings in the open-field test. In the plus maze test, CVC, at three doses significantly increased all the observed parameters in the EPM test and flumazenil was able to reverse the effects of diazepam and CVC. Therefore, CVC did not alter the sleep latency and sleeping time in the barbiturate-induced sleeping time test. These results show that CVC presents anxiolytic effects in the plus maze test which are not influenced by the locomotor activity in the open-field test.

  7. Anxiolytic Effect of Citrus aurantium L. on Patients with Chronic Myeloid Leukemia.

    Science.gov (United States)

    Pimenta, Flávia Cristina Fernandes; Alves, Mateus Feitosa; Pimenta, Martina Bragante Fernandes; Melo, Silvia Adelaide Linhares; de Almeida, Anna Alice Figueirêdo; Leite, José Roberto; Pordeus, Liana Clébia de Morais; Diniz, Margareth de Fátima Formiga Melo; de Almeida, Reinaldo Nóbrega

    2016-04-01

    The bone marrow aspiration procedure is used in hematological diseases and consists of a painful, invasive procedure causing anxiety-associated symptoms. The present study assessed the effect of Citrus aurantium L. essential oil on the treatment of anxiety, in the moment that precedes the collection of medullary material in patients with chronic myeloid leukemia (CML). Volunteers from both sexes were divided into groups receiving either the C. aurantium essential oil through inhalation, diazepam (10 mg), or the placebo. The evaluation was performed through psychometric scales [State-Trait Anxiety Inventory (STAI)] and physiological measurements (blood pressure and cardiac and respiratory frequency). Inhalation of C. aurantium was associated with a decrease in the STAI-S scores, suggesting an anxiolytic effect. In support of these results, a change in all the physiological measurements was observed in the group exposed to C. aurantium. In the diazepam group, only the diastolic pressure decreased, and no effect was observed in the placebo group. Therefore, the results showed that C. aurantium exhibits an anxiolytic effect and reduces the signs and symptoms associated with anxiety in patients with CML. Copyright © 2016 John Wiley & Sons, Ltd.

  8. Comparing augmentation with non-antidepressants over sticking to antidepressants after treatment failure in depression: a naturalistic study.

    Science.gov (United States)

    Köhler, S; Unger, T; Hoffmann, S; Steinacher, B; Fydrich, T; Bschor, T

    2013-03-01

    Non-response to an antidepressant monotherapy in unipolar depression is quite common. Therefore strategies for subsequent treatment steps are necessary. However, there is a lack of direct comparisons of these different strategies. In this naturalistic study we compared the outcome to different strategies after failure of the primary antidepressant treatment. Failure of primary antidepressant monotherapy occurred in 135 patients. 98 of these patients have been administered 4 treatment strategies of the physicians' choice: lithium augmentation (Li-Augm), switching to another antidepressant (AD-Switch), combination of 2 antidepressants (AD-Comb) or augmentation with second generation antipsychotic (SGA-Augm). Primary outcome measure was the 17-item Hamilton rating scale for depression (HRSD). Patients who received Li-Augm or augmentation with SGAs showed significantly greater improvement in HRSD and BDI compared to patients with antidepressant switch or antidepressant combination. Remission rates for Li-Augm and SGA-Augm were 89.3% and 86.2% compared to 40.7% for AD-Switch and 42.9% for AD-Comb. Changing to another pharmacological class (Li-Augm or augmentation with SGAs) showed better treatment results than sticking to the class of antidepressants (AD-Switch and AD-Comb) after primary failure in response to antidepressant monotherapy in unipolar depression. The lack of randomization and absence of a non-response definition are design flaws. Controlled studies are required to confirm the findings of this trial. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Sedative load and functional outcomes in community-dwelling older Australian men: the CHAMP study.

    Science.gov (United States)

    Gnjidic, Danijela; Le Couteur, David G; Hilmer, Sarah N; Cumming, Robert G; Blyth, Fiona M; Naganathan, Vasi; Waite, Louise; Handelsman, David J; Bell, John Simon; J S, Bell

    2014-02-01

    The aim of this cross-sectional study was to investigate the association between sedative load and functional outcomes in community-dwelling older Australian men. A total of 1696 males aged ≥ 70 years, enrolled in the Concord Health and Ageing in Men Project, were studied. Participants underwent assessments during 2005-2007. Sedative load was computed using a published model. Outcomes included activities of daily living (ADL), instrumental activities of daily living (IADL), physical performance measures and a clinical diagnosis of cognitive impairment. Of the participants, 15.3% took medications with sedative properties. After adjusting for age, education, depressive symptoms and comorbidities, participants who took one medication with sedation as a prominent side effect (sedative load = 1) had odds ratio (OR) of 2.15 (95% confidence interval, CI: 1.20-3.85) for ADL disability, compared with participants with sedative load = 0. Participants who took at least one primary sedative or two medications with sedation as a prominent side effect (sedative load ≥ 2) had an OR of 1.55 (95% CI: 1.02-2.35) for IADL disability, compared with participants with sedative load = 0. The mean 6-m walking speed (P = 0.001) and grip strength (P = 0.003) were significantly different between sedative load groups in unadjusted models only. No association between sedative load and poorer performance on balance and chair stands tests or cognitive impairment was observed. Participants with sedative load of one were more likely to report ADL disability, whereas participants with sedative load of ≥2 were more likely to report IADL disability. Higher sedative load was not associated with poorer physical performance or cognitive impairment in older Australian men. © 2012 The Authors Fundamental and Clinical Pharmacology © 2012 Société Française de Pharmacologie et de Thérapeutique.

  10. The antidepressant-like effect of Mentha spicata essential oil in animal models of depression in male mice

    Directory of Open Access Journals (Sweden)

    Behnam Jedi-Behnia

    2017-06-01

    Full Text Available Background & Objective: Previous researches have revealed analgesic and sedative properties of Mentha spicata (MS. The aim of present study was to evaluate the antidepressant effects of MS essential oil in forced swim test (FST and tail suspension test (TST in male mice. Materials & Methods: In this experimental study, 84 male mice were randomly divided into 14 groups of 6: Negative control groups received normal saline (10 ml/kg,i.p., positive control groups received fluoxetine (20mg/kg, i.p. and imipramine (30mg/kg and treatment groups received MS essential oil (30, 60,120 and 240 mg/kg i.p.. In FST, immobility time, swimming time and climbing time and immobility time in TST were recorded in six minutes. Results: Findings indicated that essential oil at doses of 120 and 240 mg/kg, fluoxetine and imipramine reduced immobility time compared to control group in FST and TST (p0.05. In contrast, imipramine increased climbing time without any significant change in swimming time (p>0.05. Conclusion: Based on the findings of the present study, MS essential oil has antidepressant-like activity similar to fluoxetine and probably their compounds (especially carvone with serotonergic mechanism induced their effect. However, further studies are needed to determine the precise mechanism of its action.

  11. Antidepressant-like behavioral, anatomical, and biochemical effects of petroleum ether extract from maca (Lepidium meyenii) in mice exposed to chronic unpredictable mild stress.

    Science.gov (United States)

    Ai, Zhong; Cheng, Ai-Fang; Yu, Yuan-Tao; Yu, Long-Jiang; Jin, Wenwen

    2014-05-01

    Maca has been consumed as a medical food in Peru for thousands of years, and exerts anxiolytic and antidepressant effects. Our present study aimed to evaluate the behavior and anatomical and biochemical effects of petroleum ether extract from maca (ME) in the chronic unpredictable mild stress (CUMS) model of depression in mice. Three different doses of maca extract (125, 250, and 500 mg/kg) were orally administrated in the six-week CUMS procedure. Fluoxetine (10 mg/kg) was used as a positive control drug. Maca extract (250 and 500 mg/kg) significantly decreased the duration of immobility time in the tail suspension test. After treatment with maca extract (250 and 500 mg/kg), the granule cell layer in the dentate gyrus appeared thicker. Maca extract (250 and 500 mg/kg) also induced a significant reduction in corticosterone levels in mouse serum. In mouse brain tissue, after six weeks of treatment, noradrenaline and dopamine levels were increased by maca extract, and the activity of reactive oxygen species was significantly inhibited. Serotonin levels were not significantly altered. These results demonstrated that maca extract (250 and 500 mg/kg) showed antidepressant-like effects and was related to the activation of both noradrenergic and dopaminergic systems, as well as attenuation of oxidative stress in mouse brain.

  12. Identifying fast-onset antidepressants using rodent models.

    Science.gov (United States)

    Ramaker, M J; Dulawa, S C

    2017-05-01

    Depression is a leading cause of disability worldwide and a major contributor to the burden of suicide. A major limitation of classical antidepressants is that 2-4 weeks of continuous treatment is required to elicit therapeutic effects, prolonging the period of depression, disability and suicide risk. Therefore, the development of fast-onset antidepressants is crucial. Preclinical identification of fast-onset antidepressants requires animal models that can accurately predict the delay to therapeutic onset. Although several well-validated assay models exist that predict antidepressant potential, few thoroughly tested animal models exist that can detect therapeutic onset. In this review, we discuss and assess the validity of seven rodent models currently used to assess antidepressant onset: olfactory bulbectomy, chronic mild stress, chronic forced swim test, novelty-induced hypophagia (NIH), novelty-suppressed feeding (NSF), social defeat stress, and learned helplessness. We review the effects of classical antidepressants in these models, as well as six treatments that possess fast-onset antidepressant effects in the clinic: electroconvulsive shock therapy, sleep deprivation, ketamine, scopolamine, GLYX-13 and pindolol used in conjunction with classical antidepressants. We also discuss the effects of several compounds that have yet to be tested in humans but have fast-onset antidepressant-like effects in one or more of these antidepressant onset sensitive models. These compounds include selective serotonin (5-HT) 2C receptor antagonists, a 5-HT 4 receptor agonist, a 5-HT 7 receptor antagonist, NMDA receptor antagonists, a TREK-1 receptor antagonist, mGluR antagonists and (2R,6R)-HNK. Finally, we provide recommendations for identifying fast-onset antidepressants using rodent behavioral models and molecular approaches.

  13. Sedation versus no sedation: Are there differences in relatives' satisfaction with the Intensive Care Unit? A survey study based on data from a randomised controlled trial.

    Science.gov (United States)

    Laerkner, Eva; Stroem, Thomas; Toft, Palle

    2017-04-01

    Currently there is a trend towards less or no use of sedation of mechanically ventilated patients. Still, little is known about how different sedation strategies affect relatives' satisfaction with the Intensive Care Unit (ICU). To explore if there was a difference in relatives' personal reactions and the degree of satisfaction with information, communication, surroundings, care and treatment in the ICU between relatives of patients who receive no sedation compared with relatives of patients receiving sedation during mechanical ventilation in the ICU. A survey study using a questionnaire with 39 questions was distributed to relatives of mechanically ventilated patients, who had been randomised to either sedation with daily wake up or no sedation. Forty-nine questionnaires were sent out and 36 relatives answered. The response rate was 73%. We found no differences in relatives' personal reactions or in the degree of satisfaction with information, communication, care and treatment in the ICU between relatives of patients in the two groups. Relatives of patients treated with no sedation felt more bothered by disturbances in the surroundings compared with relatives of patients who were sedated (p=0.03). Treating the patient during mechanical ventilation with no sedation does not affect relatives' satisfaction adversely. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Is the antidepressive effect of second-generation antidepressants a myth?

    DEFF Research Database (Denmark)

    Bech, P

    2010-01-01

    Two recent meta-analyses on second-generation antidepressants versus placebo in mild to moderate forms of major depression, based on data on all randomized clinical trials using the Hamilton Depression Scale (HAMD) submitted to FDA, have shown an effect size of approximately 0.30 in favour...

  15. Ketamine treatment involves medial prefrontal cortex serotonin to induce a rapid antidepressant-like activity in BALB/cJ mice.

    Science.gov (United States)

    Pham, T H; Mendez-David, I; Defaix, C; Guiard, B P; Tritschler, L; David, D J; Gardier, A M

    2017-01-01

    Unlike classic serotonergic antidepressant drugs, ketamine, an NMDA receptor antagonist, exhibits a rapid and persistent antidepressant (AD) activity, at sub-anaesthetic doses in treatment-resistant depressed patients and in preclinical studies in rodents. The mechanisms mediating this activity are unclear. Here, we assessed the role of the brain serotonergic system in the AD-like activity of an acute sub-anaesthetic ketamine dose. We compared ketamine and fluoxetine responses in several behavioral tests currently used to predict anxiolytic/antidepressant-like potential in rodents. We also measured their effects on extracellular serotonin levels [5-HT] ext in the medial prefrontal cortex (mPFCx) and brainstem dorsal raphe nucleus (DRN), a serotonergic nucleus involved in emotional behavior, and on 5-HT cell firing in the DRN in highly anxious BALB/cJ mice. Ketamine (10 mg/kg i.p.) had no anxiolytic-like effect, but displayed a long lasting AD-like activity, i.e., 24 h post-administration, compared to fluoxetine (18 mg/kg i.p.). Ketamine (144%) and fluoxetine (171%) increased mPFCx [5-HT] ext compared to vehicle. Ketamine-induced AD-like effect was abolished by a tryptophan hydroxylase inhibitor, para-chlorophenylalanine (PCPA) pointing out the role of the 5-HT system in its behavioral activity. Interestingly, increase in cortical [5-HT] ext following intra-mPFCx ketamine bilateral injection (0.25 μg/side) was correlated with its AD-like activity as measured on swimming duration in the FST in the same mice. Furthermore, pre-treatment with a selective AMPA receptor antagonist (intra-DRN NBQX) blunted the effects of intra-mPFCx ketamine on both the swimming duration in the FST and mPFCx [5-HT] ext suggesting that the AD-like activity of ketamine required activation of DRN AMPA receptors and recruited the prefrontal cortex/brainstem DRN neural circuit in BALB/c mice. These results confirm a key role of cortical 5-HT release in ketamine's AD-like activity following

  16. Patient-Specific Classification of ICU Sedation Levels From Heart Rate Variability.

    Science.gov (United States)

    Nagaraj, Sunil B; Biswal, Siddharth; Boyle, Emily J; Zhou, David W; McClain, Lauren M; Bajwa, Ednan K; Quraishi, Sadeq A; Akeju, Oluwaseun; Barbieri, Riccardo; Purdon, Patrick L; Westover, M Brandon

    2017-07-01

    To develop a personalizable algorithm to discriminate between sedation levels in ICU patients based on heart rate variability. Multicenter, pilot study. Several ICUs at Massachusetts General Hospital, Boston, MA. We gathered 21,912 hours of routine electrocardiogram recordings from a heterogenous group of 70 adult ICU patients. All patients included in the study were mechanically ventilated and were receiving sedatives. As "ground truth" for developing our method, we used Richmond Agitation Sedation Scale scores grouped into four levels denoted "comatose" (-5), "deeply sedated" (-4 to -3), "lightly sedated" (-2 to 0), and "agitated" (+1 to +4). We trained a support vector machine learning algorithm to calculate the probability of each sedation level from heart rate variability measures derived from the electrocardiogram. To estimate algorithm performance, we calculated leave-one-subject out cross-validated accuracy. The patient-independent version of the proposed system discriminated between the four sedation levels with an overall accuracy of 59%. Upon personalizing the system supplementing the training data with patient-specific calibration data, consisting of an individual's labeled heart rate variability epochs from the preceding 24 hours, accuracy improved to 67%. The personalized system discriminated between light- and deep-sedation states with an average accuracy of 75%. With further refinement, the methodology reported herein could lead to a fully automated system for depth of sedation monitoring. By enabling monitoring to be continuous, such technology may help clinical staff to monitor sedation levels more effectively and to reduce complications related to over- and under sedation.

  17. [Are we controlling the sedation in ICU? A multicenter study results].

    Science.gov (United States)

    Belyshev, S Iu; Levit, A; Leĭderman, I; Baĭbikov, V; Batakov, L; Bashkirova, A; Besedina, E; Boltaev, P; Bulgakova, I; Burtsev, M; Gazenkampf, A; Gapoian, L; Gladkov, N; Davydov, A; Danchenko, S; Dianov, A; Drozd, A; Dubina, O; Zaryvnykh, I; Zverev, A; Zigmantovich, E; Ivan'kov, K; Il'in, V; Kadnikov, M; Kokarev, E; Kolegova, Zh; Kondrashkin, M; Kotkova, E; Kul'minskaia, N; Leshkova, V; Litiaĭkin, A; Makhmutov, Iu; Medvedeva, G; Napol'skikh, V; Orekhov, A; Orlov, A; Piontek, A; Reshetnikova, S; Samatov, I; Samsonova, M; Semen'kova, G; Smirnov, M; Sobetova, G; Strel'tsova, E; Tiul'pin, A; Khanov, D; Khardin, E; Khlebnikova, I; Cherniak, A; Chipinskaia, E; Shvedova, M; Shevelev, M; Shevchuk, D; Shen', N; Shleĭkher, V; Shliapnikova, L

    2012-01-01

    The aim of this study is to evaluate the issues of sedation and analgesia in all-purpose ICUs in Russia. To obtain that, a single-day observational survey was performed in 55 ICUs of Ural and Siberia regions. This work enabled to describe the targets, instruments of control and patterns of sedative and analgetics and sedatives prescription, as well as to make conclusions about issues in this area and possibilities of creation and necessity of analgesia and sedation standards. The study has shown a decent percentage of use of standardized scales evaluating pain in ICU and predominance of effectivae drugs and analgesia patterns, which leads to "formalization" of analgesia and decrease of it's effectiveness. Sedation indications do not satisfy the modern concept, sedation level evaluation scores are used only in 13%, schemes and drugs are traditional. The results of this study may serve as a reason for discussion of necessity of introducing of sedative and analgetic therapy in ICU standarts.

  18. Flemish palliative-care nurses' attitudes to palliative sedation: a quantitative study.

    Science.gov (United States)

    Gielen, Joris; Van den Branden, Stef; Van Iersel, Trudie; Broeckaert, Bert

    2012-09-01

    Palliative sedation is an option of last resort to control refractory suffering. In order to better understand palliative-care nurses' attitudes to palliative sedation, an anonymous questionnaire was sent to all nurses (589) employed in palliative care in Flanders (Belgium). In all, 70.5% of the nurses (n = 415) responded. A large majority did not agree that euthanasia is preferable to palliative sedation, were against non-voluntary euthanasia in the case of a deeply and continuously sedated patient and considered it generally better not to administer artificial floods or fluids to such a patient. Two clusters were found: 58.5% belonged to the cluster of advocates of deep and continuous sedation and 41.5% belonged to the cluster of nurses restricting the application of deep and continuous sedation. These differences notwithstanding, overall the attitudes of the nurses are in accordance with the practice and policy of palliative sedation in Flemish palliative-care units.

  19. [Fatal outcome after overdosage with antidepressants].

    Science.gov (United States)

    Gude, Martin Faurholdt; Jensen, Lisbet Tokkesdal; Bjerre-Kristensen, Lars

    2014-02-10

    Serotonin syndrome (SS) is a complication after overdosage with antidepressants. SS increases the level of circulating serotonin. Fatal outcome of SS is most often seen in cases where there has been an overdosage with selective serotonin reuptake inhibitors (SSRI)/selective noradrenaline reuptake inhibitors (SNRI) in combination with other serotonin increasing drugs. This case report describes the rapid development of symptoms in a 54-year-old man who ingested a total amount of 6.5 g of SSRI and SNRI drugs as the only drug types. It proves the importance of being aware of the symptoms of SS when the patient is first seen in the emergency department.

  20. Risks for oral health with the use of antidepressants

    NARCIS (Netherlands)

    Peeters, FPML; deVries, MW; Vissink, A

    In this article, attention is focused on ornl pathology, particularly dental caries, caused by hyposalivation as a consequence of (long-term) use of antidepressants. Changes in clinical psychiatric practice and increasing numbers of presciptions of antidepressants in primary care and specialty care