Pharmacogenetics of psychotropic drugs

National Research Council Canada - National Science Library

Lerer, Bernard

2002-01-01

... of pharmacogenetics with substance dependence and brain imaging, and consider the impact of pharmacogenetics on the biotechnology and pharmaceutical industries. This book defines the young field of pharmacogenetics as it applies to psychotropic drugs and is, therefore, an essential reference for all clinicians and researchers working in this findings field. Bernard ...

Use of psychotropic drugs during pregnancy and breast-feeding.

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Larsen, E R; Damkier, P; Pedersen, L H; Fenger-Gron, J; Mikkelsen, R L; Nielsen, R E; Linde, V J; Knudsen, H E D; Skaarup, L; Videbech, P

2015-01-01

To write clinical guidelines for the use of psychotropic drugs during pregnancy and breast-feeding for daily practice in psychiatry, obstetrics and paediatrics. As we wanted a guideline with a high degree of consensus among health professionals treating pregnant women with a psychiatric disease, we asked the Danish Psychiatric Society, the Danish Society of Obstetrics and Gynecology, the Danish Paediatric Society and the Danish Society of Clinical Pharmacology to appoint members for the working group. A comprehensive review of the literature was hereafter conducted. Sertraline and citalopram are first-line treatment among selective serotonin reuptake inhibitor for depression. It is recommended to use lithium for bipolar disorders if an overall assessment finds an indication for mood-stabilizing treatment during pregnancy. Lamotrigine can be used. Valproate and carbamazepin are contraindicated. Olanzapine, risperidone, quetiapine and clozapine can be used for bipolar disorders and schizophrenia. It is important that health professionals treating fertile women with a psychiatric disease discuss whether psychotropic drugs are needed during pregnancy and how it has to be administered. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Psychotropic Drug Prescription in Adolescents: A Retrospective Study in a Swiss Psychiatric University Hospital.

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Ansermot, Nicolas; Jordanov, Véronique; Smogur, Michal; Holzer, Laurent; Eap, Chin B

2018-04-01

This retrospective study aims to evaluate off-label prescriptions and administrations of psychotropic medications in adolescents in a university psychiatric hospital in Switzerland. Data were collected during the entire stays from the electronic database for 76 inpatients in 2008 and 76 inpatients in 2014. Data collected included gender, age, psychiatric diagnosis, duration of hospitalization, and psychotropic drug prescriptions and administrations. A total of 224 psychotropic drugs (mean 2.9 drugs/patient) were prescribed in 2008 and 268 (mean 3.5 drugs/patient) in 2014. Due to the prescriptions of some drugs as required, only 76% of the prescriptions were actually administered in 2008 (mean 2.3 drugs/patient) and 55% in 2014 (mean 1.9 drugs/patient). Antipsychotics were the most frequently prescribed drugs in 2008 (74% of patients) and 2014 (86% of patients). Anxiolytics were also highly prescribed in 2008 (54% of patients) and 2014 (66% of patients), as well as antidepressants in 2008 (30% of patients), but less in 2014 (13% of patients). Overall, 69% of prescriptions were found to be off label in 2008 and 68% in 2014, according to age, diagnosis, dose, or formulation as approved by Swissmedic. The medication classes with the highest rate of off-label prescriptions were antidepressants (100% for both years), antipsychotics (94% in 2008 and 92% in 2014), and hypnotics (67% in 2008 and 100% in 2014). For both study periods, at least one off-label psychotropic drug prescription and administration was recorded in 96% and 79% of the patients, respectively. The high rate of off-label psychotropic drug use strengthens the need for clinical trials to better evaluate the efficacy and safety of these treatments in adolescents.

Influence of psychotropic drugs prescription on body weight increase

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Blanca E. Martínez de Morentin-Aldabe

2013-03-01

Full Text Available Obesity has become a major public health burden, not only by the rising prevalence but also because of the associated complications. Furthermore there is a number of diseases whose risk and onset is increased in subjects with overweight such as type 2 diabetes, dislipemias, tumors (endometrial, colon, breast, cancer, etc, skeletal disorders, digestive disturbances, cardiovascular diseases, respiratory disorders, psychological problems, obstetric and gynecological disorders.The prescription of psychotropic drugs is important and, in most countries, consumption has been increased in recent years. Indeed, several drugs used in the treatment of anxiety, depression, bipolar disorder, schizophrenia or epilepsy, can increase body weight and fat deposition or eventually decrease it. These side effects could make a previous situation of obesity to worsen, and it can even cause excessive weight gain in patients with a normal weight at the beginning of the treatment. This increase in adiposity may also contribute to the lack of adherence to the medication and thus a possible relapse of the patients.In this review we report the links between psychotropic drugs administration and weight gain as well as the potential mechanisms that are involved.DOI: http://dx.doi.org/10.14306/renhyd.17.1.4

Prevalence and correlates of psychotropic drug use in Dutch nursing-home patients with dementia

NARCIS (Netherlands)

Nijk, Renate M; Zuidema, Sytse U; Koopmans, Raymond T C M

BACKGROUND: Neuropsychiatric symptoms in dementia patients are common and are often treated with psychotropic drugs. The aim of this study was to determine the prevalence and correlates of psychotropic drug use in Dutch nursing home patients with dementia. METHODS: Psychotropic drug use of 1322

[Rational use of psychotropic drugs and social communication role].

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Montero, F

1994-06-01

Extra-clinical factors about the influences affecting the prescription and use of drugs are reviewed. Special attention is given to regulatory agencies, the pharmaceutical industry, and mass media. The problems and public health consequences of the irrational use of drugs are rarely documented in Latin America. Analysis of these factors, information sources, and rational use of psychotropic drugs will require multiple strategies such as social communication and policy formulation to define goals and objectives related to population information, doctors' and individual citizens' decision making processes, and participation of consumers in improving the use of psychotropic drugs.

Public health nurses' perception of their roles in relation to psychotropic drug use by adolescents: a phenomenographic study.

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Steffenak, Anne Kjersti Myhrene; Nordström, Gun; Hartz, Ingeborg; Wilde-Larsson, Bodil

2015-04-01

The purpose of the paper was to describe the perceptions of public health nurses' roles in relation to psychotropic drug use by adolescents. Mental health problems among adolescents are documented with studies indicating an increased use of psychotropic drugs. In Norway, care for such adolescents may fall naturally into the remit of public health nurses. A phenomenographic approach was used to analyse the data. A qualitative interview study was made of 20 Norwegian public health nurses, strategically chosen using phenomenographic methodology. The public health nurses described three categories: discovering public health nurses who become aware of psychotropic drug use in the health dialogue with adolescents and choose to either act or not act in relation to psychotropic drug use. Those public health nurses who take action are cooperating public health nurses, who cooperate with adolescents, their families, schools and others. If cooperation has been established, supporting public health nurses teach and support the adolescent in relation to psychotropic drug use. The public health nurses who do not act can hinder or delay further treatment. Public health nurses need to acquire knowledge about psychotropic drugs, to fulfil their role in nursing mental health problems among adolescents and the increasing use of psychotropic drugs. The results demonstrated that public health nurses, working in health centres and schools, have the responsibility and the opportunity to identify young people struggling with mental health problems and psychotropic drug use as well as teach and support significant others, e.g. parents and siblings. Intervention studies are needed with regard to health promotion programmes aimed at fortifying young people's mental health. © 2014 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Public health nurses’ perception of their roles in relation to psychotropic drug use by adolescents: a phenomenographic study

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Steffenak, Anne Kjersti Myhrene; Nordström, Gun; Hartz, Ingeborg; Wilde-Larsson, Bodil

2015-01-01

Aims and objectives The purpose of the paper was to describe the perceptions of public health nurses’ roles in relation to psychotropic drug use by adolescents. Background Mental health problems among adolescents are documented with studies indicating an increased use of psychotropic drugs. In Norway, care for such adolescents may fall naturally into the remit of public health nurses. Design A phenomenographic approach was used to analyse the data. Method A qualitative interview study was made of 20 Norwegian public health nurses, strategically chosen using phenomenographic methodology. Results The public health nurses described three categories: discovering public health nurses who become aware of psychotropic drug use in the health dialogue with adolescents and choose to either act or not act in relation to psychotropic drug use. Those public health nurses who take action are cooperating public health nurses, who cooperate with adolescents, their families, schools and others. If cooperation has been established, supporting public health nurses teach and support the adolescent in relation to psychotropic drug use. Conclusion The public health nurses who do not act can hinder or delay further treatment. Public health nurses need to acquire knowledge about psychotropic drugs, to fulfil their role in nursing mental health problems among adolescents and the increasing use of psychotropic drugs. Relevance to clinical practice The results demonstrated that public health nurses, working in health centres and schools, have the responsibility and the opportunity to identify young people struggling with mental health problems and psychotropic drug use as well as teach and support significant others, e.g. parents and siblings. Intervention studies are needed with regard to health promotion programmes aimed at fortifying young people's mental health. PMID:25639291

Psychotropic drug use in people with intellectual disability: patterns of use and critical evaluation : patterns of use and critical evaluation

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Scheifes, A.

2015-01-01

Treatment with psychotropic drugs is highly prevalent in people with intellectual disability, especially in those with behavioural problems. The high rates of psychotropic drug use in this population is contrasted by the limited evidence on their effectiveness and the high risk of adverse events.

Psychotropic medication patterns among youth in foster care.

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Zito, Julie M; Safer, Daniel J; Sai, Devadatta; Gardner, James F; Thomas, Diane; Coombes, Phyllis; Dubowski, Melissa; Mendez-Lewis, Maria

2008-01-01

Studies have revealed that youth in foster care covered by Medicaid insurance receive psychotropic medication at a rate > 3 times that of Medicaid-insured youth who qualify by low family income. Systematic data on patterns of medication treatment, particularly concomitant drugs, for youth in foster care are limited. The purpose of this work was to describe and quantify patterns of psychotropic monotherapy and concomitant therapy prescribed to a randomly selected, 1-month sample of youth in foster care who had been receiving psychotropic medication. METHODS. Medicaid data were accessed for a July 2004 random sample of 472 medicated youth in foster care aged 0 through 19 years from a southwestern US state. Psychotropic medication treatment data were identified by concomitant pattern, frequency, medication class, subclass, and drug entity and were analyzed in relation to age group; gender; race or ethnicity; International Classification of Diseases, Ninth Revision, psychiatric diagnosis; and physician specialty. Of the foster children who had been dispensed psychotropic medication, 41.3% received > or = 3 different classes of these drugs during July 2004, and 15.9% received > or = 4 different classes. The most frequently used medications were antidepressants (56.8%), attention-deficit/hyperactivity disorder drugs (55.9%), and antipsychotic agents (53.2%). The use of specific psychotropic medication classes varied little by diagnostic grouping. Psychiatrists prescribed 93% of the psychotropic medication dispensed to youth in foster care. The use of > or = 2 drugs within the same psychotropic medication class was noted in 22.2% of those who were given prescribed drugs concomitantly. Concomitant psychotropic medication treatment is frequent for youth in foster care and lacks substantive evidence as to its effectiveness and safety.

Risk factors for the development of pneumonia in acute psychotropic drugs poisoning

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Vučinić Slavica

2005-01-01

Full Text Available Background/Aim. Pneumonia is the most frequent complication in acute psychotropic drugs poisoning, which results in substantial morbidity and mortality, but which also increases the costs of treatment. Risk factors for pneumonia are numerous: age, sex, place of the appearance of pneumonia, severity of underlying disease, airway instrumentation (intubation, reintubation, etc. The incidence of pneumonia varies in poisoning caused by the various groups of drugs. The aim of this study was to determine the incidence and risk factors for pneumonia in the patients with acute psychotropic drugs poisoning. Methods. A group of 782 patients, out of which 614 (78.5% with psychotropic and 168 (21.5% nonpsychotropic drug poisoning were analyzed prospectively during a two-year period. The diagnosis of pneumonia was made according to: clinical presentation, new and persistent pulmonary infiltrates on chest radiography, positive nonspecific parameters of inflammation, and the microbiological confirmation of causative microorganisms. To analyze predisposing risk factors for pneumonia, the following variables were recorded: sex, age, underlying diseases, endotracheal intubation, coma, severity of poisoning with different drugs, histamine H2 blockers, corticosteroids, mechanical ventilation, central venous catheter. The univariate analysis for pneumonia risk factors in all patients, and for each group separately was done. The multivariate analysis was performed using the logistic regression technique. Results. Pneumonia was found in 94 (12.02% of the patients, 86 of which (91.5% in psychotropic and 8 (8.5% in nonpsychotropic drug poisoning. In the psychotropic drug group, pneumonia was the most frequent in antidepressant (47%, and the rarest in benzodiazepine poisoning (3.8%. A statistically significant incidence of pneumonia was found in the patients with acute antidpressant poisoning (p < 0.001. Univariate analysis showed statistical significance for the

Psychomotor developmental effects of prenatal exposure to psychotropic drugs: a study in EFEMERIS database.

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Hurault-Delarue, Caroline; Damase-Michel, Christine; Finotto, Laurent; Guitard, Claudine; Vayssière, Christophe; Montastruc, Jean-Louis; Montastruc, François; Lacroix, Isabelle

2016-10-01

Little is known about neurodevelopment of children exposed to psychotropic drugs during pregnancy. The purpose of this study was to evaluate the effects of prenatal exposure to psychotropic drugs on psychomotor development in children. This observational study used the EFEMERIS database. The database records the drugs prescribed and delivered during pregnancy and the resulting outcomes. Neurodevelopment at nine and 24 months of children born to women exposed to psychotropic drugs (anxiolytics, antidepressants, neuroleptics and anti-epileptics) during the second and/or third trimesters of pregnancy was compared to children who were not exposed to these drugs. Psychomotor development of 493 children (1.5%) exposed to psychotropic drugs during pregnancy was compared to 32 303 unexposed children. Exposure to psychotropic drugs during pregnancy was associated with an increased risk of abnormal motor development at 9 months (OR = 1.3 [1.1-2.2]) and abnormal motor and mental development at 24 months (OR = 4.8 [2.1-11.0] and OR = 2.3 [1.05-4.9]). Increased risk was observed in children born to women exposed to anti-epileptic drugs, neuroleptics or antidepressants during pregnancy. This study found a higher rate of deviation from the normal developmental milestones in children born to women exposed to psychotropic drugs during pregnancy and more particularly antidepressants, neuroleptics and anti-epileptics. © 2016 Société Française de Pharmacologie et de Thérapeutique.

Utilization of psychotropic drugs prescribed to persons with and without HIV infection

DEFF Research Database (Denmark)

Rasmussen, L. D.; Obel, D; Kronborg, G

2014-01-01

on redeemed prescription of psychotropic drugs during 1995-2009. We primarily focused our analyses on HIV-infected individuals with no history of injecting drug use (IDU) or hepatitis C virus (HCV) infection. Drug utilization was expressed as defined daily doses per 1000 person-days (DDD/1000PD...... with exposure to HAART or efavirenz was found. CONCLUSIONS: HIV-infected individuals had a higher utilization of psychotropic drugs than the background population, which was not confined to individuals with a history of IDU or HCV infection. This emphasizes the need to focus on diagnosis of, and appropriate......OBJECTIVES: The objective was to estimate the utilization of psychotropic drugs in HIV-infected individuals compared with that in the background population. METHODS: Using data obtained from the Danish HIV Cohort Study and the Danish National Prescription Registry, we analysed aggregated data...

Workplace bullying and psychotropic drug use: the mediating role of physical and mental health status.

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Niedhammer, Isabelle; David, Simone; Degioanni, Stéphanie; Drummond, Anne; Philip, Pierre; Acquarone, D; Aicardi, F; André-Mazeaud, P; Arsento, M; Astier, R; Baille, H; Bajon-Thery, F; Barre, E; Basire, C; Battu, J L; Baudry, S; Beatini, C; Beaud'huin, N; Becker, C; Bellezza, D; Beque, C; Bernstein, O; Beyssier, C; Blanc-Cascio, F; Blanchet, N; Blondel, C; Boisselot, R; Bordes-Dupuy, G; Borrelly, N; Bouhnik, D; Boulanger, M F; Boulard, J; Bourreau, P; Bourret, D; Boustière, A M; Breton, C; Bugeon, G; Buono-Michel, M; Canonne, J F; Capella, D; Cavin-Rey, M; Cervoni, C; Charreton, D; Charrier, D; Chauvin, M A; Chazal, B; Cougnot, C; Cuvelier, G; Dalivoust, G; Daumas, R; Debaille, A; De Bretteville, L; Delaforge, G; Delchambre, A; Domeny, L; Donati, Y; Ducord-Chapelet, J; Duran, C; Durand-Bruguerolle, D; Fabre, D; Faivre, A; Falleri, R; Ferrando, G; Ferrari-Galano, J; Flutet, M; Fouché, J P; Fournier, F; Freyder, E; Galy, M; Garcia, A; Gazazian, G; Gérard, C; Girard, F; Giuge, M; Goyer, C; Gravier, C; Guyomard, A; Hacquin, M C; Halimi, E; Ibagnes, T; Icart, P; Jacquin, M C; Jaubert, B; Joret, J P; Julien, J P; Kacel, M; Kesmedjian, E; Lacroix, P; Lafon-Borelli, M; Lallai, S; Laudicina, J; Leclercq, X; Ledieu, S; Leroy, J; Leroyer, L; Loesche, F; Londi, D; Longueville, J M; Lotte, M C; Louvain, S; Lozé, M; Maculet-Simon, M; Magallon, G; Marcelot, V; Mareel, M C; Martin, P; Masse, A M; Méric, M; Milliet, C; Mokhtari, R; Monville, A M; Muller, B; Obadia, G; Pelser, M; Peres, L; Perez, E; Peyron, M; Peyronnin, F; Postel, S; Presseq, P; Pyronnet, E; Quinsat, C; Raulot-Lapointe, H; Rigaud, P; Robert, F; Robert, O; Roger, K; Roussel, A; Roux, J P; Rubini-Remigy, D; Sabaté, N; Saccomano-Pertus, C; Salengro, B; Salengro-Trouillez, P; Samsom, E; Sendra-Gille, L; Seyrig, C; Stoll, G; Tarpinian, N; Tavernier, M; Tempesta, S; Terracol, H; Torresani, F; Triglia, M F; Vandomme, V; Vieillard, F; Vilmot, K; Vital, N

2011-03-01

The association between workplace bullying and psychotropic drug use is not well established. This study was aimed at exploring the association between workplace bullying, and its characteristics, and psychotropic drug use and studying the mediating role of physical and mental health. The study population consisted of a random sample of 3132 men and 4562 women of the working population in the south-east of France. Workplace bullying, evaluated using the validated instrument elaborated by Leymann, and psychotropic drug use, as well as covariates, were measured using a self-administered questionnaire. Covariates included age, marital status, presence of children, education, occupation, working hours, night work, physico-chemical exposures at work, self-reported health, and depressive symptoms. Statistical analysis was performed using logistic regression analysis and was carried out separately for men and women. Workplace bullying was strongly associated with psychotropic drug use. Past exposure to bullying increased the risk for this use. The more frequent and the longer the exposure to bullying, the stronger the association with psychotropic drug use. Observing bullying on someone else at the workplace was associated with psychotropic drug use. Adjustment for covariates did not modify the results. Additional adjustment for self-reported health and depressive symptoms reduced the magnitude of the associations, especially for men. The association between bullying and psychotropic drug use was found to be significant and strong and was partially mediated by physical and mental health.

Risk of impaired cognition after prenatal exposure to psychotropic drugs

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Wibroe, M A; Mathiasen, R; Pagsberg, A K

2017-01-01

OBJECTIVE: Prenatal exposure to psychotropic drugs may affect the trajectories of brain development. In a register study, we investigated whether such exposure is associated with long-term impaired cognitive abilities. METHOD: Individuals born in Denmark in 1995-2008 were included. As proxies...... of a neurological/mental disorder after prenatal exposure to psychoanaleptics (primarily antidepressants) (OR: 1.86[1.24-2.78). CONCLUSION: Prenatal exposure to psychotropic drugs affects proxy outcomes of cognitive disabilities at school age. Exposure to psycholeptics carries the largest risk. The role...

Risk factors for the development of pneumonia in acute psychotropic drugs poisoning

OpenAIRE

Vučinić Slavica

2005-01-01

Background/Aim. Pneumonia is the most frequent complication in acute psychotropic drugs poisoning, which results in substantial morbidity and mortality, but which also increases the costs of treatment. Risk factors for pneumonia are numerous: age, sex, place of the appearance of pneumonia, severity of underlying disease, airway instrumentation (intubation, reintubation, etc). The incidence of pneumonia varies in poisoning caused by the various groups of drugs. The aim of this study was to det...

EFFECTS OF PSYCHOTROPIC DRUGS AS BACTERIAL EFFLUX PUMP INHIBITORS ON QUORUM SENSING REGULATED BEHAVIORS

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Aynur Aybey

2014-10-01

Full Text Available Psychotropic drugs are known to have antimicrobial activity against several groups of microorganisms. The antidepressant agents such as duloxetine, paroxetine, hydroxyzine and venlafaxine are shown to act as efflux pump inhibitors in bacterial cells. In order to the investigation of the effects of psychotropic drugs were determined for clinically significant pathogens by using standart broth microdillusion method. The anti-quorum sensing (anti-QS activity of psychotropic drugs was tested against four test pathogens using the agar well diffusion method. All drugs showed strong inhibitory effect on the growth of S. typhimurium. Additionally, quorum sensing-regulated behaviors of Pseudomonas aeruginosa, including swarming, swimming and twitching motility and alkaline protease production were investigated. Most effective drugs on swarming, swimming and twitching motility and alkaline protease production, respectively, were paroxetine and duloxetine; duloxetine; hydroxyzine and venlafaxine; paroxetine and venlafaxine; venlafaxine. Accordingly, psychotropic drugs were shown strongly anti-QS activity by acting as bacterial efflux pump inhibitors and effection on motility and alkaline protease production of P. aeruginosa.

Change in psychotropic drug use in Norwegian nursing homes between 2004 and 2011

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Selbæk, G; Janus, S I M; Bergh, S; Engedal, K; Ruths, S; Helvik, A S; Šaltyte Benth, J; Zuidema, S U

BACKGROUND: We aimed to assess whether there were any changes in the use of psychotropic drugs in Norwegian nursing homes between 2004 and 2011. Also, we investigated whether the predictors of use of specific psychotropic drug groups have changed. METHODS: We conducted a secondary analysis of two

An Outline on Psychotropic Drug Use in the Developmentally Disabled Patient. Monograph #102.

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Vander Zanden, Jeanne A.

This introduction to basic principles of psychotropic drug use in developmentally disabled patients is intended to provide personnel working in the field with information on appropriate clinical use as well as potential risks. Presented in outline form, information is provided on five classes of psychotropic drugs: antipsychotics; antidepressants;…

CAN MELATONIN BE EFFECTIVELY USED TO DIMINISH SIDE EFFECTS OF VARIOUS PSYCHOTROPIC DRUGS AND ELECTROCONVULSIVE THERAPY?

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Roman Aleksandrovich Bekker

2017-10-01

Full Text Available Purpose. To study and summarize the existing evidence base for the use of melatonin as a mean to counteract or diminish the side effects of various psychotropic drugs and electroconvulsive therapy, and to provide the reader with relevant conclusions. Methodology. The authors have searched for the scientific literature regarding the use of melatonin as a mean to counteract or diminish the side effects of various psychotropic drugs and electroconvulsive therapy, using the PubMed and Google Scholar as a search tool. Then the authors thoroughly reviewed the data they found. The resulting review is presented in this article. Results. The data we have obtained from this review of the literature indicate that melatonin can be effectively used both in monotherapy and in combination with other therapeutic means in order to reduce several different side effects of psychotropic drugs and electroconvulsive therapy. Melatonin also deserves further study in this regard. The evidence base for its use in this manner is very variable in quality for different side effects. For now, the greatest evidence base exists regarding the potential effectiveness of melatonin in the prevention and treatment of drug-induced insomnia, memory and cognitive impairment, akathisia, tardive dyskinesias, and metabolic syndrome. Practical implications. The results we have obtained can be widely applied in psychiatry, neurology and addiction medicine, as well as in all those areas of general medicine, which make use of psychotropic drugs.

Psychotropic drug effects contributing to psychiatric hospitalization of children: a preliminary study.

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Fialkov, M J; Hasley, S

1984-12-01

Over an 11-month period on a Children's Psychiatric Unit 5% of 60 first admissions for hospitalization were apparently associated with adverse effects of psychotropic medication. Forty (66%) of the first admissions had used, prior to hospitalization, a wide variety of drugs including stimulants, major and minor tranquilizers, anticonvulsants, antidepressants and over-the-counter drugs containing antihistamines and analgesics. It is suggested that inappropriate and injudicious use of psychotropic medications may be associated with unanticipated adverse behavioral effects, which can result in deterioration of a child's functioning to the point of necessitating psychiatric hospitalization. Early identification of these unwanted psychotropic effects has diagnostic, prognostic, economic, and legal implications.

PROPER I: frequency and appropriateness of psychotropic drugs use in nursing home patients and its associations: a study protocol

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van der Spek, K.; Gerritsen, D.L.; Smalbrugge, M.; Nelissen-Vrancken, M.H.; Wetzels, R.B.; Smeets, C.H.; Zuidema, S.U.; Koopmans, R.T.

2013-01-01

Background: Nursing home patients with dementia use psychotropic drugs longer and more frequently than recommended by guidelines implying psychotropic drugs are not always prescribed appropriately. These drugs can have many side effects and effectiveness is limited. Psychotropic drug use between

PROPER I : Frequency and appropriateness of psychotropic drugs use in nursing home patients and its associations: a study protocol

NARCIS (Netherlands)

van der Spek, Klaas; Gerritsen, Debby L.; Smalbrugge, Martin; Nelissen-Vrancken, Marjorie H. J. M. G.; Wetzels, Roland B.; Smeets, Claudia H. W.; Zuidema, Sytse U.; Koopmans, Raymond T. C. M.

2013-01-01

Background: Nursing home patients with dementia use psychotropic drugs longer and more frequently than recommended by guidelines implying psychotropic drugs are not always prescribed appropriately. These drugs can have many side effects and effectiveness is limited. Psychotropic drug use between

[Autonomy attitudes in the treatment compliance of a cohort of subjects with continuous psychotropic drug administration].

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Baumann, M; Trincard, M

2002-01-01

Prescriptions for psychotropic drugs are part of a general practitioner's daily routine. As with all drugs, they need to be controlled by a phenomenon of observance. Respecting prescriptions is in fact a major public health concern. Our problematic is centred on the analysis of the association between observance and autonomy in order to gain a better understanding of the links between the drug, how it is to be taken, and how the patients adapt and control it. Identifying and comparing autonomous practices psychotrope users associated with attitudes put into play by those who claim to observe or not to observe their treatment is the aim of this project. The qualitative analysis of the speech is based on the categorial analysis of the contents of 46 transcriptions of 23 women et 23 men continuous (regular monthly intake for at least 5 years), aged between 50 and 65. The majority live in couples, have professional activities, and are executives. The psychotropes with the largest consumption are: anxiolytics and antidepressors. The average duration of their consumption is more than 17 years. Two types of attitude can be distinguished through the qualitative analyse. The attitudes of non-observers towards the psychotropic drug and dependence show controlled, autonomous acts. Autonomy is an influencing factor in their observation of the prescribed treatment, it is a major component of their non-observance regarding psychotropes; thus our hypothesis is confirmed. The strategy adopted around the medication arises from autonomy of action. Organising the treatment is seen as a sign of autonomy, as taking an initiative in relation to the medical prescription, and not as rebellious, or carefree behaviour, or as a sign of inconsistency. Non-observers seem more to be involved in a step towards self-regulation. Active taking verbs such as stop, diminish, increase , and success verbs succeed the I is greatly used, reinforced in some cases by myself ; this vocabulary situates the

Prescription patterns for psychotropic drugs in cancer patients; a large population study in the Netherlands

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Guan, N.C.; Boks, M.P.; Smeets, H.M.; Zainal, N.Z.; Wit, N.J. de

2013-01-01

Background: Psychotropic drugs are commonly prescribed for various psychological complaints in cancer patients. We aim to examine the prescription pattern in cancer patients of three common psychotropic drugs: benzodiazepine, antidepressant and antipsychotic. Methods: This is a retrospective

On cannabis, chloral hydrate, and career cycles of psychotropic drugs in medicine.

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Snelders, Stephen; Kaplan, Charles; Pieters, Toine

2006-01-01

This article compares the careers of two psychotropic drugs in Western psychiatry, with a focus on the nineteenth century: Cannabis indica and chloral hydrate. They were used by doctors for similar indications, such as mania, delirium tremens, and what we would now call drug dependence. The two show similar career paths consisting of three phases: initial enthusiasm and therapeutic optimism; subsequent negative appraisal; and finally, limited use. These cycles, which we term "Seige cycles," are generally typical of the careers of psychotropic drugs in modern medicine. However, differences in the careers of both drugs are also established. The phases of chloral show relatively higher peaks and lower valleys than those of cannabis. Chloral is the first typically "modern" psychotropic drug; a synthetic, it was introduced in 1869 at a time of growing asylum populations, pharmaceutical interests, and high cultural expectations of scientific medicine. Cannabis indica, introduced in the 1840s, is typically a "premodern" drug steeped in the climate of cultural Romanticism. We conclude that the analytical concept of the Seige cycle is a useful tool for future research into drug careers in medicine.

Working conditions and psychotropic drug use: cross-sectional and prospective results from the French national SIP study.

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Lassalle, Marion; Chastang, Jean-François; Niedhammer, Isabelle

2015-04-01

Prospective studies exploring the associations between a large range of occupational factors and psychotropic drug use among national samples of workers are seldom. This study investigates the cross-sectional and prospective associations between occupational factors, including a large set of psychosocial work factors, and psychotropic drug use in the national French working population. The study sample comprised 7542 workers for the cross-sectional analysis and 4213 workers followed up for a 4-year period for the prospective analysis. Psychotropic drug use was measured within the last 12 months and defined by the use of antidepressants, anxiolytics or hypnotics. Three groups of occupational factors were explored: classical and emergent psychosocial work factors, working time/hours and physical work exposures. Weighted Poisson regression analyses were performed to adjust for covariates. In the cross-sectional analysis, psychological demands, low social support and hiding emotions were associated with psychotropic drug use. Job insecurity for men and night work for women were associated with psychotropic drug use. In the prospective analysis, hiding emotions and physical exposure were predictive of psychotropic drug use. Dose-response associations were observed for the frequency/intensity of exposure and repeated exposure to occupational factors. This study underlines the role of psychosocial work factors, including emergent factors, in psychotropic drug use. Prevention policies oriented toward psychosocial work factors comprehensively may be useful to reduce this use. Copyright © 2015 Elsevier Ltd. All rights reserved.

Psychotropic Polypharmacy in Patients with Dementia

DEFF Research Database (Denmark)

Nørgaard, Ane; Jensen-Dahm, Christina; Gasse, Christiane

2017-01-01

classes (psychotropic polypharmacy) may also pose a risk for patients. OBJECTIVE: To investigate the prevalence and predictors associated with use of psychotropic polypharmacy in patients with dementia. METHODS: A population-based study using nationwide registers. Patients with dementia were identified...... to evaluate factors independently associated with the prescription of other psychotropic drug classes among patients already using antipsychotics. RESULTS: Among all patients registered with dementia (34,553), 25.3% (8,728) used ≥2 psychotropic drugs. Among patients treated with antipsychotics 75.8% (5...... of psychotropic drugs was antipsychotics and antidepressants. CONCLUSION: Concomitant use of psychotropic drugs was frequent in dementia patients. Patients living in nursing homes had the highest risk of receiving a combination of antipsychotics and other psychotropic drugs. Concomitant use of psychotropics may...

Risk of arrhythmia induced by psychotropic medications

DEFF Research Database (Denmark)

Fanoe, Søren; Kristensen, Diana; Fink-Jensen, Anders

2014-01-01

with psychotropic medications. The algorithm integrates the risk categories of the individual drugs and pre-disposing risk factors and suggests a prudent follow-up for patients with an increased risk. We believe this clinically manageable guideline might improve safety in the many and rapidly increasing number...... of the major mental disorders are associated with a large risk of suicide if untreated. The observed risk of malignant arrhythmia associated with treatment with psychotropic drugs calls for clinical guidelines integrating the risk of the individual drug and other potentially interacting risk factors......Several drugs used in the treatment of mental diseases are associated with an increased risk of sudden cardiac death (SCD). A general cause-relationship between the intake of these drugs and SCD is unattainable, but numerous case reports of drug-induced malignant arrhythmia and epidemiological...

Psychotropic Drug Use among College Students: Patterns of Use, Misuse, and Medical Monitoring

Science.gov (United States)

Oberleitner, Lindsay M. S.; Tzilos, Golfo K.; Zumberg, Kathryn M.; Grekin, Emily R.

2011-01-01

Objective: To assess whether college students who use psychotropic drugs are (1) aware of potential side effects, (2) appropriately monitored by prescribing physicians, and (3) taking medications as prescribed. Participants: Fifty-five college students, currently taking psychotropic medications, were recruited between Summer 2008 and Fall 2009.…

Pattern of Psychotropic Drug Prescription in the Elderly with Chronic Schizophrenia

Directory of Open Access Journals (Sweden)

Mohamad Reza Khodaei Ardakani

2013-04-01

Full Text Available Objectives: Psychotropic drug use in the elderly with chronic schizophrenia is an important issue in the field of psychiatry. The main goal of this study was to clarify the pattern of such drug use in these patients, in order to consider such therapy plan and focus on its cost attributing measures, for a more reasonable quality of care program. Methods: In this descriptive study, participants included 52 elderly patients at Tehran’s Razi Mental Hospital who had chronic schizophrenia in the residual phase. Selected patients were taking at least two psychotropic drugs equivalent to 500mg Chlorpromazine. We prepared the list of the drugs used by completing the pre-designed questionnaire charts. Data were analyzed with SPSS 17. Results: In one case (1.92% the entries were Risperidone, Chlorpromazine, Fluphenazine Decanoate, & Thiothixene. In 11 cases (21.2% there were three entries and in 40 cases (76.8% there were two. The Chlorpromazine equivalent dose in each group ranged from the lowest dose (750 mg to the highest (5600 mg. The highest Chlorpromazine dose (5600 mg equivalent per milligram belonged to the four entries of (Risperidone, Chlorpromazine, Fluphenazine Decanoate & Thiothixene. The lowest Chlorpromazine dose (750 mg was seen in 3 entries of Risperidone, Chlorpromazine & Fluphenazine Decanoate. Discussion: There was a high prevalence of using more than two psychotropic medications from the first atypical antipsychotic category. Less frequently, the second and the third typical antipsychotics were used. We recommend further research into more feasible patterns of psychotropic prescriptions, lowering the amount of medication use and considering their cost-benefits in the elderly with chronic schizophrenia.

Use of psychotropic drugs during pregnancy and breast-feeding

DEFF Research Database (Denmark)

Larsen, E R; Damkier, P; Pedersen, L H

2015-01-01

and carbamazepin are contraindicated. Olanzapine, risperidone, quetiapine and clozapine can be used for bipolar disorders and schizophrenia. CONCLUSION: It is important that health professionals treating fertile women with a psychiatric disease discuss whether psychotropic drugs are needed during pregnancy and how...

The integrity of the social hierarchy in mice following administration of psychotropic drugs.

OpenAIRE

Poshivalov, V. P.

1980-01-01

1 Mice in small groups develop a despotic type of social hierarchy, a feature of which is to resist alteration through the medium of psychotropic drugs. This makes a rapid pharmacologically induced change in the social hierarchy impossible. 2 Patrolling the territory and a certain level of social interaction are both critical factors in maintaining the phenomenon of inertia in the social hierarchy. Psychotropic drugs (diazepam, droperidol and mescaline) altered both these factors to a varying...

Improving psychotropic drug prescription in nursing home patients with dementia : design of a cluster randomized controlled trial

NARCIS (Netherlands)

Smeets, Claudia H. W.; Smalbrugge, Martin; Gerritsen, Debby L.; Nelissen-Vrancken, Marjorie H. J. M. G.; Wetzels, Roland B.; van der Spek, Klaas; Zuidema, Sytse U.; Koopmans, Raymond T. C. M.

2013-01-01

Background: Neuropsychiatric symptoms are highly prevalent in nursing home patients with dementia. Despite modest effectiveness and considerable side effects, psychotropic drugs are frequently prescribed for these neuropsychiatric symptoms. This raises questions whether psychotropic drugs are

Number and type of psychotropic drugs on the Scandinavian market in 1950-1977

DEFF Research Database (Denmark)

Hemminki, E; Pesonen, T; Hansen, E H

1981-01-01

This article describes the number and types of psychotropic drugs on the market in Denmark, Finland, Norway, and Sweden from 1950-1977. The total number of drugs on the market in each country depended greatly on how psychotropic drugs were defined, but trends with time and differences between...... the countries were less affected by this definition. The number of drugs was highest in Finland and lowest in Norway. In all countries, the number of drugs increased from 1950 to the mid-1960s, most abruptly in Finland. They then quickly decreased in Finland and Sweden, but remained fairly constant in Denmark...... numbers of combination drugs contributed greatly to the wide differences in the number of drugs. From the medical point of view, far too many drugs were on the market in that period....

Environmental Factors Associated with Psychotropic Drug Use in Brazilian Nightclubs.

Science.gov (United States)

Carlini, Claudia; Andreoni, Solange; Sanchez, Zila M

2017-08-01

The purpose of this study was to identify environmental factors associated with patterns of psychotropic drug use in nightclubs. Mixed methods were used to investigate psychotropic drugs consumption among patrons of 31 nightclubs in São Paulo, Brazil. A total of 1822 patrons at the entrance and exit of the venues and 30 staff members of the nightclubs were interviewed. The observational data were collected through 307 h of observational research using a structured guide to register environmental measures. Psychotropic drug use in nightclubs was classified into three categories (1: no drugs; 2: legal drugs [e.g., alcohol and tobacco]; or 3: illicit drugs regardless of alcohol and tobacco use). Illicit drugs used were self-reported by patrons, and alcohol use was measured using a breathalyzer. The data were analyzed in clusters using correlated multinomial logistic regression models. The following environmental variables were associated with illicit drug use in nightclubs: all-you-can-drink service (adjusted odds ratio (aOR) = 11.84, 95%CI [4.06;34.57]) and light effects, such as laser and "disco lights" (aOR = 24.49, 95%CI [8.48;70.77]). The number of bouncers per capita × 100 and the presence of two or more dance floors were inversely associated with the use of illicit drugs (aOR = 0.26, 95%CI [0.11;0.65], and aOR = 0.13, 95%CI [0.06;0.29], respectively). Legal drug use was associated with all-you-can-drink service (aOR = 2.17, 95%CI [1.43;5.04]), the presence of two or more dance floors (aOR = 2.06, 95%CI [1.40;3.05]), and the number of bouncers per capita × 100 (aOR = 1.39, 95%CI [1.22;1.59]). These findings suggest that this is a multivariate phenomenon that would require an integrated approach involving the venue owners, staff members, patrons, local governments, and law enforcement agencies.

Patients with Korsakoff syndrome in nursing homes: characteristics, comorbidity, and use of psychotropic drugs.

Science.gov (United States)

Gerridzen, Ineke J; Goossensen, M Anne

2014-01-01

Very limited literature exists on the care and course of patients with Korsakoff syndrome (KS) living in long-term care facilities (LTCFs). Even less literature can be found on the pharmacological treatment of behavioral symptoms of KS. The purpose of the present study was to describe baseline characteristics, comorbidity, and the use of psychotropic drugs in institutionalized patients with KS. In this cross-sectional descriptive study, 556 patients were included living in ten specialized care units in Dutch nursing homes. Data were collected by means of a retrospective chart review. The majority of patients were men (75%) and single (78%) with a mean age on admission of 56.7 years (SD 8.9, range 29.8-85.3). Mean length of stay was 6.0 years (SD 5.4, range 0.2-33.3). Sixty-eight percent of patients suffered from at least one somatic disease and 66% from at least one extra psychiatric disorder. One or more psychotropic drugs were prescribed to 71% of patients with a great variation in prescription patterns between the different nursing homes. Patients with KS depending on long-term care usually have comorbidity in more than one domain (somatic and psychiatric). The indications for prescribing psychotropic drugs are in many cases unclear and it seems probable that they are often given to manage challenging behavior. Longitudinal studies on the evidence for this prescription behavior and possible alternatives are recommended.

[The actual Russian legislation in sphere of turn-over of drug agents and psychotropic substances].

Science.gov (United States)

Abramov, A Yu; Kosolapova, N V; Mikhaiylova, Yu V

2014-01-01

The drug abuse is a social occurrence. Hence, the social economic methods are the first of all means of combating this evil. At the same time, measures of especially juridical character possess significant value since they develop corresponding legal base for applying another measures. In the Russian Federation, during fifteen years the new policy of public regulation and normative legal base in the area of legal turn-over of drug agents, psychotropic substances and their precursors were developed factually from zero ground. However, the current national legislation is not deprived of some flaws and contradictions. Frequently a uniform practice of interpretation and application of legal rules regulating the controlled turn-over is lacking. On the one hand, this circumstance decreases effectiveness of action of such rules and on the other hand favors development of situations for outflow of pharmaceuticals from legal turn-over to illegal traffic. The becoming of the Russian legislation in the area of turn-over of drug agents, precursors and psychotropic substances relates to the period of late 1990s when the Federal Law No 3 FZ "On drug agents and psychotropic substances" of January 8 1998 was developed and passed by the State Duma of the Russian Federation. The given law completely conforms to principles of legal regulation of turn-over of drug agents and psychotropic substances determined by the Constitution of the Russian Federation (provisions 76, 90, 104, 105) and federal laws ("On the government of the Russian Federation" of December 17 1997, "On the ombudsman in the Russian Federation" of February 26 1997). The main characteristic of legal rules included into given group of sources of law is that they contain regulations of general disposition as basic ones for inferior sources of law. The analysis of basic Federal law No 3 FZ "On drug agents and psychotropic substances" of January 8 1998 makes it possible to conclude that in in Russia the international legal

Psychotropic drugs and the perioperative period : A proposal for a guideline in elective surgery

NARCIS (Netherlands)

Huyse, FJ; Touw, DJ; Van Schijndel, RS; De Lange, JJ; Slaets, JPJ

Evidence-based guidelines for the perioperative management of psychotropic drugs are lacking. The level of evidence is low and is based on case reports, open trials, and non-systematic reviews. However, the interactions and effects mentioned indicate that patients who use psychotropics and require

Psychotropic Medication Adherence among Community-Based Individuals with Developmental Disabilities and Mental Illness

Science.gov (United States)

Tan, Xi; Marshall, Vincent D.; Balkrishnan, Rajesh; Patel, Isha; Chang, Jongwha; Erickson, Steven R.

2015-01-01

Psychotropic medications are a common treatment for mental illness in people with developmental disabilities. Medication adherence is a critical determinant of the effectiveness of psychotropic drugs, but psychotropic medication adherence research specific to this population remains limited. This retrospective study analyzed Marketscan®…

Off-label use of psychotropic drugs beyond officially approved indications in Colombia

Directory of Open Access Journals (Sweden)

Paola Marcela Fletscher-Covaleda

2017-07-01

Conclusions: Psychotropic drugs in Bogotá are used, to a great extent, as off-label in indications other than those officially approved. Thus, it is important to strengthen education and control to achieve a rational, effective and safe use of drugs.

Effects of Psychosocial Interventions for Behavioral and Psychological Symptoms in Dementia on the Prescription of Psychotropic Drugs: A Systematic Review and Meta-Analyses.

Science.gov (United States)

Birkenhäger-Gillesse, Elizabeth G; Kollen, Boudewijn J; Achterberg, Wilco P; Boersma, Froukje; Jongman, Lydia; Zuidema, Sytse U

2018-03-01

Dementia is often accompanied by neuropsychiatric symptoms. Psychotropic drugs for the treatment of neuropsychiatric symptoms are frequently used to manage these problems, but they are of limited effectiveness and can have serious side effects. Psychosocial interventions are advocated as first line treatment and may help to reduce psychotropic drug use. To assess the effect of multidisciplinary psychosocial interventions in nursing homes on the psychotropic drug prescription rate. Literature obtained from searches in 9 electronic databases was systematically reviewed. In addition, the pooled effects of specific psychosocial interventions in homogenous subgroups were analyzed (meta-analysis). Eleven randomized controlled studies that investigated multiple psychotropic drugs interventions (psychotropic drugs in 3, antipsychotics in 9, and antidepressants in 5 studies) as well as different types of psychosocial interventions were included. We separately analyzed interventions directed at the care staff level (educational programs in 3, in-reach services or consultation in 1, cultural or process change in 6 studies) and the individual resident level in 1 study. In 7 out of 9 studies reporting on antipsychotic drug use, the physician was actively involved. Nine studies in which antipsychotic drug use was specified reported a significant decrease in prescription rate as a result of psychosocial interventions [relative risk (RR) 0.71, 95% confidence interval (CI) 0.59-0.88], whereas meta-analysis of 5 studies investigating antidepressant drug use failed to show a significant effect (RR 0.82, 95% CI 0.64-1.02). Pooled effect sizes of 6 studies investigating cultural change, showed a significant decrease in antipsychotic drug use (RR 0.65, 95% CI 0.57-0.73). Effect sizes of 2 studies on educational programs on antipsychotic use were nonsignificant (RR 1.50, 95% CI 0.49-4.64). Sensitivity analysis of 7 studies reporting on antipsychotic drug use involving prescribing

Adverse drug reactions from psychotropic medicines in the paediatric population

DEFF Research Database (Denmark)

Aagaard, Lise; Hansen, Ebba H

2010-01-01

of these products in childhood. Little evidence has been reported about the adverse drug reactions (ADRs) of these medicines in practice. As spontaneous reports are the main source for information about previously unknown ADRs, we analysed data submitted to a national ADR database. The objective was to characterise...... ADRs reported for psychotropic medicines in the Danish paediatric population over a decade. FINDINGS: All spontaneous ADR reports from 1998 to 2007 for children from birth to 17 years of age were included. The unit of analysis was one ADR. We analysed the distribution of ADRs per year, seriousness, age...... and gender of the child, suspected medicine and type of reported ADR. A total of 429 ADRs were reported for psychotropic medicines and 56% of these were classified as serious. Almost 20% of psychotropic ADRs were reported for children from birth up to 2 years of age and one half of ADRs were reported...

Cases of Adverse Reaction to Psychotropic Drugs and Possible Association with Pharmacogenetics

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Irina Piatkov

2012-10-01

Full Text Available Thousands of samples for pharmacogenetic tests have been analysed in our laboratory since its establishment. In this article we describe some of the most interesting cases of CYP poor metabolisers associated with adverse reactions to psychotropic drugs. Prevention of disease/illness, including Adverse Drug Reaction (ADR, is an aim of modern medicine. Scientific data supports the fact that evaluation of drug toxicology includes several factors, one of which is genetic variations in pharmacodynamics and pharmacokinetics of drug pathways. These variations are only a part of toxicity evaluation, however, even if it would help to prevent only a small percentage of patients from suffering adverse drug reactions, especially life threatening ADRs, pharmacogenetic testing should play a significant role in any modern psychopharmacologic practice. Medical practitioners should also consider the use of other medications or alternative dosing strategies for drugs in patients identified as altered metabolisers. This will promise not only better and safer treatments for patients, but also potentially lowering overall healthcare costs.

[Pharmacists' interventions conducted by hospital pharmacists on psychotropic drugs pharmacotherapy].

Science.gov (United States)

Parent, G; Rose, F-X; Bedouch, P; Conort, O; Charpiat, B; Juste, M; Roubille, R; Allenet, B

2015-09-01

The French Society of Clinical Pharmacy (SFPC) through the special interest group "standardization and optimization of clinical pharmacy activities" stated that the study of pharmacists' interventions (PIs) conducted during prescription analysis was a priority. The SFPC developed an internet website named Act-IP(®) (http://www.sfpc.eu/fr/) where French speaking pharmacists were able to document PIs using a normalized codification. The objective of this study was to analyze medication-related problems linked to psychotropic drugs in hospital and to investigate PIs performed during prescription analysis. This is a multicenter, retrospective, observational study using PIs involving psychotropic medications recorded between September 2006 and February 2009 on the Act-IP(®) website. Four thousand six hundred and twenty PIs recorded by 165 pharmacists in 57 hospitals were related to psychotropic drugs. Patients concerned by these drug-related problems were 64 years old on average. Seven categories of medication-related problems represented more than 69% of PIs (1.1-Non Conformity of the drug choice compared to the formulary; 4.1 Supratherapeutic dose; 5.3 Therapeutic redundancy; 6.2 Drug interaction (all levels of severity); 7.0 Adverse drug reaction; 8.3 Inappropriate drug form; 8.5 Inappropriate timing of administration). The PIs related to 9.2 Patient's non compliance, 2.0 Untreated indication and 3.2 Length of the treatment too short were infrequent (less than 1%). The most common type of intervention was the dose adjustment. Almost 45% of these PIs involved Zopiclone or Zolpidem prescription in elderly patients. Seven hundred and nine drug interactions were identified by pharmacists. The most common type of drug interaction considered the risk of cardiac arrhythmias due to antipsychotic medications. One hundred and thirty-three PIs concerned adverse drug reaction. The most frequent adverse drug reactions were a fall (36 PIs), hemorrhage/bleeding (32 PIs

Adverse events and the relation with quality of life in adults with intellectual disability and challenging behaviour using psychotropic drugs.

Science.gov (United States)

Scheifes, Arlette; Walraven, Sanne; Stolker, Joost Jan; Nijman, Henk L I; Egberts, Toine C G; Heerdink, Eibert R

2016-01-01

Psychotropic drugs are prescribed to approximately 30-40% of adults with intellectual disability (ID) and challenging behaviour, despite the limited evidence of effectiveness and the potential of adverse events. To assess the prevalence of adverse events in association with psychotropic drug use in adults with ID and challenging behaviour and to examine the relation of these adverse events with the person's quality of life. The presence of adverse events was measured with a questionnaire that had to be filled in by the physicians of the participants. Movement disorders were measured separately with a standardised protocol. The strength of the association between adverse events and Intellectual Disability Quality of Life-16 (IDQOL-16), and daily functioning was investigated using linear regression analyses, taking into account the severity of disease (CGI-S) as potential confounder. Virtually all of 103 adults with ID and challenging behaviour had at least one adverse event (84.4%) and almost half had ≥3 adverse events (45.6%) across different subclasses. Using psychotropic drugs increased the prevalence of adverse events significantly. Respectively 13% of the patients without psychotropic drugs and 61% of the patients with ≥2 psychotropic drugs had ≥3 adverse events. Having adverse events had a significantly negative influence on the quality of life. A large majority of all patients had at least one adverse event associated with psychotropic drug use. More attention is needed for these adverse events and their negative influence on the quality of life of these patients, taking into account the lack of evidence of effectiveness of psychotropic drugs for challenging behaviour. Copyright © 2015. Published by Elsevier Ltd.

Drug-drug interactions as a result of co-administering Δ9-THC and CBD with other psychotropic agents.

Science.gov (United States)

Rong, Carola; Carmona, Nicole E; Lee, Yena L; Ragguett, Renee-Marie; Pan, Zihang; Rosenblat, Joshua D; Subramaniapillai, Mehala; Shekotikhina, Margarita; Almatham, Fahad; Alageel, Asem; Mansur, Rodrigo; Ho, Roger C; McIntyre, Roger S

2018-01-01

To determine, via narrative, non-systematic review of pre-clinical and clinical studies, whether the effect of cannabis on hepatic biotransformation pathways would be predicted to result in clinically significant drug-drug interactions (DDIs) with commonly prescribed psychotropic agents. Areas covered: A non-systematic literature search was conducted using the following databases: PubMed, PsycInfo, and Scopus from inception to January 2017. The search term cannabis was cross-referenced with the terms drug interactions, cytochrome, cannabinoids, cannabidiol, and medical marijuana. Pharmacological, molecular, and physiologic studies evaluating the pharmacokinetics of Δ 9 -tetrahydrocannabinol (Δ 9 -THC) and cannabidiol (CBD), both in vitro and in vivo, were included. Bibliographies were also manually searched for additional citations that were relevant to the overarching aim of this paper. Expert opinion: Δ 9 -Tetrahydrocannabinol and CBD are substrates and inhibitors of cytochrome P450 enzymatic pathways relevant to the biotransformation of commonly prescribed psychotropic agents. The high frequency and increasing use of cannabis invites the need for healthcare providers to familiarize themselves with potential DDIs in persons receiving select psychotropic agents, and additionally consuming medical marijuana and/or recreational marijuana.

Patients with Posttraumatic Stress Disorder with Comorbid Major Depressive Disorder Require a Higher Dose of Psychotropic Drugs.

Science.gov (United States)

Chiba, Hiromi; Oe, Misari; Uchimura, Naohisa

2016-01-01

Major depressive disorder (MDD) has been associated with stressful life events and with posttraumatic stress disorder (PTSD). PTSD and MDD comorbidity was also reported to be associated with greater symptom severity and lower levels of functioning. However, the characteristics of pharmacotherapy for PTSD with MDD are not fully understood. To understand this relationship, we conducted a retrospective review using medical charts at the Department of Neuropsychiatry, Kurume University Hospital. Information from 55 patients with PTSD was analyzed. Five cases were excluded after re-evaluation of the PTSD diagnosis. A higher rate of type II trauma was observed in the PTSD with MDD group (50.0%) than in the PTSD-only group [13.6%; χ(2) (1, n =50) = 7.26, p<0.01]. Patients with comorbid MDD were significantly older, had more severe PTSD symptomatology, and a longer duration of treatment. They also received higher doses of psychotropic drugs, regardless of the type (antidepressants, antipsychotics, benzodiazepines), than the PTSD-only group. Our results showed that comorbid MDD is associated with higher doses of psychotropic drugs, suggesting difficulties in treatment.

Rhabdomyolysis Syndrome in Alcohol, Psychotropic Drugs, and Illicit Substance Poisonings

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Seyed Kazem Taheri

2013-06-01

Full Text Available Background: Rhabdomyolysis is one of the major complications of poisoning causedby alcohol, narcotics, and psychotropic substances acute toxicity, which might lead toacute renal failure and even death. This study aimed to evaluate clinical and laboratoryfindings of rhabdomyolysis syndrome in poisoning patients who were admitted topoisoning ward of Farshchian Hospital of Hamadan, Iran.Methods: In this cross-sectional study, patients with acute toxicity by alcohol, narcotics,or psychotropic drugs who were admitted in poisoning ward of Farshchian Hospital ofHamadan were investigated during a 6-month period in 2012. Clinical and laboratorydata were collected by a standard questionnaire and analyzed by the SPSS softwareversion 16.Results: Eighty-two patients aged between 14 to 81 years were investigated. Twentytwocases developed rhabdomyolysis and narcotics related toxicity was the mostcommon cause. The most common clinical symptom in all patients was muscle pain(51cases, Laboratory studies showed some significant differences between serumcreatine kinase (CK, lactate dehydrogenase (LDH, serum creatinine, andaminotransferases (AST,ALT levels in rhabdomyolysis cases as compared to theothers (p<0.05.Conclusion: The results of this study revealed that the incidence of rhabdomyolysissyndrome in acute intoxication with alcohol and narcotics is significant and withoutproper treatment might cause serious complications such as acute renal failure andeven death. Classic clinical signs and symptoms of rhabdomyolysis are usually notpresent simultaneously, thus strong clinical suspicion and proper laboratory tests haveimportant role in early diagnosis and suitable treatment. Laboratory studies have animportant role in the diagnosis of this syndrome.

Ethnicity, self reported psychiatric illness, and intake of psychotropic drugs in five ethnic groups in Sweden.

Science.gov (United States)

Bayard-Burfield, L; Sundquist, J; Johansson, S E

2001-09-01

This study hypothesises that the presumed increased risk of self reported longstanding psychiatric illness and intake of psychotropic drugs among Iranian, Chilean, Turkish, and Kurdish adults, when these groups are compared with Polish adults, can be explained by living alone, poor acculturation, unemployment, and low sense of coherence. Data from a national sample of immigrants/refugees, who were between the ages of 20-44 years old, upon their arrival in Sweden between 1980 and 1989. Unconditional logistic regression was used in the statistical modelling. Sweden. 1059 female and 921 male migrants from Iran, Chile, Turkey, Kurdistan and Poland and a random sample of 3001 Swedes, all between the ages of 27-60 years, were interviewed in 1996 by Statistics Sweden. Compared with Swedes, all immigrants had an increased risk of self reported longstanding psychiatric illness and for intake of psychotropic drugs, with results for the Kurds being non-significant. Compared with Poles, Iranian and Chilean migrants had an increased risk of psychiatric illness, when seen in relation to a model in which adjustment was made for sex and age. The difference became non-significant for Chileans when marital status was taken into account. After including civil status and knowledge of the Swedish language, the increased risks for intake of psychotropic drugs for Chileans and Iranians disappeared. Living alone, poor knowledge of the Swedish language, non-employment, and low sense of coherence were strong risk factors for self reported longstanding psychiatric illness and for intake of psychotropic drugs. Iranian, Chilean, Turkish and Kurdish immigrants more frequently reported living in segregated neighbourhoods and having a greater desire to leave Sweden than their Polish counterparts. Evidence substantiates a strong association between ethnicity and self reported longstanding psychiatric illness, as well as intake of psychotropic drugs. This association is weakened by marital status

Experience of Psychotropic Medication -An Interview Study of Persons with Psychosis.

Science.gov (United States)

Bülow, Per; Andersson, Gunnel; Denhov, Anne; Topor, Alain

2016-11-01

Psychotropic drugs, particularly antipsychotic types, are a cornerstone of the treatment of people with psychosis. Despite numerous studies showing that drug treatment with psychotropic drugs initially alleviates psychiatric symptoms, the proportion of people with mental health problems and symptoms that do not follow doctors' prescriptions, thus exhibiting so-called non-adherence, is considerable. Non-adherence is predominantly seen as a clinical feature and as a patient characteristic that is especially due to patients' poor understanding that they are ill. There is also a widespread notion that non-adherence is of great disadvantage to the patient. This article is based on interviews with 19 persons diagnosed with psychosis. It challenges the notion of patients being either adherent or non-adherent to the doctor's orders. The findings show that persons with psychosis are active agents when it comes to adjusting medication. The interviewees created their own strategies to gain power over treatment with psychotropic drugs. The most common strategies were to adjust the doses or take breaks of varying lengths from the medication. These deviations from prescriptions were important to conceal, not only from their own psychiatrists, but from all psychiatric staff.

An analysis of psychotropic drug sales. Increasing sales of selective serotonin reuptake inhibitors anre closely related to number of products

DEFF Research Database (Denmark)

Nielsen, Margrethe; Gøtzsche, Peter C.

2011-01-01

used data from various sources to establish the sales curves of psychotropic drugs in the period 1970 to 2007, based on the Anatomic Therapeutic Classification system and Defined Daily Doses. RESULTS: Fluctuations in sales of psychotropic drugs that cannot be explained by disease prevalence were caused...

The prevalence of alcohol and psychotropic drugs in fatalities of road-traffic accidents in Jordan during 2008-2014.

Science.gov (United States)

Al-Abdallat, Imad M; Al Ali, Rayyan; Hudaib, Arwa A; Salameh, Ghada A M; Salameh, Rakiz J M; Idhair, Ahmed K F

2016-04-01

Several studies confirmed alcohol and psychotropic drug consumption as important risk factors underlying fatal accidents. This paper presents updated toxicological findings in the fatalities of road traffic accidents of Amman district, in order to have an overall picture of the occurrence of these substances in these victims in Jordan. Over a seven-year period (2008-2014), 2743, autopsies were conducted at Jordan University Hospital in which the sum of n = 311 (11.38%) were victims of road traffic accidents. Blood samples from these victims were collected. Toxicology screening for psychotropic drugs and alcohol was conducted on these samples, and the results were analyzed according to age, sex and victim's status. This study revealed that Alcohol and psychotropic drugs were positive in 36.5%, (n = 58) of the cases, and for alcohol alone (n = 13, 37.1%). The majority of the victims were pedestrians (n = 155, 49.8%). Additionally, 29.6% (n = 92) of the cases were of ages 19-29. Detected psychotropic drugs were benzodiazepines, barbiturates. None of the collected specimens were positive for illicit cocaine, amphetamines or cannabis. The results from this study proved the existence of alcohol and psychotropic drugs in the victims of road traffic accidents; Indicating an association between the uses of these substances in accident involvement. Though having some limitations, other conclusions require further data collection, cooperation with related parties in Jordan, and utilizing simple extended toxicological screens. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Inappropriate Use of Psychotropic Drugs in People Aged 60 and over

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María Magdalena Caro Mantilla

2013-03-01

Full Text Available Background: indiscriminate use of psychoactive medication can provoke multiple disorders to the elderly system. Furthermore, it can also result in drug abuse. Objective: to characterize the inappropriate use of psychotropic drugs in people aged 60 and over. Methods: a descriptive, cross-sectional and prospective study was conducted in two consultations of Health Area # II in the municipality of Cienfuegos from June to December 2006. The sample consisted of 93 adults aged over 60. The variables analyzed were age, sex, educational level, prescribed medication and its application, symptoms leading to the indication, duration of the treatment according to the prescription, follow-up, therapeutic alternatives, tolerance and abstinence. We applied a functional assessment scale: the Lawton and Brody Scale. For the statistical processing, descriptive statistics tests were performed. For computational processing, a database was created in the SPSS 11.0 program for Windows. Results: it is mostly women who consume these types of drugs. The most consumed psychoactive drugs were benzodiazepines and mainly through self-medication. Elderly presented tolerance and abstinence. There was a misuse of these drugs in relation to the time of consumption, prescription, follow-up and treatment options such as natural and traditional medicine. Conclusions: high rates of medical prescription, failures in patient’s follow-up, self-medication and non-use of therapeutic alternatives are some of the many causes of the indiscriminate use of psychoactive drugs in people aged over 60.

Exposure to reactive intermediate-inducing drugs during pregnancy and the incident use of psychotropic medications among children.

Science.gov (United States)

Tran, Yen-Hao; Groen, Henk; Bergman, Jorieke E H; Hak, Eelko; Wilffert, Bob

2017-03-01

Our study aimed to investigate the association between prenatal exposure to reactive intermediate (RI)-inducing drugs and the initiation of psychotropic medications among children. We designed a cohort study using a pharmacy prescription database. Pregnant women were considered exposed when they received a prescription of RI-inducing drugs. These drugs could be either used alone (RI+/FAA-) or combined with drugs exhibiting folic acid antagonism (FAA, RI+/FAA+). The reference group included pregnant women who did not receive any RI-inducing drugs or FAA drugs. We analyzed 4116 exposed and 30 422 reference pregnancies. The hazard ratio (HR) with 95% confidence interval (CI) was 1.27 (95%CI 1.15-1.41) for pregnancies exposed to RI-inducing drugs as a whole. Considering subgroups of RI-inducing drugs, prenatal exposure to both RI+/FAA+ and RI+/FAA- was associated with the children's initiation of psychotropic medications, HRs being 1.35 (95%CI 1.10-1.66) and 1.26 (1.13-1.41), respectively. The HRs were increased with prolonged exposure to RI-inducing drugs, especially in the first and second trimesters. In a detailed examination of the psychotropics, the incidences of receiving antimigraine preparations and psychostimulants were significantly increased for the exposed children, compared with the reference children. The incidences of receiving antipsychotics and hypnotics were also higher for the exposed children; however, the HRs did not reach significance after adjustment. We found a significantly increased incident use of psychotropic medications among children prenatally exposed to RI-inducing drugs, especially during the first and second trimesters. This suggests a detrimental effect during critical periods of brain development. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Psychotropic medicine prescriptions in Italian youths: a multiregional study.

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Piovani, Daniele; Clavenna, Antonio; Cartabia, Massimo; Bonati, Maurizio

2016-03-01

The aim of the study was to evaluate the trend of paediatric psychotropic drug prescriptions in Italy. Data sources were regional, outpatient prescription databases. Seven Italian regions, covering 50 % of the Italian population, provided data from 2006 to 2011. Prevalence and incidence of prescriptions by age and gender were evaluated for psychotropic, antidepressant, antipsychotic, and attention-deficit/hyperactivity disorders (ADHD) medications. The hospital admission rate for psychiatric conditions was calculated, also at the local health unit (LHU) level. The presence of trends in prescription prevalence and incidence during the 6 year period was assessed. Finally, the correlation between prevalence, prescription, hospital admission rates, latitude, longitude, and average annual income at the LHU level was also investigated. In 2011, 8834 youths received at least one psychotropic drug prescription, with a prevalence of 1.76 ‰ (95 % CI 1.72-1.80). The incidence of new psychotropic drug users was 1.03 ‰ (1.00-1.06). The prevalence of antidepressants was 1.02 ‰ (0.99-1.04), while that of antipsychotics was 0.70 ‰ (0.68-0.72), and that of ADHD medications 0.19 ‰ (0.18-0.21). The psychotropic drug prevalence increased with increasing age. Males were more exposed to psychotropic drugs than females (AUC0-17 male/female = 1.23). Antipsychotics were the most prescribed psychotropic drugs in males, while antidepressants were in females. Between-region prevalence ranged from 1.56 to 2.17 ‰. The overall prevalence of psychotropic drug from 2006 to 2011 was stable (χ(t)2 ≤ 0.001, p = 0.97). No correlation was found between prevalence and the variables investigated. Psychotropic drug prescription was very limited and stable. No geographical patterns were found.

Psychotropic drugs and the risk of fractures in old age: a prospective population-based study.

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Nurminen, Janne; Puustinen, Juha; Piirtola, Maarit; Vahlberg, Tero; Kivelä, Sirkka-Liisa

2010-07-06

There is evidence that the use of any psychotropic and the concomitant use of two or more benzodiazepines are related to an increased risk of fractures in old age. However, also controversial results exist. The aim was to describe associations between the use of a psychotropic drug, or the concomitant use of two or more of these drugs and the risk of fractures in a population aged 65 years or over. This study was a part of a prospective longitudinal population-based study carried out in the municipality of Lieto, South-Western Finland. The objective was to describe gender-specific associations between the use of one psychotropic drug [benzodiazepine (BZD), antipsychotic (AP) or antidepressant (AD)] or the concomitant use of two or more psychotropic drugs and the risk of fractures in a population 65 years or over. Subjects were participants in the first wave of the Lieto study in 1990-1991, and they were followed up until the end of 1996. Information about fractures confirmed with radiology reports in 1,177 subjects (482 men and 695 women) during the follow-up was collected from medical records. Two follow-up periods (three and six years) were used, and previously found risk factors of fractures were adjusted as confounding factors separately for men and women. The Poisson regression model was used in the analyses. The concomitant use of two or more BZDs and the concomitant use of two or more APs were related to an increased risk of fractures during both follow-up periods after adjusting for confounding factors in men. No similar associations were found in women. The concomitant use of several BZDs and that of several APs are associated with an increase in the risk of fractures in older men. Our findings show only risk relations. We cannot draw the conclusion that these drug combinations are causes of fractures.

[Effect of psychotropic drugs on activity of anticonvulsants in maximal electroshock test].

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Alikina, N A; Tregubov, A L; Kotegov, V P

2010-08-01

The effect ofpsychotropic drugs on the pharmacological properties of anticonvulsants was studied on white mice under maximal electroshock (ME) test conditions. Changes in the anticonvulsant effect of phenobarbital, diphenin, carbamazepine, hexamidine were traced upon their joint administration with psychotropic drugs, including piracetam, aminalon, amitriptyline, imizine, levomepromazine, and lithium oxybutyrate. An important result of research is the fact, that in no one of combinations the basic pharmacological effect of anticonvulsants was decreased. Based on the results of experiments, the most rational combinations of anticonvulsants with psychotropic preparations were revealed as manifested in the ME test. As criterion of rational combination was the increase in the activity of anticonvulsants and reduction of their toxicity in combination or at least invariance of this parameter. Rational combinations include (i) phenobarbital with piracetam, amitriptyline, levomepromazine, and lithium oxybutyrate; (ii) carbamazepine with piracetam; and (iii) hexamidine with amitriptyline, levomepromazine and imizine.

Genotoxic and immunotoxic potential effects of selected psychotropic drugs and antibiotics on blue mussel (Mytilus edulis) hemocytes

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Lacaze, Emilie; Pédelucq, Julie; Fortier, Marlène; Brousseau, Pauline; Auffret, Michel; Budzinski, Hélène; Fournier, Michel

2015-01-01

The potential toxicity of pharmaceuticals towards aquatic invertebrates is still poorly understood and sometimes controversial. This study aims to document the in vitro genotoxicity and immunotoxicity of psychotropic drugs and antibiotics on Mytilus edulis. Mussel hemocytes were exposed to fluoxetine, paroxetine, venlafaxine, carbamazepine, sulfamethoxazole, trimethoprim and erythromycin, at concentrations ranging from μg/L to mg/L. Paroxetine at 1.5 μg/L led to DNA damage while the same concentration of venlafaxine caused immunomodulation. Fluoxetine exposure resulted in genotoxicity, immunotoxicity and cytotoxicity. In the case of antibiotics, trimethoprim was genotoxic at 200 μg/L and immunotoxic at 20 mg/L whereas erythromycin elicited same detrimental effects at higher concentrations. DNA metabolism seems to be a highly sensitive target for psychotropic drugs and antibiotics. Furthermore, these compounds affect the immune system of bivalves, with varying intensity. This attests the relevance of these endpoints to assess the toxic mode of action of pharmaceuticals in the aquatic environment. - Highlights: • Psychotropic drugs and antibiotics affect the immune system of Mytilus edulis. • Genotoxic and immunotoxic endpoints were relevant to assess pharmaceuticals toxicity. • DNA metabolism is a highly sensitive target for pharmaceuticals. • Fluoxetine and paroxetine were the most toxic compounds on mussel hemocytes. - Psychotropic drugs and antibiotics have the potential to cause immune toxicity and genotoxicity on Mytilus edulis hemocytes

Effects of psychotropic drugs and psychiatric illness on vocational aptitude and interest assessment.

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Helmes, E; Fekken, G C

1986-07-01

This study examined the vocational aptitude and interest scores of 326 inpatients at a large urban psychiatric hospital. The inpatient group performed significantly below the adult normative mean on eight of nine General Aptitude Test Battery (GATB) aptitude measures; the single exception was Verbal Aptitude. Further, GATB aptitude scores (adjusted for age and education) were significantly lower for patients who were receiving (N = 210) psychotropic medication than for patients who were not receiving (N = 114) psychotropic medication, again with the exception of Verbal Aptitude. Differentiation of patients into subsamples who were receiving particular drugs or drug combinations indicated that phenothiazines in combination with Anti-Parkinsonians were associated with the poorest GATB performances. Interestingly, self-reported vocational interests were not related in any systematic fashion to receiving medication. A variety of explanations that may account for these findings, including drug side-effects and severity or type of psychiatric disorder, were investigated. Implications for vocational counselors were discussed.

Parental attitudes toward the prescription of psychotropic medications for their children

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Fatima A Al-Haidar

2008-01-01

Full Text Available Objective: To explore parental attitudes towards the prescription of psychotropic medication for their children. Method: A questionnaire built to collect socio-demographic data of parents and their attitudes was distributed among parents. Results: One thousand and ten questionnaires were filled by parents. Fathers who completed the questionnaire were double the number of mothers. Eight hundred and eighteen parents (84.3% agreed to the dispensing psychotropic medication to their children if necessary. About 83.5% preferred to start with psychotherapy before trying medication. Fathers are more than twice likely than mothers to agree to the use of psychotropic drugs. Older parents more easily agreed to give their children psychotropic drugs. Parents who used psychotropic drug themselves were more likely to agree to the use of psychotropic drug by their children. Having a child with a psychiatric illness is the most significant factor in making parents accede to giving children psychotropic medication. Other factors such as pressure from schools and the side effects of drugs could also modify decision of parents. Conclusion: Although most parents agreed to give their children psychotropic drugs if necessary, they preferred to start with psychotherapy sessions before giving them the drugs. Fear and worries about such issues as side effects of drugs or addiction should be considered. Pressure from school should also be considered when deciding on drug therapy.

Factors associated with psychotropic drug use among community-dwelling older persons: A review of empirical studies

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Lauzon Sylvie

2004-08-01

Full Text Available Abstract Background In the many descriptive studies on prescribed psychotropic drug use by community-dwelling older persons, several sociodemographic and other factors associated with drug use receive inconsistent support. Method Empirical reports with data on at least benzodiazepine or antidepressant drug use in samples of older persons published between 1990 and 2001 (n = 32 were identified from major databases and analyzed to determine which factors are most frequently associated with psychotropic drug use in multivariate analyses. Methodological aspects were also examined. Results Most reports used probability samples of users and non-users and employed cross-sectional designs. Among variables considered in 5 or more reports, race, proximity to health centers, medical consultations, sleep complaints, and health perception were virtually always associated to drug use. Gender, mental health, and physical health status were associated in about two-thirds of reports. Associations with age, marital status, medication coverage, socioeconomic status, and social support were usually not observed. Conclusions The large variety of methods to operationalize drug use, mental health status, and social support probably affected the magnitude of observed relationships. Employing longitudinal designs and distinguishing short-term from long-term use, focusing on samples of drug users exclusively, defining drug use and drug classes more uniformly, and utilizing measures of psychological well-being rather than only of distress, might clarify the nature of observed associations and the direction of causality. Few studies tested specific hypotheses. Most studies focused on individual characteristics of respondents, neglecting the potential contribution of health care professionals to the phenomenon of psychotropic drug use among seniors.

[Adaptations of psychotropic drugs in patients aged 75 years and older in a departement of geriatric internal medecine: report of 100 cases].

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Couderc, Anne-Laure; Bailly-Agaledes, Cindy; Camalet, Joëlle; Capriz-Ribière, Françoise; Gary, André; Robert, Philippe; Brocker, Patrice; Guérin, Olivier

2011-06-01

The elderly often with multiple diseases are particularly at risk from adverse drug reactions. Nearly half of iatrogenic drug in the elderly are preventable. Some medications such as psychotropic drugs are particularly involved in iatrogenic accidents. We wanted to know if the tools of the comprehensive geriatric assessment or other factors could influence the changes of psychotropic drugs in a geriatric departement. Our prospective study of four months in 100 patients aged 75 years and older hospitalized in the Geriatric Internal Medecine Departement of University Hospital of Nice investigated what were the clinical or biological reasons and tools used during changes of psychotropic drugs. We compared these changes according to the comprehensive geriatric assessment tools and we analyzed the changes based on lists of potentially inappropriate medications by Laroche et al. and from the instrument STOPP/START. The Mini Mental State Examination (MMSE) was the tool that has most influenced the changes in psychotropic including a tendency to increase and the introduction of anxiolytics when MMSE < 20 (p = 0.007) while neuroleptics instead arrested and decreased (p = 0.012). The comprehensive geriatric assessment has its place in decision support during the potentially iatrogenic prescriptions of drugs such as psychotropic and new tools such as STOPP/START can also be a help to the prescriber informed.

Social inequalities and correlates of psychotropic drug use among young adults: a population-based questionnaire study

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Baumann Michèle

2008-01-01

Full Text Available Abstract Background Use of psychotropic drugs is widespread in Europe, and is markedly more common in France than elsewhere. Young adults often fare less well than adolescents on health indicators (injury, homicide, and substance use. This population-based study assessed disparities in psychotropic drug use among people aged 18–29 from different socio-occupational groups and determined whether they were mediated by educational level, health status, income, health-related behaviours, family support, personality traits, or disability. Methods A total of 1,257 people aged 18–29, randomly selected in north-eastern France completed a post-mailed questionnaire covering sex, date of birth, height, weight, educational level, occupation, smoking habit, alcohol abuse, income, health-status, diseases, reported disabilities, self-reported personality traits, family support, and frequent psychotropic medication for tiredness, nervousness/anxiety or insomnia. The data were analyzed using the adjusted odds ratios (ORa computed with logistic models. Results Use of psychotropic drugs was common (33.2%. Compared with upper/intermediate professionals, markedly high odds ratios adjusted for sex were found for manual workers (2.57, 95% CI 1.02–6.44, employees (2.58, 1.11–5.98, farmers/craftsmen/tradesmen (4.97, 1.13–21.8, students (2.40, 1.06–5.40, and housewives (3.82, 1.39–10.5. Adjusting for all the confounders considered reduced the estimates to a pronounced degree for manual workers (adjusted OR 1.49, non-significant but only slightly for the other socio-occupational groups. The odds ratio for unemployed people did not reach statistical significance. The significant confounders were: sex, not-good health status, musculoskeletal disorders and other diseases, being worried, nervous or sad, and lack of family support (adjusted odds ratios between 1.60 and 2.50. Conclusion There were marked disparities among young adults from different socio

Effects of maternal psychotropic drug dosage on birth outcomes

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Michielsen LA

2013-12-01

Full Text Available Laura A Michielsen,1 Frank MMA van der Heijden,1 Paddy KC Janssen,2 Harold JH Kuijpers11Vincent van Gogh Institute for Psychiatry, Venlo, the Netherlands; 2Department of Pharmacy, VieCuri Medical Centre, Venlo, the NetherlandsBackground: The aim of this retrospective study was to explore the relationship between psychotropic medication dosage and birth outcomes.Methods: A total of 136 women were enrolled, who had an active mental disorder, were taking medication to prevent a relapse, or had a history of postpartum depression or psychosis. Medication use was evaluated for the three trimesters and during labor. Based on the defined daily dose, medication use was classified into three groups. Primary outcome variables included the infant gestational age at birth, birth weight, and Apgar scores at one and 5 minutes.Results: Our study showed a significantly higher incidence of Apgar score ≤7 at 5 minutes in women taking psychotropic drugs as compared with the group taking no medication, respectively (16.3% versus 0.0%, P=0.01. There was no significant difference between the two groups in Apgar score at one minute or in gestational age and birth weight. The results showed no significant differences in gestational age, birth weight, or Apgar scores for a low–intermediate or high dose of a selective serotonin reuptake inhibitor and for a low or intermediate dose of an antipsychotic.Conclusion: This study does not indicate a relationship between doses of selective serotonin reuptake inhibitors and antipsychotics and adverse neonatal outcomes.Keywords: pregnancy, psychotropic medication, dosage, birth outcomes

Rise in psychotropic drug prescribing in children and adolescents during 1992-2001: a population-based study in the UK

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Hsia Yingfen; Maclennan, Karyn

2009-01-01

Background The trend towards increased psychotropic drug prescribing in children and adolescents is well recognised in North America and continental Europe. However, it is unclear to what extent these studies are applicable to clinical practice in the United Kingdom (UK). This study was conducted to estimate the prevalence of psychotropic drug prescribing in children and adolescents aged <19 years in general practice in the UK from January 1992 to December 2001. Methods Data were obtained from the General Practice Research Database (GPRD). Annual age- and sex-specific prevalence of psychotropic drug prescribing was calculated. Results A total of 143,079 prescriptions were issued to 34,398 study subjects. Stimulant prescriptions rose significantly from 0.03 per 1,000 (95% confidence interval 0.02-0.04) in 1992 to 2.9 per 1,000 (2.52-3.32) in 2001; a 96-fold increase. Methylphenidate accounted for the majority of stimulant prescriptions; 2.4% (349/14,370) of stimulant prescriptions were prescribed to children aged <6 years. Increased prescribing was also noted for antidepressants (1.6-fold), hypnotics/anxiolytics (1.3-fold), antipsychotics (1.3-fold) and anticonvulsants (1.3-fold), whilst the prevalence of clonidine and lithium prescribing remained fairly stable throughout the study period. The use of antidepressant, hypnotic/anxiolytic and anticonvulsant increased with increasing age. A high proportion of boys received stimulants, whereas antidepressants and hypnotics/anxiolytics were more likely prescribed to girls. Conclusion There is an increased trend of psychotropic drug use in children and adolescents in the UK practice. Since most psychotropic drugs are not licensed for use in children at this time, research is needed to investigate the efficacy and long-term safety in this population

Clinical and sociodemographic correlates of severe insomnia in psychotropic drug-free, Asian outpatients with major depressive disorder.

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Srisurapanont, Manit; Likhitsathian, Surinporn; Chua, Hong Choon; Udomratn, Pichet; Chang, Sungman; Maneeton, Narong; Maneeton, Benchaluk; Chen, Chia-Hui; Shih-Yen Chan, Edwin; Bautista, Dianne; Bin Sulaiman, Ahmad Hatim

2015-11-01

Little has been known regarding the correlates of severe insomnia in major depressive disorder (MDD). This post-hoc analysis aimed to examine the sociodemographic and clinical correlates of severe insomnia in psychotropic drug-free, Asian adult outpatients with MDD. Participants were psychotropic drug-free patients with MDD, aged 18-65 years. By using the Symptom Checklist-90 Items, Revised (SCL-90-R), a score of 4 (severe distress) on any one of three insomnia items was defined as severe insomnia. Other measures included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the nine psychopathology subscales of SCL-90-R, the Physical and Mental Component Summaries of Short Form Health Survey (SF-36 PCS and SF-36 MCS), and the Sheehan Disability Scale (SDS). Of 528 participants, their mean age being 39.5 (SD=13.26) years, 64.2% were females, and 239 (45.3%) had severe insomnia. The logistic regression model revealed that low educational qualifications (less than secondary school completion), high SCL-90-R Depression scores, high SCL-90-R Anxiety scores, and low SF-36 PCS scores were independently correlated with severe insomnia (p'sdepression and anxiety severity, and poor physical health. These findings may implicate the treatment of comorbid MDD and severe insomnia, for example, sleep hygiene education, pharmacological treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

Prevalence of psychotropic drug use in military police units.

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Costa, Sérgio Henrique Nascente; Yonamine, Maurício; Ramos, Andrea Luciana Martins; Oliveira, Fernando Gomes Ferreira; Rodrigues, Caroline Rego; da Cunha, Luiz Carlos

2015-06-01

The present study aimed to verify the prevalence of psychoactive drug use (amphetamines, methamphetamines, cannabinoids, cocaine, opioids and benzodiazepines) among military police officers in the state of Goiás. Data were obtained from urine samples voluntarily provided by the officers participating in the study, who were informed of the study methods and signed a free and informed consent form. The samples were subject to screening analysis by immunochromatography (Multi-DrugOneStep Test®), with positive tests confirmed by gas chromatography- mass spectrometry (GC-MS) and data analyzed by descriptive statistics. The results indicated the presence of the following drugs: amphetamines (0.33%), cannabinoids (0.67%) and benzodiazepines (1.34%); 97.66% showed negative results. The positive cases were distributed as follows: benzodiazepines (57.1%); cannabinoids (28.6%) and amphetamines (14.3%). In conclusion, the detection of psychoactive substances in voluntary sampling of military police officers indicates the need to implement drug testing among active military officers and preventive public policies aimed at eliminating the abusive consumption of psychotropic drugs.

Dealing with sadness, madness and hostility. New psychotropic drug remedies for the future

NARCIS (Netherlands)

Loonen, A.J.M.

1992-01-01

The objective of this article is to present an overview of new forms of psychotropic drug therapy that may be expected to play a role in psychiatric practice in the 1990s. In predicting these future developments, three lines of approach have been followed. Firstly, progress in elucidating basic

[Sleep disorders and impaired sleep as adverse drug reactions of psychotropic drugs: an evaluation of data of summaries of product characteristics].

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Gahr, Maximilian; Connemann, Bernhard J; Zeiss, René; Fröhlich, Albrecht

2018-03-02

 Psychopharmacotherapy is essential in the treatment of many mental disorders. Adverse drug reactions (ADR) have impact on compliance and tolerability. Sleep disorders or impaired sleep may occur as ADRs of psychopharmacotherapy. Sleep disorders are associated with an increased risk for physical and mental illness and may impair cognition, impulse control, emotion regulation and mood. Objective of the following study was the systematic presentation of type and risk of sleep disorders/impairments of sleep of frequently prescribed psychotropic drugs.  Psychotropic agents that are most frequently prescribed in Germany were identified by using the Arzneiverordnungs-Report 2016. Summaries of product characteristics (SmPC) of corresponding original products were analyzed regarding presence and frequency of sleep disorders/impairments of sleep according to the International Classification of Sleep Disorders 3 (ICSD-3).  N = 64 SmPCs were analyzed. In most of the analyzed SmPCs, at least one sleep disorder (50/64; 78 %) was listed. At least one SmPC with a corresponding ADR was found in the categories insomnia (52 %), parasomnias (33 %), and sleep-related movement disorders (20 %); sleep-related breathing disorders (6 %) and central disorders of hypersomnolence (5 %) were rarely listed; circadian rhythm sleep-wake disorder was not found. The SmPCs of the four most frequently prescribed agents (citalopram > venlafaxine > mirtazapine > sertraline) listed insomnia as an ADR. Nearly all analysed hypnotics (except chloral hydrate) were associated with nightmares.  Most of the psychotropic agents frequently prescribed in Germany may induce sleep disorders/impairments of sleep. The four most frequently prescribed agents were antidepressants and all of the corresponding SmPCs listed insomnia as a possible ADR. Sleep disorders should be taken seriously as possible ADRs of psychopharmacotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

The effects of Psychotropic drugs On Developing brain (ePOD) study : methods and design

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Bottelier, Marco A; Schouw, Marieke L J; Klomp, Anne; Tamminga, Hyke G H; Schrantee, Anouk G M; Bouziane, Cheima; de Ruiter, Michiel B; Boer, Frits; Ruhé, Henricus G; Denys, D.; Rijsman, Roselyne; Lindauer, Ramon J L; Reitsma, Hans B; Geurts, Hilde M; Reneman, Liesbeth

2014-01-01

BACKGROUND: Animal studies have shown that methylphenidate (MPH) and fluoxetine (FLX) have different effects on dopaminergic and serotonergic system in the developing brain compared to the developed brain. The effects of Psychotropic drugs On the Developing brain (ePOD) study is a combination of

The effects of psychotropic drugs on developing brain (ePOD) study: methods and design

NARCIS (Netherlands)

Bottelier, M.A.; Schouw, M.L.J.; Klomp, A.; Tamminga, G.H.; Schrantee, A.G.M.; Bouziane, C.; de Ruiter, M.B.; Boer, F.; Ruhé, H.G.; Denys, D.; Rijsman, R.; Lindauer, R.J.L.; Reitsma, H.B.; Geurts, H.M.; Reneman, L.

2014-01-01

Background: Animal studies have shown that methylphenidate (MPH) and fluoxetine (FLX) have different effects on dopaminergic and serotonergic system in the developing brain compared to the developed brain. The effects of Psychotropic drugs On the Developing brain (ePOD) study is a combination of

The effects of Psychotropic drugs On Developing brain (ePOD) study : methods and design

NARCIS (Netherlands)

Bottelier, Marco A.; Schouw, Marieke L. J.; Klomp, Anne; Tamminga, Hyke G. H.; Schrantee, Anouk G. M.; Bouziane, Cheima; de Ruiter, Michiel B.; Boer, Frits; Ruhe, Henricus G.; Denys, Damiaan; Rijsman, Roselyne; Lindauer, Ramon J. L.; Reitsma, Hans B.; Geurts, Hilde M.; Reneman, Liesbeth

2014-01-01

Background: Animal studies have shown that methylphenidate (MPH) and fluoxetine (FLX) have different effects on dopaminergic and serotonergic system in the developing brain compared to the developed brain. The effects of Psychotropic drugs On the Developing brain (ePOD) study is a combination of

The effects of Psychotropic drugs On Developing brain (ePOD) study: methods and design

NARCIS (Netherlands)

Bottelier, Marco A.; Schouw, Marieke L. J.; Klomp, Anne; Tamminga, Hyke G. H.; Schrantee, Anouk G. M.; Bouziane, Cheima; de Ruiter, Michiel B.; Boer, Frits; Ruhé, Henricus G.; Denys, Damiaan; Rijsman, Roselyne; Lindauer, Ramon J. L.; Reitsma, Hans B.; Geurts, Hilde M.; Reneman, Liesbeth

2014-01-01

Animal studies have shown that methylphenidate (MPH) and fluoxetine (FLX) have different effects on dopaminergic and serotonergic system in the developing brain compared to the developed brain. The effects of Psychotropic drugs On the Developing brain (ePOD) study is a combination of different

Is psychotropic medication use related to organisational and treatment culture in residential care.

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Peri, Kathryn; Kerse, Ngaire; Moyes, Simon; Scahill, Shane; Chen, Charlotte; Hong, Jae Beom; Hughes, Carmel M

2015-01-01

The purpose of this paper is to establish the relationship between organisational culture and psychotropic medication use in residential care. Cross-sectional analyses of staff and resident's record survey in residential aged care facilities in Auckland, New Zealand (NZ). The competing values framework categorised organisational culture as clan, hierarchical, market driven or adhocracy and was completed by all staff. The treatment culture tool categorised facilities as having resident centred or traditional culture and was completed by registered nursing staff and general practitioners (GP). Functional and behavioural characteristics of residents were established by staff report and health characteristics and medications used were ascertained from the health record. Multiple regression was used to test for associations between measures of culture with psychotropic medication use (anxiolytics, sedatives, major tranquillisers). In total 199 staff, 27 GP and 527 residents participated from 14 facilities. On average 8.5 medications per resident were prescribed and 42 per cent of residents received psychotropic medication. Having a diagnosis of anxiety or depression (odds ratio (OR) 3.18, 95 per cent confidence interval (CI) 1.71, 5.91), followed by persistent wandering (OR 2.53, 95 per cent CI 1.59, 4.01) and being in a dementia unit (OR 2.45, 95 per cent CI 1.17, 5.12) were most strongly associated with psychotropic use. Controlling for resident- and facility-level factors, health care assistants' assignation of hierarchical organisational culture type was independently associated with psychotropic medication use, (OR 1.29, CI 1.08, 1.53) and a higher treatment culture score from the GP was associated with lower use of psychotropic medication (OR 0.95, CI 0.92, 0.98). Psychotropic medication use remains prevalent in residential care facilities in NZ. Interventions aimed at changing organisational culture towards a less hierarchical and more resident-centred culture

[Counselling customers with psychotropic vs. cardiovascular prescriptions: a survey among Austrian community pharmacists].

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Hagmair, Gisela; Amering, Michaela; Kaiser, Gerda; Katschnig, Heinz

2014-01-01

Prescriptions for psychotropic drugs in general and their share of all prescriptions have substantially risen over the last decades. Thus, also counselling by pharmacists becomes more important in this area. This study focuses on how community pharmacists see their own role when counselling persons with prescriptions for psychotropic medication and how this differs from counselling persons with other types of prescriptions. Based on the Toronto Community Pharmacists' Questionnaire an online questionnaire was developed with the assistance of the Austrian Pharmacists Association. This instrument elicits pharmacists' attitudes toward and professional interactions with users of psychotropic drugs on the one hand and of cardiovascular medication on the other. After a pilot study the questionnaire - which was to be filled in anonymously - was put on a web portal for six months and Austrian community pharmacists were invited to answer it. 125 pharmacists completed the questionnaire. Overall it was reported, that new customers with psychotropic prescriptions were less often counselled than those with prescriptions for cardiovascular medication. The main reasons for this difference seem to be the lack of privacy in public pharmacies, the fear of stigmatising customers with psychotropic medication and a perceived lack of training concerning the treatment of mental disorders. In addition to improving such training, it was suggested that seminars and workshops for communication skills should be organised. The reduced frequency in counselling new customers with psychotropic medication is related to a lack of privacy in public pharmacies, fear of stigmatising customers and a perceived need for improving the training on the treatment of mental disorders.

Associations of social and material deprivation with tobacco, alcohol, and psychotropic drug use, and gender: a population-based study.

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Baumann, Michèle; Spitz, Elisabeth; Guillemin, Francis; Ravaud, Jean-François; Choquet, Marie; Falissard, Bruno; Chau, Nearkasen

2007-11-09

The aim was to assess the relationships between social and material deprivation and the use of tobacco, excessive alcohol and psychotropic drugs by both sexes and in various age groups. Greater knowledge concerning these issues may help public health policy-makers design more effective means of preventing substance abuse. The sample comprised 6,216 people aged > or 15 years randomly selected from the population in north-eastern France. Subjects completed a post-mailed questionnaire covering socio-demographic characteristics, occupation, employment, income, smoking habit, alcohol abuse and "psychotropic" drug intake (for headache, tiredness, nervousness, anxiety, insomnia). A deprivation score (D) was defined by the cumulative number of: low educational level, manual worker, unemployed, living alone, nationality other than western European, low income, and non-home-ownership. Data were analysed using adjusted odds ratios (ORa) computed with logistic models. Deprivation was common: 37.4% of respondents fell into category D = 1, 21.2% into D = 2, and 10.0% into D > or 3a re men than women reported tobacco use (30.2% vs. 21.9%) and alcohol abuse (12.5% vs. 3.3%), whereas psychotropic drug use was more common among women (23.8% vs. 41.0%). Increasing levels of deprivation were associated with a greater likelihood of tobacco use (ORa vs. D = 0: 1.16 in D = 1, 1.49 in D = 2, and 1.93 in D > or = 3), alcohol abuse (1.19 in D = 1, 1.32 in D = 2, and 1.80 in D > or = 3) and frequent psychotropic drug intake (1.26 in D = 1, 1.51 in D = 2, and 1.91 in D > or = 3). These patterns were observed in working/other non-retired men and women (except for alcohol abuse in women). Among retired people, deprivation was associated with tobacco and psychotropic drug use only in men. Preventive measures should be designed to improve work conditions, reduce deprivation, and help deprived populations to be more aware of risk and to find remedial measures.

Associations of social and material deprivation with tobacco, alcohol, and psychotropic drug use, and gender: a population-based study

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Ravaud Jean-François

2007-11-01

Full Text Available Abstract Background The aim was to assess the relationships between social and material deprivation and the use of tobacco, excessive alcohol and psychotropic drugs by both sexes and in various age groups. Greater knowledge concerning these issues may help public health policy-makers design more effective means of preventing substance abuse. Methods The sample comprised 6,216 people aged ≥ 15 years randomly selected from the population in north-eastern France. Subjects completed a post-mailed questionnaire covering socio-demographic characteristics, occupation, employment, income, smoking habit, alcohol abuse and "psychotropic" drug intake (for headache, tiredness, nervousness, anxiety, insomnia. A deprivation score (D was defined by the cumulative number of: low educational level, manual worker, unemployed, living alone, nationality other than western European, low income, and non-home-ownership. Data were analysed using adjusted odds ratios (ORa computed with logistic models. Results Deprivation was common: 37.4% of respondents fell into category D = 1, 21.2% into D = 2, and 10.0% into D ≥ 3. More men than women reported tobacco use (30.2% vs. 21.9% and alcohol abuse (12.5% vs. 3.3%, whereas psychotropic drug use was more common among women (23.8% vs. 41.0%. Increasing levels of deprivation were associated with a greater likelihood of tobacco use (ORa vs. D = 0: 1.16 in D = 1, 1.49 in D = 2, and 1.93 in D ≥ 3, alcohol abuse (1.19 in D = 1, 1.32 in D = 2, and 1.80 in D ≥ 3 and frequent psychotropic drug intake (1.26 in D = 1, 1.51 in D = 2, and 1.91 in D ≥ 3. These patterns were observed in working/other non-retired men and women (except for alcohol abuse in women. Among retired people, deprivation was associated with tobacco and psychotropic drug use only in men. Conclusion Preventive measures should be designed to improve work conditions, reduce deprivation, and help deprived populations to be more aware of risk and to find remedial

[Treatment with psychotropic agents in patients with dementia and delirium : Gap between guideline recommendations and treatment practice].

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Hewer, Walter; Thomas, Christine

2017-02-01

Psychiatric symptoms in dementia and delirium are associated with a substantially reduced quality of life of patients and their families and often challenging for professionals. Pharmacoepidemiological surveys have shown that, in particular, patients living in nursing homes receive prescriptions of psychotropic agents in significant higher frequency than recommended by current guidelines. This article focuses on a critical appraisal of this gap from the point of view of German healthcare services. Narrative review with special reference to the German dementia guideline from 2016 and recently published practice guidelines for delirium in old age in German and English language. The indications for use of psychotropic agents, especially antipsychotics, are defined narrowly in the German dementia guideline. According to this guideline for several psychopathological symptoms evidence based recommendations cannot be given, currently. For delirium several practice guidelines related to different treatment settings have been published recently. Comparable to the German dementia guideline they recommend general medical interventions and nonpharmacological treatment as first line measures and the use of psychotropic agents only under certain conditions. These guidelines differ to some extent regarding the strength of recommendation for psychopharmacological treatment. The guidelines discussed here advocate well-founded a cautious prescription of psychotropic agents in patients with dementia and delirium. This contrasts to everyday practice which is characterized by significantly higher prescription rates. This gap may explained partially by a lack of evidence-based recommendations regarding certain psychopathological symptoms. Most notably, however, epidemiological data disclose an unacceptable rate of hazardous overtreatment with psychotropic agents, especially in long-term care of persons with dementia. In this situation counteractive measures by consequent implementation

Effects of the Financial Crisis on Psychotropic Drug Consumption in a Cohort from a Semi-Urban Region in Catalonia, Spain

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Barceló, Maria A.; Coll-Negre, Montserrat; Coll-de-Tuero, Gabriel; Saez, Marc

2016-01-01

Purpose Evidence of whether the recent economic crisis has or has not had an effect on psychotropic drug consumption is very scarce. Our objective was to determine if there had in fact been an increase in psychotropic drug use as a result of the financial crisis. Methods In our study a retrospective cohort (between January 1, 2005, and December 31, 2012) was made up of individuals from the general population in a region in the northeast of Catalonia, Spain. We specified a generalized linear mixed model along with combined ‘selection on observables’ as (propensity scoring) matching and ‘selection on unobservables’ as (random coefficient) the panel data model methods, and performed inferences using a Bayesian framework. Results In the period following the economic crisis (post 2009), there was an increase in the consumption of psychotropic drugs which was significantly higher among those who had already been consuming psychotropic drugs prior to 2009 and those most likely to be unemployed. The increase was of greater significance when consumption was measured by the number of drugs being taken, rather than by the defined daily dose (DDD), with the greatest increase occurring in 2011; the very year in which Spain was most affected by the crisis. Conclusions Once the financial crisis had ended, there was an increase in the severity, rather than the intensity, of mental health disorders in individuals who had already had disorders before the crisis. This increase occurred in those most likely to be unemployed, and the severity was accentuated in the toughest year of the economic crisis. PMID:26872210

Effects of the Financial Crisis on Psychotropic Drug Consumption in a Cohort from a Semi-Urban Region in Catalonia, Spain.

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Maria A Barceló

Full Text Available Evidence of whether the recent economic crisis has or has not had an effect on psychotropic drug consumption is very scarce. Our objective was to determine if there had in fact been an increase in psychotropic drug use as a result of the financial crisis.In our study a retrospective cohort (between January 1, 2005, and December 31, 2012 was made up of individuals from the general population in a region in the northeast of Catalonia, Spain. We specified a generalized linear mixed model along with combined 'selection on observables' as (propensity scoring matching and 'selection on unobservables' as (random coefficient the panel data model methods, and performed inferences using a Bayesian framework.In the period following the economic crisis (post 2009, there was an increase in the consumption of psychotropic drugs which was significantly higher among those who had already been consuming psychotropic drugs prior to 2009 and those most likely to be unemployed. The increase was of greater significance when consumption was measured by the number of drugs being taken, rather than by the defined daily dose (DDD, with the greatest increase occurring in 2011; the very year in which Spain was most affected by the crisis.Once the financial crisis had ended, there was an increase in the severity, rather than the intensity, of mental health disorders in individuals who had already had disorders before the crisis. This increase occurred in those most likely to be unemployed, and the severity was accentuated in the toughest year of the economic crisis.

Associations Between Magnitude of Child Maltreatment and Medicaid Expenditures for Psychotropic Medications.

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Raghavan, Ramesh; Brown, Derek S; Allaire, Benjamin T; Ross, Raven E; Landsverk, John

2016-08-01

This study examined relationships between various measures of the severity of child maltreatment and expenditures on psychotropic drugs among children in the welfare system. Child participants (N=4,453) in the first National Survey of Child and Adolescent Well-Being (NSCAW) were linked to their Medicaid claims from 36 states. Three specifications for severity of maltreatment were developed. A two-part regression of logistic and generalized linear models of expenditures on psychotropic medications was estimated for each specification. Physically abused children had higher odds (odds ratio [OR]=1.34) and neglected children had lower odds (OR=.76) of incurring psychotropic drug expenditures. Children who experienced the most severe level of harm had higher odds (OR=1.33) of medication use, compared with children without appreciable harm. No maltreatment specifications were associated with increased expenditures on psychotropic drugs. The magnitude of maltreatment affected odds of use of psychotropic drugs but had no effect on Medicaid expenditures for these drugs.

Factors Related to Psychotropic Drug Prescription for Neuropsychiatric Symptoms in Nursing Home Residents With Dementia

NARCIS (Netherlands)

Smeets, Claudia H. W.; Smalbrugge, Martin; Zuidema, Sytse U.; Derksen, Els; de Vries, Erica; van der Spek, Klaas; Koopmans, Raymond T. C. M.; Gerritsen, Debby L.

2014-01-01

Objectives: The objective of this study is to explore factors that elucidate reasons for psychotropic drug (PD) prescription for neuropsychiatric symptoms (NPS) in nursing home (NH) residents with dementia. Design: A qualitative study using a grounded theory approach. Setting: Twelve NHs in The

The use of psychological supportive care services and psychotropic drugs in patients with early-stage breast cancer: a comparison between two institutions on two continents.

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Kaidar-Person, Orit; Meattini, Icro; Deal, Allison M; Francolini, Giulio; Carta, Giulio; Terzo, Lauren; Camporeale, Jayne; Muss, Hyman; Marks, Lawrence B; Livi, Lorenzo; Mayer, Deborah K; Zagar, Timothy M

2017-08-01

The aim of this study was to evaluate the mental health consumption among patients with early-stage breast cancer in two radiation oncology departments in two countries (USA and Italy). Data were extracted from the medical records of consecutive patients treated between 2014 and 2015 in two centers. Extracted data included patient's demographics, treatment, referral to psychological supportive care programs, and prescribed psychotropic drugs. Data from the two centers were compared using Student's t, Wilcoxon, Fisher's exact, and Jonckheere-Terpstra tests. Adjusted relative risks (RR) were estimated using Poisson regression. A total of 231 (Italy = 110, USA = 121) patients were included, with a mean age of 60 years. The crude rate of psychological supportive care visits was similar in the US versus the Italian cohort (28.9 vs. 21.8%, p = 0.23). The crude rate of prescribed psychotropic drug was higher in the US cohort versus Italian cohort (43.8 vs. 18.2%, p < 0.0001). These differences remained significant after adjusting for breast cancer subtype, stage, and treatment (RR 1.8, 95 CI 1.17-2.76). Between 20 and 30% of patients receive psychological supportive care during treatment for breast cancer. The use of psychotropic medication was higher in the US cohort than the cohort from Italy. The reasons for these differences might be related to social and cultural differences and the method of prescribing medication.

Psychotropic treatments in Prader-Willi syndrome: a critical review of published literature.

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Bonnot, O; Cohen, D; Thuilleaux, D; Consoli, A; Cabal, S; Tauber, M

2016-01-01

Prader-Willi syndrome (PWS) is a rare genetic syndrome. The phenotype includes moderate to intellectual disability, dysmorphia, obesity, and behavioral disturbances (e.g., hetero and self-injurious behaviors, hyperphagia, psychosis). Psychotropic medications are widely prescribed in PWS for symptomatic control. We conducted a systematic review of published literature to examine psychotropic medications used in PWS. MEDLINE was searched to identify articles published between January 1967 and December 2014 using key words related to pharmacological treatments and PWS. Articles with original data were included based on a standardized four-step selection process. The identification of studies led to 241 records. All selected articles were evaluated for case descriptions (PWS and behavioral signs) and treatment (type, titration, efficiency, and side effects). Overall, 102 patients were included in these studies. Treatment involved risperidone (three reports, n = 11 patients), fluoxetine (five/n = 6), naltrexone (two/n = 2), topiramate (two/n = 16), fluvoxamine (one/n = 1), mazindol (one/n = 2), N-acetyl cysteine (one/n = 35), rimonabant (one/n = 15), and fenfluramine (one/n = 15). We identified promising treatment effects with topiramate for self-injury and impulsive/aggressive behaviors, risperidone for psychotic symptoms associated with uniparental disomy (UPD), and N-acetyl cysteine for skin picking. The pharmacological approach of behavioral impairment in PWS has been poorly investigated to date. Further randomized controlled studies are warranted. Behavioral disturbances in Prader-Willi syndrome including aggressive reactions, skin picking, and hyperphagia might be very difficult to manage. Antipsychotic drugs are widely prescribed, but weight gain and increased appetite are their major side effects. Topiramate might be efficient for self-injury and impulsive/aggressive behaviors, N-acetyl cysteine is apromising treatment for

A reliable and valid index was developed to measure appropriate psychotropic drug use in dementia

NARCIS (Netherlands)

van der Spek, K.; Gerritsen, D.L.; Smalbrugge, M.; Nelissen-Vrancken, M.H.J.M.; Wetzels, R.B.; Smeets, C.H.W.; Zuidema, S.U.; Koopmans, R.T.C.M.

2015-01-01

Objectives The aim of this study was to develop an index derived from the Medication Appropriateness Index (MAI) items that is suited for clinical studies evaluating appropriateness of psychotropic drug use (PDU) for neuropsychiatric symptoms (NPS) in patients with dementia in nursing homes and to

A three-country comparison of psychotropic medication prevalence in youth

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Gardner James F

2008-09-01

Full Text Available Abstract Background The study aims to compare cross-national prevalence of psychotropic medication use in youth. Methods A population-based analysis of psychotropic medication use based on administrative claims data for the year 2000 was undertaken for insured enrollees from 3 countries in relation to age group (0–4, 5–9, 10–14, and 15–19, gender, drug subclass pattern and concomitant use. The data include insured youth aged 0–19 in the year 2000 from the Netherlands (n = 110,944, Germany (n = 356,520 and the United States (n = 127,157. Results The annual prevalence of any psychotropic medication in youth was significantly greater in the US (6.7% than in the Netherlands (2.9% and in Germany (2.0%. Antidepressant and stimulant prevalence were 3 or more times greater in the US than in the Netherlands and Germany, while antipsychotic prevalence was 1.5–2.2 times greater. The atypical antipsychotic subclass represented only 5% of antipsychotic use in Germany, but 48% in the Netherlands and 66% in the US. The less commonly used drugs e.g. alpha agonists, lithium and antiparkinsonian agents generally followed the ranking of US>Dutch>German youth with very rare (less than 0.05% use in Dutch and German youth. Though rarely used, anxiolytics were twice as common in Dutch as in US and German youth. Prescription hypnotics were half as common as anxiolytics in Dutch and US youth and were very uncommon in German youth. Concomitant drug use applied to 19.2% of US youth which was more than double the Dutch use and three times that of German youth. Conclusion Prominent differences in psychotropic medication treatment patterns exist between youth in the US and Western Europe and within Western Europe. Differences in policies regarding direct to consumer drug advertising, government regulatory restrictions, reimbursement policies, diagnostic classification systems, and cultural beliefs regarding the role of medication for emotional and behavioral

Endocrine and Metabolic Adverse Effects of Psychotropic Drugs in Children and Adolescents

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Evrim Aktepe

2011-12-01

Full Text Available ABSTRACT Much as an increase in the use of psychotropic drugs is observed in children and adolescents over the last decade, the endocrine and metabolic side effects of these drugs can limit their use. Atypical antipsychotics can cause many side effects, which are not suitable for the developmental periods of children and adolescents, such as those related with thyroid, blood sugar, level of sex hormones, growth rate and bone metabolism. Children are under a more serious risk regarding the weight increasing effects of atypical antipsychotics and weight gain that is not proportionate with age is especially important due to the association between glucose or lipid abnormalities and cardiovascular mortality. Aripiprazole and ziprasidone are the least risky antipsychotic drugs when it comes to metabolic side affects. The antipsychotic drug that is associated with weight increase and diabetes in children and adolescents most is olanzapine. Even though there are no comparative long-term data concerning children, it is suggested by the currently available information that metabolic side effects including dyslipidemia and impaired glucose tolerance are at an alarming level when it comes to long-term treatment with antipsychotics. The most risky agents in terms of hyperglycemia and glucosuria development are olanzapine and clozapine. Use of risperidone and haloperidol should be undertaken with caution since it may bring about the risk of hyperprolactinemia. Among the antidepressants associated with weight loss and suppression of appetite are selective serotonin reuptake inhibitors, bupropion and venlafaxine. Thyroid functions can be affected by lithium, carbamazepine and valproate treatments. It is reported that the side effect most frequently associated with valproate is weight increase. The relationship between valproate treatment and the development of hyperandrogenism and polycystic ovary syndrome in young women should also be kept in mind. [TAF Prev

A computerized stroop test for the evaluation of psychotropic drugs in healthy participants.

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Pilli, Raveendranadh; Naidu, Mur; Pingali, Usha Rani; Shobha, J C; Reddy, A Praveen

2013-04-01

The Stroop paradigm evaluates susceptibility to interference and is sensitive to dysfunction in frontal lobes and drug effects. The aim of the present study was to establish a simple and reliable computerized version of Stroop color-word test, which can be used for screening of various psychotropic drugs. The standardized method was followed in all cases, by recording the reaction time (RT) in msec in 24 healthy participants using computerized version of Stroop color-word test. Reproducibility of the test procedure was evaluated by recording the RTs by a single experimenter on two sessions (interday reproducibility). Validity of the model was further tested by evaluating the psychotropic effect of Zolpidem 5 mg, Caffeine 500 mg, or Placebo on 24 healthy subjects in a randomized, double blind three-way crossover design. The method was found to produce low variability with coefficient of variation less than 10%. Interday reproducibility was very good as shown by Bland-Altman plot with most of the values within ±2SD. There was a significant increase in RTs in Stroop performance with Zolpidem at 1 hr and 2 hrs; in contrast, caffeine significantly decreased RTs in Stroop performance at 1 hr only compared to placebo. The Stroop color-word recording and analysis system is simple, sensitive to centrally acting drug effects, and has potential for future experimental psychomotor assessment studies.

Pervasive developmental disorder, behavior problems, and psychotropic drug use in children and adolescents with mental retardation

NARCIS (Netherlands)

de Bildt, Annelies; Mulder, Erik J.; Scheers, Tom; Minderaa, Ruud B.; Tobi, Hilde

2006-01-01

OBJECTIVE. This study investigated the interrelationship between psychopharmaco-therapy in general and the use of specific psychotropic drugs and pervasive developmental disorder and other behavior problems in children and adolescents with mental retardation. METHODS. A total of 862 participants 4

Pervasive developmental disorder, behavior problems, and psychotropic drug use in children and adolescents with mental retardation.

NARCIS (Netherlands)

Bildt, de A.; Mulder, E.J.; Scheers, T.; Minderaa, R.B.; Tobi, H.

2006-01-01

OBJECTIVE. This study investigated the interrelationship between psychopharmacotherapy in general and the use of specific psychotropic drugs and pervasive developmental disorder and other behavior problems in children and adolescents with mental retardation. METHODS. A total of 862 participants 4 to

Hormonal contraception increases the risk of psychotropic drug use in adolescent girls but not in adults: A pharmacoepidemiological study on 800 000 Swedish women.

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Zettermark, Sofia; Perez Vicente, Raquel; Merlo, Juan

2018-01-01

The burden of depression and anxiety disorders is greater in women, and female sex hormones have been shown to affect mood. Psychological side effects of hormonal contraception (HC) are also a common complaint in the clinic, but few previous studies have investigated this subject. We therefore wanted to investigate whether use of HC was associated with adverse psychological health outcomes, and whether this association was modified by age. All women aged 12-30 years on 31 December 2010, residing in Sweden for at least four years and with no previous psychiatric morbidity (n = 815 662), were included. We followed the women from their first HC use (or 31 December 2010, if they were non-users) at baseline, until a prescription fill of psychotropic drugs or the end of the one-year follow-up. We performed age-stratified logistic regression models and estimated odds ratios (OR) to measure the association between different HC methods and psychotropic drug use, as well as the area under the receiver operating curve to estimate discriminatory accuracy of HC in relation to psychotropic drugs. Overall, we found an association between HC and psychotropic drugs (adjusted OR 1.34, 95% confidence interval [CI] 1.30-1.37). In the age-stratified analysis, the strongest association was found in adolescent girls (adjusted OR 3.46, 95% CI 3.04-4.94 for age 12 to 14 years), while it was non-existent for adult women. We conclude that hormonal contraception is associated with psychotropic drug use among adolescent girls, suggesting an adverse effect of HC on psychological health in this population.

Association of variants in SH2B1 and RABEP1 with worsening of low-density lipoprotein and glucose parameters in patients treated with psychotropic drugs.

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Delacrétaz, Aurélie; Zdralovic, Adna; Vandenberghe, Frederik; Saigi-Morgui, Nuria; Glatard, Anaïs; Quteineh, Lina; Gholam-Rezaee, Mehdi; Raffoul, Wassim; Applegate, Lee Ann; Jafari, Paris; Gamma, Franziska; von Gunten, Armin; Conus, Philippe; Eap, Chin B

2017-09-10

Genetic factors associated with Body Mass Index (BMI) have been widely studied over the last decade. We examined whether genetic variants previously associated with BMI in the general population are associated with cardiometabolic parameter worsening in the psychiatric population receiving psychotropic drugs, a high-risk group for metabolic disturbances. Classification And Regression Trees (CARTs) were used as a tool capable of describing hierarchical associations, to pinpoint genetic variants best predicting worsening of cardiometabolic parameters (i.e total, HDL and LDL-cholesterol, triglycerides, body mass index, waist circumference, fasting glucose, and blood pressure) following prescription of psychotropic drugs inducing weight gain in a discovery sample of 357 Caucasian patients. Significant findings were tested for replication in a second Caucasian psychiatric sample (n=140). SH2B1 rs3888190C>A was significantly associated with LDL levels in the discovery and in the replication sample, with A-allele carriers having 0.2mmol/l (p=0.005) and 0.36mmol/l (p=0.007) higher LDL levels compared to others, respectively. G-allele carriers of RABEP1 rs1000940A>G had lower fasting glucose levels compared to others in both samples (-0.16mmol/l; p<0.001 and -0.77mmol/l; p=0.03 respectively). The present study is the first to observe such associations in human subjects, which may in part be explained by a high risk towards dyslipidemia and diabetes in psychiatric patients receiving psychotropic treatments compared to population-based individuals. These results may therefore give new insight into the etiology of LDL-cholesterol and glucose regulation in psychiatric patients under psychotropic drug therapy. Copyright © 2017 Elsevier B.V. All rights reserved.

Duration of residence and psychotropic drug use in recently settled refugees in Sweden - a register-based study

DEFF Research Database (Denmark)

Brendler-Lindqvist, Maria; Nørredam, Marie Louise; Hjern, Anders

2014-01-01

INTRODUCTION: Recently settled refugee populations have consistently been reported to have high rates of mental health problems, particularly Post-traumatic stress disorder, depression, and anxiety disorders. The aim of this study was to investigate psychotropic drug use among young adult refugee...

Exposure to reactive intermediate-inducing drugs during pregnancy and the incident use of psychotropic medications among children

NARCIS (Netherlands)

Tran, Yen-Hao; Groen, Henk; Bergman, Jorieke E H; Hak, Eelko; Wilffert, Bob

Purpose Our study aimed to investigate the association between prenatal exposure to reactive intermediate (RI)-inducing drugs and the initiation of psychotropic medications among children. Methods We designed a cohort study using a pharmacy prescription database. Pregnant women were considered

Pulmonary fibrosis associated with psychotropic drug therapy: a case report

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Thornton Clare

2009-11-01

Full Text Available Abstract Introduction Sertraline and Risperidone are commonly used psychotropic drugs. Sertraline has previously been associated with eosinopilic pneumonia. Neither drug is recognised as a cause of diffuse fibrotic lung disease. Our report represents the first such case. Case Presentation We describe the case of a 33 year old Asian male with chronic schizophrenia who had been treated for three years with sertraline and risperidone. He presented to hospital in respiratory failure following a six month history of progressive breathlessness. High resolution CT scan demonstrated diffuse pulmonary fibrosis admixed with patchy areas of consolidation. Because the aetiology of this man's diffuse parenchymal lung disease remained unclear a surgical lung biopsy was undertaken. Histological assessment disclosed widespread fibrosis with marked eosinophillic infiltration and associated organising pneumonia - features all highly suggestive of drug induced lung disease. Following withdrawal of both sertraline and risperidone and initiation of corticosteroid therapy the patient's respiratory failure resolved and three years later he remains well albeit limited by breathlessness on heavy exertion. Conclusion Drug induced lung disease can be rapidly progressive and if drug exposure continues may result in respiratory failure and death. Prompt recognition is critical as drug withdrawal may result in marked resolution of disease. This case highlights sertraline and risperidone as drugs that may, in susceptible individuals, cause diffuse pulmonary fibrosis.

Psychotropic substances in indoor environments.

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Cecinato, Angelo; Romagnoli, Paola; Perilli, Mattia; Patriarca, Claudia; Balducci, Catia

2014-10-01

The presence of drugs in outdoor air has been established, but few investigations have been conducted indoors. This study focused on psychotropic substances (PSs) at three schools, four homes and one office in Rome, Italy. The indoor drug concentrations and the relationships with the outdoor atmosphere were investigated. The optimised monitoring procedure allowed for the determination of cocaine, cannabinoids and particulate fractions of nicotine and caffeine. In-field experiments were performed during the winter, spring and summer seasons. Psychotropic substances were observed in all indoor locations. The indoor concentrations often exceeded those recorded both outdoors at the same sites and at the atmospheric pollution control network stations, indicating that the drugs were released into the air at the inside sites or were more persistent. During winter, the relative concentrations of cannabinol, cannabidiol and tetrahydrocannabinol depended on site and indoor/outdoor location at the site. Copyright © 2014 Elsevier Ltd. All rights reserved.

Use of psychotropic drugs before pregnancy and the risk for induced abortion: population-based register-data from Finland 1996-2006.

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Gissler, Mika; Artama, Miia; Ritvanen, Annukka; Wahlbeck, Kristian

2010-06-30

Some, though not all studies have reported an increased risk for mental health problems after an induced abortion. Problems with design and data have compromised these studies and the generalisation of their results. The Finnish Medication and Pregnancy database (N = 622 671 births and 114 518 induced abortions for other than fetal reasons) in 1996-2006 was utilised to study the use of psychotropic drugs in the three months before a pregnancy ending in a birth or an induced abortion. In total 2.1% of women with a birth and 5.1% of women with an induced abortion had used a psychotropic medicine 0-3 months before pregnancy. Psychotropic drug users terminated their pregnancies (30.9%) more often than other pregnant women (15.5%). Adjustment for background characteristics explained one third of this elevated risk, but the risk remained significantly increased among users of psychotropic medicine (OR 1.94, 95% confidence intervals 1.87-2.02). A similar risk was found for first pregnancies (30.1% vs. 18.9%; adjusted OR 1.53, 95% confidence intervals 1.42-1.65). The rate for terminating pregnancy was the highest for women using hypnotics and sedatives (35.6% for all pregnancies and 29.1% for first pregnancies), followed by antipsychotics (33.9% and 36.0%) and antidepressants (32.0% and 32.1%). The observed increased risk for induced abortion among women with psychotropic medication highlights the importance to acknowledge the mental health needs of women seeking an induced abortion. Further studies are needed to establish the impact of pre-existing differences in mental health on mental health outcomes of induced abortions compared to outcomes of pregnancies ending in a birth.

Serum concentrations of psychotropic drugs in neonates as a PROgnOstic Factor for admission to the neonatology ward and withdrawal symptoms: PROOF-1.

Science.gov (United States)

Sparla, Shirley C A; Coppens, Hans; Evers, Inge M; Stramrood, Claire A I; Pasker-de Jong, Pieternel C M; van der Westerlaken, Monique M L; Hogeman, Paul H G; Malingré, Mirte M

2017-05-01

The aim is to determine whether serum drug concentrations obtained from the neonate's umbilical cord can be used as a prognostic factor for admission to the neonatology ward and the occurrence of withdrawal symptoms. A retrospective observational monocenter cohort study was carried out among pregnant women using psychotropic drugs and their baby. Binary logistic regression was used for the multivariate analysis. Of the 186 neonates included, 22.6% (n=42) were admitted to the neonatology ward, 6.5% (n=12) because of withdrawal. Among women with therapeutic concentrations of psychotropic medication, 22.0% (n=5) of the neonates had withdrawal symptoms. When comparing neonates with therapeutic versus undetectable drug concentrations, an odds ratio of 3.1 (95% confidence interval: 1.1-8.6) was found for admission to the neonatology ward and an odds ratio of 20.5 (95% confidence interval: 2.2-186.1) for the occurrence of withdrawal symptoms. Therapeutic concentrations of psychotropic drugs in neonates' umbilical cord blood correspond with higher odds for admission to the neonatology ward and the occurrence of withdrawal symptoms compared with neonates with undetectable drug concentrations. The measurement of drug concentrations in the neonate may contribute toward the general clinical assessment of the physician to predict the necessity of admission to the neonatology ward and the risk of withdrawal symptoms.

Relationship between xerostomia and psychotropic drugs in patients with schizophrenia: evaluation using an oral moisture meter.

Science.gov (United States)

Okamoto, A; Miyachi, H; Tanaka, K; Chikazu, D; Miyaoka, H

2016-12-01

Patients with schizophrenia are most commonly treated with antipsychotic medications, often with the addition of anxiolytics. This study used an oral moisture meter to evaluate xerostomia in patients with schizophrenia taking typical and atypical antipsychotics, anxiolytics and non-psychotropic medications. Patients diagnosed with schizophrenia according to ICD-10 criteria in the Department of Psychiatry, Kitasato University East, and affiliated hospitals were studied. All patients were on psychotropic medications. Patients with diseases associated with xerostomia, such as Sjögren's syndrome I, were excluded. A total of 127 patients were enrolled. Mean oral moisture was 27·81 ± 2·27% (normal, ≥30·0%). A significant association was observed between objective oral moisture and the subjective sense of dry mouth. Multivariate analysis revealed a negative correlation between the number of antipsychotics and, especially, anxiolytics, and the degree of oral moisture. Drug dosages themselves were not significantly correlated with dry mouth. These findings suggest that objective oral moisture measurements show decreased moisture in patients on these medications and that the degree of moisture shows a greater negative correlation with the number, as opposed to the dosages, of psychotropic drugs administered. When patients with schizophrenia visit a dental clinic, it is important for the dentist to accurately assess the degree of oral moisture and to determine the medications being taken. Based on these findings of the association of polypharmacy with xerostomia, dentists are encouraged to inform the psychiatrist of the need to actively manage patients' xerostomia. © 2016 John Wiley & Sons Ltd.

Use of psychotropic drugs before pregnancy and the risk for induced abortion: population-based register-data from Finland 1996-2006

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Ritvanen Annukka

2010-06-01

Full Text Available Abstract Background Some, though not all studies have reported an increased risk for mental health problems after an induced abortion. Problems with design and data have compromised these studies and the generalisation of their results. Methods The Finnish Medication and Pregnancy database (N = 622 671 births and 114 518 induced abortions for other than fetal reasons in 1996-2006 was utilised to study the use of psychotropic drugs in the three months before a pregnancy ending in a birth or an induced abortion. Results In total 2.1% of women with a birth and 5.1% of women with an induced abortion had used a psychotropic medicine 0-3 months before pregnancy. Psychotropic drug users terminated their pregnancies (30.9% more often than other pregnant women (15.5%. Adjustment for background characteristics explained one third of this elevated risk, but the risk remained significantly increased among users of psychotropic medicine (OR 1.94, 95% confidence intervals 1.87-2.02. A similar risk was found for first pregnancies (30.1% vs. 18.9%; adjusted OR 1.53, 95% confidence intervals 1.42-1.65. The rate for terminating pregnancy was the highest for women using hypnotics and sedatives (35.6% for all pregnancies and 29.1% for first pregnancies, followed by antipsychotics (33.9% and 36.0% and antidepressants (32.0% and 32.1%. Conclusions The observed increased risk for induced abortion among women with psychotropic medication highlighs the importance to acknowledge the mental health needs of women seeking an induced abortion. Further studies are needed to establish the impact of pre-existing differences in mental health on mental health outcomes of induced abortions compared to outcomes of pregnancies ending in a birth.

Determinants for the use of psychotropics among nursing home residents

DEFF Research Database (Denmark)

Sørensen, Lisbeth Uhrskov; Foldspang, A; Gulmann, N C

2001-01-01

's Activities of Daily Living (ADL), behavioural problems (Nursing Home Behavior Problem Scale), orientation, communication skills and if the resident had any psychiatric disorder. Multiple logistic regression was used to select the items that determined the use of psychotropics. Results Fifty-six percent......Purpose To characterise the prescription pattern of psychotropics in Danish nursing homes and to identify diagnostic, behavioural, cognitive and performance characteristics associated with prevalent psychotropic drug use. Methods Prescribed daily medication was recorded from nurses' files. Based...

Electroconvulsive therapy in the elderly: Anesthetic considerations and Psychotropic interactions

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Harsh Garekar

2017-01-01

Full Text Available Electroconvulsive therapy (ECT has been found to be a rapid and effective treatment strategy for psychiatric and neurological conditions in the elderly, but the administration of ECT in the elderly can be challenging due to a high risk of adverse events. The increased risk can be attributed to a declined physiological reserve, the presence of physical comorbidities, and the use of multiple drugs, which interact with the electrical stimulus and the anesthetic medications used during the ECT procedure. The selection of appropriate induction agents and muscle relaxants should be guided by patient's clinical status and the psychotropic drugs being used. Modifications in the doses of psychotropic drugs also need to be carried out before ECT to reduce cardiovascular and neurological side effects. Modification in the conduct of anesthesia can also aid in augmenting seizures and in preventing common side effects of ECT. A vital step in preventing adverse events in the elderly is carrying out a thorough pre.ECT evaluation. Despite these challenges, ECT can be carried out safely in elderly patients with severe comorbidities, provided clinical ECT, and anesthetic parameters are adequately optimized.

Motor reactivity of animals exposed to ionizing radiation and treated with psychotropic drugs

International Nuclear Information System (INIS)

Szwaja, S.

1978-01-01

The influence of ionizing radiation on motor reactivity of animals and the influence of selected psychotropic drugs (fenactil, haloperidol, relanium) on the changes invoked by ionizing radiation were studied experimentally in rats whose motor reactivity was assessed on the basis of conditional reflexes. In unirradiated rats, fenactil and haloperidol, but not relanium, disordered positive conditional reactions. Roentgen irradiation of the rats with a single dose on the whole body caused a drop in positive conditional reactions. Relanium and fenactil enhanced psychomotor activity of rats after exposure to ionizing radiation. (author)

Motor reactivity of animals exposed to ionizing radiation and treated with psychotropic drugs

Energy Technology Data Exchange (ETDEWEB)

Szwaja, S [Uniwersytet Jagiellonski, Krakow (Poland)

1978-01-01

The influence of ionizing radiation on motor reactivity of animals and the influence of selected psychotropic drugs (fenactil, haloperidol, relanium) on the changes invoked by ionizing radiation were studied experimentally in rats whose motor reactivity was assessed on the basis of conditional reflexes. In unirradiated rats, fenactil and haloperidol, but not relanium, disordered positive conditional reactions. Roentgen irradiation of the rats with a single dose on the whole body caused a drop in positive conditional reactions. Relanium and fenactil enhanced psychomotor activity of rats after exposure to ionizing radiation.

Rapid determination of some psychotropic drugs in complex matrices by tandem dispersive liquid-liquid microextraction followed by high performance liquid chromatography.

Science.gov (United States)

Asghari, Alireza; Fahimi, Ebrahim; Bazregar, Mohammad; Rajabi, Maryam; Boutorabi, Leila

2017-05-01

Simple and rapid determinations of some psychotropic drugs in some pharmaceutical wastewater and human plasma samples were successfully accomplished via the tandem dispersive liquid-liquid microextraction combined with high performance liquid chromatography-ultraviolet detection (TDLLME-HPLC-UV). TDLLME of the three psychotropic drugs clozapine, chlorpromazine, and thioridazine was easily performed through two consecutive dispersive liquid-liquid microextractions. By performing this convenient method, proper sample preconcentrations and clean-ups were achieved in just about 7min. In order to achieve the best extraction efficiency, the effective parameters involved were optimized. The optimal experimental conditions consisted of 100μL of CCl 4 (as the extraction organic solvent), and the pH values of 13 and 2 for the donor and acceptor phases, respectively. Under these optimum experimental conditions, the proposed TDLLME-HPLC-UV technique provided a good linearity in the range of 5-3000ngmL -1 for the three psychotropic drugs with the correlation of determinations (R 2 s) higher than 0.996. The limits of quantification (LOQs) and limits of detection (LODs) obtained were 5.0ngmL -1 and 1.0-1.5ngmL -1 , respectively. Also the proper enrichment factors (EFs) of 96, 99, and 88 for clozapine, chlorpromazine, and thioridazine, respectively, and good extraction repeatabilities (relative standard deviations below 9.3%, n=5) were obtained. Copyright © 2017 Elsevier B.V. All rights reserved.

Psychotropic medication use in French children and adolescents.

Science.gov (United States)

Kovess, Viviane; Choppin, Sabine; Gao, Fei; Pivette, Mathilde; Husky, Mathilde; Leray, Emmanuelle

2015-03-01

The purpose of this study was to describe the patterns of psychotropic drug use in a large representative population of children and adolescents drawn from the French National Health Insurance databank. Data were drawn from a sample of 1% of the beneficiaries of the French national health insurance, selecting those 0-17 years old in 2010 (n=128,298). In addition to age and gender, data included the identification number of each drug allowing a European Pharmaceutical Marketing Research Association (EphMRA) classification, as well as the type of the prescriber. Overall, 2.5% of children and adolescents had been prescribed psychotropic medication. A majority were prescribed anxiolytics (1.9%), followed by antidepressants (0.3%), antipsychotics (0.3%), and stimulants (0.2%). Between the ages of 15 and 17, 6.1% of girls were prescribed anxiolytics and 1.1% were prescribed antidepressants. For boys, the anxiolytics remained the most prescribed psychotropic medication; however, between the ages of 11 and 14, and between the ages of 15 and 17 they received more antipsychotics (0.7% and 0.8%) and between the ages of 6 and 10, and between the ages of 11 and 14 (0.7% and 0.6%), they were prescribed more stimulants than were girls. Among those who received a prescription, a majority of youth (84.6%) received only one class of drugs, and general practitioners were found to be prescribing most of these prescriptions (81.7%). The prevalence of psychotropic drug use in France is similar to that of the Netherlands and much lower than what is observed in the United States. Stimulants are less frequently prescribed in France than in other European countries, but anxiolytics are prescribed considerably more in France than in any other country.

Patterns of Psychotropic Medication Prescriptions by Psychiatrists for Private Clinic Outpatients in Kerman Province, Iran

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Abdolreza Sabahi

2014-08-01

Full Text Available Objectives: The aim of this study was to assess the pattern and utilisation of psychotropic drug prescriptions by psychiatrists in Kerman Province, Iran. Methods: The prescriptions of 27 psychiatrists were randomly selected from two Iranian public insurance organisations and were analysed for the mean number of drugs/prescriptions, drug category and the most frequently prescribed drug in each category as well as overall. Results: A total of 6,414 prescriptions were analysed. The mean number of drugs per prescription was 2.9. Antidepressants (61.0% were the most frequently prescribed category of psychotropic medications, followed by antipsychotics (29.5%, sedative/hypnotics or anti-anxiety drugs (27.5% and mood stabilisers (18.5%. The combination of antidepressants with antipsychotics was the most commonly prescribed combination (18.8%. Fluoxetine (16.5% and trifluoperazine (13.5% were among the most frequently prescribed antidepressants and antipsychotics, respectively. Clonazepam (10.5% was the most commonly prescribed benzodiazepine agent, followed by alprazolam (8.5%. In terms of total drug utilisation, sertraline (12.4% was the most commonly used psychotropic medication followed by fluoxetine (9.7%, trifluoperazine (6.6%, propranolol (4.5% and clonazepam (3.7%. Conclusion: A high proportion of psychotropic prescriptions in Kerman Province were for antidepressants, followed by antipsychotics and the benzodiazepines. Further research is needed to determine the underlying correlation between prescription practice and the diagnosis and patient characteristics, as well as to investigate the use of different psychotropic medications.

Neuroprotective Effects of Psychotropic Drugs in Huntington’s Disease

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Edward C. Lauterbach

2013-11-01

Full Text Available Psychotropics (antipsychotics, mood stabilizers, antidepressants, anxiolytics, etc. are commonly prescribed to treat Huntington’s disease (HD. In HD preclinical models, while no psychotropic has convincingly affected huntingtin gene, HD modifying gene, or huntingtin protein expression, psychotropic neuroprotective effects include upregulated huntingtin autophagy (lithium, histone acetylation (lithium, valproate, lamotrigine, miR-222 (lithium-plus-valproate, mitochondrial protection (haloperidol, trifluoperazine, imipramine, desipramine, nortriptyline, maprotiline, trazodone, sertraline, venlafaxine, melatonin, neurogenesis (lithium, valproate, fluoxetine, sertraline, and BDNF (lithium, valproate, sertraline and downregulated AP-1 DNA binding (lithium, p53 (lithium, huntingtin aggregation (antipsychotics, lithium, and apoptosis (trifluoperazine, loxapine, lithium, desipramine, nortriptyline, maprotiline, cyproheptadine, melatonin. In HD live mouse models, delayed disease onset (nortriptyline, melatonin, striatal preservation (haloperidol, tetrabenazine, lithium, sertraline, memory preservation (imipramine, trazodone, fluoxetine, sertraline, venlafaxine, motor improvement (tetrabenazine, lithium, valproate, imipramine, nortriptyline, trazodone, sertraline, venlafaxine, and extended survival (lithium, valproate, sertraline, melatonin have been documented. Upregulated CREB binding protein (CBP; valproate, dextromethorphan and downregulated histone deacetylase (HDAC; valproate await demonstration in HD models. Most preclinical findings await replication and their limitations are reviewed. The most promising findings involve replicated striatal neuroprotection and phenotypic disease modification in transgenic mice for tetrabenazine and for sertraline. Clinical data consist of an uncontrolled lithium case series (n = 3 suggesting non-progression and a primarily negative double-blind, placebo-controlled clinical trial of lamotrigine.

Not robots: children's perspectives on authenticity, moral agency and stimulant drug treatments.

Science.gov (United States)

Singh, Ilina

2013-06-01

In this article, I examine children's reported experiences with stimulant drug treatments for attention deficit hyperactivity disorder in light of bioethical arguments about the potential threats of psychotropic drugs to authenticity and moral agency. Drawing on a study that involved over 150 families in the USA and the UK, I show that children are able to report threats to authenticity, but that the majority of children are not concerned with such threats. On balance, children report that stimulants improve their capacity for moral agency, and they associate this capacity with an ability to meet normative expectations. I argue that although under certain conditions stimulant drug treatment may increase the risk of a threat to authenticity, there are ways to minimise this risk and to maximise the benefits of stimulant drug treatment. Medical professionals in particular should help children to flourish with stimulant drug treatments, in good and in bad conditions.

Parental psychosocial attitudes and opinions on the use of psychotropic medication in mental disorders of childhood

International Nuclear Information System (INIS)

Abid, H.; Aadil, M.; Hamdani, S.U.

2018-01-01

To assess parental practices and attitude regarding administration of psychotropic agents in their children suffering from psychiatric disorders. Study Design: Cross sectional descriptive study. Place and Duration of Study: Psychiatry Out-Patient Department (OPD) Mayo Hospital conducted over a span of 6 months, from 15 Apr to 15 Oct 2017. Material and Methods: Ninety three individuals were included in the study through non-probability purposive sampling. Informed consent was taken from the parents. A closed ended questionnaire was designed to carry out a targeted survey which was focused on the knowledge and practices followed by parents during their first contact in an outpatient department. Parents were asked whether they believe that psychotropic drugs are effective in the treatment of mental disorders. Results: Results are based on ninety three responders who participated in answering the questionnaire. Eighty turned out and submitted the questionnaire for result compilation and analysis. Participants ranged from 19 to 65 years. Males outnumbered female's patients during the study period by approx, 20%. The study indicated that two third of the patients had family history of mental illness. Common diagnosis included epilepsy, behavioral/ conversion disorders and mental retardation. One thought-provoking finding among parents was that psychotropic drugs lead to certain side effects and somehow effects which may causes biological abnormalities resulting into several medical diseases. Others had a belief that these drugs are addictive and may cause vital organs failure. Conclusion: Mostly parents were of the opinion that are of psychotropic drugs lead to certain side effects and somehow effects brain which may cause biological abnormalities resulting into several medical diseases. (author)

ECG Changes In Patients On Chronic Psychotropic medication

African Journals Online (AJOL)

2006-08-31

Aug 31, 2006 ... The use of psychotropic drugs is associated with. ECG changes in ... impact, while the secondary tricyclic antidepressants (nortriptyline, desipramine) ... Human Research Ethics Committee approved the study. Procedures.

The prescribing of psychotropic drugs in mental health services in Trinidad Prescripción de psicotrópicos en los servicios de salud mental de Trinidad

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Shelley Moore

2002-09-01

Full Text Available Objective. To describe, analyze, and interpret patterns of psychotropic drug prescribing in new psychiatric patients attending psychiatric outpatient clinics in the Caribbean island of Trinidad. Design and Methods. This was a cross-sectional study of psychotropic drug prescribing by psychiatrists for 132 new psychiatric outpatients who were seen at the outpatient clinics surveyed and who were entering the mental health system during the period of research, November 1998 through February 1999. Results. A single patient could be prescribed more than one psychotropic drug. Antidepressant drugs were the class of psychotropic drugs most prescribed (79 of 132 patients, 59.8%, followed by antipsychotic drugs (67 of 132 patients, 50.8%. Tricyclic antidepressants (TCAs were the antidepressants most prescribed (58 of the 79 patients, mainly amitriptyline (53 of the 58. Fluoxetine was the only selective serotonin reuptake inhibitor (SSRI prescribed (21 of the 79 patients prescribed antidepressants. Of the 67 patients receiving antipsychotic drugs, phenothiazines accounted for 41 of those 67, including trifluoperazine (14 of the 41 and thioridazine (13 of the 41. The individual antipsychotic most prescribed was sulpiride (21 of the 67 patients. Anticholinergic drugs were prescribed to 20 of the 132 patients (15.1%. Eighty-three of the patients were prescribed more than one drug concomitantly (either more than one psychotropic or a combination of psychotropic(s and nonpsychotropic(s. Prescription by ethnicity, age, and gender coincided with the morbidity rates encountered in these patients. The prescribing of SSRIs to persons of African or East Indian ethnicity was significantly lower than it was for persons of mixed heritage. Conclusions. The prescription patterns of psychotropic drugs in Trinidad revealed the psychiatrists' preferences for traditional psychotropic drugs, the moderate use of anticholinergic drugs, and polypharmacy in some cases, with

The Neuroprotective Disease-Modifying Potential of Psychotropics in Parkinson's Disease

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Edward C. Lauterbach

2012-01-01

Full Text Available Neuroprotective treatments in Parkinson's disease (PD have remained elusive. Psychotropics are commonly prescribed in PD without regard to their pathobiological effects. The authors investigated the effects of psychotropics on pathobiological proteins, proteasomal activity, mitochondrial functions, apoptosis, neuroinflammation, trophic factors, stem cells, and neurogenesis. Only findings replicated in at least 2 studies were considered for these actions. Additionally, PD-related gene transcription, animal model, and human neuroprotective clinical trial data were reviewed. Results indicate that, from a PD pathobiology perspective, the safest drugs (i.e., drugs least likely to promote cellular neurodegenerative mechanisms balanced against their likelihood of promoting neuroprotective mechanisms include pramipexole, valproate, lithium, desipramine, escitalopram, and dextromethorphan. Fluoxetine favorably affects transcription of multiple genes (e.g., MAPT, GBA, CCDC62, HIP1R, although it and desipramine reduced MPTP mouse survival. Haloperidol is best avoided. The most promising neuroprotective investigative priorities will involve disease-modifying trials of the safest agents alone or in combination to capture salutary effects on H3 histone deacetylase, gene transcription, glycogen synthase kinase-3, α-synuclein, reactive oxygen species (ROS, reactive nitrogen species (RNS, apoptosis, inflammation, and trophic factors including GDNF and BDNF.

Psychiatric disorders are overlooked in patients with drug abuse.

Science.gov (United States)

Kruckow, Line; Linnet, Kristian; Banner, Jytte

2016-03-01

Psychiatric disease is overlooked in drug users. Patients with both drug abuse and a psychiatric disease - dual diagnosis - suffer decreased compliance to treatment and decreased life expectancy compared with single-diagnosis patients. Identifying the patients among either drug addicts or mentally ill patients is difficult. All drug addicts autopsied at the Department of Forensic Medicine, University of Copenhagen, Denmark, in the years 1992, 2002 and 2012 were included. The group was divided into two subpopulations of possible dual diagnosis patients either according to police reports stating mental illness or to psychotropics found in the toxicology screening after autopsy. We found a rise in possible mental illness in both subpopulations in the study period. Drug addicts with psychotropics in the blood at the time of death increased from 3.1% in 1992 to 48.1% in 2012, and this group was significantly younger at the time of death than those without psychotropics in the blood. Suspected dual diagnosis patients have increased in number. They die earlier than their drug addict counterparts. Methadone remains the leading cause of death in all subpopulations. Possible causes are misuse of treatment and/or illegally bought methadone, wrongly assigned cause of death due to unknown tolerance and/or polydrug toxicity in combination with psychotropic medicine. none. not relevant.

"Psychiatry is not a science like others" - a focus group study on psychotropic prescribing in primary care.

Science.gov (United States)

Hedenrud, Tove M; Svensson, Staffan A; Wallerstedt, Susanna M

2013-08-12

Psychotropic drug prescribing is problematic and knowledge of factors affecting the initiation and maintenance of such prescribing is incomplete. Such knowledge could provide a basis for the design of interventions to change prescribing patterns for psychotropics. The aim of this study was to explore the views of general practitioners (GPs), GP interns, and heads of primary care units on factors affecting the prescribing of psychotropic drugs in primary care. We performed four focus group discussions in Gothenburg, Sweden, with a total of 21 participants (GPs, GP interns, and heads of primary care units). The focus group discussions were transcribed verbatim and analyzed using manifest content analysis. Three different themes emerged from the focus group discussions. The first theme Seeking care for symptoms, reflects the participants' understanding of why patients approach primary care and comprised categories such as knowledge, attitudes, and society and the media. The second theme, Lacking a framework, resources, and treatment alternatives, which reflects the conditions for the physician-patient interaction, comprised categories such as economy and resources, technology, and organizational aspects. The third theme, Restricting or maintaining prescriptions, with the subthemes Individual factors and External influences, reflects the physicians' internal decision making and comprised categories such as emotions, knowledge, and pharmaceutical industry. The results of the present study indicate that a variety of factors may affect the prescribing of psychotropic medications in primary care. Many factors were related to characteristics of the patient, the physician or their interaction, rather than the patients' medical needs per se. The results may be useful for interventions to improve psychotropic prescribing in primary care.

Cardiotoxicité des psychotropes

OpenAIRE

TAHIRI, Abdallah

2013-01-01

Même à dose thérapeutique, les médicaments psychotropes sont susceptibles d'engendrer des troubles du rythme cardiaque graves avec risque létal concourant à expliquer la pré valence de la mort subite dans la population psychiatrique. Les situations cliniques à risque telles que poly médication (des psychotropes entre eux ou d'un psychotrope avec un non psychotrope allongeur de QTc), interactions médicamenteuses aussi bien pharmacodynamiques que pharmacocinétiques, traitement pa...

An analysis of psychotropic drug sales. Increasing sales of selective serotonin reuptake inhibitors are closely related to number of products.

Science.gov (United States)

Nielsen, Margrethe; Gøtzsche, Peter

2011-01-01

Prescribing of selective serotonin reuptake inhibitors (SSRIs) has increased dramatically. To compare the sales of benzodiazepines and SSRIs within the primary care sector in Denmark and relate changes in usage to number of indications and products on the market. We used data from various sources to establish the sales curves of psychotropic drugs in the period 1970 to 2007, based on the Anatomic Therapeutic Classification system and Defined Daily Doses. Fluctuations in sales of psychotropic drugs that cannot be explained by disease prevalence were caused by changes in sales of the benzodiazepines and SSRIs. We found a decline in the sales of benzodiazepines after a peak in 1986, likely due to the recognition that they cause dependence. From a low level in 1992, we found that the sales of SSRIs increased almost linearly by a factor of 18, up to 44 DDD per 1000 inhabitants, which was closely related to the number of products on the market that increased by a factor of 16. Sales of antidepressant drugs are mainly determined by market availability of products indicating that marketing pressures are playing an important role. Thus the current level of use of SSRIs may not be evidence-based, which is supported by studies showing that the effect of SSRIs has been overestimated.

The psychotropic education and knowledge test for nurses in nursing homes : Striving for PEAK performance

NARCIS (Netherlands)

Perehudoff, Katrina; Azermai, Majda; Wauters, Maarten; Van Acker, Sandra; Versluys, Karen; Steeman, Els; Petrovic, Mirko

2016-01-01

Objectives: The psychotropic education and knowledge test for nurses in acute geriatric care (PEAK-AC) measures knowledge of psychotropic indications, doses and adverse drug reactions in older inpatients. Given the low internal consistency and poor discrimination of certain items, this study aims to

Determination of some psychotropic drugs in serum and saliva samples by HPLC-DAD and HPLC MS.

Science.gov (United States)

Petruczynik, A; Wróblewski, K; Szultka-Młyńska, M; Buszewski, B; Karakuła-Juchnowicz, H; Gajewski, J; Morylowska-Topolska, J; Waksmundzka-Hajnos, M

2016-08-05

A simple, rapid and sensitive HPLC-DAD method has been developed and validated for the simultaneous determination of seven psychotropic drugs (risperidone, citalopram, clozapine,quetiapine, levomepromazine, perazine and aripiprazole) in human serum or saliva samples. The chromatographic analyses were performed on a XSELECT CSH Phenyl-Hexyl column with a mobile phase containing methanol, acetate buffer at pH 3.5 and 0.025mL(-1) diethylamine. The influence of concentration of methanol in injection samples and injection volume on peak symmetry and system efficiency was examined.The full separation of all investigated drugs, good peaks' symmetry and simultaneously high systems efficiency were obtained in applied chromatographic system. The method is suitable for the analysis of investigated drugs in human plasma or saliva for psychiatric patients for control of pharmacotherapy, particularly in combination therapy. HPLC-MS was applied for verification of the presence of drugs and their metabolites in serum and saliva samples from patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Increased all-cause mortality with psychotropic medication in Parkinson's disease and controls

DEFF Research Database (Denmark)

Frandsen, Rune; Baandrup, Lone; Kjellberg, Jakob

2014-01-01

AIM: Use of medication and polypharmacy is common as the population ages and its disease burden increases. We evaluated the association of antidepressants, benzodiazepines, antipsychotics and combinations of psychotropic drugs with all-cause mortality in patients with Parkinson's disease (PD...... of psychotropic medication in PD patients and controls. Hazard ratios were as follows for the medication types: selective serotonin reuptake inhibitors or serotonin-noradrenalin reuptake inhibitors, PD HR = 1.19, 95% CI = 1.04-1.36; Control HR = 1.77, 95% CI = 1.64-1.91; benzodiazepines, PD HR = 1.17, 95% CI = 0.......20-1.76; Control HR = 2.00, 95% CI 1.66-2.43; and combinations of these drugs compared with non-medicated PD patients and controls. Discontinuation of medication was associated with decreased mortality in both groups. CONCLUSIONS: The use of psychotropic medication in the elderly is associated with increased...

Factors influencing psychotropic prescription by non-psychiatrist physicians in a nursing home for the elderly in Brazil

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Florindo Stella

Full Text Available CONTEXT AND OBJECTIVE: Although psychotropics are one of the classes of medications most prescribed in nursing homes for the elderly, studies examining prescribing patterns are limited in both number and scope. The present study was undertaken to investigate factors associated with general psychotropic use in a nursing home in Brazil. DESIGN AND SETTING: Retrospective observational study at the Nursing Home for the Elderly, Institute of Biosciences, Universidade Estadual Paulista. METHODS: Information on prescriptions was retrieved from the medical records of 108 elderly residents in a nursing home. Sixty-five of these patients, with mean age 74.5 years (± standard deviation 9.4 years, who were taking medications on a regular basis, comprised the sample. The effects of demographic and clinical variables on the psychotropic prescription pattern were examined. RESULTS: Females were more likely to receive psychotropics (p = 0.038. Individuals on medicines for cardiovascular diseases received psychotropics less frequently (p = 0.001. The number of prescribed psychotropics correlated negatively with both age (p = 0.009 and number of non-psychotropic drugs (p = 0.009. CONCLUSIONS: Although preliminary, the present results indicated that cardiovascular disease was the clinical variable that most influenced psychotropic prescription. Physicians' overconcern regarding drug interactions might at least partially explain this result. Further investigations involving larger sample sizes from different regions are warranted to confirm these findings.

Somatic Treatments in Treatment of Depression During Pregnancy

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Eylem Ozten

2015-09-01

Full Text Available Although some psychotropic drugs are known to be teratogenic no psychotropic drug is of proven safety for treatment of depression during pregnancy. Untreated mood disorders during pregnancy pose significant risks for mother and the newborn. This review focuses on the use of somatic tretments of depression during pregnancy.Electroconvulsive therapy, bright light therapy, transcranial magnetic stimulation and vagal nerve stimulation are relatively safe and effective treatments during pregnancy if steps are taken to decrease potential risks. A clear information related to the somatic treatment should be given to the patient and informed consent should be obtained. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(3.000: 244-254

Psychotropic and Anticonvulsant Drug Usage in Early Childhood Special Education Programs I. Phase One: A Preliminary Report: Prevalence, Attitude, Training, and Problems.

Science.gov (United States)

Gadow, Kenneth D.

As part of a three phase study designed to survey the teachers and parents of children receiving psychotropic and anticonvulsant drugs, 208 teachers of preschool special education children on medication were mailed questionnaires. The Early Childhood Medication Questionnaire used in the survey included items relating to teacher, program, and…

Psychotropic Pharmacotherapy Associated With QT Prolongation Among Veterans With Posttraumatic Stress Disorder.

Science.gov (United States)

Stock, Eileen M; Zeber, John E; McNeal, Catherine J; Banchs, Javier E; Copeland, Laurel A

2018-04-01

In 2012, the Food and Drug Administration issued Drug Safety Communications on several drugs associated with QT prolongation and fatal ventricular arrhythmias. Among these was citalopram, a selective serotonin reuptake inhibitor (SSRI) approved for depression and commonly used for posttraumatic stress disorder (PTSD). Evaluation of the risk for QT prolongation among other psychotropic drugs for individuals with PTSD remains limited. Explore psychotropic drugs associated with QT prolongation among veterans with PTSD. Patients in the Veterans Health Administration in 2006-2009 with PTSD and QT prolongation (176 cases) were matched 1:4 on age, gender, visit date and setting, and physical comorbidity. Classification trees assessed QT prolongation risk among prescribed medications (n=880). Receipt of any drug with known risk of QT prolongation varied by group (23% QT cases vs 15% control, prisks included ziprasidone (3% vs 1%, p=0.02) and buspirone (6% vs 2%, p=0.01). Increased risk was not observed for the SSRIs, citalopram and fluoxetine. Classification trees found that sotalol and amitriptyline carried greater risk among cardiac patients and methadone, especially if prescribed with quetiapine, among noncardiac patients. Per adjusted survival model, patients with QT prolongation were at increased risk for death (hazard ratio=1.60; 95% CI=1.04-2.44). Decision models are particularly advantageous when exploring nonlinear relationships or nonadditive interactions. These findings may potentially affect clinical decision-making concerning treatment for PTSD. For patients at higher risk of QT prolongation, antidepressants other than amitriptyline should be considered. Medications for comorbid conditions should also be closely monitored for heightened QT prolongation risk.

Robust optimization of psychotropic drug mixture separation in hydrophilic interaction liquid chromatography.

Science.gov (United States)

Rakić, Tijana; Jovanović, Marko; Dumić, Aleksandra; Pekić, Marina; Ribić, Sanja; Stojanović, Biljana Jancić

2013-01-01

This paper presents multiobjective optimization of complex mixtures separation in hydrophilic interaction liquid chromatography (HILIC). The selected model mixture consisted of five psychotropic drugs: clozapine, thioridazine, sulpiride, pheniramine and lamotrigine. Three factors related to the mobile phase composition (acetonitrile content, pH of the water phase and concentration of ammonium acetate) were optimized in order to achieve the following goals: maximal separation quality, minimal total analysis duration and robustness of an optimum. The consideration of robustness in early phases of the method development provides reliable methods with low risk for failure in validation phase. The simultaneous optimization of all goals was achieved by multiple threshold approach combined with grid point search. The identified optimal separation conditions (acetonitrile content 83%, pH of the water phase 3.5 and ammonium acetate content in water phase 14 mM) were experimentally verified.

Is an unhealthy work environment in nursing home care for people with dementia associated with the prescription of psychotropic drugs and physical restraints?

NARCIS (Netherlands)

Willemse, B.M.; De Jonge, J.; Smit, D.; Dasselaar, W.; Depla, M.F.I.A.; Pot, A.M.

2016-01-01

Background: Research showed that long-term care facilities differ widely in the use of psychotropic drugs and physical restraints. The aim of this study is to investigate whether characteristics of an unhealthy work environment in facilities for people with dementia are associated with more

Staff and patient perspectives on the purpose of psychotropic prescribing in prisons: care or control?

Science.gov (United States)

Hassan, Lamiece; Edge, Dawn; Senior, Jane; Shaw, Jenny

2013-01-01

The objective was to explore perspectives on reasons for psychotropic medication use in prisons. We recruited a purposive sample of healthcare staff and patients prescribed psychotropic medicines from four East of England prisons. Participants took part in qualitative, semistructured interviews, which were recorded, transcribed and analyzed thematically. While patients and healthcare staff viewed psychotropic medicines primarily as a treatment for reducing symptoms of mental illness, they were also used as a coping strategy and to reduce insomnia. Appropriate psychotropic prescribing was also thought to contribute towards the rehabilitation agenda and helped to maintain order in prisons. Staff voiced concerns regarding possible overreliance on psychotropic medicines. However, patients perceived insufficient access to alternative, nonpharmacological forms of treatment and support in prison. Psychotropic medicines are used for multiple purposes in prisons and are generally considered a useful resource. Nonetheless, further work may be needed to find the right balance between psychotropic medicines and alternative, nonpharmacological therapies. Copyright © 2013 Elsevier Inc. All rights reserved.

ANALYSIS OF BASIC PSYCHOTROPIC DRUGS IN BIOLOGICAL FLUIDS AND TISSUES BY REVERSED-PHASE HIGH PERFORMANCE LIQUID CHROMATOGRAPHY.

Science.gov (United States)

Petruczynik, Anna; Waksmundzka-Hajnos, Monika

2017-03-01

The review of the RP HPLC analysis of basic psychotropic drugs is presented. It contains sample preparation methods with centrifugation, protein precipitation, liquid-liquid extraction (LLE), dispersive liquid-liquid microextraction (DLLME), solid-phase extraction (SPE), solid-phase microextraction (SPME), microwave-assisted extraction (MAE) and RP-HPLC analysis. Chromatographic behavior of basic drugs in aqueous media - eluents used in reversed phase systems is discussed. Methods of blocking of residue surface silanols' interaction are mentioned. Analytical methods used for the analysis are divided into parts according with the above methods: the use of low-pH eluents, the use of high-pH eluents, the use of silanol blockers, special stationary phases for basic analytes. Literature connected with the sample preparation methods and analytical systems for the drug analysis are cited in details and presented also in Table 1.

Mortality and use of psychotropic medication in patients with stroke

DEFF Research Database (Denmark)

Jennum, Poul; Baandrup, Lone; Iversen, Helle K

2016-01-01

with a diagnosis of stroke and either no drug use or preindex use of psychotropic medication (n=49,968) and compared with control subjects (n=86,100) matched on age, gender, marital status and community location. PRIMARY OUTCOME MEASURE: All-cause mortality. RESULTS: All-cause mortality was higher in patients...... about psychotropic medication use was obtained from the Danish Register of Medicinal Product Statistics. OBJECTIVES: We aimed to evaluate all-cause mortality in relation to the use of benzodiazepines, antidepressants and antipsychotics in patients with stroke and matched controls. PARTICIPANTS: Patients...

Pediatric psychotropic medication initiation and adherence: a literature review based on social exchange theory.

Science.gov (United States)

Hamrin, Vanya; McCarthy, Erin M; Tyson, Veda

2010-08-01

Psychotropic medication initiation and adherence is an identified problem. This literature review explores factors that determine families' decisions to initiate, sustain, or discontinue use of psychotropic medication in children and adolescents. Social exchange theory is used as a framework to explore decisions to initiate and adhere to psychotropic medications. Contributing factors related to psychotropic medication initiation, adherence, and discontinuation are explored. Themes in the literature encompassing costs and benefits of psychotropic medication adherence include family experiences with adverse effects, previous psychotropic medication experience, medication psychoeducation, stigma, societal views about psychotropic medication, particular diagnosis, the effect of comorbid diagnosis on adherence, attitudes and beliefs about medication by both children and parents, and relationships with the provider. The impact of family demographics including parent gender, age of the child, ethnicity, and parent educational level on psychotropic medication adherence is evaluated. International and U.S. studies from Medline, Cumulative Index for Nursing and Allied Health Literature and PsychInfo evaluating medication initiation and adherence in the pediatric psychiatric population and social exchange theory was incorporated from relevant textbook resources. Rewards experienced from medication treatment include improvement in symptoms, school performance and family relationships, and reduced level of parenting stress. Identified costs include impact of adverse side effects, social stigma, lack of response, fears of addiction, and changing the child's personality. Acceptance of the diagnosis influences adherence while medication education has varying effects. Families' attitudes, beliefs and perceptions about psychiatric illness and treatment play a large role in medication treatment decisions. A trusting provider relationship has a positive effect on adherence

Airborne psychotropic substances in eight Italian big cities: Burdens and behaviours

International Nuclear Information System (INIS)

Cecinato, Angelo; Balducci, Catia; Romagnoli, Paola; Perilli, Mattia

2012-01-01

Psychotropic substances were monitored in eight big cities of Italy over one year, starting in May 2010, in the frame of the Ariadrugs Project. Yearly average concentrations ranged from 0.02 ± 0.01 to 0.26 ± 0.11 ng/m 3 for cocaine, from 0.05 ± 0.05 to 0.96 ± 1.37 ng/m 3 for cannabinoids, from 16 ± 6 to 61 ± 28 ng/m 3 for nicotine, and from 1.0 ± 0.8 to 8 ± 7 ng/m 3 for caffeine. Palermo and Turin were the cities suffering the lowest and the highest psychotropic substance concentrations, respectively. Nicotine and cocaine exhibited trends less seasonally modulated than common air toxicants. Caffeine and cannabinoids peaked in winter dropping close to zero from May to August. In Rome, where various anthropic contours were investigated in February 2011, differences were observed both in net concentrations and ratios of psychotropic substances vs. regulated toxicants. Ambient drugs look as a consequence of addiction and their burdens give insights about the corresponding consumes. - Highlights: ► Psychotropic substances (PSs) were monitored in eight big Italian cities over one year. ► The site-to-site and year time modulations of PSs were investigated. ► The PSs contents in the air were plotted vs. air toxicants (O 3 , NO 2 , PM 10 , PAHs). ► The relationships among drug modulations and meteo-climatic variables were studied. ► The results were compared to those of previous investigations. - Both licit and illicit psychotropic substances modulate in space and time along Italy, resulting influenced by both the environmental and human contours.

Hyponatremia and psychotropics

Directory of Open Access Journals (Sweden)

Swapnajeet Sahoo

2016-01-01

Full Text Available Psychotropic-induced hyponatremia is one of the most common electrolyte abnormalities seen in routine psychiatric practice and is especially common in elderly subjects. Recent evidence suggests that even mild hyponatremia is associated with several detrimental effects in elderly. However, practicing clinicians often overlook hyponatremia due to lack of awareness about the incidence, presentation, and risk factors of psychotropic-induced hyponatremia. Available evidence suggests that all classes of psychotropics, i.e., antidepressants, antipsychotics, mood stabilizers, and sedative/hypnotics can lead to hyponatremia. Maximum evidence is available for antidepressant-associated hyponatremia. Various risk factors for hyponatremia include increasing age, female gender, low body weight, history of hyponatremia, low baseline sodium levels, summer season, initial phase of antidepressant use, early-onset psychiatric illnesses, longer duration of psychiatric disorder, prolonged admission, presence of comorbid medical conditions, concomitant use of diuretics, antihypertensives, and cytochrome P450 inhibitors. Awareness about this potentially life-threatening side effect and taking appropriate, timely steps can help in prevention of psychotropic-associated hyponatremia.

Psychotropic medication in a randomly selected group of citizens receiving residential or home care

DEFF Research Database (Denmark)

Futtrup, Tina Bergmann; Schultz, Hanne; Jensen, Margit Bak

2014-01-01

INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home...... care with focus on the prevalence of drug use, the combination of different PMs and doses in relation to current recommendations. METHODS: The medication lists of 214 citizens receiving residential care (122) and home care (92) were collected together with information on age, gender and residential...

Simultaneous determination of psychotropic drugs in human urine by capillary electrophoresis with electrochemiluminescence detection

Energy Technology Data Exchange (ETDEWEB)

Li Jianguo [Key Laboratory of Analytical Chemistry for Life Science (Education Ministry of China), School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093 (China); School of Chemistry and Chemical Engineering, Suzhou University, Suzhou 215006 (China); Zhao Fengjuan [Key Laboratory of Analytical Chemistry for Life Science (Education Ministry of China), School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093 (China); Ju Huangxian [Key Laboratory of Analytical Chemistry for Life Science (Education Ministry of China), School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093 (China)]. E-mail: hxju@nju.edu.cn

2006-08-04

Amitriptyline, doxepin and chlorpromazine are often used as psychotropic drugs in treatment of the various mental diseases, and are also partly excreted by kidney. This work developed a simple, selective and sensitive method for their simultaneous monitoring in human urine using capillary electrophoresis coupled with electrochemiluminescence (ECL) detection based on end-column ECL reaction of tris-(2,2'-bipyridyl)ruthenium(II) with aliphatic tertiary amino moieties. Acetone was used as an additive to the running buffer to obtain their absolute separation. Under optimized conditions the proposed method displayed a linear range from 5.0 to 800 ng mL{sup -1} for the three drugs with the correlation coefficients more than 0.995 (n = 8). Their limits of detection were 0.8 ng mL{sup -1} (3.6 fg), 1.0 ng mL{sup -1} (4.5 fg) and 1.5 ng mL{sup -1} (6.8 fg) at a signal to noise ratio of 3, respectively. The relative standard deviations for five determinations of 20 ng mL{sup -1} amitriptyline, doxepin and chlorpromazine were 1.7%, 4.2% and 3.6%, respectively. For practical application an extract step with 90:10 heptane/ethyl acetate (v/v) was performed to eliminate the influence of ionic strength in sample. The recoveries of amitriptyline, doxepin and chlorpromazine at different levels in human urine were between 83% and 93%, which showed that the method was valuable in clinical and biochemical laboratories for monitoring amitriptyline, doxepin and chlorpromazine.

Period prevalence of concomitant psychotropic medication usage among children and adolescents with attention-deficit/hyperactivity disorder during 2009.

Science.gov (United States)

Betts, Keith A; Sikirica, Vanja; Hodgkins, Paul; Zhou, Zhou; Xie, Jipan; DeLeon, Anthony; Erder, M Haim; Wu, Eric Q

2014-06-01

Stimulants are recommended as a first-line treatment for attention- deficit/hyperactivity disorder (ADHD); however, a subset of the patient population augments their stimulant treatment with other medications. The objective of this study was to estimate the 1 year period prevalence of concomitant psychotropic medication use among children and adolescents with ADHD during 2009. Patients 6-17 years of age with one or more primary ADHD diagnoses between July 1, 2008 and December 31, 2009 and one or more stimulant prescription fills during 2009 were identified from a large United States commercial claims database. Concomitant psychotropic medication use, defined as 30 days of continuous medication supply overlap between the augmenting agent and stimulant, was evaluated for 14 distinct psychotropic medication categories (6 with a United States Food and Drug Administration (FDA) approved indication for ADHD, 8 without an indication for ADHD). The 1 year period prevalence of concomitant psychotropic medication use (both overall and within each medication category) was calculated and compared between patients with and without psychiatric or neurologic comorbidities. Children (6-12 years) and adolescents (13-17 years) were evaluated separately. A total of 71,201 children and 49,959 adolescents met the inclusion criteria. The 1 year period prevalence of concomitant psychotropic medication use among children and adolescents was 20.3% and 23.4%, with 5.7% and 6.7% augmenting with two or more medication categories, respectively. The most common concomitant medication categories were selective serotonin reuptake inhibitors (SSRIs) (children: 6.2%; adolescents: 11.4%), atypical antipsychotics (5.8%; 6.8%) and clonidine immediate release (5.4%; 2.9%). Children and adolescents with psychiatric or neurologic comorbidities had higher rates of augmentation than did those without comorbidities (all p<0.001). This epidemiologic study found that the prevalence of concomitant psychotropic

IMPLEMENTATION OF DRUG ADDICTS RIGHT TO HEALTH PROTECTION (SEPARATE ASPECTS).

Science.gov (United States)

Shevchuk, O; Rzhevska, O; Korop, O; Pyliuha, L

2018-03-01

The purpose of the research is to analyze specific problems of the realization of the right to protect the health of people who take narcotic drugs or psychotropic substances. To achieve this goal, statistics have been analyzed on the number of people using narcotic drugs or psychotropic substances (including drug-addicted children) placed on medical records and the number of their applications for medical care. It has been found out that people in this category often face a denial of medical care that causes extremely strong physical and mental suffering. The analysis of the understanding of the legal design of the «right to health care» in the scientific literature, national legislation and international legal documents was made. State institutions and local authorities providing «the right to health care» of people taking narcotic or psychotropic drugs are singled out. The absence of grounds for restricting the right to protect the health of people who take narcotic or psychotropic drugs who are not registered is justified. In the course of the research, it was found out that people who take narcotic drugs or psychotropic substances are more likely than other patients to need medical assistance and, when requesting the right to health care, face a number of problems that require immediate solution: incomplete provision of quality free medical care; unimplementation of rehabilitation programs for such categories of patients; the lack of the right of children who take narcotic drugs or psychotropic substances to make their own decisions at the age of 14 and apply to public health institutions for the treatment of drug addiction; violations of the continuity of SMT programs and their absence in penal institutions for drug dependent people. It was proposed to introduce a number of changes in the relevant normative legal acts.

[An analysis of advertisements for psychotropic drugs in the Dutch Journal of Psychiatry ('Tijdschrift voor Psychiatrie')].

Science.gov (United States)

Vandereycken, W; Kuyken, K

2009-01-01

Through the marketing of psychotropics the pharmaceutical industry is able to influence the way in which psychiatrists practise their profession. To look at the image of psychiatry as reflected in advertisements for psychotropics. method Quantitative and qualitative analysis of the advertisements for psychotropics in the Tijdschrift voor Psychiatrie between 1999 and 2006. On average 6 per cent of the total number of pages was given over annually to advertisements of psychotropics. The number of pages used for these advertisements changed over the years, with a sharp decline between 2002 and 2004. Before 2002 the majority of advertisements was for antidepressants, but later most of them were for antipsychotics. Three-quarters of the illustrations for antidepressants featured women whereas three-quarters of the illustrations for antipsychotics featured men. In general, the advertisements were of an 'emotional' nature and surprisingly few of them contained any scientific information. The advertisements for psychotropics portrayed a stereotyped image implying that it is mainly women who are depressed and mainly men who are psychotic. In its advertisements the pharmaceutical industry seeks primarily emotional reactions and uses hardly any scientific arguments. We wonder if the editorial boards of scientific journals should perhaps adopt a more critical attitude to these kinds of advertisements.

Psychotropic drug use among persons with mental distress symptoms: a population-based study in Norway.

Science.gov (United States)

Hausken, Anne M; Skurtveit, Svetlana; Rosvold, Elin O; Bramness, Jørgen G; Furu, Kari

2007-01-01

To explore psychotropic drug use in the general population and in particular among non-institutionalized persons with mental distress symptoms. A total of 14,139 women and 11,665 men participating in the Oslo Health Study or the Oppland/Hedmark Study 2000-2001 submitted a self-administered questionnaire on health status and drug use, lifestyle, and socioeconomic factors. Respondents using antidepressants, hypnotics, and/or anxiolytics during the last four weeks were defined as users. A high Hopkins Symptoms Checklist-10 score indicated mental distress. The 15% with the highest score in each gender and age group (adults: 30/40/45 years; elderly: 60 years) were studied. The prevalence of antidepressant use among those with mental distress was, for women: adults 21%; elderly 30%; and for men, adults 15%; elderly 15%. These figures were nearly four times higher than in the general population. Not participating in the labour market was the main factor associated with use of antidepressants for subjects with mental distress: adult women (odds ratio (OR) 3.5; 95% confidence interval (CI) 2.5-5.0); elderly women (OR 5.2; CI 2.7-10.2); adult men (OR 4.7; CI 3.0-7.3); and elderly men (OR 2.9; CI 1.4-6.0). Use of analgesics was the main factor associated with use of anxiolytics/hypnotics: adult women (OR 2.4; CI 1.7-3.4); elderly women (OR 2.3; CI 1.4-3.8); adult men (OR 2.1; CI 1.3-3.3); and elderly men (OR 3.4; CI 1.9-6.0). Among individuals with mental distress, not participating in the labour market and regular use of analgesics were the main factors associated with use of psychotropics in both genders regardless of age.

Impact of HSD11B1 polymorphisms on BMI and components of the metabolic syndrome in patients receiving psychotropic treatments

KAUST Repository

Quteineh, Lina; Vandenberghe, Frederik; Saigi Morgui, Nuria; Delacré taz, Auré lie; Choong, Eva; Gholam-Rezaee, Mehdi; Magistretti, Pierre J.; Bondolfi, Guido; Von Gunten, Armin; Preisig, Martin A.; Castelao, Enrique; Vollenweider, Peter; Waeber, Gé rard; Bochud, Murielle; Kutalik, Zoltá n; Conus, Philippe O.; Eap, Chin Bin

2015-01-01

Background Metabolic syndrome (MetS) associated with psychiatric disorders and psychotropic treatments represents a major health issue. 11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) is an enzyme that catalyzes tissue regeneration of active cortisol from cortisone. Elevated enzymatic activity of 11β-HSD1 may lead to the development of MetS. Methods We investigated the association between seven HSD11B1 gene (encoding 11β-HSD1) polymorphisms and BMI and MetS components in a psychiatric sample treated with potential weight gain-inducing psychotropic drugs (n=478). The polymorphisms that survived Bonferroni correction were analyzed in two independent psychiatric samples (n R1 =168, n R2 =188) and in several large population-based samples (n 1 =5338; n 2 =123 865; n 3 >100 000). Results HSD11B1 rs846910-A, rs375319-A, and rs4844488-G allele carriers were found to be associated with lower BMI, waist circumference, and diastolic blood pressure compared with the reference genotype (P corrected <0.05). These associations were exclusively detected in women (n=257) with more than 3.1 kg/m 2, 7.5 cm, and 4.2 mmHg lower BMI, waist circumference, and diastolic blood pressure, respectively, in rs846910-A, rs375319-A, and rs4844488-G allele carriers compared with noncarriers (P corrected <0.05). Conversely, carriers of the rs846906-T allele had significantly higher waist circumference and triglycerides and lower high-density lipoprotein-cholesterol exclusively in men (P corrected =0.028). The rs846906-T allele was also associated with a higher risk of MetS at 3 months of follow-up (odds ratio: 3.31, 95% confidence interval: 1.53-7.17, P corrected =0.014). No association was observed between HSD11B1 polymorphisms and BMI and MetS components in the population-based samples. Conclusions Our results indicate that HSD11B1 polymorphisms may contribute toward the development of MetS in psychiatric patients treated with potential weight gain-inducing psychotropic drugs, but do not

No Difference in Psychotropic Medication Use in Cosmetic and General Dermatology Patients.

Science.gov (United States)

Hamilton, Heather K; Lilly, Evelyn; Arndt, Kenneth A; Dover, Jeffrey S

2016-07-01

Patients presenting for appearance-related concerns are often perceived as being more difficult (ie, more needy, more difficult to satisfy) than patients presenting for medical dermatologic problems. While the reasons for this perception are many, some hypothesize that this may be related to a higher rate of anxiety, depression, or body image issues among these patients. To determine the prevalence of psychotropic medication use in cosmetic dermatology patients compared to the prevalence of such medication use in general dermatology patients. METHODS & The study was a retrospective chart review of female patients, 18 or older, new to a private practice. Exclusion criteria included dermatologic disorders with known psychosocial comorbidity. Psychotropic medication use was recorded. The percentage of subjects in the medical group (n=156) who reported using psychotropic medications was 22.2% compared to 26.8% in the cosmetic group (n=154; P=0.09). The prevalence of psychotropic medication use among all dermatology patients in our practice was relatively high, but there was no statistically significant difference in the rate of psychotropic medication use in cosmetic dermatology patients compared to general dermatology patients. J Drugs Dermatol. 2016;15(7):858-861.

A qualitative study exploring visible components of organizational culture: what influences the use of psychotropic medicines in nursing homes?

Science.gov (United States)

Sawan, Mouna J; Jeon, Yun-Hee; Fois, Romano J; Chen, Timothy F

2016-10-01

The influence of organizational culture on how psychotropic medicines are used in nursing homes has not been extensively studied. Schein's theory provides a framework for examining organizational culture which begins with the exploration of visible components of an organization such as behaviors, structures, and processes. This study aimed to identify key visible components related to the use of psychotropic medicines in nursing homes. A qualitative study was conducted in eight nursing homes in Sydney, Australia. Purposive sampling was used to conduct semi-structured interviews with 40 participants representing a broad range of health disciplines. Thematic analysis was used to derive concepts. Three visible components were related to psychotropic medicine use. These were drugs and therapeutics committee meetings, pharmacist led medication management reviews and formal and informal meetings with residents and their families. We found that only a few nursing homes utilized drugs and therapeutics committee meetings to address the overuse of psychotropic medicines. Pharmacist led medication management reviews provided a lever to minimize inappropriate psychotropic prescribing for a number of nursing homes; however, in others it was used as a box-ticking exercise. We also found that some nursing homes used meetings with residents and their families to review the use of psychotropic medicines. This study was the first to illustrate that visible components of organizational culture do influence the use of psychotropic medicines and explains in detail what of the culture needs to be addressed to reduce inappropriate psychotropic prescribing.

Patient satisfaction with psychotropic drugs: sensitivity to change and relationship to clinical status, quality-of-life, compliance and effectiveness of treatment. Results from a nation-wide 6-month prospective study.

Science.gov (United States)

Gasquet, Isabelle; Tcherny-Lessenot, Stéphanie; Lépine, Jean-Pierre; Falissard, Bruno

2006-12-01

To see if patient satisfaction with psychotropics (PSP) could be used as a patient-oriented outcome variable in the evaluation of PSP drugs in clinical epidemiological studies, relationships between PSP, clinical status, QoL, compliance and the type of antipsychotic were analyzed. Elements of validation of PSP were also assessed. In a 6-month prospective study, 933 schizophrenic outpatients with initiation or change to their antipsychotic treatment were enrolled. Psychiatrists completed five CGI-SCH scales (positive, negative, cognitive, depressive and global), hospitalization, compliance, and prescription variables. Patients completed PSP, EuroQoL scales, sexual function and compliance variables. A satisfactory structural equation model was obtained showing significant relationships PSP/compliance (coef.=0.16), QoL/PSP (coef.=0.37), clinical status/QoL (coef.=0.61), clinical status/compliance (coef.=0.09). Patients receiving olanzapine were more satisfied than patients receiving other atypicals (coef.=012) and had better clinical status than patients treated with typicals (coef.=0.08). Evolution of PSP was related to clinical status, QoL, and continuation of treatment (all Pmeasure was not sufficiently sensitive to change. Multi-item questionnaires evaluating different dimensions are needed.

Sexual Dysfunction among Females Receiving Psychotropic Medication: A Hospital-based Cross-sectional Study

Science.gov (United States)

Shetageri, Veda N.; Bhogale, Govind S.; Patil, N. M.; Nayak, R. B.; Chate, S. S.

2016-01-01

Background: Sexual dysfunction (SD) is a known adverse effect of psychotropic medications. Even though sexual difficulties are common among women; very few studies have been carried out in India. Objective: To study the prevalence and nature of SD among females receiving psychotropic medications and to compare the SD among female patients receiving antipsychotics and antidepressants. Materials and Methods: Female investigator conducted a hospital-based cross-sectional study on female patients visiting the psychiatry outpatient department. Patients meeting inclusion criteria were assessed for SD disorder as per Diagnostic and Statistical Manual of Mental Disorders 4th Edition Text Revision. SD severity was measured using Female Sexual Function Index (FSFI) scale. Results: The prevalence of SD in this study was 68.32%. There was more than one SD in 48 (47.52%). FSFI score was significantly low in patients with SD as compared to patients not having SD (P = 0.001). SD was more common in patients who were on combination of antidepressants and benzodiazepines than antidepressant alone or antipsychotic alone. Conclusion: SD was prevalent in more than 50% of female patients on psychotropic drugs. Number of patients on individual psychotropic drugs was so small that a definite conclusion could not be drawn. Study emphasizes the need to carry out similar study on larger number of patients to get better insight into this problem. PMID:27833229

Association between prescribing of cardiovascular and psychotropic medications and hospital admission for falls or fractures.

Science.gov (United States)

Payne, Rupert A; Abel, Gary A; Simpson, Colin R; Maxwell, Simon R J

2013-04-01

Falls are a major cause of morbidity and mortality in the elderly. This study examined the frequency of hospital admission for falls or fractures, and the association with a recent change in the use of cardiovascular and psychotropic medications. We conducted a retrospective case-cohort study of 39,813 patients aged >65 years from 40 Scottish general practices. Data on current prescriptions, dates of drug changes (defined as increases in dose or starting new drugs), diagnoses and clinical measurements were extracted from primary care electronic records, linked to national hospital admissions data. Multivariable logistic regression was used to model the association of change in prescribing of cardiovascular or psychotropic medication with admission to hospital for falls or fractures in the following 60 days. A total of 838 patients (2.1 %) were admitted in the 1-year study period. Following adjustment for factors including age, sex, socioeconomic deprivation, co-morbidity and current prescribing, changes in both cardiovascular and psychotropic medications were associated with subsequent admission for falls or fractures (odds ratio [OR] 1.54 [95 % confidence interval (CI) 1.17-2.03] and 1.68 [95 % CI 1.28-2.22], respectively). There was no evidence for a difference in the effect of change in medication for different cardiovascular drug types (p = 0.86), but there was evidence (p = 0.003) for variation in the association between change in different psychotropic medications and admission; the strongest associations were observed for changes in selective serotonin reuptake inhibitor (SSRI) antidepressants (OR 1.99 [95 % CI 1.29-3.08]), non-SSRI/tricyclic antidepressants (OR 4.39 [95 % CI 2.21-8.71]) and combination psychotropic medication (OR 3.05 [95 % CI 1.66-5.63]). Recent changes in psychotropic and cardiovascular medications are associated with a substantial increase in risk of hospital admission for falls and fractures. Caution should thus be taken when

Psychotropic Medication Use during Inpatient Rehabilitation for Traumatic Brain Injury

Science.gov (United States)

Hammond, Flora M.; Barrett, Ryan S.; Shea, Timothy; Seel, Ronald T.; McAlister, Thomas W.; Kaelin, Darryl; Ryser, David; Corrigan, John D.; Cullen, Nora; Horn, Susan D.

2015-01-01

Objective To describe psychotropic medication administration patterns during inpatient rehabilitation for traumatic brain injury (TBI) and their relationship to patient pre-injury and injury characteristics. Design Prospective observational cohort. Setting multiple acute inpatient rehabilitation units or hospitals. Participants 2,130 individuals with TBI (complicated mild, moderate, or severe) admitted for inpatient rehabilitation. Interventions NA Main Outcome Measure(s) NA Results Most frequently administered was narcotic analgesics (72% of sample) followed by antidepressants (67%), anticonvulsants (47%), antianxiolytics (33%), hypnotics (30%), stimulants (28%), antipsychotics (25%), antiparkinson agents (25%), and miscellaneous psychotropics (18%). The psychotropic agents studied were administered to 95% of the sample with 8.5% receiving only 1 and 31.8% receiving 6 or more. Degree of psychotropic medication administration varied widely between sites. Univariate analyses indicated younger patients were more likely to receive anxiolytics, antidepressants, antiparkinson agents, stimulants, antipsychotics, and narcotic analgesics, while those older were more likely to receive anticonvulsants and miscellaneous psychotropics. Men were more likely to receive antipsychotics. All medication classes were less likely administered to Asians, and more likely to those with more severe functional impairment. Use of anticonvulsants was associated with having seizures at some point during acute care or rehabilitation stays. Narcotic analgesics were more likely for those with history of drug abuse, history of anxiety and depression (premorbid or during acute care), and severe pain during rehabilitation. Psychotropic medication administration increased rather than decreased during the course of inpatient rehabilitation in each of the medication categories except for narcotics. This observation was also true for medication administration within admission functional levels (defined

Forum: Psychotropic prescribing in HIV | Reid | Southern African ...

African Journals Online (AJOL)

We provide a brief guide to the diagnosis and treatment of common mental disorders in people living with HIV/AIDS, including: prescribing psychotropics in HIV; neuropsychiatric side-effects of ARVs and other medications commonly prescribed in HIV; and the diagnosis and treatment of depression, anxiety, psychosis, ...

Czech Teratology Information Service: comparison of treatments by psychotropic and antiepileptic drugs.

Science.gov (United States)

Manáková, Eva; Hubicková-Heringová, Lucie; Jelínek, Richard

2006-12-01

Care, treatment and follow-up in psychiatric and epileptic pregnant women were compared with women inquiring Czech Teratology Information Service (CZTIS) due to other exposure to drugs during pregnancy. Data were collected by CZTIS, member of European Network of Teratology Information Services from 1996. Exposed groups were compared with pregnant women exposed to drugs which were not classified as major teratogens or hyperthermia. Groups do not vary in age, reproductive history and other parameters. We observed higher frequency of miscarriage and voluntary termination of pregnancy in the group of psychiatric patients. The number of malformation in prospective follow-up cases was lower than in control group. Chronic diseases as epilepsy or psychiatric disorders have to be treated during pregnancy. Women should obtain accurate information about possible risk before pregnancy. Co-operation is needed in these cases. Physicians should keep in mind that appropriate information is to be given to the patient according to her disease, education and comprehension of the problem. If there is any doubt they should organize help for their patients.

Use of psychotropic drugs before pregnancy and the risk for induced abortion: population-based register-data from Finland 1996-2006

OpenAIRE

Ritvanen Annukka; Artama Miia; Gissler Mika; Wahlbeck Kristian

2010-01-01

Abstract Background Some, though not all studies have reported an increased risk for mental health problems after an induced abortion. Problems with design and data have compromised these studies and the generalisation of their results. Methods The Finnish Medication and Pregnancy database (N = 622 671 births and 114 518 induced abortions for other than fetal reasons) in 1996-2006 was utilised to study the use of psychotropic drugs in the three months before a pregnancy ending in a birth or a...

Prescribing patterns of psychotropic medications and clinical features in patients with major depressive disorder with and without comorbid dysthymia in China.

Science.gov (United States)

Feng, Yuan; Sha, Sha; Hu, Chen; Wang, Gang; Ungvari, Gabor S; Chiu, Helen F K; Ng, Chee H; Si, Tian-Mei; Chen, Da-Fang; Fang, Yi-Ru; Lu, Zheng; Yang, Hai-Chen; Hu, Jian; Chen, Zhi-Yu; Huang, Yi; Sun, Jing; Wang, Xiao-Ping; Li, Hui-Chun; Zhang, Jin-Bei; Xiang, Yu-Tao

2017-03-01

Little has been reported about the demographic and clinical features of major depressive disorder (MDD) with comorbid dysthymia in Chinese patients. This study examined the frequency of comorbid dysthymia in Chinese MDD patients together with the demographic and clinical correlates and prescribing patterns of psychotropic drugs. Consecutively collected sample of 1178 patients with MDD were examined in 13 major psychiatric hospitals in China. Patients' demographic and clinical characteristics and psychotropic drugs prescriptions were recorded using a standardized protocol and data collection procedure. The diagnosis of dysthymia was established using the Mini International Neuropsychiatric Interview. Medications ascertained included antidepressants, antipsychotics, benzodiazepines, and mood stabilizers. One hundred and three (8.7%) patients fulfilled criteria for dysthymia. In multiple logistic regression analyses, compared to non-dysthymia counterparts, MDD patients with dysthymia had more depressive episodes with atypical features including increased appetite, sleep, and weight gain, more frequent lifetime depressive episodes, and less likelihood of family history of psychiatric disorders. There was no significant difference in the pattern of psychotropic prescription between the 2 groups. There are important differences in the demographic and clinical features of comorbid dysthymia in Chinese MDD patients compared with previous reports. The clinical profile found in this study has implications for treatment decisions. © 2016 John Wiley & Sons Australia, Ltd.

Questioning the causal link between maternal smoking during pregnancy and offspring use of psychotropic medication: a sibling design analysis.

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Lovisa Söderström

Full Text Available A recent population-based, longitudinal study from Finland observed a dose-response association between smoking during pregnancy (SDP and use of psychotropic medications in exposed children and young adults. However, this association may be confounded by unmeasured familial characteristics related to both SDP and offspring mental health. Consequently, we aim to investigate the effect of SDP by means of a sibling design that to some extent allows controlling for unknown environmental and genetic confounders. Using the Swedish Medical Birth Register (1987-1993, which was linked to the Swedish Prescribed Drugs Register (July 2005-December 2008, we investigated 579,543 children and among them 39, 007 were discordant for use of psychotropic medication and 4,021 siblings discordant for both use of psychotropic medication and for smoking exposure. Replicating the Finnish study using traditional logistic regression methods we found an association between exposure to ≥10 cigarettes per day during pregnancy and psychotropic drug use (odds ratio = 1.61, 95% confidence interval 1.56, 1.66. Similar in size to the association reported from Finland (odds ratio = 1.63; 95% confidence interval 1.53, 1.74. However, in the adjusted sibling analysis using conditional logistic regression, the association was considerably reduced (odds ratio 1.22; 95% confidence interval 1.08, 1.38. Preventing smoking is of major public health importance. However, SDP per se appears to have less influence on offspring psychotropic drug use than previously suggested.

Influence of polygenic risk scores on lipid levels and dyslipidemia in a psychiatric population receiving weight gain-inducing psychotropic drugs.

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Delacrétaz, Aurélie; Lagares Santos, Patricia; Saigi Morgui, Nuria; Vandenberghe, Frederik; Glatard, Anaïs; Gholam-Rezaee, Mehdi; von Gunten, Armin; Conus, Philippe; Eap, Chin B

2017-12-01

Dyslipidemia represents a major health issue in psychiatry. We determined whether weighted polygenic risk scores (wPRSs) combining multiple single-nucleotide polymorphisms (SNPs) associated with lipid levels in the general population are associated with lipid levels [high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), and triglycerides] and/or dyslipidemia in patients receiving weight gain-inducing psychotropic drugs. We also determined whether genetics improve the predictive power of dyslipidemia. The influence of wPRS on lipid levels was firstly assessed in a discovery psychiatric sample (n=332) and was then tested for replication in an independent psychiatric sample (n=140). The contribution of genetic markers to predict dyslipidemia was evaluated in the combined psychiatric sample. wPRSs were significantly associated with the four lipid traits in the discovery (P≤0.02) and in the replication sample (P≤0.03). Patients whose wPRS was higher than the median wPRS had significantly higher LDL, TC, and triglyceride levels (0.20, 0.32 and 0.26 mmol/l, respectively; P≤0.004) and significantly lower HDL levels (0.13 mmol/l; Pdyslipidemia prediction of HDL (P=0.03) and a trend for improvement was observed for the prediction of TC dyslipidemia (P=0.08). Population-based wPRSs have thus significant effects on lipid levels in the psychiatric population. As genetics improved the predictive power of dyslipidemia development, only 24 patients need to be genotyped to prevent the development of one case of HDL hypocholesterolemia. If confirmed by further prospective investigations, the present results could be used for individualizing psychotropic treatment.

JUVENILE CRIMES CONNECTED WITH NARCOTICS AND PSYCHOTROPIC SUBSTANCES TRAFFICKING: CRIMINOLOGICAL ASPECTS

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Ms. Irina V. Tseveleva

2016-06-01

Full Text Available The article deals with criminological aspects of juvenile crime in the narcotics and psychotropic substances trafficking. The authors analyzed the main reasons of committing these crimes by teenagers. The proposals for the prevention of minors’ criminal behavior in drug trafficking are drafted.

Psychotropic medication in the French child and adolescent population: prevalence estimation from health insurance data and national self-report survey data

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Legleye Stéphane

2009-11-01

Full Text Available Abstract Background The aim of this work is to estimate the French frequencies of dispensed psychotropic prescriptions in children and adolescents. Prevalence estimations of dispensed prescriptions are compared to the frequencies of use of psychotropic reported by 17 year-old adolescents. Methods Prescription data is derived from national health insurance databases. Frequencies of dispensed prescriptions are extrapolated to estimate a range for the 2004 national rates. Self-report data is derived from the 2003 and 2005 ESCAPAD study, an epidemiological study based on a questionnaire focused on health and drug consumption. Results The prevalence estimation shows that the prevalence of prescription of a psychotropic medication to young persons between 3 and 18 years is about 2.2%. In 2005, the self-report study (ESCAPAD shows that 14.9% of 17 year-old adolescents took medication for "nerves" or "to sleep" during the previous 12 months. The same study in 2003 also shows that 62.3% of adolescents aged 17 and 18 reporting psychotropic use, took the medication for anxiety and 56.8% to sleep. Only 49.7% of these medications are suggested by a doctor. Conclusion This study underlines a similar range of prevalence of psychotropic prescriptions in France to that observed in other European countries. Nevertheless, the proportion of antipsychotics and benzodiazepines seems to be higher, whereas the proportion of methylphenidate is lower. Secondly, a disparity between the prevalence of dispensed prescriptions and the self-report of actual use of psychotropics has been highlighted by the ESCAPAD study which shows that these treatments are widely used as "self-medication".

The monitoring of trade in and control of psychotropic substances to guard against their diversion.

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Bayer, I

1983-01-01

The establishment of international control of opiates has been an important achievement of the international community; this is substantiated by the fact that, at the beginning of this century, legally manufactured morphine and heroin were the principal sources of illicit supply, whereas at present the illicit traffic in these drugs is supplied from illicit sources. The poppy straw process has helped to promote measures to control opium poppy cultivation in a number of European countries; Turkey has been a successful example of such control. The present large-scale illicit traffic in cannabis resin and cocaine is the consequence of the lack of the implementation of provisions of the Single Convention on Narcotic Drugs, 1961, to control the cannabis plant and the coca bush at the national level. The provisions of the 1971 Convention on Psychotropic Substances, being largely a result of international compromise, are not designed in the best possible way to prevent the diversion of psychotropic substances from legal sources to illicit channels. There are no appropriate provisions for the control and monitoring of international transactions. There is a discrepancy between the rather limited scope of international control of substances listed in schedules III and IV of the 1971 Convention and the much larger scope of control of hypnotics, sedatives and tranquillizers at national levels. The provisions of the 1971 Convention, however, constitute a legal basis for bilateral and multilateral actions for the detection of suspected diversion cases, and offer possibilities of promoting the prevention of diversion of psychotropic substances. At present, the relationship between the control of psychotropic drugs, including the prevention of diversion and the organization of the national drug supply system, as well as the efficacy of national control over pharmaceutical products, has not been fully recognized by the international community.

Psychotropic Medication Use Among Adults With Schizophrenia and Schizoaffective Disorder in the United States.

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Stroup, T Scott; Gerhard, Tobias; Crystal, Stephen; Huang, Cecilia; Tan, Zhiqiang; Wall, Melanie M; Mathai, Chacku M; Olfson, Mark

2018-05-01

The authors examined the use of different classes of psychotropic medication in outpatient treatment of schizophrenia and schizoaffective disorder. Data from the United States Medicaid program were used to examine psychotropic medication use in a cohort of patients who had a diagnosis of schizophrenia or schizoaffective disorder in the calendar year 2010. The cohort of Medicaid recipients who filled one or more prescriptions for a psychotropic medication in 2010 included 116,249 patients classified as having schizophrenia and 84,537 classified as having schizoaffective disorder. During 2010, 86.1% of patients with schizoaffective disorder and 70.1% with schizophrenia were treated with two or more different classes of psychotropic. Psychotropic medications other than antipsychotics were commonly prescribed for individuals with a diagnosis of schizophrenia or schizoaffective disorder. Their widespread use and uncertainty about their net benefits signal a need for research on their efficacy, safety, and appropriate use in these conditions.

Psychiatric disorders are overlooked in patients with drug abuse

DEFF Research Database (Denmark)

Kruckow, Line; Linnet, Kristian; Banner, Jytte

2016-01-01

Introduction: Psychiatric disease is overlooked in drug users. Patients with both drug abuse and a psychiatric disease – dual diagnosis – suffer decreased compliance to treatment and decreased life expectancy compared with single-diagnosis patients. Identifying the patients among ­either drug...... addicts or mentally ill patients is difficult. Methods: All drug addicts autopsied at the Department of Forensic Medicine, University of Copenhagen, Denmark, in the years 1992, 2002 and 2012 were included. The group was divided into two subpopulations of possible dual diagnosis patients either according...... to police reports stating mental illness or to psychotropics found in the toxicology screening after autopsy. Results: We found a rise in possible mental illness in both subpopulations in the study period. Drug addicts with psychotropics in the blood at the time of death increased from 3.1% in 1992 to 48...

Prevalence of mind and body exercises (MBE in relation to demographics, self-rated health, and purchases of prescribed psychotropic drugs and analgesics.

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Lina Rådmark

Full Text Available This study aims to identify any differences regarding gender, age, socioeconomic status (SES, self-rated health, perceived stress and the purchase of prescribed drugs among people who practice mind and body exercises (MBE extensively compared to people who do not.The study includes 3,913 men and 4,803 women aged 20-72 who participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH. The respondents were divided into three groups depending on frequency of MBE practice (never/seldom/often. Measures regarding MBE practice, health behaviors, self-rated health, and illnesses were drawn from the SLOSH questionnaire, while more objective measures of socioeconomic status and education were derived from registry data. In addition, data on purchases of prescription drugs for all respondents were included in the study. These data were obtained from the Swedish Prescribed Drug Register, which contains information about prescription drugs dispensed at Swedish pharmacies. Separate analyses were performed for mental MBE (mindfulness, meditation, relaxation techniques and physical MBE (yoga, Tai Chi, Qi Gong, respectively.A high intensity MBE practice is cross-sectionally related to poor self-assessed health (sleeping problems, pain, depressive symptoms, mental disorders, high levels of stress, and high levels of purchases of psychotropic drugs and analgesics. These cross-sectional relationships are generally stronger for mental MBE than for bodily-directed MBE. More women than men are practicing MBE on a regular basis, and physically active people participate to a greater extent in MBE compared with the physically inactive.Overall, the study shows that frequent participation in mind and body exercises is associated with high levels of purchases of psychotropic drugs and analgesics as well as with poor self-assessed health and high levels of stress. However, since this is a cross-sectional study, it is impossible to establish cause and effect

Off-label psychotropic prescribing for young persons in medium security.

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Haw, C; Stubbs, J

2010-10-01

Psychotropic drug prescribing for children and adolescents is frequently off-label and has increased over time and can be controversial. Psychotropic prescribing in two large UK medium secure units for young people has been studied. A total of 89 patients were included, 64% being aged less than 18 years. A total of 137 of 202 (67.8%) of prescriptions were off-label. The most common reasons for a prescription being off-label were the indication (N = 103) and the patient's age (N = 41). The main classes of drugs involved were antipsychotics (N = 59), antiepileptics as mood stabilisers (N = 22), anticholinergics and hyoscine (N = 15) and antidepressants (N = 11). Aggression (N = 48) and post-traumatic stress disorder (N = 30) were the most common off-label indications. Some antidepressant prescriptions were contrary to advice of the Committee on Safety of Medicines (CSM). Meta-analyses or randomised controlled trials supported 27% of off-label prescriptions, with lesser quality studies supporting a further 29.2% and expert opinion 38.7%, whereas for 5.1% no evidence could be found. Prescribers tended to over-estimate the level of evidence from clinical trials or extrapolated from findings in adults. They often quoted their own experience rather than expert sources to justify their prescribing practice. It is important that prescribers are fully aware of the quality of experimental data and the risk-benefit ratio when prescribing off-label for young persons. If the evidence base is limited, it is particularly important to provide information about the risks and benefits of the treatment to the patient/relatives. A second opinion may be helpful. Both target symptoms and side effects should be monitored and regularly reviewed.

Selective potentiation of noradrenaline in the guinea-pig vas deferens by 2-(4-methylaminobutoxy) diphenylmethane hydrochloride (MCI-2016), a new psychotropic drug.

OpenAIRE

Ohizumi, Y.; Takahashi, M.; Tobe, A.

1982-01-01

In the isolated vas deferens of the guinea-pig, the effects of 2-(4-methylaminobutoxy) diphenylmethane hydrochloride (MCI-2016), a new psychotropic drug, on the contractile response to various agonists or transmural electrical stimulation and on the release of noradrenaline (NA) from the tissue were examined and compared with cocaine. MCI-2016 (3 X 10(-6)M) and cocaine (3 X 10(-5)M) produced a leftward shift (15 and 20 times, respectively) of the dose-response curves for the contractile effec...

Comparison of Psychotropic Drug Prescribing Quality between Zagreb, Croatia and Sarajevo, B&H.

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Polić-Vižintin, Marina; Štimac, Danijela; Čatić, Tarik; Šostar, Zvonimir; Zelić, Ana; Živković, Krešimir; Draganić, Pero

2014-12-01

The purpose of this paper was to compare outpatient consumption and quality of psychotropic drug prescribing between Croatia and Bosnia & Herzegovina 2006-2010. Data on drug utilization from Zagreb Municipal Pharmacy and Sarajevo Public Pharmacy were used to calculate the number of defined daily doses (DDD) and DDD per 1000 inhabitants per day (DDD/TID) using the WHO Anatomical-Therapeutic-Chemical methodology. Total utilization of psychopharmaceuticals increased in both cities; however, it was higher in Zagreb than in Sarajevo throughout the study period. The utilization of psycholeptics increased in Zagreb by 2.4% (from 74.5 to 76.3 DDD/TID) and in Sarajevo by 3.8% (from 62.4 to 64.8 DDD/TID). The utilization of anxiolytics decreased in Zagreb by 2.1% and in Sarajevo by even 18.7%. The utilization of antidepressants increased in both cities with predominance of SSRI over TCA utilization, greater in Sarajevo (96.6%) than in Zagreb (10.2%). The anxiolytic/antidepressant ratio decreased by 11.1% in Zagreb (from 2.87 to 2.55) and by 58.7% in Sarajevo (from 5.66 to 2.34). Outpatient utilization of antipsychotics increased significantly in Sarajevo, predominated by typical ones, whereas in Zagreb the utilization of antipsychotics was stable, predominated by atypical ones. In Croatia and Bosnia & Herzegovina, there was an obvious tendency to follow western trends in drug prescribing, as demonstrated by the increased use of antidepressants and reduced use of anxiolytics. Despite some improvement observed in the prescribing quality, high use of antipsychotics with dominance of typical antipsychotics in Sarajevo points to the need of prescribing guidelines for antipsychotics.

Inhibitory effects of psychotropic drugs on the acetylcholine receptor-operated potassium current (IK.ACh) in guinea-pig atrial myocytes.

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Okada, Muneyoshi; Watanabe, Shinya; Matada, Takashi; Asao, Yoko; Hamatani, Ramu; Yamawaki, Hideyuki; Hara, Yukio

2013-01-01

Influences of psychotropic drugs, six antipsychotics and three antidepressants, on acetylcholine receptor-operated potassium current (IK.ACh) were examined by a whole-cell patch clamp method in freshly isolated guinea-pig atrial myocyte. IK.ACh was induced by a superfusion of carbachol (CCh) or by an intracellular application of guanosine 5'-[thio] triphosphate (GTPγS). To elucidate mechanism for anticholinergic action, IC50 ratio, the ratio of IC50 for GTPγS-activated IK.ACh to CCh-induced IK.ACh, was calculated. Antipsychotics and antidepressants inhibited CCh-induced IK.ACh in a concentration-dependent manner. The IC50 values were as follows; chlorpromazine 0.53 μM, clozapine 0.06 μM, fluphenazine 2.69 μM, haloperidol 2.66 μM, sulpiride 42.3 μM, thioridazine 0.07 μM, amitriptyline 0.03 μM, imipramine 0.22 μM and maprotiline 1.81 μM. The drugs, except for sulpiride, inhibited GTPγS-activated IK.ACh with following IC50 values; chlorpromazine 1.71 μM, clozapine 14.9 μM, fluphenazine 3.55 μM, haloperidol 2.73 μM, thioridazine 1.90 μM, amitriptyline 7.55 μM, imipramine 7.09 μM and maprotiline 5.93 μM. The IC50 ratio for fluphenazine and haloperidol was close to unity. The IC50 ratio for chlorpromazine, clozapine, thioridazine, amitriptyline, imipramine and maprotiline was much higher than unity. The present findings suggest that the psychotropics studied suppress IK.ACh. Chlorpromazine, clozapine, thioridazine, amitriptyline, imipramine, maprotiline and sulpiride are preferentially acting on muscarinic receptor. Fluphenazine and haloperidol may act on G protein and/or potassium channel.

Regional changes in psychotropic use among Finnish persons with newly diagnosed Alzheimer's disease in 2005-2011.

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Anna-Maija Tolppanen

Full Text Available To describe and compare temporal changes in prevalence and incidence of psychotropic use (antipsychotics, antidepressants and benzodiazepines and related drugs; BZDRs in persons with newly diagnosed Alzheimer's disease (AD between university hospital districts of Finland during 2005-2011.The MEDALZ study includes all community-dwellers of Finland who received a clinically verified AD diagnosis in 2005-2011 (N = 70,718. Prevalent and incident use of psychotropics among those who had received AD diagnosis less than one year ago were compared in 2005-2011.Regional differences in psychotropic use between university hospital districts were more evident in 2005 than 2011 for prevalent use of any psychotropic, antipsychotic and BZDRs and incident use of any psychotropic and antipsychotics. Regional differences in prevalent antidepressant use and incident BZDR use remained similar during the follow-up, while differences in incident antidepressant use increased during the follow-up. The prevalence of any psychotropic use in 2005 varied between 44.7-50.7% and between 45.0-47.9% in 2011. Incidence of any psychotropic use in 2005 was between 8.6-12.1% and 6.2-8.2% in 2011. In 2005, the distribution of incident psychotropic use followed a large scale spatial variation that, however, did not correspond to university hospital districts. During the study period from 2005 to 2011 the cyclic spatial variation disappeared. No sign of adjacent hospital districts being more or less closely related to each other compared to hospital districts in general was detected.Except for antidepressants, regional differences in psychotropic use have mainly diminished between 2005 and 2011. Our findings highlight the importance of acknowledging regional differences in a country with relatively homogeneous healthcare system and conducting future studies assessing the reasons behind these differences.

Shortage of psychotropic medications in community pharmacies in Saudi Arabia: Causes and solutions.

Science.gov (United States)

Al-Ruthia, Yazed Sulaiman; Mansy, Wael; Barasin, Mohammad; Ghawaa, Yazeed Mohammad; AlSultan, Mohammed; Alsenaidy, Mohammad A; Alhawas, Solaiman; AlGhadeer, Sultan

2017-07-01

Background: Patients with mental disorders, such as depression and anxiety, who seek medical care in private psychiatric clinics in Riyadh, Saudi Arabia, have recently expressed concerns to doctors about difficulty in filling psychotropic medications, such as Amitriptyline and Aripiprazole, at retail community pharmacies. Objectives: The aim of this study was to investigate whether there is a shortage of some commonly prescribed psychotropic medications in retail community pharmacies in Saudi Arabia, and if so, to explore the possible reasons behind the shortage of these medications. Methods: The availability of 28 commonly prescribed psychotropic medications was checked in multiple retail community pharmacies in 4 different regions of Saudi Arabia. Further, potential reasons behind the shortage of some psychotropic medications in retail community pharmacies were also explored. Results: Amitriptyline, Amoxapine, Aripiprazole, Bupropion, Buspirone, Duloxetine, Haloperidol, Hydroxyzine, Lithium, Prochlorperazine, Procyclidine, Promethazine, Thioridazine, Trazodone, and Trifluoperazine were unavailable in over half of the 248 community pharmacies surveyed. Four possible reasons behind the shortage of these medications were reported by 31 pharmacists working in different retail community pharmacies' purchasing departments, with a majority (58.06%) reporting the primary reason for a shortage of these medications that they are slow-moving items with low profit margins. Conclusions: The findings of this study should expedite the reform process in both the Ministry of Health and the Saudi Food and Drug Authority (SFDA) to publish and enforce an essential list of medications for retail community pharmacies, which should include the most commonly prescribed psychotropic medications.

Psychotropic medications and the developing brain

NARCIS (Netherlands)

Solleveld, M.M.

2018-01-01

Increasing numbers of children and adolescents are treated with psychotropic medications for Major Depressive Disorder (MDD) or Attention-Deficit/Hyperactivity Disorder (ADHD). Although these psychotropic medications have been well studied in the adult population, much less is known on their

Use of psychotropic medications by caregivers of elderly patients with dementia: is this a sign of caregiver burden?

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Einstein Francisco Camargos

2012-03-01

Full Text Available This study evaluated the consumption of psychotropic medications by caregivers of elderly patients with or without dementia. This was a cross-sectional study conducted at all geriatric units in Brasília, Brazil, during a two-month period. Structured interviews were performed with 311 caregivers of people with or without dementia and they completed questionnaires. Among the caregivers, 196 (63% were caregivers of patients with dementia and 115 (37% were caregivers of patients without dementia. Forty-four caregivers (14.1% were taking psychotropic drugs (benzodiazepines or antidepressants, and this usage was more frequent among caregivers of patients with dementia (p<0.01. Twenty-two caregivers of patients with dementia (11.4% had used sleeping pills after beginning care, compared with only five (4.3% caregivers of patients without dementia (p<0.01. In conclusion, this study found that caregivers of patients with dementia took psychotropic drugs (benzodiazepines and antidepressants more frequently than the ones of patients without dementia.

PSYCHOTROPIC MEDICINE PRESCRIPTIONS IN A PRIMARY CARE UNIT IN A BIG CITY OF SÃO PAULO STATE

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Tatiana Oliveira da Silva

2013-03-01

Full Text Available Aiming toknowthe consumptionprofileof psychotropic drugs inpopulation ofperipheral region of abig cityof São Paulo State, 800 prescriptionsfromaPrimary CareUnitareassessedaccordingto344/98-SVS/MS.In that timethecontrolof these drugs were mademanually.The results showed1371 drugsdispensedandamong those1134were psychotropic.Thetotal was64,513pillunits, an average of 107 units with 1.7 drugs per prescription, while82.1% came from public services. The total number of drugs prescribed per prescription had themajority (60.0% onedrug, 20.3%, two drugs, three drugs 11.6%, 6.6% four or moremedications, including those not controlled (14% . Twenty drugswerenot on the standard list.Of controlled, 78.4% belonged to theclassC1 and21.6% toB1.There is a large consumption ofpsychotropic medications for thispoorpopulation, with a prevalence of antidepressants. Thesubsequent implementation of the computerized system significantly reduced the units dispensed,indicating that forms of management are factors to be considered in the rational use of drugs,such as the use of technologies and also the wide range of approaches to health education, such astraining of health professionals, including prescribers

Screening for mental illness: the merger of eugenics and the drug industry.

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Sharav, Vera Hassner

2005-01-01

The implementation of a recommendation by the President's New Freedom Commission (NFC) to screen the entire United States population--children first--for presumed, undetected, mental illness is an ill-conceived policy destined for disastrous consequences. The "pseudoscientific" methods used to screen for mental and behavioral abnormalities are a legacy from the discredited ideology of eugenics. Both eugenics and psychiatry suffer from a common philosophical fallacy that undermines the validity of their theories and prescriptions. Both are wed to a faith-based ideological assumption that mental and behavioral manifestations are biologically determined, and are, therefore, ameliorated by biological interventions. NFC promoted the Texas Medication Algorithm Project (TMAP) as a "model" medication treatment plan. The impact of TMAP is evident in the skyrocketing increase in psychotropic drug prescriptions for children and adults, and in the disproportionate expenditure for psychotropic drugs. The New Freedom Commission's screening for mental illness initiative is, therefore, but the first step toward prescribing drugs. The escalating expenditure for psychotropic drugs since TMAP leaves little doubt about who the beneficiaries of TMAP are. Screening for mental illness will increase their use.

Long working hours and use of psychotropic medicine: a follow-up study with register linkage.

Science.gov (United States)

Hannerz, Harald; Albertsen, Karen

2016-03-01

This study aimed to investigate the possibility of a prospective association between long working hours and use of psychotropic medicine. Survey data drawn from random samples of the general working population of Denmark in the time period 1995-2010 were linked to national registers covering all inhabitants. The participants were followed for first occurrence of redeemed prescriptions for psychotropic medicine. The primary analysis included 25,959 observations (19,259 persons) and yielded a total of 2914 new cases of psychotropic drug use in 99,018 person-years at risk. Poisson regression was used to model incidence rates of redeemed prescriptions for psychotropic medicine as a function of working hours (32-40, 41-48, >48 hours/week). The analysis was controlled for gender, age, sample, shift work, and socioeconomic status. A likelihood ratio test was used to test the null hypothesis, which stated that the incidence rates were independent of weekly working hours. The likelihood ratio test did not reject the null hypothesis (P=0.085). The rate ratio (RR) was 1.04 [95% confidence interval (95% CI) 0.94-1.15] for the contrast 41-48 versus 32-40 work hours/week and 1.15 (95% CI 1.02-1.30) for >48 versus 32-40 hours/week. None of the rate ratios that were estimated in the present study were statistically significant after adjustment for multiple testing. However, stratified analyses, in which 30 RR were estimated, generated the hypothesis that overtime work (>48 hours/week) might be associated with an increased risk among night or shift workers (RR=1.51, 95% CI 1.15-1.98). The present study did not find a statistically significant association between long working hours and incidence of psychotropic drug usage among Danish employees.

[Drugs in pregnancy].

Science.gov (United States)

Danchev, N; Astrug, A; Tsankova, V; Nikolova, I

2006-01-01

The use of drugs in pregnancy is being discussed. The influence of different factors, both physiological and drug related (physicochemical characteristics, dose, duration of pharmacotherapy) on the processes of absorption, distribution, protein binding, metabolism and excretion are reviewed. The up-to-date classification of the drugs in relation to their effects on the fetus is presented. Special emphasize is given to drugs (antibiotics, cardio-vascular, psychotropic etc.) used for the treatment of acute and chronic conditions in the course of pregnancy. Drugs used for symptoms like pain, high temperature and constipation are also reviewed. Recommendations for the use of safer drugs in pregnancy are given. Drugs with proven teratogenic effects are presented.

Multi-exposure and clustering of adverse childhood experiences, socioeconomic differences and psychotropic medication in young adults.

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Björkenstam, Emma; Hjern, Anders; Mittendorfer-Rutz, Ellenor; Vinnerljung, Bo; Hallqvist, Johan; Ljung, Rickard

2013-01-01

Stressful childhood experiences have negative long-term health consequences. The present study examines the association between adverse childhood experiences, socioeconomic position, and risk of psychotropic medication in young adulthood. This register-based cohort study comprises the birth cohorts between 1985 and 1988 in Sweden. We followed 362 663 individuals for use of psychotropic medication from January 2006 until December 2008. Adverse childhood experiences were severe criminality among parents, parental alcohol or drug abuse, social assistance recipiency, parental separation or single household, child welfare intervention before the age of 12, mentally ill or suicidal parents, familial death, and number of changes in place of residency. Estimates of risk of psychotropic medication were calculated as odds ratio (OR) with 95% confidence intervals (CIs) using logistic regression analysis. Adverse childhood experiences were associated with increased risks of psychotropic medication. The OR for more than three adverse childhood experiences and risk of psychotropic medication was for women 2.4 (95% CI 2.3-2.5) and for men 3.1 (95% CI 2.9-3.2). The risk of psychotropic medication increased with a higher rate of adverse childhood experiences, a relationship similar in all socioeconomic groups. Accumulation of adverse childhood experiences increases the risk of psychotropic medication in young adults. Parental educational level is of less importance when adjusting for adverse childhood experiences. The higher risk for future mental health problems among children from lower socioeconomic groups, compared to peers from more advantaged backgrounds, seems to be linked to a higher rate of exposure to adverse childhood experiences.

Multi-exposure and clustering of adverse childhood experiences, socioeconomic differences and psychotropic medication in young adults.

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Emma Björkenstam

Full Text Available PURPOSE: Stressful childhood experiences have negative long-term health consequences. The present study examines the association between adverse childhood experiences, socioeconomic position, and risk of psychotropic medication in young adulthood. METHODS: This register-based cohort study comprises the birth cohorts between 1985 and 1988 in Sweden. We followed 362 663 individuals for use of psychotropic medication from January 2006 until December 2008. Adverse childhood experiences were severe criminality among parents, parental alcohol or drug abuse, social assistance recipiency, parental separation or single household, child welfare intervention before the age of 12, mentally ill or suicidal parents, familial death, and number of changes in place of residency. Estimates of risk of psychotropic medication were calculated as odds ratio (OR with 95% confidence intervals (CIs using logistic regression analysis. RESULTS: Adverse childhood experiences were associated with increased risks of psychotropic medication. The OR for more than three adverse childhood experiences and risk of psychotropic medication was for women 2.4 (95% CI 2.3-2.5 and for men 3.1 (95% CI 2.9-3.2. The risk of psychotropic medication increased with a higher rate of adverse childhood experiences, a relationship similar in all socioeconomic groups. CONCLUSIONS: Accumulation of adverse childhood experiences increases the risk of psychotropic medication in young adults. Parental educational level is of less importance when adjusting for adverse childhood experiences. The higher risk for future mental health problems among children from lower socioeconomic groups, compared to peers from more advantaged backgrounds, seems to be linked to a higher rate of exposure to adverse childhood experiences.

Drug monitoring in child and adolescent psychiatry for improved efficacy and safety of psychopharmacotherapy

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Fegert Jörg M

2009-04-01

Full Text Available Abstract Most psychotropic drugs used in the treatment of children and adolescents are applied "off label" with a direct risk of under- or overdosing and a delayed risk of long-term side effects. The selection of doses in paediatric psychiatric patients requires a consideration of pharmacokinetic parameters and the development of central nervous system, and warrants specific studies in children and adolescents. Because these are lacking for most of the psychotropic drugs applied in the Child and Adolescent and Psychiatry, therapeutic drug monitoring (TDM is a valid tool to optimise pharmacotherapy and to enable to adjust the dosage of drugs according to the characteristics of the individual patient. Multi-centre TDM studies enable the identification of age- and development-dependent therapeutic ranges of blood concentrations and facilitate a highly qualified standardized documentation in the child and adolescent health care system. In addition, they will provide data for future research on psychopharmacological treatment in children and adolescents, as a baseline for example for clinically relevant interactions with various co-medications. Therefore, a German-Austrian-Swiss "Competence Network on Therapeutic Drug Monitoring in Child and Adolescent Psychiatry" was founded 1 introducing a comprehensive internet data base for the collection of demographic, safety and efficacy data as well as blood concentrations of psychotropic drugs in children and adolescents.

Uso y abuso de psicofármacos: diseño de una actividad del proyecto comunitario con el museo de la Farmacia Habanera Use and abuse of psychotropic drugs: design of an activity of the community project with Havana's Pharmacy Museum

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Milena Díaz Molina

2008-08-01

Museum, which includes among its activities "The Infusion Afternoons", a propitious setting for the development of general topics related to drugs. One of the most selected to this end was that on psychotropic drugs, since it is a group of drugs of particular importance. Methods: "The Infusion Afternoons" are monthly activities dealing with general pharmaceutical themes that are directed to the population and to the first-year students of Pharmaceutical Sciences. In the case of psychotropic drugs, it was used the modality of round table, followed by audience/panel debate. Results: Some aspects of interest connected with the history of the use of psychotropic drugs and of the treatment of mental diseases were approached, and special emphasis was given to those psychotropic drugs most commonly known and used by the population. The attention was focused on the need of a rational use of psychotropic drugs. Discussion: The type of activity developed made possible that both the students and the population improved their knowledge about this topic. The students were linked with the activities of drug information and health education. This activity marked the beginning of their participation in the community project.

Treatment of agitation in the acute psychiatric setting. An observational study of the effectiveness of intramuscular psychotropic medication.

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Bauer, Jeanett Østerby; Stenborg, Dina; Lodahl, Tue; Mønsted, Mik Mathias

2016-11-01

Agitation is frequent in the acute psychiatric setting. The observation and treatment of agitation is important to avoid harm to patients or staff, to reduce distress of the patient, and to reduce the risk of coercion, especially physical restraint. To evaluate the effect of intramuscular treatment with psychotropics on agitation in a non-selected acute psychiatric population. The Positive and Negative Syndrome Scale Excitement Component (PANSS-EC) was implemented in the acute psychiatric ward at Psychiatric Center Copenhagen to improve assessment and treatment of agitation. During a period of almost ~2 years the staff was requested to assess agitation before and after administration of intramuscular injections. PANSS-EC was obtained at baseline and within 2 hours after injection for 135 injections with antipsychotics or benzodiazepines administered to 101 acute, non-selected psychiatric patients with high occurrence of co-morbid substance abuse. Mean PANSS-EC at baseline was 26.53 ± 4.87, and mean reduction in PANSS-EC was 14.99 ± 8.48 (p patients were subjected to physical restraint. Patients subjected to restraint had a significantly higher PANSS-EC score. Patients who received a subsequent injection had a significantly lower decline in PANSS-EC score. Besides two cases of acute dystonia following haloperidol injections, no serious side-effects were observed. Treatment of agitation with intramuscular injections of psychotropics was in general effective in this non-selected, highly agitated psychiatric population, and injections were well tolerated.

A comparison of psychotropic medication prescribing patterns in East of England prisons and the general population.

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Hassan, Lamiece; Senior, Jane; Frisher, Martin; Edge, Dawn; Shaw, Jenny

2014-04-01

While the prevalence of mental illness is higher in prisons than in the community, less is known about comparative rates of psychotropic medicine prescribing. This is the first study in a decade to determine the prevalence and patterns of psychotropic medication prescribing in prisons. It is also the first study to comprehensively adjust for age when making comparisons with the general population. Four East of England prisons, housing a total of 2222 men and 341 women were recruited to the study. On census days, clinical records were used to identify and collect data on all prisoners with current, valid prescriptions for hypnotic, anxiolytic, antipsychotic, antimanic, antidepressant and/or stimulant medication, as listed in chapters 4.1 to 4.4 of the British National Formulary. Data on 280,168 patients were obtained for comparison purposes from the Clinical Practice Research Datalink. After adjusting for age, rates of psychotropic prescribing in prison were 5.5 and 5.9 times higher than in community-based men and women, respectively. We also found marked differences in the individual psychotropic drugs prescribed in prison and community settings. Further work is necessary to determine whether psychotropic prescribing patterns in prison reflect an appropriate balance between managing mental illness, physical health risks and medication misuse.

Identification of N,N-dimethyltryptamine and beta-carbolines in psychotropic ayahuasca beverage.

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Gambelunghe, Cristiana; Aroni, Kyriaki; Rossi, Riccardo; Moretti, Luca; Bacci, Mauro

2008-10-01

Recently many people have shown great interest in traditional indigenous practices and popular medicine, involving the ingestion of natural psychotropic drugs. We received a request to analyze and determine the nature of a dark green liquid with a dark brown plant sediment, which the police had seized at an airport and inside the home of a person belonging to the 'Santo Daime' religious movement. Gas chromatography/mass spectrometry analysis of the extract identified N,N-dimethyltryptamine, a potent hallucinogen, and the beta-carboline alkaloids harmine and harmaline, revealing monoamine oxidase A-inhibiting properties. These substances are typical components of Ayahuasca, a South American psychotropic beverage obtained by boiling the bark of the liana Banisteriopsis caapi together with the leaves of various admixture plants, principally Psychotria viridis.

Pharmacological treatment of severe psychiatric disorders in the developing world : lessons from India.

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Patel, Vikram; Andrade, Chittaranjan

2003-01-01

Severe psychiatric disorders (schizophrenia, bipolar disorder and major depressive disorder) cause much morbidity and disability in developing countries. Most of the evidence on the efficacy and effectiveness of drug treatments for these disorders is based on trials conducted in Western countries. Cultural, biological and health system factors may profoundly influence the applicability of such evidence in developing countries. Attitudes towards, and concepts about, psychiatric disorders vary across cultures, and these may influence the acceptability of drug treatments. Genetic and environmental factors may lead to variations in the pharmacodynamics and pharmacokinetics of psychotropic drugs across ethnic groups. This may explain why lower doses of psychotropic drugs tend to be used for non-Caucasian patients. There is a dearth of mental health professionals and care facilities in developing countries, especially in rural areas. Epidemiological studies show that, despite this lack of services, the outcome of schizophrenia is favourable in developing countries. This suggests that cultural, genetic or environmental factors may play as much of a role in influencing outcome as access to antipsychotic treatment. Regional drug policies may influence the availability and cost of psychotropic drugs. In particular, the Indian experience, where drugs are manufactured by several local pharmaceutical firms, thus bringing their cost down, may represent a unique deregulated drug industry. However, the impending impact of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement, with the strict enforcement of patent laws, will almost certainly lead to a rise in drug costs in the coming years. This may influence the choice and cost effectiveness of various drugs. The implications of these cross-cultural variations for policy and practice are the need to ensure a reliable supply of affordable psychotropic drugs in developing countries, trained healthcare

Frequency of Pathological Changes in Lungs of Bodies with Positive Postmortem Toxicology Results for Narcotics and Psychotropic Substances

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Babak Mostafazadeh

2017-01-01

Full Text Available Background: The pattern of drug abuse in Iran has dramatically changed in recent years, turning from the traditional opioids [opium, opium dross, and refined opium dross (Shireh] into drugs with newer forms. The present study is aimed at investigating the frequency of pathological changes in the lungs of bodies with positive postmortem toxicology results for narcotics and psychotropic substances autopsied in the forensic dissection hall of Tehran, Iran [the Iranian Legal Medicine Organization (LMO]. Methods: The present study is a cross-sectional descriptive study. The sample consisted of 153 bodies, which had been referred to the LMO with positive results in postmortem toxicology for narcotics and psychotropic substances. Results: We found that narcotic drugs and psychotropic substances were used more in men than women. Moreover, the average age of death due to drug use was 36 years old. In addition, methamphetamine was the mostly-used type of substances, and smoking was the most widely used method to use the drugs. Besides, the dominant consistency and color of the lungs of half of the bodies investigated were elastic brown-gray. Moreover, the most common pathologic changes observed in the lungs of the bodies investigated were congestion and edema. Conclusion: Given the prevalence of pathological changes in the lungs of the examined bodies and congestion, edema, and pulmonary hemorrhage, the results of the present study can be particularly effective in determining the drug use and the resultant death in the absence of any previous records and/or a negative result of toxicology.

Psychotropic drug use as indicator of mental health in adolescents affected by a plexus injury at birth: A large population-based study in Sweden.

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Elia Psouni

Full Text Available Chronic handicap in early life may have a long-term impact on children's psychosocial well-being. Here, we investigated whether Brachialis Plexus Birth Injury (BPBI-an unpredictable injury at birth-is associated with worse mental health later on, as indicated by prescription and use of psychotropic drugs in adolescence. We explored further whether this association is different depending on socioeconomic characteristics of the child's family, as well as sex. Of the 641 151 children born to native parents in Sweden 1987-1993 (alive and still living in Sweden at the end of 2008, identified in the Swedish Medical Birth Registry, 1587 had suffered a BPBI. Logistic regression analysis was performed to assess the impact of socioeconomic characteristics and associations with later psychosocial health. Results show that beyond the known increased risks for females as compared to males, BPBI, but also lower family income, further increased the risk of burdened mental health requiring psychotropic drug use in adolescence. The effects were additive. Thus, compared to unaffected peers, teenagers who suffered a BPBI at birth are at higher risk of suffering poor mental health during adolescence, independently of surgical intervention and its outcome. Girls growing up in families with lower socioeconomic status have this risk added to their already increased risk of poor mental health during adolescence.

Unintentional drowning: Role of medicinal drugs and alcohol.

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Pajunen, Tuulia; Vuori, Erkki; Vincenzi, Frank F; Lillsunde, Pirjo; Smith, Gordon; Lunetta, Philippe

2017-05-19

Alcohol is a well-known risk factor in unintentional drownings. Whereas psychotropic drugs, like alcohol, may cause psychomotor impairment and affect cognition, no detailed studies have focused on their association with drowning. Finland provides extensive post-mortem toxicological data for studies on drowning because of its high medico-legal autopsy rates. Drowning cases, 2000 through 2009, for which post-mortem toxicological analysis was performed, came from the database of the Toxicological Laboratory, Department of Forensic Medicine, University of Helsinki, using the ICD-10 nature-of-injury code T75.1. The data were narrowed to unintentional drowning, using the ICD-10 external-injury codes V90, V92, and W65-74. Each drowning case had its blood alcohol concentration (BAC) and concentrations of other drugs recorded. Evaluation of the contribution of psychotropic drugs to drowning was based on their blood concentration by means of a 6-grade scale. Among victims ≥15 years old, unintentional drownings numbered 1697, of which, 303 (17.9%) were boating-related and 1394 (82.1%) non-boating-related. Among these, 65.0% of boating-related and 61.8% of non-boating-related victims were alcohol-positive (=BAC ≥ 50 mg/dL). The male-to-female ratio in alcohol-positive drownings was 7.3. At least one psychotropic drug appeared in 453 (26.7%) drowning cases, with some victims' bodies showing up to 7 different drugs. Overall 70 different psychotropic drugs were detectable, with 134 (7.9%) cases both alcohol-negative and psychotropic-drug-positive, of these, 59 (3.5%) were graded 4 to 6, indicating a possible to very probable contribution to drowning. Our findings suggest that psychotropic drugs may play a significant role in drowning, in up to 14.5% of cases, independently or in association with alcohol. Psychotropic drugs alone or in association with alcohol may be an overlooked risk factor in drowning, due to their effects on psychomotor function and cognition. Future

Oral nanomedicine approaches for the treatment of psychiatric illnesses.

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Dening, Tahnee J; Rao, Shasha; Thomas, Nicky; Prestidge, Clive A

2016-02-10

Psychiatric illnesses are a leading cause of disability and morbidity globally. However, the preferred orally dosed pharmacological treatment options available for depression, anxiety and schizophrenia are often limited by factors such as low drug aqueous solubility, food effects, high hepatic first-pass metabolism effects and short half-lives. Furthermore, the discovery and development of more effective psychotropic agents has stalled in recent times, with the majority of new drugs reaching the market offering similar efficacy, but suffering from the same oral delivery concerns. As such, the application of nanomedicine formulation approaches to currently available drugs is a viable option for optimizing oral drug delivery and maximizing treatment efficacy. This review focuses on the various delivery challenges encountered by psychotropic drugs, and the ability of nanomedicine formulation strategies to overcome these. Specifically, we critically review proof of concept in vitro and in vivo studies of nanoemulsions/microemulsions, solid lipid nanoparticles, dendrimers, polymeric micelles, nanoparticles of biodegradable polymers and nanosuspensions, and provide new insight into the various mechanisms for improved drug performance. The advantages and limitations of current oral nanomedicine approaches for psychotropic drugs are discussed, which will provide guidance for future research directions and assist in fostering the translation of such delivery systems to the clinical setting. Accordingly, emphasis has been placed on correlating the in vitro/in vivo performance of these nanomedicine approaches with their potential clinical outcomes and benefits for patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Effects of psychotropic agents on extinction of lever-press avoidance in a rat model of anxiety vulnerability

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Xilu eJiao

2014-09-01

Full Text Available Avoidance and its perseveration represent key features of anxiety disorders. Both pharmacological and behavioral approaches (i.e. anxiolytics and extinction therapy have been utilized to modulate avoidance behavior in patients. However, the outcome has not always been desirable. Part of the reason is attributed to the diverse neuropathology of anxiety disorders. Here, we investigated the effect of psychotropic drugs that target various monoamine systems on extinction of avoidance behavior using lever-press avoidance task. Here we used the Wistar-Kyoto (WKY rat, a unique rat model that exhibits facilitated avoidance and extinction resistance along with malfunction of the dopamine (DA system. Sprague Dawley (SD and WKY rats were trained to acquire lever-press avoidance. WKY rats acquired avoidance faster and to a higher level compared to SD rats. During pharmacological treatment, bupropion, and desipramine significantly reduced avoidance response selectively in WKY rats. However, after the discontinuation of drug treatment, only those WKY rats that were previously treated with desipramine exhibited lower avoidance response compared to the control group. In contrast, none of the psychotropic drugs facilitated avoidance extinction in SD rats. Instead, desipramine impaired avoidance extinction and increased non-reinforced response in SD rats. Interestingly, paroxetine, a widely used antidepressant and anxiolytic, exhibited the weakest effect in WKY rats and no effects at all in SD rats. Thus, our data suggest that malfunctions in brain catecholamine system could be one of the underlying etiologies of anxiety-like behavior, particularly avoidance perseveration. Pharmacological manipulation targeting DA and norepinephrine is more effective to facilitate extinction learning in this strain. The data from the present study may shed light on new pharmacological approaches to treat patients with anxiety disorders who are not responding to serotonin re

Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics.

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Seppala, Lotta J; Wermelink, Anne M A T; de Vries, Max; Ploegmakers, Kimberley J; van de Glind, Esther M M; Daams, Joost G; van der Velde, Nathalie

2018-04-01

Falls are a major public health problem in older adults. Earlier studies showed that psychotropic medication use increases the risk of falls. The aim of this study is to update the current knowledge by providing a comprehensive systematic review and meta-analysis on psychotropic medication use and falls in older adults. This study is a systematic review and meta-analysis. A search was conducted in Medline, PsycINFO, and Embase. Key search concepts were "falls," "aged," "medication," and "causality." Studies were included that investigated psychotropics (antipsychotics, antidepressants, anxiolytics, sedatives, and hypnotics) as risk factors for falls in participants ≥60 years of age or participants with a mean age of ≥70 years. Meta-analyses were performed using generic inverse variance method pooling unadjusted and adjusted odds ratio (OR) estimates separately. In total, 248 studies met the inclusion criteria for qualitative synthesis. Meta-analyses using adjusted data showed the following pooled ORs: antipsychotics 1.54 [95% confidence interval (CI) 1.28-1.85], antidepressants 1.57 (95% Cl 1.43-1.74), tricyclic antidepressants 1.41 (95% CI 1.07-1.86), selective serotonin reuptake inhibitors 2.02 (95% CI 1.85-2.20), benzodiazepines 1.42 (95%, CI 1.22-1.65), long-acting benzodiazepines 1.81 (95%, CI 1.05-3.16), and short-acting benzodiazepines 1.27 (95%, CI 1.04-1.56) Most of the meta-analyses resulted in substantial heterogeneity that did not disappear after stratification for population and healthcare setting. Antipsychotics, antidepressants, and benzodiazepines are consistently associated with a higher risk of falls. It is unclear whether specific subgroups such as short-acting benzodiazepines and selective serotonin reuptake inhibitors are safer in terms of fall risk. Prescription bias could not be accounted for. Future studies need to address pharmacologic subgroups as fall risk may differ depending on specific medication properties. Precise and uniform

[Club drugs].

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Guerreiro, Diogo Frasquilho; Carmo, Ana Lisa; da Silva, Joaquim Alves; Navarro, Rita; Góis, Carlos

2011-01-01

Club drugs are the following substances: Methylenedioxymethamphetamine (MDMA); Methamphetamine; Lysergic Acid Diethylamide (LSD); Ketamine; Gamma-hydroxybutyrate (GHB) and Flunitrazepam. These substances are mainly used by adolescents and young adults, mostly in recreational settings like dance clubs and rave parties. These drugs have diverse psychotropic effects, are associated with several degrees of toxicity, dependence and long term adverse effects. Some have been used for several decades, while others are relatively recent substances of abuse. They have distinct pharmacodynamic and pharmacokinetic properties, are not easy to detect and, many times, the use of club drugs is under diagnosed. Although the use of these drugs is increasingly common, few health professionals feel comfortable with the diagnosis and treatment. The authors performed a systematic literature review, with the goal of synthesising the existing knowledge about club drugs, namely epidemiology, mechanism of action, detection, adverse reactions and treatment. The purpose of this article is creating in Portuguese language a knowledge data base on club drugs, that health professionals of various specialties can use as a reference when dealing with individual with this kind of drug abuse.

Survey on the use of psychotropic drugs by twelve military police units in the municipalities of Goiânia and Aparecida de Goiânia, state of Goiás, Brazil.

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Costa, Sérgio Henrique Nascente; Cunha, Luiz Carlos da; Yonamine, Maurício; Pucci, Liuba Laxor; Oliveira, Fernando Gomes Ferreira; Souza, Camila Gabriela de; Mesquita, Guilherme Alves; Vieira, Ana Paula de Toledo; Vinhal, Ludmilla Barros; Dalastra, Janayna; Leles, Cláudio Rodrigues

2010-12-01

To determine the prevalence of psychotropic drug use among military police officers in the state of Goiás, Brazil. Study carried out at twelve military police units located in the municipalities of Goiânia and Aparecida de Goiânia between March to October 2008. Volunteers (n=221) were interviewed about drug use using a questionnaire especially designed by the Centro Brasileiro de Informações sobre Drogas Psicotrópicas (CEBRID). Descriptive statistics was used to determine the prevalence of licit and illicit drug use in the study sample. The frequency of use was divided into: 1) lifetime use: tobacco-39.9%, alcohol-87.8%, cannabis-8.1%, cocaine-1.8%, stimulants-7.2%, solvents-10.0%, sedatives, anxiolytics, antidepressants-6.8%, LSD-0.5%, Bentyl®-0.5%, anabolic steroids-5.4%; 2) use in the previous year: tobacco-15.4%, alcohol-72.9%, stimulants-6.3%, solvents-0.5%, sedatives, anxiolytics, antidepressants-3.7%; 3) use in the previous 30 days: tobacco-14.5%, alcohol-57.5%, stimulants-5.0%, solvents-0.5, sedatives, anxiolytics, antidepressants-3.7%. The high prevalence rate of psychotropic drug use found amoung military police officers in two cities of the state of Goiás in Brazil can be considered an important factor with potential influence on job activities.

Mono- and combination drug therapies in hospitalized patients with bipolar depression. Data from the European drug surveillance program AMSP

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Haeberle Anne

2012-09-01

Full Text Available Abstract Background For the pharmacological treatment of bipolar depression several guidelines exist. It is largely unknown, to what extent the prescriptions in daily clinical routine correspond to these evidence based recommendations and which combinations of psychotropic drugs are frequently used. Methods The prescriptions of psychotropic drugs were investigated of all in-patients with bipolar depression (n = 2246; time period 1994–2009 from hospitals participating in the drug surveillance program AMSP. For the drug use in 2010, 221 cases were analysed additionally. Results From 1994 to 2009, 85% of all patients received more than one class of psychotropic substances: 74% received antidepressants in combination therapy, 55% antipsychotics, 48% anticonvulsants and 33% lithium. When given in combination, lithium is the most often prescribed substance for bipolar depression (33%, followed by valproic acid (23%, mirtazapine and venlafaxine (16% each, quetiapine (15%, lamotrigine (14% and olanzapine (13%. Both, lithium and valproic acid are often combined with selective serotonin reuptake inhibitors (SSRI, but also with mirtazapine und venlafaxine. Combinations of more than one antidepressant occur quite often, whereby combinations with bupropion, paroxetine, fluoxetine or fluvoxamine are very rare. In 2010, quetiapine (alone and combined was the most frequently prescribed drug (39%; aripiprazole was administered in 10%. Conclusion Combinations of antidepressants (SSRI, mirtazapine, venlafaxine with mood stabilizers (lithium, valproic acid, lamotrigine and / or atypical antipsychotics (quetiapine, olanzapine are common. Of most of those combinations the efficacy has not been studied. The use of aripiprazole and the concomitant use of two or three antidepressants contrast the guidelines.

Psychiatric disorders, psychotropic medication use and falls among women: an observational study.

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Williams, Lana J; Pasco, Julie A; Stuart, Amanda L; Jacka, Felice N; Brennan, Sharon L; Dobbins, Amelia G; Honkanen, Risto; Koivumaa-Honkanen, Heli; Rauma, Päivi H; Berk, Michael

2015-04-08

use and other recognised confounders, suggesting an independent effect of depression on falls risk. Psychotropic drug use was also confirmed as an independent risk factor for falls, but anxiety disorders were not. Further research into the underlying mechanisms is warranted.

[Drug advertising as communication between the pharmaceutical industry and the physician: advertisements for psychotropic drugs in the Dutch medical journal, Nederlands Tijdschrift voor Geneeskunde, 1900-1940].

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van der Hoogte, Arjo Roersch; Pieters, Toine

2010-01-01

In this article we explore the historical development of drug advertisements for psychotropic drugs in the leading Dutch medical journal from 1900 to 1940. The advertisements for hypnotics and sedatives, in The Nederlands Tijdschrift voor Geneeskunde (Dutch medical journal) reflected the changes in the vocabulary and image promoted by the pharmaceutical companies. In the first two decades, the advertisements were sober and to the point, and included the trademark, company name, molecular formula and therapeutic properties of the medication. The emphasis was on creating a scientific image of reliable symptom control for the therapeutic drug. In doing so, the ethical drug companies tried (successfully) to distinguish themselves from the producers of patent medicines. Once scientific credibility was established, the form and content of the advertisements changed significantly. In the late 1920s and 1930s drug companies embraced modern advertising techniques, developing a figurative language to address the changing beliefs and practices of Dutch physicians. Instead of promoting therapeutic drugs as safe and scientific, the emphasis was on their effectiveness in comparison to similar drugs. In the process, scientific information was reduced to an indispensable standardized minimum, whereby therapeutic drugs were advertised according to the latest pharmacological taxonomy rather than molecular formulas. The image-making of 'ethical marketing' began during the interwar years when marketers applied modern advertising techniques and infotainment strategies. The scanty black and white informational bulletins transitioned into colourful advertisements. The pharmaceutical companies employed the same medical language as used by physicians, so that one word or image in an advertisement would suffice for the physician to recognize a drug and its therapeutic properties. These developments show the changing relationship between the modern ethical pharmaceutical industry and Dutch

Non-adherence to Psychotropic Medication Among Adolescents - A Systematic Review of the Literature.

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Häge, Alexander; Weymann, Lisa; Bliznak, Lucia; Märker, Viktoria; Mechler, Konstantin; Dittmann, Ralf W

2018-01-01

Whether patients take their medication as prescribed is of increasing importance in adolescent psychiatry since both the number of efficacious pharmaceutical treatments and the rate of prescriptions of psychotropic compounds are on the rise. Previous research showed high rates of medication nonadherence among both adolescents with medical disorders and adult patients with psychiatric disorders. The present review was performed according to PRISMA guidelines and evaluates existing scientific literature concerning adherence to psychotropic medication among adolescents. The goal was to determine rates of nonadherence in this age group as well as the factors associated with it. Therefore, we conducted a comprehensive literature search of PubMed from its inception until 15 September 2015 using the keywords "adherence," "compliance," "adolescent," and "psychotropic medication." A total of 607 pertinent articles were collected and screened; 15 publications were selected for detailed review. The studies differed, among other things, regarding sample characteristics, medication type, and indications. Furthermore, the definitions of what constitutes nonadherence and the methods used to assess it varied widely. Nonadherence rates ranged from 6 % to 62 % (median 33 %). Nonadherence to psychotropic medication is a clinically relevant problem among adolescents. Because of the methodological heterogeneity across studies and partially contradictory results, no conclusions could be drawn concerning the influence of factors such as psychopathology, medication type, side effects, the effectiveness of treatment, or family-related factors. Well-designed long-term studies of large patient samples and a consensus regarding definitions are therefore warranted. Such research would facilitate the design of tailored strategies to improve adherence in these patients.

Psychotropic medication use among patients with celiac disease.

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Zylberberg, Haley M; Ludvigsson, Jonas F; Green, Peter H R; Lebwohl, Benjamin

2018-03-27

Celiac disease is a multi-system disorder with manifestations that may result in psychiatric disorders. We assessed the prevalence of medication use to treat psychiatric disorders in celiac disease patients. We conducted a cross-sectional study of patients undergoing esophagogastroduodenoscopy over 9-years at a celiac disease referral center. We compared the prevalence of psychotropic medication use among celiac disease patients (n = 1293) to a control group (n = 1401) with abdominal pain or reflux. Among all patients the mean age was 48.4 years, most were female (69.5%), and 22.7% used any psychotropic medication. There was no difference between overall psychotropic medication use among celiac disease patients and controls (23.9% vs 21.8%, OR 1.16; 95% CI 0.96-1.39, p = 0.12). However, those with celiac disease were more likely to use antidepressants on univariate (16.4% vs 13.4%, p = 0.03) and multivariate analysis (OR 1.28; 95% CI 1.03-1.59; p = 0.03). Use of psychotropic medications was not associated with disease duration or mode of presentation of celiac disease. Celiac disease patients use psychotropic medications at similar rates as those with other gastrointestinal diseases, though subgroup analysis suggests they may use more antidepressants. Future studies should investigate whether celiac disease is associated with mood disorders that are not treated with medications.

[Psychotropic medication use by French active self-employed workers].

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Ha-Vinh, Philippe; Régnard, Pierre; Sauze, Laurent

2011-04-01

INTERESTS OF THE STUDY: In the self-employed workers population (shop keepers, craft men, industrialists and liberal professions), psychotropic medications use and discrepancies between occupational situations have never been evaluated before. It is nevertheless a prerequisite in preventive actions against addictions, stress and injuries caused by disorders of attentiveness at work. The French Self Employed Workers Health Care Insurance Fund affiliate members data base was analysed for active workers from 18 to 60 years of age living in the Provence Alpes Côte d'Azur Region. From this population the cases were defined as having refunded ambulatory prescription of behind the counter psychotropic treatment during the year 2009 (anxiolytic, antidepressant, hypnotic, neuroleptic, lithium, alcoholic or opioid dependance therapy) and the randomised control sample was constituted by drawing the key of the social security number. A case-control multivariate logistic regression adjusted for gender, age and place of abode was used for searching discrepancy between occupational situations. Anxiolytic, antidepressant or hypnotic consumers are the most numerous (906; 557 and 446 consumers per 10 000 persons-year respectively). Antidepressant, neuroleptic and opioid dependance therapy are the three main posts of expense for the health insurance (584 505; 169 947 and 151 201 € per year respectively). When compared to workers of the construction sector, workers of retail trade of clothes had an Odd Ratio of 2,04 [95%CI 1,46-2,85] for anxiolytics consumption and 2,29 [95%CI 1,67-3,14] for antidepressants consumption, workers in the sector of the hotel and catering had an Odd Ratio of 1,62 [95%CI 1,19-2,22] for alcoholic dependance therapy medicines consumption, workers in the accountant, legal and financial sector had an Odd Ratio of 0,05 [95%CI 0,01-0,32] for opioid dependence therapy medicines consumption. Occupations associated with increased psychotropic medicines

Psychotropic medication in children : A study from the Netherlands

NARCIS (Netherlands)

Schirm, E; Tobi, H; Zito, JM; de Jong-van den Berg, LTW

Objective. Although there is a global concern about the increased use of psychotropic agents in children, most research literature originates in the United States and is based on figures from the first half of the 1990s. Also, few studies document the use of various types of psychotropic agents. The

Acute liver failure following recreational use of psychotropic "head shop" compounds.

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Fröhlich, S; Lambe, E; O'Dea, J

2011-03-01

The recreational use of the so-called "legal-highs" has been in both the medical and political arena over the last year as a result of the appearance of "head shops" in many towns in Ireland. These shops specialized in selling new psychotropic compounds that circumvented established drug legislation. Little is known about the potentially harmful effects of these substances but case reports suggest a plethora of harmful psychological and physical effects. Our case describes for the first time acute liver failure associated with the ingestion of two of these amphetamine type compounds.

A guide to psychopharmacological treatment of patients with intellectual disability in psychiatry.

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Molina-Ruiz, Rosa M; Martín-Carballeda, Julia; Asensio-Moreno, Inmaculada; Montañés-Rada, Francisco

2017-03-01

Background Subjects with intellectual disability are at increased risk of having comorbid psychiatric disorders and worse response to psychotherapeutic and psychopharmacological treatment interventions. On the other hand, available data on best treatment approach in this population are scarce and lack scientific evidence due to methodological limitations. The present study aims to perform a systematic review of the literature to facilitate the use of psychotropic drugs in clinical practice and better establish future research targets in this field. Objectives To review the available psychopharmacological strategies for patients with intellectual disabilities, psychiatric disorders, and behavioural disturbances. Serve as a quick guide for clinicians working in the field of intellectual disability. Methods We conducted a selective evidence-based review of the literature using Pubmed and EMBASE databases and selected most recent and relevant papers for this review. Results There are several available psychotropic drugs for the treatment of patients with intellectual disability and comorbid psychiatric disorders, although scientific evidence is limited. Treatment should be individualized according to risk-benefit balance. Discussion Further studies are needed and new available drugs should be considered to gain knowledge in effectiveness of different therapeutic approaches available in this population.

Workplace bullying and subsequent psychotropic medication: a cohort study with register linkages

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Lallukka, Tea; Haukka, Jari; Partonen, Timo; Rahkonen, Ossi; Lahelma, Eero

2012-01-01

Objectives We aimed to examine longitudinally whether workplace bullying was associated with subsequent psychotropic medication among women and men. Design A cohort study. Setting Helsinki, Finland. Participants Employees of the City of Helsinki, Finland (n=6606, 80% women), 40–60 years at baseline in 2000–2002, and a register-based follow-up on medication. Primary and secondary outcome measures Workplace bullying comprised questions about current and earlier bullying as well as observing bullying. The Finnish Social Insurance Institution's register data on purchases of prescribed reimbursed psychotropic medication were linked with the survey data. All psychotropic medication 3 years prior to and 5 years after the baseline survey was included. Covariates included age, prior psychotropic medication, childhood bullying, occupational class, and body mass index. Cox proportional hazard models (HR, 95% CI) were fitted and days until the first purchase of prescribed psychotropic medication after baseline were used as the time axis. Results Workplace bullying was associated with subsequent psychotropic medication after adjusting for age and prior medication among both women (HR 1.51, 95% CI 1.18 to 1.93) and men (HR 2.15, 95% CI 1.36 to 3.41). Also observing bullying was associated with subsequent psychotropic medication among women (HR 1.53, 95% CI 1.25 to 1.88) and men (HR 1.92, 95% CI 1.23 to 2.99). The associations only modestly attenuated after full adjustment. Conclusions Our findings highlight the significance of workplace bullying to subsequent psychotropic medication reflecting medically confirmed mental problems. Tackling workplace bullying likely helps prevent mental problems among employees. PMID:23242240

The use of psychotropic medication during pregnancy: how about the newborn?

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Kieviet N

2013-08-01

Full Text Available Noera Kieviet,1 Koert M Dolman,1 Adriaan Honig2 1Department of Paediatrics, 2Department of Psychiatry, Psychiatry Obstetrics Paediatrics Expert Center, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands Abstract: Infants are at risk of developing symptoms of Poor Neonatal Adaptation (PNA after exposure to psychotropic drugs in utero. Such symptoms are largely similar after exposure to antidepressants, antipsychotics and benzodiazepines and consist of mostly mild neurologic, autonomic, respirator and gastro-intestinal abnormalities. Most symptoms develop within 48 hours after birth and last for 2–6 days. After exposure to Selective Serotonin Reuptake Inhibitors (SSRIs, mirtazapine or venlafaxine in utero, breastfeeding is presumably protective for development of PNA. The dosage of antidepressants does not seem to be related to the risk of PNA. In order to objectify possible symptoms of PNA, observation of mother and child at the maternity ward is advisable. If PNA symptoms do not occur, an observation period of 48–72 hours is sufficient. This applies to all types of psychotropic drugs. When PNA symptoms are present it is advisable to observe the infant until the symptoms are fully resolved. Observation can be performed by trained nurses using the Finnegan scoring list. This observation list should be administered every 8 hours. Interpretation of the scores should be carried out by a paediatrician. In most cases symptoms are non-specific. Therefore other diagnoses, such as infection or neurologic problems, have to be excluded. When there is any doubt on possible intoxications during pregnancy, toxicological urine screening is indicated. Most cases of PNA are mild, of short duration and self-limiting without need for treatment. Supporting measures such as frequent small feedings, swaddling and increase of skin to skin contact with the mother is usually sufficient. In case of severe PNA it is advised to admit the infant to the Neonatal Care

Educational gradients in psychotropic medication use among older adults in Costa Rica and the United States.

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Domino, Marisa Elena; Dow, William H; Coto-Yglesias, Fernando

2014-10-01

The relationship of education, psychiatric diagnoses, and use of psychotropic medication has been explored in the United States, but little is known about this relationship in poorer countries, despite the high burden of mental illness in these countries. This study estimated educational gradients in diagnosis and psychotropic drug use in the United States and Costa Rica, a middle-income country with universal health insurance. Analyses were conducted by using data of older adults (≥60) from the 2005 U.S. Medical Expenditure Panel Survey (N=4,788) and the 2005 Costa Rican Longevity and Healthy Aging Study (N=2,827). Logistic regressions examined the effect of education level (low, medium, or high) and urban residence on the rates of self-reported mental health diagnoses, screening diagnosis, and psychotropic medication use with and without an associated psychiatric diagnosis. Rates of self-reported diagnoses were lower in the United States (12%) than in Costa Rica (20%), possibly reflecting differences in survey wording. In both countries, the odds of having depression were significantly lower among persons with high education. In Costa Rica, use of psychotropic medication among persons with self-reported diagnoses increased by education level. The educational gradients in medication use were different in the United States and Costa Rica, and stigma and access to care in these countries may play an important role in these differences, although type of insurance did not affect educational gradients in the United States. These analyses increase the evidence of the role of education in use of the health care system.

Time Trends in Antipsychotic Drug Use in Patients with Dementia

DEFF Research Database (Denmark)

Nørgaard, Ane; Jensen-Dahm, Christina; Gasse, Christiane

2015-01-01

: To investigate time trends in use of antipsychotics and other psychotropic drugs in dementia care. METHODS: The study included longitudinal data on all Danish residents ≥65 years. The study population was defined on January 1 of each year from 2000-2012. Data included prescriptions, discharge diagnoses......, and somatic and psychiatric comorbidities. Multivariate time trend analyses of psychotropic drug use in patients with dementia within 4-year age bands were performed. RESULTS: Overall, among patients with dementia the prevalence of antipsychotic drug use decreased from 31.3% in 2000 to 20.4% in 2012...

Control authorities of internal affairs bodies in the sphere of drug trafficking

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О. М. Шевчук

2014-06-01

Full Text Available The article deals with control authorities of internal Affairs bodies in the sphere of turnover of narcotic drugs, psychotropic substances and precursors. Established the concept of the legal status of the Management of the fight against illegal circulation of drugs of the Ministry of interior of Ukraine and describes its features. The classification of control authorities of internal Affairs bodies in the sphere of turnover of narcotic drugs, psychotropic substances and precursors and analyzed for their content.

Psychotropic and neurotropic drugs and neurotransmitter receptors

International Nuclear Information System (INIS)

Takahashi, Ryo

1986-01-01

Neurotransmitters are important in nervous and mental diseases because of their part in the pathogenesis of such diseases; at the same time, they play significant roles in the actions of effective therapeutic drugs. Studies of the mechanisms involved in the actions of such drugs not only generate useful methods to elucidate the pathogenesis of nervous and mental disorders but also serve as indispensable means of developing new drugs. In this field, investigations using both animal models of certain diseases and healthy animals are essential. Development of these animal models is urgently required. In this workshop, studies were presented of the mechanisms of action of major neuropsychotropic drugs such as anxiolytics, antidepressants, and antipsychotics, assessed in terms of the parts played by neurotransmitters and receptors. (Auth.)

Successful Management of Psychotropics Induced Stuttering Priapism with Pseudoephedrine in a Patient with Schizophrenia.

Science.gov (United States)

Thippaiah, Srinagesh Mannekote; Nagaraja, Soumya; Birur, Badari; Pandurangi, Ananda

2018-02-05

Stuttering Priapism is a recurrent, persistent penile erection in the absence of sexual desire due to altered genital hemodynamics, affecting the arterial component (high flow, non-ischemic) or the veno-occlusive mechanism (low flow, ischemic). Both typical and atypical antipsychotics increase the risk for priapism with greater implications in typicals than atypicals. Prompt recognition and treatment are important as 40% to 50% of patients with stuttering priapism may develop an erectile dysfunction if left untreated. There are several case reports in the literature about the association between psychotropic agents and priapism. However, there are no reports of successfully treating stuttering priapism using pseudoephedrine (sudafed) in the adult population. Here we present successful management of psychotropics induced stuttering priapism with pseudoephedrine in a male patient with schizophrenia.

Demographic and clinical features and prescribing patterns of psychotropic medications in patients with the melancholic subtype of major depressive disorder in China.

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Yu-Tao Xiang

Full Text Available BACKGROUND: Little has been known about the demographic and clinical features of the melancholic subtype of major depressive disorder (MDD in Chinese patients. This study examined the frequency of melancholia in Chinese MDD patients and explored its demographic and clinical correlates and prescribing patterns of psychotropic drugs. METHODS: A consecutively collected sample of 1,178 patients with MDD were examined in 13 psychiatric hospitals or psychiatric units of general hospitals in China nationwide. The cross-sectional data of patients' demographic and clinical characteristics and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure. The diagnosis of the melancholic subtype was established using the Mini International Neuropsychiatric Interview (MINI. Medications ascertained included antidepressants, mood stabilizers, antipsychotics and benzodiazepines. RESULTS: Six hundred and twenty nine (53.4% of the 1,178 patients fulfilled criteria for melancholia. In multiple logistic regression analyses, compared to non-melancholic counterparts, melancholic MDD patients were more likely to be male and receive benzodiazepines, had more frequent suicide ideations and attempts and seasonal depressive episodes, while they were less likely to be employed and receive antidepressants and had less family history of psychiatric disorders and lifetime depressive episodes. CONCLUSIONS: The demographic and clinical features of melancholic MDD in Chinese patients were not entirely consistent with those found in Western populations. Compared to non-melancholic MDD patients, melancholic patients presented with different demographic and clinical features, which have implications for treatment decisions.

[Modern treatment approaches to gambling].

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Egorov, A Iu

2014-01-01

Compulsive gambling has received widespread attention in the last decade. Gambling has become the first non-chemical addiction, which went down to the section "Addiction and related disorders" of the modern DSM-V. The review considers non-pharmacological and pharmacological approaches to the treatment of gambling. Among non-drug approaches, cognitive-behavioral therapy and 12-step programs have gained the most popularity in the "Gamblers Anonymous" community. Among pharmacological approaches, three classes of drugs: antidepressants (mainly SSRIs), opiate antagonists (naltrexone and nalmefene) and mood stabilizers (valproate, lithium, topiramate) proved to be effective in treatment of gambling. No differences in the efficacy of the three classes of psychotropic drugs have been identified. Preliminary results for N-acetylcysteine and memantine cause optimism in terms of perspective.

Accounting for psychotropic medication changes in prisons: patient and doctor perspectives.

Science.gov (United States)

Hassan, Lamiece; Edge, Dawn; Senior, Jane; Shaw, Jenny

2015-07-01

Psychotropic medicines are widely used to treat mental illness; however, people entering prison commonly report that prescribed psychotropic medicines are changed or withdrawn, adding to their distress in difficult times. Drawing on three extracts from a larger qualitative dataset in which patients and doctors were interviewed about psychotropic medication use in English prisons, we combined discursive psychological and Foucauldian discourse analysis techniques to examine how individuals accounted for medication changes. Patients used four discursive strategies to organize descriptions of medication changes: they established entitlement to psychotropic medication, questioned the clinical judgment of prison doctors; highlighted communication problems; and attributed negative health outcomes to medication regime changes. In contrast, we examined an effective defense by a general practitioner, which showed how clinical needs were prioritized over previously held prescriptions when making prescribing decisions. Wider implications for continuity and equivalence of care between prisons and the wider community are discussed. © The Author(s) 2014.

ADMINISTRATIVE AND ORGANIZATIONAL ASPECTS OF FUNCTIONING OF THE SYSTEM OF AVAILABILITY NARCOTIC AND PSYCHOTROPIC MEDICINAL PREPARATIONS FOR PATIENTS WHO NEED THEM

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I. A. Kaminskaya

2016-01-01

Full Text Available Narcotic drugs and psychotropic substances still remain indispensable in medicine. One of the top priorities of health care is to ensure the required availability of this group of drugs. The development of an effective system which can ensure crucially important availability of narcotic and psychotropic agents to people who need them for medical purposes must rely on the identification and analysis of the nature and specificity of the problems related to them as well as the ways of solving these problems. ThePurpose of the Study was to explore the constituents of the system ensuring medicinal availability of narcotic and psychotropic agents and to identify the factors hindering the availability of this group of medicinal agents.Materials and Methods. The study involved the systematic review analysis of the scientific publications and guidance  documents regulating various aspects of activities involving the turnover of controlled drugs, and the results of surveys and interviews in which medical and pharmaceutical professionals were engaged. The study employed the methods of content analysis, logical and functional analysis, etc.Results and Discussion. The system of narcotic and psychotropic drug (NPD availability for patients who need them is currently going through reforms which have been conditioned by low accessibilty of these drugs when used for medical purposes. Those engaged in the drug supply system including medical and pharmaceutical professionals point out that excessive bureaucratization of the system of NPD supply and availability, complexity of documentation and paperwork reporting thedrug flow, costliness of these activities, and strict liability account for low availability of such drugs. To ensure the rights of the citizens to relieve pain due to diseases or medical interventions, a number of changes in the laws and regulations have been made. They have simplified the requirements for NPD

Use of psychotropic drugs in Lombardy in time of economic crisis (2007-2011): a population-based study of adult employees.

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Vittadini, Giorgio; Beghi, Massimiliano; Mezzanzanica, Mario; Ronzoni, Gloria; Cornaggia, Cesare Maria

2014-12-15

Over years, there has been an increase in the prescription of psychotropic drugs (PDs), particularly antidepressants (ADs). The aim of the study was to evaluate the consumption of PDs in adult employees in a productive area of Italy and the possible changes induced by the "economic crisis". The study is a retrospective survey in all adult employees in Lombardy, Northern Italy, aged >18 years in the period 2007-2011, classified by gender, age class, nationality, education and province. During the 5-year period, there were 3,554,860 employed adults in Lombardy, of whom 277,865 (7.8%) used PDs. The use of PDs (particularly ADs) was associated with being an Italian woman aged >55 years with a basic education, a blue collar job, and an unstable working position. In 39% of cases, the use of PDs was limited to one trimester. The increase in the number of prescriptions of PDs after the economic crisis was the same as before it. The increase in PD use can be attributed more to ADs and anti-epileptic drugs with anxiolytic properties. Although continuously increasing, the use of AD fluctuated and was greater during the fall and winter. The increase involved all the provinces in Lombardy in a similar manner. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

AN APPRAISAL OF PSYCHOTROPIC DRUGS AND THEIR ...

African Journals Online (AJOL)

The study further discovers the negative implications in terms of health risk and low productivity (i.e. caffeine(93%),create anxiety, disorder and sleep ... at least every quarter of the year on drug abuse or drug related issues or where special assistances in terms of professional advise and health intervention are given.

Psychotropic Medication Trends among Children and Adolescents with Autism Spectrum Disorder in the Medicaid Program

Science.gov (United States)

Schubart, Jane R.; Camacho, Fabian; Leslie, Douglas

2014-01-01

This study characterized psychotropic medication use among Medicaid-enrolled children and adolescents with autism spectrum disorders by examining trends over time, including length of treatment and polypharmacy using 4 years of administrative claims data from 41 state Medicaid programs (2000-2003). The data set included nearly 3 million children…

Motivational interviewing: a tool for increasing psychotropic medication adherence for youth.

Science.gov (United States)

Hamrin, Vanya; McGuinness, Teena M

2013-06-01

There are serious outcomes to nonadherence to psychotropic medications in children and adolescents, including poor school performance, prolonged duration of illness, increased psychopathology, poor interpersonal relationships, increased psychiatric episodes, and suicide attempts. Medication treatment has demonstrated improved psychiatric functioning and a 50% reduction in suicidal behavior. more than 50% of youth with mental health problems are nonadherent with psychiatric medications. A review of literature examining motivational interviewing (MI) for the problem of treatment adherence in children and adolescents is discussed. MI has great potential to improve psychiatric medication adherence in adolescents. An example of how to implement MI with youth is provided.

Does an 8-week home-based exercise program affect physical capacity, quality of life, sick leave, and use of psychotropic drugs in patients with pulmonary embolism? Study protocol for a multicenter randomized clinical trial.

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Rolving, Nanna; Brocki, Barbara C; Mikkelsen, Hanne R; Ravn, Pernille; Bloch-Nielsen, Jannie Rhod; Frost, Lars

2017-05-30

The existing evidence base in pulmonary embolism (PE) is primarily focused on diagnostic methods, medical treatment, and prognosis. Only a few studies have investigated how everyday life is affected by PE, although many patients are negatively affected both physically and emotionally after hospital discharge. Currently, no documented rehabilitation options are available for these patients. We aim to examine whether an 8-week home-based exercise intervention can influence physical capacity, quality of life, sick leave, and use of psychotropic drugs in patients medically treated for PE. One hundred forty patients with incident first-time PE will be recruited in five hospitals. After inclusion, patients will be randomly allocated to either the control group, receiving usual care, or the intervention group, who will be exposed to an 8-week home-based exercise program in addition to usual care. The intervention includes an initial individual exercise planning session with a physiotherapist, leading to a recommended exercise program of a minimum of three weekly training sessions of 30-60 minutes' duration. The patients have regular telephone contact with the physiotherapist during the 8-week program. At the time of inclusion, after 2 months, and after 6 months, the patients' physical capacity is measured using the Incremental Shuttle Walk test. Furthermore the patients' quality of life, sick leave, and use of psychotropic drugs is measured using self-reported questionnaires. In both randomization arms, all follow-up measurements and visits will take place at the hospital from which the patient was discharged. Levels of eligibility, consent, adherence, and retention will be used as indicators of study feasibility. We expect that the home-based exercise program will improve the physical capacity and quality of life for the patients in the intervention group. The study will furthermore contribute significantly to the limited knowledge about the optimal rehabilitation of

Variability in market uptake of psychotropic medications in Europe reflects cultural diversity.

NARCIS (Netherlands)

Hoebert, J M; Mantel-Teeuwisse, A K; Leufkens, H G M; van Dijk, L

2017-01-01

In the last 20-30 years, many international studies have found substantial differences in the use of (older) psychotropic medication between European countries. The majority mentioned an important role for attitudes and beliefs towards psychotropic medication. So far, no studies have looked into the

Oral health in patients taking psychotropic medications: Results from a pharmacy-based pilot study.

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Heaton, Lisa J; Swigart, Kimberly; McNelis, Gavin; Milgrom, Peter; Downing, Donald F

2016-01-01

Individuals with mental illness face an increased risk of oral disease compared with those without mental illness. The goals of this study were to examine the self-reported oral health and dental access of individuals filling psychotropic medication prescriptions and to determine whether pharmacy patients would choose to speak with a pharmacist about their oral health if given the option to do so. Pharmacists across 6 community pharmacies within a local chain identified and surveyed adult patients filling prescriptions for psychotropic medications. Surveys included questions about oral health, dry mouth, and dental care utilization. Six community pharmacy locations. Adults (≥18 years of age) filling prescriptions for psychotropic medications. Not applicable. Self-reported oral health, dental utilization, desire to discuss oral health with a pharmacist. Participants (N = 178) filling prescriptions were mostly (65.9%) female with a mean age of 48.2 years (SD 14.3, range 19-82 years). One in 4 (24.9%) said their mouths "always" or "frequently" felt dry; these individuals were significantly more likely to have last seen a dentist for emergency (rather than routine) treatment (P oral health as significantly worse (P oral health; they reported poorer oral health than those who opted not to speak with a pharmacist (P oral health than patients without dry mouth. Although dry mouth and poor oral health were common in this sample of individuals taking psychotropic medications, this did not consistently translate into seeking information regarding oral health. Future research will focus on pharmacist-initiated oral health interventions with high-risk patients. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

REDRESS AND CRIMINAL DEVIANCE IN USE OF DRUGS AND PSYCHOTROPIC SUBSTANCES IN ROMANIA

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Bogdan MARINESCU

2018-05-01

Full Text Available In Romania, the approach to assistance to drug users had an incoherent evolution that ranged from a medical approach to drug-intensive psychiatric drug use since the 1990s, focusing on detox services and only exceptionally on methadone substitution, to a system integrated assistance. Accordingly,"until 1999, the addicted persons had many relapses/relapses due to the lack of all therapeutic treatments (eg socio-vocational center and therapeutic communities and the fact that, following diagnosis, consumers were not entitled to assistance free medical service"1 . In 2000, the first strategic response from the Ministry of Health emerged to meet the needs of assistance in this field, namely the National Health Program of the Ministry of Health (Program 8, which led to the development of pilot sections for treatment within some psychiatric hospitals, and a first methadone maintenance center. Thus, in addition to the medical perspective, the development of the principles of harm reduction is envisaged. The lack of a complete therapy unit leads to a large number of relapses, and the recovery of patients is often impossible. Starting with 2004, the system of integrated medical, psychological and social assistance of drug users was established. By GD no. 1093/2004, the 47 Drug Counseling and Prevention Evaluation Centers (6 in Bucharest and one in each county became territorial structures of ANA (National Antidrug Agency2 and, since 2005, according to the standards of the National System of Medical, Psychological and Social Assistance to Consumers drugs3 , coordination of consumer assistance and general management of each case across different services.

PSYCHOSOMATIC ASPECTS IN THE TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE

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V. I. Trofimov

2015-01-01

Full Text Available Gastroesophageal reflux disease is the most common disease of the esophagus, through the development of which is impaired motor function of the upper gastrointestinal system, allowing the disease to be quite be classified as psychosomatic, especially in the early stages of development, when no apparent organic complications that affect the structure of tissues. A significant percentage of mental disorders is observed in patients even before the development of somatic complaints. Patients in number of 105 people are examined. The first group — experienced (71 patient received complex treatment, which includes the basic pathogenetic, symptomatic, and psychotropic treatment in the form of anxiolytics and antidepressants. The choice of drug was based on the results of psychological testing. The second group — the comparison group (34 patients received only conventional treatment, without psychiatric support. Analysis was conducted of the astheno-vegetative syndrome, psychological characteristics of patients in relation to their disease, indicators of anxiety level and severity of depression. Patients with not erosive reflux disease have a frequency of detection of a depression and uneasiness was more than twice higher, than at patients with erosive reflux disease. After carrying out psychotropic treatment these indicators were practically made even. Prescription of psychotropic therapy in the form of antidepressants and anxiolytics has allowed to minimize the timing regression of clinical and psychosomatic manifestations of disease.

Psychoactive Drugs and Quality of Life

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Soren Ventegodt

2003-01-01

Full Text Available This study was performed on a representative sample of the Danish population in order to investigate the connection to the use of psychoactive drugs and quality of life (QOL by way of a questionnaire-based survey. The questionnaire was mailed in February 1993 to 2,460 persons aged between 18 and 88, randomly selected from the CPR (Danish Central Register, and 7,222 persons from the Copenhagen Perinatal Birth Cohort 1959–61.A total of 1,501 persons between the ages 18 and 88 years and 4,626 persons between the ages 31 and 33 years returned the questionnaire (response rates of 61.0% and 64.1%, respectively. Variables investigated in this study were ten different psychotropic drugs and quality of life.Our study showed that over half the Danish population had used illegal psychotropic drugs. The most commonly used was cannabis (marijuana though experience of this drug appeared not to co-vary with QOL to any significant extent. Cocaine, amphetamine, and psilocybin had been used by 1.2 to 3.3% of the population and this varied with QOL to a clear albeit small extent. LSD has been used by 1.2% of the population and the users had a QOL score 10% lower than those who had never used psychotropic drugs. The group with the lowest quality of life was found to be persons who had used heroin, morphine, methadone, and a mixture of alcohol and tranquilizers (10–20% below the group with the highest quality of life.

Epigenetic developmental programs and adipogenesis: implications for psychotropic induced obesity.

Science.gov (United States)

Chase, Kayla; Sharma, Rajiv P

2013-11-01

Psychotropic agents are notorious for their ability to increase fat mass in psychiatric patients. The two determinants of fat mass are the production of newly differentiated adipocytes (adipogenesis), and the volume of lipid accumulation. Epigenetic programs have a prominent role in cell fate commitments and differentiation required for adipogenesis. In parallel, epigenetic effects on energy metabolism are well supported by several genetic models. Consequently, a variety of psychotropics, often prescribed in combinations and for long periods, may utilize a common epigenetic effector path causing an increase in adipogenesis or reduction in energy metabolism. In particular, the recent discovery that G protein coupled signaling cascades can directly modify epigenetic regulatory enzymes implicates surface receptor activity by psychotropic medications. The potential therapeutic implications are also suggested by the effects of the clinically approved antidepressant tranylcypromine, also a histone demethylase inhibitor, which has impressive therapeutic effects on metabolism in the obese phenotype.

Shaping the use of psychotropic medicines in nursing homes: A qualitative study on organisational culture.

Science.gov (United States)

Sawan, Mouna; Jeon, Yun-Hee; Chen, Timothy F

2018-04-01

Psychotropic medicines have limited efficacy in the management of behavioural and psychological disturbances, yet they are commonly used in nursing homes. Organisational culture is an important consideration influencing use of psychotropic medicines. Schein's theory elucidates that organisational culture is underpinned by basic assumptions, which are the taken for granted beliefs driving organisational members' behaviour and practices. By exploring the basic assumptions of culture we are able to find explanations for why psychotropic medicines are prescribed contrary to standards. A qualitative study guided by Schein's theory was conducted using semi-structured interviews with 40 staff representing a broad range of roles from eight nursing homes. Findings from the study suggest two basic assumptions influenced the use of psychotropic medicines: locus of control and necessity for efficiency or comprehensiveness. Locus of control pertained to whether staff believed they could control decisions when facing negative work experiences. Necessity for efficiency or comprehensiveness concerned how much time and effort was spent on a given task. Participants' arrived at decisions to use psychotropic medicines that were inconsistent with ideal standards when they believed they were helpless to do the right thing by the resident and it was necessary to restrict time on a given task. Basic assumptions tended to provide the rationale for staff to use psychotropic medicines when it was not compatible with standards. Organisational culture is an important factor that should be addressed to optimise psychotropic medicine use. Copyright © 2018 Elsevier Ltd. All rights reserved.

PARENTAL ATTITUDES TOWARD THE PRESCRIPTION OF PSYCHOTROPIC MEDICATIONS FOR THEIR CHILDREN

OpenAIRE

Al-Haidar, Fatima A.

2008-01-01

Objective: To explore parental attitudes towards the prescription of psychotropic medication for their children. Method: A questionnaire built to collect socio-demographic data of parents and their attitudes was distributed among parents. Results: One thousand and ten questionnaires were filled by parents. Fathers who completed the questionnaire were double the number of mothers. Eight hundred and eighteen parents (84.3%) agreed to the dispensing psychotropic medication to their child...

Differential effectiveness of selected non-psychotropic phytocannabinoids on human sebocyte functions implicates their introduction in dry/seborrhoeic skin and acne treatment.

Science.gov (United States)

Oláh, Attila; Markovics, Arnold; Szabó-Papp, Judit; Szabó, Pálma Tímea; Stott, Colin; Zouboulis, Christos C; Bíró, Tamás

2016-09-01

Acne is a common skin disease characterized by elevated sebum production and inflammation of the sebaceous glands. We have previously shown that a non-psychotropic phytocannabinoid ((-)-cannabidiol [CBD]) exerted complex anti-acne effects by normalizing 'pro-acne agents'-induced excessive sebaceous lipid production, reducing proliferation and alleviating inflammation in human SZ95 sebocytes. Therefore, in this study we aimed to explore the putative anti-acne effects of further non-psychotropic phytocannabinoids ((-)-cannabichromene [CBC], (-)-cannabidivarin [CBDV], (-)-cannabigerol [CBG], (-)-cannabigerovarin [CBGV] and (-)-Δ(9) -tetrahydrocannabivarin [THCV]). Viability and proliferation of human SZ95 sebocytes were investigated by MTT and CyQUANT assays; cell death and lipid synthesis were monitored by DilC1 (5)-SYTOX Green labelling and Nile Red staining, respectively. Inflammatory responses were investigated by monitoring expressions of selected cytokines upon lipopolysaccharide treatment (RT-qPCR, ELISA). Up to 10 μm, the phytocannabinoids only negligibly altered the viability of the sebocytes, whereas high doses (≥50 μm) induced apoptosis. Interestingly, basal sebaceous lipid synthesis was differentially modulated by the substances: CBC and THCV suppressed it, and CBDV had only minor effects, whereas CBG and CBGV increased it. Importantly, CBC, CBDV and THCV significantly reduced arachidonic acid (AA)-induced 'acne-like' lipogenesis. Moreover, THCV suppressed proliferation, and all phytocannabinoids exerted remarkable anti-inflammatory actions. Our data suggest that CBG and CBGV may have potential in the treatment of dry-skin syndrome, whereas CBC, CBDV and especially THCV show promise to become highly efficient, novel anti-acne agents. Moreover, based on their remarkable anti-inflammatory actions, phytocannabinoids could be efficient, yet safe novel tools in the management of cutaneous inflammations. © 2016 John Wiley & Sons A/S. Published by John

DRUG ABUSE IN KISUMU TOWN WESTERN KENYA Otieno AO ...

African Journals Online (AJOL)

drug abuse among secondary school students in nine schools in Kisumu town, ... Kenya. The objective of this study was to determine the effect of age, gender and peer .... A preliminary survey of drug abuse was conducted among secondary school ..... illegal and medically prescribed psychotropic drugs from adolescence to.

Os livros didáticos e o ensino para a saúde: o caso das drogas psicotrópicas Didactic books and teaching for health: the case of psychotropic drugs

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Beatriz Carlini-Cotrim

1991-08-01

Full Text Available Foram analisados 18 livros didáticos de primeiro e segundo graus, das disciplinas de Ciências/Biologia, Educação Moral e Cívica e Organização Social e Política do Brasil, em relação ao tratamento dado ao tema consumo de drogas psicotrópicas. A análise da estrutura dos textos evidenciou preocupação excessiva com a discussão dos efeitos (nocivos das drogas em detrimento de outros tópicos como conceituação, causas que levam ao uso, incidência, tratamento ou prevenção. Os textos se caracterizaram por uma linguagem pouco científica, onde o apelo emocional e o estilo dramático são a tônica. O usuário de drogas foi retratado como sendo necessariamente um ser decadente moral, física e psicologicamente. Os resultados da análise são discutidos à luz de teorias recentes de prevenção ao abuso de drogas.Eighteen didactic books on Sciences/Biology, Civic and Moral Education and Brazilian Political and Social Studies, for primary and secondary schools, were analyzed, with a view to assessing the way in which the issue of psychotropic drug use is dealt with. The texts analyzed are structurally centered on the discussion of the harmful effects of drugs instead of discussing others topics (such as etiology, concepts, treatment, incidence and prevalence. The texts are characterized especially by the use of non-scientific language in which emotional appeal and an exceedingly exacerbated style are the rule. The drug user is described as being necessarily a moral, physical and psychological decadent. The results were discussed in the light of recent theories on the prevention of drug abuse.

Sex differences in the subjective tolerability of antipsychotic drugs

NARCIS (Netherlands)

Barbui, Corrado; Nosè, Michela; Bindman, Jonathan; Schene, Aart; Becker, Thomas; Mazzi, Maria A.; Kikkert, Martijn; Camara, Jayne; Born, Anja; Tansella, Michele

2005-01-01

In recent years, research efforts have been directed to better characterize the Subjective experience of taking psychotropic drugs. This Study investigated the sex difference in the subjective tolerability of antipsychotic drugs. Participants were recruited from patients under the care of

The fallacy of the medical model and the dangers of psychotropic drugs as a mode of treatment for mental disorders.

Science.gov (United States)

Sanua, V D

1996-09-01

With the decline of psychoanalytic thinking since the 50's and the 60's, mental disorders have been attributed to organic factors. This has been influenced by Social Darwinism, a belief in the survival of the fittest. The implication of such a philosophy is that social intervention is not the appropriate approach for the treatment of mental aberrations. The source of the problem lies within the individual. For example, schizophrenia has been attributed to brain anomalies, chemical imbalances or to the inheritance of genetic factors. To this day, in spite of the research efforts in that direction, the pursuit of these findings were proven to be illusive. Nevertheless, the search continues with a complete neglect of social factors. One problem is that writers disagreeing with this philosophy, find it difficult to publish their dissenting views. Since the source of the problem is within the individual, aberrations should be treated with drugs. However the efficacy of these drugs have not yet been confirmed and instead have been causing a lot of physical problems for patients. It is unfortunate that a number of influential clinical psychologists have adopted the medical model and are trying to obtain by legislation "prescription privileges" for psychologists. The author believes that this trend could be destructive to the profession of psychology, since it will weaken if not destroy the humanistic approach in the treatment of the mentally ill.

Relationship between Organizational Culture and the Use of Psychotropic Medicines in Nursing Homes: A Systematic Integrative Review.

Science.gov (United States)

Sawan, Mouna; Jeon, Yun-Hee; Chen, Timothy F

2018-03-01

Psychotropic medicines are commonly used in nursing homes, despite marginal clinical benefits and association with harm in the elderly. Organizational culture is proposed as a factor explaining the high-level use of psychotropic medicines. Schein describes three levels of culture: artifacts, espoused values, and basic assumptions. This integrative review aimed to investigate the facets and role of organizational culture in the use of psychotropic medicines in nursing homes. Five databases were searched for qualitative, quantitative, and mixed method empirical studies up to 13 February 2017. Articles were included if they examined an aspect of organizational culture according to Schein's theory and the use of psychotropic medicines in nursing homes for the management of behavioral and sleep disturbances in residents. Article screening and data extraction were performed independently by one reviewer and checked by the research team. The integrative review method, an approach similar to the method of constant comparison analysis was utilized for data analysis. Twenty-four studies met the inclusion criteria: 13 used quantitative methods, 9 used qualitative methods, 1 was quasi-qualitative, and 1 used mixed methods. Included studies were found to only address two aspects of organizational culture in relation to the use of psychotropic medicines: artifacts and espoused values. No studies addressed the basic assumptions, the unsaid taken-for-granted beliefs, which provide explanations for in/consistencies between the ideal use of psychotropic medicines and the actual use of psychotropic medicines. Previous studies suggest that organizational culture influences the use of psychotropic medicines in nursing homes; however, what is known is descriptive of culture only at the surface level, that is the artifacts and espoused values. Hence, future research that explains the impact of the basic assumptions of culture on the use of psychotropic medicines is important.

[Integrated management of patients with schizophrenia: beyond psychotropic drugs].

Science.gov (United States)

Taborda Zapata, Eliana; Montoya Gonzalez, Laura Elisa; Gómez Sierra, Natalia María; Arteaga Morales, Laura María; Correa Rico, Oscar Andrés

2016-01-01

Schizophrenia is a complex disease with severe functional repercussions; therefore it merits treatment which goes beyond drugs. It requires an approach that considers a diathesis-stress process that includes rehabilitation, psychotherapeutic strategies for persistent cognitive, negative and psychotic symptoms, psychoeducation of patient and communities, community adaptation strategies, such as the introduction to the work force, and the community model, such as a change in the asylum paradigm. It is necessary to establish private and public initiatives for the integrated care of schizophrenia in the country, advocating the well-being of those with the disease. The integrated management of schizophrenic patients requires a global view of the patient and his/her disease, and its development is essential. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Bidirectional longitudinal relationship between leisure-time physical activity and psychotropic medication usage: A register linked follow-up study.

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Stubbs, Brendon; Vancampfort, Davy; Mänty, Minna; Svärd, Anna; Rahkonen, Ossi; Lahti, Jouni

2017-01-01

This study aimed to examine the bidirectional relationship between psychotropic medication use and changes in leisure-time physical activity (LTPA) among a population cohort study. Phase 1 data were collected by mail surveys in 2000-2002 among 40-60-year-old employees of the City of Helsinki, Finland, and phase 2 follow up survey was conducted in 2007. Based on self-report, the respondents were classified as inactive and active (≥14.75 MET-hours/week) at the phases 1 and 2. Hazard ratios (HR) were calculated for subsequent (2007-10) psychotropic medication purchasing according to changes in physical activity (phases 1-2). Odds ratios (OR) for physical inactivity at phase 2 were calculated according to the amount of psychotropic medication between phases 1-2. Overall, 5361 respondents were included (mean age 50 years, 80% women). Compared with the persistently active, the persistently inactive, those decreasing and adopting LTPA had an increased risk for psychotropic medication. Only the persistently inactive remained at increased risk for psychotropic medication use, following the adjustment for prior psychotropic medication use. Compared with those having no medication, the risk for physical inactivity increased as the psychotropic medication increased. Our data suggest that physical activity has an important role in maintaining wellbeing and reducing psychotropic medication usage. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Drugs ID Obesity

African Journals Online (AJOL)

a new attitude to eating. Adjunctive measures aimed at modifying behaviour, such as psychotherapy and group therapy, may help in individual cases. Psychological factors in response to stress would appear to be the basis of some cases of obesity, but the use of psychotropic drugs is limited and for specific indications only.

The Effects of Fall-Risk-Increasing Drugs on Postural Control : A Literature Review

NARCIS (Netherlands)

de Groot, Maartje H.; van Campen, Jos P. C. M.; Moek, Marije A.; Tulner, Linda R.; Beijnen, Jos H.; Lamoth, Claudine J. C.

Meta-analyses showed that psychotropic drugs (antidepressants, neuroleptics, benzodiazepines, antiepileptic drugs) and some cardiac drugs (digoxin, type IA anti-arrhythmics, diuretics) are associated with increased fall risk. Because balance and gait disorders are the most consistent predictors of

Work-related violence and incident use of psychotropics

DEFF Research Database (Denmark)

Madsen, Ida E H; Burr, Hermann; Diderichsen, Finn

2011-01-01

Although the mental health consequences of domestic violence are well documented, empirical evidence is scarce regarding the mental health effects of violence in the workplace. Most studies have used data from small occupation-specific samples, limiting their generalizability. This article examines...... whether direct exposure to work-related violence is associated with clinically pertinent mental health problems, measured by purchases of psychotropics (antidepressants, anxiolytics, hypnotics), in a cross-occupational sample of 15,246 Danish employees free from using psychotropics at baseline. Self......-reported data on work-related violence were merged with other data on purchases of medications through a national registry to estimate cause-specific hazard ratios during 3.6 years (1,325 days) of follow-up in the years 1996-2008. Outcomes were examined as competing risks, and analyses were adjusted for gender...

Benefits of adherence to psychotropic medications on depressive symptoms and antiretroviral medication adherence among men and women living with HIV/AIDS.

Science.gov (United States)

Cruess, Dean G; Kalichman, Seth C; Amaral, Christine; Swetzes, Connie; Cherry, Chauncey; Kalichman, Moira O

2012-04-01

Psychotropic medications are commonly used for depressive symptoms among people living with HIV/AIDS. We examined the relationships between adherence to psychotropic medications, depressive symptoms, and antiretroviral adherence. We assessed depressive symptoms among 324 people living with HIV/AIDS across a 3-month period (70% men; mean age 45 years; 90% African-American). Psychotropic and antiretroviral adherence was assessed using monthly, unannounced telephone pill counts. Multiple-regression and mediation analyses were utilized to examine associations under investigation. Greater depressive symptoms were associated with lower antiretroviral and psychotropic medication adherence. Greater adherence to psychotropic medications regardless of medication class was positively related to higher antiretroviral adherence. Greater adherence to psychotropic medications also significantly mediated the association between depressive symptoms and antiretroviral adherence. This study demonstrates the benefits of adherence to psychotropic medications on both depressive symptoms and antiretroviral adherence. Future work examining psychotropic medication adherence on disease outcomes in people living with HIV/AIDS is warranted.

Treatment profiles in a Danish psychiatric university hospital department

DEFF Research Database (Denmark)

Okkels, Niels; Mogensen, Rasmus Beyer; Crean, Lea Catherine

2017-01-01

BACKGROUND: Despite concerns about rising treatment of psychiatric patients with psychotropic medications and declining treatment with psychotherapy, actual treatment profiles of psychiatric patients are largely unknown. AIMS: To describe patterns in the treatment of patients in a large psychiatric......-eight patients (94%) used psychotropic medication, 37 (19%) as monotherapy, and 148 (74%) in combination with non-pharmacological therapy. Ninety-seven (49%) had psychotherapy and 104 (52%) social support. Among inpatients, 21 (64%) had physical therapy, and 10 (30%) electroconvulsive therapy. In total, 163 (82...... widely across all settings and patient categories. However, psychotropic medication clearly dominates as the most frequently applied treatment....

Drug-related problems and changes in drug utilization after medication reviews in nursing homes in Oslo, Norway.

Science.gov (United States)

Fog, Amura Francesca; Kvalvaag, Gunnar; Engedal, Knut; Straand, Jørund

2017-12-01

We describe the drug-related problems (DRPs) identified during medication reviews (MRs) and the changes in drug utilization after MRs at nursing homes in Oslo, Norway. We explored predictors for the observed changes. Observational before-after study. Forty-one nursing homes. MRs performed by multidisciplinary teams during November 2011 to February 2014. In all, 2465 long-term care patients. DRPs identified by explicit criteria (STOPP/START and NORGEP) and drug-drug interaction database; interventions to resolve DRPs; drug use changes after MR. A total of 6158 DRPs were identified, an average of 2.6 DRPs/patient, 2.0 for regular and 0.6 for pro re nata (prn) drugs. Of these patients, 17.3% had no DRPs. The remaining 82.7% of the patients had on average 3.0 DRPs/patient. Use of unnecessary drugs (43.5%), excess dosing (12.5%) and lack of monitoring of the drug use (11%) were the most frequent DRPs. Opioids and psychotropic drugs were involved in 34.4% of all DRPs. The mean number of drugs decreased after the MR from 6.8 to 6.3 for regular drugs and from 3.0 to 2.6 for prn drugs. Patients with DRPs experienced a decrease of 1.1 drugs after MR (0.5 for regular and 0.6 for prn drugs). The reduction was most pronounced for the regular use of antipsychotics, antidepressants, hypnotics/sedatives, diuretics, antithrombotic agents, antacid drugs; and for prn use of anxiolytics, opioids, hypnotics/sedatives, metoclopramide and NSAIDs. The medication review resulted in less drug use, especially opioids and psychotropic drugs.

Links between Psychotropic Substance Use and Sensation Seeking in a Prevalence Study: The Role of Some Features of Parenting Style in a Large Sample of Adolescents

OpenAIRE

Scalese, Marco; Curzio, Olivia; Cutrupi, Valentina; Bastiani, Luca; Gori, Mercedes; Denoth, Francesca; Molinaro, Sabrina

2014-01-01

Aims. The objectives of the study were to (a) investigate the prevalence risk of current drug users and (b) explore the association between parental monitoring, adolescent-parent relationship, family structure, financial status, and sensation-seeking and psychotropic substance use. Methods. Data were drawn from the 2002 Italian student population survey of the European School Survey Project on Alcohol and Other Drugs. The sample size was 10,790 adolescents, aged 15–19 years. Multivariate logi...

Prevalence and appropriateness of psychotropic medication prescribing in a nationally representative cross-sectional survey of male and female prisoners in England

Directory of Open Access Journals (Sweden)

Lamiece Hassan

2016-10-01

prisons, especially among women, and for a wider range of indications than are currently recommended. These findings raise questions about whether the prescribing of psychotropic medicines in prisons is wholly appropriate and proportionate to the level of clinical need. Prisons need to develop a wider array of treatment responses, other than medicines, to effectively tackle mental illness, challenging behaviours and distress.

[Is cocoa a psychotropic drug? Psychopathologic study of a population of subjects self-identified as chocolate addicts].

Science.gov (United States)

Dallard, I; Cathebras, P; Sauron, C; Massoubre, C

2001-01-01

The aim of this work was to search for eating disorders, DSM III-R Axis I mental disorders, personality disorders, and addictive behavior, in self-labeled "chocolate addicts". Subjects were recruited through advertisements placed in a university and a hospital. Fifteen subjects were included, 3 men and 12 women aged between 18 and 49. Most of them were not overweight, although 7 thought they had a weight problem. They consumed an average of 50 g per day of pure cacao and, for 13 subjects, this consumption was lasting since childhood or adolescence. The psychological effects of chocolate, as indicated by the subjects, consisted in feelings of increased energy or increased concentration ability, and in an anxiolytic effect during stress. Seven subjects described minor withdrawal symptoms. None of the subjects reached the thresholds for eating disorders on the EAT and BULIT scales. The structured interview (MINI) identified an important ratio of subjects with a history of major depressive episode (13/15), and one woman was currently experiencing a major depressive episode. Four people suffered, or had suffered from anxiety disorders. Although only one subject satisfied all criteria for a personality disorder on the DIP-Q, seven displayed some pathological personality features. The self-labeled "chocoholics" do not seem to suffer from eating disorders, but may represent a population of psychologically vulnerable and depression--or anxiety--prone people. They seem to use chocolate as a light psychotropic drug able to relieve some of their distress. The amount of cacao consumed, although very chronically, remains moderate, and they rarely display other addictive behaviors.

[Medical drug abuse and aging].

Science.gov (United States)

Nubukpo, Philippe; Clément, Jean-Pierre

2013-09-01

Drug addiction is often underestimated among the aged. Opiate drugs (mostly pain killers) are the most frequently implicated in drug addiction after benzodiazepines (BZD) in the aged. The subjects aged of 65 years or more are the most represented among the BZD users in France. Frequency of BZD use varies according to various studies from 39 to 55% in this age group. Leading a lonely life is associated with the use of psychotropic drugs among retired people (OR=1.7). Vulnerability at this age must take into account not only polypathology, but also the faster aging of a minority of the population under opiate drugs substitution treatment (OST), more subjects to drugs interaction. Drug addiction among elderly often reflects the drift of "lawful" doctor's instructions that leads to an increase in drugs use. The difficulty has to do with a lack of specificity of diagnosis of addiction at this age, but perhaps also with physicans'instructions in the aged. Some authors suggest that continued and prolonged use should be considered the main criterion for BZD addiction at this age, with or without increase in doses and failed attempt at cessation. Besides, the prescription of BZD increases after retirement and loneliness.

Assessing Potential Vulnerability and Response of Fish to Simulated Avian Predation after Exposure to Psychotropic Pharmaceuticals

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Melanie L. Hedgespeth

2016-04-01

Full Text Available Psychotropic pharmaceuticals present in the environment may impact organisms both directly and via interaction strengths with other organisms, including predators; therefore, this study examined the potential effects of pharmaceuticals on behavioral responses of fish to avian predators. Wild-caught juvenile perch (Perca fluviatilis were assayed using a striking bird model after a seven-day exposure to psychotropic pharmaceuticals (the antidepressants fluoxetine or sertraline, or the β-blocker propranolol under the hypotheses that exposure would increase vulnerability to avian predation via increasing the probability of predator encounter as well as degrading evasive behaviors upon encounter. None of the substances significantly affected swimming activity of the fish, nor did they increase vulnerability by affecting encounter probability or evasive endpoints compared to control treatments. Counter to our expectations, fish exposed to 100 μg/L fluoxetine (but no other concentrations or pharmaceuticals were less likely to enter the open area of the arena, i.e., less likely to engage in risky behavior that could lead to predator encounters. Additionally, all fish exposed to environmentally relevant, low concentrations of sertraline (0.12 μg/L and propranolol (0.1 μg/L sought refuge after the simulated attack. Our unexpected results warrant further research as they have interesting implications on how these psychotropic pharmaceuticals may affect predator-prey interactions spanning the terrestrial-aquatic interface.

Current obesity drug treatment

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Marcio C. Mancini

2006-03-01

Full Text Available Pharmacological treatment of obesity is an area of sudden changes,development of new drugs and treatment propositions. This articlepresents information on physiological agents that are currentlybeing used as well as drugs that were widely used but are nomore available.

Exploring the link between organizational climate and the use of psychotropic medicines in nursing homes: A qualitative study.

Science.gov (United States)

Sawan, Mouna; Jeon, Yun-Hee; Fois, Romano A; Chen, Timothy F

Research concerning the overprescribing of psychotropic medicines in nursing homes suggests that organizational climate plays a significant role in the use of psychotropic medicines. Organizational climate refers to how members of the organization perceive their work environment as well as interactions with each other or outsiders. This study aimed to explore the key dimensions of organizational climate and their subsequent influence on the use of psychotropic medicines. Semi-structured interviews were conducted with 40 on-site and visiting staff from eight nursing homes in Sydney, Australia. Purposive sampling was used to recruit participants representing a broad range of health disciplines and roles. Transcripts were content coded for participants' perceptions related to the work environment and descriptions of psychotropic medicines use. Thematic analysis was used to derive key concepts. Three salient dimensions of organizational climate were linked to the use of psychotropic medicines in nursing homes: staffing, managerial expectations and teamwork among visiting and on-site staff. Inadequate staffing levels were perceived to influence on-site staff requests for initiation of psychotropic medicines to cope with high workload. Participants reported managers that prioritized the non-pharmacological management of behavioral disturbances led other on-site staff to have a reduced preference for psychotropic medicines. In addition, trust and open communication among on-site and visiting staff facilitated the cessation of psychotropic medicines. This study illustrates that organizational climate is an important factor influencing the use of psychotropic medicines. Furthermore, the study highlights what aspects of organizational climate need to be addressed to reduce the inappropriate prescribing of psychotropic medicines. Copyright © 2016 Elsevier Inc. All rights reserved.

[Acting out and psychoactive substances: alcohol, drugs, illicit substances].

Science.gov (United States)

Gillet, C; Polard, E; Mauduit, N; Allain, H

2001-01-01

In humans, some psychotropic agents (alcohol, drugs, illicit substances) have been suggested to play a role in the occurrence of major behavioural disorders, mainly due to the suppression of psychomotor inhibition. Behavioural disinhibition is a physiological mechanism which allows humans to behave appropriately according to a given environmental situation. The behavioural disinhibition induced by either therapeutic dosage or misuse involves the loss of restraint over certain types of social behaviour and may increase the risk of auto or hetero-aggression and acting out. The increased use of psychotropic agents in recent years and the occurrence of unwanted effects are worrying and must be detected and evaluated. The objective of the present study was to establish a causal relationship between psychoactive substance use and occurrence of major behavioural disorders, such as paradoxical rage reactions and suicidal behaviour, based on a literature analysis. It consisted of reviewing reports of drug-induced violent reactions in healthy volunteers and demonstrating, where possible, a cause-effect relationship. Patients with schizophrenia and psychopathic personalities were not included in our study since psychiatric comorbidity could influence behavioural responses. Psychotropic agents included drugs, licit and illicit substances already associated with violence in the past. Many reports used the "Go/No Go test" to evaluate the disinhibiting effect of psychotropic substances; this allows the "cognitive mapping" of drugs. The results suggest that only alcohol, antidepressants, benzodiazepines and cocaïne are related to aggressive behaviour. The best known precipitant of behavioural disinhibition is alcohol, which induces aggressive behaviour. However, there are large differences between individuals, and attentional mechanisms are now recognised as being important in mediating the effects of alcohol. Suicidal tendency as an adverse antidepressant reaction is rare

Use of PET and the radioligand [carbonyl-11C]WAY-100635 in psychotropic drug development

International Nuclear Information System (INIS)

Andree, Bengt; Halldin, Christer; Thorberg, Seth-Olov; Sandell, Johan; Farde, Lars

2000-01-01

Positron-emission tomography (PET) provides potential in neuropsychiatric drug development by expanding knowledge of drug action in the living human brain and reducing time consumption and costs. The 5-hydroxytryptamine 1A (5-HT 1A ) receptor is of central interest as a target for the treatment of anxiety, depression, and schizophrenia. Research on the clinical significance of the 5-HT 1A receptor now benefits from the highly selective radioligand [carbonyl- 11 C]WAY-100635 (WAY) for quantitative determination of 5-HT 1A receptors in the primate and human brain in vivo using PET. In this paper, three studies are reviewed to demonstrate the suitability of WAY as radioligand for quantification of central 5-HT 1A receptors in brain and as an applicable tool for drug development. In the first study a monkey model was used to characterize WAY binding. It was confirmed that the reference ligand 8-OH-DPAT and psychoactive drugs such as buspirone and pindolol occupies 5-HT 1A receptors in the primate brain. Pindolol is an β-adrenoreceptor antagonist with a high affinity to 5-HT 1A receptors. This drug has been suggested in combination with selective serotonin reuptake inhibitors for the treatment of depression and was given to healthy males in the second study. Pindolol induced a marked inhibition of central 5-HT 1A receptors as calculated by the ratio-analysis method and simplified reference tissue model, 2 h after administration of 10 mg as a single oral dose. This observation suggests that pindolol may have a role for the suggested potentiation of selective serotonin reuptake inhibitor treatment of depression. The third study was on robalzotan (NAD-299), a recently developed 5-HT 1A receptor antagonist and putative drug with implications for the treatment of depression. In the cynomolgus monkey brain, robalzotan in the dose range 2-100 μg/kg IV occupied 5-HT 1A receptors in a dose-dependent and saturable manner with a maximal calculated occupancy of 70-80%. The

QT interval prolongation related to psychoactive drug treatment: a comparison of monotherapy versus polytherapy

Directory of Open Access Journals (Sweden)

Piccinelli Marco

2005-01-01

Full Text Available Abstract Background Several antipsychotic agents are known to prolong the QT interval in a dose dependent manner. Corrected QT interval (QTc exceeding a threshold value of 450 ms may be associated with an increased risk of life threatening arrhythmias. Antipsychotic agents are often given in combination with other psychotropic drugs, such as antidepressants, that may also contribute to QT prolongation. This observational study compares the effects observed on QT interval between antipsychotic monotherapy and psychoactive polytherapy, which included an additional antidepressant or lithium treatment. Method We examined two groups of hospitalized women with Schizophrenia, Bipolar Disorder and Schizoaffective Disorder in a naturalistic setting. Group 1 was composed of nineteen hospitalized women treated with antipsychotic monotherapy (either haloperidol, olanzapine, risperidone or clozapine and Group 2 was composed of nineteen hospitalized women treated with an antipsychotic (either haloperidol, olanzapine, risperidone or quetiapine with an additional antidepressant (citalopram, escitalopram, sertraline, paroxetine, fluvoxamine, mirtazapine, venlafaxine or clomipramine or lithium. An Electrocardiogram (ECG was carried out before the beginning of the treatment for both groups and at a second time after four days of therapy at full dosage, when blood was also drawn for determination of serum levels of the antipsychotic. Statistical analysis included repeated measures ANOVA, Fisher Exact Test and Indipendent T Test. Results Mean QTc intervals significantly increased in Group 2 (24 ± 21 ms however this was not the case in Group 1 (-1 ± 30 ms (Repeated measures ANOVA p Conclusions No significant prolongation of the QT interval was found following monotherapy with an antipsychotic agent, while combination of these drugs with antidepressants caused a significant QT prolongation. Careful monitoring of the QT interval is suggested in patients taking a

Cholesterol - drug treatment

Science.gov (United States)

... this page: //medlineplus.gov/ency/patientinstructions/000314.htm Cholesterol - drug treatment To use the sharing features on ... treatment; Hardening of the arteries - statin Statins for Cholesterol Statins reduce your risk of heart disease, stroke, ...

Is the efficacy of psychopharmacological drugs comparable to the efficacy of general medicine medication?

Directory of Open Access Journals (Sweden)

Seemüller Florian

2012-02-01

Full Text Available Abstract There is an ongoing debate concerning the risk benefit ratio of psychopharmacologic compounds. With respect to the benefit, recent reports and meta-analyses note only small effect sizes with comparably high placebo response rates in the psychiatric field. These reports together with others lead to a wider, general critique on psychotropic drugs in the scientific community and in the lay press. In a recently published article, Leucht and his colleagues compare the efficacy of psychotropic drugs with the efficacy of common general medicine drugs in different indications according to results from reviewed meta-analyses. The authors conclude that, overall, the psychiatric drugs were generally not less effective than most other medical drugs. This article will highlight some of the results of this systematic review and discuss the limitations and the impact of this important approach on the above mentioned debate.

Factors That Affect Adolescent Drug Users' Suicide Attempts

OpenAIRE

Park, Subin; Song, Hokwang

2016-01-01

Drug abuse has been widely linked to suicide risk. We examined the factors that affect adolescent drug users' suicide attempts in South Korea. This study analyzed the data of 311 adolescents who had used drugs such as inhalants, psychotropic drugs, and marijuana (195 males and 116 females). Among 311 subjects, 109 (35.0%) had attempted suicide during the last 12 months. After adjusting for other variables, depressive mood (OR=19.79) and poly-drug use (OR=2.79), and low/middle levels of academ...

Treatment of imprisoned drug users

OpenAIRE

Koňák, Tomáš

2015-01-01

The main goal of the theoretical part of submitted theses is to describe the field of specialized treatment of imprisoned drug users. The author's emphasis is to put the specialized treatment to a broader frame of the Risk-needs theory as well as to the frame of physical diseases and mental disorders that are often associated with addiction or drug abuse. Different kinds of specialized interventions that are usually used for treatment of imprisoned drug users in different countries are descri...

The impact of a good practice manual on professional practice associated with psychotropic PRN in acute mental health wards: an exploratory study.

Science.gov (United States)

Baker, J A; Lovell, K; Harris, N

2008-10-01

As required or pro re nata (PRN) psychotropic medicines are frequently used in acute mental health wards. PRN is known to contribute to polypharmacy and high doses of antipsychotic medication. Few studies have attempted to improve clinician's use of these potentially harmful drugs. The objectives of the study were to determine the impact and acceptability of a good practice manual on prescribing and administration practices of PRN psychotropic medication in acute mental health wards. The study used a pre-post exploratory design with two acute mental health wards in the NW of England. Over the total trial period of 10 weeks, 28 of 35 patients received 484 doses of PRN. Patients had a mean of 3.6 prescriptions of 14 different PRN medications in 34 different dose combinations prescribed. Medication errors beyond poor quality of prescribing occurred in 23 of the 35 patients (65.7%). Prescription quality improved following the introduction of the intervention but quality of nursing notes reduced. Acceptability of the manual to both nursing and medical staff was high. The introduction of the manual appeared to influence some of the practices associated with the prescribing and administration of PRN psychotropic medications. Further, larger, more robust studies are required in this area. In particular research is required to identify the reasons why professionals continue to rely so heavily on using PRN medication.

Affect Expression and Self-Regulation Capacities of Infants Exposed In Utero to Psychotropics

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Pratibha N Reebye

2012-02-01

Full Text Available This study explored the affect expression and self-regulation capacities of eight month old infants exposed in utero to psychotropic medications. This is a continuation of our previous study conducted on the same cohort when infants were three months old. Psychotropics implicated are antidepressant medications: selective serotonin reuptake inhibitors (SSRI, and a benzodiazepine derivative anxiolytic (clonazepam. The three comparison groups were: control (n=23 (infants gestationally non-exposed to psychotropics, SSRI-alone (n=22 (infants exposed to SSRIs only and having mothers who had a primary diagnosis of depressive disorder without having comorbid anxiety disorder, and SSRI+ group (n=15 (infants gestationally exposed to SSRIs and Clonazepam and having mothers that had both clinical depression and anxiety disorder. Thirty-seven participants from the initial cohort were recruited. Using the Parent Child Early Relational Assessment Scale (PCERA, infants were assessed in a dyadic context during free play and a structured task. There were clear significant differences in psychotropic exposed and non-exposed dyads regarding infant negative affect management. Notable findings were that the SSRI+ group mothers showed significant associations with only one infant affect: i.e. infant negative affect. This group of mothers also showed significant associations with infant’s averting and avoiding behaviors. These associations were seen in both free play and structured task situations signifying probable established pattern. SSRI-alone group was similar to control mothers and showed variable associations with infant’s positive, negative and sober moods unlike SSRI+ group. There were no differences in infants’ capacity for self–regulation in psychotropic exposed and non-exposed groups. Increased awareness of these vulnerable subgroups (SSRI-alone and SSRI+ is needed, in order to safeguard these dyads through better support systems and improved

Patterns of pre-treatment drug abuse, drug treatment history and characteristics of addicts in methadone maintenance treatment in Iran

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Shekarchizadeh Hajar

2012-06-01

Full Text Available Abstract Background Opiates are the main drugs of abuse, and Methadone Maintenance Treatment (MMT is the most widely administered drug addiction treatment program in Iran. Our study aimed to investigate patterns of pre-treatment drug abuse, addiction treatment history and characteristics of patients in MMT in Tehran. Methods We applied a stratified cluster random sampling technique and conducted a cross-sectional survey utilizing a standard patient characteristic and addiction history form with patients (n = 810 in MMT. The Chi-square test and t-test served for statistical analyses. Results A clear majority of the participants were men (96%, more than 60% of whom were between 25 and 44 years of age, educated (89% had more than elementary education, and employed (>70%. The most commonly reported main drugs of abuse prior to MMT entry were opium (69% and crystalline heroin (24%. The patients’ lifetime drug experience included opium (92%, crystalline heroin (28%, cannabis (16%, amphetamines (15%, and other drugs (33%. Crystalline heroin abusers were younger than opium users, had begun abusing drugs earlier, and reported a shorter history of opiate addiction. Conclusion Opium and crystalline heroin were the main drugs of abuse. A high rate of addiction using more dangerous opiate drugs such as crystalline heroin calls for more preventive efforts, especially among young men.

Patterns of pre-treatment drug abuse, drug treatment history and characteristics of addicts in methadone maintenance treatment in Iran

Science.gov (United States)

2012-01-01

Background Opiates are the main drugs of abuse, and Methadone Maintenance Treatment (MMT) is the most widely administered drug addiction treatment program in Iran. Our study aimed to investigate patterns of pre-treatment drug abuse, addiction treatment history and characteristics of patients in MMT in Tehran. Methods We applied a stratified cluster random sampling technique and conducted a cross-sectional survey utilizing a standard patient characteristic and addiction history form with patients (n = 810) in MMT. The Chi-square test and t-test served for statistical analyses. Results A clear majority of the participants were men (96%), more than 60% of whom were between 25 and 44 years of age, educated (89% had more than elementary education), and employed (>70%). The most commonly reported main drugs of abuse prior to MMT entry were opium (69%) and crystalline heroin (24%). The patients’ lifetime drug experience included opium (92%), crystalline heroin (28%), cannabis (16%), amphetamines (15%), and other drugs (33%). Crystalline heroin abusers were younger than opium users, had begun abusing drugs earlier, and reported a shorter history of opiate addiction. Conclusion Opium and crystalline heroin were the main drugs of abuse. A high rate of addiction using more dangerous opiate drugs such as crystalline heroin calls for more preventive efforts, especially among young men. PMID:22676557

Effects of Neuroactive Drugs in the Discharge Patterns of Microsternarchus (Hypopomidae: Gymnotiformes) Electric Organ.

Science.gov (United States)

de Jesus, Isac Silva; Ferreira, Milena; Silva-Júnior, Urbano Lopes; Alves-Gomes, José Antônio

2017-12-01

Considering the conserved nature of synaptic physiology among vertebrates, we tested the effects of three psychotropics (diazepam, doxapram, and nicotine) on Microsternarchus cf. bilineatus, measuring 10 parameters associated to the electric organ discharges rhythm and waveform before and after the administration of each drug and a control group. There were statistically significant differences (p electric organ's (EO) firing rate, regardless of the expected stimulant or depressor effect of the drugs on the central nervous system (CNS). The intensity of the response changed with the treatment. The observed changes in the fishes' behavior may be a result of the drugs' direct action on the CNS or a combination of this with systemic effects of each substance tested, also in the EO.

Extent and patterns of drug abuse and its associated factors in Egypt.

Science.gov (United States)

Soueif, M I; Yunis, F A; Taha, H S

1986-01-01

The article provides an integrated picture of the drug abuse situation in Egypt based on a series of large scale field surveys that the authors have conducted since 1957. Apart from the consumption of alcohol and tobacco, the results of the surveys show that cannabis remains the most widely abused psycho-active substance in Egypt. Cannabis use has been known in the country for a long time. The abuse of psychotropic substances emerged as a problem during the 1970s and has remained one of the major drug problems ever since. The abuse of cocaine and heroin first emerged as a problem in the period following the First World War. It disappeared during the early 1930s, when the country was struck by an economic crisis, only to re-emerge during the 1980s. The most recent surveys show that 30 per cent of male industrial workers and 20 per cent of male students have used drugs at some time in their lives, and, among them, approximately 25 per cent have continued to do so. The respondents rank alcohol as the most frequently abused substance, followed by natural narcotics (e.g. cannabis and opiates) and psychotropic substances. The first use of alcohol and cannabis most often occurs during some social occasion or in the company of friends, while the first use of psychotropic substances is usually an effort to cope with psychological or physical discomfort, or stress-triggering situations. In general, it is the drug users, rather than the non-users, who hear about drugs, see drugs and have personal friends and relatives who themselves abuse drugs.

Stories of change in drug treatment

DEFF Research Database (Denmark)

Andersen, Ditte

2015-01-01

’ (story content) and ‘the hows’ (storying process) the article presents four findings: (1) stories of change function locally as an institutional requirement; (2) professional drug treatment providers edit young people's storytelling through different techniques; (3) the narrative environment of the drug...... treatment. Building on the sociology of storytelling and ethnographic fieldwork conducted at two drug treatment institutions for young people in Denmark, this article argues that studying stories in the context of their telling brings forth novel insights. Through a narrative analysis of both ‘the whats...... treatment institution shapes how particular stories make sense of the past, present and future; and (4) storytelling in drug treatment is an interactive achievement. A fine-grained analysis illuminates in particular how some stories on gender and drug use are silenced, while others are encouraged...

Marijuana-based drugs: innovative therapeutics or designer drugs of abuse?

Science.gov (United States)

Seely, Kathryn A; Prather, Paul L; James, Laura P; Moran, Jeffery H

2011-02-01

The principal psychoactive component of marijuana, Δ(9)-tetrahydrocannabinol (THC), activates CB1 cannabinoid receptors (CB1Rs). Unfortunately, pharmacological research into the design of effective THC analogs has been hampered by psychiatric side effects. THC-based drug design of a less academic nature, however, has led to the marketing of "synthetic marijuana," labeled as K2 or "Spice," among other terms, which elicits psychotropic actions via CB1R activation. Because of structural dissimilarity to THC, the active ingredients of K2/Spice preparations are widely unregulated. The K2/Spice "phenomenon" provides a context for considering whether marijuana-based drugs will truly provide innovative therapeutics or merely perpetuate drug abuse.

Use of PET and the radioligand [carbonyl-{sup 11}C]WAY-100635 in psychotropic drug development

Energy Technology Data Exchange (ETDEWEB)

Andree, Bengt; Halldin, Christer; Thorberg, Seth-Olov; Sandell, Johan; Farde, Lars

2000-07-01

Positron-emission tomography (PET) provides potential in neuropsychiatric drug development by expanding knowledge of drug action in the living human brain and reducing time consumption and costs. The 5-hydroxytryptamine{sub 1A} (5-HT{sub 1A}) receptor is of central interest as a target for the treatment of anxiety, depression, and schizophrenia. Research on the clinical significance of the 5-HT{sub 1A} receptor now benefits from the highly selective radioligand [carbonyl-{sup 11}C]WAY-100635 (WAY) for quantitative determination of 5-HT{sub 1A} receptors in the primate and human brain in vivo using PET. In this paper, three studies are reviewed to demonstrate the suitability of WAY as radioligand for quantification of central 5-HT{sub 1A} receptors in brain and as an applicable tool for drug development. In the first study a monkey model was used to characterize WAY binding. It was confirmed that the reference ligand 8-OH-DPAT and psychoactive drugs such as buspirone and pindolol occupies 5-HT{sub 1A} receptors in the primate brain. Pindolol is an {beta}-adrenoreceptor antagonist with a high affinity to 5-HT{sub 1A} receptors. This drug has been suggested in combination with selective serotonin reuptake inhibitors for the treatment of depression and was given to healthy males in the second study. Pindolol induced a marked inhibition of central 5-HT{sub 1A} receptors as calculated by the ratio-analysis method and simplified reference tissue model, 2 h after administration of 10 mg as a single oral dose. This observation suggests that pindolol may have a role for the suggested potentiation of selective serotonin reuptake inhibitor treatment of depression. The third study was on robalzotan (NAD-299), a recently developed 5-HT{sub 1A} receptor antagonist and putative drug with implications for the treatment of depression. In the cynomolgus monkey brain, robalzotan in the dose range 2-100 {mu}g/kg IV occupied 5-HT{sub 1A} receptors in a dose-dependent and saturable

Drug treatment of metabolic syndrome.

Science.gov (United States)

Altabas, Velimir

2013-08-01

The metabolic syndrome is a constellation of risk factors for cardiovascular diseases including: abdominal obesity, a decreased ability to metabolize glucose (increased blood glucose levels and/or presence of insulin resistance), dyslipidemia, and hypertension. Patients who have developed this syndrome have been shown to be at an increased risk of developing cardiovascular disease and/or type 2 diabetes. Genetic factors and the environment both are important in the development of the metabolic syndrome, influencing all single components of this syndrome. The goals of therapy are to treat the underlying cause of the syndrome, to reduce morbidity, and to prevent complications, including premature death. Lifestyle modification is the preferred first-step treatment of the metabolic syndrome. There is no single effective drug treatment affecting all components of the syndrome equally known yet. However, each component of metabolic syndrome has independent goals to be achieved, so miscellaneous types of drugs are used in the treatment of this syndrome, including weight losing drugs, antidiabetics, antihypertensives, antilipemic and anticlothing drugs etc. This article provides a brief insight into contemporary drug treatment of components the metabolic syndrome.

First household survey on drug abuse in São Paulo, Brazil, 1999: principal findings

Directory of Open Access Journals (Sweden)

José Carlos Fernandes Galduróz

Full Text Available CONTEXT: In order to establish prevention programs regarding psychotropic drug use that are adapted to specific populations it is, first of all, important to have data on the realities of such consumption. Single data points are not enough for drawing up a profile of society in relation to drugs. OBJECTIVE: The aim of this household survey was to determine the incidence of illegal drug, alcohol, tobacco and psychotropic medication use, and thus the number of persons dependent on drugs, alcohol and nicotine, and to evaluate their perception regarding how easy it is to obtain psychotropic drugs. TYPE OF STUDY: Epidemiological survey. SETTING: All of the 24 cities in the State of Sao Paulo with more 200,000 inhabitants participated in the study. METHOD: The sampling was constructed from weighted probabilistic stratified conglomerates obtained via two-stage selection. In each municipality sampled, census sectors (generally 200-300 households were first selected. Then, households and a respondent were selected to provide information from his/her point of view. The SAMHSA questionnaire (Substance Abuse and Mental Health Services Administration of the U.S. Department of Public Health was used, after translation and adaptation to Brazilian conditions. RESULTS: A total of 2,411 persons aged 12-65 years old were interviewed, of whom 39.9% weremen. Lifetime use of any psychotropic drug other than alcohol and tobacco was 11.6%: much less than in the U.S. (34.8%. The alcohol dependence rate was 6%, similar to findings from other countries. Marijuana was the illegal drug most cited as used daily (6.6%: a prevalence much lower than in the U.S. (32.0%. Inhalant use was next in frequency of use (2.7%: about 10 times less than in the United Kingdom (20%. Cocaine use (2.1% was about 5 times less than in the U.S. (10.6%. There was no report of heroin use, although there was a surprisingly high perception regarding the ease of obtaining heroin: 38.3% said it was

Sex differences in concomitant medication with benzodiazepines or antidepressants in first-break schizophrenic patients treated with antipsychotic medication

NARCIS (Netherlands)

Rijcken, C.A.W.; Knegtering, H; Bruggeman, R; Tobi, H; de Jong-van den Berg, Lolkje Theodora Wilhelmina

2005-01-01

During a first episode of psychosis, treatment with antipsychotic drugs can improve both positive and negative symptoms. If sufficient amelioration does not occur, adding psychotropic comedication may result in a favorable outcome. To establish sex differences in psychotropic comedication use, we

Prices, profits, and innovation: examining criticisms of new psychotropic drugs' value.

Science.gov (United States)

Huskamp, Haiden A

2006-01-01

High profits and high drug costs have brought increased scrutiny of the pharmaceutical industry over the issue of whether the drugs they produce are worth the costs. I examine several related complaints, including the proliferation of me-too drugs and product reformulations, which some argue have little value relative to their cost; the baseless promotion of newer drug classes as more effective than existing, less expensive drugs; legal strategies to extend market exclusivity that result in high brand-name drug prices for an extended period of time; and large promotional expenditures that result in higher prices.

Patterns of psychotropic medication use in inpatient and outpatient psychiatric settings in Saudi Arabia

Directory of Open Access Journals (Sweden)

Alosaimi FD

2016-04-01

(27.9%, and antianxiety (6.2%. However, compared to outpatients, the current use of medications for inpatients was more frequent (93.8% vs 89.9%, P=0.019 with inpatients more likely to be treated with multiple medications (2.1 vs 1.8 medications. A similar trend was observed in the case of antipsychotics, high potency first-generation antipsychotics, second-generation antipsychotics, mood stabilizers, and antianxiety medicines where inpatients were more frequently treated with these medications for all psychiatric diagnoses when compared with outpatients. On the contrary, in the case of antidepressant treatment, an opposite trend was observed with more number of treated outpatients in comparison to inpatients. Among elderly patients, 75.9% received antipsychotics, mainly second-generation formulations (67.2%, whereas only 41% received antidepressants and 13.8% received mood stabilizers.Conclusion: Based upon the present study data, it is concluded that among all the psychotropic medications, antipsychotics were heavily used and the frequency was found to be significantly high in the case of inpatients compared with outpatients. Such a practice may lead to multiple negative consequences among the Saudi psychiatric patient population. Further, extensive use of sodium valproate in the case of bipolar disorder, and also among females either in childbearing age or during pregnancy is also the cause of concern and warrants logical use. Overall, this study may help in assessing the burden of psychiatric illness within specific patient demographics and might be effectively used to strategically plan health resources allocation, generate new treatment hypothesis, or be used as a source of evidence that could further integrate other observational studies.Keywords: psychotropic, inpatient, outpatient, antipsychotics, antidepressants, mood stabilizers, Saudi Arabia

Consommation des psychotropes en milieu scolaire, au Burkina Faso

African Journals Online (AJOL)

Consommation des psychotropes en milieu scolaire, au Burkina Faso : Prévalences et facteurs de risque. L Nikiéma, S Kouanda, I Seck, S Tiendrebéogo, HG Ouédraogo, M Yaméogo, B Méda, B Doulogou, I Guissou, B Sondo ...

Psychotropics without borders: ethics and legal implications of internet-based access to psychiatric medications.

Science.gov (United States)

Klein, Carolina A

2011-01-01

Medical practitioners are revisiting many of the ethics and the legal implications surrounding the clinical frameworks within which we operate. In today's world, distinguishing between virtual and physical reality continues to be increasingly difficult. The physician may be found grappling with the decision of whether to continue to treat a patient who may be obtaining psychotropic medications through the Internet. This article approaches some of the clinical and legal implications and the ethics regarding the availability of prescription psychotropics over the Internet.

Protein binding of psychotropic agents

International Nuclear Information System (INIS)

Hassan, H.A.

1990-01-01

Based upon fluorescence measurements, protein binding of some psychotropic agents (chlorpromazine, promethazine, and trifluoperazine) to human IgG and HSA was studied in aqueous cacodylate buffer, PH7. The interaction parameters determined from emission quenching of the proteins. The interaction parameters determined include the equilibrium constant (K), calculated from equations derived by Borazan and coworkers, the number of binding sites (n) available to the monomer molecules on a single protein molecule. The results revealed a high level of affinity, as reflected by high values of K, and the existence of specific binding sites, since a limited number of n values are obtained. 39 tabs.; 37 figs.; 83 refs

Clinical Use of Mood Stabilizers With Antidepressants in Asia: Report From the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) Projects in 2004 and 2013.

Science.gov (United States)

Rajaratnam, Kamini; Xiang, Yu-Tao; Tripathi, Adarsh; Chiu, Helen F K; Si, Tian-Mei; Chee, Kok-Yoon; Avasthi, Ajit; Grover, Sandeep; Chong, Mian-Yoon; Kuga, Hironori; Kanba, Shigenobu; He, Yan-Ling; Lee, Min-Soo; Yang, Shu-Yu; Udomratn, Pichet; Kallivayalil, Roy A; Tanra, Andi J; Maramis, Margarita M; Shen, Winston W; Sartorius, Norman; Kua, Ee-Heok; Tan, Chay-Hoon; Mahendran, Rathi; Shinfuku, Naotaka; Sum, Min Yi; Baldessarini, Ross J; Sim, Kang

2017-04-01

As most reports concerning treatment with combinations of mood stabilizer (MS) with antidepressant (AD) drugs are based in the West, we surveyed characteristics of such cotreatment in 42 sites caring for the mentally ill in 10 Asian countries. This cross-sectional, pharmacoepidemiologic study used 2004 and 2013 data from the REAP-AD (Research Study on Asian Psychotropic Prescription Patterns for Antidepressants) to evaluate the rates and doses of MSs given with ADs and associated factors in 4164 psychiatric patients, using standard bivariate methods followed by multivariable logistic regression modeling. Use of MS + AD increased by 104% (5.5% to 11.2%) between 2004 and 2013 and was much more associated with diagnosis of bipolar disorder than major depression or anxiety disorder, as well as with hospitalization > outpatient care, psychiatric > general-medical programs, and young age (all P contemporary use of MSs with ADs in Asia, support predictions that such treatment increased in recent years, and was associated with diagnosis of bipolar disorder, treatment in inpatient and psychiatric settings, and younger age.

Marijuana-based Drugs: Innovative Therapeutics or Designer Drugs of Abuse?

OpenAIRE

Seely, Kathryn A.; Prather, Paul L.; James, Laura P.; Moran, Jeffery H.

2011-01-01

Marijuana has been used recreationally and medicinally for centuries. The principle psychoactive component, Δ9-tetrahydrocannabinol (Δ9-THC), activates CB1 cannabinoid receptors (CB1Rs). CB1R agonists and antagonists could potentially treat a wide variety of diseases; unfortunately, therapeutic doses produce unacceptable psychiatric effects. “K2” or “Spice” (K2/Spice), an emerging drug of abuse, exhibits psychotropic actions via CB1R activation. Because of structural dissimilarity to Δ9-THC, ...

A large pharmacy claims-based descriptive analysis of patients with migraine and associated pharmacologic treatment patterns

Directory of Open Access Journals (Sweden)

Muzina DJ

2011-11-01

Full Text Available David J Muzina, William Chen, Steven J BowlinMedco Health Solutions Inc and Medco Research Institute, LLC, Franklin Lakes, NJ, USAPurpose: To investigate drug use, prescribing patterns, and comorbidities among patients with migraine in a large pharmacy claims database.Methods: 104,625 migraine subjects (identified according to the criteria in the International Classification of Diseases, Ninth Revision [ICD-9] for migraine or migraine-specific acute medication use and an equal number of control patients were selected from a de-identified claims database; the prevalence of patients with migraine-specific claims was determined. Patient demographics, migraine-related medication use, other psychotropic medication use, and comorbidities over a 12-month period were compared between the migraine population and the control group and between migraine subgroups.Results: Of the study population, 3.5% had a migraine diagnosis according to the ICD-9 or received a migraine-specific acute medication. Compared with controls, migraine patients had significantly greater disease comorbidity and higher use of prescription nonsteroidal anti-inflammatory drugs and controlled painkillers; they were also more likely to receive medications used to prevent migraines and other nonmigraine psychotropic medications, such as anxiolytics and hypnotics. Among migraine patients, 66% received acute migraine-specific medication while only 20% received US Food and Drug Administration–approved migraine preventive therapy. Notably, one-third of high triptan users did not receive any kind of preventive medication. Multiple medical and psychiatric comorbidities were observed at higher rates among migraine sufferers. In addition to significantly higher utilization of antidepressants compared with controls, migraine patients also received significantly more other psychotropic drugs by a factor of 2:1.Conclusion: Acute migraine medications are commonly used and frequently dispensed at

Complex psychotropic polypharmacy in bipolar disorder across varying mood polarities: A prospective cohort study of 2712 inpatients.

Science.gov (United States)

Golden, Julia C; Goethe, John W; Woolley, Stephen B

2017-10-15

It is common for patients with bipolar disorder (BP) to receive multiple psychotropics, but few studies have assessed demographic and clinical features associated with risk for receiving complex psychotropic polypharmacy. This longitudinal cohort study examined 2712 inpatients with a DSM-IV clinical diagnosis of BP to assess associations between complex polypharmacy (defined as ≥4 psychotropics) and demographic and clinical features; associations with risk of rehospitalization were also examined. Logistic regressions were performed with the sample as a whole and with each of four DSM-IV BP subtypes individually. Complex polypharmacy was present in 21.0%. BP-I depressed patients were more likely to receive complex regimens than BP-I manic, BP-I mixed or BP-II patients. In the sample as a whole, variables significantly associated with complex polypharmacy included female, white, psychotic features and a co-diagnosis of borderline personality, post-traumatic stress or another anxiety disorder. The only examined medication not significantly associated with complex polypharmacy was lithium, although only in BP-I depressed and BP-I mixed. Complex polypharmacy was associated with rehospitalization in BP-I mania within 15 and 30days post index hospitalization. All data were from one clinical facility; results may not generalize to other settings and patient populations. BP-I depression may pose a greater treatment challenge than the other BP subtypes. Lithium may confer an overall advantage compared to other medications in BP-I depressed and BP-I mixed. Further research is needed to guide pharmacotherapy decisions in BP patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Drug treatment or alleviating the negative consequences of imprisonment? A critical view of prison-based drug treatment in Denmark.

Science.gov (United States)

Kolind, Torsten; Frank, Vibeke Asmussen; Dahl, Helle

2010-01-01

The availability of prison-based drug treatment has increased markedly throughout Europe over the last 15 years in terms of both volume and programme diversity. However, prison drug treatment faces problems and challenges because of the tension between ideologies of rehabilitation and punishment. This article reports on a study of four cannabis treatment programmes and four psychosocial drug treatment programmes in four Danish prisons during 2007. The data include the transcripts of 22 semi-structured qualitative interviews with counsellors and prison employees, prison statistics, and information about Danish laws and regulations. These treatment programmes reflect the 'treatment guarantee' in Danish prisons. However, they are simultaneously embedded in a new policy of zero tolerance and intensified disciplinary sanctions. This ambivalence is reflected in the experiences of treatment counsellors: reluctantly, they feel associated with the prison institution in the eyes of the prisoners; they experience severe opposition from prison officers; and the official goals of the programmes, such as making clients drug free and preparing them for a life without crime, are replaced by more pragmatic aims such as alleviating the pain of imprisonment felt by programme clients. The article concludes that at a time when prison-based drug treatment is growing, it is crucial that we thoroughly research and critically discuss its content and the restrictions facing such treatment programmes. One way of doing this is through research with counsellors involved in delivering drug treatment services. By so doing, the programmes can become more pragmatic and focused, and alternatives to prison-based drug treatment can be seriously considered.

Patterns of psychotropic prescribing and polypharmacy in older hospitalized patients in Ireland: the influence of dementia on prescribing.

LENUS (Irish Health Repository)

Walsh, Kieran Anthony

2016-08-16

Neuropsychiatric Symptoms (NPS) are ubiquitous in dementia and are often treated pharmacologically. The objectives of this study were to describe the use of psychotropic, anti-cholinergic, and deliriogenic medications and to identify the prevalence of polypharmacy and psychotropic polypharmacy, among older hospitalized patients in Ireland, with and without dementia.

New drugs in treatment of asthma.

Science.gov (United States)

Weisberg, S C; Kaiser, H B

1976-09-01

Therapy for bronchial asthma should be preventive when possible. Around-the-clock treatment with theophylline is a new way of using an old drug. Beta2-adrenergic receptor stimulators, cromolyn sodium, and steroids in aerosol form are new drugs that are useful in treatment of asthma. The good news with respect to drug treatment of asthma is that in addition to the old reliable medications which have provided good relief-including epinephrine, ephedrine, isoproterenol, aminophylline, and steroids given orally and parenterally-new drugs are available which have been extremely helpful in controlling symptoms in many patients. The bad news is that none of the new agents is a panacea and that many of them have significant undesirable side effects. It is the physician's responsibility to be wary of the new drugs for asthma and to use them appropriately.

Generic legislation of new psychoactive drugs.

Science.gov (United States)

van Amsterdam, Jan; Nutt, David; van den Brink, Wim

2013-03-01

New psychoactive drugs (NPDs, new psychoactive substances) enter the market all the time. However, it takes several months to ban these NPDs and immediate action is generally not possible. Several European countries and drug enforcement officers insist on a faster procedure to ban NPDs. Introduction of generic legislation, in which clusters of psychotropic drugs are banned in advance, has been mentioned as a possible solution. Here we discuss the pros and cons of such an approach. First, generic legislation could unintentionally increase the expenditures of enforcement, black market practices, administrative burden and health risks for users. Second, it may have a negative impact on research and the development of new treatments. Third, due to the complexity of generic legislation, problems in the enforcement are anticipated due to lack of knowledge about the chemical nomenclature. Finally, various legal options are already available to ban the use, sale and trade of NPDs. We therefore conclude that the currently used scientific benefit-risk evaluation should be continued to limit the adverse health effects of NPDs. Only in emergency cases, where fatal incidents (may) occur, should this approach be overruled.

The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management

Science.gov (United States)

Montejo, Angel L.; Montejo, Laura; Baldwin, David S.

2018-01-01

Sexual dysfunction often accompanies severe psychiatric illness and can be due to both the mental disorder itself and the use of psychotropic treatments. Many sexual symptoms resolve as the mental state improves, but treatment‐related sexual adverse events tend to persist over time, and are unfortunately under‐recognized by clinicians and scarcely investigated in clinical trials. Treatment‐emergent sexual dysfunction adversely affects quality of life and may contribute to reduce treatment adherence. There are important differences between the various compounds in the incidence of adverse sexual effects, associated with differences in mechanisms of action. Antidepressants with a predominantly serotonergic activity, antipsychotics likely to induce hyperprolactinaemia, and mood stabilizers with hormonal effects are often linked to moderate or severe sexual dysfunction, including decreased libido, delayed orgasm, anorgasmia, and sexual arousal difficulties. Severe mental disorders can interfere with sexual function and satisfaction, while patients wish to preserve a previously satisfactory sexual activity. In many patients, a lack of intimate relationships and chronic deterioration in mental and physical health can be accompanied by either a poor sexual life or a more frequent risky sexual behaviour than in the general population. Here we describe the influence of psychosis and antipsychotic medications, of depression and antidepressant drugs, and of bipolar disorder and mood stabilizers on sexual health, and the optimal management of patients with severe psychiatric illness and sexual dysfunction. PMID:29352532

Age-related trends in psychotropic medication use among very young children in foster care.

Science.gov (United States)

dosReis, Susan; Tai, Ming-Hui; Goffman, David; Lynch, Sean E; Reeves, Gloria; Shaw, Terry

2014-12-01

The specific objectives were to investigate changes in the prevalence of psychotropic medication use for each year increase in age from three to six years old among children in foster care and to examine time-varying odds of longer duration of use by each year of age. A retrospective analysis of data on mental health and pharmacy services was conducted for 1,491 children age six and younger who were in foster care in 2010 and had at least 365 days in foster care during 2009-2011. A total of 178 children received at least one psychotropic medication from 2009 through 2011. Psychotropic prevalence and average days of use were calculated for each therapeutic class. Longitudinal regression models assessed the time-varying relationship between year of age and duration of use, controlling for demographic and clinical covariates. Approximately 12% of children age six and younger in foster care for 365 days or more received at least one psychotropic medication over the three-year study period. Prevalence of ADHD medication and antipsychotic medication and duration increased with each year of age (p<.001). In adjusted longitudinal models, each year increase in age was associated with a nearly twofold higher likelihood of longer duration of antipsychotic and ADHD medication use. Young children who initiated antipsychotic and ADHD medications before the age of six continued to receive them for longer periods of time. There is a critical need for long-term studies to evaluate the effect of chronic exposure on children's health and well-being.

Assaying of drugs in body fluids

International Nuclear Information System (INIS)

Braestrup, C.; Squires, R.F.

1981-01-01

The invention provides, in general terms, a process for determining the concentration of a psychotropically active benzodiazepine drug in blood or other body fluid or urine, including bringing a sample of the fluid or urine into contact with brain tissue and with tritium labelled molecules of a benzodiazepine which can bind reversibly to receptors of the brain tissue to induce binding of molecules of the unlabelled drug and of the tritium labelled benzodiazepine to the receptors, and determining the radioactivity of the brain tissue, preferably by scintillation counting. (author)

The International Nexus Between Drugs and Terror: Lessons in Conflict and Diplomacy

Science.gov (United States)

2010-12-01

opium, marijuana , coffee, coca, hallucinogens and many other drugs that predate history to keep themselves awake, lessen pain and increase virility...of the drugs that are mainly derived from natural plants such as cocaine, heroin and marijuana . The Convention on Psychotropic Substances of 1971...and 1972 amendment protocol of Single Convention, addressed the synthetic substances, creating provisions to regulate their trade, selling

Structured outpatient treatment of alcohol vs. drug dependencies.

Science.gov (United States)

Washton, A M

1990-01-01

This chapter describes the rationale, indications, design, and use of a structured outpatient treatment approach as an effective alternative to residential treatment for alcohol and drug dependencies. An increasing demand for outpatient treatment services is being created by a combination of clinical and economic factors, including the influx of employed drug abusers who do not need or desire residential care and mounting financial pressures to contain health care costs. To be effective as a primary treatment modality, outpatient programs must be highly structured and intensive and able to deal with the full spectrum of alcohol and drug addictions. Perpetuating the historical separation between alcoholism and drug abuse treatment programs is unnecessary and counterproductive, although certain modifications in treatment approaches are needed to accommodate the distinctive characteristics of particular classes of drugs and the people who use them. The "outpatient rehab," a treatment model that approximates the intensity of inpatient treatment on an outpatient basis, may help to maximize the clinical efficacy and cost-effectiveness of outpatient treatment as a viable alternative to residential care. Initial treatment results with this model are encouraging.

Admissions of injection drug users to drug abuse treatment following HIV counseling and testing.

Science.gov (United States)

McCusker, J; Willis, G; McDonald, M; Lewis, B F; Sereti, S M; Feldman, Z T

1994-01-01

The outcomes of counseling and testing programs related to human immunodeficiency virus (HIV) infection and risk of infection among injection drug users (IDUs) are not well known or understood. A counseling and testing outcome of potential public health importance is attaining admission to drug abuse treatment by those IDUs who are either infected or who are at high risk of becoming infected. The authors investigated factors related to admission to drug abuse treatment among 519 IDUs who received HIV counseling and testing from September 1987 through December 1990 at a men's prison and at community-based testing sites in Worcester, MA. By June 1991, 123 of the 519 IDUs (24 percent) had been admitted to treatment. Variables associated with their admission included a long history of drug injection, frequent recent drug injection, cleaning injection equipment using bleach, prior drug treatment, and a positive HIV test result. Logistic regression analyses, controlling for effects of recruitment site, year, sex, and area of residence, generally confirmed the associations. IDUs in the study population who were HIV-infected sought treatment or were admitted to treatment more frequently than those who were not infected. The results indicate that access to drug abuse treatment should be facilitated for high-risk IDUs and for those who have begun to inject drugs recently.

Paliperidone for the treatment of ketamine-induced psychosis: a case report.

Science.gov (United States)

Zuccoli, M L; Muscella, A; Fucile, C; Carrozzino, R; Mattioli, F; Martelli, A; Orengo, S

2014-01-01

Ketamine is an anaesthetic and analgesic drug synthesized in the 1960s from phencyclidine. The recreational use of ketamine increased among the dance culture of techno and house music, in particular in clubs, discotheques, and rave parties. The psychotropic effects of ketamine are now well known and they range from dissociation to positive, negative, and cognitive schizophrenia-like symptoms. We report a case of a chronic oral consumption of ketamine which induced agitation, behavioral abnormalities, and loss of contact with reality in a poly-drug abuser; these symptoms persisted more than two weeks after the drug consumption had stopped. Antipsychotic treatment with paliperidone led to a successful management of the psychosis, getting a complete resolution of the clinical picture. Paliperidone has proven to be very effective in the treatment of ketamine-induced disorders. Moreover, the pharmacological action and metabolism of paliperidone are poorly dependent from the activity of liver enzymes, so that it seems to be one of the best second generation antipsychotics for the treatment of smokers and alcohol abusers.

Psychopharmacological treatment with lithium and antiepileptic drugs

DEFF Research Database (Denmark)

Licht, R W; Vestergaard, P; Kessing, L V

2003-01-01

A subcommittee under the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark have recently developed national guidelines for the psychopharmacological treatment with lithium and antiepileptic drugs, and the present translation aims at contributing...... to the international discussion on the development of proper guidelines for the treatment of bipolar disorder. Among the antiepileptic drugs, the report deals with valproate, carbamazepine and lamotrigine and to a lesser extent with oxcarbazepine, gabapentin and topiramate. The various drugs will be reviewed......, outlining the scientific evidence for mood-stabilizing properties and discussing major side effects, the most important interactions with other drugs and practical use. Special considerations during pregnancy and lactation, during treatment of children and adolescents and during treatment of the elderly...

Studies of long-term noopept and afobazol treatment in rats with learned helplessness neurosis.

Science.gov (United States)

Uyanaev, A A; Fisenko, V P

2006-08-01

Long-lasting effects of new Russian psychotropic drugs Noopept and Afobazol on active avoidance conditioning and formation of learned helplessness neurosis were studied on an original experimental model in rats. Noopept eliminated the manifestations of learned helplessness after long-term (21-day) treatment by increasing the percent of trained animals. Afobazol was low effective in preventing manifestations of learned helplessness, but if used for a long time, it reduced the incidence of learned helplessness development by increasing the percent of untrained animals.

2010 drug packaging review: identifying problems to prevent errors.

Science.gov (United States)

2011-06-01

Prescrire's analyses showed that the quality of drug packaging in 2010 still left much to be desired. Potentially dangerous packaging remains a significant problem: unclear labelling is source of medication errors; dosing devices for some psychotropic drugs create a risk of overdose; child-proof caps are often lacking; and too many patient information leaflets are misleading or difficult to understand. Everything that is needed for safe drug packaging is available; it is now up to regulatory agencies and drug companies to act responsibly. In the meantime, health professionals can help their patients by learning to identify the pitfalls of drug packaging and providing safe information to help prevent medication errors.

28 CFR 550.52 - Non-residential drug abuse treatment services.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

Emerging drugs for the treatment of obesity

DEFF Research Database (Denmark)

Martinussen, Christoffer; Bojsen-Møller, Kirstine Nyvold; Svane, Maria Saur

2017-01-01

INTRODUCTION: The increasing prevalence of obesity represents a huge threat to public health and the current pharmacological treatment options are limited. Bariatric surgery is by far the most effective treatment for severe obesity, highlighting the urgent need for new and improved drug therapies....... Areas covered: Based on the physiological regulation of energy homeostasis, pharmacological strategies to treat obesity are evaluated with focus on drugs in phase 2 and 3 clinical development. The potential impact of these drugs on current treatment standards and the barriers for development...... are discussed and set in a historical perspective of previous antiobesity medications. Expert opinion: The radical effects of bariatric surgery have extended our understanding of the mechanisms controlling appetite and boosted the search for new drug targets in obesity treatment. Accordingly, several compounds...

Prescribing of psychotropic medication for nursing home residents with dementia: a general practitioner survey

Directory of Open Access Journals (Sweden)

Cousins JM

2017-10-01

Full Text Available Justin M Cousins, Luke RE Bereznicki, Nick B Cooling, Gregory M Peterson School of Medicine, Faculty of Health, University of Tasmania, Hobart, TAS, Australia Objective: The aim of this study was to identify factors influencing the prescribing of psychotropic medication by general practitioners (GPs to nursing home residents with dementia.Subjects and methods: GPs with experience in nursing homes were recruited through professional body newsletter advertising, while 1,000 randomly selected GPs from south-eastern Australia were invited to participate, along with a targeted group of GPs in Tasmania. An anonymous survey was used to collect GPs’ opinions.Results: A lack of nursing staff and resources was cited as the major barrier to GPs recommending non-pharmacological techniques for behavioral and psychological symptoms of dementia (BPSD; cited by 55%; 78/141, and increasing staff levels at the nursing home ranked as the most important factor to reduce the usage of psychotropic agents (cited by 60%; 76/126.Conclusion: According to GPs, strategies to reduce the reliance on psychotropic medication by nursing home residents should be directed toward improved staffing and resources at the facilities. Keywords: dementia, nursing homes, general practitioners, antipsychotic agents, benzodiazepines

Comparison of drug treatment histories of single and multiple drug abusers in detox.

Science.gov (United States)

Greberman, S B; Jasinski, D

2001-01-01

This study was undertaken to determine differences in previous treatment patterns in individuals currently using different numbers of substances. Medical records of 1198 inpatient detoxification (detox) admissions were analyzed. Numbers of past admissions to completed detox, methadone, or other types of drug abuse treatment were totaled and ranked to determine most frequent type. Within gender, treatment histories of single and multiple drug abusers usually do not differ. The one exception is male multiple drug abusers ages 26-30, who show increased admissions. Possible explanations are that men do not seek treatment before developing medical complications of addiction or until external factors influence admission. There were differences in treatment histories between genders in multiple drug abusers only. Before age 30, women reported increased treatment of certain types. Possible explanations are that treatment priority is given to women who are, or may be, pregnant. Also, younger men may not enter or complete treatment. Previous treatment history may influence many behaviors. The results of this study delineate several valuable indicators for assessing past history.

Mining the topography and dynamics of the 4D Nucleome to identify novel CNS drug pathways.

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Higgins, Gerald A; Allyn-Feuer, Ari; Georgoff, Patrick; Nikolian, Vahagn; Alam, Hasan B; Athey, Brian D

2017-07-01

The pharmacoepigenome can be defined as the active, noncoding province of the genome including canonical spatial and temporal regulatory mechanisms of gene regulation that respond to xenobiotic stimuli. Many psychotropic drugs that have been in clinical use for decades have ill-defined mechanisms of action that are beginning to be resolved as we understand the transcriptional hierarchy and dynamics of the nucleus. In this review, we describe spatial, temporal and biomechanical mechanisms mediated by psychotropic medications. Focus is placed on a bioinformatics pipeline that can be used both for detection of pharmacoepigenomic variants that discretize drug response and adverse events to improve pharmacogenomic testing, and for the discovery of novel CNS therapeutics. This approach integrates the functional topology and dynamics of the transcriptional hierarchy of the pharmacoepigenome, gene variant-driven identification of pharmacogenomic regulatory domains, and mesoscale mapping for the discovery of novel CNS pharmacodynamic pathways in human brain. Examples of the application of this pipeline are provided, including the discovery of valproic acid (VPA) mediated transcriptional reprogramming of neuronal cell fate following injury, and mapping of a CNS pathway glutamatergic pathway for the mood stabilizer lithium. These examples in regulatory pharmacoepigenomics illustrate how ongoing research using the 4D nucleome provides a foundation to further insight into previously unrecognized psychotropic drug pharmacodynamic pathways in the human CNS. Copyright © 2017. Published by Elsevier Inc.

Skin too thin? The developing utility of zebrafish skin (neuro)pharmacology for CNS drug discovery research.

Science.gov (United States)

Nguyen, Michael; Poudel, Manoj K; Stewart, Adam Michael; Kalueff, Allan V

2013-09-01

Skin coloration can be affected by many genetic, environmental and pharmacological factors. Zebrafish (Danio rerio) are a useful and versatile model organism in biomedical research due to their genetic tractability, physiological homology to mammals, low cost, reproducibility and high throughput. Zebrafish coloration is mediated by chromatophores - the skin color pigment cells largely controlled by endocrine and neural mechanisms. The characteristic darkening of zebrafish skin is caused by the dispersion (and paling - by aggregation) of melanosomes (pigment-containing organelles), which show high homology to mammalian structures. Various pharmacological agents potently affect zebrafish coloration - the phenotype that often accompanies behavioral effects of the drugs, and may be used for drug discovery. Although zebrafish behavior and skin responses are usually not directly related, they share common regulatory (neural, endocrine) mechanisms, and therefore may be assessed in parallel during psychotropic drug screening. For example, some psychoactive drugs can potently affect zebrafish skin coloration. Can we use this knowledge to refine phenotype-driven psychotropic drug discovery? Here, we present current models using zebrafish skin coloration assays, and discuss how these models may be applied to enhance in vivo CNS drug discovery. Copyright © 2013 Elsevier Inc. All rights reserved.

Evaluación de la percepción de riesgo del consumo de psicofármacos durante el embarazo, en mujeres hospitalizadas en el Centro Hospitalario Pereira Rossell

OpenAIRE

Antonella Rossi; Gabriela Souto; Julietai Rijo; Mariana Odizzio; Mario Moraes; Gabriel González; Claudio Sosa

2015-01-01

Most people and health professionals think that the use of psychotropic drugs should be avoided during pregnancy, specially during the first trimester. The choice of medications should be based on an individual analysis of risks and benefits of the given treatment. The principal aim of this study was to understand the perception of risk in the consumption of psychotropic drugs during pregnancy in post partum women hospitalized at the Centro Hospitalario Pereira Rossell (C.H.P.R). A des...

Young people and the struggle against drug abuse in the Arab countries.

Science.gov (United States)

Okasha, A

1985-01-01

While cannabis consumption in Egypt has a centuries-long tradition, recent evidence on drug abuse shows new patterns and trends: young people from all socio-economic strata of society are increasingly involved with both traditional drugs, such as hashish, and the new pharmaceutical psychotropic substances that are emerging. A recent survey of the university students in Egypt, carried out by the author and others, showed that 34 per cent of the students who had succeeded in their studies and 42 per cent of those who had failed used drugs. In addition to the situation in Egypt, the article briefly reviews drug abuse among young people in some other Arab countries. To cope more effectively with the problems of drug abuse among the young, the author suggests that comprehensive community-based programmes need to be organized to improve the personal and social functioning of drug-dependent persons, to promote drug education and to increase understanding between younger and older generations. Epidemiological studies of the nature and extent of drug abuse, as well as evaluative studies of ongoing prevention and treatment programmes, need to be organized and carried out with a view to improving the effectiveness of drug abuse intervention among the young in the Arab countries.

Vaccines against drugs of abuse: a viable treatment option?

Science.gov (United States)

Kantak, Kathleen M

2003-01-01

Drug addiction is a chronically relapsing brain disorder. There is an urgent need for new treatment options for this disease because the relapse rate among drug abusers seeking treatment is quite high. During the past decade, many groups have explored the feasibility of using vaccines directed against drugs of abuse as a means of eliminating illicit drug use as well as drug overdose and neurotoxicity. Vaccines work by inducing drug-specific antibodies in the bloodstream that bind to the drug of abuse and prevent its entry into the brain. The majority of work in this area has been conducted with vaccines and antibodies directed against cocaine and nicotine. On the basis of preclinical work, vaccines for cocaine and nicotine are now in clinical trials because they can offer long-term protection with minimal treatment compliance. In addition, vaccines and antibodies for phencyclidine, methamphetamine and heroin abuse are currently under development. An underlying theme in this research is the need for high concentrations of circulating drug-specific antibodies to reduce drug-seeking and drug-taking behaviour when the drug is repeatedly available, especially in high doses. Although vaccines against drugs of abuse may become a viable treatment option, there are several drawbacks that need to be considered. These include: a lack of protection against a structurally dissimilar drug that produces the same effects as the drug of choice;a lack of an effect on drug craving that predisposes an addict to relapse; and tremendous individual variability in antibody formation. Forced or coerced vaccination is not likely to work from a scientific perspective, and also carries serious legal and ethical concerns. All things considered, vaccination against a drug of abuse is likely to work best with individuals who are highly motivated to quit using drugs altogether and as part of a comprehensive treatment programme. As such, the medical treatment of drug abuse will not be radically

Prescribing in prison: minimizing psychotropic drug diversion in correctional practice.

Science.gov (United States)

Pilkinton, Patricia D; Pilkinton, James C

2014-04-01

Correctional facilities are a major provider of mental health care throughout the United States. In spite of the numerous benefits of providing care in this setting, clinicians are sometimes concerned about entering into correctional care because of uncertainty in prescribing practices. This article provides an introduction to prescription drug use, abuse, and diversion in the correctional setting, including systems issues in prescribing, commonly abused prescription medications, motivation for and detection of prescription drug abuse, and the use of laboratory monitoring. By understanding the personal and systemic factors that affect prescribing habits, the clinician can develop a more rewarding correctional practice and improve care for inmates with mental illness.

The Controversy of Applying the Death Sentence for Criminal Acts Related to Drugs

OpenAIRE

Hasan Asy’ari, Syamsul Hidayat &

2013-01-01

In anticipation of the threat and the dangers of drug abuse and illicit trafficking, Indonesia as a whole has had the law on ratification of the Convention , including the United Nations on combating illicit trafficking in narcotic drugs and psychotropic substances in 1988. Policy is required drug crimes (penal policy). Applicable policies regarding how to commit criminal law legislation in force at the moment and formulated policies that lead to renewal (penal law reform) who formulated the ...

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

Racial and ethnic differences in psychotropic medication use among community-dwelling persons with dementia in the United States.

Science.gov (United States)

Grace, Elsie L; Allen, Rebecca S; Ivey, Keisha; Knapp, Shannon M; Burgio, Louis D

2018-04-01

Little is known about the patterns of psychotropic medication use in community-dwelling minority persons with dementia (PWD). The purpose of this study was to investigate racial/ethnic differences in psychotropic medication use across a diverse population of community-dwelling PWD and to examine the extent to which caregiver characteristics influence this use. Data were drawn from the baseline assessment of the Resources for Enhancing Alzheimer's Caregiver Health II trial. Generalized linear models were used to identify racial/ethnic differences in psychotropic medication use. Akaike Information Criterion (AIC) model selection was used to evaluate possible explanations for observed differences across racial/ethnic group. Differences in anxiolytic and antipsychotic medication use were observed across racial/ethnic groups; however, race/ethnicity alone was not sufficient to explain those differences. Perceptions of caregiving and caregiver socioeconomic status were important predictors of anxiolytic use while PWD characteristics, including cognitive impairment, functional impairment, problem behavior frequency, pain, relationship to the caregiver, sex, and age were important for antipsychotic use. Racial/ethnic differences in psychotropic medication use among community-dwelling PWD cannot be explained by race/ethnicity alone. The importance of caregiver characteristics in predicting anxiolytic medication use suggest that interventions aimed at caregivers may hold promise as an effective alternative to pharmacotherapy.

A religiosidade, a espiritualidade e o consumo de drogas Religiosity, spirituality and psychotropic drug use

Directory of Open Access Journals (Sweden)

Zila van der Meer Sanchez

2007-01-01

Full Text Available CONTEXTO: A religiosidade e a espiritualidade vêm sendo claramente identificadas como fatores protetores ao consumo de drogas em diversos níveis. OBJETIVO: A presente revisão da literatura pretendeu descrever os principais estudos científicos que tratam do papel da religiosidade no tratamento e na prevenção do consumo de drogas. MÉTODO: As fontes citadas neste artigo de revisão são indexadas nas bases de dados PubMed e Scielo, entre 1976 e 2006, tratando de questões relativas à religiosidade, à espiritualidade e ao consumo de drogas. RESULTADOS: Estudos têm apontado para evidência de que as pessoas que freqüentam regularmente um culto religioso, ou que dão relevante importância à sua crença religiosa, ou ainda que praticam, no cotidiano, as propostas da religião professada, apresentam menores índices de consumo de drogas lícitas e ilícitas. Além disso, os dependentes de drogas apresentam melhores índices de recuperação quando seu tratamento é permeado por uma abordagem espiritual, de qualquer origem, quando comparados a dependentes que são tratados exclusivamente por meio médico. CONCLUSÕES: Devido ao forte papel de assistência social das religiões no Brasil, a exploração deste tema no contexto brasileiro seria de grande relevância para a saúde pública.BACKGROUND: Religiosity and spirituality have been clearly identified as strong protective factors against drug use in many levels. OBJECTIVE: The present revision of literature intended to describe the main scientific studies that deal with the role of religiosity in the treatment and prevention of drug use. METHOD: The sources cited in this revision article are indexed in the databases PubMed and Scielo, between 1976 and 2006, treating questions relative to religiosity, spirituality and drug use. RESULTS: Studies have to the evidence that people who regularly attend a religious worship, of any kind, or that give relevant importance to their religious belief

Prices, Profits and Innovation: Examining Criticisms of the Value of New Psychotropic Drugs

Science.gov (United States)

Huskamp, Haiden A.

2008-01-01

High profits and high drug costs have brought increased scrutiny of the pharmaceutical industry over the issue of whether the drugs they produce are worth the costs. I examine several related complaints, including the proliferation of me-too drugs and product reformulations, which some argue have little value relative to their cost; promotion of newer drug classes as more effective than existing, less expensive drugs in the absence of evidence of superior effectiveness; legal strategies to extend market exclusivity that result in high brand drug prices for an extended period of time; and large promotional expenditures that result in higher prices. PMID:16684726

Associations of traffic noise with self-rated health and psychotropic medication use.

Science.gov (United States)

Halonen, Jaana I; Lanki, Timo; Yli-Tuomi, Tarja; Turunen, Anu W; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi

2014-05-01

Road traffic noise is a common environmental nuisance, which has been thought to increase the risk of many types of health problems. However, population-level evidence often remains scarce. This study examined whether road traffic noise is associated with self-rated health and use of psychotropic medication in a cohort of public sector employees. Data are from the Finnish Public Sector Study cohort. Geographical information system (GIS) was used to link modeled outdoor road traffic noise levels (L den) to residential addresses of 15 611 men and women with cross-sectional survey responses on self-rated health and register-based information on the use of antidepressants, anxiolytics, and hypnotics. High trait anxiety scores were used to identify potentially vulnerable individuals. The analyses were run with logistic regression models adjusting for individual and area-level variables. All participants were blind to the aim of the study. Mean level of road traffic noise at participants' home addresses was 52 decibels (dB) (standard deviation 8.1). Noise level >60 dB versus ≤45 dB was associated with poor self-rated health in men [odds ratio (OR) 1.58, 95% confidence interval (95% CI) 1.14-2.21]. Further stratification revealed that the association was evident only among men with high trait anxiety scores (OR 2.23, 95% CI 1.28-3.89). No association was found with psychotropic medication use or among women. Exposure to road traffic noise was not associated with increased use of psychotropic medication, although it was associated with weakened self-rated health among men.

Pharmacological treatment of disruptive behavior in Smith-Magenis syndrome.

Science.gov (United States)

Laje, Gonzalo; Bernert, Rebecca; Morse, Rebecca; Pao, Maryland; Smith, Ann C M

2010-11-15

Smith-Magenis syndrome (SMS) is a complex genetic syndrome caused by an interstitial deletion of chromosome 17p11.2. Children and adults with SMS appear to have unique neurobehavioral problems that include: sleep disturbance, self-injurious and maladaptive behaviors, stereotypies, and sensory integration disorders. We gathered retrospective psychotropic use information from parents or other caregivers of 62 individuals with SMS who were asked about use of psychotropic medication from a list of commonly used psychiatric medications. For those drugs identified, respondents were asked to rate the experience with the particular medication using a likert-type scale. Drugs were grouped into seven main categories: (1) stimulants; (2) antidepressants; (3) antipsychotics; (4) sleep aides; (5) mood stabilizers; (6) alpha 2 agonists; and (7) benzodiazepines. Relative frequencies, means and standard deviations pertaining to age and medication effect were derived for each medication category. Six of the seven medication categories examined showed no meaningful deviations from the "no change" score. The benzodiazepine group showed a mild detrimental effect. There were no gender differences in efficacy. Use of psychotropic medication started early in life (mean age 5 years), particularly with sleep aides. Although no medication category was identified as efficacious in SMS, all the categories reported herein may be considered as an option for brief symptomatic relief.

New Horizons in Pediatric Psychopharmacology.

Science.gov (United States)

Khan, Sarah; Rathore, Vijaylaxmi; Khan, Shahida

2016-12-01

Preclinical Research Recent advances in pediatric psychopharmacology have been rather uneven. Increased use of psychotropic drugs among the pediatric population has raised concerns regarding their inappropriate use and safety. While clinical trials have been conducted on various pediatric psychopharmacological drugs, there has been an insignificant amount of importance to innovation in holistic treatment. A rational approach toward elucidating the various challenges would be contingent on the convergence of the development of novel efficacious psychotropic drugs with concrete conceptual frameworks and guidelines fostering enhanced outcomes. A research infrastructure concerning the relevance of the clinician's perspective, combining drugs with alternative therapies, the need for pediatric specific formulations and relevance of these in developing countries provides a basis on which innovative treatment/development can be constructed. The current commentary highlights these comprehensive and targeted treatment guidelines as aspects necessary for building the future of the field. Drug Dev Res 77 : 474-478, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Filiation et consommation de medicaments psychotropes

Directory of Open Access Journals (Sweden)

Alain Ducousso-Lacaze

Full Text Available A partir de deux entretiens semi-directifs l’auteur présente certains aspects des résultats d’une recherche clinique réalisée avec des patients de l’hôpital général consommant des médicaments psychotropes. Il s’agit de mette en évidence comment, pour certains patients, la consommation et la prescription prennent un sens par rapport aux enjeux de la filiation narcissique. Les analyses cliniques portent essentiellement sur la fonction de support imaginaire de la transmission que peuvent revêtir les médicaments ainsi que leur rôle dans les conflits entre appartenance et différenciation à l’égard du groupe familial.

Adverse drug reactions due to antipsychotics and sedative-hypnotics in the elderly

Directory of Open Access Journals (Sweden)

Natasha S Kate

2015-01-01

Full Text Available Psychotropic drugs are commonly used to manage mental and behavioral problems in geriatric patients. This is, however, accompanied by the risk of developing adverse drug reactions (ADRs, impacting the safety with which the drug can be used. In this article, we provide an overview of the factors associated with the ADRs due to psychotropic medication in the elderly, and the ADRs associated with the use of antipsychotics and sedative-hypnotics in the geriatric population. For this, literature searches were conducted through MEDLINE, PubMed, and Google Scholar using keyword terms: Geriatric, elderly, safety, adverse events, ADRs, antipsychotic, names of individual antipsychotics, benzodiazepine, sedative, hypnotic, zolpidem, zaleplon, zopiclone. Research data indicate that antipsychotics are associated with an increased risk of metabolic syndrome, thromboembolism, cerebrovascular and cardiac events, pneumonia, fractures, and increased mortality. Among antipsychotics, aripiprazole seems to have fewer ADRs while other antipsychotics (typical and atypicals have reports of troublesome side effect profiles. Sedative-hypnotics are associated with a risk of falls, fractures, cognitive impairment, and may increase the risk of developing dementia with long-term use. The risk of these complications is present with both benzodiazepines and medications such as zolpidem and zopiclone.

[Vaccines for the treatment of drug addiction].

Science.gov (United States)

Zorzoli, Ermanno; Marino, Maria Giulia; Bagnato, Barbara; Franco, Elisabetta

2016-01-01

The treatment of drug addiction is a very wide-ranging sector within modern medicine. The use of immunotherapy in this context represents an innovative approach. The purpose of this paper is to illustrate, through a literature review, the main avenues of research and the results obtained with immunotherapy in the treatment of drug addiction.

Drugs as instruments: a new framework for non-addictive psychoactive drug use.

Science.gov (United States)

Müller, Christian P; Schumann, Gunter

2011-12-01

Most people who are regular consumers of psychoactive drugs are not drug addicts, nor will they ever become addicts. In neurobiological theories, non-addictive drug consumption is acknowledged only as a "necessary" prerequisite for addiction, but not as a stable and widespread behavior in its own right. This target article proposes a new neurobiological framework theory for non-addictive psychoactive drug consumption, introducing the concept of "drug instrumentalization." Psychoactive drugs are consumed for their effects on mental states. Humans are able to learn that mental states can be changed on purpose by drugs, in order to facilitate other, non-drug-related behaviors. We discuss specific "instrumentalization goals" and outline neurobiological mechanisms of how major classes of psychoactive drugs change mental states and serve non-drug-related behaviors. We argue that drug instrumentalization behavior may provide a functional adaptation to modern environments based on a historical selection for learning mechanisms that allow the dynamic modification of consummatory behavior. It is assumed that in order to effectively instrumentalize psychoactive drugs, the establishment of and retrieval from a drug memory is required. Here, we propose a new classification of different drug memory subtypes and discuss how they interact during drug instrumentalization learning and retrieval. Understanding the everyday utility and the learning mechanisms of non-addictive psychotropic drug use may help to prevent abuse and the transition to drug addiction in the future.

Drug-resistant tuberculosis: emerging treatment options

Directory of Open Access Journals (Sweden)

Adhvaryu MR

2011-12-01

Full Text Available Meghna Adhvaryu1, Bhasker Vakharia21Department of Biotechnology, SRK Institute of Computer Education and Applied Sciences, 2R&D, Bhuma Research in Ayurvedic and Herbal Medicine, Surat, Gujarat, IndiaAbstract: Multidrug-resistant tuberculosis has emerged worldwide, with an increasing incidence due to failure of implementation of apparently effective first-line antituberculous therapy as well as primary infection with drug-resistant strains. Failure of current therapy is attributed to a long duration of treatment leading to nonadherence and irregular therapy, lack of patient education about the disease, poverty, irregular supply by care providers, drug–drug interactions in patients coinfected with human immunodeficiency virus (HIV, inadequate regulations causing market overlap and irresponsible drug usage in the private sector, and lack of research, with no addition of new drugs in the last four decades. Present standards of care for the treatment of drug-susceptible tuberculosis, multidrug-resistant tuberculosis, tuberculosis-HIV coinfection, and latent tuberculosis infection are all unsatisfactory. Since 2000, the World Health Organization (WHO has focused on drug development for tuberculosis, as well as research in all relevant aspects to discover new regimens by 2015 and to eliminate tuberculosis as a public health concern by 2050. As a result, some 20 promising compounds from 14 groups of drugs have been discovered. Twelve candidates from eight classes are currently being evaluated in clinical trials. Ongoing research should prioritize identification of novel targets and newer application of existing drugs, discovery of multitargeted drugs from natural compounds, strengthening host factors by immunopotentiation with herbal immunomodulators, as well as protective vaccines before and after exposure, consideration of surgical measures when indicated, development of tools for rapid diagnosis, early identification of resistant strains, and

Impulsive aggression, delay discounting, and adolescent suicide attempts: effects of current psychotropic medication use and family history of suicidal behavior.

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Bridge, Jeffrey A; Reynolds, Brady; McBee-Strayer, Sandra M; Sheftall, Arielle H; Ackerman, John; Stevens, Jack; Mendoza, Kristen; Campo, John V; Brent, David A

2015-03-01

Impulsive-aggressive behaviors have been consistently implicated in the phenomenology, neurobiology, and familial aggregation of suicidal behavior. The purpose of this study was to extend previous work by examining laboratory behavioral measures of delayed reward impulsivity and impulsive aggression in adolescent suicide attempters and never-suicidal comparison subjects. Using the Point Subtraction Aggression Paradigm (PSAP) and the Delay Discounting Task (DDQ), the authors examined delay discounting and impulsive aggression in 40 adolescent suicide attempters, ages 13-18, and 40 never-suicidal, demographically matched psychiatric comparison subjects. Overall, suicide attempters and comparison subjects performed similarly on the PSAP and DDQ. There was a significant group by current psychotropic medication use interaction (p=0.013) for mean aggressive responses on the PSAP. Group comparisons revealed that attempters emitted more aggressive responses per provocation than comparison subjects, only in those not on psychotropic medication (p=0.049), whereas for those currently treated with psychotropic medication, there were no group differences (p>0.05). This interaction effect was specific to current antidepressant use. Among all subjects, family history of suicidal behavior (suicide or suicide attempt) in first degree relatives was significantly correlated with both delay discounting (r=-0.22, p=0.049), and aggressive responding (r=0.27, p=0.015). Family history of suicidal behavior was associated with delay discounting, but not with aggressive responding on the PSAP, after controlling for relevant covariates. In this study, impulsive-aggressive responding was associated with suicide attempt only in those not being treated with antidepressants. Future work to replicate and extend these findings could have important therapeutic implications for the treatment of depressed suicide attempters, many of whom are affected by impulsive aggression.

Therapeutic drug monitoring: how to improve drug dosage and patient safety in tuberculosis treatment

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Giovanni Sotgiu

2015-03-01

Full Text Available In this article we describe the key role of tuberculosis (TB treatment, the challenges (mainly the emergence of drug resistance, and the opportunities represented by the correct approach to drug dosage, based on the existing control and elimination strategies. In this context, the role and contribution of therapeutic drug monitoring (TDM is discussed in detail. Treatment success in multidrug-resistant (MDR TB cases is low (62%, with 7% failing or relapsing and 9% dying and in extensively drug-resistant (XDR TB cases is even lower (40%, with 22% failing or relapsing and 15% dying. The treatment of drug-resistant TB is also more expensive (exceeding €50 000 for MDR-TB and €160 000 for XDR-TB and more toxic if compared to that prescribed for drug-susceptible TB. Appropriate dosing of first- and second-line anti-TB drugs can improve the patient's prognosis and lower treatment costs. TDM is based on the measurement of drug concentrations in blood samples collected at appropriate times and subsequent dose adjustment according to the target concentration. The ‘dried blood spot’ technique offers additional advantages, providing the rationale for discussions regarding a possible future network of selected, quality-controlled reference laboratories for the processing of dried blood spots of difficult-to-treat patients from reference TB clinics around the world.

When 'drugs' become 'drugs': issues of pharmaceutical abuse in France from the 1960s to the 1990s.

Science.gov (United States)

Marchant, Alexandre

2014-01-01

Since the 1970s, media frenzies about drug addiction have focused mainly on illicit drugs taken by rebellious or marginalised addicts, relegating iatrogenic drug abuse, and policies and problems linked to psychotropic pharmaceuticals available by prescription or over-the-counter to the shadows. In this article I go beyond the division between illicit drugs and medicines still configuring both public representations and historiography: using archival materials from the 1960s-1990s in France, I highlight some blind spots in drug history. Firstly I demonstrate the role of pharmaceutical abuse in the career of addicts, and then examine regulation policies, which are the dark side, however complementary, of drug policies and prohibition. Finally, I analyse the role of physicians and pharmacists in this control, and discuss the various professional debates relating to the legal supply of psychoactive drugs. In all these issues, the frame of the Cold War context will also be highlighted.

Treatment as Part of Drug Court: The Impact on Graduation Rates

Science.gov (United States)

Taxman, Faye S.; Bouffard, Jeffrey A.

2005-01-01

Drug treatment is one of the critical components of drug court programming, yet it has not been thoroughly studied in the drug court literature. Very little is understood about the nature of drug treatment services provided in the drug court setting. The purpose of this study was to examine the effects of selected treatment variables on drug court…

Brand-name drug, generic drug, orphan drug. Pharmacological therapy with biosimilar drugs - provision of due diligence in the treatment process.

Science.gov (United States)

Zajdel, Justyna; Zajdel, Radosław

2013-01-01

Due diligence in the process of provision of healthcare services refers, among other elements, to the application of pharmacological therapy at a time which offers the greatest chance for a successful outcome of treatment, i.e. for achieving the optimum expected effect understood as an improvement in the patient's health, reduction of health risks or elimination of the disease. However, due diligence may also refer to actions aimed at ensuring that neither the patient nor the healthcare payer is required to incur unreasonable costs in the process of treatment. The validity of that statement stems not only from normative acts but also from ethical standards laid down in the Medical Code of Ethics (Article 57 section 2). It often happens that the provision of optimal treatment calls for deviations from the formal provisions included in Summary Product Characteristics (SPCs), and the application of drugs that are bioequivalent to reference drugs, which translates into a significant reduction of costs. The present study addresses the problem of acceptability of a specific form of drug substitution consisting in the replacement of a reference drug with a generic drug. Also explored are legal aspects associated with the possibility of therapy based on "off-label use". The study reviews normative acts existing in the Polish and EU legislation. It also provides a clear definition of orphan drug, which has made it possible to make a distinction and investigate mutual relations between the concepts of brand-name (reference) drug, orphan drug and generic drug.

Variability in market uptake of psychotropic medications in Europe reflects cultural diversity

Directory of Open Access Journals (Sweden)

J. M. Hoebert

2017-11-01

Full Text Available Abstract Background In the last 20–30 years, many international studies have found substantial differences in the use of (older psychotropic medication between European countries. The majority mentioned an important role for attitudes and beliefs towards psychotropic medication. So far, no studies have looked into the effects of cultural diversity on the use of new medications entering the market. As national cultures relate deeply to held values regarding, for example, what is seen as effective versus ineffective or safe versus dangerous, (cultural diversity in decision making around the role of new medications in clinical practice may already be expected from the first day after market authorization. Methods This study examined the relation between cultural diversity, described in Hofstede’s model of cultural dimensions (Power Distance, Individualism, Masculinity, Uncertainty Avoidance, Indulgence and Long-Term Orientation and utilization of three new psychotropic medications, namely aripiprazole, duloxetine and pregabalin in Europe. Country level sales data of the case study medications were correlated to country-specific scores of Hofstede’s cultural dimensions. IMS Health’s MIDAS database has been used for sales data (converted to Defined Daily Doses/1000 inhabitants/day for the case study medications from the market authorization date in 2004 until December 2009 for 23 EU member states. Results Consumption of the case study medications was seen in all countries. In general, pregabalin was used more often than aripiprazole and duloxetine. In 2 years after market authorization, approximately 80% of all countries have reported use of all three molecules. Correlations between Hofstede dimensions individualism, long-term orientation and indulgence and total use of the case study medications tended to become stronger over time, but they were only statistically significant for indulgence at two years after market authorization (rho

Variability in market uptake of psychotropic medications in Europe reflects cultural diversity.

Science.gov (United States)

Hoebert, J M; Mantel-Teeuwisse, A K; Leufkens, H G M; van Dijk, L

2017-11-06

In the last 20-30 years, many international studies have found substantial differences in the use of (older) psychotropic medication between European countries. The majority mentioned an important role for attitudes and beliefs towards psychotropic medication. So far, no studies have looked into the effects of cultural diversity on the use of new medications entering the market. As national cultures relate deeply to held values regarding, for example, what is seen as effective versus ineffective or safe versus dangerous, (cultural) diversity in decision making around the role of new medications in clinical practice may already be expected from the first day after market authorization. This study examined the relation between cultural diversity, described in Hofstede's model of cultural dimensions (Power Distance, Individualism, Masculinity, Uncertainty Avoidance, Indulgence and Long-Term Orientation) and utilization of three new psychotropic medications, namely aripiprazole, duloxetine and pregabalin in Europe. Country level sales data of the case study medications were correlated to country-specific scores of Hofstede's cultural dimensions. IMS Health's MIDAS database has been used for sales data (converted to Defined Daily Doses/1000 inhabitants/day) for the case study medications from the market authorization date in 2004 until December 2009 for 23 EU member states. Consumption of the case study medications was seen in all countries. In general, pregabalin was used more often than aripiprazole and duloxetine. In 2 years after market authorization, approximately 80% of all countries have reported use of all three molecules. Correlations between Hofstede dimensions individualism, long-term orientation and indulgence and total use of the case study medications tended to become stronger over time, but they were only statistically significant for indulgence at two years after market authorization (rho = 0.51, p = 0.014) and three years after market

Antiretroviral Drugs Used in the Treatment of HIV Infection

Science.gov (United States)

... HIV/AIDS Treatment Antiretroviral drugs used in the treatment of HIV infection Share Tweet Linkedin Pin it More sharing ... Pin it Email Print Drugs Used in the Treatment of HIV Infection All FDA-approved medicines used in the ...

Psychopharmacologic treatment of children prenatally exposed to drugs of abuse.

Science.gov (United States)

Hulvershorn, Leslie A; Schroeder, Kristen M; Wink, Logan K; Erickson, Craig A; McDougle, Christopher J

2015-05-01

This pilot study compared the pharmacologic treatment history and clinical outcomes observed in pediatric outpatients with psychiatric disorders exposed to drugs of abuse in utero to those of an age-matched, sex-matched and psychiatric disorder-matched, non-drug-exposed group. In this matched cohort study, medical records of children treated at an academic, child and adolescent psychiatry outpatient clinic were reviewed. Children with caregiver-reported history of prenatal drug exposure were compared with a non-drug-exposed control group being cared for by the same providers. Patients were rated with the Clinical Global Impressions-Severity scale (CGI-S) throughout treatment. The changes in pre-treatment and post-treatment CGI-S scores and the total number of medication trials were determined between groups. The drug-exposed group (n = 30) had a higher total number of lifetime medication trials compared with the non-drug-exposed group (n = 28) and were taking significantly more total medications, at their final assessment. Unlike the non-drug-exposed group, the drug-exposed group demonstrated a lack of clinical improvement. These results suggest that in utero drug-exposed children may be more treatment-refractory to or experience greater side effects from the pharmacologic treatment of psychiatric disorders than controls, although we cannot determine if early environment or drugs exposure drives these findings. Copyright © 2015 John Wiley & Sons, Ltd.

Drug overprescription in nursing homes: an empirical evaluation of administrative data.

Science.gov (United States)

Stroka, Magdalena A

2016-04-01

A widely discussed shortcoming of long-term care in nursing homes for the elderly is the inappropriate or suboptimal drug utilization, particularly of psychotropic drugs. Using administrative data from the largest sickness fund in Germany, this study was designed to estimate the effect of institutionalization on the drug intake of the frail elderly. Difference-in-differences propensity score matching techniques were used to compare drug prescriptions for the frail elderly who entered a nursing home with those who remained in the outpatient care system; findings suggest that nursing home residents receive more doses of antipsychotics, antidepressants, and analgesics. The potential overprescription correlates with estimated drug costs of about €87 million per year.

Early discontinuation of attention-deficit/hyperactivity disorder drug treatment: a danish nationwide drug utilization study

DEFF Research Database (Denmark)

Pottegård, Anton; Bjerregaard, B. K.; Kortegaard, L. S.

2015-01-01

Knowledge of patterns of treatment discontinuation in attention-deficit/hyperactivity disorder (ADHD) drug treatment is of importance, for both the clinical practice and the study of long-term treatment outcomes. The purpose of this study was to describe early discontinuation of ADHD drug treatme...

Use of psychotropic medications in São Paulo Metropolitan Area, Brazil: pattern of healthcare provision to general population.

Science.gov (United States)

Campanha, Angela Maria; Siu, Erica Rosanna; Milhorança, Igor André; Viana, Maria Carmen; Wang, Yuan-Pang; Andrade, Laura Helena

2015-11-01

We estimate the proportion of psychotropic medication use (PMU) among adults in São Paulo Metropolitan Area, Brazil. We investigated whether socio-demographic factors, comorbidity, and disease severity influence PMU among individuals with psychiatric disorders. Data are from the São Paulo Megacity Mental Health Survey, a cross-sectional, population-based study, the Brazilian branch of the World Mental Health Survey Initiative. Trained lay interviewers face-to-face assessed psychiatric disorders and PMU through the Composite International Diagnostic Interview. Respondents were asked about use of healthcare service and prescribed medications for mental disorders in the previous year. Information on PMU was collected for 2935 adult residents in the area and among those with disorders who received treatment. Around 6% of respondents reported PMU in the past year: hypnotics or sedatives were used by 3.7% and antidepressants by 3.5%. Among individuals with 12-month disorders, only 14% reported past year PMU. Gender, age, education, income, occupational status, comorbidity, and severity were significant predictors for PMU. Among those with 12-month DSM-IV disorders who obtained treatment in healthcare settings, almost 40% received medication only. Among those treated in specialty mental health service, around 23% received combination of medication and psychotherapy. Our study has pointed out that the recent trend of access to mental healthcare in Brazil depicts unmet needs, characterized by a low prevalence of PMU among individuals with psychiatric disorders. Policies that improve appropriate access to prescribed drugs for those most in need are urgent public health priority. Copyright © 2015 John Wiley & Sons, Ltd.

Transportation and retention in outpatient drug abuse treatment programs.

Science.gov (United States)

Friedmann, P D; Lemon, S C; Stein, M D

2001-09-01

To determine whether certain types of transportation assistance improve outpatient treatment retention beyond thresholds shown to have therapeutic benefits, we analyzed data from 1,144 clients in 22 outpatient methadone maintenance (OMM) programs and 2,031 clients in 22 outpatient drug-free (ODF) programs in the Drug Abuse Treatment Outcomes Study (DATOS), a national, 12-month, longitudinal study of drug abuse treatment programs. Directors' surveys provided information about provision of car, van, or contracted transportation services or individual vouchers/payment for public transportation. Chart-abstracted treatment retention was dichotomized at 365 days for OMM and 90 days for ODF. Separate multivariate hierarchical linear models revealed that provision of car, van, or contracted transportation services improved treatment retention beyond these thresholds for both OMM and ODF, but individual vouchers or payment for public transportation did not. Future research should validate whether car, van, or contracted transportation services improve retention and other treatment outcomes in outpatient drug abuse treatment.

Epidemiology of drug abuse treatment in South Africa

Directory of Open Access Journals (Sweden)

Shandir Ramlagan

2010-04-01

Full Text Available Background. The aim of the study was to explore the epidemiology of drug abuse treatment in South Africa. Methods. Treatment demand statistics were analysed from South African National Council on Alcoholism and Drug Dependence and the South African Community Epidemiology Network on Drug Use records, and a rapid situation assessment was conducted. Twenty-one key informant interviews were conducted in all 9 provinces among provincial substance abuse co-ordinators, and one manager per treatment centre from a sample of treatment centres. Three focus groups were conducted and 46 self-administered questionnaires were distributed among inpatients at 2 selected treatment centres in Free State and North West provinces. Qualitative data were analysed using grounded theory, and quantitative data analysed using SPSS. Results. Treatment records show that the most frequent substance of abuse was alcohol (51%, followed by cannabis (21%, crack/cocaine (9.6%, heroin/opiates (7.9%, methamphetamine (Tik (4.5%, prescription/over-the-counter drugs (2.0%, and cannabis/mandrax (1.7%. More substance abusers were male, of lower education, white or black, than were female, more highly educated, coloured and Indian/Asian. Key informant interviews showed that females are the ‘hidden’ substance abusers and tend not to be identified in research statistics and at treatment centres. Poverty, unemployment, lack of recreational facilities, being surrounded by substance abusers, and long work shifts were also mentioned as factors contributing to substance abuse. The age of initiation of substance abuse using non-drugs such as glue was 9 years old, alcohol 10 - 12 years old, dagga 11 - 12 years old, poly-drug use (alcohol, tobacco and dagga 14 years old, and harder drugs such as cocaine and heroin at 16 - 17 years old, as reported by key informants. Family care and support, improved socio-economic conditions and increased law enforcement would help to discourage substance

A Review of Moxifloxacin for the Treatment of Drug-Susceptible Tuberculosis.

Science.gov (United States)

Naidoo, Anushka; Naidoo, Kogieleum; McIlleron, Helen; Essack, Sabiha; Padayatchi, Nesri

2017-11-01

Moxifloxacin, an 8-methoxy quinolone, is an important drug in the treatment of multidrug-resistant tuberculosis and is being investigated in novel drug regimens with pretomanid, bedaquiline, and pyrazinamide, or rifapentine, for the treatment of drug-susceptible tuberculosis. Early results of these studies are promising. Although current evidence does not support the use of moxifloxacin in treatment-shortening regimens for drug-susceptible tuberculosis, it may be recommended in patients unable to tolerate standard first-line drug regimens or for isoniazid monoresistance. Evidence suggests that the standard 400-mg dose of moxifloxacin used in the treatment of tuberculosis may be suboptimal in some patients, leading to worse tuberculosis treatment outcomes and emergence of drug resistance. Furthermore, a drug interaction with the rifamycins results in up to 31% reduced plasma concentrations of moxifloxacin when these are combined for treatment of drug-susceptible tuberculosis, although the clinical relevance of this interaction is unclear. Moxifloxacin exhibits extensive interindividual pharmacokinetic variability. Higher doses of moxifloxacin may be needed to achieve drug exposures required for improved clinical outcomes. Further study is, however, needed to determine the safety of proposed higher doses and clinically validated targets for drug exposure to moxifloxacin associated with improved tuberculosis treatment outcomes. We discuss in this review the evidence for the use of moxifloxacin in drug-susceptible tuberculosis and explore the role of moxifloxacin pharmacokinetics, pharmacodynamics, and drug interactions with rifamycins, on tuberculosis treatment outcomes when used in first-line tuberculosis drug regimens. © 2017, The American College of Clinical Pharmacology.

The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: a randomized controlled trial.

Science.gov (United States)

Holtyn, August F; Koffarnus, Mikhail N; DeFulio, Anthony; Sigurdsson, Sigurdur O; Strain, Eric C; Schwartz, Robert P; Leoutsakos, Jeannie-Marie S; Silverman, Kenneth

2014-11-01

Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N=98) could work and earn pay for 26 weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users. Clinical trial registration number: NCT01416584. Copyright © 2014 Elsevier Inc. All rights reserved.

Competitive release of drug resistance following drug treatment of mixed Plasmodium chabaudi infections.

Science.gov (United States)

de Roode, Jacobus C; Culleton, Richard; Bell, Andrew S; Read, Andrew F

2004-09-14

Malaria infections are often genetically diverse, potentially leading to competition between co-infecting strains. Such competition is of key importance in the spread of drug resistance. The effects of drug treatment on within-host competition were studied using the rodent malaria Plasmodium chabaudi. Mice were infected simultaneously with a drug-resistant and a drug-sensitive clone and were then either drug-treated or left untreated. Transmission was assessed by feeding mice to Anopheles stephensi mosquitoes. In the absence of drugs, the sensitive clone competitively suppressed the resistant clone; this resulted in lower asexual parasite densities and also reduced transmission to the mosquito vector. Drug treatment, however, allowed the resistant clone to fill the ecological space emptied by the removal of the sensitive clone, allowing it to transmit as well as it would have done in the absence of competition. These results show that under drug pressure, resistant strains can have two advantages: (1) they survive better than sensitive strains and (2) they can exploit the opportunities presented by the removal of their competitors. When mixed infections are common, such effects could increase the spread of drug resistance.

New Drugs and Treatment Targets in Psoriasis

DEFF Research Database (Denmark)

Kofoed, Kristian; Skov, Lone; Zachariae, Claus

2015-01-01

, and phosphodiesterase inhibitors. We review published clinical trials, and conference abstracts presented during the last years, concerned with new drugs under development for the treatment of psoriasis. In conclusion, our psoriasis armamentarium will be filled with several new effective therapeutic options the coming...... years. We need to be aware of the limitations of drug safety data when selecting new novel treatments. Monitoring and clinical registries are still important tools....

Medical school gift restriction policies and physician prescribing of newly marketed psychotropic medications: difference-in-differences analysis.

Science.gov (United States)

King, Marissa; Essick, Connor; Bearman, Peter; Ross, Joseph S

2013-01-30

To examine the effect of attending a medical school with an active policy on restricting gifts from representatives of pharmaceutical and device industries on subsequent prescribing behavior. Difference-in-differences approach. 14 US medical schools with an active gift restriction policy in place by 2004. Prescribing patterns in 2008 and 2009 of physicians attending one of the schools compared with physicians graduating from the same schools before the implementation of the policy, as well as a set of contemporary matched controls. Probability that a physician would prescribe a newly marketed medication over existing alternatives of three psychotropic classes: lisdexamfetamine among stimulants, paliperidone among antipsychotics, and desvenlafaxine among antidepressants. None of these medications represented radical breakthroughs in their respective classes. For two of the three medications examined, attending a medical school with an active gift restriction policy was associated with reduced prescribing of the newly marketed drug. Physicians who attended a medical school with an active conflict of interest policy were less likely to prescribe lisdexamfetamine over older stimulants (adjusted odds ratio 0.44, 95% confidence interval 0.22 to 0.88; P=0.02) and paliperidone over older antipsychotics (0.25, 0.07 to 0.85; P=0.03). A significant effect was not observed for desvenlafaxine (1.54, 0.79 to 3.03; P=0.20). Among cohorts of students who had a longer exposure to the policy or were exposed to more stringent policies, prescribing rates were further reduced. Exposure to a gift restriction policy during medical school was associated with reduced prescribing of two out of three newly introduced psychotropic medications.

determining treatment levels of comorbid psychiatric conditions

African Journals Online (AJOL)

SITWALA COMPUTERS

This low treatment rate may contribute to poor treatment outcomes. INTRODUCTION ... significance was set at p ≤ 0.05 for all statistical analyses. All confidence .... psychotropic effects , it is strongly associated with birth defects when used in ...

Synthèse, étude toxicologique et activité psychotrope de nouvelles ...

African Journals Online (AJOL)

Hilaire

Pharmacology. Synthèse, étude toxicologique et activité psychotrope de nouvelles arylidènpyridazin-. 3-ones N-substituées. Adnane BENMOUSSA1*, Pascal Manuele KANYONGA2,3, M'Hammed ANSAR1, Amina ZELLOU2, J EL. HARTI1, Jamal LAMSAOURI1, My Abbes FAOUZI2 , Ahmed ZAHIDI1, Hamid BENZIANE1, ...

Memory, forgetting, and economic crisis: drug use and social fragmentation in an Argentine shantytown.

Science.gov (United States)

Epele, Maria E

2010-03-01

Closely linked to the increase in psychotropic pill consumption, forgetting and remembering emerged from devastated social scenarios as a new local idiom among poor youth in the late 1990s and the new millennium. Drawing on ethnographic fieldwork carried out during the years of the deepest economic crisis in Argentina (2001-03), I argue that psychotropic pill consumption is associated with not only deteriorating economic conditions but also changes in the quality and price of cocaine, and in the scarcity and subsequent change of status of medications during the economic breakdown. Taking into account developments in the field of memory studies, I examine the relationship among political economy, social memory work, and changing drug-use practices. Regarding memory as a social practice, I argue that the growth of psychotropic pill consumption in the late 1990s can be understood through the interplay of Paul Ricoeur's notions regarding different kinds and levels of forgetting. By analyzing changing survival strategies, social network dismantlement, changing mortality patterns, and abusive police repression, I discuss how social fragmentation engendered by structural reforms has modified social memory work.

Brand-name drug, generic drug, orphan drug. Pharmacological therapy with biosimilar drugs – provision of due diligence in the treatment process

Science.gov (United States)

Zajdel, Justyna

2013-01-01

Due diligence in the process of provision of healthcare services refers, among other elements, to the application of pharmacological therapy at a time which offers the greatest chance for a successful outcome of treatment, i.e. for achieving the optimum expected effect understood as an improvement in the patient's health, reduction of health risks or elimination of the disease. However, due diligence may also refer to actions aimed at ensuring that neither the patient nor the healthcare payer is required to incur unreasonable costs in the process of treatment. The validity of that statement stems not only from normative acts but also from ethical standards laid down in the Medical Code of Ethics (Article 57 section 2). It often happens that the provision of optimal treatment calls for deviations from the formal provisions included in Summary Product Characteristics (SPCs), and the application of drugs that are bioequivalent to reference drugs, which translates into a significant reduction of costs. The present study addresses the problem of acceptability of a specific form of drug substitution consisting in the replacement of a reference drug with a generic drug. Also explored are legal aspects associated with the possibility of therapy based on “off-label use”. The study reviews normative acts existing in the Polish and EU legislation. It also provides a clear definition of orphan drug, which has made it possible to make a distinction and investigate mutual relations between the concepts of brand-name (reference) drug, orphan drug and generic drug. PMID:24592133

California Drug and Alcohol Treatment Assessment (CALDATA-1991-1993)

Data.gov (United States)

U.S. Department of Health & Human Services — The California Drug and Alcohol Treatment Assessment (CALDATA) was designed to study the costs, benefits, and effectiveness of the state's alcohol and drug treatment...

A Qualitative Exploration of Drug Abuse Relapse Following Treatment

Science.gov (United States)

Islam, Manirul; Hashizume, Masahiro; Yamamoto, Taro; Alam, Faruq; Rabbani, Golam

2012-01-01

Drug use is an alarming issue in Bangladesh. Most drug users return to drugs after treatment, in what becomes a vicious cycle of treatment and relapse. This study explored why they return and what pathways they follow. We carried out 5 key informant interviews, 10 in-depth interviews, 2 focus group discussions, 3 case studies, 8 observations, and…

The use of psychotropic medication in patients with emotionally unstable personality disorder under the care of UK mental health services.

Science.gov (United States)

Paton, Carol; Crawford, Michael J; Bhatti, Sumera F; Patel, Maxine X; Barnes, Thomas R E

2015-04-01

Guideline recommendations for the pharmacologic treatment of personality disorder lack consensus, particularly for emotionally unstable personality disorder (EUPD), and there is limited information on current prescribing practice in the United Kingdom. To characterize the nature and quality of current prescribing practice for personality disorder across the United Kingdom, as part of a quality improvement program. A cross-sectional survey of self-selected psychiatric services providing care for adults with personality disorder (ICD-10 criteria) was conducted. Data were collected during May 2012. Of 2,600 patients with a diagnosis of personality disorder, more than two-thirds (68%) had a diagnosis of EUPD. Almost all (92%) patients in the EUPD subgroup were prescribed psychotropic medication, most commonly an antidepressant or antipsychotic, principally for symptoms and behaviors that characterize EUPD, particularly affective dysregulation. Prescribing patterns were similar between those who had a diagnosed comorbid mental illness and those who had EUPD alone, but the latter group was less likely to have had their medication reviewed over the previous year, particularly with respect to tolerability (53% vs 43%). The use of psychotropic medication in EUPD in the United Kingdom is largely outside the licensed indications. Whether the treatment target is identified as intrinsic symptoms of EUPD or comorbid mental illness may depend on the diagnostic threshold of individual clinicians. Compared with prescribing for EUPD where there is judged to be a comorbid mental illness, the use of off-label medication for EUPD alone is less systematically reviewed and monitored, so opportunities for learning may be lost. Treatment may be continued long term by default. © Copyright 2015 Physicians Postgraduate Press, Inc.

Increased all-cause mortality with use of psychotropic medication in dementia patients and controls

DEFF Research Database (Denmark)

Jennum, Poul; Baandrup, Lone; Ibsen, Rikke

2015-01-01

compared with 44,286 control subjects with a minimum follow-up of four years and matched on age, gender, marital status, and community location. Information about psychotropic medication use (benzodiazepines, antidepressants, antipsychotics) was obtained from the Danish Medicinal Product Statistics. All...

The effects of drugs on human models of emotional processing: an account of antidepressant drug treatment.

Science.gov (United States)

Pringle, Abbie; Harmer, Catherine J

2015-12-01

Human models of emotional processing suggest that the direct effect of successful antidepressant drug treatment may be to modify biases in the processing of emotional information. Negative biases in emotional processing are documented in depression, and single or short-term dosing with conventional antidepressant drugs reverses these biases in depressed patients prior to any subjective change in mood. Antidepressant drug treatments also modulate emotional processing in healthy volunteers, which allows the consideration of the psychological effects of these drugs without the confound of changes in mood. As such, human models of emotional processing may prove to be useful for testing the efficacy of novel treatments and for matching treatments to individual patients or subgroups of patients.

Alcohol and drug abusers' reasons for seeking treatment.

Science.gov (United States)

Cunningham, J A; Sobell, L C; Sobell, M B; Gaskin, J

1994-01-01

Clients at two different treatment facilities were asked at assessment how influential each of 10 possible reasons were in their decision to change their alcohol or drug use. Clients at both facilities most often endorsed "weighing the pros and cons of drinking or drug use" and a "warning from spouse." Client's reasons for seeking treatment were also examined in relation to treatment compliance. Three reasons--"weighing the pros and cons," "hitting rock bottom," and experiencing a "major lifestyle change"--were predictive of treatment compliance. Clients who rated any of these reasons as influential were more likely to enter and complete treatment. Although more research is needed, knowledge of clients' reasons for seeking treatment might be useful in treatment matching.

Emerging drugs and alternative possibilities in the treatment of tuberculosis

NARCIS (Netherlands)

Hofman, S.; Segers, M.M.; Ghimire, S.; Bolhuis, M.S.; Sturkenboom, M.G.; Soolingen, D. van; Alffenaar, J.W.

2016-01-01

INTRODUCTION: Tuberculosis (TB) remains a global health problem. Drug resistance, treatment duration, complexity, and adverse drug reactions associated with anti-TB regimens are associated with treatment failure, prolonged infectiousness and relapse. With the current set of anti-TB drugs the goal to

Emerging drugs and alternative possibilities in the treatment of tuberculosis

NARCIS (Netherlands)

Hofman, S.; Segers, M. M.; Ghimire, S.; Bolhuis, M. S.; Sturkenboom, M. G. G.; Van Soolingen, D.; Alffenaar, J. W. C.

2016-01-01

Introduction: Tuberculosis (TB) remains a global health problem. Drug resistance, treatment duration, complexity, and adverse drug reactions associated with anti-TB regimens are associated with treatment failure, prolonged infectiousness and relapse. With the current set of anti-TB drugs the goal to

Joint association of physical activity and overweight with subsequent psychotropic medication: a register-linked follow-up study among employees.

Science.gov (United States)

Loponen, Tiina; Lallukka, Tea; Holstila, Ansku; Lahti, Jouni

2015-10-03

Physical activity level and overweight have shown associations with mental health problems but it is not known whether the risk of mental health problems due to overweight varies by physical activity. We examined joint association of physical activity and overweight with subsequent psychotropic medication among 40-60-year-old employees. The questionnaire survey data were derived from Helsinki Health Study baseline postal questionnaires in 2000-02 among employees of the City of Helsinki aged 40-60 years (n = 8960, response rate 67%). Baseline survey data were linked with prospective register data on prescribed psychotropic medication (ATC-codes N05 and N06, except N06D) among those with written consent (74%) for such linkage. The analyses included 6169 responders (78% women, corresponding to the target population). We divided participants into six groups according to their baseline self-reported body mass index and leisure-time physical activity using physically highly active normal-weight participants as a reference group. We used Cox regression analysis adjusted for age, gender, psychotropic medication prior to baseline, and socioeconomic position, marital status, working conditions, limiting long-standing illness, alcohol use, and smoking. At baseline, 49% were overweight and 23% were physically inactive. After adjusting for age and gender, inactive normal-weight (hazard ratio (HR) 1.3, 95% CI 1.1-1.5), moderately active overweight (HR 1.3, 95% CI 1.1-1.5) and inactive overweight (HR 1.4, 95% CI 1.2-1.6) had higher risk for any psychotropic medication compared with group of highly active normal-weight. After adjusting for prior medication, only the inactive overweight group had higher risk (HR 1.4, 95% CI 1.2-1.6). Other covariates made but a minor contribution to the examined associations. For antidepressants the associations were somewhat stronger than for sedatives. Both normal-weight and physical activity help prevent psychotropic medication but physical

Attitude towards psychiatric treatment and referral pattern in the ...

African Journals Online (AJOL)

clinical practice in both primary and secondary care.4 It is therefore ... specifically related to stigma4, severity of illness and past ... patients, stigma, concerns about the effect of psychiatric referral on ... They found the use of psychotropic drugs often necessary, ... The cross-sectional study was conducted at the University of.

28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

Testimony on Drug Treatment Alternatives to Incarceration

National Research Council Canada - National Science Library

Iguchi, Martin

2000-01-01

... treatment within the criminal justice system. Players in that policy game focused, as we are doing today, on the need to provide criminal offenders with drug abuse treatment as an alternative to incarceration...

Cell proliferation in dimethylhydrazine-induced colonic adenocarcinomata following cytotoxic drug treatment.

Science.gov (United States)

Tutton, P J; Barkla, D H

1978-08-25

A stathmokinetic technique was used to study cell proliferation in dimethylhydrazine-induced adenocarcinomata of rat colon following treatment with cytotoxic drugs. The rate of cell division was significantly increased three days after treatment with 5,7-dihydroxytryptamine and seven days after treatment with 5-fluorouracil. Acceleration of tumour cell proliferation following 5,7-dihydroxytryptamine treatment was inhibited by treating animals with the antiseritoninergic drug Xylamidine Tosylate. Acceleration of tumour cell proliferation following 5-fluorouracil treatment was inhibited by treating animals either with the antiseritoninergic drug BW501 or with the histamine H2-receptor blocking drug Cimetidine.

Anticonvulsiva bij agressie, angststoornissen, psychotische stoornissen en alcohol- en cocaïneonttrekkingsverschijnselen

NARCIS (Netherlands)

Barth-Van Veldhuizen, H.G.J.; Reinders, C.; Loonen, A.J.M.; Nolen, W.A.

2003-01-01

BACKGROUND: There is an increasing interest in the treatment of psychiatric symptoms with anticonvulsants, especially in the treatment of refractory patients. It is questionable whether or not the efficacy of anticonvulsants as psychotropic drugs is sufficiently verified. AIM: To examine the

Update on Nanotechnology-based Drug Delivery Systems in Cancer Treatment.

Science.gov (United States)

Ho, Benjamin N; Pfeffer, Claire M; Singh, Amareshwar T K

2017-11-01

The emerging field of nanotechnology meets the demands for innovative approaches in the diagnosis and treatment of cancer. The nanoparticles are biocompatible and biodegradable and are made of a core, a particle that acts as a carrier, and one or more functional groups on the core which target specific sites. Nanotech in drug delivery includes nanodisks, High Density Lipoprotein nanostructures, liposomes, and gold nanoparticles. The fundamental advantages of nanoparticles are: improved delivery of water-insoluble drugs, targeted delivery, co-delivery of two or more drugs for combination therapy, and visualization of the drug delivery site by combining imaging system and a therapeutic drug. One of the potential applications of nanotechnology is in the treatment of cancer. Conventional methods for cancer treatments have included chemotherapy, surgery, or radiation. Early recognition and treatment of cancer with these approaches is still challenging. Innovative technologies are needed to overcome multidrug resistance, and increase drug localization and efficacy. Application of nanotechnology to cancer biology has brought in a new hope for developing treatment strategies on cancer. In this study, we present a review on the recent advances in nanotechnology-based approaches in cancer treatment. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Changes in psychosocial and physical working conditions and psychotropic medication in ageing public sector employees: a record-linkage follow-up study.

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Kouvonen, Anne; Mänty, Minna; Lallukka, Tea; Pietiläinen, Olli; Lahelma, Eero; Rahkonen, Ossi

2017-07-12

To investigate whether changes in psychosocial and physical working conditions are associated with subsequent psychotropic medication in ageing employees. Data were from the Helsinki Health Study, a cohort study of Finnish municipal employees, aged 40-60 years at phase 1 (2000-2002). Changes in psychosocial and physical working conditions were measured between phase 1 and phase 2 (2007). Survey data were longitudinally linked to data on prescribed, reimbursed psychotropic medication purchases (Anatomical Therapeutic Chemical) obtained from the registers of the Social Insurance Institution of Finland between the phase 2 survey and December 2013 (N=3587; 80% women). Outcomes were any psychotropic medication; antidepressants (N06A); anxiolytics (N05B); and sedatives and hypnotics (N05C). Cox regression analyses were performed. During the follow-up, 28% of the participants were prescribed psychotropic medication. Repeated exposures to low job control, high job demands and high physical work load were associated with an increased risk of subsequent antidepressant and anxiolytic medication. Increased and repeated exposure to high physical work load, increased job control and repeated high job demands were associated with subsequent sedative and hypnotic medication. Age and sex-adjusted HR varied from 1.18 to 1.66. Improvement in job control was associated with a lower risk of anxiolytic, but with a higher risk of sedatives and hypnotic medication. Decreased physical work load was associated with a lower risk of antidepressant and anxiolytic medications. Improvement in working conditions could lower the risk of mental ill-health indicated by psychotropic medication. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Drugs and development: the global impact of drug use and trafficking on social and economic development.

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Singer, Merrill

2008-12-01

Locating development efforts within the context of globalism and global drug capitalism, this article examines the significant health and social impact both legal and illegal drugs have on international development efforts. The paper takes on an issue that is generally overlooked in the development debate and is not much addressed in the current international development standard, the Millennium Development Goals, and yet is one that places serious constraints on the ability of underdeveloped nations to achieve improvement. The relationship between psychotropic or "mind/mood altering" drugs and sustainable development is rooted in the contribution that the legal and illegal drug trade makes to a set of barriers to development, including: (1) interpersonal crime and community violence; (2) the corruption of public servants and the disintegration of social institutions; (3) the emergence of new or enhanced health problems; (4) the lowering of worker productivity; (5) the ensnarement of youth in drug distribution and away from productive education or employment; (6) the skewing of economies to drug production and money laundering. The paper emphasizes the need for new approaches for diminishing the burden placed by drugs on development.

[Treatment approaches for synthetic drug addiction].

Science.gov (United States)

Kobayashi, Ohji

2015-09-01

In Japan, synthetic drugs have emerged since late 2000s, and cases of emergency visits and fatal traffic accidents due to acute intoxication have rapidly increased. The synthetic drugs gained popularity mainly because they were cheap and thought to be "legal". The Japanese government restricted not only production and distribution, but also its possession and use in April 2014. As the synthetic drug dependent patients have better social profiles compared to methamphetamine abusers, this legal sanction may have triggered the decrease in the number of synthetic drug dependent patient visits observed at Kanagawa Psychiatric Center since July 2014. Treatment of the synthetic drug dependent patients should begin with empathic inquiry into the motives and positive psychological effects of the drug use. In the maintenance phase, training patients to trust others and express their hidden negative emotions through verbal communications is essential. The recovery is a process of understanding the relationship between psychological isolation and drug abuse, and gaining trust in others to cope with negative emotions that the patients inevitably would face in their subsequent lives.

[The Nature and Issues of Drug Addiction Treatment under Constraint].

Science.gov (United States)

Quirion, Bastien

This article is exploring different forms of constraint that are exerted in the field of drug addiction treatment. The objective of this article is to establish benchmarks and to stimulate reflection about the ethical and clinical implications of those constraints in the field of drug addiction treatment. This article is presenting a critical review of different forms of constraint that can be exerted in Canada in regard to the treatment of drug addiction. In the first section of the article, a definition of therapeutic intervention is proposed, that includes the dimension of power, which justifies the importance of considering the coercive aspects of treatment. The second section, which represents the core section of the paper, is devoted to the presentation of different levels of constraint that can be distinguished in regard to drug addicts who are under treatment. Three levels of constraint are exposed: judicial constraint, institutional constraint and relational constraint. The coercive aspect of treatment can then be recognized as a combination of all tree levels of constraint. Judicial constraint refers to any form of constraint in which the court or the judge is imposing or recommending treatment. This particular level of constraint can take different forms, such as therapeutic remands, conditions of a probation order, conditions of a conditional sentence of imprisonment, and coercive treatment such as the ones provided through drug courts. Institutional constraint refers to any form of constraint exerted within any institutional setting, such as correctional facilities and programs offered in community. Correctional facilities being limited by their own specific mission, it might have a major impact on the way the objectives of treatment are defined. Those limitations can then be considered as a form of constraint, in which drug users don't have much space to express their personal needs. Finally, relational constraint refers to any form of constraint in

From wanting to willing - controlled drug use as a treatment goal.

Science.gov (United States)

Järvinen, Margaretha

2017-03-01

This paper uses rational choice theory to analyse a new - and controversial - treatment approach to drug problems: services aimed at making clients capable of controlled use of illegal drugs. The paper highlights three mechanisms used in control-focused treatment: attempts to move drug use from the sphere of "wanting" to the sphere of "willing"; temporal framing of illegal drug use; and a therapeutic focus on clients' resources rather than their problems. Furthermore, the paper identifies some of the main challenges associated with this kind of treatment. The paper is based on 30 qualitative interviews with young people (aged 18-25) enrolled in drug treatment in Copenhagen, Denmark. Copyright © 2017 Elsevier Ltd. All rights reserved.

Chiral drug analysis using mass spectrometric detection relevant to research and practice in clinical and forensic toxicology.

Science.gov (United States)

Schwaninger, Andrea E; Meyer, Markus R; Maurer, Hans H

2012-12-21

This paper reviews analytical approaches published in 2002-2012 for chiral drug analysis and their relevance in research and practice in the field of clinical and forensic toxicology. Separation systems such as gas chromatography, high performance liquid chromatography, capillary electromigration, and supercritical fluid chromatography, all coupled to mass spectrometry, are discussed. Typical applications are reviewed for relevant chiral analytes such as amphetamines and amphetamine-derived designer drugs, methadone, tramadol, psychotropic and other CNS acting drugs, anticoagulants, cardiovascular drugs, and some other drugs. Usefulness of chiral drug analysis in the interpretation of analytical results in clinical and forensic toxicology is discussed as well. Copyright © 2012 Elsevier B.V. All rights reserved.

A South African outpatient drug treatment centre | Karassellos ...

African Journals Online (AJOL)

The Cape Town Drug Counselling Centre is an outpatient drug treatment ... Management of clients, which includes psychotherapy with an emphasis on ... medical intervention, is described, and proposed areas for further research are outlined.

Cannabinoids: New Promising Agents in the Treatment of Neurological Diseases

Directory of Open Access Journals (Sweden)

Sabrina Giacoppo

2014-11-01

Full Text Available Nowadays, Cannabis sativa is considered the most extensively used narcotic. Nevertheless, this fame obscures its traditional employ in native medicine of South Africa, South America, Turkey, Egypt and in many regions of Asia as a therapeutic drug. In fact, the use of compounds containing Cannabis and their introduction in clinical practice is still controversial and strongly limited by unavoidable psychotropic effects. So, overcoming these adverse effects represents the main open question on the utilization of cannabinoids as new drugs for treatment of several pathologies. To date, therapeutic use of cannabinoid extracts is prescribed in patients with glaucoma, in the control of chemotherapy-related vomiting and nausea, for appetite stimulation in patients with anorexia-cachexia syndrome by HIV, and for the treatment of multiple sclerosis symptoms. Recently, researcher efforts are aimed to employ the therapeutic potentials of Cannabis sativa in the modulation of cannabinoid receptor activity within the central nervous system, particularly for the treatment of neurodegenerative diseases, as well as psychiatric and non-psychiatric disorders. This review evaluates the most recent available data on cannabinoids utilization in experimental and clinical studies, and highlights their beneficial effects in the prevention of the main neurological diseases and for the clinical treatment of symptoms with them correlated.

[MEDICAL CANNABIS - A SOURCE FOR A NEW TREATMENT FOR AUTOIMMUNE DISEASE?].

Science.gov (United States)

Katz, Daphna; Katz, Itay; Golan, Amir

2016-02-01

Medical uses of Cannabis sativa have been known for over 6,000 years. Nowadays, cannabis is mostly known for its psychotropic effects and its ability to relieve pain, even though there is evidence of cannabis use for autoimmune diseases like rheumatoid arthritis centuries ago. The pharmacological therapy in autoimmune diseases is mainly based on immunosuppression of diffefent axes of the immune system while many of the drugs have major side effects. In this review we set out to examine the rule of Cannabis sativa as an immunomodulator and its potential as a new treatment option. In order to examine this subject we will focus on some major autoimmune diseases such as diabetes type I and rheumatoid arthritis.

Drug-induced status epilepticus.

Science.gov (United States)

Cock, Hannah R

2015-08-01

Drug-induced status epilepticus (SE) is a relatively uncommon phenomenon, probably accounting for less than 5% of all SE cases, although limitations in case ascertainment and establishing causation substantially weaken epidemiological estimates. Some antiepileptic drugs, particularly those with sodium channel or GABA(γ-aminobutyric acid)-ergic properties, frequently exacerbate seizures and may lead to SE if used inadvertently in generalized epilepsies or less frequently in other epilepsies. Tiagabine seems to have a particular propensity for triggering nonconvulsive SE sometimes in patients with no prior history of seizures. In therapeutic practice, SE is most commonly seen in association with antibiotics (cephalosporins, quinolones, and some others) and immunotherapies/chemotherapies, the latter often in the context of a reversible encephalopathy syndrome. Status epilepticus following accidental or intentional overdoses, particularly of antidepressants or other psychotropic medications, has also featured prominently in the literature: whilst there are sometimes fatal consequences, this is more commonly because of cardiorespiratory or metabolic complications than as a result of seizure activity. A high index of suspicion is required in identifying those at risk and in recognizing potential clues from the presentation, but even with a careful analysis of patient and drug factors, establishing causation can be difficult. In addition to eliminating the potential trigger, management should be as for SE in any other circumstances, with the exception that phenobarbitone is recommended as a second-line treatment for suspected toxicity-related SE where the risk of cardiovascular complications is higher anyways and may be exacerbated by phenytoin. There are also specific recommendations/antidotes in some situations. The outcome of drug-induced status epilepticus is mostly good when promptly identified and treated, though less so in the context of overdoses. This article is

[The costs of new drugs compared to current standard treatment].

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Ujeyl, Mariam; Schlegel, Claudia; Gundert-Remy, Ursula

2013-01-01

Until AMNOG came into effect Germany had free pricing of new drugs. Our exemplary work investigates the costs of new drugs that were licensed in the two years prior to AMNOG, and compares them to the costs of standard treatment that has been used in pivotal trials. Also, the important components of pharmaceutical prices will be illustrated. We retrospectively analysed the European Public Assessment Reports of proprietary medicinal products that the European Medicinal Agency initially approved in 2009 and 2010 and that were tested against an active control in at least one pivotal trial. If the standard treatment was a generic, the average pharmacy retail price of new drugs was 7.4 times (median 7.1) higher than that of standard treatment. If the standard treatment was an originator drug the average price was 1.4 times (median 1.2) higher than that of the new drug. There was no clear correlation of an increase in costs for new drugs and their "grade of innovation" as rated according to the criteria of Fricke. Our study shows that prices of new drugs must be linked to the evidence of comparative benefit; since German drug pricing is complex, cost saving effects obtained thereby will depend on a range of other rules and decisions. Copyright © 2013. Published by Elsevier GmbH.

Rhabdomyolysis induced by antiepileptic drugs: characteristics, treatment and prognosis.

Science.gov (United States)

Jiang, Wei; Wang, Xuefeng; Zhou, Shengnian

2016-01-01

Rhabdomyolysis syndrome refers to a variety of factors that affect the striated muscle cell membrane, the membrane channels and its energy supply. Most cases of rhabdomyolysis are due to direct trauma. However, infection, toxins, drugs, muscle ischemia, electrolyte imbalance, metabolic diseases, genetic diseases and abnormal body temperature can also lead to rhabdomyolysis. Epilepsy is one of the most common chronic neurological diseases. The primary long-term treatment is antiepileptic drugs (AEDs), which may cause rhabdomyolysis. This article summarizes the characteristics, treatment methods and prognosis of patients with rhabdomyolysis that is induced by antiepileptic drugs. This review is based on PubMed, EMBASE and MEDLINE searches of the literature using the keywords "epilepsy", "antiepileptic drugs","status epilepticus","rhabdomyolysis", and "antiepileptic drugs and rhabdomyolysis syndrome" as well as extensive personal clinical experience with various antiepileptic drugs. Potential relationships between antiepileptic drugs and rhabdomyolysis are discussed. Worldwide, there are approximately 50 million epilepsy patients, most of whom are treated with drugs. Reports have indicated that the majority of antiepileptic drugs on the market can cause rhabdomyolysis. Although rhabdomyolysis induced by antiepileptic drugs is a rare condition with a low incidence, this condition has serious consequences and merits attention from clinicians.

Prisoners’ experiences of drug treatment and punishment in four Nordic countries

Directory of Open Access Journals (Sweden)

Giertsen Hedda

2015-04-01

Full Text Available AIMS - This article describes and analyses prisoners’ experiences of drug treatment in prison in four Nordic countries: Denmark, Finland, Norway and Sweden. The article examines how prisoners experience drug treatment, control and sanctions as related to three main topics, namely motivation; the content of the measure and relations to staff; and control and sanctions. METHODS & DATA - The article is based on data from twelve prisons, three in each of the four countries; 91 interviews with prisoners; and around six months of observation. The two main kinds of drug treatment measures are drug treatment units and day programmes. RESULTS - Prisoners described several motives to participate in drug treatment measures: to leave drugs and crime; to renew relations with family and friends; to solve health problems; and to improve their prison conditions. Prisoners found that drug treatment measures offered possibilities to acquire new ways of being. Staff behaviour seemed to be more important to prisoners than the methods used, and some prisoners seemed more positive to staff involved with the drug treatment than to other staff. A surprising finding was the prisoners’ limited critique of controls and sanctions. We see this as embedded in the situation of being a prisoner, and also in relation to contexts outside prison. CONCLUSION - In discussing their experiences in the treatment units, prisoners are not so concerned about the rehabilitative features or the controls and sanctions. They evaluate their present situation in light of a future, which is their real concern. This is in line with a main task for staff, which is to prepare prisoners for release.

Effectiveness of multiple sclerosis treatment with current immunomodulatory drugs.

Science.gov (United States)

Milo, Ron

2015-04-01

Multiple sclerosis (MS) is a chronic inflammatory disease of the CNS of a putative autoimmune origin characterized by neurologic dysfunction disseminated in space and time due to demyelination and axonal loss that results in progressive disability. Recent advances in understanding the immune pathogenesis of the disease resulted in the introduction of numerous effective immunomodulatoty drugs having diverse mechanisms of action, modes of administration and risk-benefit profiles. This results in more complex albeit more promising treatment selection and choices. The epidemiology, clinical features, pathogenesis and diagnosis of the disease are discussed. The mode of action and main characteristics of current immunomodulatory drugs for MS and their place in the therapeutic algorithm of the disease based on evidence from clinical trials are described. Speculation on new paradigms, treatment goals and outcome measures aimed at improving the landscape of MS treatment is presented. Multiple disease, drug and patient-related factors should be taken into consideration when selecting the appropriate drug and treatment strategy to the appropriate patient, thus paving the road for personalized medicine in MS.

Divorce and changes in the prevalence of psychotropic medication use: a register-based longitudinal study among middle-aged Finns.

Science.gov (United States)

Metsä-Simola, Niina; Martikainen, Pekka

2013-10-01

The annual prevalence of psychotropic medication use exceeds 10 percent in Europe and the United States, the prevalence being higher among the divorced than the married. We analysed changes in the three-month prevalence of psychotropic medication use (psycholeptics and psychoanaleptics excluding medication for dementia) by proximity to divorce, sex, medication type and socio-demographic characteristics, using register-data on 304,111 Finns between 25 and 64 years of age, of whom 23,956 divorced between 1995 and 2003 and 142,093 were continuously married from 1995 to 2004. Five years before divorce, men and women already displayed about one percentage point higher prevalence of psychotropic medication use than those who continued their marriage. The excess prevalence increased with approaching divorce and peaked six to nine months before divorce, reaching 7.3 percent (95% CI 6.8-8.0) among divorcing men and 8.1 percent (95% CI 7.5-8.8) among divorcing women. The peak was followed by an 18-month decline, after which the excess compared to the continuously married settled at nearly three percentage points. The excess was not due to being socio-economically disadvantaged, and socio-demographic factors also seemed to have few modifying effects. The changes in prevalence were largest for antidepressants and almost non-existent for antipsychotics. Our results suggest that the high prevalence of psychotropic medication use among the divorced results both from selective factors already present five years before divorce and the acute and long-term causal effects of becoming and being divorced. Counselling is needed for individuals in the process of divorce, rather than economic support for divorced individuals. Copyright © 2013 Elsevier Ltd. All rights reserved.

Use of a computerized medication shared decision making tool in community mental health settings: impact on psychotropic medication adherence.

Science.gov (United States)

Stein, Bradley D; Kogan, Jane N; Mihalyo, Mark J; Schuster, James; Deegan, Patricia E; Sorbero, Mark J; Drake, Robert E

2013-04-01

Healthcare reform emphasizes patient-centered care and shared decision-making. This study examined the impact on psychotropic adherence of a decision support center and computerized tool designed to empower and activate consumers prior to an outpatient medication management visit. Administrative data were used to identify 1,122 Medicaid-enrolled adults receiving psychotropic medication from community mental health centers over a two-year period from community mental health centers. Multivariate linear regression models were used to examine if tool users had higher rates of 180-day medication adherence than non-users. Older clients, Caucasian clients, those without recent hospitalizations, and those who were Medicaid-eligible due to disability had higher rates of 180-day medication adherence. After controlling for sociodemographics, clinical characteristics, baseline adherence, and secular changes over time, using the computerized tool did not affect adherence to psychotropic medications. The computerized decision tool did not affect medication adherence among clients in outpatient mental health clinics. Additional research should clarify the impact of decision-making tools on other important outcomes such as engagement, patient-prescriber communication, quality of care, self-management, and long-term clinical and functional outcomes.

Patterns of drug treatment entry by Latino male injection drug users from different national/geographical backgrounds.

Science.gov (United States)

Reynoso-Vallejo, Humberto; Chassler, Deborah; Witas, Julie; Lundgren, Lena M

2008-02-01

This study examined patterns of treatment entry by Puerto Rican, Central American, Dominican, and other Latino male injection drug users (IDUs) in the state of Massachusetts over the time period 1996-2002. Specifically, it explored whether these populations had different patterns relative to three paths: entry into detoxification only, entry into residential treatment, or entry into methadone maintenance. Using a state-level MIS dataset on all substance abuse treatment entries to all licensed treatment programs, bi-variate and logistic regression methods were employed to examine patterns of drug treatment utilization among Latino men residing in Massachusetts. Three logistic regression models, which controlled for age, education, homelessness, employment, history of mental health treatment, health insurance, criminal justice involvement, having injected drugs in the past month, and number of treatment entries, indicated that Puerto Rican men were significantly less likely to only use detoxification services and residential treatment services, and significantly more likely to enter methadone maintenance compared to Latino men from Central American, Dominican, or other Latino backgrounds. For example, Central American men were 2.4 times more likely to enter only detoxification programs and 54% less likely to enter methadone maintenance programs than Puerto Rican male IDUs. For program planning, include the need to (a) develop varied drug treatment services to meet the needs of non-homogenous Latino groups within the population, (b) tailor outreach efforts to effectively reach all Latino groups, and (c) increase awareness among practitioners of differential patterns of treatment utilization.

Effect of herb drug medicine Treatment for Functional Dyspepsia:Controlled Trial

Directory of Open Access Journals (Sweden)

Lee Jae-Jin

2009-06-01

Full Text Available Obejective : Functional dyspepsia is a prevalent disease. It impedes subjective quality of life. The purpose of this research is to examine the equivalent effect of herb drug medicine treatment(H-Dand Over the Counter(OTC for functional dyspepsia. Method : In this controlled study, we compared herb drug medicine(H-D with Over the Counter(OTC of functional dyspepsia. 30 volunteers who satisfied the requirements were enrolled in study. Severity of dyspepsia was measured by Nepean Dyspepsia Index(NDI-K before and after treatments. Result : The results are summarized as follows. 1. In Herb drug medicine and Over the Counter groups, total key symptoms score of after treatment were significantly decreased and improve rate of key symptoms was higher than before treatment, but there were no statistical significance between two groups. 2. In Herb drug medicine and Over the Counter groups, each symptoms score of after treatment were significantly decreased and improve rate of key symptoms was higher than before treatment, but there were no statistical significance between two groups. 3. In Herb drug medicine and Over the Counter groups, quality of life score of after treatment were significantly decreased and improve rate of key symptoms was higher than before treatment, but there were no statistical significance between two groups. Conclusion : Herb drug medicine treatment(H-D is effective to improve the symptoms and quality of life in patients with functional dyspepsia.

Availability of prescription drugs for bipolar disorder at online pharmacies.

Science.gov (United States)

Monteith, Scott; Glenn, Tasha; Bauer, Rita; Conell, Jörn; Bauer, Michael

2016-03-15

There is increasing use of online pharmacies to purchase prescription drugs. While some online pharmacies are legitimate and safe, there are many unsafe and illegal so-called "rogue" online pharmacies. This study investigated the availability of psychotropic drugs online to consumers in the US, using 5 commonly prescribed drugs for bipolar disorder. Using the search term "buy [drug name]" in the Google, Yahoo and Bing search engines, the characteristics of the online pharmacies found on the first two pages of search results were investigated. The availability of the requested dosage and formulations of two brand (Seroquel XR, Abilify) and three generic drugs (lamotrigine, lithium carbonate and bupropion SR) were determined. Of 30 online pharmacies found, 17 (57%) were rated as rogue by LegitScript. Of the 30 pharmacies, 15 (50%) require a prescription, 21 (70%) claim to be from Canada, with 20 of these having a Canadian International Pharmacy association (CIPA) seal on the website. Only 13 of the 20 sites with a CIPA seal were active CIPA members. There were about the same number of trust verification seals on the rogue and legitimate pharmacy sites. Some rogue pharmacies are professional in appearance, and may be difficult for consumers to recognize as rogue. All five brand and generic drugs were offered for sale online, with or without a prescription. However, many substitutions were presented such as different strengths and formulations including products not approved by the FDA. No evaluation of product quality, packaging or purchasing. Psychotropic medications are available online with or without a prescription. The majority of online pharmacy websites were rogue. Physicians should ask about the use of online pharmacies. For those who choose to use online pharmacies, two measures to detect rogue pharmacies are recommended: (1) only purchase drugs from pharmacies that require a prescription, and (2) check all pharmacy verification seals directly on the website

Prevalence of medicinal drugs in suspected impaired drivers and a comparison with the use in the general Dutch population

NARCIS (Netherlands)

Bezemer, Karlijn D B; Smink, Beitske E; van Maanen, Rianne; Verschraagen, Miranda; de Gier, Johan J

The aim of this study was to investigate the prevalence of psychotropic medicines in drivers suspected of driving under the influence of medicinal and illicit drugs in The Netherlands and to compare the prevalence of selected impairing medicines with the use of these medicines in the general Dutch

A 24-week, randomized, controlled trial of adjunctive sibutramine versus topiramate in the treatment of weight gain in overweight or obese patients with bipolar disorders

NARCIS (Netherlands)

McElroy, Susan L.; Frye, Mark A.; Altshuler, Lori L.; Suppes, Trisha; Hellemann, Gerhard; Black, David; Mintz, Jim; Kupka, Ralph; Nolen, Willem; Leverich, Gabriele S.; Denicoff, Kirk D.; Post, Robert M.; Keck, Paul E.

Objectives: Patients with bipolar disorder (BD) have an increased risk of obesity as well as psychotropic-associated weight gain. The objective of this study was to compare sibutramine and topiramate as adjunctive treatments for psychotropic-associated weight gain in overweight or obese outpatients

[Manneristic catatonia. A psychotropic drug refractory chronic progressive course].

Science.gov (United States)

Stöber, G; Jungkunz, G; Franzek, E; Beckmann, H

1996-07-01

Manneristic catatonia, one form of Leonhard's systematic schizophrenias, is illustrated in nine case notes. The essential syndrome of this rare disorder (described by Leonhard in the preneuroleptic era) consisted in mannerisms and progressive stiffness of psychomotor activity. Mannerisms often developed from obsessive and compulsive ideas; whereas distress disappeared, repetitive behavior developed into a stereotype. Complex movements (e.g. not to shake hands; mutism) became mannerisms. With disease progression stiffness of facial expression and gestures and an impairment of voluntary motor activity became increasingly prominent. There were no signs of (neuroleptic-induced) parkinsonism. Manneristic catatonia affects preponderantly men and exhibits an early age of onset (median: 23 years). In none of the cases a family history of psychiatric illness was noted. Severe obstetric and birth complications as well as the high prevalence of supratentorial and cerebellar CT/MR abnormalities in this patient group point to deviations of prenatal brain maturation. The median yearly dose of neuroleptics was 83.1 g chlorpromazin equivalents. The characteristic psychopathology was not essentially influenced by modern psychopharmacological treatment neither in the beginning nor in the long run irrespective of the time of onset of the disease. Continuous high-dose neuroleptic treatment is not efficacious in this distinct group of systematic schizophrenias. Behavioural training in a rehabilitation unit is the treatment of choice from the early beginning.

Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: a chart review study.

Science.gov (United States)

Adler, Benjamin A; Wink, Logan K; Early, Maureen; Shaffer, Rebecca; Minshawi, Noha; McDougle, Christopher J; Erickson, Craig A

2015-01-01

Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define drug-refractory aggression, self-injurious behavior, and severe tantrums in people with autism spectrum disorders as behavioral symptoms requiring medication adjustment despite previous trials of risperidone and aripiprazole or previous trials of three psychotropic drugs targeting the symptom cluster, one of which was risperidone or aripiprazole. We reviewed the medical records of individuals of all ages referred to our clinic for autism spectrum disorder diagnostic evaluation, as well as pharmacotherapy follow-up notes for all people meeting autism spectrum disorder criteria, for drug-refractory symptoms. Among 250 consecutively referred individuals, 135 met autism spectrum disorder and enrollment criteria, and 53 of these individuals met drug-refractory symptom criteria. Factors associated with drug-refractory symptoms included age 12 years or older (p diagnosis of autistic disorder (p = 0.0139), and presence of intellectual disability (p = 0.0273). This pilot report underscores the significance of drug-refractory aggression, self-injurious behavior, and severe tantrums; suggests the need for future study clarifying factors related to symptom development; and identifies the need for focused treatment study of this impairing symptom domain. © The Author(s) 2014.

Suicidal behaviours in male and female users of illicit drugs recruited in drug treatment facilities

Directory of Open Access Journals (Sweden)

Elisabet Arribas-Ibar

2017-07-01

Conclusions: Prevalence of suicidal ideation/plans was high among illicit drug users recruited from healthcare facilities. Besides psychological variables, participation in illegal market activities and crime ought to be considered in drug users’ suicidal prevention. Suicide risk needs to be evaluated in drug treatment facilities and psychological status and context contemplated.

QT interval and dispersion in drug-free anorexia nervosa adolescents: a case control study.

Science.gov (United States)

Bomba, Monica; Tremolizzo, Lucio; Corbetta, Fabiola; Nicosia, Franco; Lanfranconi, Francesca; Poggioli, Gianni; Goulene, Karine; Stramba-Badiale, Marco; Conti, Elisa; Neri, Francesca; Nacinovich, Renata

2017-11-16

Long QT values have been reported in patients with anorexia nervosa of the restricting type (ANr) potentially increasing the risk of fatal arrhythmia, especially if psychotropic drug treatment is required. Nevertheless, the previous studies on this topic are biased by drug exposure, long disease durations, and small sample sizes. This study is aimed at assessing QTc and QTcd values in ANr adolescents with recent onset and drug free, as compared to subjects affected by psychiatric disorders other than ANr. We evaluated QTc and its dispersion (QTcd) in a population of 77 drug-free ANr female adolescents and compared to an equal number of healthy controls (H-CTRL) and pathological controls (P-CTRL, mixed psychiatric disorders). The QT determination was performed on a standard simultaneous 12-lead ECG in blind by a single experienced investigator. QTc was calculated by the Bazett's formula and QTcd was determined as the difference between the maximum and minimum QTc intervals in different leads. Only for ANr patients, clinico-demographic data, hormones, and electrolytes were obtained. QTc was slightly reduced in ANr patients (27.7 ms, studies are needed to understand if the previously reported increase might be related to other associated chronic disorders, such as hormonal or electrolyte imbalance.

Simultaneous Determination of Antipsychotic Drugs and Their Active Metabolites by LC-MS-MS and its Application to Therapeutic Drug Monitoring.

Science.gov (United States)

Miroshnichenko, Igor I; Baymeeva, Natalia V

2018-04-07

A quantitative method was developed to support therapeutic drug monitoring of eight antipsychotic drugs: chlorpromazine, haloperidol, zuclopenthixol, clozapine, risperidone, quetiapine, aripiprazole or olanzapine and some active metabolites (dehydroaripiprazole, N-desmethylclozapine and 9-hydroxyrisperidone) in human serum. Separation of the compounds was achieved using a Zorbax SB-C18 (150 mm × 4.6 mm, 5 μm) column and mass-spectrometric detection in multiple reaction monitoring mode. Human blood samples were collected in vacutainer tubes and the analytes were extracted with methyl-tert-butyl ether. The lower limits of quantitation were equal 0.5-1 ng/mL for all analytes. The method was applied with success to serum samples from schizophrenic patients undergoing polypharmacy with two or more different antipsychotic drugs. Precision data, accuracy results were satisfactory, and no interference from other psychotropic drugs was found. Hence, the method is suitable for the TDM of the analytes in psychotic patients' serum.

Enhanced transmission of drug-resistant parasites to mosquitoes following drug treatment in rodent malaria.

Directory of Open Access Journals (Sweden)

Andrew S Bell

Full Text Available The evolution of drug resistant Plasmodium parasites is a major challenge to effective malaria control. In theory, competitive interactions between sensitive parasites and resistant parasites within infections are a major determinant of the rate at which parasite evolution undermines drug efficacy. Competitive suppression of resistant parasites in untreated hosts slows the spread of resistance; competitive release following treatment enhances it. Here we report that for the murine model Plasmodium chabaudi, co-infection with drug-sensitive parasites can prevent the transmission of initially rare resistant parasites to mosquitoes. Removal of drug-sensitive parasites following chemotherapy enabled resistant parasites to transmit to mosquitoes as successfully as sensitive parasites in the absence of treatment. We also show that the genetic composition of gametocyte populations in host venous blood accurately reflects the genetic composition of gametocytes taken up by mosquitoes. Our data demonstrate that, at least for this mouse model, aggressive chemotherapy leads to very effective transmission of highly resistant parasites that are present in an infection, the very parasites which undermine the long term efficacy of front-line drugs.

Drug Repositioning for Effective Prostate Cancer Treatment.

Science.gov (United States)

Turanli, Beste; Grøtli, Morten; Boren, Jan; Nielsen, Jens; Uhlen, Mathias; Arga, Kazim Y; Mardinoglu, Adil

2018-01-01

Drug repositioning has gained attention from both academia and pharmaceutical companies as an auxiliary process to conventional drug discovery. Chemotherapeutic agents have notorious adverse effects that drastically reduce the life quality of cancer patients so drug repositioning is a promising strategy to identify non-cancer drugs which have anti-cancer activity as well as tolerable adverse effects for human health. There are various strategies for discovery and validation of repurposed drugs. In this review, 25 repurposed drug candidates are presented as result of different strategies, 15 of which are already under clinical investigation for treatment of prostate cancer (PCa). To date, zoledronic acid is the only repurposed, clinically used, and approved non-cancer drug for PCa. Anti-cancer activities of existing drugs presented in this review cover diverse and also known mechanisms such as inhibition of mTOR and VEGFR2 signaling, inhibition of PI3K/Akt signaling, COX and selective COX-2 inhibition, NF-κB inhibition, Wnt/β-Catenin pathway inhibition, DNMT1 inhibition, and GSK-3β inhibition. In addition to monotherapy option, combination therapy with current anti-cancer drugs may also increase drug efficacy and reduce adverse effects. Thus, drug repositioning may become a key approach for drug discovery in terms of time- and cost-efficiency comparing to conventional drug discovery and development process.

[Treatment of a serious autistic disorder in a child with Naltrexone in an oral suspension form].

Science.gov (United States)

Desjardins, S; Doyen, C; Contejean, Y; Kaye, K; Paubel, P

2009-04-01

CLINICAL BACKGROUND: Autism is a developmental disorder that is usually diagnosed in early childhood. According to ICD-10 criteria, autism can be characterized by delays in language skills, by impaired social interaction, verbal or non-verbal communication and by repetitive, stereotyped or severely restricted activities and interests. The causes of autism are not yet elucidated, but both genetics and environment seem to play a role in 10 to 25% of autism cases. Several biochemical abnormalities, such as impairment of serotoninergic, catecholinergic, dopaminergic, and opioid systems have been reported. Autism therapies are designed to treat symptoms, and medication can be associated with psychoeducational and environmental interventions. Generally, the medications that are currently used are not intended for autism, and must be used with caution and selected according to the type and intensity of symptoms. The most common medication consists of psychotropic therapies by administration of dopaminergic and/or serotoninergic receptor antagonists (haloperidol, risperidone, clomipramine). Several drugs, such as anxiolytics (buspirone), mood stabilisers (lithium, sodium valproate), vitamins (vitamins B6, B12) or opioid antagonists (naltrexone) can be prescribed, in second intention, in cases of severe behavioural disorders. The prescription of opioid antagonists is based on the possible implication of an opioid system disorder observed in some cases. Nevertheless, several clinical studies reveal its variable effectiveness. Naltrexone is a competitive antagonist of opioid receptors OPRM1, OPRD1 and OPRK1. In France, this drug is prescribed for treating opioid and alcohol dependence. Moreover, several studies describe naltrexone as a possible treatment of autistic children in cases of developmental disorder and hyperactivity. In the Child and Adolescent Psychopathology Department of Sainte-Anne's Hospital, autistic children benefit from a multidisciplinary treatment program

Long working hours and subsequent use of psychotropic medicine: a study protocol.

Science.gov (United States)

Hannerz, Harald; Albertsen, Karen

2014-09-19

Mental ill health is the most frequent cause of long-term sickness absence and disability retirement in Denmark. Some instances of mental ill health might be due to long working hours. A recent large cross-sectional study of a general working population in Norway found that not only "very much overtime", but also "moderate overtime" (41-48 work hours/week) was significantly associated with increased levels of both anxiety and depression. These findings have not been sufficiently confirmed in longitudinal studies. The objective of the study is to give a detailed plan for a research project aimed at investigating the possibility of a prospective association between weekly working hours and use of psychotropic medicine in the general working population of Denmark. People from the general working population of Denmark have been surveyed, at various occasions in the time period 1995-2010, and interviewed about their work environment. The present study will link interview data from these surveys to national registers covering all inhabitants of Denmark. The participants will be followed for the first occurrence of redeemed prescriptions for psychotropic medicine. Poisson regression will be used to analyze incidence rates as a function of weekly working hours (32-40; 41-48; > 48 hours/week). The analyses will be controlled for gender, age, sample, shift work, and socioeconomic status. According to our feasibility studies, the statistical power is sufficient and the exposure is stable enough to make the study worth the while. The publication of the present study protocol ends the design phase of the project. In the next phase, the questionnaire data will be forwarded to Statistics Denmark where they will be linked to data on deaths, migrations, socioeconomic status, and redeemed prescriptions for psychotropic medication. We expect the analysis to be completed by the end of 2014 and the results to be published mid 2015. The proposed project will be free from hindsight bias

Epidemiology of drug abuse treatment in South Africa

African Journals Online (AJOL)

Texas, USA, where alcohol was found to be the primary drug of abuse in ... distributed among inpatients at 2 selected treatment centres ... group participants attributed their reasons for drug use to family ... NW provinces, where one currently finds limited data. .... full-time, 26% were unemployed, and 25% were students.

[Adherence of people with type 2 diabetes mellitus to drug treatment].

Science.gov (United States)

Boas, Lilian Cristiane Gomes-Villas; Foss-Freitas, Maria Cristina; Pace, Ana Emilia

2014-01-01

This cross-sectional and quantitative study aimed to evaluate the adherence to drug treatment of the people with diabetes mellitus and its relation to clinical, treatment and metabolic control variables. Sample consisted of 162 people with type 2 diabetes mellitus on follow-up outpatient care. The Measure of Treatment Adherence and consultation to the participants' medical records were used for data collection. A high adherence to drug treatment was obtained. For a p<0.05, it was obtained an inverse correlation with diastolic blood pressure and a direct correlation with the frequency of daily administration of insulin and oral antidiabetic agents. There were no statistically significant correlations between adherence and metabolic control variables. Results diverge from the literature regarding the adherence to drug treatment in chronic diseases, as well as in the correlation between adherence and complexity of drug regimen, which points to the need for more studies on this theme.

Is cannabis an effective treatment for joint pain?

Science.gov (United States)

Miller, Richard J; Miller, Rachel E

2017-01-01

Cannabis has been used to treat pain for thousands of years. However, since the early part of the 20th century, laws restricting cannabis use have limited its evaluation using modern scientific criteria. Over the last decade, the situation has started to change because of the increased availability of cannabis in the United States for either medical or recreational purposes, making it important to provide the public with accurate information as to the effectiveness of the drug for joint pain among other indications. The major psychotropic component of cannabis is Δ9-tetrahydrocannabinol (THC), one of some 120 naturally occurring phytocannabinoids. Cannabidiol (CBD) is another molecule found in herbal cannabis in large amounts. Although CBD does not produce psychotropic effects, it has been shown to produce a variety of pharmacological effects. Hence, the overall effects of herbal cannabis represent the collective activity of THC, CBD and a number of minor components. The action of THC is mediated by two major G-protein coupled receptors, cannabinoid receptor type 1 (CB1) and CB2, and recent work has suggested that other targets may also exist. Arachidonic acid derived endocannabinoids are the normal physiological activators of the two cannabinoid receptors. Natural phytocannabinoids and synthetic derivatives have produced clear activity in a variety of models of joint pain in animals. These effects are the result of both inhibition of pain pathway signalling (mostly CB1) and anti-inflammatory effects (mostly CB2). There are also numerous anecdotal reports of the effectiveness of smoking cannabis for joint pain. Indeed, it is the largest medical request for the use of the drug. However, these reports generally do not extend to regulated clinical trials for rheumatic diseases. Nevertheless, the preclinical and human data that do exist indicate that the use of cannabis should be taken seriously as a potential treatment of joint pain.

Treatment of hyperthyroidism with radioiodine: adjunctive therapy with antithyroid drugs reconsidered

International Nuclear Information System (INIS)

Velkeniers, B.; Vanhaelst, L.; Cytryn, R.; Jonckheer, M.H.

1988-01-01

To assess the value of antithyroid drugs as an adjunct to radioactive iodine for the treatment of hyperthyroidism the incidence of relapse or hypothyroidism after a mean follow-up of 51/2 years (range 2-7 years) was reviewed retrospectively for 206 patients, some treated with and others without antithyroid drugs after radioiodine therapy. Allocation to treatment group had been random, and both groups were similar in all respects except for the adjunctive treatment with antithyroid drugs. All doses of 131 I had been calculated by one physician. Compared with those who received 131 I alone, those starting on antithyroid drugs within 8 days after 131 I had a lower incidence of hypothyroidism but a higher incidence of early post-treatment recurrence or persistence of hyperthyroidism, and considerably lower incidence of remission. (author)

[Psychosocial Treatment of Addictive Disorders--An Overview of Psychotherapeutic Options and their Efficacy].

Science.gov (United States)

Walter, M; Dürsteler, K M; Petitjean, S A; Wiesbeck, G A; Euler, S; Sollberger, D; Lang, U E; Vogel, M

2015-04-01

Addictive disorders are chronic relapsing conditions marked by compulsive and often uncontrolled use of psychotropic substances or stimuli. In this review, we present and discuss the current specific psychosocial interventions for addictive disorders and their effectiveness. In particular cognitive behavioral therapy, motivational interviewing, relapse prevention, the community reinforcement approach, and contingency management were found to be effective. For these psychotherapeutic treatments, mostly moderate effect sizes have been found. Their effectiveness seems to be highest in cannabis dependence. Empirical evidence for dependence on "hard" drugs is largest for contingency management, while for alcohol dependence motivational interviewing and the community reinforcement approach show the largest effect sizes. Presumably, combinations of different approaches as well as online interventions will bring further progress in the psychosocial treatment of addictive disorders in the future. © Georg Thieme Verlag KG Stuttgart · New York.

Purified Cannabidiol, the main non-psychotropic component of Cannabis sativa, alone, counteracts neuronal apoptosis in experimental multiple sclerosis.

Science.gov (United States)

Giacoppo, S; Soundara Rajan, T; Galuppo, M; Pollastro, F; Grassi, G; Bramanti, P; Mazzon, E

2015-12-01

Multiple Sclerosis (MS) is a global concern disease leading to a progressive, chronic and demyelinating condition, affecting the central nervous system (CNS). The pathology has an inflammatory/autoimmune origin; nevertheless, neuronal cell death mechanisms are not to be underestimated. The present study was designed to test the effects of intraperitoneal administration of cannabidiol (CBD), the main non-psychotropic cannabinoid of Cannabis sativa (CS), in an experimental model of MS. The aim is to evaluate the capability of CBD administration to thwart the cascade of mediators involved in MS-induced apoptosis. Experimental Autoimmune Encephalomyelitis (EAE) was induced by immunization with myelin oligodendroglial glycoprotein (MOG)35-55 peptide in mice. After immunization, mice were observed daily for signs of EAE and weight loss. Disease signs were evaluated using a standardized scoring system. Immunohistochemical and Western blot assessments of key apoptotic markers reveal that CBD treatment is able to avoid Fas pathway activation, phospho-ERK p42/44 and cleaved caspase-3 triggering as well as alterations in mitochondrial permeability due to Bax/Bcl-2 unbalance. Moreover, CBD interferes with p53-p21 axis activation. As results, the absence of tissue apobody formation in spinal cord tissues of EAE-mice treated with CBD was established. Most of therapeutic properties of CS are currently ascribed to the psychotropic effects of phenylterpenoid delta-9 tetrahydrocannabinol. We have demonstrated that, alone, purified CBD possesses an anti-apoptotic power against the neurodegenerative processes underlying MS development. This represents an interesting new profile of CBD that could lead to its introduction in the clinical management of MS.

Antipsychotic drug treatment for patients with schizophrenia: theoretical background, clinical considerations and patients preferences

DEFF Research Database (Denmark)

Nielsen, René Ernst; Nielsen, Jimmi

2009-01-01

  The cornerstone in treatment of psychosis is antipsychotic drugs. Treatment options have increased over the years; newer antipsychotic drugs with a proposed efficacy regarding negative and cognitive symptoms, but also a shift in side-effects from neurological side-effects to metabolic side......-effects have arisen as the new challenge. The basis of successful pharmacological treatment is a fundamental understanding of the mechanisms of action, the desired effects and side-effects of antipsychotic drugs, a good relationship with the patient and a thorough monitoring of the patient before and during...... treatment. The clinically relevant aspects of antipsychotic drug treatment are reviewed; mechanism of antipsychotic drug action, clinical considerations in treatment, switching antipsychotic drugs, polypharmacy, safety and patient preference.  ...

Illicit drug use and treatment in South Africa: a review.

Science.gov (United States)

Peltzer, Karl; Ramlagan, Shandir; Johnson, Bruce D; Phaswana-Mafuya, Nancy

2010-11-01

This review synthesizes available epidemiological data on current drug use and substance user treatment admissions in South Africa since 1994, and how changes in the political, economic, and social structures within South Africa, both before and after Apartheid, has made the country more vulnerable to drug use. Based on national surveys, current use of cannabis ranged among adolescents from 2% to 9% and among adults it was 2%, cocaine/crack (0.3%), mandrax/sedatives (0.3%), club drugs/amphetamine-type stimulants (0.2%), opiates (0.1%), and hallucinogens (0.1%). The use of primary illicit substance at admission to South African drug user treatment centers was cannabis 16.9%, methamphetamine (tik) 12.8%, crack/cocaine 9.6%, cannabis and mandrax 3.4%, heroin/opiates 9.2%, and prescription and OTC drugs 2.6%. An increase in substance user treatment admissions has increased. While the prevalence of illicit drug use in South Africa is relatively low compared to the United States and Australia, prevention and intervention policies need to be designed to reduce these levels by targeting the more risky subpopulations identified from this review.

Chinese Herbal Medicine for the Treatment of Drug Addiction.

Science.gov (United States)

Zhu, Weili; Zhang, Yinan; Huang, Yingjie; Lu, Lin

2017-01-01

This chapter summarizes recent developments in preclinical and clinical research on Chinese herbal medicines and their neurochemical mechanism of action for the treatment of drug addiction. We searched Chinese and English scientific literature and selected several kinds of Chinese herbal medicines that have beneficial effects on drug addiction. Ginseng (Renshen) may be clinically useful for the prevention of opioid abuse and dependence. Rhizoma Corydalis (Yanhusuo) may be used to prevent relapse to chronic drug dependence. Alkaloids of Uncaria rhynchophylla (Gouteng) appear to have positive effects on methamphetamine and ketamine addiction. Both Salvia miltiorrhiza (Danshen) and Radix Pueraiae (Gegen) have beneficial inhibitory effects on alcohol intake. Sinomenine has been shown to have preventive and curative effects on opioid dependence. l-Stepholidine, an alkaloid extract of the Chinese herb Stephania intermedia (Rulan), attenuated the acquisition, maintenance, and reacquisition of morphine-induced conditioned place preference and antagonized the heroin-induced reinstatement of heroin seeking. Traditional Chinese herbal medicines may be used to complement current treatments for drug addiction, including withdrawal and relapse. As the molecular mechanisms of action of traditional Chinese herbal medicines are elucidated, further advances in their use for the treatment of drug addiction are promising. © 2017 Elsevier Inc. All rights reserved.

Gifts and influence: Conflict of interest policies and prescribing of psychotropic medications in the United States.

Science.gov (United States)

King, Marissa; Bearman, Peter S

2017-01-01

The pharmaceutical industry spends roughly 15 billion dollars annually on detailing - providing gifts, information, samples, trips, honoraria and other inducements - to physicians in order to encourage them to prescribe their drugs. In response, several states in the United States adopted policies that restrict detailing. Some states banned gifts from pharmaceutical companies to doctors, other states simply required physicians to disclose the gifts they receive, while most states allowed unrestricted detailing. We exploit this geographic variation to examine the relationship between gift regulation and the diffusion of four newly marketed medications. Using a dataset that captures 189 million psychotropic prescriptions written between 2005 and 2009, we find that uptake of new costly medications was significantly lower in states with marketing regulation than in areas that allowed unrestricted pharmaceutical marketing. In states with gift bans, we observed reductions in market shares ranging from 39% to 83%. Policies banning or restricting gifts were associated with the largest reductions in uptake. Disclosure policies were associated with a significantly smaller reduction in prescribing than gift bans and gift restrictions. In states that ban gift-giving, peer influence substituted for pharmaceutical detailing when a relatively beneficial drug came to market and provided a less biased channel for physicians to learn about new medications. Our work suggests that policies banning or limiting gifts from pharmaceutical representatives to doctors are likely to be more effective than disclosure policies alone. Copyright © 2016 Elsevier Ltd. All rights reserved.

Improving drug treatment in general practice

NARCIS (Netherlands)

Veninga, CCM; Denig, P; Zwaagstra, R; Haaijer-Ruskamp, FM

In the international Drug Education Project, an educational program involving auditing and feedback in peer groups to improve the treatment of asthma and urinary tract infections (UTI) was developed and tested in primary care. Individualized feedback was provided and discussed in 24 Dutch peer

Psychiatric manifestations of Graves' hyperthyroidism: pathophysiology and treatment options.

Science.gov (United States)

Bunevicius, Robertas; Prange, Arthur J

2006-01-01

Graves' disease is an autoimmune disorder that is the most common cause of hyperthyroidism. Other symptoms associated with the disease are goitre, ophthalmopathy, and psychiatric manifestations such as mood and anxiety disorders and, sometimes, cognitive dysfunction. Graves' hyperthyroidism may result in these latter manifestations via the induction of hyperactivity of the adrenergic nervous system. This review addresses the psychiatric presentations, and their pathophysiology and treatment, in patients with hyperthyroidism, based on literature identified by a PubMed/MEDLINE database search. Although the focus is on mental symptoms associated with Graves' disease, it is not always clear from the literature whether patients had Graves' disease: in some studies, the patients were thought to have Graves' disease based on clinical findings such as diffuse goitre or ophthalmopathy or on measurements of thyroid antibodies in serum; however, in other studies, no distinction was made between Graves' hyperthyroidism and hyperthyroidism from other causes. Antithyroid drugs combined with beta-adrenoceptor antagonists are the treatments of choice for hyperthyroidism, as well as for the psychiatric disorders and mental symptoms caused by hyperthyroidism. A substantial proportion of patients have an altered mental state even after successful treatment of hyperthyroidism, suggesting that mechanisms other than hyperthyroidism, including the Graves' autoimmune process per se and ophthalmopathy, may also be involved. When psychiatric disorders remain after restoration of euthyroidism and after treatment with beta-adrenoceptor antagonists, specific treatment for the psychiatric symptoms, especially psychotropic drugs, may be needed.

OPPIDUM surveillance program: 20 years of information on drug abuse in France.

Science.gov (United States)

Frauger, Elisabeth; Moracchini, Christophe; Le Boisselier, Reynald; Braunstein, David; Thirion, Xavier; Micallef, Joëlle

2013-12-01

It is important to assess drug abuse liability in 'real life' using different surveillance systems. Some are based on specific population surveys, such as individuals with drug abuse or dependence, or under opiate maintenance treatment, because this population is very familiar with drugs and is more likely to divert or abuse them. In France, an original surveillance system based on this specific population and called 'Observation of illegal drugs and misuse of psychotropic medications (OPPIDUM) survey' was set up in 1990 as the first of its kind. The aim of this article is to describe this precursor of French drug abuse surveillance using different examples, to demonstrate its ability to effectively give health authorities and physicians interesting data on drug abuse. OPPIDUM is an annual, cross-sectional survey that anonymously collects information on abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. From 1990 to 2010, a total of 50,734 patients were included with descriptions of 102,631 psychoactive substance consumptions. These data have outlined emergent behaviors such as the misuse of buprenorphine by intravenous or nasal administration. It has contributed to assess abuse liability of emergent drugs such as clonazepam or methylphenidate. This surveillance system was also able to detect the decrease of flunitrazepam abuse following implementation of regulatory measures. OPPIDUM's twenty years of experience clearly demonstrate that collection of valid and useful data on drug abuse is possible and can provide helpful information for physicians and health authorities. © 2013 The Authors Fundamental and Clinical Pharmacology © 2013 Société Française de Pharmacologie et de Thérapeutique.

Exploring mortality among drug treatment clients: The relationship between treatment type and mortality.