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Sample records for psychopharmacology

  1. Competent psychopharmacology.

    PubMed

    Gardner, David M

    2014-08-01

    There is little doubt that undergraduate and post-graduate training of physicians, pharmacists, and nurses is insufficient to prepare them to use psychotropics safely and effectively, especially in the context of their expanded off-label uses. Therefore, the development of competencies in psychotropic prescribing needs to be approached as a long-term, practice-based learning commitment. Proposed are the abilities and knowledge components necessary for safe and effective use of psychotropics. Typical challenges in prescribing for chronic and recurrent illnesses include highly variable responses and tolerability, drug interactions, and adverse effects that can be serious, irreversible, and even fatal. Prescribing psychotropics is further complicated by negative public and professional reports and growing patient concerns about the quality of care, and questions about the efficacy, safety, and addictive risks of psychotropics. Increased efforts are needed to enhance clinical training and knowledge in psychopharmacology among trainees and practising clinicians, with more comprehensive and sustained attention to the assessment of individual patients, and greater reliance on patient education and collaboration. Improved competence in psychotropic prescribing should lead to more informed, thoughtful, and better-targeted applications as one component of more comprehensive clinical care. PMID:25161064

  2. Competent Psychopharmacology

    PubMed Central

    Gardner, David M

    2014-01-01

    There is little doubt that undergraduate and post-graduate training of physicians, pharmacists, and nurses is insufficient to prepare them to use psychotropics safely and effectively, especially in the context of their expanded off-label uses. Therefore, the development of competencies in psychotropic prescribing needs to be approached as a long-term, practice-based learning commitment. Proposed are the abilities and knowledge components necessary for safe and effective use of psychotropics. Typical challenges in prescribing for chronic and recurrent illnesses include highly variable responses and tolerability, drug interactions, and adverse effects that can be serious, irreversible, and even fatal. Prescribing psychotropics is further complicated by negative public and professional reports and growing patient concerns about the quality of care, and questions about the efficacy, safety, and addictive risks of psychotropics. Increased efforts are needed to enhance clinical training and knowledge in psychopharmacology among trainees and practising clinicians, with more comprehensive and sustained attention to the assessment of individual patients, and greater reliance on patient education and collaboration. Improved competence in psychotropic prescribing should lead to more informed, thoughtful, and better-targeted applications as one component of more comprehensive clinical care. PMID:25161064

  3. Psychopharmacology Curriculum Field Test

    ERIC Educational Resources Information Center

    Zisook, Sidney; Balon, Richard; Benjamin, Sheldon; Beresin, Eugene; Goldberg, David A.; Jibson, Michael D.; Thrall, Grace

    2009-01-01

    Objective: As part of an effort to improve psychopharmacology training in psychiatric residency programs, a committee of residency training directors and associate directors adapted an introductory schizophrenia presentation from the American Society of Clinical Psychopharmacology's Model Psychopharmacology Curriculum to develop a multimodal,…

  4. A Counselor's Guide to Psychopharmacology.

    ERIC Educational Resources Information Center

    Ponterotto, Joseph G.

    1985-01-01

    Presents basic information on psychopharmacology and discusses the major antipsychotic, antidepressant, anti-anxiety, and lithium salt medications used with adults. The importance and implications of psychopharmacology for the counseling profession are highlighted. (Author)

  5. Teaching Psychopharmacology: Two Trainees' Perspectives

    ERIC Educational Resources Information Center

    Georgiopoulos, Anna M.; Huffman, Jeff C.

    2005-01-01

    Objective: To describe our experience of learning clinical psychopharmacology during residency, in order to assist educators planning psychopharmacology curricula. Methods: We describe how psychopharmacology teaching was structured in our program, dividing our experience into two phases, early residency (PGY-I and PGY-II) and late residency…

  6. Philosophy of clinical psychopharmacology.

    PubMed

    Aragona, Massimiliano

    2013-03-01

    The renewal of the philosophical debate in psychiatry is one exciting news of recent years. However, its use in psychopharmacology may be problematic, ranging from self-confinement into the realm of values (which leaves the evidence-based domain unchallenged) to complete rejection of scientific evidence. In this paper philosophy is conceived as a conceptual audit of clinical psychopharmacology. Its function is to criticise the epistemological and methodological problems of current neopositivist, ingenuously realist and evidence-servant psychiatry from within the scientific stance and with the aim of aiding psychopharmacologists in practicing a more self-aware, critical and possibly useful clinical practice. Three examples are discussed to suggest that psychopharmacological practice needs conceptual clarification. At the diagnostic level it is shown that the crisis of the current diagnostic system and the problem of comorbidity strongly influence psychopharmacological results, new conceptualizations more respondent to the psychopharmacological requirements being needed. Heterogeneity of research samples, lack of specificity of psychotropic drugs, difficult generalizability of results, need of a phenomenological study of drug-induced psychopathological changes are discussed herein. At the methodological level the merits and limits of evidence-based practice are considered, arguing that clinicians should know the best available evidence but that guidelines should not be constrictive (due to several methodological biases and rhetorical tricks of which the clinician should be aware, sometimes respondent to extra-scientific, economical requests). At the epistemological level it is shown that the clinical stance is shaped by implicit philosophical beliefs about the mind/body problem (reductionism, dualism, interactionism, pragmatism), and that philosophy can aid physicians to be more aware of their beliefs in order to choose the most useful view and to practice coherently

  7. Ethical issues in psychopharmacology

    PubMed Central

    McHenry, L

    2006-01-01

    The marketing of selective serotonin reuptake inhibitors in the psychopharmacological industry presents a serious moral problem for the corporate model of medicine. In this paper I examine ethical issues relating to the efficacy and safety of these drugs. Pharmaceutical companies have a moral obligation to disclose all information in their possession bearing on the true risks and benefits of their drugs. Only then can patients make fully informed decisions about their treatment. PMID:16816041

  8. Who Is Teaching Psychopharmacology? Who Should Be Teaching Psychopharmacology?

    ERIC Educational Resources Information Center

    Dubovsky, Steven L.

    2005-01-01

    Objective: To review the current status of psychopharmacology education for medical students, residents, and practitioners in psychiatry and other specialties. Methods: A search of the MEDLINE and PsychInfo data bases was conducted using four keywords: pharmacology, psychopharmacology, teaching, and student. Additional references were obtained…

  9. Motivational Interviewing and Adolescent Psychopharmacology

    ERIC Educational Resources Information Center

    Dilallo, John J.; Weiss, Gony

    2009-01-01

    The use of motivational interviewing strategies in the practice of adolescent psychopharmacology is described. Motivational interviewing is an efficient and collaborative style of clinical interaction and this helps adolescent patients to integrate their psychiatric difficulties into a more resilient identity.

  10. Psychopharmacology in pediatric critical care.

    PubMed

    Stoddard, Frederick J; Usher, Craigan T; Abrams, Annah N

    2006-07-01

    Psychopharmacologic treatment in pediatric critical care requires a careful child or adolescent psychiatric evaluation, including a thorough review of the history of present illness or injury, any current or pre-existing psychiatric disorder, past history, and laboratory studies. Although there is limited evidence to guide psychopharmacologic practice in this setting, psychopharmacologic treatment is increasing in critical care, with known indications for treatment, benefits, and risks; initial dosing guidelines; and best practices. Treatment is guided by the knowledge bases in pediatric physiology, psycho-pharmacology, and treatment of critically ill adults. Pharmacologic considerations include pharmacokinetic and pharmcodynamic aspects of specific drugs and drug classes, in particular elimination half-life, developmental considerations, drug interactions, and adverse effects. Evaluation and management of pain is a key initial step, as pain may mimic psychiatric symptoms and its effective treatment can ameliorate them. Patient comfort and safety are primary objectives for children who are acutely ill and who will survive and for those who will not. Judicious use of psychopharmacolgic agents in pediatric critical care using the limited but growing evidence base and a clinical best practices collaborative approach can reduce anxiety,sadness, disorientation, and agitation; improve analgesia; and save lives of children who are suicidal or delirious. In addition to pain, other disorders or indications for psychopharmacologic treatment are affective disorders;PTSD; post-suicide attempt patients; disruptive behavior disorders (especially ADHD); and adjustment, developmental, and substance use disorders. Treating children who are critically ill with psychotropic drugs is an integral component of comprehensive pediatric critical care in relieving pain and delirium; reducing inattention or agitation or aggressive behavior;relieving acute stress, anxiety, or depression; and

  11. Psychopharmacology in autism.

    PubMed

    Tsai, L Y

    1999-01-01

    Autism is a neurobiological disorder. The core clinical features of autism include impairment in social interaction, impairments in verbal and nonverbal communication, and restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. Autism often has coexisting neuropsychiatric disorders, including seizure disorders, attention deficit hyperactivity disorder, affective disorders, anxiety disorder, obsessive-compulsive disorder, and Tourette disorder. No etiology-based treatment modality has been developed to cure individuals with autism. However, comprehensive intervention, including parental counseling, behavior modification, special education in a highly structured environment, sensory integration training, speech therapy, social skill training, and medication, has demonstrated significant treatment effects in many individuals with autism. Findings from preliminary studies of major neurotransmitters and other neurochemical agents strongly suggest that neurochemical factors play a major role in autism. The findings also provide the rationale for psychopharmacotherapy in individuals with autism. This article reviews studies of neurochemical systems and related psychopharmacological research in autism and related neuropsychiatric disorders. Clinical indications for pharmacotherapy are described, and uses of various medications are suggested. This article also discusses new avenues of investigation that may lead to the development of more effective medication treatments in persons with autism. PMID:10511014

  12. Psychopharmacology in Primary Care Settings.

    PubMed

    Benich, Joseph J; Bragg, Scott W; Freedy, John R

    2016-06-01

    Psychopharmacology requires clinicians to stay current on the latest guidelines and to use dynamic treatment strategies. Psychiatric conditions are prevalent in the primary care population. Choice of treatment with psychopharmacology should be based on controlling the patient's predominant symptoms while taking into consideration patient age, treatment compliance, patient past response to treatments, dosing frequency, patient preference, medication side effects, potential medication interactions, drug precautions/warnings, and cost. Response to therapy, as well as side effects, needs to be evaluated at regular intervals. The goal is to minimize symptoms and return patients to their maximal level of functioning. PMID:27262011

  13. Alternate Methods of Teaching Psychopharmacology

    ERIC Educational Resources Information Center

    Zisook, Sidney; Benjamin, Sheldon; Balon, Richard; Glick, Ira; Louie, Alan; Moutier, Christine; Moyer, Trenton; Santos, Cynthia; Servis, Mark

    2005-01-01

    Objective: This article reviews methods used to teach psychopharmacology to psychiatry residents that utilize principles of adult learning, enlist active participation of residents, and provide faculty with skills to seek, analyze, and use new information over the course of their careers. Methods: The pros and cons of five "nonlecture" methods of…

  14. Ethical problems in psychopharmacological research.

    PubMed

    Gentili, C; Ferrari, G

    1979-01-01

    1. Scientific research poses considerable ethical problems which in human psychopharmacological studies are frequently faced by singling out consent as the only reliable source of human respect, although it is never free, spontaneous, or informed. 2. On the other hand, various ethical problems present in the "life" of a new substance in the case of industry and preclinical, clinical and mass experiments, are left behind. 3. Thus there arise justified protests which go so far as disowning science and technology. To criticize science and technology is of no use: incorrect use of them must be prevented. 4. Such a guarantee can only come from an international control committee, capable of coping with a multinational power such as industry, supported by peripheral elective committees, which grant the citizens a direct participation in the administration of health. PMID:400986

  15. [Psychopharmacological treatment of bipolar disease].

    PubMed

    Licht, Rasmus W; Vestergaard, Per

    2002-05-01

    This paper gives an update on the psychopharmacological treatment of bipolar disorder. The antimanic efficacy of lithium is well documented. The same applies to valproate, which is also efficacious in mixed mania. Conventional antipsychotics act fast in mania and do not require blood tests, but they have considerable neurological side effects. The newer antipsychotics, olanzapine, risperidone, and ziprasidone, have also been shown to have antimanic efficacy. Clozapine is extremely effective, also when other treatment fails. For the treatment of bipolar depression, lithium, lamotrigine, and antidepressants all seem to work, but antidepressants may sometimes precipitate mania or worsen the course of illness. For prophylaxis, lithium is still to be considered the first drug of choice. However, for several reasons, for instance treatment failure or side effects, long-term treatment with antiepileptics may often be necessary. Among the antiepileptics, carbamazepine, valproate, and lamotrigine are the best studied. PMID:12025705

  16. Psychopharmacologic treatment of borderline personality disorder.

    PubMed

    Ripoll, Luis H

    2013-06-01

    The best available evidence for psychopharmacologic treatment of borderline personality disorder (BPD) is outlined here. BPD is defined by disturbances in identity and interpersonal functioning, and patients report potential medication treatment targets such as impulsivity, aggression, transient psychotic and dissociative symptoms, and refractory affective instability Few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, although multiple reviews have converged on the effectiveness of specific anticonvulsants, atypical antipsychotic agents, and omega-3 fatty acid supplementation. Stronger evidence exists for medication providing significant improvements in impulsive aggression than in affective or other interpersonal symptoms. Future research strategies will focus on the potential role of neuropeptide agents and medications with greater specificity for 2A serotonin receptors, as well as optimizing concomitant implementation of evidence-based psychotherapy and psychopharmacology, in order to improve BPD patients' overall functioning. PMID:24174895

  17. Psychopharmacologic treatment of borderline personality disorder

    PubMed Central

    Ripoll, Luis H.

    2013-01-01

    The best available evidence for psychopharmacologic treatment of borderline personality disorder (BPD) is outlined here. BPD is defined by disturbances in identity and interpersonal functioning, and patients report potential medication treatment targets such as impulsivity, aggression, transient psychotic and dissociative symptoms, and refractory affective instability Few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, although multiple reviews have converged on the effectiveness of specific anticonvulsants, atypical antipsychotic agents, and omega-3 fatty acid supplementation. Stronger evidence exists for medication providing significant improvements in impulsive aggression than in affective or other interpersonal symptoms. Future research strategies will focus on the potential role of neuropeptide agents and medications with greater specificity for 2A serotonin receptors, as well as optimizing concomitant implementation of evidence-based psychotherapy and psychopharmacology, in order to improve BPD patients' overall functioning. PMID:24174895

  18. Psychopharmacology with the Behaviorally Disturbed: A Review.

    ERIC Educational Resources Information Center

    McClain, William A.; Jerman, George

    Reviewed on a layman's level was research on psychopharmacology with the emotionally and behaviorally disturbed. General conclusions drawn from the man y studies were that the effect of drugs on intellectual functioning had not been determined and that there was little evidence to indicate that the learning process was consistently and reliably…

  19. Teaching Critical Appraisal of Articles on Psychopharmacology

    ERIC Educational Resources Information Center

    Mohr, Pavel; Hoschl, Cyril; Volavka, Jan

    2012-01-01

    Objective: Psychiatrists and other physicians sometimes read publications superficially, relying excessively on abstracts. The authors addressed this problem by teaching critical appraisal of individual articles. Method: The authors developed a 23-item appraisal instrument to assess articles in the area of psychopharmacology. The results were…

  20. [Psychopharmacologic properties of Lippia multiflora].

    PubMed

    Abena, A A; Ngondzo-Kombeti, G R; Bioka, D

    1998-01-01

    Lippia multiflora (L.m.) is a verbenacea used in Congo as conventional tea decoction. No traditional indication is known in this country. Nevertheless, in Ghana the plant is used for the treatment of arterial hypertension. The aim of this study is to investigate the psychotropic activity of the aqueous extract of L.m. using the classical tests of experimental psychopharmacology. The extract of L.m. is constituted by lyophilisated powder obtained from an infusion of dried leaves. Different doses are prepared: 200, 400, 600, 800, 1,000 and 1,200 mg/kg dissolved in 1 ml of NaCl 0.9%. L.m. is administered by intraperitoneal or oral route. The wistar rats of both sexes, weighing between 150-200 g, are used. Animal's behaviour is observed macroscopically. The spontaneous motor activity is appreciated by using the number of squares crossed by animal with the four paws in ten minutes (Martin and al. method slightly modified). The rectal temperature is measured. The effect of L.m. on stereotypies induced by apomorphin and anesthesia induced by phenobarbital are studied. The traction test is used to investigate the muscle relaxant effect of L.m. and analgesic activity is evaluated by using acetic acid and hot plate methods by comparison with diazepam 2 and 4 mg/kg. Fischer-t test is used for the statistical analysis of results. L.m. is well tolerated by rats. No mortality is observed with the doses used. So the doses of 200, 400 and 600 mg/kg were selected for experiments. At theses doses L.m. caused: a precocious ataxia, a sedation, a ptosis and a yellow coloration of urines, these effects are dose dependent; a significant reduction of spontaneous motor activity: control 61.60 +/- 6.48, L.m. 200: 16.40 +/- 5.68 (P < 0.01), L.m. 400: 12.20 +/- 2.01 and L.m. 600: 9.60 +/- 1.90 (P < 0.01); no modification of rectal temperature and apomorphin stereotypies; a reduction of sleep latence: control 22.40 +/- 1.89 min, L.m. 200: 17.20 +/- 2.74 min (P < 0.01), L.m. 400: 13.80 +/- 1

  1. Pediatric psychopharmacology: too much or too little?

    PubMed Central

    Rapoport, Judith L

    2013-01-01

    This paper provides a selective overview of the past, present and future of pediatric psychopharmacology. The acceptance of medication use in child psychiatry was based on the results of double-blind, placebo-controlled trials documenting the efficacy of drug treatments for attention-deficit/hyperactivity disorder, enuresis, depression, anxiety disorders, obsessive-compulsive disorder and psychoses. This period of success was followed by a series of challenges, including a growing awareness of the long-term adverse effects of medications and of the inadequacy of long-term drug surveillance. There is great concern today that children are being overtreated with medication, especially in the US. Further advances in pediatric psychopharmacology may come from examination of large medical data sets including both pharmacological and psychiatric information, which could lead to drug repurposing, as well as from preclinical translational studies such as those using human induced pluripotent stem cells. PMID:23737413

  2. Treatment of Bulimia Nervosa: Psychological and Psychopharmacologic Considerations.

    ERIC Educational Resources Information Center

    Phillips, Elaine L.; Greydanus, Donald E.; Pratt, Helen D.; Patel, Dilip R.

    2003-01-01

    Reviews the current literature on psychological and psychopharmacologic treatments for bulimia nervosa in the adolescent population. Describes the two most researched psychological treatments--cognitive behavior therapy and interpersonal therapy--in terms of treatment protocols and outcome research. Reviews psychopharmacologic treatment, including…

  3. Advancing Social Work Curriculum in Psychopharmacology and Medication Management

    ERIC Educational Resources Information Center

    Farmer, Rosemary L.; Bentley, Kia J.; Walsh, Joseph

    2006-01-01

    The authors reviewed current literature and curriculum resources on psychopharmacology and social work. They argue that baccalaureate and master of social work courses need to routinely include more in-depth knowledge on psychopharmacology and provide a more critical social work-focused approach to this content due to the increasing complexity of…

  4. The Limited Role of Expert Guidelines in Teaching Psychopharmacology

    ERIC Educational Resources Information Center

    Salzman, Carl

    2005-01-01

    Objective: To consider the limited usefulness of expert guidelines for teaching psychopharmacology. Method: Potential problems using expert guidelines for teaching psychopharmacology are reviewed. Results: Expert guidelines are an important contribution to the growth of evidence-based psychiatry. As such, they may also be used to teach…

  5. Teaching the Prescriber's Role: The Psychology of Psychopharmacology

    ERIC Educational Resources Information Center

    Mintz, David L.

    2005-01-01

    Objective: The author examines one aspect of the psychopharmacology curriculum: the psychology of psychopharmacology. Method: Drawing from his experience teaching this subject to trainees at many different levels and from an emerging evidence base suggesting that psychosocial factors in the doctor-patient relationship may be crucial for medication…

  6. Prescription Privileges, Psychopharmacology and School Psychology: An Overview.

    ERIC Educational Resources Information Center

    Carlson, Cindy; Kubiszyn, Tom

    1994-01-01

    Focuses on psychopharmacology and prescription privileges for psychologists. Summarizes nine major findings from Task Force on Psychopharmacology in the Schools, created to review literature on prescription privileges for psychologists; identify specific issues attendant to use of psychoactive medications with children; and clarify implications…

  7. Challenges and Promises of Pediatric Psychopharmacology.

    PubMed

    Giles, Lisa L; Martini, D Richard

    2016-08-01

    Most prescriptions for psychotropic medications are written by primary care physicians, yet pediatricians, many of whom are teaching residents and medical students about pediatric psychopharmacology, often feel inadequately trained to treat mental health concerns. Over the past several decades, the number, size, and quality of psychopharmacologic studies in youth has greatly increased. Here we review the current evidence for efficacy and safety of each of the major pharmacologic drug classes in youth (psychostimulants, antidepressants, mood stabilizers, and antipsychotics). Psychostimulants have a robust body of literature supporting their evidence as first-line treatment for attention-deficit/hyperactivity disorder. Selective serotonin reuptake inhibitors (SSRIs) have documented efficacy for pediatric depression and multiple different anxiety disorders with childhood onset. Combining cognitive-behavioral therapy with SSRI treatment enhances treatment benefit and minimizes adverse events of medication. Mood stabilizers, including lithium and anticonvulsant medications, have a less robust strength of evidence and come with more problematic side effects. However, they are increasingly prescribed to youth, often to treat irritability, mood lability, and aggression, along with treatment of bipolar disorder. Antipsychotics have long been a mainstay of treatment for childhood-onset schizophrenia, and in recent years, the evidence base for providing antipsychotics to youth with bipolar mania and autistic disorder has grown. Most concerning with antipsychotics are the metabolic side effects, which appear even more problematic in youth than adults. By better understanding the evidence-based psychopharmacologic interventions, academic pediatricians will be able to treat patients and prepare future pediatrician to address the growing mental health care needs of youth. PMID:27064142

  8. Cardiovascular side effects of psychopharmacologic therapy.

    PubMed

    Potočnjak, Ines; Degoricija, Vesna; Vukičević Baudoin, Dina; Čulig, Josip; Jakovljević, Miro

    2016-09-15

    WHO defined in 1976 psychopharmaca as drugs affecting psychological functions, behaviour and self-perception. Psychopharmacology is the study of pharmacological agents that affect mental and emotional functions. Creative approach to psychopharmacotherapy reflects a transdisciplinary, integrative and person-centered psychiatry. Psychiatric disorders often occur in cardiac patients and can affect the clinical presentation and morbidity. Cardiovascular (CV) side effects (SE) caused by psychopharmaceutic agents require comprehensive attention. Therapeutic approach can increase placebo and decrease nocebo reactions. The main purpose of this review is to comprehend CV SE of psychotropic drugs (PD). Critical overview of CV SE of PD will be presented in this review. Search was directed but not limited to CV effects of psychopharmacological substances, namely antipsychotics, anxiolytics, hypnotics, sedatives, antidepressants and stimulants. Literature review was performed and data identified by searches of Medline and PubMed for period from 2004 to 2015. Only full articles and abstracts published in English were included. SE of PD are organized according to the following types of CV effects: cardiac and circulatory effects, abnormalities of cardiac repolarisation and arrhythmias and heart muscle disease. There is wide spectrum and various CV effects of PD. Results of this review are based on literature research. The reviewed data came largely from prevalence studies, case reports, and cross-sectional studies. Psychopharmacotherapy of psychiatric disorders is complex and when concomitantly present with CV disease, presentation of drug SEs can significantly contribute to illness course. Further development of creative psychopharmacotherapy is required to deal with CV effects of PD. PMID:27352209

  9. Complementary and Alternative Medicine (CAM) Treatments and Pediatric Psychopharmacology

    ERIC Educational Resources Information Center

    Rey, Joseph M.; Walter, Garry; Soh, Nerissa

    2008-01-01

    Children and adolescents often use complementary and alternative medicine (CAM) treatments outside their indications, particularly to lose weight. Some of the herbal remedies and dietary supplements that may of relevance for psychopharmacological practice are discussed with respect to CAM treatments.

  10. Psychopharmacologic treatment of eating disorders: emerging findings.

    PubMed

    McElroy, Susan L; Guerdjikova, Anna I; Mori, Nicole; Keck, Paul E

    2015-05-01

    Psychopharmacologic treatment is playing a greater role in the management of patients with eating disorders. In this paper, we review randomized, placebo-controlled trials (RCTs) conducted in anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other eating disorders over the past 3 years. Fluoxetine remains the only medication approved for an eating disorder, that being BN. RCTs of antipsychotics in AN have had mixed results; the only agent with some evidence of efficacy is olanzapine. One study suggests dronabinol may induce weight gain in AN. Preliminary studies suggest lack of efficacy of alprazolam, dehydroepiandrosterone, or physiologic estrogen replacement in AN; erythromycin in BN; and the opioid antagonist ALKS-33 in BED. In BED with obesity or overweight, bupropion may cause mild weight loss without seizures, and chromium may improve glucose regulation. Also in BED, three RCTs suggest the stimulant prodrug lisdexamfetamine may reduce binge eating episodes, and another RCT suggests intranasal naloxone may decrease time spent binge eating. There remains a disconnection between the size of eating disorders as a public health problem and the lack of pharmacotherapy research of these conditions. PMID:25796197

  11. [Generic drugs in psychopharmacology: pros and cons].

    PubMed

    Cuenca, E; Zaragozá, F

    1999-01-01

    Legislation to facilitate process for generic products has been enacted and generic drugs have entered the market soon after the patent for the brand-name agent have expired. In every instance, the rationale has been economic since it is generally assumed that the copies are not only therapeutically equivalent but also a great deal less expensive than the original. Sometimes this may be so. In this short review several comments are made in order to establish the variables that may influence bioequivalence between the brand-name drug and its generics. Among them emphasis is given to the particle sizes, pharmaceutical supply, choice of the right excipient, in order to avoid possible interactions with the drug, ingredient quality and purity, etc. All these variables must be carefully controlled. Even so a patient who is changed from a trade name product to a generic drug (or vice versa) may respond a little differently, which is important in Psychopharmacology. Two or more products should be considered biologically equivalent only when it can demonstrated that they fulfil three conditions: that they have the same pharmaceutical properties; that they are equally effective in therapeutic use and that they are tolerated equally by patients being treated for the indicated uses. Regulatory agencies could require subsequent versions of an original therapeutic product the type of data regarding pharmacology, toxicology and chemical assessment that was mandatory for the introduction of the original. PMID:10611558

  12. Child psychopharmacology: Is it more similar than different from adult psychopharmacology?

    PubMed

    Sareen, Himanshu; Trivedi, Jitendra Kumar

    2013-07-01

    Despite having a large chunk of human population, Asian countries face shortage of mental health professionals. There is further shortage of doctors dealing with special groups of population like the children, the elderly, and the medically ill. However, in this era of super-specializations, are the basic principles of general psychopharmacology being forgotten? Dealing with child population is different and often more difficult than adult population but are management guidelines for the two populations vastly divergent? A close look at this paints a different picture. Psychotherapies applied in adults and those in children and adolescents are disparate owing to cognitive, social, emotional, and physical immaturation in children and adolescents. But the drugs for the treatment of pediatric psychiatric disorders are mostly similar to those prescribed for adults (case in point -bipolar disorders, obsessive compulsive disorder, schizophrenia). Rather than focusing energy on propagating the differences in assorted subgroups of population, honing of skills regarding intricacies of psychopharmacology is required to be emphasized. Detailed history taking, careful evaluation of the patient, sound diagnostic formulation, and prescribing medications which are tailor made to the patient will all go a long way in ensuring a functional recovery of the patients irrespective of the group they belong to. PMID:24082257

  13. Tinnitus psychopharmacology: A comprehensive review of its pathomechanisms and management

    PubMed Central

    Fornaro, Michele; Martino, Matteo

    2010-01-01

    Background: Subjective tinnitus is a frequent, impairing condition, which may also cause neurotransmitter imbalance at the cochlea. Psychopharmacologic agents, although not being the first-line treatment for tinnitus, may modulate cochlear neurotransmission, thereby influencing the subjective tinnitus experience. Method: A comprehensive review of MEDLINE literature (from January 1990–January 2010) was performed searching for: “tinnitus”, major classes of psychopharmacological agents, and psychiatric disorders. The most relevant clinical evidence is reported briefly along with a concise description of the main neurotransmitters purported to be involved in tinnitus, in order to provide the reader with a rational evaluation of tinnitus therapy with psychopharmacological agents. Results: Although strong methodological issues limit the reliability of the current results, a broad number of psychopharmacological agents have already been considered for tinnitus, both as candidate triggers or potential therapies. Conclusions: Selected psychopharmacological drugs may play a role in the clinical management of this disorder. While the rational use of these agents for the treatment of tinnitus should not be overlooked, research should be undertaken on their neuromodulating actions at the cochlea. PMID:20628627

  14. The ethics of psychopharmacological research in legal minors

    PubMed Central

    Tan, Jacinta OA; Koelch, Michael

    2008-01-01

    Research in psychopharmacology for children and adolescents is fraught with ethical problems and tensions. This has practical consequences as it leads to a paucity of the research that is essential to support the treatment of this vulnerable group. In this article, we will discuss some of the ethical issues which are relevant to such research, and explore their implications for both research and standard care. We suggest that finding a way forward requires a willingness to acknowledge and discuss the inherent conflicts between the ethical principles involved. Furthermore, in order to facilitate more, ethically sound psychopharmacology research in children and adolescents, we suggest more ethical analysis, empirical ethics research and ethics input built into psychopharmacological research design. PMID:19063724

  15. Psychopharmacological interventions in autism spectrum disorder.

    PubMed

    Politte, Laura C; Henry, Charles A; McDougle, Christopher J

    2014-01-01

    After participating in this educational activity, the physician should be better able to1. Prescribe the appropriate psychotropic medication to treat symptoms of ASD.2. Identify the side effects of the psychotropic medications used to treat ASD.Autism spectrum disorders (ASDs) are characterized by core deficits in social communication and language, and restrictive and repetitive behaviors that cause significant functional impairment and distress for affected individuals and their caregivers. The increasing prevalence of ASD, most recently estimated as 1 in 88 children, presents an ever-increasing burden on families, schools, medical systems, and society at large. Individuals with ASD commonly present for treatment of associated emotional and behavioral disturbances that include anxiety, symptoms of ADHD, compulsions and other repetitive behaviors, mood lability, irritability, aggression, and sleep disturbance. Psychotropic medications are widely utilized in alleviating these symptoms, though rigorous clinical trials in ASD are lacking for most areas of impairment. Strong evidence from randomized, placebo-controlled trials supports the use of atypical antipsychotics, particularly risperidone and aripiprazole, for managing severe irritability and aggression in ASD. Serotonin reuptake inhibitors are commonly used to treat anxiety and compulsions, though reports of efficacy in the literature are mixed, and behavioral side effects in children are common. Minimal evidence supports the utility of anticonvulsants and traditional mood stabilizers in managing mood lability and aggression. Stimulant and nonstimulant ADHD medications can be effective for reducing hyperactivity, inattention, and impulsivity, though to a lesser degree than in ADHD populations without ASD and with greater risk of adverse effects. Psychopharmacological interventions in development for core symptoms of autism include those that target the glutamatergic and GABAergic neurotransmitter systems and the

  16. Computer System for Monitoring Drug Effects in Psychopharmacologic Research

    PubMed Central

    Latham, Georgia S.; Martinez, Rick; Sunderland, Trey

    1990-01-01

    To aid in the evaluation of cognitive effects and side effects of drugs in psychopharmacologic trials, a computerized battery was developed to assess memory, attention, mood, physical side effects, and reaction time. Parallel forms of the battery allow for repeated measures within subjects design. All aspects of task performance are automatically recorded, permitting qualification of drug-induced effects on multiple stages of information processing. Data collected with the battery can be output as hard copy case reports or files formatted for statistical analysis. The battery and its utility in psychopharmacologic trials are described.

  17. 75 FR 47309 - Psychopharmacologic Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... HUMAN SERVICES Food and Drug Administration Psychopharmacologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public advisory committee of the Food and Drug Administration (FDA). The meeting will be...

  18. 76 FR 65736 - Psychopharmacologic Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-24

    ... HUMAN SERVICES Food and Drug Administration Psychopharmacologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public advisory committee of the Food and Drug Administration (FDA). The meeting will be...

  19. 78 FR 13349 - Psychopharmacologic Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ... HUMAN SERVICES Food and Drug Administration Psychopharmacologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public advisory committee of the Food and Drug Administration (FDA). The meeting will be...

  20. Psychopharmacology and Mental Retardation: A 10 Year Review (1990- 1999).

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Bamburg, Jay W.; Mayville, Erik A.; Pinkston, Jim; Bielecki, Joanne; Kuhn, David; Smalls, Yemonja; Logan, James R.

    2000-01-01

    Review of the literature on psychopharmacology and mental retardation from 1990-1999 found most studies had major methodological flaws. Also, most drug administrations were not based in science, were not evaluated appropriately, and generally did not follow best practices for treatment of persons with mental retardation. A table lists the studies…

  1. Using Game-Based Learning to Teach Psychopharmacology

    ERIC Educational Resources Information Center

    Scarlet, Janina; Ampolos, Lauren

    2013-01-01

    This article reviews several approaches used to teach psychopharmacology for graduate clinical psychology students. In order to promote engagement and increase student interest, students were broken up into groups and were asked to demonstrate their understanding of the material through a variety of interactive games (i.e., game-based learning, or…

  2. Psychopharmacology: A Guide for Helping Professionals. ERIC Digest.

    ERIC Educational Resources Information Center

    Smith, Robert L.; Garcia, Elda E.

    Certain mental disorders are caused by or accompanied by neurochemical abnormalities. The use of psychotropic medications has dramatically increased over the past two decades in all age groups, particularly with children. Therefore, psychopharmacology, the branch of pharmacology dealing with the psychological effects of drugs, needs to be…

  3. Teaching a Psychopharmacology Course to Counselors: Justification, Structure, and Methods.

    ERIC Educational Resources Information Center

    Ingersoll, R. Elliot

    2000-01-01

    In the last decade, the use of medication to treat psychological disorders has greatly expanded. In order to work effectively in school and community settings, counselors will need a sophisticated knowledge of psychopharmacology. This article describes the curriculum, structure, resources, and teaching methods suggested for effective instruction…

  4. Improving the Pedagogy Associated with the Teaching of Psychopharmacology

    ERIC Educational Resources Information Center

    Glick, Ira D.; Salzman, Carl; Cohen, Bruce M.; Klein, Donald F.; Moutier, Christine; Nasrallah, Henry A.; Ongur, Dost; Wang, Po; Zisook, Sidney

    2007-01-01

    Objective: The authors summarize two special sessions focused on the teaching of psychopharmacology at the 2003 and 2004 annual meeting of the American College of Neuropsychopharmacology (ACNP). The focus was on whether "improving the teaching-learning process" in psychiatric residency programs could improve clinical practice. Method: Problems of…

  5. Child Psychopharmacology: How School Psychologists Can Contribute to Effective Outcomes

    ERIC Educational Resources Information Center

    DuPaul, George J.; Carlson, John S.

    2005-01-01

    Psychopharmacological treatments have been used with increased frequency to treat a variety of internalizing and externalizing disorders in children. Given the potential impact that medication has on children's school performance, school psychologists should be involved in helping physicians and families make effective decisions by assisting with…

  6. Psychopharmacology in School-Based Mental Health Services.

    ERIC Educational Resources Information Center

    Del Mundo, Amor S.; Pumariega, Andres J.; Vance, Hubert R.

    1999-01-01

    Discusses issues regarding the use of a pharmacological approach to the treatment of children with serious emotional and mental disorders that interfere with learning. Addresses the current state of psychopharmacological treatment for diagnostic entities and behavioral symptomatology. Discusses the roles of the child, family, and health and…

  7. Psychopharmacology of Autism Spectrum Disorders: A Selective Review

    ERIC Educational Resources Information Center

    Mohiuddin, Sarah; Ghaziuddin, Mohammad

    2013-01-01

    While there is no cure for autism spectrum disorder, psychopharmacologic agents are often used with behavioral and educational approaches to treat its comorbid symptoms of hyperactivity, irritability, and aggression. Studies suggest that at least 50% of persons with autism spectrum disorder receive psychotropic medications during their life span.…

  8. Practical Clinical Trials in Psychopharmacology: a Systematic Review

    PubMed Central

    Vitiello, Benedetto

    2015-01-01

    Practical clinical trials (PCT) are randomized experiments under typical practice conditions with the aim of testing the “real life” benefits and risks of therapeutic interventions. Influential PCTs have been conducted in cardiology, oncology, and internal medicine. Psychotropic medications are widely and increasingly used in medical practice. This review examines recent progress in conducting PCTs in psychopharmacology. The January 2000 – October 2014 MEDLINE, Scopus, and ClinicalTrials.gov databases were searched for peer-reviewed publications of PCTs with at least 100 subjects per treatment arm. Most PCTs in psychiatry evaluated mental health services or psychosocial interventions rather than specific pharmacotherapies. Of 157 PCTs in psychiatry, 30 (19%) were in psychopharmacology, with a median of 2 publications per year and no increase over the period of observation. Sample size ranged from 200 to 18,154; only 11 studies randomized 500 patients or more. Psychopharmacology PCTs were equally likely to be funded by industry as by public agencies. There were 10 PCTs of antidepressants, for a total of 4,206 patients (in comparison with at least 46 PCT of antihypertensive medications, for a total of 208,014 patients). Some psychopharmacology PCTs used suicidal behavior, treatment discontinuation, or mortality as primary outcome, and produced effectiveness and safety data that have influenced both practice guidelines and regulatory decisions. PCTs can constitute an important source of information for clinicians, patients, regulators, and policy makers, but have been relatively underutilized in psychopharmacology. Electronic medical records and integrated practice research networks offer promising platforms for a more efficient conduct of PCTs. PMID:25679131

  9. Somatic treatments excluding psychopharmacology in obsessive- compulsive disorder: a review.

    PubMed

    Atmaca, Murad

    2013-06-01

    Somatic treatments other than psychotropic drugs are increasingly used in the patients with obsessive compulsive disorder (OCD), however there has been little systematic review of them. Therefore, the present review deals with a variety of somatic treatment methods excluding psychotropic drugs. A literature search was performed on the PubMed database from the beginning of 1980, to September 2012, for published English, Turkish and French-language articles of somatic treatment approaches (excluding psychopharmacological agents) in the treatment of OCD. The search was carried out by using some terms in detail. Afterwards, the obtained investigations on electroconvusive therapy (ECT), deep brain stimulation (DBS), neurosurgical methods and transcranial magnetic stimulation (TMS) were presented. Although psychopharmacological treatment and psychotherapeutic approaches are primary treatment modalities in the management of OCD, other somatic treatment options seem to be used as alternatives, especially for patients with treatmentresistant OCD. PMID:24032546

  10. Psychopharmacology of ADHD in pediatrics: current advances and issues

    PubMed Central

    Greydanus, Donald E; Nazeer, Ahsan; Patel, Dilip R

    2009-01-01

    Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral developmental disorder found in 3% to 8% of children and adolescents. An important part of ADHD management is psychopharmacology, which includes stimulants, norepinephrine reuptake inhibitors, alpha-2 agonists, and antidepressants. Medications with the best evidence-based support for ADHD management are the stimulants methylphenidate and amphetamine. A number of newer, long-acting stimulants are now available and a number of new medications are considered that are under current research. PMID:19557112

  11. Females' participation in psychopharmacology research as authors, editors, and subjects.

    PubMed

    Poling, Alan; Durgin, Amy; Bradley, Kelly P; Porter, Lindsay K; Van Wagner, Karen; Weeden, Marc; Panos, John J

    2009-04-01

    This study determined the involvement of women as first authors and other authors for every article published in Experimental and Clinical Psychopharmacology, Pharmacology Biochemistry and Behavior, and Psychopharmacology in 1991, 1996, 2001, and 2006. Their involvement as editors also was determined. Women's participation as authors, but not as editors, slightly increased over time. In 2006, 43% of first authors, 38% of other authors, and 24% of editors were women. The gender of subjects was examined for the same years and journals, but could not be determined for 6% and 9% of articles employing nonhuman and human subjects, respectively. In 2006, when subjects' gender could be determined, 77% of articles involving nonhuman subjects used only males, 9% only females, and 14% both males and females. In articles using human subjects in that same year, 17% involved only males, 6% only females, and 77% both males and females. Women researchers clearly make substantial contributions to the psychopharmacology literature, but are nonetheless underrepresented as editors. Findings regarding subjects indicate that there is growing recognition of the importance of gender as a determinant of drug effects, although the vast majority of nonhuman studies continue to involve only male subjects. PMID:19331487

  12. Survey of Nationally Certified School Psychologists' Roles and Training in Psychopharmacology

    ERIC Educational Resources Information Center

    Shahidullah, Jeffrey D.; Carlson, John S.

    2014-01-01

    A randomly selected group of Nationally Certified School Psychologists (NCSPs; n = 817) were mailed the 42-item "School Psychopharmacology Roles and Training Evaluation" (SPRTE) which inquired about their caseloads, practice roles as proposed by DuPaul and Carlson ([DuPaul, G. J., 2005]), and prior training in psychopharmacology. A…

  13. A Survey of School Psychologists' Knowledge and Training in Child Psychopharmacology

    ERIC Educational Resources Information Center

    Carlson, John S.; Demaray, Michelle Kilpatrick; Hunter-Oehmke, Shana

    2006-01-01

    A national sample of 320 school-based, practicing members of the National Association of School Psychologists provided information on (a) their caseloads receiving medications, (b) types of school psychopharmacology training opportunities available and perceptions of their current training in child psychopharmacology, and (c) information about…

  14. Assessment of Psychopharmacology on the American Board of Psychiatry and Neurology Examinations

    ERIC Educational Resources Information Center

    Juul, Dorthea; Winstead, Daniel K.; Sheiber, Stephen C.

    2005-01-01

    OBJECTIVE: To report the assessment of psychopharmacology on the certification and recertification exams in general psychiatry and in the subspecialties administered by the American Board of Psychiatry and Neurology (ABPN). METHODS: The ABPN's core competencies for psychiatrists were reviewed. The number of items addressing psychopharmacology or…

  15. Psychopharmacology in Medical Practice—The Benefits and the Risks

    PubMed Central

    Sack, Robert L.; Shore, James H.

    1981-01-01

    Psychopharmacology has become a major approach to treatment in primary medical care. However, combined psychiatric and medical illness can give rise to some challenging diagnostic problems. Furthermore, drug treatment of patients with such illnesses can involve important drug-disease interactions and drug-drug interactions. One should keep in mind the issues that arise when an emotionally troubled patient would benefit from a psychotropic drug but a concurrent medical illness complicates this treatment. An awareness of both the medical and psychiatric issues involved may make successful treatment possible. PMID:7269559

  16. Psychopharmacological options for adult patients with anorexia nervosa.

    PubMed

    Miniati, Mario; Mauri, Mauro; Ciberti, Agnese; Mariani, Michela Giorgi; Marazziti, Donatella; Dell'Osso, Liliana

    2016-04-01

    The aim of this review was to summarize evidence from research on psychopharmacological options for adult patients with anorexia nervosa (AN). Database searches of MEDLINE and PsycINFO (from January 1966 to January 2014) were performed, and original articles published as full papers, brief reports, case reports, or case series were included. Forty-one papers were screened in detail, and salient characteristics of pharmacological options for AN were summarized for drug classes. The body of evidence for the efficacy of pharmacotherapy in AN was unsatisfactory, the quality of observations was questionable (eg, the majority were not blinded), and sample size was often small. More trials are needed, while considering that nonresponse and nonremission are typical of patients with AN. PMID:26145463

  17. Clinical psychopharmacology and medical malpractice: the four Ds.

    PubMed

    Preskorn, Sheldon H

    2014-09-01

    The four Ds of medical malpractice are duty, dereliction (negligence or deviation from the standard of care), damages, and direct cause. Each of these four elements must be proved to have been present, based on a preponderance of the evidence, for malpractice to be found. The principles of psychopharmacology and the information in the package insert for a drug often play a central role in deciding whether dereliction and direct cause for damages were or were not applicable in a particular case. The author uses data from two cases in which patients were inadvertently fatally poisoned by medication to illustrate two ways in which such information can affect the outcome. In one case, the clinician should have known that he was giving a toxic dose to the patient, whereas that was not true in the other case. PMID:25226197

  18. [Adherence to psychopharmacological treatment: Psychotherapeutic strategies to enhance adherence].

    PubMed

    Lencer, R; Korn, D

    2015-05-01

    Effective psychopharmacological medication with good tolerability represents the cornerstone of treatment for severe mental illness; however, the 1-year adherence rates are only approximately 50%. The term adherence emphasizes the collaborative responsibility of the clinician and the patient for a positive treatment outcome. Reasons for non-adherence are manifold and include patient-specific factors, such as self-stigmatization, lack of social and familial support, cognitive impairment and substance use besides insufficient effectiveness and the occurrence of side effects of the psychotropic drugs. To enhance adherence, both clinician and patient have to fully understand all the reasons for and against adherence to medication before a collaborative decision is made on future long-term treatment. A positive attitude towards medication critically depends on whether patients feel that the medication supports the attainment of the individual goals. PMID:25903501

  19. Legal and Ethical Issues in School Psychologists' Participation in Psychopharmacological Interventions with Children.

    ERIC Educational Resources Information Center

    DeMers, Stephen T.

    1994-01-01

    Discusses expanded role for psychologists and school psychologists ranging from increased knowledge about psychopharmacology to collaborative practice with prescribing physician to obtaining limited independent prescription privileges. Explores legal issues associated with such role expansion: credential concerns, malpractice liability, and record…

  20. Brave New World versus Island--utopian and dystopian views on psychopharmacology.

    PubMed

    Schermer, M H N

    2007-06-01

    Aldous Huxley's Brave New World is a famous dystopia, frequently called upon in public discussions about new biotechnology. It is less well known that 30 years later Huxley also wrote a utopian novel, called Island. This paper will discuss both novels focussing especially on the role of psychopharmacological substances. If we see fiction as a way of imagining what the world could look like, then what can we learn from Huxley's novels about psychopharmacology and how does that relate to the discussion in the ethical and philosophical literature on this subject? The paper argues that in the current ethical discussion the dystopian vision on psychopharmacology is dominant, but that a comparison between Brave New World and Island shows that a more utopian view is possible as well. This is illustrated by a discussion of the issue of psychopharmacology and authenticity. The second part of the paper draws some further conclusions for the ethical debate on psychopharmacology and human enhancement, by comparing the novels not only with each other, but also with our present reality. It is claimed that the debate should not get stuck in an opposition of dystopian and utopian views, but should address important issues that demand attention in our real world: those of evaluation and governance of enhancing psychopharmacological substances in democratic, pluralistic societies. PMID:17486431

  1. Behavioral and psychopharmacological treatment of the paraphilic and hypersexual disorders.

    PubMed

    Krueger, Richard B; Kaplan, Meg S

    2002-01-01

    In this article, the second of a two-part series, the authors present information on the clinical assessment of individuals with paraphilias and hypersexual disorders. They review ethical considerations in the assessment and treatment of individuals with paraphilias. The role of interview and subjective and objective instruments in the assessment of individuals with paraphilias and hypersexual disorders is discussed. The authors discuss the use of penile plethysmography or phallometry, polygraphy, and viewing time assessments. Risk assessment of sexual offenders is reviewed. The authors then discuss behavioral, environmental, and psychopharmacological treatments for paraphilias and hypersexual disorders. Cognitive-behavioral therapy appears to be the most effective nonpharmacological strategy. The authors describe cognitive-behavioral techniques for decreasing and/or controlling sexual urges (e.g., satiation, covert sensitization, fading, cognitive restructuring, victim empathy therapy) as well as methods for enhancing appropriate sexual interest and arousal (e.g., social skills training, assertiveness skills training, sex education, couples therapy). The authors also discuss the role of relapse prevention therapy and 12-step programs, as well as other nonbiological therapies such as surveillance networks. The importance of providing appropriate treatment for comorbid conditions (e.g., depression, substance abuse or dependence) is stressed. The authors then review psychopharmacological treatments, including serotonin reuptake inhibitors (SRIs) and antiandrogens, in particular, the use of gonadotropin-releasing hormone (GNRH) agonists. SRIs have been studied in these disorders in an uncontrolled way and appear promising. Earlier antiandrogens (e.g., estrogen, progesterone, and cyproterone acetate) have demonstrated efficacy in the treatment of paraphilias. The newer GNRH agonists have the advantage over the earlier treatments of being available in long-acting depot

  2. Autism spectrum disorders: early detection, intervention, education, and psychopharmacological management.

    PubMed

    Bryson, Susan E; Rogers, Sally J; Fombonne, Eric

    2003-09-01

    Our understanding and treatment of children with autism have changed dramatically since Leo Kanner first formally documented the disorder in 1943. With reference to the historical context, this paper reviews recent research addressing 4 major issues: early detection, intervention, education, and psychopharmacological management of children with autism and related (autistic) spectrum disorders (hereafter, "autism"). We conclude from our review of the evidence that, in the absence of additional, more compelling data, the clinical usefulness of existing screening instruments remains questionable. However, the potential importance of such research is underscored by the clear benefits of early behavioural intervention: despite differences in orientation, outcomes for children with autism can be significantly enhanced with early intensive intervention. Although many questions remain (notably, What are the critical therapeutic components? For whom? For what domains of development? For what level of intensity and duration?), interventions shown to be effective are all carefully planned, engineered, monitored, and designed to target specific skill domains. Including children with autism in regular classes within the public school system poses several challenges, the most pressing of which is the large number of school personnel who need to be trained in evidence-based teaching and behavioural management practices. Finally, psychotropic drugs may help to reduce some symptoms, but they are neither curative nor a substitute for other forms of support and intervention. PMID:14574826

  3. Odds and ends in psychopharmacology from the past 10 years.

    PubMed

    Howland, Robert H

    2015-01-01

    Seven topics previously described in this column are revisited. The use of quantitative electroencephalography has been shown in a prospective study to be effective for predicting antidepressant treatment response. A novel antidepressant drug, agomelatine, has generated much controversy, and its development for the U.S. market was discontinued. A long awaited revised system for categorizing the safety of medications during pregnancy and lactation has finally been published by the Food and Drug Administration. Dextromethorphan/quinidine, eslicarbazepine acetate, levomilnacipran, and esketamine are recent examples of drugs that were developed based on the complex concepts of chirality and stereochemistry. Lisdexamfetamine, a stimulant drug, failed to show benefit as an augmentation therapy for the treatment of depression. The combination drug naltrexone/bupropion was finally approved as a therapy for obesity, after its cardiovascular safety was confirmed in a prospective premarketing study. Further development of the glucocorticoid receptor antagonist drug mifepristone as a treatment for psychotic depression was stopped based on a large negative trial, but the drug continues to be investigated for other potential psychiatric indications. These examples illustrate how the field of psychopharmacology continues to evolve. PMID:25622272

  4. Psychodynamic Trojan horses: using psychopharmacology to teach psychodynamics.

    PubMed

    Mintz, David

    2006-01-01

    Concurrences of scientific, cultural, and economic developments in the past decade have changed psychiatric practice and psychiatric training. The explosion in neurobiological sciences has left residents with an overwhelming amount of neurobiology to master at the same time that managed care has led to a de-emphasis on psychiatrists providing psychotherapy. Consequently, many residents are left questioning the relevance of psychodynamics for psychiatry, given that the majority will function primarily as prescribers. However, the illusion, increasingly common in our culture, that medications are a simple fix leaves residents unprepared to make sense of the complex and irrational processes that happen in the acts of prescribing and taking medications (or not taking medications). Consequently, residents may feel confused, angry, hopeless, and/or abandoned in their role. These residents are often hungry for a context to explain why they feel hopeless, confused, or defeated in carrying out the "simple" task of prescribing. A psychodynamic understanding can provide such a holding context, just as it can give residents tools for backing out of futile and/or destructive enactments and turning conflicts around medications to some therapeutic good. Many psychodynamic concepts that initially may have seemed to residents part of some arcane and outmoded pseudoscience suddenly become relevant when they provide both a context for understanding the resident's distress and useful clinical tools. Those psychodynamic psychiatrists wishing to promulgate a psychodynamic understanding may need to meet psychiatric trainees at their developmental level and take seriously the current emphasis on providing effective somatic treatments. By engaging trainees at the junction of psychodynamics and psychopharmacology, psychodynamic psychiatrists may find a more receptive audience and open the door for greater interest in developing psychodynamic understanding and technical skills. PMID:16548753

  5. [A unique psychopharmacologic profile of adrafinil in mice].

    PubMed

    Rambert, F A; Pessonnier, J; de Sereville, J E; Pointeau, A M; Duteil, J

    1986-01-01

    The following psychopharmacological effects of adrafinil have been observed in mice: increase in locomotor activity (64-256 mg.kg-1), antagonism (16-128 mg.kg-1) of the hypnotic effects of barbitone but not of pentobarbitone, reduction of immobility duration in the forced swimming test (16-256 mg.kg-1); slight antagonism (256 mg.kg-1) of electroshock-induced convulsions; no modification of rectal temperature; no stereotyped or climbing behaviour; no increase in lethality in aggregated mice (LD50 isolated = 1022 mg.kg-1, LD50 aggregated = 859 mg.kg-1); lack of effects on the provisional tests for antidepressants: no interaction with reserpine-, oxotremorine-, or apomorphine-induced hypothermia but potentiation of yohimbine-induced toxicity; lack of peripheral sympathetic effects (no mydriasis, no salivation, no contraction of the pilomotor muscles, no antagonism of reserpine-induced ptosis); lack of peripheral anticholinergic effects (no mydriasis, no antagonism of oxotremorine-induced salivation or lacrimation). As compared to no analeptic, anticholinergic or antidepressant drugs, adrafinil shows a unique behavioural profile in mice defined on the one hand by a specific stimulant activity associated with antidepressant-like effects that do no seem related to a beta-adrenergic mechanism and on the other hand by a lack of dopaminergic effects. Most adrafinil-induced effects (increase in locomotor activity, reduction of immobility duration in the forced swimming test) may correspond to a central alpha 1-adrenergic stimulation, but the unexpected lack of peripheral sympathetic effects remains unexplained. PMID:3713198

  6. Defensive burying in rodents: ethology, neurobiology and psychopharmacology.

    PubMed

    De Boer, Sietse F; Koolhaas, Jaap M

    2003-02-28

    Defensive burying refers to the typical rodent behavior of displacing bedding material with vigorous treading-like movements of their forepaws and shoveling movements of their heads directed towards a variety of noxious stimuli that pose a near and immediate threat, such as a wall-mounted electrified shock-prod. Since its introduction 25 years ago by Pinel and Treit [J. Comp. Physiol. Psychol. 92 (1978) 708], defensive (shock-prod) burying has been the focus of a considerable amount of research effort delineating the methodology/ethology, psychopharmacology and neurobiology of this robust and species-specific active avoidance or coping response. The present review gives a summary of this research with special reference to the behavioral (face and construct) and pharmacological (predictive) validity of the shock-prod burying test as an animal model for human anxiety. Emphasis is also placed on some recent modifications of the paradigm that may increase its utility and reliability as to individual differences in expressed emotional coping responses and sensitivity to pharmacological treatments. Overall, the behavioral and physiological responses displayed in the shock-prod paradigm are expressions of normal and functionally adaptive coping patterns and the extremes of either active (i.e., burying) or passive (i.e., freezing) forms of responding in this test cannot simply be regarded as inappropriate, maladaptive or pathological. For this reason, the shock-prod paradigm is not an animal model for anxiety disorder or for any other psychiatric disease, but instead possesses a high degree of face and construct validity for normal and functionally adaptive human fear and anxious apprehension. However, the apparent good pharmacological validation (predictive validity) of this test reinforces the view that normal and pathological anxiety involves, at least partly, common neurobiological substrates. Therefore, this paradigm is not only suitable for screening potential

  7. Psychopharmacologic treatment of dissociative fugue and PTSD in an Ethiopian refugee.

    PubMed

    Liu-Barbaro, Dorothy; Stein, Murray

    2015-07-01

    Despite widespread awareness of their frequent co-occurrence, little is known about treatment of individuals with comorbid posttraumatic stress disorder (PTSD) and dissociative disorders. Patients with dissociative disorders do not respond well to standard exposure therapy, and few psychopharmacologic trials exist. Fluoxetine proved ineffective for depersonalization disorder, but paroxetine showed efficacy in decreasing dissociative symptoms in PTSD patients. PMID:26115334

  8. Psychopharmacological Treatment Options for Global Child and Adolescent Mental Health: The WHO Essential Medicines Lists

    ERIC Educational Resources Information Center

    Kutcher, Stan; Murphy, Andrea; Gardner, David

    2008-01-01

    The article examines the World Health Organization's Model List of Essential Medicines (EML) and suggests modification for appropriate psychopharmacological treatment of child- and adolescent-onset mental disorders. The EML enlists few of the psychotropic medicines that are useful for the treatment of young people thereby limiting the…

  9. Practical Paediatric Psychopharmacological Prescribing in Autism: The Potential and the Pitfalls.

    ERIC Educational Resources Information Center

    Gringras, Paul

    2000-01-01

    This article discusses the evidence behind two approaches to psychopharmacological management in children with autism: selecting and treating target symptoms or treatment or curing the primary social impairment underlying autism. The effectiveness of stimulants, antidepressants, melatonin, naltrexone, fenfluramine, and secretin is appraised. The…

  10. Posttraumatic Stress Disorder in Children and Adolescents: A Review of Psychopharmacological Treatment

    ERIC Educational Resources Information Center

    Huemer, J.; Erhart, F.; Steiner, H.

    2010-01-01

    PTSD in children and adolescents differs from the adult disease. Therapeutic approaches involve both psychotherapy and psychopharmacotherapy. Objectives: The current paper aims at reviewing studies on psychopharmacological treatment of childhood and adolescent PTSD. Additionally, developmental frameworks for PTSD diagnosis and research along with…

  11. Integrating Genetic, Psychopharmacological and Neuroimaging Studies: A Converging Methods Approach to Understanding the Neurobiology of ADHD

    ERIC Educational Resources Information Center

    Durston, Sarah; Konrad, Kerstin

    2007-01-01

    This paper aims to illustrate how combining multiple approaches can inform us about the neurobiology of ADHD. Converging evidence from genetic, psychopharmacological and functional neuroimaging studies has implicated dopaminergic fronto-striatal circuitry in ADHD. However, while the observation of converging evidence from multiple vantage points…

  12. The Challenge of Teaching Psychopharmacology in the New Millennium: The Role of Curricula

    ERIC Educational Resources Information Center

    Glick, Ira D.; Zisook, Sidney

    2005-01-01

    Objective: For a variety of pedagogical, political and financial reasons, there are major problems in achieving effective teaching of cutting-edge psychopharmacology for psychiatric residents. This article focuses on ways to improve the teaching/learning process, in part through the use of structured curricula. The authors review 1) attempted…

  13. Child and Adolescent Psychopharmacology in the New Millennium: A Workshop for Academia, Industry, and Government

    ERIC Educational Resources Information Center

    Deveaugh-Geiss, Joseph; March, John; Shapiro, Mark; Andreason, Paul J.; Emslie, Graham; Ford, Lisa M.; Greenhill, Laurence; Murphy, Dianne; Prentice, Ernest; Roberts, Rosemary; Silva, Susan; Swanson, James M.; van Zwieten-Boot, Barbara; Vitiello, Benedetto; Wagner, Karen Dineen; Mangum, Barry

    2006-01-01

    Objective: To give academic researchers, government officials, and industry scientists an opportunity to assess the state of pediatric psychopharmacology and identify challenges facing professionals in the field. Method: Increased federal spending and the introduction of pediatric exclusivity led to large increases in pediatric psychopharmacology…

  14. Comparison of Increasingly Detailed Elicitation Methods for the Assessment of Adverse Events in Pediatric Psychopharmacology.

    ERIC Educational Resources Information Center

    Greenhill, Laurence L.; Vitiello, Benedetto; Fisher, Prudence; Levine, Jerome; Davies, Mark; Abikoff, Howard; Chrisman, Allan K.; Chuang, Shirley; Findling, Robert L.; March, John; Scahill, Lawrence; Walkup, John; Riddle, Mark A.

    2004-01-01

    Objective: To improve the gathering of adverse events (AEs) in pediatric psychopharmacology by examining the value and acceptability of increasingly detailed elicitation methods. Method: Trained clinicians administered the Safety Monitoring Uniform Report Form (SMURF) to 59 parents and outpatients (mean age [+ or -] SD = 11.9 [+ or -] 3.2 years)…

  15. Guidelines, Algorithms, and Evidence-Based Psychopharmacology Training for Psychiatric Residents

    ERIC Educational Resources Information Center

    Osser, David N.; Patterson, Robert D.; Levitt, James J.

    2005-01-01

    Objective: The authors describe a course of instruction for psychiatry residents that attempts to provide the cognitive and informational tools necessary to make scientifically grounded decision making a routine part of clinical practice. Methods: In weekly meetings over two academic years, the course covers the psychopharmacology of various…

  16. Psychopharmacology Training and Canadian Counsellors: Are We Getting What We Want and Need?

    ERIC Educational Resources Information Center

    Schaefer, David; Wong-Wylie, Gina

    2008-01-01

    The psychopharmacology training experiences and attitudes of Canadian counsellors were the focus of our national Internet-based survey. This study was part of a larger investigation on Canadian counsellors' attitudes, practices, and training experiences related to clients on antidepressants. Results of the current study indicate Canadian…

  17. The Role of the Pharmaceutical Industry in Teaching Psychopharmacology: A Growing Problem

    ERIC Educational Resources Information Center

    Brodkey, Amy C.

    2005-01-01

    OBJECTIVE: To describe and examine the role of the pharmaceutical industry in the teaching of psychopharmacology to residents and medical students and to make recommendations for changes in curriculum and policy based on these findings. METHODS: Literature reviews and discussions with experts, educators, and trainees. RESULTS: The pharmaceutical…

  18. Psychopharmacology for Children and Adolescents: Commentary on Current Issues and Future Challenges.

    ERIC Educational Resources Information Center

    Kratochwill, Thomas R.

    1994-01-01

    Notes that biological interventions have been relatively neglected within field of school psychology in terms of its professional training, research agendas, and professional relationships with other specialties within psychology. Responds to previous articles in this special miniseries on psychopharmacology with children and adolescents, and…

  19. Pediatric Psychopharmacology and Prescription Privileges: Implications and Opportunities for School Psychology.

    ERIC Educational Resources Information Center

    Kubiszyn, Tom

    1994-01-01

    Reviews literature on pediatric psychopharmacology practice, lack of empirical support for efficacy and safety of most psychotropics for pediatric use, and need for further basic and clinical trials research and evaluation. Identifies shortcomings in training and experience that must be addressed if school psychology is to meet demands of three…

  20. Mental Health Issues among College Students: Who Gets Referred for Psychopharmacology Evaluation?

    ERIC Educational Resources Information Center

    Kirsch, Daniel J.; Doerfler, Leonard A.; Truong, Debbie

    2015-01-01

    Objective: To describe diagnostic and psychotropic medication prescription characteristics among college students referred by college counseling centers for psychopharmacologic evaluation. Participants: Participants were 540 college students referred by 6 college counseling centers in Massachusetts between November 2005 and May 2011. Methods:…

  1. Current Practices and Future Directions in Psychopharmacological Training and Collaboration in School Psychology

    ERIC Educational Resources Information Center

    Sulkowski, Michael L.; Jordan, Cary; Nguyen, Matthew L.

    2009-01-01

    School psychologists frequently examine children who are prescribed psychotropic medications. With advanced training in psychological assessment and professional consultation, school psychologists may play an integral role in assisting with children's psychopharmacological treatment regimens. In this vein, this article discusses various ways for…

  2. The Formal Instruction of Psychopharmacology in CACREP-Accredited Counselor Education Programs

    ERIC Educational Resources Information Center

    Sepulveda, Victoria I.

    2011-01-01

    Counseling professionals and researchers have advocated for counselor training in psychopharmacology in order to heighten counselors' awareness of client needs and treatment standards (Ingersoll, 2000; King & Anderson, 2004; Smith & Garcia, 2003). There has been a lack of this training within counselor education graduate programs (Buelow, Hebert,…

  3. Assessment of various psychopharmacological combinations in the treatment of presenile and senile primary degenerative dementia.

    PubMed

    Tudorache, B; Lupulescu, R; Duţan, I; Sârbulescu, A

    1990-01-01

    The effects of various psychopharmacological combinations were used in a sample of 90 patient fulfilling the DMS-III criteria for presenile or senile primary degenerative dementia divided into 3 equal subgroups. Regardless of the drug combination used, an improvement of verbal test performances was noticed. PMID:2100154

  4. Off-Label Prescription of Psychopharmacological Drugs in Child and Adolescent Psychiatry.

    PubMed

    Braüner, Julie Vestergaard; Johansen, Lily Manzello; Roesbjerg, Troels; Pagsberg, Anne Katrine

    2016-10-01

    This study aimed to describe the frequency of off-label prescriptions of psychopharmacological drugs in a child and adolescent psychiatric setting. A cross-sectional study was conducted on November 1, 2014, including all inpatients and outpatients at the Mental Health Centre for Child and Adolescent Psychiatry, Capital Region of Denmark, aged 0 to 17 years receiving medical treatment with antidepressants, antipsychotic agents, benzodiazepines, melatonin and/or attention deficit hyperactivity disorder (ADHD) medication. We included a total of 5555 prescriptions representing 2932 patients. The main findings were that 32.3% of all prescriptions were off-label, and 41.6% of subjects received at least 1 off-label prescription. The most frequent off-label category was low age, 72.2%, meaning that the drug was not approved for the age group of the patient. The off-label rates for each drug class were as follows: melatonin, 100%; antipsychotic agents, 95.6%; benzodiazepines, 72.5%; antidepressants, 51.1%; and ADHD medication, 2.7%. Prescription of 2 or more psychopharmacological drugs per patient was common (31.5%). The group of subjects with 4 or more prescriptions (n = 36) was characterized by a higher frequency of inpatients, older age, and a different distribution of diagnoses. This study found a frequent use of off-label prescriptions when treating children and adolescents with psychopharmacological drugs other than ADHD medication. In addition, prescription of more than 1 psychotropic drug is common. These findings support the need for extending the evidence base for psychopharmacologic treatment in children and adolescents. PMID:27529772

  5. Does psychopharmacology training enhance the knowledge of mental health nurses who prescribe?

    PubMed

    Jones, M; Robson, D; Whitfield, S; Gray, R

    2010-11-01

    The implementation of Mental Health Nurse (MHN) prescribing in the UK remains disappointing. A much cited critique of MHNs prescribing is that it would be unsafe, as MHN would not have the appropriate knowledge of pharmacology to practise mental health prescribing. The knowledge of pharmacology of MHNs with the prescribing qualification has not been assessed in the UK. In addition, the views of MHNs with the prescribing qualification who have undertaken a psychopharmacology course have not been explored. The aims of this study are to measure the efficacy of a 10-day advanced training programme on psychopharmacology on the knowledge levels of MHNs with the prescribing qualification; and to explore the positive and negative experiences of individual participants of the training in psychopharmacology and how it supported their prescribing practice. A repeated measures design was used in which participants acted as their own controls. Participants were assessed 10 weeks before the training programme and again on day one of the training programme using a Multiple Choice Questionnaire. In addition, a series of focus groups were conducted to explore the helpful and unhelpful aspects of the course in sustaining the MHNs' prescribing practice. Following the training period there were significant increases in the MHNs' knowledge of psychopharmacology in comparison with the two base line means. Participants when interviewed 18 months after completing the training described the training as a helpful though they described it had not resulted in large increases in prescribing practice, citing systemic barriers to its implementation. Short and focussed training for MHNs who prescribe may increase their knowledge of psychopharmacology. The development of such programmes may well be part of the solution to support MHNs with the prescribing qualification to prescribe, supported by the views of the MHNs who participated in the focus groups. However, further work is required to remove

  6. Pediatric psychopharmacological research in the post EU regulation 1901/2006 era.

    PubMed

    Schmäl, Christine; Becker, Katja; Berg, Ruth; Brünger, Michael; Lehmkuhl, Gerd; Oehler, Klaus-Ulrich; Ruppert, Thorsten; Staudter, Claus; Trott, Götz-Erik; Dittmann, Ralf W

    2014-11-01

    Although the use of psychotropic medications in child and adolescent psychiatry in Germany is on the increase, most compounds are in fact prescribed "off-label" because of a lack of regulatory approval in these age groups. In 2007, the European Parliament introduced Regulation 1901/2006 concerning medicinal products in pediatric populations, with a subsequent amendment in the form of Regulation 1902/2006. The main aim of this legislation was to encourage research and clinical trials in children and adolescents, and thus promote the availability of medications with marketing authorization for these age groups. Furthermore, initiatives such as the European 7th Framework Program of the European Union now offer substantial funding for pediatric pharmacological research. At a recent Congress of the German Society for Child and Adolescent Psychiatry and Psychotherapy (DGKJP), experts from the field and the pharmaceutical industry held a symposium with lay representatives in order to discuss attitudes toward, and experience with, pediatric psychopharmacology research in Germany since 2007. Several areas of concern were identified. The present paper derives from that symposium and provides an overview of these opinions, which remain crucial to the field. A wider discussion of how to facilitate psychopharmacological research in Germany in order to optimize the treatment and welfare of children and adolescents with psychiatric disorders is now warranted. PMID:25335522

  7. 'Is getting well ever an art?': Psychopharmacology and madness in Robert Lowell's Day by Day.

    PubMed

    Travis, Isabelle

    2011-12-01

    On the publication of Robert Lowell's Life Studies in 1959, some critics were shocked by the poet's use of seemingly frank autobiographical material, in particular the portrayal of his hospitalizations for bipolar disorder. During the late fifties and throughout the sixties, a rich vein, influenced by Lowell, developed in American poetry. Also during this time, the nascent science of psychopharmacology competed with and complemented the more established somatic treatments, such as psychosurgery, shock treatments, and psychoanalytical therapies. The development of Thorazine was a remarkable breakthrough allowing patients previously thought incurable to leave hospital. In 1955, the release of Miltown, the first 'minor' tranquilizer, was heralded with a media fanfare promising a new dawn of psychological cure-all. These two events blurred the boundary between 'normality' and madness by making treatment in the community more widely possible and by medicalizing more commonplace distress. Lowell's early depictions of madness situate it as emblematic of the cultural malaise of 'the tranquilized fifties.' By his final collection, Day by Day (1977), mental illness had lost its symbolic power. These late poems explore the power of art as a way of representing and remedying suffering in a culture where psychopharmacology has normalized madness. PMID:21853380

  8. [Critical flicker fusion frequency in psychopathology and psychopharmacology. Review of the literature].

    PubMed

    Bobon, D P; Lecoq, A; von Frenckell, R; Mormont, I; Lavergne, G; Lottin, T

    1982-01-01

    As far back as the second century, Ptolemy reported the apparent immobility of wheel radius at a certain speed. The psychophysical laws of this flicker fusion phenomenon related to the frequency of the light stimulus were established in 1834-1835 by the Englishman Talbot and by the Belgian Plateau, whose thesis in Liège is described as a landmark in the field. CFF is more a measurement of cortical arousal than of visual functions. In psychophysiology, CFF underwent periods of success and oblivion, at the mercy of researcher's enthusiasm or disappointment. At the turn of this century, Pierre Janet measured CFF in the laboratory of physiology of the Salpêtrière Hospital and demonstrated its decrease 'in hysteria, in states of depression, of lowered tension'. All reviewers of CFF literature have overlooked these observations, reported by Henri Piéron in the 'Melanges dedicated to Monsieur Pierre Janet'. When CFF falls into disgrace, it is because of the variability of its results, due to differences in apparatus and designs of the trials as well as the great number and the intrication of the variables which modify CFF thresholds, among them the nonsensory variables. When CFF is reappraised, as it has been the case in psychopharmacology in recent years, the reason is that it represents a brief, easy and economical measure of vigilance which, under certain conditions, seems to be also reliable, valid and sensitive. In the present monograph, the first in French on CFF, the authors try to analyze the most important contributions of the literature from the standpoint of the most relevant variables: characteristics of the stimulus (light intensity, wave form, wavelength, light-dark-ratio, diameter of the flickering point), test procedure (light vs. dark adaptation, visual angle, continuous vs. discontinuous presentation, monocular vs. binocular vision), influence of various physiological or psychological conditions (pupillary diameter, age, training, IQ; anxiety

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

    PubMed Central

    2012-01-01

    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. PMID:22335858

  10. Ahead of the game: the use of gaming to enhance knowledge of psychopharmacology.

    PubMed

    Beek, Terra S; Boone, Cheryl; Hubbard, Grace

    2014-12-01

    Experiential teaching strategies have the potential to more effectively help students with critical thinking than traditional lecture formats. Gaming is an experiential teaching-learning strategy that reinforces teamwork, interaction, and enjoyment and introduces the element of play. Two Bachelor of Science in Nursing students and a clinical instructor created a Jeopardy!(®)-style game to enhance understanding of psychopharmacology, foster student engagement in the learning process, and promote student enjoyment during clinical postconference. The current article evaluates the utility, relevance, and effectiveness of gaming using a Jeopardy!(®)-style format for the psychiatric clinical setting. Students identified the strengths of this learning activity as increased awareness of knowledge deficits, as well as the reinforcement of existing knowledge and the value of teamwork. PMID:25207557

  11. Psychopharmacological treatments in persons with dual diagnosis of psychiatric disorders and developmental disabilities

    PubMed Central

    Antochi, R; Stavrakaki, C; Emery, P

    2003-01-01

    People with developmental disabilities are at considerable risk for the development of comorbid psychiatric conditions. Psychopharmacological treatments may have a crucial role in a multidisciplinary and multimodal approach to the management of psychopathology in this population. Psychiatric illnesses that are particularly amenable include mood disorders, anxiety disorders, schizophrenia, and attention deficit hyperactivity disorders (ADHDs) and antidepressants, mood stabilisers, anxiolytics, antipsychotics, and stimulants should be considered, respectively. ADHD may also respond to α2-agonists. Psychotropic agents such as ß-antagonists can target aggressive, self injurious, and stereotypical behaviours and opioid antagonists may be helpful in treating self injurious behaviour and stereotypy. Selective serotonin reuptake inhibitors, newer anticonvulsants, and atypical neuroleptics are preferred when treating psychiatric disorders among people with developmental disabilities. This paper will review the major studies of pharmacological treatment of mental illness in individuals with developmental disabilities. PMID:12697912

  12. Herbal medicine for depression, anxiety and insomnia: a review of psychopharmacology and clinical evidence.

    PubMed

    Sarris, Jerome; Panossian, Alexander; Schweitzer, Isaac; Stough, Con; Scholey, Andrew

    2011-12-01

    Research in the area of herbal psychopharmacology has increased markedly over the past decades. To date however, a comprehensive review of herbal antidepressant, anxiolytic and hypnotic psychopharmacology and applications in depression, anxiety and insomnia has been absent. A search of MEDLINE (PubMed), CINAHL, PsycINFO, and the Cochrane Library databases was conducted (up to February 21st 2011) on commonly used psychotropic herbal medicines. A review of the literature was conducted to ascertain mechanisms of action of these botanicals, in addition to a systematic review of controlled clinical trials for treatment of mood, anxiety and sleep disorders, which are common comorbid psychiatric disorders. Specific emphasis was given to emerging phytomedicines. Analysis of evidence levels was conducted, as were effect sizes (Cohen's d) where data were available. Results provided evidence of a range of neurochemical, endocrinological, and epigenetic effects for 21 individual phytomedicines, which are detailed in this paper. Sixty six controlled studies were located involving eleven phytomedicines. Several of these provide a high level of evidence, such as Hypericum perforatum for major depression, and Piper methysticum for anxiety disorders. Several human clinical trials provide preliminary positive evidence of antidepressant effects (Echium amoenum, Crocus sativus, and Rhodiola rosea) and anxiolytic activity (Matricaria recutita, Ginkgo biloba, Passiflora incanata, E. amoenum, and Scutellaria lateriflora). Caution should however be taken when interpreting the results as many studies have not been replicated. Several herbal medicines with in vitro and in vivo evidence are currently unexplored in human studies, and along with use of emerging genetic technologies "herbomics", are areas of potential future research. PMID:21601431

  13. Changes in Clinical Trials Methodology Over Time: A Systematic Review of Six Decades of Research in Psychopharmacology

    PubMed Central

    Brunoni, André R.; Tadini, Laura; Fregni, Felipe

    2010-01-01

    Background There have been many changes in clinical trials methodology since the introduction of lithium and the beginning of the modern era of psychopharmacology in 1949. The nature and importance of these changes have not been fully addressed to date. As methodological flaws in trials can lead to false-negative or false-positive results, the objective of our study was to evaluate the impact of methodological changes in psychopharmacology clinical research over the past 60 years. Methodology/Principal Findings We performed a systematic review from 1949 to 2009 on MEDLINE and Web of Science electronic databases, and a hand search of high impact journals on studies of seven major drugs (chlorpromazine, clozapine, risperidone, lithium, fluoxetine and lamotrigine). All controlled studies published 100 months after the first trial were included. Ninety-one studies met our inclusion criteria. We analyzed the major changes in abstract reporting, study design, participants' assessment and enrollment, methodology and statistical analysis. Our results showed that the methodology of psychiatric clinical trials changed substantially, with quality gains in abstract reporting, results reporting, and statistical methodology. Recent trials use more informed consent, periods of washout, intention-to-treat approach and parametric tests. Placebo use remains high and unchanged over time. Conclusions/Significance Clinical trial quality of psychopharmacological studies has changed significantly in most of the aspects we analyzed. There was significant improvement in quality reporting and internal validity. These changes have increased study efficiency; however, there is room for improvement in some aspects such as rating scales, diagnostic criteria and better trial reporting. Therefore, despite the advancements observed, there are still several areas that can be improved in psychopharmacology clinical trials. PMID:20209133

  14. Reassessing the cultural and psychopharmacological significance of Banisteriopsis caapi: preparation, classification and use among the Piaroa of Southern Venezuela.

    PubMed

    Rodd, Robin

    2008-09-01

    Recent attention to the monoamine oxidase inhibiting properties of Banisteriopsis caapi's harmala alkaloids has precluded a balanced assessment of B. caapi's overall significance to indigenous South American societies. Relatively little attention has been paid to the cultural contexts, local meanings and patterns of use of B. caapi among snuff-using societies, such as the Piaroa, who do not prepare decoctions containing N,N-dimethyltryptamine (DMT) admixtures. This article reviews the psychopharmacological literature on B. caapi in light of recent ethnographic work conducted among the Piaroa of southern Venezuela. Piaroa shamans use only B. caapi's cambium, identify at least five distinct varieties of B. caapi, and emphasise the plant's importance for heightening empathy. Some Piaroa people also attribute a range of extra-shamanic uses to B. caapi, including as a stimulant and hunting aid. In light of the psychopharmacological complexity of harmala alkaloids, and ethnographic evidence for a wide range of B. caapi uses,future research should reconsider B. caapi's cultural heritage and psychopharmacological potential as a stimulant and antidepressant-like substance. PMID:19004422

  15. The Psychopharmacology Algorithm Project at the Harvard South Shore Program: An Algorithm for Generalized Anxiety Disorder.

    PubMed

    Abejuela, Harmony Raylen; Osser, David N

    2016-01-01

    This revision of previous algorithms for the pharmacotherapy of generalized anxiety disorder was developed by the Psychopharmacology Algorithm Project at the Harvard South Shore Program. Algorithms from 1999 and 2010 and associated references were reevaluated. Newer studies and reviews published from 2008-14 were obtained from PubMed and analyzed with a focus on their potential to justify changes in the recommendations. Exceptions to the main algorithm for special patient populations, such as women of childbearing potential, pregnant women, the elderly, and those with common medical and psychiatric comorbidities, were considered. Selective serotonin reuptake inhibitors (SSRIs) are still the basic first-line medication. Early alternatives include duloxetine, buspirone, hydroxyzine, pregabalin, or bupropion, in that order. If response is inadequate, then the second recommendation is to try a different SSRI. Additional alternatives now include benzodiazepines, venlafaxine, kava, and agomelatine. If the response to the second SSRI is unsatisfactory, then the recommendation is to try a serotonin-norepinephrine reuptake inhibitor (SNRI). Other alternatives to SSRIs and SNRIs for treatment-resistant or treatment-intolerant patients include tricyclic antidepressants, second-generation antipsychotics, and valproate. This revision of the GAD algorithm responds to issues raised by new treatments under development (such as pregabalin) and organizes the evidence systematically for practical clinical application. PMID:27384395

  16. Involvement of the endogenous opioid system in the psychopharmacological actions of ethanol: the role of acetaldehyde

    PubMed Central

    Font, Laura; Luján, Miguel Á.; Pastor, Raúl

    2013-01-01

    Significant evidence implicates the endogenous opioid system (EOS) (opioid peptides and receptors) in the mechanisms underlying the psychopharmacological effects of ethanol. Ethanol modulates opioidergic signaling and function at different levels, including biosynthesis, release, and degradation of opioid peptides, as well as binding of endogenous ligands to opioid receptors. The role of β-endorphin and µ-opioid receptors (OR) have been suggested to be of particular importance in mediating some of the behavioral effects of ethanol, including psychomotor stimulation and sensitization, consumption and conditioned place preference (CPP). Ethanol increases the release of β-endorphin from the hypothalamic arcuate nucleus (NArc), which can modulate activity of other neurotransmitter systems such as mesolimbic dopamine (DA). The precise mechanism by which ethanol induces a release of β-endorphin, thereby inducing behavioral responses, remains to be elucidated. The present review summarizes accumulative data suggesting that the first metabolite of ethanol, the psychoactive compound acetaldehyde, could participate in such mechanism. Two lines of research involving acetaldehyde are reviewed: (1) implications of the formation of acetaldehyde in brain areas such as the NArc, with high expression of ethanol metabolizing enzymes and presence of cell bodies of endorphinic neurons and (2) the formation of condensation products between DA and acetaldehyde such as salsolinol, which exerts its actions via OR. PMID:23914161

  17. State of the art psychopharmacological treatment options in seasonal affective disorder.

    PubMed

    Yildiz, Mesut; Batmaz, Sedat; Songur, Emrah; Oral, Esat Timuçin

    2016-03-01

    Seasonal affective disorder (SAD) is defined as a subtype of mood disorders in DSM 5, and it is characterized by a seasonal onset. SAD is proposed to be related to the seasonal changes in naturally occurring light, and the use of bright light therapy for depressive symptoms has been shown to reduce them in placebo controlled trials. Cognitive behavioral therapy has also been demonstrated to be effective in SAD. This review article aims to focus on the psychopharmacological treatment options for SAD. According to clinical trial results, first line treatment options seem to be sertraline and fluoxetine, and are well tolerated by the patients. There is some evidence that other antidepressants (e.g. bupropion) might be effective as well. Although clinical trials have shown that some of these antidepressants may be of benefit, a recent review has concluded that there is not enough evidence to support the use of any of these agents for the treatment of SAD yet. Moreover, more studies are still needed to evaluate the effectiveness of other treatment options, e.g., propranolol, melatonin, hypericum, etc. In addition to the above proposed treatments, patients with seasonal depressive symptoms should thoroughly be evaluated for any cues of bipolarity, and their treatment should be planned accordingly. PMID:26938817

  18. The psychopharmacology algorithm project at the Harvard South Shore Program: an algorithm for acute mania.

    PubMed

    Mohammad, Othman; Osser, David N

    2014-01-01

    This new algorithm for the pharmacotherapy of acute mania was developed by the Psychopharmacology Algorithm Project at the Harvard South Shore Program. The authors conducted a literature search in PubMed and reviewed key studies, other algorithms and guidelines, and their references. Treatments were prioritized considering three main considerations: (1) effectiveness in treating the current episode, (2) preventing potential relapses to depression, and (3) minimizing side effects over the short and long term. The algorithm presupposes that clinicians have made an accurate diagnosis, decided how to manage contributing medical causes (including substance misuse), discontinued antidepressants, and considered the patient's childbearing potential. We propose different algorithms for mixed and nonmixed mania. Patients with mixed mania may be treated first with a second-generation antipsychotic, of which the first choice is quetiapine because of its greater efficacy for depressive symptoms and episodes in bipolar disorder. Valproate and then either lithium or carbamazepine may be added. For nonmixed mania, lithium is the first-line recommendation. A second-generation antipsychotic can be added. Again, quetiapine is favored, but if quetiapine is unacceptable, risperidone is the next choice. Olanzapine is not considered a first-line treatment due to its long-term side effects, but it could be second-line. If the patient, whether mixed or nonmixed, is still refractory to the above medications, then depending on what has already been tried, consider carbamazepine, haloperidol, olanzapine, risperidone, and valproate first tier; aripiprazole, asenapine, and ziprasidone second tier; and clozapine third tier (because of its weaker evidence base and greater side effects). Electroconvulsive therapy may be considered at any point in the algorithm if the patient has a history of positive response or is intolerant of medications. PMID:25188733

  19. Psychopharmacological properties of an aqueous extract of Tetracarpidium conophorum Hutch. & Dalziel in mice.

    PubMed

    Aladeokin, Aderemi C; Umukoro, Solomon

    2011-07-01

    The extract of the nut of Tetracarpidium conophorum (TC), commonly known as African walnut, is widely used to relieve pain, increase sperm count, enhance sexual performance in males and as a nerve tonic in ethnomedicine. This study describes the psychopharmacological properties of the aqueous extract of the nut of TC in mice. The spectrum of activities studied were the effects of TC on the duration of immobility in the forced swim test of the behavioural despair model of depression; prolongation of the duration of sleep produced by thiopentone; amphetamine-induced stereotyped behaviour; and on pain episodes produced by acetic acid and by formalin. Orally administered TC (50-200 mg/kg) produced a significant and dose-related decrease in the duration of immobility in the forced swim test in mice. TC also exhibited analgesic property, as shown by its ability to reduce the frequency of abdominal constrictions induced by acetic acid and to inhibit the nociceptive responses produced by formalin. However, at the tested oral doses of 50-200 mg/kg, TC did not prolong the duration of sleep produced by thiopentone nor alter the pattern of the stereotyped behaviour induced by amphetamine. This investigation provides evidence that may support the ethnomedicinal applications of the extract of the nut of TC in the treatment of pain. The study also revealed that TC seems to demonstrate antidepressant-like activity, as evidenced by its ability to shorten the period of immobility in the forced swim test; however, further studies are necessary to clearly define the role of TC in depression. PMID:21327522

  20. Investigation of serotonin-1A receptor function in the human psychopharmacology of MDMA.

    PubMed

    Hasler, F; Studerus, E; Lindner, K; Ludewig, S; Vollenweider, F X

    2009-11-01

    Serotonin (5-HT) release is the primary pharmacological mechanism of 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy') action in the primate brain. Dopamine release and direct stimulation of dopamine D2 and serotonin 5-HT2A receptors also contributes to the overall action of MDMA. The role of 5-HT1A receptors in the human psychopharmacology of MDMA, however, has not yet been elucidated. In order to reveal the consequences of manipulation at the 5-HT1A receptor system on cognitive and subjective effects of MDMA, a receptor blocking study using the mixed beta-adrenoreceptor blocker/5-HT1A antagonist pindolol was performed. Using a double-blind, placebo-controlled within-subject design, 15 healthy male subjects were examined under placebo (PL), 20 mg pindolol (PIN), MDMA (1.6 mg/kg b.wt.), MDMA following pre-treatment with pindolol (PIN-MDMA). Tasks from the Cambridge Neuropsychological Test Automated Battery were used for the assessment of cognitive performance. Psychometric questionnaires were applied to measure effects of treatment on core dimensions of Altered States of Consciousness, mood and state anxiety. Compared with PL, MDMA significantly impaired sustained attention and visual-spatial memory, but did not affect executive functions. Pre-treatment with PIN did not significantly alter MDMA-induced impairment of cognitive performance and only exerted a minor modulating effect on two psychometric scales affected by MDMA treatment ('positive derealization' and 'dreaminess'). Our findings suggest that MDMA differentially affects higher cognitive functions, but does not support the hypothesis from animal studies, that some of the MDMA effects are causally mediated through action at the 5-HT1A receptor system. PMID:18635693

  1. Clinical practice with anti-dementia drugs: a consensus statement from British Association for Psychopharmacology.

    PubMed

    Burns, Alistair; O'Brien, John; Auriacombe, Sophie; Ballard, Clive; Broich, Karl; Bullock, Roger; Feldman, Howard; Ford, Gary; Knapp, Martin; McCaddon, Andrew; Iliffe, Steve; Jacova, Claudia; Jones, Roy; Lennon, Sean; McKeith, Ian; Orgogozo, Jean-Marc; Purandare, Nitin; Richardson, Mervyn; Ritchie, Craig; Thomas, Alan; Warner, James; Wilcock, Gordon; Wilkinson, David

    2006-11-01

    The British Association for Psychopharmacology (BAP) coordinated a meeting of experts to review the evidence on the drug treatment for dementia. The level of evidence (types) was rated using a standard system: Types 1a and 1b (evidence from meta-analysis of randomised controlled trials or at least one controlled trial respectively); types 2a and 2b (one well-designed study or one other type of quasi experimental study respectively); type 3 (non-experimental descriptive studies); and type 4 (expert opinion). There is type 1a evidence for cholinesterase inhibitors (donepezil, rivastigmine and galantamine) for mild to moderate Alzheimer's disease; memantine for moderate to severe Alzheimer's disease; and for the use of bright light therapy and aromatherapy. There is type 1a evidence of no effect of anti inflammatory drugs or statins. There is conflicting evidence regarding oestrogens, with type 2a evidence of a protective effect of oestrogens but 1b evidence of a harmful effect. Type 1a evidence for any effect of B12 and folate will be forthcoming when current trials report. There is type 1b evidence for gingko biloba in producing a modest benefit of cognitive function; cholinesterase inhibitors for the treatment of people with Lewy body disease (particularly neuropsychiatric symptoms); cholinesterase inhibitors and memantine in treatment cognitive impairment associated with vascular dementia; and the effect of metal collating agents (although these should not be prescribed until more data on safety and efficacy are available). There is type 1b evidence to show that neither cholinesterase inhibitors nor vitamin E reduce the risk of developing Alzheimer's disease in people with mild cognitive impairment; and there is no evidence that there is any intervention that can prevent the onset of dementia. There is type 1b evidence for the beneficial effects of adding memantine to cholinesterase inhibitors, and type 2b evidence of positive switching outcomes from one

  2. Receptor and transporter imaging studies in schizophrenia, depression, bulimia and Tourette's disorder--implications for psychopharmacology.

    PubMed

    Kasper, Siegfried; Tauscher, Johannes; Willeit, Matthäus; Stamenkovic, Mara; Neumeister, Alexander; Küfferle, Bernd; Barnas, Christian; Stastny, Jürgen; Praschak-Rieder, Nicole; Pezawas, Lukas; de Zwaan, Martina; Quiner, Sylvia; Pirker, Walter; Asenbaum, Susanne; Podreka, Ivo; Brücke, Thomas

    2002-07-01

    significantly decreased the beta-CIT binding potential, however, no significant dose relationship has been obtained in depression. Genotyping depressed patients for the serotonin transporter promoter gene region (5-HTTLPR) did not provide evidence for in vivo functional regulation of 5-HTT availability by 5-HTTLPR in the thalamus-hypothalamus and mesencephalon-pons of healthy subjects. In patients suffering from Tourette's disorder (TD) we were unable to detect differences of dopamine transporter densities between psychotropic drug-naïve TD patients and controls. Furthermore, no difference could be found between currently treated (with antipsychotics) and psychotropic drug-naïve TD patients. Our data provide insight into the pathophysiology of neuropsychiatric disorders and may guide future psychopharmacological drug developments. PMID:12478878

  3. [Review of psychopharmacological treatments in adolescents and adults with autistic disorders].

    PubMed

    Baghdadli, A; Gonnier, V; Aussilloux, C

    2002-01-01

    Autism is an early developmental disorder. It leads to severe and durable disturbances. Given this problem, no treatment can be excluded a priori. Thus, many approaches are used to deal with autistic disorders. In France, pharmacological treatments are, for instance, largely and mostly used in adults. In the USA, these treatments concern 50% of persons with autism of any age. Nevertheless, they are rarely based on controlled studies. At the present, however, prescriptions and expected effects appear to be hard to localize. Furthermore, only few controlled studies validate their use. Aim - We offer a review of studies about medical treatments used in adolescents and adults with autism. They are classified in 3 categories: the first (category I) includes drugs used for their neurochemical effects focusing on autistic signs. The second (category II) covers drugs used for treatment of behavioural disorders frequently associated with autism. The third (category III) corresponds to a wide range of drugs or vitamins for wich only few case studies exist reporting irregular positive effects. The main hypothesis of this review is that autism involves a dysfunction of the neuromediation systems. This hypothesis opens new perspectives in the research of medical treatments in autism by focusing on molecules, which are supposed to have an effect on neuromediation systems. Method - Our review is based on studies, which have been published during the past twenty years. For many studies, data are limited to adolescents and adults. So we expanded our review to data available in children. The data bases that we have used are medline and psyclit. Keywords have been chosen according to: pharmacological considerations (psychotropic, psychoactive drugs, psychopharmacology) and clinical symptoms (autism, automutilations, aggressive behavior, and hyperactivity). Hypothesis of a dysfunction in the neuromediation systems in autism - Many studies exist about biochemical abnormalities in

  4. Brain Functional Effects of Psychopharmacological Treatments in Schizophrenia: A Network-based Functional Perspective Beyond Neurotransmitter Systems

    PubMed Central

    De Rossi, Pietro; Chiapponi, Chiara; Spalletta, Gianfranco

    2015-01-01

    Psychopharmacological treatments for schizophrenia have always been a matter of debate and a very important issue in public health given the chronic, relapsing and disabling nature of the disorder. A thorough understanding of the pros and cons of currently available pharmacological treatments for schizophrenia is critical to better capture the features of treatment-refractory clinical pictures and plan the developing of new treatment strategies. This review focuses on brain functional changes induced by antipsychotic drugs as assessed by modern functional neuroimaging techniques (i.e. fMRI, PET, SPECT, MRI spectroscopy). The most important papers on this topic are reviewed in order to draw an ideal map of the main functional changes occurring in the brain during antipsychotic treatment. This supports the hypothesis that a network-based perspective and a functional connectivity approach are needed to fill the currently existing gap of knowledge in the field of psychotropic drugs and their mechanisms of action beyond neurotransmitter systems. PMID:26412063

  5. Brain Functional Effects of Psychopharmacological Treatments in Schizophrenia: A Network-based Functional Perspective Beyond Neurotransmitter Systems.

    PubMed

    De Rossi, Pietro; Chiapponi, Chiara; Spalletta, Gianfranco

    2015-01-01

    Psychopharmacological treatments for schizophrenia have always been a matter of debate and a very important issue in public health given the chronic, relapsing and disabling nature of the disorder. A thorough understanding of the pros and cons of currently available pharmacological treatments for schizophrenia is critical to better capture the features of treatment-refractory clinical pictures and plan the developing of new treatment strategies. This review focuses on brain functional changes induced by antipsychotic drugs as assessed by modern functional neuroimaging techniques (i.e. fMRI, PET, SPECT, MRI spectroscopy). The most important papers on this topic are reviewed in order to draw an ideal map of the main functional changes occurring in the brain during antipsychotic treatment. This supports the hypothesis that a network-based perspective and a functional connectivity approach are needed to fill the currently existing gap of knowledge in the field of psychotropic drugs and their mechanisms of action beyond neurotransmitter systems. PMID:26412063

  6. Lights! Camera! Action Projects! Engaging Psychopharmacology Students in Service-based Action Projects Focusing on Student Alcohol Abuse

    PubMed Central

    Kennedy, Susan

    2016-01-01

    Alcohol abuse continues to be an issue of major concern for the health and well-being of college students. Estimates are that over 80% of college students are involved in the campus “alcohol culture.” Annually, close to 2000 students die in the United States due to alcohol-related accidents, with another 600,000 sustaining injury due to alcohol-related incidents (NIAAA, 2013). Students enrolled in a Psychopharmacology course engaged in action projects (community outreach) focused on alcohol abuse on our campus. Research has indicated that these types of projects can increase student engagement in course material and foster important skills, including working with peers and developing involvement in one’s community. This paper describes the structure and requirements of five student outreach projects and the final projects designed by the students, summarizes the grading and assessment of the projects, and discusses the rewards and challenges of incorporating such projects into a course. PMID:27385923

  7. Lights! Camera! Action Projects! Engaging Psychopharmacology Students in Service-based Action Projects Focusing on Student Alcohol Abuse.

    PubMed

    Kennedy, Susan

    2016-01-01

    Alcohol abuse continues to be an issue of major concern for the health and well-being of college students. Estimates are that over 80% of college students are involved in the campus "alcohol culture." Annually, close to 2000 students die in the United States due to alcohol-related accidents, with another 600,000 sustaining injury due to alcohol-related incidents (NIAAA, 2013). Students enrolled in a Psychopharmacology course engaged in action projects (community outreach) focused on alcohol abuse on our campus. Research has indicated that these types of projects can increase student engagement in course material and foster important skills, including working with peers and developing involvement in one's community. This paper describes the structure and requirements of five student outreach projects and the final projects designed by the students, summarizes the grading and assessment of the projects, and discusses the rewards and challenges of incorporating such projects into a course. PMID:27385923

  8. The role of psychopharmacology in the medical abuses of the Third Reich: from euthanasia programmes to human experimentation.

    PubMed

    López-Muñoz, Francisco; Alamo, Cecilio; García-García, Pilar; Molina, Juan D; Rubio, Gabriel

    2008-12-16

    German psychiatry and pharmacology both enjoyed an extraordinary international reputation prior to the promulgation of the Third Reich. However, with the triumph of eugenic ideas and the imposition of a "racial hygiene" policy by the Nazi regime, various organs of the German health system saw themselves involved in a perverse system of social control, in which the illicit use of psychopharmacological tools became customary. In the present work, we review, from the historical perspective, the factors that helped to bring about this situation and we analyze the abuses (known and documented) committed through the specific use of psychotropic drugs during the Nazi period. Among such abuses we can identify the following illegitimate activities: the use of psychoactive drugs, mainly sedatives from the barbiturates family, in the different euthanasia programmes implemented by the Nazi authorities, in police activity and various types of repression, and for purely criminal and extermination purposes within the so-called "Final Solution"; psychopharmacological research on the mentally ill, without the slightest ethical requirements or legal justification; and the use of psychotropic agents in research on healthy subjects, recruited from concentration camps. Finally, we refer to the role of poisonous nerve agents (tabun, sarin and soman) as instruments of chemical warfare and their development by the German authorities. Many of these activities, though possibly only a small portion of the total - given the destruction of a great deal of documentation just before the end of World War II - came to light through the famous Nuremberg Trials, as well as through other trials in which specific persons were brought to justice unilaterally by individual Allied nations or by the authorities of the new German government after the War. PMID:18848972

  9. The interface between publicly funded and industry-funded research in pediatric psychopharmacology: opportunities for integration and collaboration.

    PubMed

    Vitiello, Benedetto; Heiligenstein, John H; Riddle, Mark A; Greenhill, Laurence L; Fegert, Jörg M

    2004-07-01

    Pediatric psychopharmacology research is undergoing a major expansion consequent to increasing use of psychotropic medications in children and recent legislative incentives to industry. In this rapidly changing context, the interface between publicly and privately funded research needs to be reconsidered to integrate activities and avoid unnecessary duplication of efforts. Once, by default, the almost exclusive domain of public research, child research is now increasingly funded by industry. There are, however, important issues unlikely to be addressed through private funding for which public support is needed, such as direct comparisons between active medications, between pharmacological and psychosocial interventions, or between combined and single treatment modalities; development of effective treatment strategies for patients unresponsive to first-line treatments; development of better research methods to assess efficacy and safety; identification of moderators and mechanisms of treatment response; and impact of treatment on illness course and prognosis. Industry-sponsored research is limited by the restricted access to proprietary databases, which impedes independent analyses and meta-analyses. Translation of basic neuroscience discoveries into treatment applications for children with mental illness is a critical area of inquiry that can benefit from integration of efforts and collaborations among academia, government, and industry. PMID:15219466

  10. The Psychopharmacology of ±3,4 Methylenedioxymethamphetamine and its Role in the Treatment of Posttraumatic Stress Disorder.

    PubMed

    Amoroso, Timothy

    2015-01-01

    Prior to 1985, ±3,4-methylenedioxymethamphetamine (MDMA) was readily used as a psychotherapeutic adjunct. As MDMA became popular in treating various psychiatric illnesses by mental health professionals, the public started to abuse the MDMA-containing recreational drug "ecstasy." This alarmed the DEA, which led to emergency scheduling of MDMA as a Schedule I drug. Due to its scheduling in 1985, human research and clinical use has been limited. The majority of research on MDMA has been focused on the drug's potential harmful effects rather than its possible therapeutic effects. The limitations on retrospective human studies and preclinical animal models of MDMA neurotoxicity are examined in this analysis. New research has shown that MDMA, used as a catalyst in psychotherapy, is effective in treating posttraumatic stress disorder (PTSD). This review also examines the psychopharmacological basis for the efficacy of MDMA-assisted psychotherapy. Specifically, the brain regions involved with both PTSD and those activated by MDMA (i.e., amygdala, anterior cingulate cortex, and hippocampus) are examined. Also, the possible neurochemical mechanisms involved in MDMA's efficacy in treating PTSD are reviewed. PMID:26579955

  11. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders.

    PubMed

    Wilson, S J; Nutt, D J; Alford, C; Argyropoulos, S V; Baldwin, D S; Bateson, A N; Britton, T C; Crowe, C; Dijk, D-J; Espie, C A; Gringras, P; Hajak, G; Idzikowski, C; Krystal, A D; Nash, J R; Selsick, H; Sharpley, A L; Wade, A G

    2010-11-01

    Sleep disorders are common in the general population and even more so in clinical practice, yet are relatively poorly understood by doctors and other health care practitioners. These British Association for Psychopharmacology guidelines are designed to address this problem by providing an accessible up-to-date and evidence-based outline of the major issues, especially those relating to reliable diagnosis and appropriate treatment. A consensus meeting was held in London in May 2009. Those invited to attend included BAP members, representative clinicians with a strong interest in sleep disorders and recognized experts and advocates in the field, including a representative from mainland Europe and the USA. Presenters were asked to provide a review of the literature and identification of the standard of evidence in their area, with an emphasis on meta-analyses, systematic reviews and randomized controlled trials where available, plus updates on current clinical practice. Each presentation was followed by discussion, aimed to reach consensus where the evidence and/or clinical experience was considered adequate or otherwise to flag the area as a direction for future research. A draft of the proceedings was then circulated to all participants for comment. Key subsequent publications were added by the writer and speakers at draft stage. All comments were incorporated as far as possible in the final document, which represents the views of all participants although the authors take final responsibility for the document. PMID:20813762

  12. Evidence-based guidelines for treating bipolar disorder: revised third edition Recommendations from the British Association for Psychopharmacology

    PubMed Central

    Goodwin, G.M.; Haddad, P. M.; Ferrier, I.N.; Aronson, J.K.; Barnes, T.R.H.; Cipriani, A.; Coghill, D.R.; Fazel, S.; Geddes, J.R.; Grunze, H.; Holmes, E.A.; Howes, O.; Hudson, S.; Hunt, N.; Jones, I.; Macmillan, I.C.; McAllister-Williams, H.; Miklowitz, D.M.; Morriss, R.; Munafò, M.; Paton, C.; Saharkian, B.J.; Saunders, K.E.A.; Sinclair, J.M.A.; Taylor, D.; Vieta, E.; Young, A.H.

    2016-01-01

    The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines: in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change. PMID:26979387

  13. Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology.

    PubMed

    Goodwin, G M; Haddad, P M; Ferrier, I N; Aronson, J K; Barnes, Trh; Cipriani, A; Coghill, D R; Fazel, S; Geddes, J R; Grunze, H; Holmes, E A; Howes, O; Hudson, S; Hunt, N; Jones, I; Macmillan, I C; McAllister-Williams, H; Miklowitz, D R; Morriss, R; Munafò, M; Paton, C; Saharkian, B J; Saunders, Kea; Sinclair, Jma; Taylor, D; Vieta, E; Young, A H

    2016-06-01

    The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change. PMID:26979387

  14. CCNP Award Paper: Unveiling the role of melatonin MT2 receptors in sleep, anxiety and other neuropsychiatric diseases: a novel target in psychopharmacology

    PubMed Central

    Comai, Stefano; Gobbi, Gabriella

    2014-01-01

    Background Melatonin (MLT) is a pleiotropic neurohormone controlling many physiological processes and whose dysfunction may contribute to several different diseases, such as neurodegenerative diseases, circadian and mood disorders, insomnia, type 2 diabetes and pain. Melatonin is synthesized by the pineal gland during the night and acts through 2 G-protein coupled receptors (GPCRs), MT1 (MEL1a) and MT2 (MEL1b). Although a bulk of research has examined the physiopathological effects of MLT, few studies have investigated the selective role played by MT1 and MT2 receptors. Here we have reviewed current knowledge about the implications of MT2 receptors in brain functions. Methods We searched PubMed, Web of Science, Scopus, Google Scholar and articles reference lists for studies on MT2 receptor ligands in sleep, anxiety, neuropsychiatric diseases and psychopharmacology, including genetic studies on the MTNR1B gene, which encodes the melatonin MT2 receptor. Results These studies demonstrate that MT2 receptors are involved in the pathophysiology and pharmacology of sleep disorders, anxiety, depression, Alzheimer disease and pain and that selective MT2 receptor agonists show hypnotic and anxiolytic properties. Limitations Studies examining the role of MT2 receptors in psychopharmacology are still limited. Conclusion The development of novel selective MT2 receptor ligands, together with further preclinical in vivo studies, may clarify the role of this receptor in brain function and psychopharmacology. The superfamily of GPCRs has proven to be among the most successful drug targets and, consequently, MT2 receptors have great potential for pioneer drug discovery in the treatment of mental diseases for which limited therapeutic targets are currently available. PMID:23971978

  15. Clinical practice with anti-dementia drugs: a revised (second) consensus statement from the British Association for Psychopharmacology.

    PubMed

    O'Brien, John T; Burns, Alistair

    2011-08-01

    The British Association for Psychopharmacology (BAP) coordinated a meeting of experts to review and revise its first (2006) Guidelines for clinical practice with anti-dementia drugs. As before, levels of evidence were rated using accepted standards which were then translated into grades of recommendation A to D, with A having the strongest evidence base (from randomized controlled trials) and D the weakest (case studies or expert opinion). Current clinical diagnostic criteria for dementia have sufficient accuracy to be applied in clinical practice (B) and brain imaging can improve diagnostic accuracy (B). Cholinesterase inhibitors (donepezil, rivastigmine, and galantamine) are effective for mild to moderate Alzheimer's disease (A) and memantine for moderate to severe Alzheimer's disease (A). Until further evidence is available other drugs, including statins, anti-inflammatory drugs, vitamin E and Ginkgo biloba, cannot be recommended either for the treatment or prevention of Alzheimer's disease (A). Neither cholinesterase inhibitors nor memantine are effective in those with mild cognitive impairment (A). Cholinesterase inhibitors are not effective in frontotemporal dementia and may cause agitation (A), though selective serotonin reuptake inhibitors may help behavioural (but not cognitive) features (B). Cholinesterase inhibitors should be used for the treatment of people with Lewy body dementias (Parkinson's disease dementia and dementia with Lewy bodies (DLB)), especially for neuropsychiatric symptoms (A). Cholinesterase inhibitors and memantine can produce cognitive improvements in DLB (A). There is no clear evidence that any intervention can prevent or delay the onset of dementia. Although the consensus statement focuses on medication, psychological interventions can be effective in addition to pharmacotherapy, both for cognitive and non-cognitive symptoms. Many novel pharmacological approaches involving strategies to reduce amyloid and/or tau deposition are in

  16. A Pharmacovigilance Study in First Episode of Psychosis: Psychopharmacological Interventions and Safety Profiles in the PEPs Project

    PubMed Central

    Bioque, Miquel; Llerena, Adrián; Cabrera, Bibiana; Mezquida, Gisela; Lobo, Antonio; González-Pinto, Ana; Díaz-Caneja, Covadonga M.; Corripio, Iluminada; Aguilar, Eduardo J.; Bulbena, Antoni; Castro-Fornieles, Josefina; Vieta, Eduard; Lafuente, Amàlia; Mas, Sergi; Parellada, Mara; Saiz-Ruiz, Jerónimo; Cuesta, Manuel J.

    2016-01-01

    Background: The characterization of the first episode of psychosis and how it should be treated are principal issues in actual research. Realistic, naturalistic studies are necessary to represent the entire population of first episode of psychosis attended in daily practice. Methods: Sixteen participating centers from the PEPs project recruited 335 first episode of psychosis patients, aged 7 to 35 years. This article describes and discusses the psychopharmacological interventions and safety profiles at baseline and during a 60-day pharmacovigilance period. Results: The majority of first episode of psychosis patients received a second-generation antipsychotic (96.3%), orally (95%), and in adjusted doses according to the product specifications (87.2%). A total of 24% were receiving an antipsychotic polytherapy pattern at baseline, frequently associated with lower or higher doses of antipsychotics than the recommended ones. Eight patients were taking clozapine, all in monotherapy. Males received higher doses of antipsychotic (P=.043). A total of 5.2% of the patients were being treated with long-acting injectable antipsychotics; 12.2% of the patients received anticholinergic drugs, 12.2% antidepressants, and 13.7% mood stabilizers, while almost 40% received benzodiazepines; and 35.52% reported at least one adverse drug reaction during the pharmacovigilance period, more frequently associated with higher antipsychotic doses and antipsychotic polytherapy (85.2% vs 45.5%, P<.001). Conclusions: These data indicate that the overall pharmacologic prescription for treating a first episode of psychosis in Spain follows the clinical practice guideline recommendations, and, together with security issues, support future research of determinate pharmacological strategies for the treatment of early phases of psychosis, such as the role of clozapine, long-acting injectable antipsychotics, antipsychotic combination, and the use of benzodiazepines. PMID:26506856

  17. Psychopharmacology of lycanthropy.

    PubMed Central

    Davis, W M; Wellwuff, H G; Garew, L; Kydd, O U

    1992-01-01

    OBJECTIVE: To develop pharmacotherapies for the orphan disease lycanthropy through the pursuit of the etiologic hypothesis of a genetically determined hypersecretion of endogenous lycanthropogens. DESIGN: Quadruple-blind, Rubik's Cube matrix analysis. SETTING: Community practice and malpractice. PARTICIPANTS: Subjects selected from inbred Ruficolla populations in Mississippi, Georgia, North Carolina and Minnesota. All who entered the study finished it. INTERVENTIONS: Chemical screening of blood samples over a hypothesized secretory cycle of lycanthropogen peaking on the day of maximum lunar illumination. Administration of synthetic lycanthropogens for behavioural testing. Experimental lycosomatization through the illumination method of Kirschbaum. OUTCOME MEASURES: None were post hoc, but some are still in hock. MAIN RESULTS: Two putative lycanthropogens were isolated from the blood samples. Structural elucidation and synthesis permitted animal and clinical trials; in each of these, behavioural dysfunction was observed. Antilycanthropogen strategies included application of the principle of caged compounds and generation of a therapeutic immunoglobulin. The effects of a newly developed antihirsutic agent seemed promising. An interaction of the lycanthropogen-secretion system and ethanol was noted, which may explain behavioural aspects of alcoholism. CONCLUSIONS: The incidence of lycomania in North America is underestimated. Soon-to-be-available pharmacotherapies should promote its early detection and treatment. Full control may depend upon advances in gene therapy. PMID:1555146

  18. Psychopharmacology and Bariatric Surgery.

    PubMed

    Roerig, James L; Steffen, Kristine

    2015-11-01

    Currently, it has been demonstrated that psychotropic drugs, particularly antidepressants, are frequently prescribed for patients who seek bariatric surgery. Many bariatric surgery patients have a history of a mood disorder. Unlike medications for diabetes, hypertension or hyperlipidemia, which are generally reduced and at times discontinued, postsurgery antidepressants use is only slightly reduced. The Roux-en-Y procedure is most frequently associated with alteration in drug exposure. Medication disintegration, dissolution, absorption, metabolism and excretion have been found to be altered in postbariatric patients, although data are sparse at this time. This paper will review the current evidence regarding the effect of bariatric surgery on drug treatment including mechanism of interference as well as the extent of changes identified to date. Data will be presented as controlled trials followed by case series and reports. PMID:26338011

  19. Data acquisition instruments: Psychopharmacology

    SciTech Connect

    Hartley, D.S. III

    1998-01-01

    This report contains the results of a Direct Assistance Project performed by Lockheed Martin Energy Systems, Inc., for Dr. K. O. Jobson. The purpose of the project was to perform preliminary analysis of the data acquisition instruments used in the field of psychiatry, with the goal of identifying commonalities of data and strategies for handling and using the data in the most advantageous fashion. Data acquisition instruments from 12 sources were provided by Dr. Jobson. Several commonalities were identified and a potentially useful data strategy is reported here. Analysis of the information collected for utility in performing diagnoses is recommended. In addition, further work is recommended to refine the commonalities into a directly useful computer systems structure.

  20. Aggression: Psychopharmacologic Management

    PubMed Central

    Conlon, Patrick; Frommhold, Kristine

    1989-01-01

    Aggression may be part of a variety of psychiatric diagnoses. The appropriate treatment requires that the physician recognize the underlying cause. Pharmacologic agents may form part of the overall treatment of the patient. The number of possible drugs for treating aggression has expanded rapidly, and it is important that the physician be familiar with the various options avilable. PMID:21248947

  1. Brain Peptides and Psychopharmacology

    ERIC Educational Resources Information Center

    Arehart-Treichel, Joan

    1976-01-01

    Proteins isolated from the brain and used as drugs can improve and apparently even transfer mental states and behavior. Much of the pioneering work and recent research with humans and animals is reviewed and crucial questions that are being posed about the psychologically active peptides are related. (BT)

  2. Neuroimaging and Psychopharmacology

    ERIC Educational Resources Information Center

    Semrud-Clikeman, Margaret; Pliszka, Steve R.

    2005-01-01

    This review presents the most recent research concerning neuroimaging in developmental disabilities. Changes in structure and activation have been found in children with ADHD and learning disabilities, following intervention. For the children with learning disabilities changes in activation have been found following intensive behavioral and…

  3. Psychopharmacology in the Schools

    ERIC Educational Resources Information Center

    Abrams, Laura; Flood, Jillian; Phelps, LeAdelle

    2006-01-01

    Psychotropic medications prescribed frequently to children and adolescents for the treatment of anxiety, depression, and attention deficit hyperactivity disorder are reviewed. Pediatric pharmacological options based on double-blind, randomized studies are examined. We advocate that psychotropic medications be used only in conjunction with…

  4. Serendipity and psychopharmacology.

    PubMed

    Howland, Robert H

    2010-10-01

    This article describes several examples where the development of drugs and devices for use in psychiatry followed from initial serendipitous observations. The potential psychotropic properties of chlorpromazine (Thorazine(®)) were first noted in surgical patients when the drug was being investigated as a potentiator of anesthesia. Similar findings were noted with iproniazid (Marsilid(®)), developed for the treatment of tuberculosis, and the drug was later released for clinical use as an antidepressant agent. The development of meprobamate (Miltown(®)), an approved treatment for anxiety, evolved from initial efforts to find a chemical that would inhibit the enzymatic destruction of the antibiotic drug penicillin. The psychiatric uses of lamotrigine (Lamictal(®)) and vagus nerve stimulation were prompted by initial observations that epilepsy patients receiving these treatments had positive mood effects. Nurses should be familiar with the concept of serendipity, as they often are in the best position to observe, record, and report on unexpected clinical effects in patients taking any kind of prescription or nonprescription medication. PMID:20873698

  5. Mood stabilizer psychopharmacology

    PubMed Central

    Gould, Todd D.; Chen, Guang; Manji, Husseini K.

    2012-01-01

    Mood stabilizers represent a class of drugs that are efficacious in the treatment of bipolar disorder. The most established medications in this class are lithium, valproic acid, and carbamazepine. In addition to their therapeutic effects for treatment of acute manic episodes, these medications often are useful as prophylaxis against future episodes and as adjunctive antidepressant medications. While important extracellular effects have not been excluded, most available evidence suggests that the therapeutically relevant targets of this class of medications are in the interior of cells. Herein we give a prospective of a rapidly evolving field, discussing common effects of mood stabilizers as well as effects that are unique to individual medications. Mood stabilizers have been shown to modulate the activity of enzymes, ion channels, arachidonic acid turnover, G protein coupled receptors and intracellular pathways involved in synaptic plasticity and neuroprotection. Understanding the therapeutic targets of mood stabilizers will undoubtedly lead to a better understanding of the pathophysiology of bipolar disorder and to the development of improved therapeutics for the treatment of this disease. Furthermore, the involvement of mood stabilizers in pathways operative in neuroprotection suggests that they may have utility in the treatment of classical neurodegenerative disorders. PMID:22707923

  6. Introduction to the special issue: 50th anniversary of APA Division 28: The past, present, and future of psychopharmacology and substance abuse.

    PubMed

    Stoops, William W; Sigmon, Stacey C; Evans, Suzette M

    2016-08-01

    This is an introduction to the special issue "50th Anniversary of APA Division 28: The Past, Present, and Future of Psychopharmacology and Substance Abuse." Taken together, the scholarly contributions included in this special issue serve as a testament to the important work conducted by our colleagues over the past five decades. Division 28 and its members have advanced and disseminated knowledge on the behavioral effects of drugs, informed efforts to prevent and treat substance abuse, and influenced education and policy issues more generally. As past and current leaders of the division, we are excited to celebrate 50 years of Division 28 and look forward to many more successful decades for our division and its members. (PsycINFO Database Record PMID:27454671

  7. A pilot study of actigraphy as an objective measure of SSRI activation symptoms; results from a randomized placebo controlled psychopharmacological treatment study

    PubMed Central

    Bussing, Regina; Reid, Adam M.; McNamara, Joseph P.H.; Meyer, Johanna M.; Guzick, Andrew G.; Mason, Dana M.; Storch, Eric A.; Murphy, Tanya K.

    2015-01-01

    Selective serotonin reuptake inhibitors (SSRIs) are an efficacious and effective treatment for pediatric obsessive-compulsive disorder (OCD) but have received scrutiny due to a potential side effect constellation called activation syndrome. While recent research introduced a subjective measure of activation syndrome, objective measures have not been tested. This pilot study, using data from a larger randomized-controlled trial, investigated the potential of actigraphy to provide an objective measure of activation symptoms in 44 youths with OCD beginning an SSRI medication regimen. Data were collected over the first four weeks of a multisite, parallel, double-blind, randomized, placebo controlled psychopharmacological treatment study and statistical modeling was utilized to test how activation syndrome severity predicts daily and nightly activity levels. Results indicated that youths with higher activation symptoms had lower daytime activity levels when treatment averages were analyzed; in contrast youths who experienced onset of activation symptoms one week were more likely to have higher daytime and night-time activity ratings that week. Results support actigraphy as a potential objective measure of activation symptoms. Subsequent studies are needed to confirm these findings and test clinical applications for use by clinicians to monitor activation syndrome during SSRI treatment. National Institutes of Health (5UO1 MH078594-01); NCT00382291. PMID:25535011

  8. Self-management of psychiatric symptoms using over-the-counter (OTC) psychopharmacology: the S-DTM therapeutic model--Self-diagnosis, self-treatment, self-monitoring.

    PubMed

    Charlton, Bruce G

    2005-01-01

    Pharmacological self-management is becoming more widespread in modernizing societies, as part of a general expansion of health care. This may exert a vital corrective balance to the professionalization of health by ensuring that the individual perspective of patients is not neglected. There are many 'good ideas' for new treatments being published which have a plausible scientific rationale for effectiveness and a low likelihood of harm, yet are essentially ignored by mainstream medical research. The most likely avenue for progress is probably the spread of self-management, together with increased sharing of experience via the internet. There is considerable scope for self-management of psychiatric symptoms with psychoactive medication purchased 'over-the-counter' (OTC) and without prescription. A surprisingly wide range of effective psychoactive agents are available with the potential to self-treat many of the common psychiatric problems. These include 'medical' psychopharmacological agents such as analgesics and antihistamines, a plant extract called St. John's Wort (Hypericum), and physical treatments such as early morning bright light therapy. But self-management currently lacks an explicit therapeutic model. A three stage process of S-DTM - self-diagnosis, self-treatment and self-monitoring is proposed and described in relation to psychiatric symptoms. Self-diagnosis describes the skill of introspection to develop awareness of inner bodily states and emotions. A specific sensation is identified and isolated as the 'focal symptom' for subsequent treatment and monitoring. Self-treatment involves choosing a drug (or other therapy) which is intended to alleviate the focal symptom. Self-monitoring entails a continued awareness of the focal system and of general well-being in order to evaluate effect of therapy. Self-monitoring could involve repeated cycles of dose-adjustment, and on-off ('challenge-dechallenge-rechallenge') therapeutic trials. An example of S

  9. [Pre-Columbian indigenous psychopharmacology].

    PubMed

    Jiménez-Olivares, E

    1978-01-01

    A careful review has been carried out on texts concerning Mexican medicine plants, especially on texts obtained directly from the XVI century Indian reports. The plants utilized for psychiatric purposes have been separated from the huge group of 1 500 medicine plants used by the prehispanic Indians, and have been found about 150 plants which have been classified in the modern way of antipsychotic, antidepressant, minor tranquilizer, hallucinogens, sedatives, hypnotics, brain tonics, stimulants and anticonvulsants. The intention in making this research is to awake the interest of the people in the experimenting field; as experiments have been effected only on hallucinogen up to now, and if these have proved to possess the effects caused to the Indians, supposedly large part of the other plants have the effects according to the indications they have mentioned. PMID:360092

  10. Psychopharmacological enhancement: a conceptual framework

    PubMed Central

    2012-01-01

    The availability of a range of new psychotropic agents raises the possibility that these will be used for enhancement purposes (smart pills, happy pills, and pep pills). The enhancement debate soon raises questions in philosophy of medicine and psychiatry (eg, what is a disorder?), and this debate in turn raises fundament questions in philosophy of language, science, and ethics. In this paper, a naturalistic conceptual framework is proposed for addressing these issues. This framework begins by contrasting classical and critical concepts of categories, and then puts forward an integrative position that is based on cognitive-affective research. This position can in turn be used to consider the debate between pharmacological Calvinism (which may adopt a moral metaphor of disorder) and psychotropic utopianism (which may emphasize a medical metaphor of disorder). I argue that psychiatric treatment of serious psychiatric disorders is justified, and that psychotropics are an acceptable kind of intervention. The use of psychotropics for sub-threshold phenomena requires a judicious weighing of the relevant facts (which are often sparse) and values. PMID:22244084

  11. The ethics of elective psychopharmacology

    PubMed Central

    Mohamed, Ahmed D.; Sahakian, Barbara J.

    2012-01-01

    Pharmacological cognitive enhancers (PCEs) are used to improve cognitive functions, such as attention, learning, memory and planning in patients with impairments in cognition resulting from traumatic brain injury (TBI) or from neuropsychiatric disorders such as Alzheimer's disease (AD), mild cognitive impairment, schizophrenia, and attention deficit hyperactivity disorder (ADHD). Moreover, PCEs have been shown to improve cognition in healthy volunteers with no psychiatric disorders. This article describes the rationale behind the need for their use in neuropsychiatric patients and illustrates how PCEs can ameliorate cognitive impairments, improve quality of life and wellbeing, and therefore reduce the economic burden associated with these disorders. We also describe evidence that PCEs are being used as cognitive enhancers by healthy people. Crucially, as the lifestyle use of these drugs becomes very popular in the healthy population, a final aim is to present an overview of the current and future neuroethical considerations of enhancing the healthy brain. As information regarding their actual use, benefits and harms in various healthy populations is currently lacking, we propose research that aims to obtain relevant empirical data, monitor the short- and long-term effectiveness and side-effects, and initiate accurate surveys to determine current patterns and quantity of usage of PCE drugs by healthy people. Furthermore, in order to instigate a dialogue between neuroethics and neuropsychopharmacology, we urge scientists to explore and communicate the social and ethical implications of their research to the public. Finally, we discuss and highlight other means of enhancing cognition in both patients and healthy adults, including education and physical exercise. PMID:21396152

  12. Evidence-based guidelines for management of attention-deficit/hyperactivity disorder in adolescents in transition to adult services and in adults: recommendations from the British Association for Psychopharmacology.

    PubMed

    Nutt, D J; Fone, K; Asherson, P; Bramble, D; Hill, P; Matthews, K; Morris, K A; Santosh, P; Sonuga-Barke, E; Taylor, E; Weiss, M; Young, S

    2007-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is an established diagnosis in children, associated with a large body of evidence on the benefits of treatment. Adolescents with ADHD are now leaving children's services often with no readily identifiable adult service to support them, which presents problems as local pharmacy regulations often preclude the prescription of stimulant drugs by general practitioners (GPs). In addition, adults with ADHD symptoms are now starting to present to primary care and psychiatry services requesting assessment and treatment. For these reasons, the British Association for Psychopharmacology (BAP) thought it timely to hold a consensus conference to review the body of evidence on childhood ADHD and the growing literature on ADHD in older age groups. Much of this initial guidance on managing ADHD in adolescents in transition and in adults is based on expert opinion derived from childhood evidence. We hope that, by the time these guidelines are updated, much evidence will be available to address the many directions for future research that are detailed here. PMID:17092962

  13. [25 Years After Re-Unification of Germany: An Overview on Eastern German Psychiatry. Part 1: Post-War Era, Pavlovization, Psychopharmacological Era and Social Psychiatric Reform Movement].

    PubMed

    Steinberg, H

    2016-04-01

    This is the first of a 2-part study on the history of psychiatry in Eastern Germany, i. e. the Soviet Occupied Zone and later German Democratic Republic. It mainly covers the years post World War II up until the beginning of the 1970s. The first post-war years were determined by the new power holders' attempts to overcome National Socialist (Nazi) heritage and to re-organize mental health and care in general. The doctrine of a strict denazifization in East Germany must, however, be regarded as a myth. Promoted by centralized organization, there was an increase in communist party-ideological influence and harassment as well as aligning scientific views and research with Soviet paradigms (Pavlovization) during the 1950s and early 1960s. This, however, led to an enormous rise in exodus of skilled labor to West Germany, which in turn further increased the notorious lack of staff. After the erection of the inner-German wall, this problem was mitigated, yet never fully solved over the 40 years of the existence of the GDR. Despite adverse conditions, East German psychiatrists made major original contributions to the development of psychiatry in general, at least up until the 1960s. Academic psychiatry was mainly based on biological concepts that were further promoted by new somatic and psychopharmacological therapeutic options. In the 1960s, social psychiatric reformist forces emerged, primarily in the large psychiatric hospitals. The improvements achieved by these forces, however, were not implemented on a nation-wide scale, but mainly restricted to one particular or several institutions. PMID:27100844

  14. Psychopharmacological treatment of aggression in schizophrenic patients.

    PubMed

    Brieden, T; Ujeyl, M; Naber, D

    2002-05-01

    Aggressive behavior is frequently observed in schizophrenic patients. More than 50 % of all psychiatric patients and 10 % of schizophrenic patients show aggressive symptoms varying from threatening behavior and agitation to assault. The pharmacological treatment of acute, persisting and repetitive aggression is a serious problem for other patients and staff members. Not only is violent behavior from mentally ill patients the most detrimental factor in their stigmatization, aggression is also a considerable direct source of danger for the patients themselves. Based on rather limited evidence, a wide variety of medications for the pharmacological treatment of aggression has been recommended: typical and atypical antipsychotics, benzodiazepines, mood stabilizers, beta-blockers and selective serotonin reuptake inhibitors (SSRIs). Most clinical information on treating aggression has been collected for atypical neuroleptics, particularly for clozapine. Several retrospective and open studies indicate its efficacy. Treatment duration of 6 months is recommended to induce a stable reduction of physical and verbal aggression. Severe side effects have very rarely been seen. At the moment, clozapine seems to be the first choice in aggression treatment. Within the last few years, about 10 articles were published showing that this is the most effective antiaggressive agent in the treatment of aggression and agitation in psychiatric patients, independent of psychiatric diagnosis. However, clozapine, like all the other substances used, does not have an established indication for the treatment of aggressive symptoms. Noncompliance with medication makes it difficult to choose the right preparation for the medication: tablets, liquids, intramuscular injections and readily soluble "FDDFs" are available. Ethical, juridical and methodological problems prevent controlled studies from establishing a reference in the treatment of aggression in mentally ill patients. This review summarizes the current discussion and publications on the pharmacological treatment of aggression in schizophrenic patients of the last 20 years. In addition, we will briefly present studies and case reports concerning the treatment of aggression in other psychiatric patients. PMID:12107851

  15. Psychopharmacological interactions between nicotine and ethanol.

    PubMed

    Rose, Jed E; Brauer, Lisa H; Behm, Frederique M; Cramblett, Matthew; Calkins, Kevin; Lawhon, Dawn

    2004-02-01

    Epidemiological, clinical, and laboratory evidence has shown a positive correlation between cigarette smoking and ethanol use, and previous studies suggest some commonality in the neural pathways mediating effects of nicotine and ethanol. In this study, the subjective and behavioral interactions among nicotine, ethanol, and the nicotinic antagonist mecamylamine were investigated. The main objectives were to determine how the rewarding effects of nicotine might be modified by ethanol, and to compare the effects of ethanol with those of a nicotinic antagonist (mecamylamine). A total of 48 smokers who regularly consumed alcoholic beverages participated in four laboratory sessions presenting a 2 (nicotine vs. denicotinized cigarette smoke)x2 (10 mg oral mecamylamine hydrochloride vs. placebo)x2 (ethanol.5 g/kg vs. placebo) design, with ethanol as a between-subjects factor. Dependent measures included blood alcohol concentration (BAC), as assessed by breath alcohol detector; subjective drug effects; and rate of ad lib smoking during a 2-hr period. Results showed that peak BAC averaged.03 g/dl in the ethanol condition. Ethanol potentiated some of the subjective rewarding effects of nicotine, including smoking satisfaction, stimulant as well as calming effects, and relief of craving for cigarettes. During the ad lib smoking period, mecamylamine decreased satisfaction associated with the nicotine-containing cigarettes; mecamylamine also induced smoking but only in the placebo ethanol condition. These results highlight the potent interaction between ethanol and nicotinic systems, and suggest that ethanol can potentiate the rewarding effects of nicotine as well as offset some of the effects of a nicotinic antagonist. PMID:14982697

  16. The psychopharmacology of violence: making sensible decisions.

    PubMed

    Citrome, Leslie; Volavka, Jan

    2014-10-01

    Violent behavior associated with mental disorders is a common reason for admission to a psychiatric inpatient unit. Once hospitalized, patients may continue to be intermittently agitated and have persistent aggressive behaviors, preventing their discharge back into the community. Managing agitation quickly with effective pharmacological agents can avoid further escalation to aggression and violence. In the acute setting, this usually involves the parenteral use of antipsychotics, with or without benzodiazepines. Within the past decade, short-acting intramuscular formulations of second-generation antipsychotics have become available and provide a means to induce calm with a substantially lower risk of acute dystonia or akathisia compared with haloperidol. New alternative formulations that avoid injections include inhalation and sublingual administration. Longer-term management of persistent aggressive behavior by reducing the frequency and intensity of future episodes of agitation is more complex. In contrast to agitation associated with schizophrenia or bipolar mania, no agents have yet been approved by regulatory agencies for the treatment of persistent aggressive behavior. The strongest evidence supports the use of clozapine as an antihostility agent, followed by olanzapine. Adjunctive strategies with anticonvulsants and beta-adrenergic agents may also be worthwhile to consider. PMID:24571828

  17. Human psychopharmacology of N,N-dimethyltryptamine.

    PubMed

    Strassman, R J

    1996-01-01

    We generated dose-response data for the endogenous and ultra-short-acting hallucinogen, N,N-dimethyltryptamine (DMT), in a cohort of experienced hallucinogen users, measuring multiple biological and psychological outcome measures. Subjective responses were quantified with a new rating scale, the HRS, which provided better resolution of dose effects than did the biological variables. A tolerance study then was performed, in which volunteers received four closely spaced hallucinogenic doses of DMT. Subjective responses demonstrated no tolerance, while biological measures were inconsistently reduced over the course of the sessions. Thus, DMT remains unique among classic hallucinogens in its inability to induce tolerance to its psychological effects. To assess the role of the 5-HT1A site in mediating DMT's effects, a pindolol pre-treatment study was performed. Pindolol significantly increased psychological responses to DMT, suggesting a buffering effect of 5-HT1A agonism on 5-HT2-mediated psychedelic effects. These data are opposite to those described in lower animal models of hallucinogens' mechanisms of action. PMID:8788488

  18. A group approach to psychopharmacology with schizophrenics.

    PubMed Central

    Skolnick, M. R.

    1985-01-01

    Theoretical and practical issues involved in integrating pharmacotherapy and psychosocial therapy in a long-term day hospital for schizophrenics are addressed. The limitations and risks of relying too heavily on a biomedical conceptual framework are discussed. In addition to diagnosis, target symptoms, pharmacodynamics, and pharmacokinetics, individual interpersonal, family, and institutional dynamics can exert profound effects on the effectiveness of medication. Through case illustrations it is shown how an open systems model and a group approach can allow for an integration of the many variables involved in the medication process. A weekly medication group which emphasizes education, informed choice, patient responsibility, and the examination of the boundary between medication effect and the need for psychological work is described. It is shown that the chemical control of psychosis alone may reinforce the psychosocial aspects of the schizophrenic syndrome. A distinction is drawn between chemical control of psychosis and the sensitive use of medication as a facilitator of growth-promoting psychosocial treatment. PMID:2864762

  19. Psychopharmacologic treatment of depression during pregnancy.

    PubMed

    Gold, Liza H

    2003-06-01

    Increasing numbers of patients are being treated for mood disorders. Most of these patients, particularly those with the diagnosis of major depression, are women of childbearing years. Depression can also occur in the context of bipolar disorder. Concerns regarding fetal exposure to medication, either planned or unplanned, are becoming more pressing in the clinical practices of psychiatrists and primary care physicians. There are relatively few study data available to guide clinicians in the use of psychotropic medications during pregnancy, owing to obvious problems in designing studies of the effects of medications on pregnant women, fetuses, and infants. In this article clinically relevant study and practice information is provided, and suggestions regarding the approach to the treatment of mood disorders during pregnancy based on a risk assessment mode are given. PMID:12734035

  20. Pediatric Psychopharmacology for Prepubertal Internalizing Disorders

    ERIC Educational Resources Information Center

    Kubiszyn, Tom; Carlson, John S.; DeHay, Tamara

    2005-01-01

    Evidence-based studies of drug, psychosocial and combined treatments for prepubertal internalizing disorders (depression, obsessive-compulsive disorder [OCD], and non-OCD anxiety) were reviewed. No age effects were found. Although no combined studies met evidence-based criteria, efficacious and possibly efficacious psychosocial and pharmacological…

  1. Training School Psychologists in Psychopharmacology Consultation

    ERIC Educational Resources Information Center

    Roberts, Holly J.; Floress, Margaret T.; Ellis, Cynthia R.

    2009-01-01

    The number of children taking psychotropic medications has dramatically increased in recent years. These children typically take medication during school hours, thereby making the school setting an optimal venue in which evaluate the effectiveness of medications. Given their training in data-based decision making, intervention, and assessment,…

  2. Behavioral addictions: a novel challenge for psychopharmacology.

    PubMed

    Marazziti, Donatella; Presta, Silvio; Baroni, Stefano; Silvestri, Stefano; Dell'Osso, Liliana

    2014-12-01

    Although addictive syndromes have been traditionally related to substance-use disorders, during the last few decades a novel addictive group, including the so-called "behavioral or no-drug addictions," has been recognized and has attracted increasing attention for its relevant social impact. This group includes pathological gambling, compulsive shopping, TV/Internet/social network/videogame addictions, workaholism, sex and relationship addictions, orthorexia, and overtraining syndrome. Substance and behavioral addictions show similar phenomenological features, such as craving, dependence, tolerance, and abstinence, and perhaps they share a common possible pathophysiology. It is, however, controversial whether all or at least some of them should be considered real disorders or just normal, albeit extreme, behaviors. The aim of this article is to review current data on pharmacological treatment of behavioral addictions. As no specific and validated treatment algorithms are currently available, only an improved knowledge on their psychopathological, clinical, and neurobiological features may have relevant implications for more focused preventive and therapeutic strategies. PMID:24589040

  3. Low Dose Effects in Psychopharmacology: Ontogenetic Considerations

    PubMed Central

    Spear, Linda Patia; Varlinskaya, Elena I.

    2005-01-01

    Low doses of psychoactive drugs often elicit a behavioral profile opposite to that observed following administration of more substantial doses. Our laboratory has observed that these effects are often age-specific in rats. For instance, whereas moderate to high doses of the dopamine agonist apomorphine increase locomotion, suppressed locomotor activity is seen following low dose exposure, with this low dose effect not emerging consistently until adolescence. A somewhat earlier emergence of a low dose “paradoxical” effect is seen with the 5HT1a receptor agonist, 8-OH-DPAT, with late preweanling, but not neonatal, rats showing increases in ingestive behavior at low doses but suppression at higher doses. In contrast to these ontogenetic increases in expression of low dose drug effects, low dose facilitation of social behavior is seen following ethanol only in adolescent rats and not their mature counterparts, although suppression of social interactions at higher doses is seen at both ages. This hormesis-like low dose stimulation appears related in part to overcompensation, with brief social suppression preceding the subsequent stimulation response, and also bears a number of ontogenetic similarities to acute tolerance, a well characterized, rapidly emerging adaptation to ethanol. Implications of these and other ontogenetic findings for studies of hormesis are discussed. PMID:19330157

  4. Medication Adherence in Psychopharmacologically Treated Adults with ADHD

    ERIC Educational Resources Information Center

    Safren, Steven A.; Duran, Petra; Yovel, Iftah; Perlman, Carol A.; Sprich, Susan

    2007-01-01

    Objective: One of the potential causes of residual symptoms of ADHD in adults can be difficulties with consistent adherence to medications. Method: This formative study examined self-reported medication adherence in adults with ADHD with clinically significant symptoms despite medication treatment. Results: Mean adherence for the two-week period…

  5. Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA.

    PubMed

    Mithoefer, Michael C; Grob, Charles S; Brewerton, Timothy D

    2016-05-01

    4-phosphorloxy-N,N-dimethyltryptamine (psilocybin) and methylenedioxymethamfetamine (MDMA), best known for their illegal use as psychedelic drugs, are showing promise as therapeutics in a resurgence of clinical research during the past 10 years. Psilocybin is being tested for alcoholism, smoking cessation, and in patients with advanced cancer with anxiety. MDMA is showing encouraging results as a treatment for refractory post-traumatic stress disorder, social anxiety in autistic adults, and anxiety associated with a life-threatening illness. Both drugs are studied as adjuncts or catalysts to psychotherapy, rather than as stand-alone drug treatments. This model of drug-assisted psychotherapy is a possible alternative to existing pharmacological and psychological treatments in psychiatry. Further research is needed to fully assess the potential of these compounds in the management of these common disorders that are difficult to treat with existing methods. PMID:27067625

  6. The Impact of Psychopharmacology on Contemporary Clinical Psychiatry

    PubMed Central

    Vázquez, Gustavo H

    2014-01-01

    Clinical psychiatric evaluations of patients have changed dramatically in recent decades. Both initial assessments and follow-up visits have become brief and superficial, focused on searching for categorical diagnostic criteria from checklists, with limited inquiry into patient-reported symptomatic status and tolerability of treatments. The virtually exclusive therapeutic task has become selecting a plausible psychotropic, usually based on expert consensus guidelines. These guidelines and practice patterns rest mainly on published monotherapy trials that may or may not be applicable to particular patients but are having a profound impact, not only on modern psychiatric practice but also on psychiatric education, research, and theory. PMID:25161065

  7. Efficacy Profiles of Psychopharmacology: Divalproex Sodium in Conduct Disorder

    ERIC Educational Resources Information Center

    Khanzode, Leena A.; Saxena, Kirti; Kraemer, Helena; Chang, Kiki; Steiner, Hans

    2006-01-01

    Little is known about how deeply medication treatment penetrates different levels of the mind/brain system. Psychopathology consists of relatively simple constructs (e.g., anger, irritability), or complex ones (e.g., responsibility). This study examines the efficacy of a specific compound, divalproex sodium (DVPX), on the various levels of…

  8. Psychopharmacology in Fragile X Syndrome--Present and Future

    ERIC Educational Resources Information Center

    Berry-Kravis, Elizabeth; Potanos, Kristina

    2004-01-01

    In addition to cognitive disability, fragile X syndrome (FXS) is associated with behavioral problems that are often functionally limiting. There are few controlled trials to guide treatment; however, available information does suggest that medications can be quite helpful for a number of categories of behavioral disturbance in FXS. Specifically,…

  9. Effect of certain psychopharmacological preparations on adaptation under stress conditions

    NASA Technical Reports Server (NTRS)

    Stanishevskaya, A. V.; Mezentseva, L. N.

    1980-01-01

    Experiments staged on rats demonstrated that the formation of pathological states caused by stress and accompanied by the development of ulcerative lesion of the gastric mucosa are associated with the degree of the catecholamines level drop in the mesencephalon and hypothalamus. The application of seduxen and also of combinations consisting of L-DOPA with seduxen, or with an L-adrenoblocking agent pyroxan tends to reduce the frequency of developing alcerative lesions of the stomach. The protective effect produced by the combination of L-DOPA with an L-adrenoblocking agent pyroxan is barred by an additional administration of an B-adrenoblocking agent, inderal.

  10. Practitioner Review: Psychopharmacology in Children and Adolescents with Mental Retardation

    ERIC Educational Resources Information Center

    Handen, Benjamin L.; Gilchrist, Richard

    2006-01-01

    Background: The use of psychotropic medication to treat children and adults with mental retardation (MR) has a long and extensive history. There are no identified medications to address specific cognitive deficits among persons with MR. Instead, psychotropic medications are used to treat specific behavioral symptoms and/or psychiatric syndromes.…

  11. Early Onset Bipolar Spectrum Disorder: Psychopharmacological, Psychological, and Educational Management

    ERIC Educational Resources Information Center

    McIntosh, David E.; Trotter, Jeffrey S.

    2006-01-01

    Although published research continues to advocate medication as the first line of treatment for early onset bipolar spectrum disorder (EOBSD; N. Lofthouse & M.A. Fristad, 2004), preliminary research demonstrating the utility of cognitive, cognitive-behavioral, and psychoeducational therapies is promising. It appears as if future treatment of EOBSD…

  12. [Administrative and juridicial problems in psychopharmacology (author's transl)].

    PubMed

    Heimann, H

    1975-11-01

    The problem of a juridical and administrative regulation for therapeutic drugs is analyzed. There are 3 concurring factors of public interest: 1. protection of the patient against dangerous side-effects, 2. promotion of new effective therapies. 3. position and responsibility of the physician. Risks and problems of control are discussed in the light of development of a new preparation. A scheme of functions in the clinical trial under auspices of medico-ethical postulations is mentioned. Restrictive facts on behalf of a quick development of drug therapy are discussed. The necessity of intensifying biological basic research is emphasized. PMID:1106443

  13. The psychopharmacology of European herbs with cognition-enhancing properties.

    PubMed

    Kennedy, David O; Scholey, Andrew B

    2006-01-01

    Extensive research suggests that a number of plant-derived chemicals and traditional Oriental herbal remedies possess cognition-enhancing properties. Widely used current treatments for dementia include extracts of Ginkgo biloba and several alkaloidal, and therefore toxic, plant-derived cholinergic agents. Several non-toxic, European herbal species have pan-cultural traditions as treatments for cognitive deficits, including those associated with ageing. To date they have not received research interest commensurate with their potential utility. Particularly promising candidate species include sage (Salvia lavandulaefolia/officinalis), Lemon balm (Melissa officinalis) and rosemary (Rosmarinus officinalis). In the case of sage, extracts possess anti-oxidant, estrogenic, and anti-inflammatory properties, and specifically inhibit butyryl- and acetyl-cholinesterase. Acute administration has also been found to reliably improve mnemonic performance in healthy young and elderly cohorts, whilst a chronic regime has been shown to attenuate cognitive declines in sufferers from Alzheimer's disease. In the case of Melissa officinalis, extracts have, most notably, been shown to bind directly to both nicotinic and muscarinic receptors in human brain tissue. This property has been shown to vary with extraction method and strain. Robust anxiolytic effects have also been demonstrated following acute administration to healthy humans, with mnemonic enhancement restricted to an extract with high cholinergic binding properties. Chronic regimes of aromatherapy and essential oil respectively have also been shown to reduce agitation and attenuate cognitive declines in sufferers from dementia. Given the side effect profile of prescribed cholinesterase inhibitors, and a current lack of a well tolerated nicotinic receptor agonist, these herbal treatments may well provide effective and well-tolerated treatments for dementia, either alone, in combination, or as an adjunct to conventional treatments. PMID:17168769

  14. Understanding the agreements and controversies surrounding childhood psychopharmacology

    PubMed Central

    Parens, Erik; Johnston, Josephine

    2008-01-01

    The number of children in the US taking prescription drugs for emotional and behavioral disturbances is growing dramatically. This growth in the use of psychotropic drugs in pediatric populations has given rise to multiple controversies, ranging from concerns over off-label use and long-term safety to debates about the societal value and cultural meaning of pharmacological treatment of childhood behavioral and emotional disorders. This commentary summarizes the authors' eight main findings from the first of five workshops that seek to understand and produce descriptions of these controversies. The workshop series is convened by The Hastings Center, a bioethics research institute located in Garrison, New York, U.S.A. PMID:18261228

  15. Systems psychopharmacology: A network approach to developing novel therapies

    PubMed Central

    Gebicke-Haerter, Peter J

    2016-01-01

    The multifactorial origin of most chronic disorders of the brain, including schizophrenia, has been well accepted. Consequently, pharmacotherapy would require multi-targeted strategies. This contrasts to the majority of drug therapies used until now, addressing more or less specifically only one target molecule. Nevertheless, quite some searches for multiple molecular targets specific for mental disorders have been undertaken. For example, genome-wide association studies have been conducted to discover new target genes of disease. Unfortunately, these attempts have not fulfilled the great hopes they have started with. Polypharmacology and network pharmacology approaches of drug treatment endeavor to abandon the one-drug one-target thinking. To this end, most approaches set out to investigate network topologies searching for modules, endowed with “important” nodes, such as “hubs” or “bottlenecks”, encompassing features of disease networks, and being useful as tentative targets of drug therapies. This kind of research appears to be very promising. However, blocking or inhibiting “important” targets may easily result in destruction of network integrity. Therefore, it is suggested here to study functions of nodes with lower centrality for more subtle impact on network behavior. Targeting multiple nodes with low impact on network integrity by drugs with multiple activities (“dirty drugs”) or by several drugs, simultaneously, avoids to disrupt network integrity and may reset deviant dynamics of disease. Natural products typically display multi target functions and therefore could help to identify useful biological targets. Hence, future efforts should consider to combine drug-target networks with target-disease networks using mathematical (graph theoretical) tools, which could help to develop new therapeutic strategies in long-term psychiatric disorders. PMID:27014599

  16. Psychopharmacologic analysis of an alleged oneirogenic plant: Calea zacatechichi.

    PubMed

    Mayagoitia, L; Díaz, J L; Contreras, C M

    1986-12-01

    Calea zacatechichi is a plant used by the Chontal Indians of Mexico to obtain divinatory messages during dreaming. At human doses, organic extracts of the plant produce the EEG and behavioral signs of somnolence and induce light sleep in cats. Large doses elicit salivation, ataxia, retching and occasional vomiting. The effects of the plant upon cingulum discharge frequency were significantly different from hallucinogenic-dissociative drugs (ketamine, quipazine, phencyclidine and SKF-10047). In human healthy volunteers, low doses of the extracts administered in a double-blind design against placebo increased reaction time and time-lapse estimation. A controlled nap sleep study in the same volunteers showed that Calea extracts increased the superficial stages of sleep and the number of spontaneous awakenings. The subjective reports of dreams were significantly higher than both placebo and diazepam, indicating an increase in hypnagogic imagery occurring during superficial sleep stages. PMID:3821139

  17. Towards a Better Understanding of the Psychopharmacology of Nutmeg: Activities in the Mouse Tetrad Assay

    PubMed Central

    El-Alfy, Abir; Wilson, Lisa; ElSohly, Mahmoud A.; Abourashed, Ehab A.

    2009-01-01

    Ethnopharmacological relevance Nutmeg, the seeds of Myritica fragrans (family Myristicaceae), is a well known kitchen spice with a long-standing reputation as a psychoactive herb. Nutmeg at high doses is considered a cheap substitute to several drugs of abuse. Earlier reports have attributed amphetamine-like activities to nutmeg. Aim of the study To characterize the neuropharmacological effects of different nutmeg extracts, administered orally and intraperitoneally, in comparison to Δ9-terahydrocannabinol, amphetamine, and morphine. Materials and methods Methanolic (ME), dichloromethane (DE), and hexane (HE) extracts were obtained from a chromatographically fingerprinted batch of nutmeg. Biological evaluation was conducted in sets of 6–8 mice in the tetrad assay at doses ranging from 100–500 and 500–1000 mg/kg for i.p. and oral administration, respectively. Results While oral administration of all the nutmeg extracts at 500 mg/kg caused a significant increase in locomotor activity, the i.p. administration of DE showed significant reduction in rectal temperature along with a significant increase in tail flick latency at 300 mg/kg. A significant decrease in core body temperature was observed with HE at 100 mg/kg, while higher doses caused significant increases in hot plate latency. Conclusion Different behavioral effects were observed that varied by the type of extract as well as by the route of administration. PMID:19703539

  18. Psychopharmacology of chronic pain: a focus on antidepressants and atypical antipsychotics.

    PubMed

    Khouzam, Hani Raoul

    2016-01-01

    Chronic pain is considered one of the most prevalent causes of costly and disabling medical conditions. This review will define chronic pain and its categories and then will summarize the effectiveness and side effects associated with the use of various antidepressants, including the tricyclics, the selective serotonin reuptake inhibitors, the serotonin norepinephrine reuptake inhibitors, other miscellaneous antidepressants and the atypical antipsychotics in the treatment of chronic pain. PMID:26821680

  19. Off-label psychopharmacologic prescribing for children: History supports close clinical monitoring

    PubMed Central

    Zito, Julie M; Derivan, Albert T; Kratochvil, Christopher J; Safer, Daniel J; Fegert, Joerg M; Greenhill, Laurence L

    2008-01-01

    The review presents pediatric adverse drug events from a historical perspective and focuses on selected safety issues associated with off-label use of medications for the psychiatric treatment of youth. Clinical monitoring procedures for major psychotropic drug classes are reviewed. Prior studies suggest that systematic treatment monitoring is warranted so as to both minimize risk of unexpected adverse events and exposures to ineffective treatments. Clinical trials to establish the efficacy and safety of drugs currently being used off-label in the pediatric population are needed. In the meantime, clinicians should consider the existing evidence-base for these drugs and institute close clinical monitoring. PMID:18793403

  20. Metabolic syndrome and obesity among users of second generation antipsychotics: A global challenge for modern psychopharmacology.

    PubMed

    Rojo, Leonel E; Gaspar, Pablo A; Silva, H; Risco, L; Arena, Pamela; Cubillos-Robles, Karen; Jara, Belen

    2015-11-01

    Second generation antipsychotics (SGAs), such as clozapine, olanzapine, risperidone and quetiapine, are among the most effective therapies to stabilize symptoms schizophrenia (SZ) spectrum disorders. In fact, clozapine, olanzapine and risperidone have improved the quality of life of billions SZ patients worldwide. Based on the broad spectrum of efficacy and low risk of extrapyramidal symptoms displayed by SGAs, some regulatory agencies approved the use of SGAs in non-schizophrenic adults, children and adolescents suffering from a range of neuropsychiatric disorders. However, increasing number of reports have shown that SGAs are strongly associated with accelerated weight gain, insulin resistance, diabetes, dyslipidemia, and increased cardiovascular risk. These metabolic alterations can develop in as short as six months after the initiation of pharmacotherapy, which is now a controversial fact in public disclosure. Although the percentage of schizophrenic patients, the main target group of SGAs, is estimated in only 1% of the population, during the past ten years there was an exponential increase in the number of SGAs users, including millions of non-SZ patients. The scientific bases of SGAs metabolic side effects are not yet elucidated, but the evidence shows that the activation of transcriptional factor SRBP1c, the D1/D2 dopamine, GABA2 and 5HT neurotransmitions are implicated in the SGAs cardiovascular toxicity. Polypharmacological interventions are either non- or modestly effective in maintaining low cardiovascular risk in SGAs users. In this review we critically discuss the clinical and molecular evidence on metabolic alterations induced by SGAs, the evidence on the efficacy of classical antidiabetic drugs and the emerging concept of antidiabetic polyphenols as potential coadjutants in SGA-induced metabolic disorders. PMID:26218604

  1. Sex Hormones, Neurotransmitters, and Psychopharmacological Treatments in Men with Paraphilic Disorders

    ERIC Educational Resources Information Center

    Saleh, Fabian M.; Berlin, Fred S.

    2003-01-01

    Paraphilic disorders are psychiatric syndromes primarily characterized by deviant sexual thoughts, cravings, urges, and/or behaviors. Paraphilic men may engage in inappropriate sexual behaviors when cravings for socially unacceptable sexual acts become overpowering. These often chronic disorders may not only cause emotional distress and social…

  2. Human psychopharmacology of hoasca, a plant hallucinogen used in ritual context in Brazil.

    PubMed

    Grob, C S; McKenna, D J; Callaway, J C; Brito, G S; Neves, E S; Oberlaender, G; Saide, O L; Labigalini, E; Tacla, C; Miranda, C T; Strassman, R J; Boone, K B

    1996-02-01

    A multinational, collaborative, biomedical investigation of the effects of hoasca (ayahuasca), a potent concoction of plant hallucinogens, was conducted in the Brazilian Amazon during the summer of 1993. This report describes the psychological assessment of 15 long-term members of a syncretic church that utilizes hoasca as a legal, psychoactive sacrament as well as 15 matched controls with no prior history of hoasca ingestion. Measures administered to both groups included structured psychiatric diagnostic interviews, personality testing, and neuropsychological evaluation. Phenomenological assessment of the altered state experience as well as semistructured and open-ended life story interviews were conducted with the long-term use hoasca group, but not the hoasca-naive control group. Salient findings included the remission of psychopathology following the initiation of hoasca use along with no evidence of personality or cognitive deterioration. Overall assessment revealed high functional status. Implications of this unusual phenomenon and need for further investigation are discussed. PMID:8596116

  3. Drugs Are Not Enough: Some Principles of Psychopharmacology for General Medical Practice

    PubMed Central

    Ross, W. Donald

    1963-01-01

    There is no necessary antagonism between the judicious use of drugs and a psychotherapeutic approach to patients in general medical practice. A table is presented with a simple pragmatic classification of types of drugs for altering emotional and mental states. Three general principles are given for the use of such drugs, illustrated by examples of the use and misuse of tranquillizers. Some differentiation is made between sedatives and tranquillizers and between different types of tranquillizers, particularly with reference to the need to consider depressive features in patients. Suggestions are made for the use of drugs for mild depressions and for depressions accompanying organic disease. One may have to take an “experimental” approach to new drugs to determine which to them are of value in relation to the particular emotional states of one's own patients. ImagesFig. 1 PMID:14060167

  4. Psychopharmacological Intervention. I: Teacher Perceptions of Psychotropic Medication for Students with Serious Emotional Disturbance.

    ERIC Educational Resources Information Center

    Singh, Nirbhay N.; And Others

    1990-01-01

    The study examined perceptions, knowledge, and opinions regarding medication of 146 teachers of students with serious emotional disturbances. Among findings were that global impressions were most often used to evaluate drug effects and that hyperactivity and delusions/hallucinations were most likely to lead to medication. (DB)

  5. Herbal Insomnia Medications that Target GABAergic Systems: A Review of the Psychopharmacological Evidence

    PubMed Central

    Shi, Yuan; Dong, Jing-Wen; Zhao, Jiang-He; Tang, Li-Na; Zhang, Jian-Jun

    2014-01-01

    Insomnia is a common sleep disorder which is prevalent in women and the elderly. Current insomnia drugs mainly target the γ-aminobutyric acid (GABA) receptor, melatonin receptor, histamine receptor, orexin, and serotonin receptor. GABAA receptor modulators are ordinarily used to manage insomnia, but they are known to affect sleep maintenance, including residual effects, tolerance, and dependence. In an effort to discover new drugs that relieve insomnia symptoms while avoiding side effects, numerous studies focusing on the neurotransmitter GABA and herbal medicines have been conducted. Traditional herbal medicines, such as Piper methysticum and the seed of Zizyphus jujuba Mill var. spinosa, have been widely reported to improve sleep and other mental disorders. These herbal medicines have been applied for many years in folk medicine, and extracts of these medicines have been used to study their pharmacological actions and mechanisms. Although effective and relatively safe, natural plant products have some side effects, such as hepatotoxicity and skin reactions effects of Piper methysticum. In addition, there are insufficient evidences to certify the safety of most traditional herbal medicine. In this review, we provide an overview of the current state of knowledge regarding a variety of natural plant products that are commonly used to treat insomnia to facilitate future studies. PMID:24851093

  6. Salvia divinorum: a psychopharmacological riddle and a mind-body prospect.

    PubMed

    Diaz, Jose-Luis

    2013-03-01

    The multidisciplinary research on Salvia divinorum and its chemical principles is analyzed concerning whether the ethnobotany, phytochemistry, mental effects, and neuropharmacology of this sacred psychoactive plant and main principle clarify its experienced effects and divinatory uses. The scientific pursuit spans from the traditional practices, continues with the botanical identification, isolation of active molecules, characterization of mental and neural effects, possible therapeutic applications, and impinges upon the mind-body problem. The departure point is ethnopharmacology and therefore the traditional beliefs, ritual uses, and mental effects of this Mazatec sacred mint recorded during a 1973- 1983 field research project are described. A water potion of crushed leaves produced short-lasting light-headedness, dysphoria, tactile and proprioceptive sensations, a sense of depersonalization, amplified sound perception, and an increase visual and auditory imagery, but not actual hallucinations. Similar effects were described using questionnaires and are attributable to salvinorin A, but cannot be explained solely by its specific and potent brain kappa-opioid receptor agonist activity. Some requirements for a feasible classification and mechanism of action of consciousness-altering products are proposed and include the activation of neural networks comprising several neurochemical systems. Top-down analyses should be undertaken in order to characterize such neural networks and eventually allowing to explore the differential ethnic effects. As is the case for other consciousness-altering preparations, a careful and encompassing research on this plant and principle can be consequential to endeavors ranging from the mind-body problem, a better understanding of shamanic ecstasy, to the potential generation of analgesic, antidepressant, and drug-abuse attenuating products. PMID:23627785

  7. Future Trends in the Application and Impact of Psychopharmacology within the School Setting

    ERIC Educational Resources Information Center

    Noggle, Chad A.

    2009-01-01

    The number of children and adolescents using prescription medications is continually climbing. The preceding articles have offered discussions on a multitude of areas within this subject matter. This article will serve to summarize some of those points raised with particular emphasis on where we go from here in terms of training and professional…

  8. Current Practice in Psychopharmacology for Children and Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Floyd, Elizabeth Freeman; McIntosh, David E.

    2009-01-01

    Autism spectrum disorders (ASDs) are a complex group of neurodevelopmental conditions that develop in early childhood and involve a range of impairments in core areas of social interaction, communication, and restricted behavior and interests. Associated behavioral problems such as tantrums, aggression, and self-injury frequently compound the core…

  9. Positive Attitude Change toward Psychiatry in Pharmacy Students Following an Active Learning Psychopharmacology Course

    ERIC Educational Resources Information Center

    Einat, Haim; George, Angela

    2008-01-01

    Objective: Psychiatric care in many rural communities has been demonstrated to be less adequate compared with urban environments partially because of attitudes and stigmatization issues. Educated pharmacists with professional attitudes can have a major impact in helping mental health patients receive more accurate diagnostic assessments and safe…

  10. Aacap 2002 Research Forum: Placebo and Alternatives to Placebo in Randomized Controlled Trials in Pediatric Psychopharmacology

    ERIC Educational Resources Information Center

    March, John; Kratochvil, Christopher; Clarke, Gregory; Beardslee, William; Derivan, Albert; Emslie, Graham; Green, Evelyn P.; Heiligenstein, John; Hinshaw, Stephen; Hoagwood, Kimberly; Jensen, Peter; Lavori, Philip; Leonard, Henrietta; McNulty, James; Michaels, M. Alex; Mossholder, Andrew; Osher, Trina; Petti, Theodore; Prentice, Ernest; Vitiello, Benedetto; Wells, Karen

    2004-01-01

    Objective: The use of placebo in the pediatric age group has come under increasing scrutiny. At the 2002 Annual Meeting of the American Academy of Child and Adolescent Psychiatry, the Academy's Workgroup on Research conducted a research forum. The purpose was to identify challenges and their solutions regarding the use of placebo in randomized…

  11. Psychopharmacological profile of Chamomile (Matricaria recutita L.) essential oil in mice.

    PubMed

    Can, Ozgür Devrim; Demir Özkay, Umide; Kıyan, Hülya Tuba; Demirci, Betül

    2012-02-15

    In this study, the effect of Matricaria recutita L. essential oil (MEO) on the central nervous system (CNS) of mice was investigated using some behavioral methods. Chemical profiling both by GC and GC-MS analyses of the hydrodistilled essential oil of M. recutita revealed α-bisabolol oxide A (28%), α-bisabolol oxide B (17.1%), (Z)-β-Farnesene (15.9%) and α-bisabolol (6.8%) as the main components. Changes induced by MEO (25, 50 and 100 mg/kg) and reference drug caffeine (25 mg/kg) in spontaneous locomotor activities and motor coordinations of mice were investigated by activity cage measurements and Rota-Rod tests, respectively. Open field, social interaction and elevated plus-maze tests were applied to assess the emotional state of the animals. Further, tail-suspension test was performed for evaluating the effect of MEO on depression levels of mice. As a result, at 50 and 100 mg/kg, MEO significantly increased the numbers of spontaneous locomotor activities, exhibited anxiogenic effect in the open field, elevated plus-maze and social interaction tests and decreased the immobility times of animals in tail suspension tests. The falling latencies in Rota-Rod tests did not change. This activity profile of MEO was similar to the typical psychostimulant caffeine. The exact mechanism of action underlying this stimulant-like effect should be clarified with further detailed studies. PMID:22070986

  12. Music Performance Anxiety: An Overview of Technological Advances in Therapy, Psychopharmacology & Bio-Feedback.

    ERIC Educational Resources Information Center

    Hipple, John

    Incidence of anxiety among musicians has been investigated mostly among classical players and music students. This paper determines that any intervention requires a comprehensive understanding of the primary problem. The presentation of music performance anxiety varies from individual to individual with many possible sources of origin as well as…

  13. Separate and combined psychopharmacological effects of alprazolam and oxycodone in healthy volunteers

    PubMed Central

    Zacny, James P.; Paice, Judith A.; Coalson, Dennis W.

    2013-01-01

    Background There are epidemiological data indicating that medical and/or nonmedical use of prescription opioids oftentimes involves concurrent use of other substances. One of those substances is benzodiazepines. It would be of relevance to characterize the effects of an opioid and a benzodiazepine when taken together to determine if measures related to abuse liability-related effects and psychomotor performance impairment are increased compared to when the drugs are taken alone. Methods Twenty volunteers participated in a crossover, randomized, double-blind study in which they received placebo, 0.5 mg alprazolam, 10mg oxycodone, and 0.5 mg alprazolam combined with 10mg oxycodone, all p.o. Subjective, psychomotor, and physiological measures were assessed during each of the four sessions. Results Oxycodone by itself increased drug liking and “take again” ratings relative to placebo, but these ratings were not increased when oxycodone was taken with alprazolam, which by itself did not increase either of these ratings. The two drugs in combination produced stronger effects (larger in magnitude or longer lasting) than when either was taken alone on a number of measures, including psychomotor performance impairment. Conclusions In healthy volunteers, abuse liability-related subjective effects of oxycodone were not enhanced by alprazolam. There was enhanced behavioral toxicity when the drugs were taken together, and thus, this is of significant concern from a public safety standpoint. PMID:22365897

  14. Tourette syndrome associated with attention deficit hyperactivity disorder: The impact of tics and psychopharmacological treatment options.

    PubMed

    Oluwabusi, Olumide O; Parke, Susan; Ambrosini, Paul J

    2016-02-01

    Tourette syndrome (TS) is a neurodevelopmental disorder characterized by multiple chronic motor and vocal tics beginning in childhood. Several studies describe the association between TS and attention deficit hyperactivity disorder (ADHD). Fifty percent of children diagnosed with ADHD have comorbid tic disorder. ADHD related symptoms have been reported in 35% to 90% of children with TS. Since ADHD is the most prevalent comorbid condition with TS and those with concomitant TS and ADHD present with considerable psychosocial and behavioral impairments, it is essential for clinicians to be familiar with these diagnoses and their management. This paper highlights the association between treating ADHD with stimulants and the development of tic disorders. The two cases discussed underscore the fact that children with TS may present with ADHD symptomatology prior to the appearance of any TS related symptoms. Appropriate management of TS in a patient diagnosed with ADHD can lead to quality of life improvements and a reduction in psychosocial impairments. PMID:26862512

  15. Medical treatment overview: traditional and novel psycho-pharmacological and complementary and alternative medications

    PubMed Central

    Anagnostou, Evdokia; Hansen, Robin

    2016-01-01

    Purpose of review Up to 35% of children and youth with autism spectrum disorder (ASD) receive at least one psychotropic medication. 50–70% of this population also receives biologically based complementary and alternative medicine (CAM). The data evaluating such practices are being reviewed. Recent findings There are accumulating data to suggest that atypical antipsychotics and stimulants may be useful for the treatment of irritability and hyperactivity in children and youth with ASD. The data for the use of selective serotonin reuptake inhibitors are less promising. New avenues of pharmacologic research targeting molecular targets identified by genomics, animal models and neuropathology are being evaluated. Areas of interest include glutamate/gamma-aminobutyric acid systems, neuropeptides such as oxytocin, and immune dysfunction, among others. In the case of biologically based CAM, a few compounds have been shown to be well tolerated, although efficacy is still being evaluated, such as melatonin, certain vitamins, and omega 3 fatty acids. Others have safety concerns without demonstrated efficacy, such as chelation therapies. Summary Accumulating data suggest a series of existing medications may be useful in ASD and large randomized clinical trials are necessary to evaluate safety and efficacy of both pharmaceuticals and alternative treatments. PMID:22001766

  16. Psychopharmacology of Attention-Deficit Hyperactivity Disorder: Effects and Side Effects.

    PubMed

    Golmirzaei, Javad; Mahboobi, Hamidreza; Yazdanparast, Maryam; Mushtaq, Gohar; Kamal, Mohammad A; Hamzei, Enayatollah

    2016-01-01

    Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in children which manifests with hyperactivity, impulsivity, and/or inattention. Several drugs are used in treatment of ADHD. Stimulants, atomoxetine, anti-depressants, and bupropion are common medications used in the treatment of ADHD. Stimulants are widely used as the first line treatment in children with ADHD. Their mechanism of action is the release of dopamine and norepinephrine in central nervous system. Methylphenidate is the most common stimulant used for the treatment of ADHD. Methylphenidate significantly reduces ADHD symptoms in children both at home and school and improves their social skills. Methylphenidate is safe in healthy children and has shown to have no cardiac side effects in these patients. Other medications include: Atomoxetine, Amphetamines, Clonidine, Melatonin, and anti-depressants. Effects, side effects, and mechanism of action these drugs have been discussed in this paper. PMID:26601963

  17. [Determinants of chilliness among young women and their application to psychopharmacological trials].

    PubMed

    Yamada, Noriko; Yoshimura, Hiroyuki

    2009-11-01

    Chilliness is a common complaint among menopausal women. Increasing evidence indicates that young women also suffer from chilliness, resulting in decreased learning, motivation, and concentration. Neither diagnostic criteria nor drug therapies exist for chilliness, and thus, young women suffer from insomnia, fatigue, and mood disturbance. Because chilliness is correlated with hormonal changes observed during premenstrual, postpartum, and menopausal periods, reproductive hormones are likely involved. Recently, we elucidated methodological issues related to identifying young women with chilliness. We used a new questionnaire to determine complaint severity with regard to chills and assessed physical parameters (BMI, body fat ratio, basal metabolism, blood pressure), peripheral circulation, and recovery of skin surface temperature after mild cold-water finger immersion. Using a discriminant analysis (hit ratio, 84.5%), we demonstrated that four parameters (blood flow, difference between underarm and surface temperature, recovery rate after mild cold exposure, and score for chilliness-related complaints) were important determinants of chilliness. Among traditional candidate substances for alleviating chilliness, Piper longum and royal jelly showed significant effects. Additionally, we investigated seasonal change in the experience of chilliness and found that young women suffer from chilliness during the summer. These findings have important implications for understanding chilliness in women. PMID:20030189

  18. Neurobiological and psychopharmacological basis in the therapy of bulimia and anorexia.

    PubMed

    Mauri, M C; Rudelli, R; Somaschini, E; Roncoroni, L; Papa, R; Mantero, M; Longhini, M; Penati, G

    1996-02-01

    1. Eating disorders can be found in several psychiatric pathologies: schizophrenia, delusional disorder (somatic type), bipolar disorders, major depressive disorder, borderline personality disorder, generalized anxiety disorder, body dysmorphic disorder, somatization disorder and conversion disorder. 2. Although their clinical features have been defined, relatively little is known about the role of neurobiological patterns in the pathogenesis of these disorders. Several CNS neurotransmitters and neuromodulators are involved in the regulation of eating behavior in animals and have been implicated in symptoms such as depression and anxiety often observed in patients with eating disorders. The authors will review some studies on NA, DA, 5-HT, beta-endorphins, CRH, VP, OT, CCK, NPY and PYY involved in eating disorders. Furthermore, we will highlight some of the studies on drug therapy of eating disorders taking into account the effects of these agents on neurotransmitters and neuromodulators. 3. Antidepressant drugs have long been used for anorexia nervosa and bulimia, these disorders been claimed to be affective equivalent. Antidepressant agents seem to be effective in reducing the frequency of binge-eating episodes, purging behavior and depressive symptomatology. It is notable that antidepressant agents have been proved to be effective in patients with chronic bulimic symptoms, even in cases persisting for many years and in patients who had repeatedly failed courses of alternative therapeutic approaches. In all of the positive studies, antidepressant agents appeared effective even in bulimic subjects who did not display concomitant depression. 4. Few controlled studies on use of medications for anorexia nervosa have been published. Central serotonergic receptor-blocking compounds such as cyproheptadine cause marked increase in appetite and body weight. Zinc supplementation or cisapride could be a therapeutic option in addition to psychological and other approaches in anorexia nervosa. 5. There is no therapy as yet which is fully effective in alimentary disorders. Psychotropic drugs give some relief from symptoms, but they cannot cure the disorders. An integrated approach, either pharmacological or psychological, is still recommendable. PMID:8861189

  19. [Psychopharmacology of anxiety and depression: Historical aspects, current treatments and perspectives].

    PubMed

    Javelot, H

    2016-03-01

    Pharmacological treatment of acute anxiety still relies on benzodiazepines, while chronic anxiety disorders and depression are treated with different antidepressants, according to specific indications. The monoaminergic axis is represented by two families which are being developed: (i) serotonin-norepinephrine-dopamine reuptake inhibitors (SNDRI), also called triple reuptake inhibitors (TRI), for the treatment of depression (amitifadine), (ii) multimodal antidepressants for depression and anxiety disorders (generalized anxiety disorder mainly) (tedatioxetine, vortioxetine and vilazodone). Third-generation antipsychotics (aripiprazole, lurasidone, brexpiprazole, cariprazine) appear relevant in the treatment of resistant depression and some anxiety disorders. Among the modulators of the glutamatergic axis, promising compounds include: (i) ionotropic regulators of NMDA receptors: esketamine, AVP-923 and AVP-786, CERC-301, rapastinel (Glyx-13), NRX-1074 developed for depression, rapastinel and bitopertine developed for obsessive compulsive disorder, (ii) metabotropic glutamate receptors modulators: decoglurant and basimglurant developed for depression and mavoglurant developed for obsessive compulsive disorder. PMID:26472602

  20. Tourette syndrome associated with attention deficit hyperactivity disorder: The impact of tics and psychopharmacological treatment options

    PubMed Central

    Oluwabusi, Olumide O; Parke, Susan; Ambrosini, Paul J

    2016-01-01

    Tourette syndrome (TS) is a neurodevelopmental disorder characterized by multiple chronic motor and vocal tics beginning in childhood. Several studies describe the association between TS and attention deficit hyperactivity disorder (ADHD). Fifty percent of children diagnosed with ADHD have comorbid tic disorder. ADHD related symptoms have been reported in 35% to 90% of children with TS. Since ADHD is the most prevalent comorbid condition with TS and those with concomitant TS and ADHD present with considerable psychosocial and behavioral impairments, it is essential for clinicians to be familiar with these diagnoses and their management. This paper highlights the association between treating ADHD with stimulants and the development of tic disorders. The two cases discussed underscore the fact that children with TS may present with ADHD symptomatology prior to the appearance of any TS related symptoms. Appropriate management of TS in a patient diagnosed with ADHD can lead to quality of life improvements and a reduction in psychosocial impairments. PMID:26862512

  1. Psychopharmacological treatment of 2195 in-patients with borderline personality disorder: A comparison with other psychiatric disorders.

    PubMed

    Bridler, René; Häberle, Anne; Müller, Sabrina T; Cattapan, Katja; Grohmann, Renate; Toto, Sermin; Kasper, Siegfried; Greil, Waldemar

    2015-06-01

    Patients with borderline personality disorder (BPD) are usually prescribed a variety of psychotropic drugs; however, none is recommended in the guidelines nor has any been approved for this indication. As data on drug prescriptions for BPD are sparse, cross-sectional data from the European Drug Safety Project AMSP were used to analyse drug prescriptions of 2195 in-patients with BPD between 2001 and 2011, and the mean values, confidence intervals and regression analyses were calculated. 70% of all BPD patients were medicated with antipsychotics and/or antidepressants, 33% with anticonvulsants, 30% with benzodiazepines, and 4% with lithium; 90% received at least one, 80%≥2, and 54%≥3 psychotropic drugs concomitantly (mean: 2.8). Prescription rates for quetiapine, the single drug most often used in BPD (22%), increased significantly over time. In view of the high percentage of young females with BPD, 18-40 year-old female patients with BPD were compared with patients of the same age but with depression (unipolar and bipolar) and schizophrenia. Typical sedative antipsychotics and anticonvulsants were prescribed more often in BPD than in the other diagnostic groups, with the exception of bipolar depression; this was true for the single substances quetiapine, levomepromazine, chlorprothixene, carbamazepine, and valproate. A limitation of the study was the use of clinical data without verifying the diagnoses by structured interviews. Contrary to the guidelines, about 90% of in-patients with BPD received psychotropic drugs. Polypharmacy was common, and antipsychotics with sedative profiles such as quetiapine and mood-stabilizing anticonvulsants such as valproate appear to be preferred. PMID:25907249

  2. Psychopharmacologic Services for Homeless Veterans: Comparing Psychotropic Prescription Fills Among Homeless and Non-Homeless Veterans with Serious Mental Illness.

    PubMed

    Hermes, Eric; Rosenheck, Robert

    2016-02-01

    Using national Veterans Health Administration (VHA) administrative data, this study evaluated differences in psychotropic medication use between homeless and non-homeless adults with serious mental illness (SMI) who used VHA services in 2010. The adjusted mean number of psychotropic prescription fills associated with homeless individuals were identified using regression models adjusted for socio-demographics, diagnoses, and use of health services. Of the 876,989 individuals with SMI using VHA services, 7.2 % were homeless at some time during 2010. In bivariate analysis, homeless individuals filled more psychotropic medication prescriptions compared with non-homeless individuals. However, after adjusting for potentially confounding variables, homeless individuals were found to have filled 16.2 % fewer prescriptions than non-homeless individuals when all psychotropics were analyzed together (F = 6947.1, p < .001) and for most individual classes of psychotropics. Greater use of residential/inpatient mental health services by the homeless was the most important single factor associated with filling more psychotropic prescriptions than non-homeless individuals. PMID:26202545

  3. Brief Report: Social Disability in Autism Spectrum Disorder--Results from Research Units on Pediatric Psychopharmacology (RUPP) Autism Network Trials

    ERIC Educational Resources Information Center

    Scahill, Lawrence; Hallett, Victoria; Aman, Michael G.; McDougle, Christopher J.; Arnold, L. Eugene; McCracken, James T.; Tierney, Elaine; Deng, Yanhong; Dziura, James; Vitiello, Benedetto

    2013-01-01

    There is growing interest in measuring social disability as a core element of autism spectrum disorders in medication trials. We conducted a secondary analysis on the Aberrant Behavior Checklist Social Withdrawal subscale using data from two federally-funded, multi-site, randomized trials with risperidone. Study 1 included 52 subjects assigned to…

  4. Brain Functional Effects of Psychopharmacological Treatment in Major Depression: A Focus on Neural Circuitry of Affective Processing

    PubMed Central

    Wessa, Michèle; Lois, Giannis

    2015-01-01

    In the last two decades, neuroimaging research has reached a much deeper understanding of the neurobiological underpinnings of major depression (MD) and has converged on functional alterations in limbic and prefrontal neural networks, which are mainly linked to altered emotional processing observed in MD patients. To date, a considerable number of studies have sought to investigate how these neural networks change with pharmacological antidepressant treatment. In the current review, we therefore discuss results from a) pharmacological functional magnetic resonance imaging (fMRI) studies investigating the effects of selective serotonin or noradrenalin reuptake inhibitors on neural activation patterns in relation to emotional processing in healthy individuals, b) treatment studies in patients with unipolar depression assessing changes in neural activation patterns before and after antidepressant pharmacotherapy, and c) predictive neural biomarkers of clinical response in depression. Comparing results from pharmacological fMRI studies in healthy individuals and treatment studies in depressed patients nicely showed parallel findings, mainly for a reduction of limbic activation in response to negative stimuli. A thorough investigation of the empirical findings highlights the importance of the specific paradigm employed in every study which may account for some of the discrepant findings reported in treatment studies in depressed patients. PMID:26412066

  5. The Application of Child Analytic Principles to Educational Models, School Consultations, and Psychopharmacology: Introduction to the Section.

    PubMed

    Whitman, Laura

    2015-01-01

    In this collection of papers, psychoanalytic principles come to life in a variety of settings: in a therapeutic nursery, in two schools serving children with special needs, in mainstream schools, and in a psychiatric practice. From dyadic work with a two-year-old's tantrums, to play therapy using deep-sea symbolism with a five-year-old; from the interchange with parents and school administrators in a middle school regarding "sexting, " to the in-depth assessment of children upon entry to a special school, these papers illustrate enriching exchanges between psychoanalysts, educators, children, and their communities. PMID:27337821

  6. The Role of the Noradrenergic System in the Exploration–Exploitation Trade-Off: A Psychopharmacological Study

    PubMed Central

    Jepma, Marieke; te Beek, Erik T.; Wagenmakers, Eric-Jan; van Gerven, Joop M.A.; Nieuwenhuis, Sander

    2010-01-01

    Animal research and computational modeling have indicated an important role for the neuromodulatory locus coeruleus–norepinephrine (LC–NE) system in the control of behavior. According to the adaptive gain theory, the LC–NE system is critical for optimizing behavioral performance by regulating the balance between exploitative and exploratory control states. However, crucial direct empirical tests of this theory in human subjects have been lacking. We used a pharmacological manipulation of the LC–NE system to test predictions of this theory in humans. In a double-blind parallel-groups design (N = 52), participants received 4 mg reboxetine (a selective norepinephrine reuptake inhibitor), 30 mg citalopram (a selective serotonin reuptake inhibitor), or placebo. The adaptive gain theory predicted that the increased tonic NE levels induced by reboxetine would promote task disengagement and exploratory behavior. We assessed the effects of reboxetine on performance in two cognitive tasks designed to examine task (dis)engagement and exploitative versus exploratory behavior: a diminishing-utility task and a gambling task with a non-stationary pay-off structure. In contrast to predictions of the adaptive gain theory, we did not find differences in task (dis)engagement or exploratory behavior between the three experimental groups, despite demonstrable effects of the two drugs on non-specific central and autonomic nervous system parameters. Our findings suggest that the LC–NE system may not be involved in the regulation of the exploration–exploitation trade-off in humans, at least not within the context of a single task. It remains to be examined whether the LC–NE system is involved in random exploration exceeding the current task context. PMID:21206527

  7. Psychopharmacological and Other Treatments in Preschool Children with Attention-Deficit/Hyperactivity Disorder: Current Evidence and Practice

    PubMed Central

    Arnold, L. Eugene; Anthony, Bruno J.

    2008-01-01

    Abstract Objective This article reviews rational approaches to treating attention-deficit/hyperactivity disorder (ADHD) in preschool children, including pharmacological and nonpharmacological treatments. Implications for clinical practice are discussed. Data Sources We searched MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health, Educational Resources Information Center, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects for relevant literature published in English from 1967 to 2007 on preschool ADHD. We also reviewed the references cited in identified reports. Study Selection Studies were reviewed if the sample included at least some children younger than 6 years of age or attending kindergarten, the study participants had a diagnosis of ADHD or equivalent symptoms, received intervention aimed at ADHD symptoms, and included a relevant outcome measure. Data Extraction Studies were reviewed for type of intervention and outcome relevant to ADHD and were rated for the level of evidence for adequacy of the data to inform clinical practice. Conclusions The current level of evidence for adequacy of empirical data to inform clinical practice for short-term treatment of ADHD in preschool children is Level A for methylphenidate and Level B for parent behavior training, child training, and additive-free elimination diet. PMID:18844482

  8. A Systematic Review of Treatments for Anxiety in Youth with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Vasa, Roma A.; Carroll, Laura M.; Nozzolillo, Alixandra A.; Mahajan, Rajneesh; Mazurek, Micah O.; Bennett, Amanda E.; Wink, Logan K.; Bernal, Maria Pilar

    2014-01-01

    This study systematically examined the efficacy and safety of psychopharmacological and non-psychopharmacological treatments for anxiety in youth with autism spectrum disorders (ASD). Four psychopharmacological, nine cognitive behavioral therapy (CBT), and two alternative treatment studies met inclusion criteria. Psychopharmacological studies were…

  9. Recreational 3,4-methylenedioxy-N-methylamphetamine (MDMA) or 'ecstasy' and self-focused compassion: Preliminary steps in the development of a therapeutic psychopharmacology of contemplative practices.

    PubMed

    Kamboj, Sunjeev K; Kilford, Emma J; Minchin, Stephanie; Moss, Abigail; Lawn, Will; Das, Ravi K; Falconer, Caroline J; Gilbert, Paul; Curran, H Valerie; Freeman, Tom P

    2015-09-01

    3,4-methylenedioxy-N-methylamphetamine (MDMA) produces diverse pro-social effects. Cognitive training methods rooted in Eastern contemplative practices also produce these effects through the development of a compassionate mindset. Given this similarity, we propose that one potential mechanism of action of MDMA in psychotherapy is through enhancing effects on intrapersonal attitudes (i.e. pro-social attitudes towards the self). We provide a preliminary test of this idea. Recreational MDMA (ecstasy) users were tested on two occasions, having consumed or not consumed ecstasy. Self-critical and self-compassionate responses to self-threatening scenarios were assessed before (T1) and after (T2) ecstasy use (or non-use), and then after compassionate imagery (T3). Moderating roles of dispositional self-criticism and avoidant attachment were examined. Separately, compassionate imagery and ecstasy produced similar sociotropic effects, as well as increases in self-compassion and reductions in self-criticism. Higher attachment-related avoidance was associated with additive effects of compassionate imagery and ecstasy on self-compassion. Findings were in line with MDMA's neuropharmacological profile, its phenomenological effects and its proposed adjunctive use in psychotherapy. However, although conditions were balanced, the experiment was non-blind and MDMA dose/purity was not determined. Controlled studies with pharmaceutically pure MDMA are still needed to test these effects rigorously. PMID:25990558

  10. Research Units of Pediatric Psychopharmacology (RUPP) Autism Network Randomized Clinical Trial of Parent Training and Medication: One-Year Follow-Up

    ERIC Educational Resources Information Center

    Arnold, L. Eugene; Aman, Michael G.; Li, Xiaobai; Butter, Eric; Humphries, Kristina; Scahill, Lawrence; Lecavalier, Luc; McDougle, Christopher J.; Swiezy, Naomi B.; Handen, Benjamin; Wilson, Krystina; Stigler, Kimberly A.

    2012-01-01

    Objective: To follow up on a three-site, 24-week randomized clinical trial (N = 124) comparing antipsychotic medication alone (MED) with antipsychotic medication plus parent training in the behavior management (COMB) of children with autism spectrum disorders and severe behavior problems. The COMB treatment had shown a significant advantage for…

  11. A systematic review of treatments for anxiety in youth with autism spectrum disorders.

    PubMed

    Vasa, Roma A; Carroll, Laura M; Nozzolillo, Alixandra A; Mahajan, Rajneesh; Mazurek, Micah O; Bennett, Amanda E; Wink, Logan K; Bernal, Maria Pilar

    2014-12-01

    This study systematically examined the efficacy and safety of psychopharmacological and non-psychopharmacological treatments for anxiety in youth with autism spectrum disorders (ASD). Four psychopharmacological, nine cognitive behavioral therapy (CBT), and two alternative treatment studies met inclusion criteria. Psychopharmacological studies were descriptive or open label, sometimes did not specify the anxiety phenotype, and reported behavioral activation. Citalopram and buspirone yielded some improvement, whereas fluvoxamine did not. Non-psychopharmacological studies were mainly randomized controlled trials (RCTs) with CBT demonstrating moderate efficacy for anxiety disorders in youth with high functioning ASD. Deep pressure and neurofeedback provided some benefit. All studies were short-term and included small sample sizes. Large scale and long term RCTs examining psychopharmacological and non-psychopharmacological treatments are sorely needed. PMID:25070468

  12. Psychotherapists' Perceptions and Understanding of Pharmacotherapy.

    ERIC Educational Resources Information Center

    Brammer, Robert; Haller, Katherine; Roberson, Janice

    Attendees at the 1998 Texas Counseling Association's annual convention were given a brief survey and short test on psychopharmacology. Analysis was performed to examine the effects of demographic and ideological variables. The model moderately explained the variance on the psychopharmacology test with only 2.5% of the adjusted variance explained…

  13. A Catalog of Psychiatric Medications Used in the Treatment of Child and Adolescent Mental Disorders.

    ERIC Educational Resources Information Center

    James, Susan Hackbarth; Nims, Donald R.

    1996-01-01

    Although school counselors are increasingly involved in administering medications to students with emotional, conduct, and behavioral problems, few counselors have training in psychopharmacology. Gives a brief history of psychopharmacological interventions, and describes usage and side effects of drugs for psychosis, depression, anxiety, and…

  14. Outcome Studies in the Treatment of Panic Disorder: A Review.

    ERIC Educational Resources Information Center

    Beamish, Patricia M.; And Others

    1996-01-01

    Reviews outcome studies in the treatment of panic disorder without agoraphobia for adults. Presents evidence supporting the efficacy of psychopharmacological and cognitive-behavioral interventions. Addresses the need for standards of care in counseling persons with panic disorder. (RB)

  15. 40 CFR 798.6200 - Motor activity.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... addition to the reporting requirements specified under 40 CFR part 792, subpart J the final test report... activity,” Handbook of Psychopharmacology. Vol. 7. Eds. Iversen, L.L., Iversen, D.S., Snyder, S.H....

  16. 40 CFR 798.6200 - Motor activity.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... addition to the reporting requirements specified under 40 CFR part 792, subpart J the final test report... activity,” Handbook of Psychopharmacology. Vol. 7. Eds. Iversen, L.L., Iversen, D.S., Snyder, S.H....

  17. 40 CFR 798.6200 - Motor activity.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... addition to the reporting requirements specified under 40 CFR part 792, subpart J the final test report... activity,” Handbook of Psychopharmacology. Vol. 7. Eds. Iversen, L.L., Iversen, D.S., Snyder, S.H....

  18. The pharmacologic approach to the critically ill patient

    SciTech Connect

    Chernow, B. )

    1988-01-01

    This book contains papers addressing the pharmacologic approach to the critically ill patient. Chapter topics include: Radiation injury; Red cell substitutes: a current appraisal; and Psychopharmacology in the ICU.

  19. 40 CFR 798.6200 - Motor activity.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... addition to the reporting requirements specified under 40 CFR part 792, subpart J the final test report... activity,” Handbook of Psychopharmacology. Vol. 7. Eds. Iversen, L.L., Iversen, D.S., Snyder, S.H....

  20. 40 CFR 798.6200 - Motor activity.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... addition to the reporting requirements specified under 40 CFR part 792, subpart J the final test report... activity,” Handbook of Psychopharmacology. Vol. 7. Eds. Iversen, L.L., Iversen, D.S., Snyder, S.H....

  1. Diagnosis, assessment, and treatment of hypersexuality.

    PubMed

    Kaplan, Meg S; Krueger, Richard B

    2010-03-01

    This article reviews the current evidence base for the diagnosis, assessment, and treatment of hypersexual conditions. Controversy concerning this diagnosis is discussed. Terminology and diagnostic criteria, as well as psychological, psychopharmacological, and other treatment approaches, are presented. PMID:20358460

  2. Predisposition Factors in Anorexia Nervosa.

    ERIC Educational Resources Information Center

    Nagel, K. L.; Jones, Karen H.

    1992-01-01

    Reviews literature concerned with investigating psychiatric disturbances and genetic variables hypothesized as predisposing factors in etiology of anorexia nervosa. Gives particular emphasis to research which discusses association between anorexia nervosa and depression. Reviews psychopharmacological evidence and family genetics studies. Offers…

  3. Erratum.

    PubMed

    2016-06-01

    Erratum for THE LINK BETWEEN USE OF PSYCHEDELIC DRUGS AND MENTAL HEALTH PROBLEMS BY: Nesvåg R, Bramness JG, Ystrom E. Journal of Psychopharmacology October 2015 29: 1035-1036, doi: 10.1177/0269881115596156. PMID:27166388

  4. [Psychopharmacotherapy in pregnancy and lactation. 2: Lactation].

    PubMed

    Lanczik, M; Knoche, M; Fritze, J

    1998-01-01

    Whilst the incidence of psychiatric disorders decreases during pregnancy, the risk during the postpartum period increases significantly, often leading to the necessity of psychopharmacological intervention during the puerperium, and subsequently during lactation and breast-feeding. The necessity for lithium prophylaxis in manic-depressive women after childbirth has been identified, and it is recommended that weaning rather than omission of psychopharmacological treatment is preferable during the puerperium. PMID:9522328

  5. The Sociopharmacology of Tobacco Addiction: Implications for Understanding Health Disparities.

    PubMed

    Leventhal, Adam M

    2016-02-01

    Efforts to reduce the public health burden of tobacco use have not equally benefited all members of society, leading to disparities in tobacco use as a function of ethnicity/race, socioeconomic position, physical/behavioral comorbidity, and other factors. Although multilevel transdisciplinary models are needed to comprehensively understand sources of tobacco-related health disparities (TRHD), the incorporation of psychopharmacology into TRHD research is rare. Similarly, psychopharmacology researchers have often overlooked the societal context in which tobacco is consumed. In an effort to facilitate transdisciplinary research agendas for studying TRHD and the psychopharmacology of tobacco use, this article introduces a novel paradigm, called "sociopharmacology." Sociopharmacology is a platform for investigating how contextual factors amplify psychopharmacological determinants of smoking to disproportionately enhance vulnerability to smoking in populations subject to TRHD. The overall goal of sociopharmacology is to identify proximal person-level psychopharmacological mechanisms that channel distal societal-level influences on TRHD. In this article I describe: (1) sociopharmacology's overarching methodology and theoretical framework; (2) example models that apply sociopharmacology to understand mechanisms underlying TRHD; (3) how sociopharmacological approaches may enhance the public health impact of basic research on the psychopharmacology of tobacco use; and (4) how understanding sociopharmacological mechanisms of TRHD might ultimately translate into interventions that reduce TRHD. PMID:25890832

  6. Intervening in the psychopath's brain.

    PubMed

    Glannon, Walter

    2014-02-01

    Psychopathy is a disorder involving personality and behavioral features associated with a high rate of violent aggression and recidivism. This paper explores potential psychopharmacological therapies to modulate dysfunctional neural pathways in psychopaths and reduce the incidence of their harmful behavior, as well as the ethical and legal implications of offering these therapies as an alternative to incarceration. It also considers whether forced psychopharmacological intervention in adults and children with psychopathic traits manifesting in violent behavior can be justified. More generally, the paper addresses the question of how to weigh the psychopath's presumptive right to non-interference in his brain and mind against the public interest in avoiding harm. PMID:24381085

  7. Research on Disorders of the Mind. Progress & Prospects.

    ERIC Educational Resources Information Center

    National Inst. of Mental Health (DHEW), Rockville, MD.

    The 14 conference papers on mental illness focus on the biological, genetic, psychopharmacological, psychopathological, and epidemiological and social factors related to psychoses. Divided into five sections each preceded by a brief introduction, entries include the following titles and authors: "The Biological Substrates of Schizophrenia" (S.…

  8. Pharmacotherapy of Disruptive Behavior in Mentally Retarded Subjects: A Review of the Current Literature

    ERIC Educational Resources Information Center

    Hassler, Frank; Reis, Olaf

    2010-01-01

    The review presented here describes the state of the art of pharmacological treatment of aggression in subjects with mental retardation (MR) summing up results for both, children and adults. In general, psychopharmacological treatment of disruptive behavior in individuals with MR is similar to the treatment in subjects without MR. Compared to…

  9. Guidelines for the Clinical Evaluation of Psychoactive Drugs in Infants and Children.

    ERIC Educational Resources Information Center

    Food and Drug Administration (DHEW), Washington, DC.

    These guidelines are intended to help those who design and conduct investigations of psychopharmacologic agents in children. A progression of studies in four phases is advocated. First, early short term studies should establish single and multiple dose safety baselines. Second, early pilot efficacy studies may be initiated jointly with longer…

  10. Mechanisms of Action in Cognitive-Behavioral and Pharmacological Interventions for Obesity and Bulimia Nervosa.

    ERIC Educational Resources Information Center

    Craighead, Linda W.; Agras, W. Stewart

    1991-01-01

    Summarizes data pertaining to separate and combined effects of cognitive-behavioral and psychopharmacologic treatments for obesity and bulimia nervosa. Anorexiant medication appears to enhance restraint and facilitates weight loss with behavioral interventions in the treatment of obesity, but relapse occurs once medication is withdrawn.…

  11. Bibliography on the Hyperkinetic Behavior Syndrome.

    ERIC Educational Resources Information Center

    Kirson, Tamara; And Others

    The bibliography on the hyperkinetic behavior syndrome focuses on the behavior characteristics of and treatment for hyperactivity. Entries are divided into the following sections (sample subsections are in parentheses): general review of pediatric psychopharmacology; the hyperkinetic behavior syndrome (overview, diagnosis and evaluation,…

  12. The Current State of Empirical Support for the Pharmacological Treatment of Selective Mutism

    ERIC Educational Resources Information Center

    Carlson, John S.; Mitchell, Angela D.; Segool, Natasha

    2008-01-01

    This article reviews the current state of evidence for the psychopharmacological treatment of children diagnosed with selective mutism within the context of its link to social anxiety disorder. An increased focus on potential medication treatment for this disorder has resulted from significant monetary and resource limitations in typical practice,…

  13. Understanding Bipolar Disorder: Implications for Mental Health Counselors.

    ERIC Educational Resources Information Center

    Withrow, J. Steve; Hinkle, J. Scott

    1990-01-01

    Provides an overview of bipolar disorder, including a discussion of diagnostic indicators, etiological theories, and psychopharmacological treatment. Examines treatment implications for mental health counselors, including role in psychiatric liaison, individual counseling, marriage and family therapy, and vocational counseling. (Author/ABL)

  14. Antipsychotics, Lithium, Benzodiazepines, Beta-Blockers.

    ERIC Educational Resources Information Center

    Karper, Laurence P.; And Others

    1994-01-01

    The psychopharmacologic treatment of aggression is a critical component of the treatment of psychiatric patients. The diagnostic assessment of aggressive patients is reviewed and relevant literature is presented to help clinicians select appropriate medication. Side-effects, dosages, and methods of administration are highlighted. (JPS)

  15. Best Practices for Mental Health in Child Welfare: Screening, Assessment, and Treatment Guidelines

    ERIC Educational Resources Information Center

    Romanelli, Lisa Hunter; Landsverk, John; Levitt, Jessica Mass; Leslie, Laurel K.; Hurley, Maia M.; Bellonci, Christopher; Gries, Leonard T.; Pecora, Peter J.; Jensen, Peter S.

    2009-01-01

    The Best Practices for Mental Health in Child Welfare Consensus Conference focused on developing guidelines in five key areas (screening and assessment, psychosocial interventions, psychopharmacologic treatment, parent engagement, and youth empowerment) related to children's mental health. This paper provides an overview of issues related to the…

  16. The Boston State Hospital case: "involuntary mind control," the constitution, and the "right to rot".

    PubMed

    Appelbaum, P S; Gutheil, T G

    1980-06-01

    The recent Boston State Hospital case represents a problematic decision on the right of inpatients to refuse treatment. The authors describe how basic misconceptions of psychopharmacology led to questionable analysis of the constitutional issues at stake. The effects of the decision may seriously impair proper care for the hospitalized mentally ill. PMID:7377395

  17. Mind Altering Drugs and the Future

    ERIC Educational Resources Information Center

    Evans, Wayne O.

    1971-01-01

    A researcher in psychopharmacology foresees a flood of new drugs that will make man feel happy, cause him to forget his past, and arouse his sexual desires. Man may actually have the possibility of attaining sustained happiness, or something like it, through drugs, and so must ask the question, Is happiness what I most want?" (Author)

  18. Developmental Pharmacology

    ERIC Educational Resources Information Center

    van den Anker, Johannes N.

    2010-01-01

    Understanding the pharmacokinetics and pharmacodynamics of drugs used in psychopharmacology across the pediatric age spectrum from infants to adolescents represents a major challenge for clinicians. In pediatrics, treatment protocols use either standard dose reductions for these drugs for children below a certain age or use less conventional…

  19. On the Difference between Designing Children and Raising Them: Ethics and the Use of Educationally Oriented Biotechnology

    ERIC Educational Resources Information Center

    Stein, Zachary

    2010-01-01

    The use of educationally oriented biotechnology has grown drastically in recent decades and is likely to continue to grow. Advances in both the neurosciences and genetics have opened up important areas of application and industry, from psychopharmacology to gene-chip technologies. This article reviews the current state of educationally oriented…

  20. Factor Structure and Differential Validity of the Expanded Brief Psychiatric Rating Scale

    ERIC Educational Resources Information Center

    Thomas, Adrian; Donnell, Alison J.; Young, Tony R.

    2004-01-01

    The Brief Psychiatric Rating Scale (BPRS) is one of the most widely used measures in psychiatric outcome and clinical psychopharmacology research. To date, however, research on the psychometric properties of the expanded version of the BPRS (BPRS-E) has been limited. An exploratory factor analysis (n = 360) using maximum likelihood extraction with…

  1. The Role of Exercise in Reducing Childhood and Adolescent PTSD, Anxiety, and Depression

    ERIC Educational Resources Information Center

    Motta, Robert W.; Kuligowski, Jenna M.; Marino, Dawn M.

    2010-01-01

    A great many interventions for posttraumatic stress disorder (PTSD) in adults have been described in the literature. These include, but are not limited to, cognitive-behavioral therapy, psychodynamic therapy, psychopharmacology, exposure therapy, anxiety management training, stress management techniques, eye movement desensitization and…

  2. Parting Reflections on Education of Children with Emotional or Behavioral Disorders [and] Response to Forness.

    ERIC Educational Resources Information Center

    Forness, Steven R.; Oswald, Donald

    2003-01-01

    This article discusses the need to incorporate research findings in developmental psychopathology, psychiatric comorbidity, and psychopharmacology in school mental health programs to enable early detection and primary prevention of emotional and behavioral disorders in students. A response stresses the need for a multidisciplinary approach.…

  3. Therapeutic Implications of Pharmacotherapy: Current Trends and Ethical Issues.(practice & Theory)

    ERIC Educational Resources Information Center

    King, Jason H.; Anderson, Shannon M.

    2004-01-01

    The use of psychotropic medications (pharmacotherapy) in conjunction with psychotherapy is regarded as the standard of care for many mental health disorders. Counselors, therefore, need to be knowledgeable about psychopharmacology to monitor its impact on the therapeutic relationship and on client outcome. Discussed are potential ethical dilemmas…

  4. Predictors and Moderators of Parent Training Efficacy in a Sample of Children with Autism Spectrum Disorders and Serious Behavioral Problems

    ERIC Educational Resources Information Center

    Farmer, Cristan; Lecavalier, Luc; Yu, Sunkyung; Arnold, L. Eugene; McDougle, Christopher J.; Scahill, Lawrence; Handen, Benjamin; Johnson, Cynthia R.; Stigler, Kimberly A.; Bearss, Karen; Swiezy, Naomi B.; Aman, Michael G.

    2012-01-01

    The Research Units on Pediatric Psychopharmacology-Autism Network reported additional benefit when adding parent training (PT) to antipsychotic medication in children with autism spectrum disorders and serious behavior problems. The intent-to-treat analyses were rerun with putative predictors and moderators. The "Home Situations Questionnaire"…

  5. Teaching Medication Compliance to Psychiatric Residents: Placing an Orphan Topic into a Training Curriculum

    ERIC Educational Resources Information Center

    Weiden, Peter J.; Rao, Nyapati

    2005-01-01

    OBJECTIVE: Medication compliance is an orphan topic. Training in the understanding and management of noncompliance does not neatly fall within the domain of psychopharmacology, nor does it clearly fit into other core curricula areas, such as clinical interviewing or psychotherapy training. The objective of this article is to increase awareness…

  6. Gastrointestinal Symptoms in a Sample of Children with Pervasive Developmental Disorders

    ERIC Educational Resources Information Center

    Nikolov, Roumen N.; Bearss, Karen E.; Lettinga, Jelle; Erickson, Craig; Rodowski, Maria; Aman, Michael G.; McCracken, James T.; McDougle, Christopher J.; Tierney, Elaine; Vitiello, Benedetto; Arnold, L. Eugene; Shah, Bhavik; Posey, David J.; Ritz, Louise; Scahill, Lawrence

    2009-01-01

    Objective: To evaluate gastrointestinal (GI) problems in a large, well-characterized sample of children with pervasive developmental disorders (PDDs). Methods: One hundred seventy two children entering one of two trials conducted by the Research Units on Pediatric Psychopharmacology (RUPP) Autism Network were assessed comprehensively prior to…

  7. Sensitivity of the Modified Children's Yale-Brown Obsessive Compulsive Scale to Detect Change: Results from Two Multi-Site Trials

    ERIC Educational Resources Information Center

    Scahill, Lawrence; Sukhodolsky, Denis G.; Anderberg, Emily; Dimitropoulos, Anastasia; Dziura, James; Aman, Michael G.; McCracken, James; Tierney, Elaine; Hallett, Victoria; Katz, Karol; Vitiello, Benedetto; McDougle, Christopher

    2016-01-01

    Repetitive behavior is a core feature of autism spectrum disorder. We used 8-week data from two federally funded, multi-site, randomized trials with risperidone conducted by the Research Units on Pediatric Psychopharmacology Autism Network to evaluate the sensitivity of the Children's Yale-Brown Obsessive Compulsive Scale modified for autism…

  8. Use and Management of Medications for Children Diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).

    ERIC Educational Resources Information Center

    Kollins, Scott H.; Barkley, Russell A.; DuPaul, George J.

    2001-01-01

    This article provides information and guidelines for the effective use of medication in treating attention deficit hyperactivity disorder (ADHD). Basic principles of psychopharmacology, different types of medications that have been used successfully to treat ADHD, and best practices for assessing the effects of medication in children with ADHD are…

  9. The Control of Responsiveness in ADHD by Catecholamines: Evidence for Dopaminergic, Noradrenergic and Interactive Roles

    ERIC Educational Resources Information Center

    Oades, Robert D.; Sadile, Adolfo G.; Sagvolden, Terje; Viggiano, Davide; Zuddas, Alessandro; Devoto, Paola; Aase, Heidi; Johansen, Espen B.; Ruocco, Lucia A.; Russell, Vivienne A.

    2005-01-01

    We explore the neurobiological bases of attention deficit hyperactivity disorder (ADHD) from the viewpoint of the neurochemistry and psychopharmacology of the catecholamine-based behavioural systems. The contributions of dopamine (DA) and noradrenaline (NA) neurotransmission to the motor and cognitive symptoms of ADHD (e.g. hyperactivity, variable…

  10. Current Directions in ADHD and Its Treatment

    ERIC Educational Resources Information Center

    Norvilitis, Jill M., Ed.

    2012-01-01

    The treatment of Attention Deficit Hyperactivity Disorder is a matter of ongoing research and debate, with considerable data supporting both psychopharmacological and behavioral approaches. Researchers continue to search for new interventions to be used in conjunction with or in place of the more traditional approaches. These interventions run the…

  11. An Assessment of the Role of Computer Technology in the Classroom.

    ERIC Educational Resources Information Center

    Snyder, Katherine

    This study assessed the impact of two teaching styles on how well 30 students mastered a section of the psychopharmacology unit within the Survey of Physiological Psychology course. The first method consisted of the instructor's primary method of instruction, a lecture supplemented by demonstrations and discussions, neither of which involved…

  12. Adequacy of Antidepressant Treatment by Psychiatric Residents: The Antidepressant Treatment History Form as a Possible Assessment Tool

    ERIC Educational Resources Information Center

    Dew, Rachel Elizabeth; Kramer, Stephen I.; McCall, W. Vaughn

    2005-01-01

    Objective: Facility in psychopharmacology is a major goal of psychiatric residency. This study assesses the adequacy of pharmacotherapy provided to depressed patients in a resident clinic. Methods: Charts of all 285 patients seen in an outpatient triage clinic during 2000 were reviewed. One hundred twelve patients had diagnoses of major…

  13. Selecting an Antidepressant for the Treatment of Pediatric Depression

    ERIC Educational Resources Information Center

    Kratochvil, Christopher J.; Vitiello, Benedetto; Brent, David; Bostic, Jeff Q.; Naylor, Michael W.

    2006-01-01

    This column aims to discuss practical approaches to everyday issues in pediatric pharmacotherapy. The cases and discussions specifically target aspects of clinical care related to psychopharmacology for which there are no adequate applicable controlled trials. Given the need to address symptoms in youths with complex, severe, and comorbid…

  14. Assessment in Multisite Randomized Clinical Trials of Patients with Autistic Disorder: The Autism RUPP Network.

    ERIC Educational Resources Information Center

    Arnold, L. Eugene; Aman, Michael G.; Martin, Andres; Collier-Crespin, Angie; Vitiello, Benedetto; Tierney, Elaine; Asarnow, Robert; Bell-Bradshaw, Felicia; Freeman, Betty Jo; Gates-Ulanet, Patricia; Klin, Ami; McCracken, James T.; McDougle, Christopher J.; McGough, James J.; Posey, David J.; Scahill, Lawrence; Swiezy, Naomi B.; Ritz, Louise; Volkmar, Fred

    2000-01-01

    This paper explains how the Autism Research Units on Pediatric Psychopharmacology (RUPP Autism Network) resolved common assessment problems including communication problems compromising use of the patient as informant, broad subject heterogeneity, difficulties in assessing low-end IQs, scarcity of autism-adapted cognitive and neuropsychological…

  15. Review of Research for People with ID and Mental Health Problems: A View from the United Kingdom

    ERIC Educational Resources Information Center

    Hemmings, Colin; Deb, Shoumitro; Chaplin, Eddie; Hardy, Steve; Mukherjee, Rittick

    2013-01-01

    This review of research into mental disorders in people with intellectual disabilities (ID) focuses on research in this field that has originated from the United Kingdom in the last 2 decades. It considers research developments into the epidemiology of mental disorders and problem behaviors, psychopharmacology, psychosocial interventions, and…

  16. Panic Disorder in Clinically Referred Children and Adolescents

    ERIC Educational Resources Information Center

    Doerfler, Leonard A.; Connor, Daniel F.; Volungis, Adam M.; Toscano, Peter F., Jr.

    2007-01-01

    The present study examined the frequency and characteristics of panic disorder in children and adolescents who had been referred to a pediatric psychopharmacology clinic. Of the 280 children and adolescents evaluated in this clinic, 35 were diagnosed with panic disorder using a semi-structured clinical interview (K-SADS) and other objective…

  17. Children's Yale-Brown Obsessive Compulsive Scale Modified for Pervasive Developmental Disorders

    ERIC Educational Resources Information Center

    Scahill, Lawrence; McDougle, Christopher J.; Williams, Susan K.; Dimitropoulos, Anastasia; Aman, Michael G.; McCracken, James T.; Tierney, Elaine; Arnold, L. Eugene; Cronin, Pegeen; Grados, Marco; Ghuman, Jaswinder; Koenig, Kathleen; Lam, Kristen S. L.; McGough, James; Posey, David J.; Ritz, Louise; Swiezy, Naomi B.; Vitiello, Benedetto

    2006-01-01

    Objective: To examine the psychometric properties of the Children's Yale-Brown Obsessive Compulsive Scales (CYBOCS) modified for pervasive developmental disorders (PDDs). Method: Raters from five Research Units on Pediatric Psychopharmacology (RUPP) Autism Network were trained to reliability. The modified scale (CYBOCS-PDD), which contains only…

  18. The Heavy Burden of Psychiatric Comorbidity in Youth with Autism Spectrum Disorders: A Large Comparative Study of a Psychiatrically Referred Population

    ERIC Educational Resources Information Center

    Joshi, Gagan; Petty, Carter; Wozniak, Janet; Henin, Aude; Fried, Ronna; Galdo, Maribel; Kotarski, Meghan; Walls, Sarah; Biederman, Joseph

    2010-01-01

    The objective of the study was to systematically examine patterns of psychiatric comorbidity in referred youth with autism spectrum disorders (ASD) including autistic disorder and pervasive developmental disorder not otherwise specified. Consecutively referred children and adolescents to a pediatric psychopharmacology program were assessed with…

  19. The Effectiveness of Parent-Child Interaction Therapy for Families of Children on the Autism Spectrum

    ERIC Educational Resources Information Center

    Solomon, Marjorie; Ono, Michele; Timmer, Susan; Goodlin-Jones, Beth

    2008-01-01

    We report the results of a pilot trial of an evidence-based treatment--Parent-Child Interaction Therapy (PCIT; Eyberg et al. "Psychopharmacology Bulletin", 31(1), 83-91, 1995) for boys aged 5-12 with high functioning autism spectrum disorders and clinically significant behavioral problems. The study also included an investigation of the role of…

  20. Evaluating Psychotropic Drugs in People with Mental Retardation: Where Are the Social Validity Data?

    ERIC Educational Resources Information Center

    Poling, Alan; LeSage, Mark

    1995-01-01

    Journal articles dealing with drug treatment of individuals with mental retardation were examined to determine treatment goals and outcomes of treating behavior problems. Analysis of articles published from 1987 to 1993 in 5 major journals revealed that none of the 68 articles concerned with the psychopharmacology of mental retardation reported…

  1. The Texas Children's Medication Algorithm Project: Revision of the Algorithm for Pharmacotherapy of Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Pliszka, Steven R.; Crismon, M. Lynn; Hughes, Carroll W.; Corners, C. Keith; Emslie, Graham J.; Jensen, Peter S.; McCracken, James T.; Swanson, James M.; Lopez, Molly

    2006-01-01

    Objective: In 1998, the Texas Department of Mental Health and Mental Retardation developed algorithms for medication treatment of attention-deficit/hyperactivity disorder (ADHD). Advances in the psychopharmacology of ADHD and results of a feasibility study of algorithm use in community mental health centers caused the algorithm to be modified and…

  2. Psychotropic Medication Consultation in Schools: An Ethical and Legal Dilemma for School Psychologists

    ERIC Educational Resources Information Center

    Carlson, John S.; Thaler, Cara L.; Hirsch, Amanda J.

    2006-01-01

    Assessing, consulting, and intervening with students being treated with psychotropic medications is an increasingly common activity for school psychologists. This article reviews some of the literature providing evidence for the greater need for training in school psychopharmacology. A legal and ethical case study is presented that highlights the…

  3. Psychotropic Medications: An Investigation of the Knowledge of Counseling Graduate Students and Attitudes toward Coursework of Counselor Educators.

    ERIC Educational Resources Information Center

    Escobedo, Pedro Sanchez; Beamish, Patricia M.; Stump, Earl; Krause, Naomi

    Counselors working in clinical settings are frequently confronted with clients taking psychotropic medications. Counselors working in non-clinical school and industrial settings are often required to identify clients who need referral for psychopharmacological support. If counselors are to assist their clients in exploring treatment options, it is…

  4. Parting Reflections on Education of Children with Emotional or Behavioral Disorders.

    ERIC Educational Resources Information Center

    Forness, Steven R.

    2003-01-01

    The author urges the field of education for children with emotional or behavioral disorders to address three critical areas: (1) developmental psychopathology (to improve early identification and prevention); (2) psychiatric comorbidity (e.g., disruptive disorders present with depression or anxiety disorder); and (3) psychopharmacology (especially…

  5. A Mindfulness-Based Strategy for Self-Management of Aggressive Behavior in Adolescents with Autism

    ERIC Educational Resources Information Center

    Singh, Nirbhay N.; Lancioni, Giulio E.; Manikam, Ramasamy; Winton, Alan S. W.; Singh, Ashvind N. A.; Singh, Judy; Singh, Angela D. A.

    2011-01-01

    Some individuals with autism engage in physical aggression to an extent that interferes with not only their quality of life, but also that of their parents and siblings. Behavioral and psychopharmacological treatments have been the mainstay of treatments for aggression in children and adolescents with autism. We evaluated the effectiveness of a…

  6. Antidepressants and Suicidal Ideation in Adolescence: A Paradoxical Effect

    ERIC Educational Resources Information Center

    Pierson, Eric E.

    2009-01-01

    The past two decades have seen a rapid increase in the number and types of psychopharmacological medications that are available for the treatment of depression in children and adolescents. Parents and adolescents often raise questions as to the potential increase in suicidal ideation associated with the use of primarily selective serotonin…

  7. Early Intensive Behavioral Intervention (EIBI) for Young Children with Autism Spectrum Disorders (ASD): A Systematic Review. Campbell Systematic Reviews 2014:9

    ERIC Educational Resources Information Center

    Reichow, Brian; Barton, Erin E.; Boyd, Brian A.; Hume, Kara

    2014-01-01

    Background: The rising prevalence of autism spectrum disorders (ASD) increases the need for evidence-based behavioral treatments to lessen the impact of symptoms on children's functioning. At present, there are no curative or psychopharmacological therapies to effectively treat all symptoms of the disorder. Early intensive behavioral intervention…

  8. 78 FR 104 - Advisory Committees; Tentative Schedule of Meetings for 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-02

    ... Medicine (the IOM) conducted a study of the use of FDA's advisory committees. In its final report, one of... Pharmaceutical Date(s), if needed, to be Science and Clinical Pharmacology. determined. Psychopharmacologic Drugs... Devices Panel....... May 17, May 24, June 27, September 27, November 22. Clinical Chemistry and...

  9. 76 FR 78931 - Advisory Committees; Tentative Schedule of Meetings for 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-20

    ... Institute of Medicine (the IOM) conducted a study of the use of FDA's advisory committees. In its final... Committee for Pharmaceutical March 14. Science and Clinical Pharmacology. Psychopharmacologic Drugs Advisory... determined. Clinical Chemistry and Clinical April 20, July 18-19, September Toxicology Devices Panel....

  10. A Comparison of the Effectiveness of Individualized and Traditional Instructional Methods for Student Nurses.

    ERIC Educational Resources Information Center

    Biegert, Lydia E.; Withrow, M. Jean

    The objective of this study was to determine the effectiveness of an audio-visual instrument in teaching psychopharmacology to high and low achieving associate degree nursing students at Alvin Community College (Texas). Students were grouped as either high or low achieving according to their scores on an American College Testing (ACT) program test…

  11. The Dialogic Instructor: Co-Teaching across the Disciplines.

    ERIC Educational Resources Information Center

    Jankiewicz, Henry

    This paper explains that an interdepartmental writing across the curriculum course at Syracuse University was developed and proposed by a writing teacher and a professor of experimental psychology and psychopharmacology. The paper states that the course, Perspectives on Drug Experience, was to be offered in both writing and psychology and sought…

  12. Approaches to recognition and management of childhood psychiatric disorders in pediatric primary care.

    PubMed

    Cassidy, L J; Jellinek, M S

    1998-10-01

    Psychiatric disorders occur in 14% to 20% of American children and adolescents and are a leading cause of disability among them, yet fewer than one in five of these children are recognized. The most common psychiatric disorders presenting to pediatricians include ADHD, anxiety disorders, depression, substance-use disorders, and conduct disorder, Approaches to recognition include screening for psychosocial concerns using specific questions in the clinical interview, and using brief, written questionnaires. Case vignettes illustrate comprehensive treatment planning for children with psychiatric disorders in the primary care context. As psychopharmacologic treatments and the new subspecialty of pediatric psychopharmacology take on growing importance, the traditional oversight role of the pediatrician and effective communication among referring and consulting physicians remain critical to quality care. PMID:9884674

  13. Current challenges and pitfalls in the pharmacological treatment of depression

    PubMed Central

    Popa-Velea, O; Gheorghe, IR; Truţescu, CI; Purcărea, VL

    2015-01-01

    The multifactorial etiology of depression obliges needs an individual assessment, the psychopharmacological approach involving a biopsychosocial analysis for each individual case. The rebalancing of the depressive patient, seen as a return to a normal level of psychosocial functioning and reduced risk of relapse is achieved with a prompt and constant support of specialized teams. Treatment should include psychopharmacological and psychosocial approaches, the results being interrelated and contributing to the prognosis of the disorder. Progress in clinical and pharmacological research, vivid dynamics of socio-economic environment, the complexity of diagnostic evaluation and the need for an interdisciplinary approach may cause difficulties in addressing the depressive patient and the ethical controversies. The aim of this paper is to present a brief analysis of challenges encountered in the present psychiatric practice, starting from the heterogeneity of depressive manifestations and finishing with the prioritization of interventional forms. PMID:25866576

  14. Functional antagonistic properties of clozapine at the 5-HT3 receptor.

    PubMed

    Hermann, B; Wetzel, C H; Pestel, E; Zieglgänsberger, W; Holsboer, F; Rupprecht, R

    1996-08-23

    The atypical neuroleptic clozapine is thought to exert its psychopharmacological actions through a variety of neurotransmitter receptors. It binds preferentially to D4 and 5-HT2 receptors; however, little is known on it's interaction with the 5-HT3 receptor. Using a cell line stably expressing the 5-HT3 receptor, whole-cell voltage-clamp analysis revealed functional antagonistic properties of clozapine at low nanomolar concentrations in view of a binding affinity in the upper nanomolar range. Because the concentration of clozapine required for an interaction with the 5-HT3 receptor can be achieved with therapeutical doses, functional antagonistic properties at this ligand-gated ion channel may contribute to its unique psychopharmacological profile. PMID:8780717

  15. ‘Primum non nocere’: A review of Taking America off Drugs: Why Behavioral Therapy is More Effective for Treating ADHD, OCD, Depression and Other Psychological Problems by Stephen Ray Flora

    PubMed Central

    van Haaren, Frans

    2009-01-01

    Taking America off Drugs by Stephen Ray Flora provides an overview of effective behavioral interventions to treat a variety of mental health concerns, including depression and phobias. These disorders are better treated with behavioral than psychopharmacological interventions. Yet, the latter prevail in today's society. Taking America off Drugs provides the background to help us understand why, as it puts the treatment of behavioral disorders in the context of modern psychiatry and its relationship with the pharmaceutical industry. This review provides an overview and critical evaluation of the book, but it also extends its context by discussing the history of the treatment of mental illness and practices of the pharmaceutical-medical complex and by offering an optimistic scenario by which psychopharmacological agents will ultimately be replaced by interventions based on the principles of applied behavior analysis. PMID:22477708

  16. Explaining the link between violence perpetration, victimization and drug use.

    PubMed

    Weiner, Michelle D; Sussman, Steve; Sun, Ping; Dent, Clyde

    2005-07-01

    This study examined relationships between illegal and legal drug use and violence perpetration and victimization as well as possible mediators of these relationships. Subjects were continuation high school students followed prospectively over 5 years. Results indicated that illegal drug use predicted violence and victimization 5 years later and that earlier victimization was also associated with later illegal drug use. A measure intending to tap a psychopharmacological effects system, consistent with its definition in [Goldstein, P. J. (1985). The drugs/violence nexus: A tripartite conceptual framework. Journal of Drug Issues, 15(4), 493-506] tripartite model, was found to mediate the relationships between illegal drug use and victimization and violence. Results suggest that violence and victimization prevention efforts may benefit by addressing the psychopharmacological effects of adolescent illegal drug use. PMID:15925136

  17. Creativity in psychopharmacotherapy - the bright side of face of psychiatric god Janus.

    PubMed

    Damjanović, Aleksandar

    2015-09-01

    This paper discusses about challenges to psychopharmacotherapy, evidence-based psychopharmacology, creative psychopharmacology, creativity and dopamine, creative-rational polypharmacy as a paradigm for creativity in psychopharmacotherapy, and about polypharmacy classification as a good, bad and ugly By stimulating the patient to participate in the creative and artistic process we effect on his optimal identification with the role of the sick person. Through creation, imagination and visualization patients can recognize their own reservoir of inner healing and create a healthier new identity. Psychopharmacotherapy can prevent the deterioration of creativity affecting the quality of life and personal recovery. It may also affect the goals and aspirations of patients as well as the way in forming strategies of their realization. PMID:26400142

  18. Current challenges and pitfalls in the pharmacological treatment of depression.

    PubMed

    Popa-Velea, O; Gheorghe, I R; Truţescu, C I; Purcărea, V L

    2015-01-01

    The multifactorial etiology of depression obliges needs an individual assessment, the psychopharmacological approach involving a biopsychosocial analysis for each individual case. The rebalancing of the depressive patient, seen as a return to a normal level of psychosocial functioning and reduced risk of relapse is achieved with a prompt and constant support of specialized teams. Treatment should include psychopharmacological and psychosocial approaches, the results being interrelated and contributing to the prognosis of the disorder. Progress in clinical and pharmacological research, vivid dynamics of socio-economic environment, the complexity of diagnostic evaluation and the need for an interdisciplinary approach may cause difficulties in addressing the depressive patient and the ethical controversies. The aim of this paper is to present a brief analysis of challenges encountered in the present psychiatric practice, starting from the heterogeneity of depressive manifestations and finishing with the prioritization of interventional forms. PMID:25866576

  19. Diagnostic crossover from obesity to atypical anorexia nervosa - a case report.

    PubMed

    Wolter, Heike; Schneider, Nora; Pfeiffer, Ernst; Lehmkuhl, Ulrike

    2009-01-01

    A 15-year-old, female, formerly obese adolescent was referred to our day care clinic due to self-induced massive weight loss and depressive symptoms. Intense treatment, additional dialectical behavioral therapy and psychopharmacological treatment prevented further weight loss and improved her affective state. Due to remaining anorexic symptoms such as body image distortion, outpatient psychotherapeutic treatment is continued. This case report indicates the importance of further research on diagnostic crossover from obesity to atypical anorexia nervosa. PMID:20054205

  20. Classics in Chemical Neuroscience: Diazepam (Valium)

    PubMed Central

    2014-01-01

    Diazepam (Valium) is among the most successful drugs from the onset of the psychopharmacological revolution that began during the 1950s. Efficacious in treating a wide-spectrum of CNS disorders, including anxiety and epilepsy, it set the standard for pharmacotherapy in terms of potency, onset of action, and safety. In this Review, the legacy of diazepam to chemical neuroscience will be considered along with its synthesis, pharmacology, drug metabolism, adverse events and dependence, clinical use, and regulatory issues. PMID:24552479

  1. Opportunities on the Internet for child and adolescent psychopharmacologists: net access and mailing lists.

    PubMed

    Giedd, J N; Allen, A J; Behr, R

    1996-01-01

    The Internet, a system linking computers around the world, provides clinical and research psychopharmacologists with a convenient and efficient way to exchange information and offers a growing number of services to facilitate patient care. These opportunities are not theoretical, not in the future, and not for a select few. Many patients are already benefitting from practitioners who have sought guidance for their clinical work on the Internet. This article describes, for the novice user, how to begin the Internet journey. It also discusses psychopharmacology-related mailing lists, including a site that specializes in child and adolescent psychopharmacology. Subsequent articles will (1) show how to use Medlines to conduct literature searches and retrieve abstracts and articles from the computer screen, (2) describe ways to enter and traverse the World Wide Web (the "multimedia" portion of Internet), and (3) survey the use of "Web browsers" to find specialized psychopharmacology resources and databases, electronic journals, pertinent bulletin boards, and support services for patients and families-all with an emphasis on direct benefits to the practicing psychopharmacologist. PMID:9231307

  2. Pharmacotherapeutic Management of Dementia Across Settings of Care

    PubMed Central

    Rattinger, Gail B.; Burcu, Mehmet; Dutcher, Sarah K.; Chhabra, Pankdeep T.; Rosenberg, Paul B.; Simoni-Wastila, Linda; Franey, Christine S.; Walker, Loreen D.; Zuckerman, Ilene H.

    2013-01-01

    Objectives To describe population-based use of cognitive-enhancing and psychopharmacological medications across care settings among Medicare beneficiaries with dementia. Design One-year (2008) cross-sectional study Setting Medicare administrative claims froma 5% random sample Participants 52,754 Medicare beneficiaries with dementia aged ≥65 years with continuous Medicare Parts A, B, and D coverage and alive throughout 2008. To ascertain dementia, ≥1 medical claim with a dementia ICD-9-CM code was required prior to 2008 and an additional claim was required in 2008 to confirm active disease. Measurements Use of medications commonly prescribed in managing dementia (cognitive enhancers, antidepressants, antipsychotics, and mood stabilizers) was assessed using three separate measures: 1) Annual prevalence of use; 2) Consistency of use; 3) Count of psychopharmacological medication classes. Care setting was determined using the number of months of nursing home (NH) residency: no-NH (zero months), partial-NH (1–11 months), and full-NH (12 months). Results Community-dwellers represented 41.3% of the cohort, while 42.4% and 16.3% resided partially and fully in a NH, respectively. Annual prevalence of use was 57.1% for cognitive enhancers, 56.4% for antidepressants, 34.0% for antipsychotics, and 8.8% for mood stabilizers. Cognitive enhancer use was significantly lower among those with any NH-stay [adjusted-prevalence-ratio (99% CI) partial-NH vs. no-NH 0.84 (0.83–0.86); full-NH versus no-NH0.83 (0.81–0.85)]. In contrast, those with any NH residence had significantly higher use for all psychopharmacological medication classes compared with community-dwellers. Over half the cohort had consistent medication regimens during 2008 (64.8%). The number of psychopharmacological medication classes used increased with increasing NH-stay duration. Conclusion This population-based study documents significant differences in medication use for managing dementia across care

  3. Defining a Clinically Meaningful Effect for the Design and Interpretation of Randomized Controlled Trials

    PubMed Central

    Kraemer, Helena C.; Epstein, Robert S.; Frank, Ellen; Haynes, Ginger; Laughren, Thomas P.; Mcnulty, James; Reed, Shelby D.; Sanchez, Juan; Leon, Andrew C.

    2013-01-01

    Objective: This article captures the proceedings of a meeting aimed at defining clinically meaningful effects for use in randomized controlled trials for psychopharmacological agents. Design: Experts from a variety of disciplines defined clinically meaningful effects from their perspectives along with viewpoints about how to design and interpret randomized controlled trials. Setting: The article offers relevant, practical, and sometimes anecdotal information about clinically meaningful effects and how to interpret them. Participants: The concept for this session was the work of co-chairs Richard Keefe and the late Andy Leon. Faculty included Richard Keefe, PhD; James McNulty, AbScB; Robert S. Epstein, MD, MS; Shelby D. Reed, PhD; Juan Sanchez, MD; Ginger Haynes, PhD; Andrew C. Leon, PhD; Helena Chmura Kraemer, PhD; Ellen Frank, PhD, and Kenneth L. Davis, MD. Results: The term clinically meaningful effect is an important aspect of designing and interpreting randomized controlled trials but can be particularly difficult in the setting of psychopharmacology where effect size may be modest, particularly over the short term, because of a strong response to placebo. Payers, regulators, patients, and clinicians have different concerns about clinically meaningful effects and may describe these terms differently. The use of moderators in success rate differences may help better delineate clinically meaningful effects. Conclusion: There is no clear consensus on a single definition for clinically meaningful differences in randomized controlled trials, and investigators must be sensitive to specific concerns of stakeholders in psychopharmacology in order to design and execute appropriate clinical trials. PMID:23882433

  4. Perceived social support in Spanish cancer outpatients with psychiatric disorder.

    PubMed

    Costa-Requena, Gema; Ballester Arnal, Rafael; Gil, Francisco

    2013-12-01

    This study examines differences in perceived social support during oncology treatment of cancer patients, whilst taking into account the presence of psychiatric disorder. Of particular interest were cancer patients who received psychopharmacology treatment compared with those who did not. A total of 760 cancer outpatients were recruited from one hospital in Spain. Multivariate analysis of variance with the general linear model procedure was used. The Medical Outcomes Study Social Support Survey was used to assess social support perceived. The Diagnostic Interview Schedule using DSM-III-R criteria was utilized for the diagnosis of psychiatric disorders. There were significant differences between the patients diagnosed with a psychiatric disorder and those not diagnosed with psychiatric disorders in terms of perceived Emotional/Informational Support (F = 19.11, p < 0.01), Affectionate Support (F = 12.30, p < 0.01) and the Overall Support Index (F = 16.73, p < 0.01). In patients requiring psychopharmacology treatment, significant differences were presented with Structural Support (F = 4.32, p < 0.05), Emotional/Informational Support perceived (F = 7.87, p < 0.01), Instrumental Support (F = 4.17, p < 0.05) and Overall Support Index (F = 7.84, p < 0.01). Psychopharmacology treatment helped to increase the perception of social support received by the patient. Healthcare professionals could provide support that would normalize cancer patients' distress, taking into account the importance of perceived social support for the psychological well-being of patients. PMID:23436700

  5. Frequency of reporting of adverse events in randomized controlled trials of psychotherapy vs. psychopharmacotherapy

    PubMed Central

    Vaughan, Barney; Goldstein, Michael H.; Alikakos, Maria; Cohen, Lisa J.; Serby, Michael J.

    2015-01-01

    Background Psychopharmacology and psychotherapy are the two main therapies in mental health. It is common practice to consider adverse events (AEs) of medications, but it’s not clear this occurs with psychotherapy. Aim This study investigates the frequency with which reports of AEs occur in clinical trials using either psychopharmacology alone, psychotherapy alone, or combined approaches. Methods Forty-five articles of randomized trials published in high-impact journals were chosen from a Medline search, and separated into three groups of 15 articles: pharmacotherapy alone (M), psychotherapy alone (T) and combined studies that looked at the effect of both a psychotherapeutic (CT) and psychopharmacologic (CM) intervention. Criteria for what defines an AE were established and the papers were rated for mentions of AEs in papers as a whole and by each section. Results The χ2-analysis of AE mentions showed significant differences between the four study conditions in terms of each paper as a whole (χ2: 10.1, p < 0.018), and by section. Medication (M + CM) and psychotherapy papers (T + CT) were then combined into two groups to compare the odds that one was more likely to mention AEs than the other. Bivariate logistic regression yielded statistically significant odds ratios ranging from 9.33 to 20.99, with medications being far more likely to mention AEs. Conclusion We believe the difference in reports of AEs mirrors the attitudes researchers and providers. It’s critical to consider, and standardize the definition of, AEs in psychotherapy, and imperative to identify and address potential AEs in psychotherapy research. PMID:24630200

  6. Update on the Pharmacological Treatment of Pathological Gambling

    PubMed Central

    Bullock, Scott A.; Potenza, Marc N.

    2014-01-01

    This is an update to a previously published article discussing the neuropsychopharmacology of pathological gambling (PG) (1). In the prior manuscript, we described how cortico-limbic circuitry and neurotransmitter systems (norepinephrine, serotonin, dopamine, opioids, glutamate, and gamma-aminobutyric acid (GABA)) have been implicated in PG. These systems represent potential targets for psychopharmacological treatments for PG, with opioid antagonists arguably showing the most consistent benefit in RCTs. In the past year and half since this publication was prepared, there has been one additional randomized clinical trial (RCT) published along with a single case study. Our original manuscript did not describe in detail findings from case studies or open-label studies so in addition to the new RCT data and a new case report involving naltrexone, here we describe case and open-label findings. A PubMed search was conducted using terms such as “pathological gambling treatment”, “clinical trials and gambling”, and “gambling psychopharmacology.” Using these search terms, numerous results were obtained, necessitating further search modifiers. For example, using just “pathological gambling treatment” results in over 1600 hits. In order to focus in on the search modalities, we searched within the initial results for specific phrases such as “psychopharmacology, clinical trial, medication, serotonergic, dopaminergic, etc.” in addition to searching for specific medications. Results not directly related to the treatment of pathological gambling were not included. The study of pathological gambling is relatively new. As such, our search did not exclude any studies due to age of material, but with a few exceptions, the majority of the studies discussed were published later than 2000. This resulted in 24 case studies and/or RCTs not previously included in our original review article. These findings in conjunction with our prior publication provide a

  7. REVIEW ON PHYTOCHEMICAL AND MEDICINAL ASPECTS OF JUSSIAEA SUFERUTICOSA LINN

    PubMed Central

    Murugesan, T.; Sinha, Sanghamitra; Pal, M.; Saha, B.P.

    2002-01-01

    The whole plant of Jussiaea suffruticosa Linn. Has been widely used in traditional medicine of India. Important bioactive molecules of the plant extract have been explored with modern phytochemical approaches and reported to consist of betulinic acid, quercetin and β- sitosterol. Furthermore, the experimental data obtained from rational clinical studies indicated that the methanol extract of the whole plant has found to possess potent anti-HIV, anti-diabetic, anti-diarrheal, anti- inflammatory, anti-pyretic, diuretic and psychopharmacological activities in several animal models. This paper reveales the phytochemical and clinical importance of the plant extract. PMID:22557056

  8. Review on phytochemical and medicinal aspects of jussiaea suferuticosa linn.

    PubMed

    Murugesan, T; Sinha, Sanghamitra; Pal, M; Saha, B P

    2002-01-01

    The whole plant of Jussiaea suffruticosa Linn. Has been widely used in traditional medicine of India. Important bioactive molecules of the plant extract have been explored with modern phytochemical approaches and reported to consist of betulinic acid, quercetin and β- sitosterol. Furthermore, the experimental data obtained from rational clinical studies indicated that the methanol extract of the whole plant has found to possess potent anti-HIV, anti-diabetic, anti-diarrheal, anti- inflammatory, anti-pyretic, diuretic and psychopharmacological activities in several animal models. This paper reveales the phytochemical and clinical importance of the plant extract. PMID:22557056

  9. An abused psychotic preadolescent at risk for Huntington's disease.

    PubMed

    Sokol, M S; Pfeffer, C R; Solomon, G E; Esman, A H; Robinson, G; Gold, R L; Orr-Andrawes, A; Esman, A

    1989-07-01

    An abused 10-year-old girl with a family history of Huntington's disease developed incapacitating abdominal pain with concomitant behavioral symptomatology suggestive of dementia. The pseudoneurologic nature of her symptoms was clarified through exhaustive evaluation and did not appear to be that of early-onset Huntington's disease. Assessment included pediatric, psychiatric, neurologic, and gynecologic examination; extensive radiologic and laboratory tests; and chronobiology studies. Successful treatment necessitated the integration of numerous therapeutic modalities including dynamically oriented psychotherapy, psychopharmacologic intervention, physical therapy, behavior modification, and electroconvulsive therapy. PMID:2527841

  10. Functional neuroimaging and the law: trends and directions for future scholarship.

    PubMed

    Tovino, Stacey A

    2007-09-01

    Under the umbrella of the burgeoning neurotransdisciplines, scholars are using the principles and research methodologies of their primary and secondary fields to examine developments in neuroimaging, neuromodulation and psychopharmacology. The path for advanced scholarship at the intersection of law and neuroscience may clear if work across the disciplines is collected and reviewed and outstanding and debated issues are identified and clarified. In this article, I organize, examine and refine a narrow class of the burgeoning neurotransdiscipline scholarship; that is, scholarship at the interface of law and functional magnetic resonance imaging (fMRI). PMID:17849344

  11. Psychiatric treatments in dermatology: an update.

    PubMed

    Sambhi, R; Lepping, P

    2010-03-01

    There is a considerable degree of connection between psychiatry and dermatology. This connection is relevant both for diagnosis and management of dermatological pathology. This article summarises common psychiatric conditions seen in patients with skin disease, both primary psychiatric disorders and psychiatric disorders secondary to dermatological pathology. Diagnosis of relevant psychiatric conditions such as anxiety, depression, obsessive-compulsive disorder, delusional parasitosis and dermatitis artefacta, and psychiatric treatments are discussed. It gives an update of psychopharmacology relevant to the dermatologist including important interactions between psychotropic and dermatological agents. PMID:19874324

  12. A review of transpersonal theory and its application to the practice of psychotherapy.

    PubMed

    Kasprow, M C; Scotton, B W

    1999-01-01

    Transpersonal theory proposes that there are developmental stages beyond the adult ego, which involve experiences of connectedness with phenomena considered outside the boundaries of the ego. In healthy individuals, these developmental stages can engender the highest human qualities, including altruism, creativity, and intuitive wisdom. For persons lacking healthy ego development, however, such experiences can lead to psychosis. Superficially, transpersonal states look similar to psychosis. However, transpersonal theory can assist clinicians in discriminating between these two conditions, thereby optimizing treatment. The authors discuss various therapeutic methods, including transpersonal psychopharmacology and the therapeutic use of altered states of consciousness. PMID:9888104

  13. [MANAGEMENT OF PSYCHOTROPIC DRUGS IN HIV-INFECTED PATIENTS].

    PubMed

    Zirulnik, Jorge L

    2015-01-01

    Here we make a revision about the rational use of psychopharmacological drugs in HIV/AIDS patients. We revised the clinical use of psychotropic drugs in this setting. In the clinical spectrum, the most frequent clinical pictures are the depression, anxiety disorders, psychosis, delirium, and the cognitive and behavioral neuropsychiatric symptoms associated with the HIV/AIDS dementia and the substance abuse-dependence. Also, we analyzed the most important pharmacological interactions between psychotropic drugs and antiretrovirals. The medical education and the interdisciplinary work are the basic topics to an adequate clinical management of this kind of patients. PMID:26650559

  14. Cade's identification of lithium for manic-depressive illness--the prospector who found a gold nugget.

    PubMed

    Cole, Neil; Parker, Gordon

    2012-12-01

    John Cade's identification of lithium as a treatment of manic-depressive illness has been judged as a landmark biomedical advance and as an initiator of modern psychopharmacology. His personal background, interests, character, experiences, and key observational skills are sketched to provide the background and logic for his discovery and to argue against his simple self-description as a clinician administrator. The Cade story illustrates the potential strengths of clinical research whereby the clinician observes "signals," formulates hypotheses and explanations, and then pursues or encourages their validity and application. The suggestion that Cade simply "rediscovered lithium" is rejected. PMID:23197126

  15. [Charles Bonnet syndrome in an elderly patient with bilateral vision loss, hyperthyroidism and relative digitalis overdose].

    PubMed

    Gödecke-Koch, T; Schlimme, J; Rada, D; Emrich, H M

    2002-05-01

    Charles Bonnet syndrome (CBS) is characterized by the presence of visual hallucinations in elderly, mentally healthy people. We report a visually impaired 90-year-old woman suddenly complaining of visual hallucinations, suffering from hyperthyroidism and a relative digitalis overdose. The diagnosis of CBS could be made after the exclusion of an intoxication and other neurological and psychiatric syndromes. In this case, visual hallucinations ceased without specific psychopharmacological therapy. A brief review of this organic hallucinosis, differential diagnosis, especially hyperthyroidism-induced psychosis, and digitoxin-induced psychosis is given and current therapeutic strategies are suggested. PMID:12078028

  16. [The guideline for the treatment of mood disorders in USA and Japan].

    PubMed

    Higuchi, T

    2001-08-01

    Recently, the number of available antidepressants has increased dramatically and psychopharmacological treatment is becoming complex. It is important to present some guideline for supporting clinical decision making. Three different kinds of guideline for the treatment of mood disorders, that is, the APA style guideline, the algorithm and the consensus guideline, have been developed in our country. The APA style guideline and the algorithm are basically evidence based and the consensus guideline is developed through the consensus panel format. These guidelines should be used as 'a starting point' for specifying decisions that will be modified occasionally. PMID:11519148

  17. [Anorexia nervosa is frequently associated with psychiatric co-morbidity].

    PubMed

    Panchenko, Anna; Arnfred, Sidse Marie Hemmingsen

    2015-09-21

    Recent literature is explored focusing on the relationship between symptoms of anorexia nervosa (AN) and other psychiatric disorders and lines of treatment. In AN, restrictive subtype, anxiety and obsessive-compulsive disorders are the most frequent co-morbidities. In AN, bulimic subtype, depression, emotional instability/borderline and dependency disorders are most frequent. Psychopharmacological treatment could be tried in cases with AN and co-morbid depression, but otherwise the evidence base is lacking and pharmacological treatment relies on case stories and experience. PMID:26418641

  18. Employing mirtazapine to aid benzodiazepine withdrawal.

    PubMed

    Chandrasekaran, P K

    2008-06-01

    Insomnia and depression are frequently encountered in patients during withdrawal from substances. While there are no approved medications for treating them, off-label attempts to address these phenomena with mirtazapine have shown some promising results. This case describes the use of mirtazapine as an aid in benzodiazepine withdrawal and its potential benefits in alleviating insomnia and depression in a 32-year-old man. It was found to ameliorate sleep myoclonus that was thought to be associated with his withdrawal syndrome. It is hoped this report will generate interest and stimulate further research in this area of psychopharmacology. PMID:18581012

  19. [Significance of the German Act on the Reform of the Market for Medicinal Products for psychopharmacotherapy].

    PubMed

    Gründer, G

    2016-04-01

    The German Act on the Reform of the Market for Medicinal Products (AMNOG) will lead to rapid disappearance of many new psychotropic drugs from the market in Germany over the next few years or their not being introduced in the first place. This article lists the reasons and discusses possible solutions. In the long term, the AMNOG could not only lead to an improvement of psychopharmacology but also contribute to the development of psychiatry as a whole, especially if its standards become an international reference. PMID:26983820

  20. Intensive Care Unit Psychosis

    PubMed Central

    Monks, Richard C.

    1984-01-01

    Patients who become psychotic in intensive care units are usually suffering from delirium. Underlying causes of delirium such as anxiety, sleep deprivation, sensory deprivation and overload, immobilization, an unfamiliar environment and pain, are often preventable or correctable. Early detection, investigation and treatment may prevent significant mortality and morbidity. The patient/physician relationship is one of the keystones of therapy. More severe cases may require psychopharmacological measures. The psychotic episode is quite distressing to the patient and family; an educative and supportive approach by the family physician may be quite helpful in patient rehabilitation. PMID:21279016

  1. “Moving Along” in Psychotherapy With Schizophrenia Patients

    PubMed Central

    Rogan, Alice

    2000-01-01

    Current treatment of the schizophrenic patient relies primarily on psychopharmacological management, psychoeducation, and family work. If individual psychotherapy is an adjunct, it is generally supportive. Recent focus on determinants of change in classical psychoanalysis suggests that noninterpretive mechanisms may have an impact at least equivalent to that of the well-timed transference interpretation. The author argues that the same noninterpretive mechanisms may be even more important for change in patients in a supportive process. A case study is used to illustrate that such an application of psychoanalytic principles and developmental research can be used to help even the most disturbed patients. PMID:10896741

  2. Neuroethics: the pursuit of transforming medical ethics in scientific ethics.

    PubMed

    Figueroa, Gustavo

    2016-01-01

    Ethical problems resulting from brain research have given rise to a new discipline termed neuroethics, representing a new kind of knowledge capable of discovering the neural basis for universal ethics. The article (1) tries to evaluate the contributions of neuroethics to medical ethics and its suitability to outline the foundations of universal ethics, (2) critically analyses the process of founding this universal ethic. The potential benefits of applying neuroimaging, psychopharmacology and neurotechnology have to be carefully weighed against their potential harm. In view of these questions, an intensive dialogue between neuroscience and the humanities is more necessary than ever. PMID:26897168

  3. A Review of Transpersonal Theory and Its Application to the Practice of Psychotherapy

    PubMed Central

    Kasprow, Mark C.; Scotton, Bruce W.

    1999-01-01

    Transpersonal theory proposes that there are developmental stages beyond the adult ego, which involve experiences of connectedness with phenomena considered outside the boundaries of the ego. In healthy individuals, these developmental stages can engender the highest human qualities, including altruism, creativity, and intuitive wisdom. For persons lacking healthy ego development, however, such experiences can lead to psychosis. Superficially, transpersonal states look similar to psychosis. However, transpersonal theory can assist clinicians in discriminating between these two conditions, thereby optimizing treatment. The authors discuss various therapeutic methods, including transpersonal psychopharmacology and the therapeutic use of altered states of consciousness. (The Journal of Psychotherapy Practice and Research 1999; 8:12–23) PMID:9888104

  4. New treatment models for compulsive disorders.

    PubMed

    Grant, Jon E; Fineberg, Naomi; van Ameringen, Michael; Cath, Danielle; Visser, Henny; Carmi, Lior; Pallanti, Stefano; Hollander, Eric; van Balkom, Anton J L M

    2016-05-01

    Obsessive compulsive disorder (OCD) as well as related disorders such as body dysmorphic disorder, tic disorder, and trichotillomania are all common and often debilitating. Although treatments are available, more effective approaches to these problems are needed. Thus this review article presents what is currently known about OCD and related disorders and suggests that understanding OCD more broadly as a compulsive disorder may allow for more effective treatment options. Toward that goal, the review presents new models of psychopharmacology and psychotherapy, as well as new brain stimulation strategies. Treatment advances, grounded in the neuroscience, have promise in advancing treatment response for OCD as well as other disorders of compulsivity. PMID:26621260

  5. Lithium in Medicine: Mechanisms of Action.

    PubMed

    Mota de Freitas, Duarte; Leverson, Brian D; Goossens, Jesse L

    2016-01-01

    In this chapter, we review the mechanism of action of lithium salts from a chemical perspective. A description on how lithium salts are used to treat mental illnesses, in particular bipolar disorder, and other disease states is provided. Emphasis is not placed on the genetics and the psychopharmacology of the ailments for which lithium salts have proven to be beneficial. Rather we highlight the application of chemical methodologies for the characterization of the cellular targets of lithium salts and their distribution in tissues. PMID:26860311

  6. Psychiatric components of a Health Maintenance Facility (HMF) on Space Station

    NASA Technical Reports Server (NTRS)

    Santy, Patricia A.

    1987-01-01

    The operational psychiatric requirements for a comprehensive Health Maintenance Facility (HMF) on a permanently manned Space Station are examined. Consideration is given to the psychological health maintenance program designed for the diagnosis of mental distress in astronauts during flight and for prevention of mental breakdown. The types of mental disorders that can possibly affect the astronauts in flight are discussed, including various organic, psychotic, and affective mental disorders, as well as anxiety, adjustment, and somatoform/dissociative disorders. Special attention is given to therapeutic considerations for psychiatric operations on Space Station, such as restraints, psychopharmacology, psychotherapy, and psychosocial support.

  7. Building strengths with the Six Es of medication management.

    PubMed

    Phelps, Kenneth; Bullard, Crystal; Helps, Stacey; Getz, Alexander

    2015-04-01

    The authors provide a template of focused skills drawn from various psychotherapy modalities for integration into follow-up psychopharmacology appointments. Titled the Six E model, this approach includes strategies to elicit an agenda, externalize the presenting problem, seek exceptions, engage empathetically, utilize enactments, and offer education. The template was trialed in a child and adolescent outpatient residency clinic under the guidance of two attendings. Qualitative feedback was solicited from fellows following utilization of the template. The Six E model was felt to improve structure and subjective satisfaction of patient, family, and provider participating in the brief appointments. PMID:25026946

  8. Countertransference. Its continued importance in psychiatric education

    PubMed Central

    Rao, Nyapati R.; Meinzer, Arthur E.; Berman, Sheldon S.

    1997-01-01

    Psychotherapy is likely to play a minor or nonexistent role in the future general psychiatrist's training and practice. However, the component skills of recognition and management of the countertransference will remain important. Because psychotherapy training and supervision have been the venues for countertransference learning, the field is in danger of losing its teaching laboratory and hence losing these skills. The authors examine the concept of countertransference and discuss its importance in four increasingly significant areas: managed care, psychopharmacological treatment, emergency intervention, and the management of professional boundaries regarding sexual misconduct. Methods are discussed for enhancing residents' countertransference skills through supervision, training groups, and the resident's personal psychotherapy. PMID:9058556

  9. The neurobiology of psychopathy: recent developments and new directions in research and treatment.

    PubMed

    Cummings, Michael A

    2015-06-01

    Psychopathic individuals account for substantial predatory and impulsive violence. To the present, the principal intervention used to decrease the harm inflicted by psychopaths has been confinement. Nevertheless, most confined psychopathic persons return to the community. Recent advances in the understanding of the neurobiology of psychopathy hold promise for new research directions and more effective treatments. In this article, we will explore recent advances in genetics, electrophysiology, brain imaging, and psychopharmacology, as well as, in brief, their implications for new directions in research and treatment. PMID:25698308

  10. [Violence and alcohol consumption in intimate heterosexual relationships].

    PubMed

    Gerevich, József; Bácskai, Erika

    2006-06-25

    Health and addiction harm of violence related to drinking is a very important aspect of the recent research studies. The social exchange theory, the family systems approach of alcoholism, the psychopharmacological model, the economic motivational model, and the tripartitate conceptual framework of Goldstein focus on the phenomenon within different causal contexts. According to recent studies approximately half of the cases is related to the alcohol consumption. Especially the binge drinking can facilitate violence. The problem is moderated by social, cultural, and ethnic specialties. The likelihood of alcohol related aggression increases in a rapidly changing society. Exposure to drinking related violence is frequent among women with pregnancy. PMID:16893133

  11. Behavior within fortuitous environments: The entwined history of Division 28 and the fields of behavioral pharmacology and toxicology.

    PubMed

    Campbell, Nancy D

    2016-08-01

    Behavioral pharmacology emerged in the early to mid-20th century as an experimental and observational science, helping to consolidate an empirically based psychological science of behavior. Behavioral psychologists came to play significant roles in toxicology, neuropharmacology, and psychopharmacology. This article traces the first 3 decades of American Psychological Association Division 28. Sources include the Division 28 Oral History Project; formal interviews conducted by the author in the early 2000s with behavioral, experimental, and clinical pharmacologists; and the archived newsletters of Division 28. (PsycINFO Database Record PMID:27454672

  12. True to oneself? Broad and narrow ideas on authenticity in the enhancement debate.

    PubMed

    Bolt, L L E

    2007-01-01

    Our knowledge of the human brain and the influence of pharmacological substances on human mental functioning is expanding. This creates new possibilities to enhance personality and character traits. Psychopharmacological enhancers, as well as other enhancement technologies, raise moral questions concerning the boundary between clinical therapy and enhancement, risks and safety, coercion and justice. Other moral questions include the meaning and value of identity and authenticity, the role of happiness for a good life, or the perceived threats to humanity. Identity and authenticity are central in the debate on psychopharmacological enhancers. In this paper, I first describe the concerns at issue here as extensively propounded by Carl Elliott. Next, I address David DeGrazia's theory, which holds that there are no fundamental identity-related and authenticity-related arguments against enhancement technologies. I argue, however, that DeGrazia's line of reasoning does not succeed in settling these concerns. His conception of identity does not seem able to account for the importance we attach to personal identity in cases where personal identity is changed through enhancement technology. Moreover, his conception of authenticity does not explain the reason why we find inauthentic values objectionable. A broader approach to authenticity can make sense of concerns about changes in personal identity by means of enhancement technologies. PMID:17909988

  13. Prefrontal brain metabolites in short-term weight-recovered adolescent anorexia nervosa patients.

    PubMed

    Castro-Fornieles, Josefina; Garcia, Ana Isabel; Lazaro, Luisa; Andrés-Perpiñá, Susana; Falcón, Carles; Plana, Maria Teresa; Bargallo, Nuria

    2010-08-16

    Various neuroimaging techniques have revealed morphological and functional alterations in anorexia nervosa (AN), although few spectroscopic magnetic resonance studies have examined short-term weight-recovered AN patients. Subjects were 32 female adolescent patients (between 13 and 18 years old) seen consecutively in our department and who met DSM-IV diagnostic criteria for AN. All of them had received a minimum of six months of treatment and were short-term weight-recovered (for one to three months) with a body mass index ranging from 18 to 23. A group of 20 healthy female volunteer controls of similar age were also included. All subjects were assessed with psychopathological scales and magnetic resonance spectroscopy. Total choline (Cho) (p=0.007) and creatine (Cr) (p=0.008) levels were significantly higher in AN patients than in controls. AN patients receiving psychopharmacological treatment with SSRIs (N=9) had metabolite levels similar to control subjects, but patients without this treatment did not. The present study shows abnormalities in brain neurometabolites related to Cho compounds and Cr in the prefrontal cortex in short-term weight-recovered adolescent AN patients, principally in patients not undergoing psychopharmacological treatment. More studies with larger samples are necessary to test the generalizability of the present results. PMID:20580920

  14. Startle response memory and hippocampal changes in adult zebrafish pharmacologically-induced to exhibit anxiety/depression-like behaviors.

    PubMed

    Pittman, Julian T; Lott, Chad S

    2014-01-17

    Zebrafish (Danio rerio) are rapidly becoming a popular animal model for neurobehavioral and psychopharmacological research. While startle testing is a well-established assay to investigate anxiety-like behaviors in different species, screening of the startle response and its habituation in zebrafish is a new direction of translational biomedical research. This study focuses on a novel behavioral protocol to assess a tapping-induced startle response and its habituation in adult zebrafish that have been pharmacologically-induced to exhibit anxiety/depression-like behaviors. We demonstrated that zebrafish exhibit robust learning performance in a task adapted from the mammalian literature, a modified plus maze, and showed that ethanol and fluoxetine impair memory performance in this maze when administered after training at a dose that does not impair motor function, however, leads to significant upregulation of hippocampal serotoninergic neurons. These results suggest that the maze associative learning paradigm has face and construct validity and that zebrafish may become a translationally relevant study species for the analysis of the mechanisms of learning and memory changes associated with psychopharmacological treatment of anxiety/depression. PMID:24184510

  15. Assessment and Treatment of Anxiety Disorders in Children and Adolescents

    PubMed Central

    Wehry, Anna M.; Beesdo-Baum, Katja; Hennelly, Meghann M.; Connolly, Sucheta D.; Strawn, Jeffrey R.

    2015-01-01

    Recent advances in the developmental epidemiology, neurobiology and treatment of pediatric anxiety disorders have increased our understanding of these conditions and herald improved outcomes for affected children and adolescents. This article reviews the current epidemiology, longitudinal trajectory, and neurobiology of anxiety disorders in youth. Additionally, we summarize the current evidence for both psychotherapeutic and psychopharmacologic treatments of fear-based anxiety disorders (e.g., generalized, social and separation anxiety disorders) in children and adolescents. Current data suggest that these disorders begin in childhood and adolescence, exhibit homotypic continuity and increase the risk of secondary anxiety and mood disorders. Psychopharmacologic trials involving selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are effective in pediatric patients with anxiety disorders and have generally demonstrated moderate effect sizes. Additionally, current data support cognitive-behavioral therapy (CBT) are efficacious in the treatment of these conditions in youth and that combination of CBT + an SSRI may be associated with greater improvement than would be expected with either treatment as monotherapy. PMID:25980507

  16. The role of serendipity in the discovery of the clinical effects of psychotropic drugs: beyond of the myth.

    PubMed

    López-Muñoz, Francisco; Baumeister, Alan A; Hawkins, Mike F; Alamo, Cecilio

    2012-01-01

    The serendipity is the faculty for making a discovery through a combination of accident and sagacity. In psychopharmacology, the serendipity played a key role in the discovery of many psychotropic drugs, although there are marked disputes in this regard, possibly due to semantic differences in relation to the meaning of this term. We have implemented an operational definition of serendipity based on the discovery of something unexpected or not sought intentionally, irrespective of the systematic process leading to the accidental observation. The present paper analyses some representative examples of discoveries in the field of psychopharmacology according to different serendipitous intervention patterns. Following this approach there would be four different imputability patterns: pure serendipitous discoveries (valproic acid/valproate); serendipitous observation leading to a non-serendipitous discoveries (imipramine); non-serendipitous discoveries secondarily associated with serendipitous observation (barbiturates); non-serendipitous discoveries (haloperidol). We can conclude that pure serendipitous discoveries in this field are not very frequent, most common being a mixed pattern; an initial serendipitous observation which leads to a non-serendipitous discovery of clinical utility. This is the case of imipramine, lithium salts, chlorpromazine or meprobamate. PMID:22344494

  17. Mindfulness-Based Cognitive Therapy and the Adult ADHD Brain: A Neuropsychotherapeutic Perspective

    PubMed Central

    Bachmann, Katharina; Lam, Alexandra P.; Philipsen, Alexandra

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a recognized serious mental disorder that often persists into adulthood. The symptoms and impairments associated with ADHD often cause significant mental suffering in affected individuals. ADHD has been associated with abnormal neuronal activity in various neuronal circuits, such as the dorsofrontostriatal, orbitofrontostriatal, and frontocerebellar circuits. Psychopharmacological treatment with methylphenidate hydrochloride is recommended as the first-line treatment for ADHD. It is assumed that medication ameliorates ADHD symptoms by improving the functioning of the brain areas affected in the condition. However, side effects, contraindications, or non-response can limit the effectiveness of a psychopharmacological treatment for ADHD. It is therefore necessary to develop non-pharmacological interventions that target neuronal mechanisms associated with the condition in the same way as pharmacological treatment. We think that mindfulness meditation employed as a neuropsychotherapeutic intervention could help patients with ADHD to regulate impaired brain functioning and thereby reduce ADHD symptoms. In this paper, we highlight the mechanisms of such mindfulness meditation, and thus provide a rationale for further research and treatment development from a neuropsychotherapeutic perspective. We conclude that mindfulness meditation employed as a neuropsychotherapeutic intervention in therapy is a promising treatment approach in ADHD. PMID:27445873

  18. [Psychopharmacotherapy during pregnancy and lactation. 1: Pregnancy].

    PubMed

    Lanczik, M; Knoche, M; Fritze, J

    1998-01-01

    Approximately one-third of all pregnant women take psychotropic drugs at least once during pregnancy. At the same time, there are no preparations on the market that can be considered entirely appropriate for expectant mothers. The effects of psychopharmacological therapies have exclusively been discussed in the context of their risk during the first trimester. However, treatment after this phase is not absolutely without risk, and it is striking that there are grave differences between various substances. There are currently controversial discussions going on in literature as far as the teratogenicity of lithium is concerned, especially during the formation of the heart. It is suggested that the risk for congenital malformations is increased after intrauterine lithium exposure, whereas such a risk cannot be proved for most of the antidepressants and neuroleptics. Still, it should be noted that psychopharmacology is not harmless even after the organogenesis, as intrauterine exposure during the 2nd and 3rd trimester can lead to postnatal complications. For example, floppy-infant syndrome after taking benzodiazepines, and the extrapyramidal-motor effects on the newborn after neuroleptic therapy during pregnancy should be mentioned. PMID:9522327

  19. Noradrenaline effects on social behaviour, intergroup relations, and moral decisions.

    PubMed

    Terbeck, S; Savulescu, J; Chesterman, L P; Cowen, P J

    2016-07-01

    Recent research has begun to elucidate the neural basis of higher order social concepts, such as the mechanisms involved in intergroup relations, and moral judgments. Most theories have concentrated on higher order emotions, such as guilt, shame, or empathy, as core mechanisms. Accordingly, psychopharmacological and neurobiological studies have investigated the effects of manipulating serotonin or oxytocin activity on moral and social decisions and attitudes. However, recently it has been determined that changes in more basic emotions, such as fear and anger, might also have a significant role in social and moral cognition. This article summarizes psychopharmacological and fMRI research on the role of noradrenaline in higher order social cognition suggesting that indeed noradrenergic mediated affective changes might play key - and probably causal - role in certain social attitudes and moral judgments. Social judgments may also be directly influenced by numerous neurotransmitter manipulations but these effects could be mediated by modulation of basic emotions which appear to play an essential role in the formation of social concepts and moral behaviour. PMID:27126289

  20. [Treatment of psychiatric disorders during pregnancy and the breast feeding : Psychotherapy and other nondrug therapies].

    PubMed

    Kittel-Schneider, S; Reif, A

    2016-09-01

    The majority of women suffering from psychiatric disorders in pregnancy and the breast feeding prefer psychotherapy and other nonpharmacological treatment over psychopharmacological treatment although the risk of malformations and postnatal complications in children exposed to psychopharmacological drugs must be regarded as acceptable in moderate to severely ill patients. Data are lacking, but several psychotherapeutic and biological treatments as well as noninvasive brain stimulation procedures have been investigated to treat depressive episodes and anxiety disorders in pregnancy and the breast feeding. In mild to moderate depressive episodes different psychotherapy treatments and counseling are significantly more effective in reducing depressive symptoms than no treatment.The same seems to be true for anxiety disorders; however, studies on this are sparse. Treatment by telephone and internet also seems to improve symptoms, which is of interest especially in the less flexible group of breast feeding women and for the development of future health care structures. Noninvasive stimulation treatment has been shown to be an effective nonpharmacological therapeutic option. Data for other recent noninvasive brain stimulation treatments and biological treatments as well as exercise therapy are sparse. In severe and delusional cases as well as treatment-resistant depressive episodes, electroconvulsive therapy should be considered in pregnant women. Because several patients prefer nonpharmacological therapy during this period, those should be applied if available and feasible. Regarding nonpharmacological treatment of obsessive-compulsive disorder, bipolar disorder and schizophrenia during pregnancy and the breast feeding, no recommendation can currently be given. PMID:27448177

  1. Creative, person-centered and narrative psychopharmacotherapy or how to prevent and overcome treatment resistance in psychiatry.

    PubMed

    Jakovljevic, Miro

    2015-09-01

    Despite of the huge progress in clinical psychopharmacology and recent introduction of many new mental health medicines, a significant proportion of psychiatric patients do not respond satisfactory to pharmacological treatment. Such patients are commonly labeled "treatment resistant" although there is no full agreement about definition of the term. The precise prevalence of treatment resistance is hard to determine due to the lack of consensus regarding the term definition and too many cases of pseudo-resistance. Resistant and refractory mental disorders have significant economic, social, physical, and psychological consequences. The suffering and disability associated with chronic, unremitting mental disorders is profound. Changing treatment philosophy may be a critical step towards overcoming what some view as "therapeutic stagnation in psychiatry" and providing better treatment effectiveness and efficiency for patients benefit. A "paradigm shift" is needed from the mechanistic, formistic and reducionistic way of thinking of technical and impersonal psychopharmacology to contextual and systemic thinking with new treatment holodigm individualizing and personalizing psychopharmacotherapy in a more creative manner. Treatment resistance as a construct should be reconsidered as well as "monotherapy before polytherapy" treatment strategy. The best treatments are those that utilize and integrate multiple therapeutic modalities. The concept of creative, person-centered narrative psychopharmacotherapy gives a hope for increasing treatment effectiveness and efficiency in psychiatry. PMID:26400141

  2. [Neurocosmetics, transhumanism and eliminative materialism: toward new ways of eugenics].

    PubMed

    Echarte Alonso, Luis E

    2012-01-01

    In this paper I present similarities and connections between Transhumanism and Eliminative Materialism. Concretely, I study the arguments with which in both positions it is defended a merely instrumental idea of human body and, because of that, one infinitely mouldable. First, I show the social relevance of this idea and its projections in phenomena as medicalization of human condition and, especially, cosmetic psychopharmacology. Besides, I denounce that such influences are caused by illegitimate transference of authority between philosophical and scientific forums. Second, according to my analysis, these new postmodern fashions of chemical sentimentalism (related with radical changes on personal identity and human nature) drive to new eugenic forms what I name autoeugenics. Finally, I call attention to the important role of utopian speeches about the science of tomorrow and super-human civilization in a Carpe Diem society. In my conclusions, I claim that historical reasoning or warnings about what is coming are not efficient strategies to control neither new psychopharmacological habits nor passivity generated by them. Returning social confidence in the power of reason to achieve reality (and other human beings) is, in my opinion, the best way to rehabilitate a more and more devalued human action. PMID:22548656

  3. Psychotropic dose equivalence in Japan.

    PubMed

    Inada, Toshiya; Inagaki, Ataru

    2015-08-01

    Psychotropic dose equivalence is an important concept when estimating the approximate psychotropic doses patients receive, and deciding on the approximate titration dose when switching from one psychotropic agent to another. It is also useful from a research viewpoint when defining and extracting specific subgroups of subjects. Unification of various agents into a single standard agent facilitates easier analytical comparisons. On the basis of differences in psychopharmacological prescription features, those of available psychotropic agents and their approved doses, and racial differences between Japan and other countries, psychotropic dose equivalency tables designed specifically for Japanese patients have been widely used in Japan since 1998. Here we introduce dose equivalency tables for: (i) antipsychotics; (ii) antiparkinsonian agents; (iii) antidepressants; and (iv) anxiolytics, sedatives and hypnotics available in Japan. Equivalent doses for the therapeutic effects of individual psychotropic compounds were determined principally on the basis of randomized controlled trials conducted in Japan and consensus among dose equivalency tables reported previously by psychopharmacological experts. As these tables are intended to merely suggest approximate standard values, physicians should use them with discretion. Updated information of psychotropic dose equivalence in Japan is available at http://www.jsprs.org/en/equivalence.tables/. [Correction added on 8 July 2015, after first online publication: A link to the updated information has been added.]. PMID:25601291

  4. Psychotherapy and Its Role in Psychiatric Practice: A Position Paper. II. Objective, Subjective, and Intersubjective Science.

    PubMed

    Shapiro, Yakov; John, Nicholas; Scott, Rowan; Tomy, Nadia

    2016-07-01

    In the first article in this 2-part series, we outlined a psychobiological model of psychiatric treatment and reviewed the evidence showing psychotherapy to be a form of biological intervention that induces lasting alterations in brain structure and function. In this second article, we focus on the adaptive model of psychopathology, the effectiveness of psychotherapeutic interventions, the synergistic effects of combined psychotherapy and psychopharmacology treatments, and attention to the patient's subjective experience and the doctor-patient alliance to complement an "objective" case formulation. The evidence strongly suggests the need for an integrated treatment approach based on the objective, subjective, and intersubjective science that forms the foundation of psychiatry as a clinical discipline, in which psychotherapy and psychopharmacology are seen as complementary treatments within a systemic approach to psychiatric care and training. What emerges is the integrated psychobiological model of care with a complex treatment matrix unique to each patient-provider pair and comprised of biological, experiential, and relational domains of treatment which form the foundation of psychiatry as a science of attachment and meaning. PMID:27427844

  5. ECT as a therapeutic option in severe brain injury.

    PubMed

    Kant, R; Bogyi, A M; Carosella, N W; Fishman, E; Kane, V; Coffey, C E

    1995-03-01

    Electroconvulsive therapy (ECT) is a safe, highly effective, and rapidly acting treatment for certain major psychiatric illnesses, most notably severe mood disorders. Disturbances in mood and behavior as symptoms of delirium may complicate recovery from traumatic brain injury, but virtually no data exist on the role of ECT as a treatment modality in such clinical situations. We describe a patient with severe, unremitting, agitated behavior following a severe closed head injury from a motor vehicle accident. The initial Glasgow Coma Scale score was 3, with computed tomographic evidence of bilateral frontal and left thalamic contusions. After awakening from a 21-day coma, the patient failed to improve beyond a Ranchos Los Amigos level 4 recovery stage. He exhibited persistent severe agitation with vocal outbursts and failed to assist in performing activities of daily living. His difficulties proved unresponsive to combined behavioral therapy and multiple trials of various psychopharmacologic agents. As an intervention of "last resort," he then received six brief-pulse, bilateral ECT treatments that resulted in marked lessening of his agitation and improvement in his ability to express his needs and participate in his self-care. Also, following the ECT, he showed a markedly enhanced response to psychopharmacologic agents. These findings may have important clinical implications for treatment of prolonged delirium after traumatic brain injury. PMID:7796068

  6. Psychopharmacotherapy of Posttraumatic Stress Disorder

    PubMed Central

    Kozarić-Kovačić, Dragica

    2008-01-01

    Posttraumatic stress disorder (PTSD) is a psychiatric disorder that develops after a psychological trauma usually caused by a situation perceived as deeply threatening to a person’s life or integrity. Complex neurobiological changes triggered by such a traumatic and stressful experience may explain a wide range of PTSD symptoms and provide the rationale for psychopharmacological treatment. Selective serotonin-reuptake inhibitors make the first-line treatment of PTSD. Clinical experience has shown that they are more effective than noradrenalin-reuptake inhibitors or tricyclic antidepressants. Antipsychotic drugs, especially atypical ones, have been shown effective in PTSD patients with psychotic characteristics or refractoriness to other treatments. Mood stabilizers seem to reduce mostly autonomous overreactions to stress, whereas the evidence for effectiveness of monoamine oxidase inhibitors is largely inconclusive. Other groups of medications, such as serotonin agonists and antagonists, new antidepressants, dual inhibitors of serotonin- and noradrenalin-reuptake, anticonvulsants, and opiate antagonists are also sometimes used in PTSD treatment. However, as shown in the present review, most clinical studies performed to date to investigate the effectiveness of different psychopharmacological agents in the therapy of PTSD have serious limitations in terms of small sample size, lack of blinding and randomization, and small effect size. More rigorously designed, comparative studies are needed to determine the usefulness, efficacy, tolerability, and safety of particular psychopharmaceutical drugs in the treatment of this therapeutically and functionally challenging disorder. PMID:18716993

  7. Mindfulness-Based Cognitive Therapy and the Adult ADHD Brain: A Neuropsychotherapeutic Perspective.

    PubMed

    Bachmann, Katharina; Lam, Alexandra P; Philipsen, Alexandra

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a recognized serious mental disorder that often persists into adulthood. The symptoms and impairments associated with ADHD often cause significant mental suffering in affected individuals. ADHD has been associated with abnormal neuronal activity in various neuronal circuits, such as the dorsofrontostriatal, orbitofrontostriatal, and frontocerebellar circuits. Psychopharmacological treatment with methylphenidate hydrochloride is recommended as the first-line treatment for ADHD. It is assumed that medication ameliorates ADHD symptoms by improving the functioning of the brain areas affected in the condition. However, side effects, contraindications, or non-response can limit the effectiveness of a psychopharmacological treatment for ADHD. It is therefore necessary to develop non-pharmacological interventions that target neuronal mechanisms associated with the condition in the same way as pharmacological treatment. We think that mindfulness meditation employed as a neuropsychotherapeutic intervention could help patients with ADHD to regulate impaired brain functioning and thereby reduce ADHD symptoms. In this paper, we highlight the mechanisms of such mindfulness meditation, and thus provide a rationale for further research and treatment development from a neuropsychotherapeutic perspective. We conclude that mindfulness meditation employed as a neuropsychotherapeutic intervention in therapy is a promising treatment approach in ADHD. PMID:27445873

  8. Assessment and treatment of anxiety disorders in children and adolescents.

    PubMed

    Wehry, Anna M; Beesdo-Baum, Katja; Hennelly, Meghann M; Connolly, Sucheta D; Strawn, Jeffrey R

    2015-07-01

    Recent advances in the developmental epidemiology, neurobiology, and treatment of pediatric anxiety disorders have increased our understanding of these conditions and herald improved outcomes for affected children and adolescents. This article reviews the current epidemiology, longitudinal trajectory, and neurobiology of anxiety disorders in youth. Additionally, we summarize the current evidence for both psychotherapeutic and psychopharmacologic treatments of fear-based anxiety disorders (e.g., generalized, social, and separation anxiety disorders) in children and adolescents. Current data suggest that these disorders begin in childhood and adolescence, exhibit homotypic continuity, and increase the risk of secondary anxiety and mood disorders. Psychopharmacologic trials involving selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are effective in pediatric patients with anxiety disorders and have generally demonstrated moderate effect sizes. Additionally, current data support cognitive behavioral therapy (CBT) for the treatment of these conditions in youth and suggest that the combination of psychotherapy + an SSRI may be associated with greater improvement than would be expected with either treatment as monotherapy. PMID:25980507

  9. Let's use those tests! Evaluations of crime-related amnesia claims.

    PubMed

    Peters, Maarten J V; van Oorsouw, Kim I M; Jelicic, Marko; Merckelbach, Harald

    2013-02-21

    Suspects awaiting trial often claim that they cannot remember important parts of their violent crimes. It is not unusual that forensic experts readily accept such claims and interpret them in terms of dissociative amnesia or, more specifically, a "red-out". This interpretation hinges on the assumption that heightened levels of stress implicated in violent crimes interfere with memory. We argue that the notion of red-out is a priori not plausible and that alternative interpretations-primarily malingering and substance-induced organic amnesia-should be considered and ruled out first before concluding that memory loss is dissociative in nature. We illustrate our point with four cases that superficially have the contours of red-out tragedies. We believe that, in such cases, neuropsychological tests and/or psychopharmacological information on dose-response relationships can assist forensic experts to exclude malingering or substance-induced amnesia. There is no reason for not using tests and tools from neuropsychology and psychopharmacology. PMID:23425323

  10. Biomarkers in the psychotherapeutic relationship: the role of physiology, neurobiology, and biological correlates of E.M.P.A.T.H.Y.

    PubMed

    Riess, Helen

    2011-01-01

    Emerging biomarker research could powerfully influence the practice of psychotherapy, a standard treatment that is as strongly rooted in brain plasticity as are psychopharmacologic interventions. Psychotherapy is associated with measurable changes in central and peripheral neurophysiology. These markers could be harnessed to aid informed, personalized recommendations for specific psychosocial treatments, to guide a course of treatment, and to predict treatment outcomes, in lieu of relying on costly, trial-and-error approaches. Psychotherapy and empathy research also demonstrate that the patient-doctor relationship has important neurophysiological correlates that can be salient to treatment outcomes, as illustrated in a case example. These correlates include autonomic nervous system arousal manifested by heart rate, respiration rate, muscle tension, and galvanic skin resistance; electroencephalography; and brain-imaging markers. While additional biomarker research is unfolding, there are specific neurobiologically based clinical and subclinical observations, organized by using the E.M.P.A.T.H.Y. mnemonic, that may guide and enhance psychotherapy. Empathic attunement to patients is equally relevant for psychopharmacologic interventions and psychotherapy, and for all patient-doctor relationships. PMID:21631162

  11. Accuracy of drug advertisements in medical journals under new law regulating the marketing of pharmaceutical products in Switzerland

    PubMed Central

    Santiago, Macarena Gonzalez; Bucher, Heiner C; Nordmann, Alain J

    2008-01-01

    Background New legal regulations for the marketing of pharmaceutical products were introduced in 2002 in Switzerland. We investigated whether claims in drug advertisements citing published scientific studies were justified by these studies after the introduction of these new regulations. Methods In this cross-sectional study, two independent reviewers screened all issues of six major Swiss medical journals published in the year 2005 to identify all drug advertisements for analgesic, gastrointestinal and psychopharmacologic drugs and evaluated all drug advertisements referring to at least one publication. The pharmaceutical claim was rated as being supported, being based on a potentially biased study or not to be supported by the cited study according to pre-specified criteria. We also explored factors likely to be associated with supported advertisement claims. Results Of 2068 advertisements 577 (28%) promoted analgesic, psychopharmacologic or gastrointestinal drugs. Among them were 323 (56%) advertisements citing at least one reference. After excluding multiple publications of the same drug advertisement and advertisements with non-informative references, there remained 29 unique advertisements with at least one reference to a scientific study. These 29 advertisements contained 78 distinct pairs of claims of analgesic, gastrointestinal and psychopharmacologic drugs and referenced studies. Thirty-seven (47%) claims were supported, 16 (21%) claims were not supported by the corresponding reference, and 25 (32%) claims were based on potentially biased evidence, with no relevant differences between drug groups. Studies with conflict of interest and studies stating industry funding were more likely to support the corresponding claim (RR 1.52, 95% CI 1.07–2.17 and RR 1.50, 95% CI 0.98–2.28) than studies without identified conflict of interest and studies without information on type of funding. Conclusion Following the introduction of new regulations for drug

  12. [Extensive conservative treatment of obesity].

    PubMed

    Buri, Caroline; Laederach, Kurt

    2013-02-01

    The treatment of obesity is complex due to the multifactorial etiology. A modern therapy concept must therefore be tailored to the individual needs and problems and depends on various factors such as degree of obesity, the presence of physical complications, psychological co-morbidities, any treatment measures the patient underwent up to now as well as on motivational factors. Before deciding on a therapeutic measure a structured multidisciplinary cooperation is essential including psychosomatic medicine/psychiatry/psychotherapy, endocrinology, sports medicine, nutritional medicine and surgery as well. The treatment must be carried out in a multidisciplinary team and includes an adequate therapy of comorbidities and sometimes a psychopharmacological support. The success of a conservative treatment of obesity is remarkable and long-lasting and can be straightforwardly compared to bariatric surgery in financial as well as ethical terms, although for patients and their physicians the latter often carries the allure of quick success. PMID:23385187

  13. What's in the pipeline? Drugs in development for autism spectrum disorder.

    PubMed

    Sung, Min; Chin, Chee Hon; Lim, Choon Guan; Liew, Hwee Sen Alvin; Lim, Chau Sian; Kashala, Espérance; Weng, Shih-Jen

    2014-01-01

    Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder with both core symptoms and associated symptoms (eg, irritability, aggression, and comorbidities) that affect both the individual and the family/systems around them. There have been recent advances in the understanding of the underlying pathophysiology of ASD pertaining to genetics, epigenetics, neurological, hormonal, and environmental factors that contribute to the difficulties found in individuals with ASD. With this improved understanding, there has been a shift in the application of psychopharmacology in ASD and its related disorders. A literature review was conducted to examine research published in the last 5 years between different classes of psychotropic medications and ASD. The broad scope of the existing literature for the use of conventional medications is summarized and novel medications are discussed. PMID:24591832

  14. Complex trauma, dissociation, and the use of symbolism in therapy.

    PubMed

    Spermon, Deborah; Gibney, Paul; Darlington, Yvonne

    2009-01-01

    As therapists are confronted with clients who have childhood histories of severe interpersonal trauma, the challenge is to understand how this trauma affects individuals developmentally and how healing might be facilitated. This article explores how integration might be understood in the context of complex posttraumatic stress disorder. It is proposed that the symbolic function is central both to the fracturing of selfhood due to early trauma and to its resolution. The article provides a detailed discussion of symbolism and therapeutic possibilities for the use of symbolism as an adjunct to therapy with sufferers of complex posttraumatic stress disorder. It is argued that symbols provide a potentially powerful means of assisting reintegration and that this can be used within a range of therapeutic traditions, including cognitive-behavioral, psychodynamic, psychopharmacological, and neurophysiological approaches. The work of the first author in this regard is illustrated by means of a case study. PMID:19821178

  15. Exanthema medicamentosum as a side effect of promazine.

    PubMed

    Lasić, Davor; Cvitanović, Marija Zuljan; Uglešić, Boran; Višić, Vitomir; Hlevnjak, Ivana

    2011-06-01

    Dermatological side effects of psychopharmacological drugs are fortunately not so often. They are mostly presented in the group of mood stabilizers and antiepileptic drugs, particularly the carbamazepine and lamotrigine, and can be manifested through the Stevens Johnson syndrome, Toxic Epidermal Necrolysis (TEN)/Lyell's syndrome with about 30% lethality. According to the literature the group of phenothiazines is the category of drugs with rare appearances of skin reactions. Promazine, aliphatic phenothiazines antipsychotic, including less frequent side effects in the leaflet states increased skin sensitivity to sun, skin rash-associated with contact dermatitis, allergic reactions, cholestatic icterus. The only reported dermatological side effect of promazine is its metabolites deposition in the cornea. Analyzing the e-data basis we have not found references connecting the Exanthema medicamentosum as a side effect of promazine. A forty-two years old female patient was admitted to the Dermatological Clinic because of suspected exanthema, undoubtedly caused by promazine as a medication for Sy. Borderline. PMID:21685860

  16. Chronobiological Therapy for Mood Disorders.

    PubMed

    Dallaspezia, Sara; Suzuki, Masahiro; Benedetti, Francesco

    2015-12-01

    Chronobiological therapies for mood disorders include manipulations of the sleep-wake cycle such as sleep deprivation and sleep phase advance and the controlled exposure to light and darkness. Their antidepressant efficacy can overcome drug resistance and targets the core depressive symptoms including suicide, thus making them treatment options to be tried either alone or as adjunctive treatments combined with common psychopharmacological interventions. The specific pattern of mood change observed with chronobiological therapies is characterized by rapid and sustained effects, when used among themselves or combined with drugs. Effects sizes are the same reported for the most effective psychiatric treatments, but side effects are usually marginal or absent. New treatment protocols are developed to adapt them in different clinical settings. This review deals with the general principles of clinical chronobiology and the latest findings in this rapidly developing field. PMID:26478195

  17. [SSRI AND BONE METABOLISM IN HIV + PATIENTS WITH ANTIRETROVIRAL THERAPY].

    PubMed

    Mazzoglio y Nabar, Martín J; Muñiz, Milagros María; Mejías Delamano, Alexis A; Muñoz, Santiago; Magrath Guimet, Nahuel

    2015-01-01

    We report a series of 9 male HIV + patients, average age of 41.2 years, viral load negative (<50 copies RNA/ml), treated with antiretroviral (nucleoside and non-nucleoside inhibitors of reverse transcriptase) without systemic infections, the CNS diseases or marker or corticoidoterapia in progress. Were evaluated and supported by their infectologists interconsultation during the period October 2008-October 2013 by depressive syndrome. Psychotherapeutic and psychiatric treatment was initiated with SSRIs and clonazepam; Neuroimaging control and biochemical laboratory studies at baseline and 2 months of treatment were conducted. In the course of psychopharmacological treatment not suffer fractures due to falls and alterations were detected in bone metabolism markers and images. He studied with endocrinology and interdisciplinary medical clinic, decided to withdraw the SSRIs with normalization of biochemical values and psychotherapeutic treatment was continued. We will raise the associations between the use of SSRIs, disturbances of bone metabolism with clinical correlation and possible drug interactions between antidepressants and antiretroviral. PMID:26650557

  18. Severe agitation in depression precipitated by dasatinib.

    PubMed

    Sami, Musa Basseer; Yousaf, Farida; Fialho, Antonio

    2014-01-01

    We describe a case of a man with chronic myeloid leukaemia who achieved remission through dasatinib therapy after being unable to tolerate several tyrosine kinase inhibitor (TKI) regimens due to severe physical side effects. However, this coincided with the onset of distressing agitation, insomnia and motor restlessness leading him to take a large zopiclone overdose. Start of appropriate therapy with a clonazepam, venlafaxine and mirtazapine combination led to a rapid improvement in symptomatology. We discuss the differential diagnosis and review the literature of neuropsychiatric complications of TKIs. This case serves as an illustrative reminder that in cases of complicated agitation referral to specialist mental health teams for rational psychopharmacological management is advised. PMID:25115782

  19. Recent Advances in the Neuropsychopharmacology of Serotonergic Hallucinogens

    PubMed Central

    Halberstadt, Adam L.

    2014-01-01

    Serotonergic hallucinogens, such as (+)-lysergic acid diethylamide, psilocybin, and mescaline, are somewhat enigmatic substances. Although these drugs are derived from multiple chemical families, they all produce remarkably similar effects in animals and humans, and they show cross-tolerance. This article reviews the evidence demonstrating the serotonin 5-HT2A receptor is the primary site of hallucinogen action. The 5-HT2A receptor is responsible for mediating the effects of hallucinogens in human subjects, as well as in animal behavioral paradigms such as drug discrimination, head twitch response, prepulse inhibition of startle, exploratory behavior, and interval timing. Many recent clinical trials have yielded important new findings regarding the psychopharmacology of these substances. Furthermore, the use of modern imaging and electrophysiological techniques is beginning to help unravel how hallucinogens work in the brain. Evidence is also emerging that hallucinogens may possess therapeutic efficacy. PMID:25036425

  20. Motivated attention: Incentive effects on attentional modification of prepulse inhibition

    PubMed Central

    Ashare, Rebecca L.; Hawk, Larry W.; Mazzullo, Rebecca J.

    2008-01-01

    Prepulse inhibition (PPI) of startle is greater for attended compared to ignored prestimuli, and, consistent with theories of motivated attention, initial evidence suggests that this effect is greater among participants given performance-based incentives. The present study examined a within-subjects incentive manipulation. Participants (n = 41) completed two blocks of a tone discrimination task. During the incentive block, participants received trialwise feedback with small monetary incentives for task performance. Startle eyeblink EMG responses to auditory probes were assessed at 60-, 120-, and 180-ms tone-probe stimulus onset asynchronies (SOAs). As predicted, PPI was enhanced during attended compared to ignored prestimuli only at the 120-ms SOA in the incentive condition. There was no evidence of attentional modification in the no-incentive condition. These data suggest that attentional modification of PPI is sensitive to within-subjects manipulations of incentive, providing a useful tool for testing models of motivated attention in psychopathology and psychopharmacology. PMID:17640265

  1. [Amoxapine and clomipramine. A controlled multicenter study in patients with major depression].

    PubMed

    Saubadu, S

    1991-12-01

    This multicentric study carried out in 1987 in 6 University hospital Centers enabled the comparison, under double blind conditions, of the antidepressant efficacy of amoxapine with that of clomipramine. For the planning, the design and the documentation of this study, the BLIPS/BDP (Biometric Laboratory Information Processing System/Banca Dati Psicofarmacologia) at the CCPDD (Center for Clinical Psychopharmacology Data Documentation) from the Institute of Psychiatry of the Pisa University was used. A total number of 108 patients, who fulfilled the DSM III criteria for major depressive episode, were treated (54 by amoxapine, and 54 by clomipramine). The results have shown: 1) The antidepressant activity of amoxapine was at least comparable to that of clomipramine. 2) The onset of action of amoxapine was quicker than that of clomipramine. 3) Amoxapine is well tolerated and the frequency of unwanted effects is lower compared to that of clomipramine. PMID:1807971

  2. [Lifestyle drugs in medicine].

    PubMed

    Harth, Wolfgang; Seikowski, Kurt; Hermes, Barbara; Gieler, Uwe

    2008-01-01

    Lifestyle drugs have become an important new group of medications, which are taken by healthy people to increase the individual well-being and quality of life. Nootropics, psychopharmaceuticals, hormones and "ecodrugs" are today the main groups. The wish for eternal youth, beauty and potency is central, and lifestyle medications are also requested to influence cosmetic findings, which are usually simply a result of the natural aging process. Lifestyle drugs seem to be harmless, but the physician must pay attention to possible abuse, side effects, risks and complications. Additionally, however, lifestyle drugs are also frequently used by patients suffering from emotional disorders such as somatoform disorders. Medicalization of physiological life is then expected to solve psychosocial problems, but without success. The use of lifestyle medications in somatoform disorders is contraindicated and psychotherapy or psychopharmacological treatment come first. With this overview article, we would like to make an update of new lifestyle drugs. PMID:18330527

  3. Psychodynamic Psychotherapy for Children and Adolescents: An Old Friend Revisited

    PubMed Central

    Delgado, Sergio V.

    2008-01-01

    The treatment of children and adolescents with psychotherapy is gradually losing ground to psychopharmacology. The author reviews the value the various forms of psychotherapy have in the treatment of children and the importance of having a clear curriculum for teaching this skill in residency programs. Although the importance of psychodynamic psychotherapy has a long history in the treatment of children, the reluctance some faculty have in recommending this form of therapy may be due to limited experience and limited knowledge of its benefits. The author highlights that a psychodynamic diagnostic evaluation is essential to assess a child’s suitability for psychotherapy. The characteristics of children who will benefit from psychodynamic psychotherapy, their defense mechanisms, and optimal characteristics of their parents are reviewed. The qualifications a psychiatrist needs to succeed in this endeavor are discussed. Two cases illustrate not only the importance in the suitability of the patient, but also the application of psychodynamic theory to practice. PMID:19727254

  4. On the Asclepian spirit and the future of psychoanalysis.

    PubMed

    Whitehead, Clay C

    2002-01-01

    The dynamics of the Asclepian myth are analyzed, and generic dynamics of the healing imperative are illustrated. The story teaches much about the early theories and practice of ancient medicine, and originated the healing symbol of the staff and serpent which appears on the emblem of the American Academy. The multi-modal therapeutic approach used at the Asclepia was often climaxed by dream incubation as a centerpiece of the treatment. Dreams from modern physicians in analysis will be introduced to show that while our practice has changed in external trappings, the underlying dynamics of ancient and modern healers reflect a common humanity. Modern therapists have reacquired the use of dreams and invented a new set of explanatory myths. Consideration of future developments leads to linking the "psychosomatic model" of antiquity with the psychopharmacological interventions which are now common-place in psychodynamic psychotherapy. The Asclepian emphasis on spirituality is also finding increasing recognition among psychoanalysts and other scientists. PMID:12064034

  5. Depression in adolescents and young adults with cancer

    PubMed Central

    Park, Eliza M.; Rosenstein, Donald L.

    2015-01-01

    Adolescents and young adults (AYAs) with cancer are at risk for depression due to disruptions in their developmental trajectory, greater physical symptom burden, and increased likelihood of developing aggressive disease. Rates of depression and other psychological disorders are substantially higher in AYAs with cancer when compared with older adults. Psychiatrists caring for these patients must consider the age-appropriate developmental context of these patients along with familial and medical factors that may influence the presentation and treatment of depression. Previous research suggests that psychosocial interventions specifically designed for AYA patients are promising, but studies of psychopharmacology treatments for depression are lacking. There is a pressing need for prospective studies and controlled clinical trials that evaluate the optimal strategies for treating depression in this patient group. PMID:26246791

  6. Mental health care use by soldiers conducting counterinsurgency operations.

    PubMed

    Applewhite, Larry; Keller, Nathan; Borah, Adam

    2012-05-01

    Counterinsurgency (COIN) has become the cornerstone of the military's strategy to combat terrorist threats. COIN operations are complex and often expose soldiers to unfamiliar stressors as they fight the enemy while developing and maintaining rapport with the local populace. Utilizing a retrospective record review protocol, we examined 282 mental health files of soldiers assigned to a brigade combat team that operated from a large forward operating base in Iraq during the counterinsurgency campaign. Most reported sleep disturbance, depression, anxiety, irritability, and conflict with supervisors related to either operational stress, exposure to direct combat, or home front concerns. Most received brief individual supportive therapy or attended solution-focused group counseling emphasizing life skills training, post-traumatic stress treatment, women's support, or relationship skills. Psychopharmacologic treatment was an essential adjunct to the counseling program. Results indicate that supporting a COIN deployment requires a comprehensive mental health program that can respond to a wide range of mental health problems. PMID:22645874

  7. Fragile X syndrome. Molecular and clinical insights and treatment issues.

    PubMed Central

    Hagerman, R J

    1997-01-01

    The fragile X syndrome is the most common inherited cause of mental retardation that is known. The prevalence of mental retardation from this syndrome ranges from 1 in 1,250 to 1 in 4,000 in the general population, although the prevalence of female carriers has been reported to be as high as 1 in 259. The discovery of the FMR1 gene mutation in 1991 has simplified diagnosis, enhanced our understanding of the spectrum of involvement in the fragile X syndrome, and stimulated research regarding the normal function of the FMR1 protein in brain development. Advances have also occurred in the treatment of the fragile X syndrome, and psychopharmacologic and educational interventions are reviewed here. Images Figure 1. PMID:9109330

  8. Attention deficit hyperactivity disorder across the lifespan: the child, adolescent, and adult.

    PubMed

    Greydanus, Donald E; Pratt, Helen D; Patel, Dilip R

    2007-02-01

    Management of a child, adolescent, college student, or adult with ADD/ADHD (ADHD) is reviewed with emphasis on pharmacologic approaches in the adult. Psychological treatment includes psychotherapy, cognitive-behavior therapy, support groups, parent training, biofeedback, meditation, and social skills training. Medications are reviewed that research has revealed can improve the core symptomatology of a child or adolescent with ADHD. These medications include stimulants (psychostimulants), antidepressants, alpha-2 agonists, and a norepinephrine reuptake inhibitor. Psychopharmacology approved and/or used in pediatric patients are also used in adults with ADHD, though most are not officially FDA-approved. It is emphasized that ADHD management should include a multi-modal approach, involving appropriate educational interventions, appropriate psychological management of the patient of any age, and judicious use of medications. Such an approach is recommended to benefit those with ADHD achieve their maximum potential across the human life span. PMID:17386306

  9. Design and subject characteristics in the federally-funded citalopram trial in children with pervasive developmental disorders.

    PubMed

    Scahill, Lawrence; McCracken, James T; Bearss, Karen; Robinson, Fay; Hollander, Eric; King, Bryan; Bregman, Joel; Sikich, Lin; Dukes, Kimberly; Sullivan, Lisa; Anagnostou, Evdokia; Donnelly, Craig; Kim, Young-Shin; Ritz, Louise; Hirtz, Deborah; Wagner, Ann

    2012-03-01

    The Studies to Advance Autism Research and Treatment Network conducted a randomized trial with citalopram in children with Pervasive developmental disorders (PDDs). We present the rationale, design and sample characteristics of the citalopram trial. Subjects (128 boys, 21 girls) had a mean age of 9.3 (±3.12) years; 132 (88.6%) were diagnosed with autistic disorder (4.7% with Asperger's Disorder; 6.7% with PDD-not otherwise specified). Less than half of the subjects were intellectually disabled; 117 (78.5%) were rated Moderate or Marked on the Clinical Global Impression for Severity. Study measures were similar to previous Research Units on Pediatric Psychopharmacology trials. Subjects in this trial were slightly older and more likely to have complaints of repetitive behavior than participants in RUPP trials. PMID:21667200

  10. Aripiprazole Improved Obsessive Compulsive Symptoms in Asperger's Disorder.

    PubMed

    Celik, Gonca; Tahiroglu, Aysegul Yolga; Firat, Sunay; Avci, Ayşe

    2011-12-01

    There are many comorbid disorders associated with autism spectrum disorders in child and adolescent population. Although obsessive compulsive disorder and autism spectrum disorders (ASD) comorbidity has common in clinical practice, there are few reports about psychopharmacological treatment for obsessive compulsive symptoms in children with ASD in the literacy. We report a successful treatment case with aripiprazole in Asperger's Disorder with obsessive compulsive symptoms. The Yale Brown Obsessive Compulsive Scale was performed to assess symptom variety. This case report supports the effectiveness of aripiprazole in treatment of obsessive compulsive symptoms in Asperger's Disorder or ASDs. Aripiprazole may be beneficial to obsessive compulsive disorder comorbid autism spectrum disorders in child and adolescent age group. PMID:23429759

  11. Psychoactive natural products: overview of recent developments.

    PubMed

    Ujváry, István

    2014-01-01

    Natural psychoactive substances have fascinated the curious mind of shamans, artists, scholars and laymen since antiquity. During the twentieth century, the chemical composition of the most important psychoactive drugs, that is opium, cannabis, coca and "magic mushrooms", has been fully elucidated. The mode of action of the principal ingredients has also been deciphered at the molecular level. In the past two decades, the use of herbal drugs, such as kava, kratom and Salvia divinorum, began to spread beyond their traditional geographical and cultural boundaries. The aim of the present paper is to briefly summarize recent findings on the psychopharmacology of the most prominent psychoactive natural products. Current knowledge on a few lesser-known drugs, including bufotenine, glaucine, kava, betel, pituri, lettuce opium and kanna is also reviewed. In addition, selected cases of alleged natural (or semi-natural) products are also mentioned. PMID:24695249

  12. Perils of Pragmatic Psychiatry: How We Can Do Better

    PubMed Central

    Koola, Maju Mathew; Sebastian, Joseph

    2016-01-01

    Etiologic and pathophysiologic understanding of psychiatric disorders is still in its early stages. The neurobiology of major psychiatric disorders has yet to be fully elucidated. Psychiatric diagnoses are often based on presenting symptoms, lacking reliability and stability. For a variety of reasons, many notable laboratory and clinical observations have not been tested in large trials. Lacking this validation, these potentially valuable practices have not been widely disseminated nor translated into real world practice. Pragmatic practice today requires optimum use of the available resources. This may sometimes require translating novel treatments supported by strong, evidence-based, level II evidence; but still lacking level I evidence into practice and greater utilization of evidence-based approved practices. The purpose of this paper is to highlight some common avoidable pitfalls in practice, and to offer a few psychopharmacological pearls. PMID:26998529

  13. Review of the evidence base for treatment of childhood psychopathology: internalizing disorders.

    PubMed

    Compton, Scott N; Burns, Barbara J; Helen, L Egger; Robertson, Elizabeth

    2002-12-01

    This article reviews the empirical literature on psychosocial, psychopharmacological, and adjunctive treatments for children between the ages of 6 and 12 with internalizing disorders. The aim of this review was to identify interventions that have potential to prevent substance use disorders in adolescence by treating internalizing disorders in childhood. Results suggest that a variety of behavioral, cognitive-behavioral, and pharmacological interventions are effective in reducing symptoms of childhood depression, phobias, and anxiety disorders. None of the studies reviewed included substance abuse outcomes. Thus, little can be said about the relationship between early treatment and the prevention of later substance use. The importance of evaluating the generalizability of research-supported interventions to community settings is highlighted and recommendations for future research are offered. PMID:12472300

  14. Update on schizophrenia and bipolar disorder: focus on cariprazine.

    PubMed

    Roberts, Rona Jeannie; Findlay, Lillian Jan; El-Mallakh, Peggy L; El-Mallakh, Rif S

    2016-01-01

    Schizophrenia and bipolar disorder are severe psychiatric disorders that are frequently associated with persistent symptoms and significant dysfunction. While there are a multitude of psychopharmacologic agents are available for treatment of these illnesses, suboptimal response and significant adverse consequences limit their utility. Cariprazine is a new, novel antipsychotic medication with dopamine D2 and D3 partial agonist effects. Its safety and efficacy have been investigated in acute psychosis of schizophrenia, bipolar mania, bipolar depression, and unipolar depression. Efficacy has been demonstrated in schizophrenia and mania. It is unclear if cariprazine is effective in depression associated with unipolar or bipolar illness. Adverse consequences include extrapyramidal symptoms including akathisia, and various gastrointestinal symptoms. The US Food and Drug Administration (FDA) has recently approved cariprazine. This review will provide clinicians with basic information regarding the research program of cariprazine. PMID:27524901

  15. Mood and metabolism: Anhedonia as a clinical target in Type 2 diabetes.

    PubMed

    Carter, Jasmine; Swardfager, Walter

    2016-07-01

    Epidemiological evidence suggests a bidirectional relationship between depression and Type 2 diabetes mellitus. In Type 2 diabetes, depression affects behavioural factors such as diet and physical activity that promote positive energy balance and influence diabetes outcomes. Examinations of depressive symptoms by dimension have suggested that anhedonia, the inability to anticipate, seek, choose and enjoy reward, may be of particular clinical importance. Structural and functional brain changes in Type 2 diabetes distributed throughout the principally dopaminergic reward circuitry suggest a neurobiological basis for motivational and decisional aspects of anhedonia. Interrelated neuroendocrine, bio-energetic, oxidative and inflammatory changes suggest mechanisms underlying neuronal damage and dopaminergic deficits. A consequential shift in effort-related reward choices and their effects on energy expenditure, self-care and eating behaviours is suggested to affect Type 2 diabetes outcomes. The clinical implications for screening and psychopharmacology of depressive symptoms in people with Type 2 diabetes are discussed. PMID:27088371

  16. A review of behavioral tailoring strategies for improving medication adherence in serious mental illness

    PubMed Central

    Kreyenbuhl, Julie; Record, Elizabeth J.; Palmer-Bacon, Jessica

    2016-01-01

    Nonadherence to psychopharmacological treatments poses a significant challenge to treatment success in individuals with serious mental illness, with upwards of 60% of people not taking their psychiatric medications as prescribed. Nonadherence is associated with adverse outcomes, including exacerbation of psychiatric symptoms, impaired functioning, increased hospitalizations and emergency room use, and increased health care costs. Whereas interventions using psychoeducation or cognitive approaches, such as motivational interviewing, have largely proven ineffective in improving adherence, approaches employing behavioral tailoring that incorporate medication taking into the daily routine and/or use environmental supports have shown promise. Recently, adherence-enhancing behavioral tailoring interventions that utilize novel technologies, such as electronic monitors and mobile phones, have been developed. Although interventions utilizing these platforms have the potential for widespread dissemination to a broad range of individuals, most require further empirical testing. This paper reviews selected behavioral tailoring strategies that aim to improve medication adherence and other functional outcomes among individuals with serious mental illness. PMID:27489459

  17. Psychotherapy and pharmacotherapy for patients with dissociative identity disorder.

    PubMed

    Gentile, Julie P; Dillon, Kristy S; Gillig, Paulette Marie

    2013-02-01

    There is a wide variety of what have been called "dissociative disorders," including dissociative amnesia, dissociative fugue, depersonalization disorder, dissociative identity disorder, and forms of dissociative disorder not otherwise specified. Some of these diagnoses, particularly dissociative identity disorder, are controversial and have been questioned by many clinicians over the years. The disorders may be under-diagnosed or misdiagnosed, but many persons who have experienced trauma report "dissociative" symptoms. Prevalence of dissociative disorders is unknown, but current estimates are higher than previously thought. This paper reviews clinical, phenomenological, and epidemiological data regarding diagnosis in general, and illustrates possible treatment interventions for dissociative identity disorder, with a focus on psychotherapy interventions and a review of current psychopharmacology recommendations as part of a comprehensive multidisciplinary treatment plan. PMID:23556139

  18. The drugs-violence nexus among rural felony probationers.

    PubMed

    Oser, Carrie B; Mooney, Jennifer L; Staton-Tindall, Michele; Leukefeld, Carl G

    2009-08-01

    Little research has focused on the drugs-violence nexus in rural areas. As such, the purpose of this study is to use Goldstein's tripartite conceptual framework to examine the relationship between drugs and violence among felony probationers in rural Appalachian Kentucky (n = 799). Data on demographics, substance use criminal history, and violence were collected between 2001 and 2004 using an interviewer-administered questionnaire. Rural probationers are partitioned into four groups based on lifetime violent victimization/perpetration experiences: (a) neither a perpetrator nor a victim, (b) perpetrator only, (c) victim only, and (d) both a perpetrator and a victim. Chi-square analyses indicate substance use, and criminal history varies across the four groups. Binary logistic regression analyses are used to explore the significant correlates of both perpetration and victimization. Multivariate analyses support both the psychopharmacological model and the economic compulsive models of perpetration and victimization. Further implications of these findings are discussed. PMID:18719220

  19. Clonidine Use in Psychiatry: Panacea or Panache.

    PubMed

    Naguy, Ahmed

    2016-01-01

    Clonidine, an alpha agonist, formally prescribed in clinical medicine as antihypertensive medication, is currently being used more frequently to address a multitude of psychiatric entities. The long-acting formulation is approved by the Food and Drug Administration for use in treating the attention-deficit/hyperactivity disorder. In addition to this only legitimate indication, it has long been used successfully for opiate detoxification, post-traumatic stress disorder and de la Tourette syndrome. Moreover, clonidine helps in the treatment of neuroleptic-induced akathisia, stimulant-induced insomnia and clozapine-induced sialorrhea. It has been tried in treating menopausal syndrome and psychogenic polydipsia. Although the strength of evidence supporting the use of clonidine in such clinical scenarios is highly variable and oscillating, from strong to only flimsy, this overview is intended to shed some light on the clonidine portfolio as a potential and attractive addition to the psychopharmacologic armamentarium. PMID:27161101

  20. [Critical evaluation of the use of antidepressives in childhood].

    PubMed

    Conde López, V J; Ballesteros Alcalde, M C; Franco Martín, M A; Geijo Uribe, M S

    1997-01-01

    In the introduction the authors study some technical, methodological, ethical, administrative and marketing problems about the evaluation and investigation in child and adolescence psychopharmacology. They make a revision and critical evaluation about. As a whole the clinic use of antidepressive drugs in childhood psychiatry. Then, some open and controlled trial about tricyclic antidepressives are evaluated. After this, the authors present the most important advances about the open and controlled clinic trials with several antidepressives: tricyclic, tetracyclic, ISSR and MAO-Inhibitors and other drugs (placebo response, psychotherapy, imipramine, nortryptiline, amitriptyline, fluoxetine, MAO-Inhibitors, lithium, mianserin, maprotyline, etc.). Beside, placebo effect, response prediction factors, biologic markers, diagnostic criteria, evaluation methods and technics, drugs associations, clinic types of child depression, etc, are studied. In the last, the authors present some clinical conclusions about this subject. PMID:9245188

  1. Pediatric IBD and Depression: Treatment Implications

    PubMed Central

    Keethy, Divya; Mrakotsky, Christine; Szigethy, Eva

    2014-01-01

    Purpose of review Depression in pediatric inflammatory bowel disease (IBD) is increasingly recognized to be a heterogeneous condition with diverse underlying predisposing and precipitating factors. Although there is a growing awareness regarding the benefits of integrating behavioral health into medical care, the way psychiatric treatments can best target different aspects of depression and related dysfunction has not been systematically explored. Recent findings This review discusses neurobiological risk factors for depression in IBD including inflammation, associated anti-inflammatory treatment with corticosteroids, pain, and sleep disturbance, as well as psychosocial factors including reactions to illness, illness perception, and disease and environmental stressors with emphasis of how these factors can influence treatment decisions. Empirically-supported psychosocial and psychopharmacological interventions are discussed within this context. Summary Understanding the diverse pathways that can lead to depression in youth with IBD can lead to the development of more targeted interventions and better integration of psychosocial care into the medical treatment of IBD. PMID:25010217

  2. "I did what?" Zolpidem and the courts.

    PubMed

    Daley, Christopher; McNiel, Dale E; Binder, Renée L

    2011-01-01

    Zolpidem is a widely prescribed nonbenzodiazepine hypnotic medication available in the United States since 1992. Attention has been drawn recently to its potential to cause sleep-related, complex behaviors such as sleepwalking and sleep driving. These automatic behaviors have led to a deluge of legal claims. To the authors' knowledge, this is the first review in the forensic literature of the legal ramifications of zolpidem. In this article, the medical literature will be reviewed to explore the current understanding of zolpidem's specific psychopharmacology. Case law will be explored to determine how the courts have handled the claims surrounding sleep-related, complex behaviors alleged to be caused by zolpidem. Finally, a summary of recommendations will be provided for forensic psychiatrists who are asked to be experts in these cases. PMID:22159981

  3. Treatment of depression during pregnancy.

    PubMed

    Gold, L H

    1999-06-01

    Increasing numbers of patients are being treated for mood disorders. The majority of these patients, particularly with the diagnosis of major depression, are women of childbearing years. Concerns about fetal exposure to medication, both planned and unplanned, are becoming more pressing in the clinical practices of both psychiatrists and primary care physicians. There are relatively few study data available to guide clinicians in the use of psychotropic medications during pregnancy because of obvious problems in designing studies of the effects of medication on pregnant women, fetuses, and infants. Clinicians in all specialties receive little or no formal training in this area of psychopharmacology. This article gathers clinically relevant studies and practice information and provides suggestions regarding the approach to treatment of mood disorders during pregnancy, based on a risk assessment model. PMID:10839645

  4. Safety and Tolerability of Pharmacological Treatment of Alcohol Dependence: Comprehensive Review of Evidence.

    PubMed

    Sinclair, Julia M A; Chambers, Sophia E; Shiles, Celia J; Baldwin, David S

    2016-07-01

    Alcohol use disorders (AUD) cause significant morbidity and mortality worldwide, but pharmacological treatments for them are underused, despite evidence of efficacy. Acamprosate, naltrexone, nalmefene and disulfiram are all approved in one or more region for the treatment of AUD. Baclofen currently has a temporary indication in France. Safety considerations for using psychopharmacological treatments in this patient group include the impact of concurrent alcohol consumption at high levels; multiple physical comorbidities that may interfere with pharmacological effects, distribution and metabolism; and concomitant medication for the treatment of comorbid physical and psychiatric conditions. The five drugs, including an extended-release injectable suspension of naltrexone, have different safety profiles that need to be balanced with the treatment objective (initiation or continuation of abstinence, or reduction of drinking), individual patient preferences and comorbid conditions. Appropriate treatment will be based on the unique risk-benefit profile in each case. PMID:27023898

  5. Neurologic bases for comorbidity of balance disorders, anxiety disorders and migraine: neurotherapeutic implications

    PubMed Central

    Balaban, Carey D; Jacob, Rolf G; Furman, Joseph M

    2011-01-01

    The comorbidity among balance disorders, anxiety disorders and migraine has been studied extensively from clinical and basic research perspectives. From a neurological perspective, the comorbid symptoms are viewed as the product of sensorimotor, interoceptive and cognitive adaptations that are produced by afferent interoceptive information processing, a vestibulo–parabrachial nucleus network, a cerebral cortical network (including the insula, orbitofrontal cortex, prefrontal cortex and anterior cingulate cortex), a raphe nuclear–vestibular network, a coeruleo–vestibular network and a raphe–locus coeruleus loop. As these pathways overlap extensively with pathways implicated in the generation, perception and regulation of emotions and affective states, the comorbid disorders and effective treatment modalities can be viewed within the contexts of neurological and psychopharmacological sites of action of current therapies. PMID:21375443

  6. [Atypical antipsychotics and metabolic syndrome].

    PubMed

    Baranyi, Andreas; Yazdani, Renè; Haas-Krammer, Alexandra; Stepan, Alexandra; Kapfhammer, Hans-Peter; Rothenhäusler, Hans-Bernd

    2007-01-01

    The introduction of atypical antipsychotics in psychopharmacology represented a major advance in the treatment of psychotic disorders. However, there have been numerous studies that certain atypical antipsychotics may be associated with a greater risk of metabolic abnormalities than others, including weight gain, hyperlipidemia and new-onset typ 2 diabetes mellitus. A G-Protein beta3 subunit Gen (C825T) polymorphism, an increased carbohydrate metabolism and dyshormonism are discussed as pathogenetic mechanisms. High risk patients (adiposity, hyperlipidaemia, hyperglycaemia, preexisting diabetes) should maintain an antipsychotic agent with a favourable side effect profile. In these cases a periodical diabetes screening and blood lipid controls are required. Clinicans must balance the significant benefits of atypical antipsychotics against the risk of metabolic disturbances. In this article recent findings are reviewed. PMID:17915438

  7. Recent advances in the neuropsychopharmacology of serotonergic hallucinogens.

    PubMed

    Halberstadt, Adam L

    2015-01-15

    Serotonergic hallucinogens, such as (+)-lysergic acid diethylamide, psilocybin, and mescaline, are somewhat enigmatic substances. Although these drugs are derived from multiple chemical families, they all produce remarkably similar effects in animals and humans, and they show cross-tolerance. This article reviews the evidence demonstrating the serotonin 5-HT2A receptor is the primary site of hallucinogen action. The 5-HT2A receptor is responsible for mediating the effects of hallucinogens in human subjects, as well as in animal behavioral paradigms such as drug discrimination, head twitch response, prepulse inhibition of startle, exploratory behavior, and interval timing. Many recent clinical trials have yielded important new findings regarding the psychopharmacology of these substances. Furthermore, the use of modern imaging and electrophysiological techniques is beginning to help unravel how hallucinogens work in the brain. Evidence is also emerging that hallucinogens may possess therapeutic efficacy. PMID:25036425

  8. Chronic physical illness: a psychophysiological approach for chronic physical illness.

    PubMed

    Purdy, Jana

    2013-03-01

    Growing evidence demonstrates that psychological risk variables can contribute to physical disease. In an effort to thoroughly investigate potential etiological origins and optimal interventions, this broad review is divided into five sections: the stress response, chronic diseases, mind-body theoretical models, psychophysiological interventions, and integrated health care solutions. The stress response and its correlation to chronic disorders such as cardiovascular, gastrointestinal, autoimmune, metabolic syndrome, and chronic pain are comprehensively explored. Current mind-body theoretical models, including peripheral nerve pathway, neurophysiological, and integrative theories, are reviewed to elucidate the biological mechanisms behind psychophysiological interventions. Specific interventions included are psychotherapy, mindfulness meditation, yoga, and psychopharmacology. Finally, the author advocates for an integrated care approach as a means by which to blur the sharp distinction between physical and psychological health. Integrated care approaches can utilize psychiatric nurse practitioners for behavioral assessment, intervention, research, advocacy, consultation, and education to optimize health outcomes. PMID:23483831

  9. Lack of imprinting of the human dopamine D4 receptor (DRD4) gene

    SciTech Connect

    Cichon, S.; Noethen, M.M.; Propping, P.; Wolf, H.K.

    1996-04-09

    The term genomic imprinting has been used to refer to the differential expression of genetic material depending on whether it has come from the male or female parent. In humans, the chromosomal region 11p15.5 has been shown to contain 2 imprinted genes (H19 and IGF2). The gene for the dopamine D4 receptor (DRD4), which is of great interest for research into neuropsychiatric disorders and psychopharmacology, is also located in this area. In the present study, we have examined the imprinting status of the DRD4 gene in brain tissue of an epileptic patient who was heterozygous for a 12 bp repeat polymorphism in exon 1 of the DRD4 gene. We show that both alleles are expressed in equivalent amounts. We therefore conclude that the DRD4 gene is not imprinted in the human brain. 30 refs., 1 fig.

  10. Severe agitation in depression precipitated by dasatinib

    PubMed Central

    Sami, Musa Basseer; Yousaf, Farida; Fialho, Antonio

    2014-01-01

    We describe a case of a man with chronic myeloid leukaemia who achieved remission through dasatinib therapy after being unable to tolerate several tyrosine kinase inhibitor (TKI) regimens due to severe physical side effects. However, this coincided with the onset of distressing agitation, insomnia and motor restlessness leading him to take a large zopiclone overdose. Start of appropriate therapy with a clonazepam, venlafaxine and mirtazapine combination led to a rapid improvement in symptomatology. We discuss the differential diagnosis and review the literature of neuropsychiatric complications of TKIs. This case serves as an illustrative reminder that in cases of complicated agitation referral to specialist mental health teams for rational psychopharmacological management is advised. PMID:25115782

  11. A novel relationship for schizophrenia, bipolar and major depressive disorder Part 7: A hint from chromosome 7 high density association screen.

    PubMed

    Chen, Xing; Long, Feng; Cai, Bin; Chen, Xiaohong; Chen, Gang

    2015-10-15

    Convergent evidence from genetics, symptology and psychopharmacology imply that there are intrinsic connection between schizophrenia (SCZ), bipolar disorder (BPD) and major depressive disorder (MDD). Also, any two or even three of these disorders could co-existe in some families. A total of 47,144 single nucleotide polymorphism (SNPs) on chromosome 7 were genotyped by Affymetrix Genome-Wide Human SNP array 6.0 on 119 SCZ, 253 BPD (type-I), 177 MDD, and 1000 controls. Associated SNP loci were comprehensively revealed and outstanding susceptibility genes were identified including CNTNAP2. a neurexin family gene. Unexpectedly, flanking genes for up to 94.74 % of of the associated SNPs were replicated (P≤9.9 E-8) in an enlarged cohort of 986 SCZ patients. Considering other convergent evidence, our results further implicate that BPD and MDD are subtypes of SCZ. PMID:26192912

  12. ESCAP Expert Paper: New developments in the diagnosis and treatment of adolescent anorexia nervosa--a European perspective.

    PubMed

    Herpertz-Dahlmann, Beate; van Elburg, Annemarie; Castro-Fornieles, Josefina; Schmidt, Ulrike

    2015-10-01

    Anorexia nervosa is a potentially life-threatening disorder with a typical onset in adolescence and high rates of medical complications and psychiatric comorbidity. This article summarizes issues relating to classification in DSM-5 and presents a narrative review of key evidence-based medical and behavioral interventions for adolescent AN and subthreshold restricting eating disorders, mainly, but not exclusively published between 2012 and 2014. In addition, it systematically compares the clinical guidelines of four European countries (Germany, Spain, The Netherlands, and United Kingdom) and outlines common clinical practice, in relation to treatment settings, nutritional rehabilitation, family-oriented and individual psychotherapy, and psychopharmacological treatment. With the exception of family-based treatment, which is mainly evaluated and practiced in Anglo-American countries, the evidence base is weak, especially for medical interventions such as refeeding and pharmacological intervention. There is a need for common European research efforts, to improve the available evidence base and resulting clinical guidance. PMID:26226918

  13. Ketamine as a promising prototype for a new generation of rapid-acting antidepressants

    PubMed Central

    Abdallah, Chadi G.; Averill, Lynnette A.; Krystal, John H.

    2015-01-01

    The discovery of ketamine’s rapid and robust antidepressant effects opened a window into a new generation of antidepressants. Multiple controlled trials and open-label studies have demonstrated these effects across a variety of patient populations known to often achieve little to no response from traditional antidepressants. Ketamine has been generally well tolerated across patient groups, with transient mild to moderate adverse effects during infusion. However, the optimal dosing and route of administration and the safety of chronic treatment is not fully known. This review summarizes the clinical effects of ketamine and its neurobiological underpinnings and mechanisms of action that may provide insight into the neurobiology of depression, relevant biomarkers, and treatment targets. Moreover, we offer suggestions for future research that can continue to advance the field forward and ultimately improve the psychopharmacologic interventions available for those individuals struggling with depressive and trauma-related disorders. PMID:25727103

  14. Skinner boxes for psychotics: Operant conditioning at Metropolitan state hospital

    PubMed Central

    Rutherford, Alexandra

    2003-01-01

    Between 1953 and 1965, Ogden Lindsley and his associates conducted free-operant research with psychiatric inpatients and normal volunteers at Metropolitan State Hospital in Waltham, Massachusetts. Their project, originally named “Studies in Behavior Therapy,” was renamed “Harvard Medical School Behavior Research Laboratory” in 1955. This name change and its implications were significant. The role of the laboratory in the history of the relationship between the experimental analysis of behavior and applied behavior analysis is discussed. A case is made for viewing Lindsley's early work as foundational for the subfield of the experimental analysis of human behavior that formally coalesced in the early 1980s. The laboratory's work is also contextualized with reference to the psychopharmacological revolution of the 1950s. Finally, a four-stage framework for studying the historical and conceptual development of behavior analysis is proposed. PMID:22478407

  15. Clinical practices in the pharmacological treatment of comorbid psychopathology in adolescents with alcohol use disorders.

    PubMed

    Clark, Duncan B; Wood, D Scott; Cornelius, Jack R; Bukstein, Oscar G; Martin, Christopher S

    2003-12-01

    This study examined the use of psychiatric medications in 277 adolescents in treatment for alcohol use disorders. Subjects were recruited from addictions treatment sites, psychiatric programs, and juvenile justice settings. Characteristics studied included the use of and indications for specific medications, changes in clinical practices from 1991 through 2000, and continuation of psychopharmacological treatment over a 1-year followup period. Among adolescents taking psychiatric medications at baseline (n = 51), indicated DSM-IV mental disorders were typically present, use of antidepressants was most common (n = 41), benzodiazepine prescription was rare, and about one third reported continuing pharmacological treatment at one-year followup. In those with comorbid major depressive disorder and alcohol use disorders (n = 110), antidepressant medication use increased significantly from 18% to 55% over the decade studied. The treatment setting did not significantly influence antidepressant prescribing practices. The common and increasing use of psychiatric medications in this population emphasizes the urgent need for empirically based clinical guidelines. PMID:14693259

  16. [Biological psychiatry (neuropsychiatry)--status and perspectives for for the 1990s].

    PubMed

    Rosenberg, R

    1993-01-01

    In recent years, research into biological aspects of psychiatric disorders has had high priority. Biological psychiatry, or neuropsychiatry, is characterised by (a) empiricist epistemology, (b) a diathesis-stress disease model, (c) neurobiological pathogenetic theories, (d) chemical or physical treatment as an essential though not necessarily sufficient measure, and (e) a patient-oriented ethical approach. A short review of some major topics is given, including standardised assessment, clinical and molecular genetics, neurotransmitter theories, neuro-imaging techniques, panic disorder, classic and novel psychopharmacological compounds, and alcohol and drug dependence. Avenues of future research endeavours are delineated, and it is concluded that in the future neuropsychiatry should play a major part in psychiatry, though closely integrated with psychological and social theory. PMID:8098866

  17. Psychotherapy and Pharmacotherapy for Patients with Dissociative Identity Disorder

    PubMed Central

    Gentile, Julie P.; Dillon, Kristy S.

    2013-01-01

    There is a wide variety of what have been called “dissociative disorders,” including dissociative amnesia, dissociative fugue, depersonalization disorder, dissociative identity disorder, and forms of dissociative disorder not otherwise specified. Some of these diagnoses, particularly dissociative identity disorder, are controversial and have been questioned by many clinicians over the years. The disorders may be under-diagnosed or misdiagnosed, but many persons who have experienced trauma report “dissociative” symptoms. Prevalence of dissociative disorders is unknown, but current estimates are higher than previously thought. This paper reviews clinical, phenomenological, and epidemiological data regarding diagnosis in general, and illustrates possible treatment interventions for dissociative identity disorder, with a focus on psychotherapy interventions and a review of current psychopharmacology recommendations as part of a comprehensive multidisciplinary treatment plan. PMID:23556139

  18. [Movement disorders is psychiatric diseases].

    PubMed

    Hidasi, Zoltan; Salacz, Pal; Csibri, Eva

    2014-12-01

    Movement disorders are common in psychiatry. The movement disorder can either be the symptom of a psychiatric disorder, can share a common aetiological factor with it, or can be the consequence of psychopharmacological therapy. Most common features include tic, stereotypy, compulsion, akathisia, dyskinesias, tremor, hypokinesia and disturbances of posture and gait. We discuss characteristics and clinical importance of these features. Movement disorders are frequently present in mood disorders, anxiety disorders, schizophrenia, catatonia, Tourette-disorder and psychogenic movement disorder, leading to differential-diagnostic and therapeutical difficulties in everyday practice. Movement disorders due to psychopharmacotherapy can be classified as early-onset, late-onset and tardive. Frequent psychiatric comorbidity is found in primary movement disorders, such as Parkinson's disease, Wilson's disease, Huntington's disease, diffuse Lewy-body disorder. Complex neuropsychiatric approach is effective concerning overlapping clinical features and spectrums of disorders in terms of movement disorders and psychiatric diseases. PMID:25577484

  19. The liberal state and the rogue agency: FDA’s regulation of drugs for mood disorders, 1950s–1970s☆

    PubMed Central

    Shorter, Edward

    2013-01-01

    The theory of the liberal state does not generally contemplate the possibility that regulatory agencies will turn into “rogues,” regulating against the interests of their clients and, indeed, the public interest. In the years between circa 1955 and 1975 this seems to have happened to one of the prime regulatory agencies of the US federal government: the Food and Drug Administration (FDA). Intent upon transforming itself from a traditional “cop” agency to a regulatory giant, the FDA campaigned systematically to bring down some safe and effective drugs. This article concentrates on hearings in the area of psychopharmacology regarding several antianxiety drugs, namely meprobamate (Miltown), chlordiazepoxide (Librium) and diazepam (Valium). In addition, from 1967 to 1973 this regulatory vengefulness occurred on a broad scale in the Drug Efficacy Study Implementation (DESI), an administrative exercise that removed from the market almost half of the psychopharmacopoeia. The article explores possible bureaucratic motives for these actions. PMID:18343498

  20. Factor structure and differential validity of the expanded Brief Psychiatric Rating Scale.

    PubMed

    Thomas, Adrian; Donnell, Alison J; Young, Tony R

    2004-06-01

    The Brief Psychiatric Rating Scale (BPRS) is one of the most widely used measures in psychiatric outcome and clinical psychopharmacology research. To date, however; research on the psychometric properties of the expanded version of the BPRS (BPRS-E) has been limited. An exploratory factor analysis (n = 360) using maximum likelihood extraction with oblimin rotation found a four-factor solution (Thought Disturbance, Animation, Mood Disturbance, Apathy) to underlie the BPRS-E. Furthermore, these factors were logical in nature and estimates of internal consistency were acceptable. A confirmatory factor analysis conducted on a second, independent sample (n = 280)found that for the five models currently available in the literature, the model developed herein provided the best fit to the data. Again, estimates of internal consistency were found acceptable. Finally, the four factors demonstrated appropriate differential validity with regards to both demographic variables and various psychiatric diagnoses. PMID:15171466

  1. Antinociceptive Activity of the Chloroform Fraction of Dioclea virgata (Rich.) Amshoff (Fabaceae) in Mice

    PubMed Central

    Mota, Vanine Gomes; de Carvalho, Fabíola Lélis; de Morais, Liana Clébia Soares Lima; Bhattacharyya, Jnanabrata; de Almeida, Reinaldo Nóbrega; de Alencar, Jacicarlos Lima

    2011-01-01

    Acute treatment with the chloroform fraction of Dioclea virgata (Rich.) Amshoff (CFDv) in mice produced decreased ambulation and sedation in the behavioral pharmacological screening. Doses of 125 and 250 mg/kg CFDv decreased latency of sleep onset in the test of sleeping time potentiation. In the open field, animals treated with CFDv reduced ambulation and rearing (250 mg/kg), as well as defecation (125; 250 mg/kg). Regarding the antinociceptive activity, CFDv (125, 250, 500 mg/kg) increased latency to first writhing and decreased the number of writhings induced by acetic acid. In the formalin test, CFDv (250 mg/kg) decreased paw licking time in the first and second phases indicating antinociceptive activity that can be mediated both peripherally and at the central level. CFDv did not affect motor coordination until 120 minutes after treatment. CFDv shows psychopharmacological effects suggestive of CNS-depressant drugs with promising antinociceptive activity. PMID:21776190

  2. A view from Riggs: treatment resistance and patient authority-IX. Integrative psychodynamic treatment of psychotic disorders.

    PubMed

    Tillman, Jane G

    2008-01-01

    Psychotic spectrum disorders present treatment challenges for patients, families, and clinicians. This article addresses the history of the dualism in the field between biological and psychological approaches to mental disorders, and surveys the contemporary literature about the etiology and treatment of psychotic spectrum disorders. An integrative approach to treatment derived from work at Austen Riggs with previously treatment refractory patients with psychotic spectrum disorders is described that combines individual psycho- dynamic psychotherapy, psychopharmacology, family systems approaches, and intensive psychosocial engagement. Helping patients develop their own authority to join the treatment, use relationships for learning, and understand the meaning of their symptoms is central to the treatment at Austen Riggs. An extended case vignette of a patient diagnosed with a schizoaffective disorder is presented illustrating this integrative psychodynamic treatment approach. PMID:19113964

  3. [Clinical management and rehabilitation of the treatment refractory patient: conceptual foundations and outcome data].

    PubMed

    Silverstein, Steven M; Hatashita-Wong, Michi; Wilkniss, Sandra; Lapasset, Jerôme; Bloch, Andrew; McCarthy, Richard

    2004-01-01

    Despite advances in psychopharmacology for people with schizophrenia, many patients remain too disabled to be discharged from public psychiatric facilities. This paper describes the development of a public-private partnership which led to the creation of a specialized, intensive behavioral rehabilitation program for schizophrenia patients who were considered to be treatment-refractory at public hospitals. The essential elements of this treatment program are described, along with the philosophical bases of its treatment. Outcome data are discussed to emphasize the point that when evidence-based treatment is implemented with this population, outcomes can be positive in most cases, and therefore, the number of "treatment-refractory" patients is actually less than is estimated based on response to medication alone. PMID:15928786

  4. A crash course in Chinese herbology for the psychopharmocological prescriber.

    PubMed

    White, Kathryn P

    2009-12-01

    Given the unparalleled popularity of botanicals in the United States, it is safe to say that almost every psychopharmacological prescriber will see some patients using Chinese herbs. Data show that between 36% and 42% of Americans use complementary and alternative medicine (CAM) each year and that persons suffering from depression and anxiety (67%) use CAM services significantly more than do their nonanxious and nondepressed counterparts (39%). This article gives an overview of several classical Chinese medical single herbs and herbal formulas commonly used for persons with psychiatric disorders and discusses some of the herbs that have the potential to interact with various pharmaceutical drugs. In addition, the article reviews scientific evidence and, at times, the lack thereof to validate the use of Chinese herbs and formulas in treating psychiatric conditions. Overall, the article seeks to prepare the pharmacological prescriber for working with patients concomitantly taking psychiatric medications and Chinese herbs. PMID:19968403

  5. Update on schizophrenia and bipolar disorder: focus on cariprazine

    PubMed Central

    Roberts, Rona Jeannie; Findlay, Lillian Jan; El-Mallakh, Peggy L; El-Mallakh, Rif S

    2016-01-01

    Schizophrenia and bipolar disorder are severe psychiatric disorders that are frequently associated with persistent symptoms and significant dysfunction. While there are a multitude of psychopharmacologic agents are available for treatment of these illnesses, suboptimal response and significant adverse consequences limit their utility. Cariprazine is a new, novel antipsychotic medication with dopamine D2 and D3 partial agonist effects. Its safety and efficacy have been investigated in acute psychosis of schizophrenia, bipolar mania, bipolar depression, and unipolar depression. Efficacy has been demonstrated in schizophrenia and mania. It is unclear if cariprazine is effective in depression associated with unipolar or bipolar illness. Adverse consequences include extrapyramidal symptoms including akathisia, and various gastrointestinal symptoms. The US Food and Drug Administration (FDA) has recently approved cariprazine. This review will provide clinicians with basic information regarding the research program of cariprazine. PMID:27524901

  6. [Anhedonia in depression].

    PubMed

    Gaillard, R; Gourion, D; Llorca, P M

    2013-09-01

    Anhedonia, or markedly diminished interest or pleasure, is a hallmark symptom of major depression, schizophrenia, and other neuropsychiatric disorders. The term "anhedonia" was introduced by the French psychologist Ribot in 1896 to describe the counterpart to analgesia in his patients, for which "it was impossible to find the least pleasure". Over the last decades, the clinical definition of anhedonia has remained relatively unchanged, but recently, behavioral neurosciences have significantly changed our knowledge of reward-related processes. Now, the construct of anhedonia reflects deficits in hedonic capacity, and is closely linked to the processes of reward valuation, decision-making, anticipation, and motivation. The neural circuits underlying these reward-related mechanisms include essentially the ventral striatum and prefrontal cortical regions. Here, we review the clinical concepts, neural bases and psychopharmacological data related to the deficits of hedonia in depression. Understanding anhedonia will facilitate diagnosis and treatment management. PMID:23937895

  7. A review of behavioral tailoring strategies for improving medication adherence in serious mental illness.

    PubMed

    Kreyenbuhl, Julie; Record, Elizabeth J; Palmer-Bacon, Jessica

    2016-06-01

    Nonadherence to psychopharmacological treatments poses a significant challenge to treatment success in individuals with serious mental illness, with upwards of 60% of people not taking their psychiatric medications as prescribed. Nonadherence is associated with adverse outcomes, including exacerbation of psychiatric symptoms, impaired functioning, increased hospitalizations and emergency room use, and increased health care costs. Whereas interventions using psychoeducation or cognitive approaches, such as motivational interviewing, have largely proven ineffective in improving adherence, approaches employing behavioral tailoring that incorporate medication taking into the daily routine and/or use environmental supports have shown promise. Recently, adherence-enhancing behavioral tailoring interventions that utilize novel technologies, such as electronic monitors and mobile phones, have been developed. Although interventions utilizing these platforms have the potential for widespread dissemination to a broad range of individuals, most require further empirical testing. This paper reviews selected behavioral tailoring strategies that aim to improve medication adherence and other functional outcomes among individuals with serious mental illness. PMID:27489459

  8. The Drugs-Violence Nexus among Rural Felony Probationers*

    PubMed Central

    Palmer, Jennifer Mooney; Tindall, Michele Staton; Leukefeld, Carl G.

    2009-01-01

    Little research has focused on the drugs-violence nexus in rural areas. As such, the purpose of this study was to use Goldstein’s (1985) tripartite conceptual framework to examine the relationship between drugs and violence among felony probationers in rural Appalachian Kentucky (n=800). Data on demographics, substance use, criminal history, and violence were collected between 2001 and 2004 using an interviewer-administered questionnaire. Rural probationers were partitioned into four groups based on lifetime violent victimization/perpetration experiences: (1) neither a perpetrator nor a victim, (2) perpetrator only, (3) victim only, and (4) both a perpetrator and a victim. Chi-square analyses indicated substance use and criminal history varied across the four groups. Binary logistic regression analyses were used to explore the significant correlates of both perpetration and victimization. Multivariate analyses supported both the psychopharmacological model and the economic compulsive models of perpetration and victimization. Further implications of these findings are discussed. PMID:18719220

  9. ["On bitter and sweet"--women and chocolate].

    PubMed

    Rabinerson, David; Melamed, Nir

    2009-08-01

    Chocolate has been known in the Western World since being introduced to Europe in the 16th century by the Spanish Conquistadors who brought it from Mexico. From the beginning, chocolate had an immense power of appeal to people, Leading to craving and addiction especially among women. This appeal lies in its content, texture and aroma, as well as the presence of ingredients that are believed to have psycho-pharmacologic influence. This issue, combined with hormonal changes during the menstrual cycle, is discussed in an attempt to understand women's attraction to chocolate. Despite all existing theories on chocolate having a particular appeal to women, there is no explanation that comprehensively elaborates this well-known phenomenon. PMID:19899259

  10. Challenges and Limitations to Treating ADHD in Incarcerated Populations.

    PubMed

    Hall, Ryan C W; Myers, Wade C

    2016-06-01

    An often underappreciated and hard-to-treat condition in correctional institutions is attention-deficit/hyperactivity disorder (ADHD). Although there are many effective psychopharmacologic treatments for ADHD, such as various formulations of amphetamines, many physicians are hesitant to prescribe controlled stimulants in correctional settings because of concerns about abuse and safety. Although nonstimulant alternatives are available, they are generally seen as less effective than stimulants. However, there are many unique factors regarding corrections populations and their responses to treatment, which makes it difficult to know what the ideal treatment regimen would be for this population. We review the standard treatments for ADHD, for prescribing in correctional institutions, barriers to using medications for off-label treatment of ADHD, and suggest future research that could better guide correctional treatment staff on how to approach patients with ADHD. PMID:27236170

  11. Body dysmorphic disorder and life-style drugs. Overview and case report with finasteride.

    PubMed

    Harth, W; Linse, R

    2001-07-01

    The body dysmorphic disorder is the repeated preoccupation with a minimal or non-evident defect and includes a wide spectrum of imagined defects in appearance. These patients present themselves in every clinical practice and are extraordinarily difficult to treat. The focus of the preoccupation concerns head, face, chest and the genital area. Following the introduction of the new "life-style" drug, finasteride, we observed a dramatic increase in the number of patients suffering from body dysmorphic disorder attending our clinic for skin diseases in Erfurt. These patients frequently contact their doctor demanding specifically for prescription of a particular life-style drug. However, there is no indication for using life-style drugs for the treatment of a body dysmorphic disorder. The appropriate treatment includes psychotherapy and psychopharmacological treatment. PMID:11471771

  12. Attention deficit disorder during adolescence: a review.

    PubMed

    Faigel, H C; Sznajderman, S; Tishby, O; Turel, M; Pinus, U

    1995-03-01

    Attention deficit disorder (ADD) in adolescents has received scant attention when compared with that given to children. With or without hyperactivity, ADD does not disappear at puberty and is an important factor in scholastic and social failure in adolescents. As a condition associated with decreased metabolism in the premotor and prefrontal superior cerebral cortex, ADD in adolescents responds well to treatment with stimulants, tricyclic antidepressants and monoamine oxidase inhibitors. Nonpharmacologic modalities such as behavior modification, individual and family therapy, and cognitive therapy are useful adjuncts to psychopharmacologic management. Without effective treatment, ADD often results in increased risk of trauma, substance abuse and conduct and affective disorders during adolescence, and marital disharmony, family dysfunction, divorce, and incarceration in adulthood. Properly treated with medication and counseling, adolescents with ADD succeed as well as their peers. PMID:7779826

  13. AACAP Official Action. Summary of the practice parameters for the assessment and treatment of children, adolescents, and adults with ADHD.

    PubMed

    Dulcan, M K; Benson, R S

    1997-09-01

    This summary of the practice parameters describes the assessment, differential diagnosis, and treatment of children, adolescents, and adults who present with symptoms of attention-deficit/hyperactivity disorder. The rationales for specific recommendations are based on a review of the scientific literature and clinical consensus which is contained in the complete document. Assessment includes clinical interviews with the child and parents and standardized rating scales from parent and teachers. Testing of intelligence and academic achievement is usually required. Comorbidity is common. The cornerstones of treatment are support and education of parents, appropriate school placement, and psychopharmacology. The primary medications are psychostimulants, but antidepressants and alpha-adrenergic agonists are used in special circumstances. Other treatments such as behavior modification, school consultation, family therapy, and group therapy address remaining symptoms. PMID:9291734

  14. [Herbal remedies in depression--state of the art].

    PubMed

    Szafrański, Tomasz

    2014-01-01

    Recent decades have seen development of research and an increased interest in the psychopharmacology of natural remedies. More than 20 herbal remedies have been identified that may potentially be applied in medicine as antidepressive, anxiety relieving or sleep-inducing agents. Patients often prefer to take herbal remedies and often take them on their own, without consulting a physician. The aim of the study is to present the state of the art concerning the use of natural remedies in the treatment of depression. Following a literature review, 7 herbal remedies for which preclinical and clinical trials suggest their antidepressive influence have been identified: hypericum, lavender, borage, roseroot, chamomile, saffron and ginseng. For two of these, i.e. hypericum and saffron extracts, antidepressive effect in subjects with mild or moderate depression has been confirmed in controlled randomized clinical trials. PMID:24946435

  15. Psychotropic drug prescribing in child and adolescent learning disability psychiatry.

    PubMed

    Bramble, David

    2007-07-01

    This postal questionnaire study investigated the prescribing practices of a group of senior British psychiatrists who have responsibilities for children and adolescents with learning disabilities (mental retardation). The study revealed that all of the clinicians surveyed (n = 16) were prescribing psychotropic medication; psychostimulants and major tranquillizers represented the most frequently prescribed classes and, respectively, methylphenidate, risperidone, melatonin, sodium valproate and carbamazepine were the most frequently employed specific agents. Most patients were receiving monotherapy. Many (14/16) clinicians reported difficulties in shared-care prescribing arrangements with General Practitioners. The study concludes that psychopharmacology is an established part of the psychiatric management of learning disabled children but acknowledges the need for the elaboration of clinical governance standards to this area of practice. PMID:17446203

  16. Exogenous cortisol causes a shift from deliberative to intuitive thinking.

    PubMed

    Margittai, Zsofia; Nave, Gideon; Strombach, Tina; van Wingerden, Marijn; Schwabe, Lars; Kalenscher, Tobias

    2016-02-01

    People often rely on intuitive judgments at the expense of deliberate reasoning, but what determines the dominance of intuition over deliberation is not well understood. Here, we employed a psychopharmacological approach to unravel the role of two major endocrine stress mediators, cortisol and noradrenaline, in cognitive reasoning. Healthy participants received placebo, cortisol (hydrocortisone) and/or yohimbine, a drug that increases noradrenergic stimulation, before performing the cognitive reflection test (CRT). We found that cortisol impaired performance in the CRT by biasing responses toward intuitive, but incorrect answers. Elevated stimulation of the noradrenergic system, however, had no effect. We interpret our results in the context of the dual systems theory of judgment and decision making. We propose that cortisol causes a shift from deliberate, reflective cognition toward automatic, reflexive information processing. PMID:26658173

  17. Skinner boxes for psychotics: operant conditioning at Metropolitan State Hospital.

    PubMed

    Rutherford, Alexandra

    2003-01-01

    Between 1953 and 1965, Ogden Lindsley and his associates conducted free-operant research with psychiatric inpatients and normal volunteers at Metropolitan State Hospital in Waltham, Massachusetts. Their project, originally named "Studies in Behavior Therapy," was renamed "Harvard Medical School Behavior Research Laboratory" in 1955. This name change and its implications were significant. The role of the laboratory in the history of the relationship between the experimental analysis of behavior and applied behavior analysis is discussed. A case is made for viewing Lindsley's early work as foundational for the subfield of the experimental analysis of human behavior that formally coalesced in the early 1980s. The laboratory's work is also contextualized with reference to the psychopharmacological revolution of the 1950s. Finally, a four-stage framework for studying the historical and conceptual development of behavior analysis is proposed. PMID:22478407

  18. Chronic Physical Illness: A Psychophysiological Approach for Chronic Physical Illness

    PubMed Central

    Purdy, Jana

    2013-01-01

    Growing evidence demonstrates that psychological risk variables can contribute to physical disease. In an effort to thoroughly investigate potential etiological origins and optimal interventions, this broad review is divided into five sections: the stress response, chronic diseases, mind-body theoretical models, psychophysiological interventions, and integrated health care solutions. The stress response and its correlation to chronic disorders such as cardiovascular, gastrointestinal, autoimmune, metabolic syndrome, and chronic pain are comprehensively explored. Current mind-body theoretical models, including peripheral nerve pathway, neurophysiological, and integrative theories, are reviewed to elucidate the biological mechanisms behind psychophysiological interventions. Specific interventions included are psychotherapy, mindfulness meditation, yoga, and psychopharmacology. Finally, the author advocates for an integrated care approach as a means by which to blur the sharp distinction between physical and psychological health. Integrated care approaches can utilize psychiatric nurse practitioners for behavioral assessment, intervention, research, advocacy, consultation, and education to optimize health outcomes. PMID:23483831

  19. Clinical recommendations in current practice guidelines for diagnosis and treatment of ADHD in adults.

    PubMed

    Gibbins, Christopher; Weiss, Margaret

    2007-10-01

    Attention-deficit/hyperactivity disorder (ADHD) is a lifelong neurodevelopmental disorder in which approximately two thirds of patients experience impairment in adulthood. Although some adults with ADHD were diagnosed as children, many are first diagnosed as adults. This poses particular challenges given the limited familiarity with ADHD of many adult mental health services. As a result, several organizations, including the Canadian ADHD Resource Alliance, the American Academy of Child and Adolescent Psychiatry, the National Institutes of Health, and the British Association for Psychopharmacology, have developed practice guidelines for the assessment and treatment of adults with ADHD. This article reviews those guidelines in order to examine current best practices in adult ADHD. There is considerable agreement among these guidelines, which should be a critical part of moving from emerging knowledge to patient care, although both empirical evaluation and ongoing updates as new knowledge emerges will be important for their future development. PMID:17915083

  20. Practice parameter on disaster preparedness.

    PubMed

    Pfefferbaum, Betty; Shaw, Jon A

    2013-11-01

    This Practice Parameter identifies best approaches to the assessment and management of children and adolescents across all phases of a disaster. Delivered within a disaster system of care, many interventions are appropriate for implementation in the weeks and months after a disaster. These include psychological first aid, family outreach, psychoeducation, social support, screening, and anxiety reduction techniques. The clinician should assess and monitor risk and protective factors across all phases of a disaster. Schools are a natural site for conducting assessments and delivering services to children. Multimodal approaches using social support, psychoeducation, and cognitive behavioral techniques have the strongest evidence base. Psychopharmacologic interventions are not generally used but may be necessary as an adjunct to other interventions for children with severe reactions or coexisting psychiatric conditions. PMID:24157398

  1. Main clinical features in patients at their first psychiatric admission to Italian acute hospital psychiatric wards. The PERSEO study

    PubMed Central

    Ballerini, Andrea; Boccalon, Roberto M; Boncompagni, Giancarlo; Casacchia, Massimo; Margari, Francesco; Minervini, Lina; Righi, Roberto; Russo, Federico; Salteri, Andrea; Frediani, Sonia; Rossi, Andrea; Scatigna, Marco

    2007-01-01

    Background Few data are available on subjects presenting to acute wards for the first time with psychotic symptoms. The aims of this paper are (i) to describe the epidemiological and clinical characteristics of patients at their first psychiatric admission (FPA), including socio-demographic features, risk factors, life habits, modalities of onset, psychiatric diagnoses and treatments before admission; (ii) to assess the aggressive behavior and the clinical management of FPA patients in Italian acute hospital psychiatric wards, called SPDCs (Servizio Psichiatrico Diagnosi e Cura = psychiatric service for diagnosis and management). Method Cross-sectional observational multi-center study involving 62 Italian SPDCs (PERSEO – Psychiatric EmeRgency Study and EpidemiOlogy). Results 253 FPA aged <= 40 were identified among 2521 patients admitted to Italian SPDCs over the 5-month study period. About half of FPA patients showed an aggressive behavior as defined by a Modified Overt Aggression Scale (MOAS) score greater than 0 Vs 46% of non-FPA patients (p = 0.3651). The most common was verbal aggression, while about 20% of FPA patients actually engaged in physical aggression against other people. 74% of FPA patients had no diagnosis at admission, while 40% had received a previous psychopharmacological treatment, mainly benzodiazepines and antidepressants. During SPDC stay, diagnosis was established in 96% of FPA patients and a pharmacological therapy was prescribed to 95% of them, mainly benzodiazepines, antipsychotics and mood stabilizers. Conclusion Subjects presenting at their first psychiatric ward admission have often not undergone previous adequate psychiatric assessment and diagnostic procedures. The first hospital admission allows diagnosis and psychopharmacological treatment to be established. In our population, aggressive behaviors were rather frequent, although most commonly verbal. Psychiatric symptoms, as evaluated by psychiatrists and patients, improved

  2. An influence of delayed reinforcement on the effectiveness of psychostimulants to enhance indices of attention under a five-choice serial reaction time procedure in male rats.

    PubMed

    Slezak, Jonathan M; Katz, Jonathan L

    2013-10-01

    The five-choice serial reaction time (5-CSRT) procedure has been considered a translational tool for assessments of the psychopharmacology of attention in preclinical research. Because greater sensitivity to delayed reinforcement may promote the development of attention-deficit/hyperactivity disorder (ADHD) symptoms, effects of reinforcer delay and psychostimulants on performances under a 5-CSRT procedure were determined. Male rats were trained to respond under a 5-CSRT procedure with different delay-of-reinforcement conditions (0, 2, 4, 8, 16 s), and effects of d-amphetamine, methylphenidate, and morphine (as a negative control) were assessed at 0- and 16-s delays. Under nondrug conditions, as the delay increased both response latency and the number of trials in which a response did not occur (omissions) increased, and the percent correct on trials when responses were emitted decreased. Only modest increases in the percent correct were found with psychostimulants during the 0-s delay condition; however, more substantial enhancements were found with a 16-s delay. Consistent effects of both psychostimulants at either delay on omissions and response latency were not observed. Morphine increased omissions and response latency at both delays and decreased the percent correct (16-s delay). Generally, responses during the intertrial interval were not systematically affected under any condition. The current results demonstrate that measures of attention in a 5-CSRT procedure are sensitive to changes in the delay to reinforcer delivery. More important, psychostimulants significantly enhanced a measure of attention only when reinforcers were delayed, which may be reflective of the psychopharmacological mechanisms involved with clinical treatment of ADHD symptoms. PMID:24099356

  3. Attention-Deficit Hyperactivity Disorder Symptoms in Children and Adolescents with Sex Chromosome Aneuploidy: XXY, XXX, XYY, and XXYY

    PubMed Central

    Tartaglia, Nicole R.; Ayari, Natalie; Hutaff-Lee, Christa; Boada, Richard

    2012-01-01

    Objective Attentional problems, hyperactivity, and impulsivity have been described as behavioral features associated with sex chromosome aneuploidy (SCA). In this study, the authors compare attention-deficit hyperactivity disorder (ADHD) symptoms in 167 participants aged 6 to 20 years with 4 types of SCA (XXY n = 56, XYY n = 33, XXX n = 25, and XXYY n = 53). They also evaluate factors associated with ADHD symptomatology (cognitive and adaptive scores, prenatal vs postnatal ascertainment) and describe the clinical response to psychopharmacologic medications in a subset of patients treated for ADHD. Methods Evaluation included medical and developmental history, cognitive and adaptive functioning assessment, and parent and teacher ADHD questionnaires containing DSM-IV criteria. Results In the total study group, 58% (96/167) met DSM-IV criteria for ADHD on parent-report questionnaires (36% in XXY, 52% in XXX, 76% in XYY, and 72% in XXYY). The Inattentive subtype was most common in XXY and XXX, whereas the XYY and XXYY groups were more likely to also have hyperactive/impulsive symptoms. There were no significant differences in Verbal, Performance, or Full Scale IQ between children with symptom scores in the ADHD range compared with those below the ADHD range. However, adaptive functioning scores were significantly lower in the group whose scores in the ADHD range were compared with those of the group who did not meet ADHD DSMIV criteria. Those with a prenatal diagnosis of XXY were less likely to meet criteria for ADHD compared with the postnatally diagnosed group. Psychopharmacologic treatment with stimulants was effective in 78.6% (66/84). Conclusions Children and adolescents with SCA are at increased risk for ADHD symptoms. Recommendations for ADHD evaluation and treatment in consideration of other aspects of the SCA medical and behavioral phenotype are provided. PMID:22333574

  4. Ketamine Suppresses the Ventral Striatal Response to Reward Anticipation: A Cross-Species Translational Neuroimaging Study.

    PubMed

    Francois, Jennifer; Grimm, Oliver; Schwarz, Adam J; Schweiger, Janina; Haller, Leila; Risterucci, Celine; Böhringer, Andreas; Zang, Zhenxiang; Tost, Heike; Gilmour, Gary; Meyer-Lindenberg, Andreas

    2016-04-01

    Convergent evidence implicates regional neural responses to reward anticipation in the pathogenesis of several psychiatric disorders, such as schizophrenia, where blunted ventral striatal responses to positive reward are observed in patients and at-risk populations. In vivo oxygen amperometry measurements in the ventral striatum in awake, behaving rats reveal reward-related tissue oxygen changes that closely parallel blood oxygen level dependent (BOLD) signal changes observed in human functional magnetic resonance imaging (fMRI), suggesting that a cross-species approach targeting this mechanism might be feasible in psychopharmacology. The present study explored modulatory effects of acute, subanaesthetic doses of ketamine-a pharmacological model widely used in psychopharmacological research, both preclinically and clinically-on ventral striatum activity during performance of a reward anticipation task in both species, using fMRI in humans and in vivo oxygen amperometry in rats. In a region-of-interest analysis conducted following a cross-over placebo and ketamine study in human subjects, an attenuated ventral striatal response during reward anticipation was observed following ketamine relative to placebo during performance of a monetary incentive delay task. In rats, a comparable attenuation of ventral striatal signal was found after ketamine challenge, relative to vehicle, in response to a conditioned stimulus that predicted delivery of reward. This study provides the first data in both species demonstrating an attenuating effect of acute ketamine on reward-related ventral striatal (O2) and fMRI signals. These findings may help elucidate a deeper mechanistic understanding of the potential role of ketamine as a model for psychosis, show that cross-species pharmacological experiments targeting reward signaling are feasible, and suggest this phenotype as a promising translational biomarker for the development of novel compounds, assessment of disease status, and

  5. The effect of retrograde and anterograde glucose administration on memory performance in healthy young adults.

    PubMed

    Sünram-Lea, Sandra I; Foster, Jonathan K; Durlach, Paula; Perez, Catalina

    2002-08-21

    Memory for a list of 20 words can be enhanced by preceding learning by consumption of 25 g of glucose, compared with consumption of an equally sweet aspartame solution (Psychopharmacology 137 (1998) 259; Psychopharmacology 157 (2001) 46). However, using this anterograde administration procedure, it is impossible to separate whether glucose affects encoding, consolidation, or retrieval. The present placebo-controlled, double-blind study investigated the effect of anterograde and retrograde administration on memory performance in healthy young participants. In order to evaluate whether post-acquisition administration of glucose can improve memory performance and to compare possible differences in the size of the effect, participants were administered 25 g of glucose immediately before or immediately after presentation of a word list. Moreover, in order to investigate whether the effect of glucose administration on memory performance is time-dependent, a third group received 25 g of glucose 15 min before learning the word list. Word- list recall was tested 30 min and 24 h after word list presentation. Measures of spatial memory performance and working memory were also evaluated. The results of this study showed that both pre- and post-acquisition oral glucose administration (25 g) can improve memory performance. However, as the time interval between anterograde glucose administration and memory encoding increased, the glucose memory facilitation effect decreased. This study provides evidence that glucose enhances memory performance in healthy young people even when it is given after learning has taken place, and that this effect is observed at least up to 24 h after glucose administration. Moreover, it provides evidence that the effect of glucose on memory performance may be time-dependent, as the enhancement of retention was decreased when the administration-learning interval was increased. PMID:12191837

  6. Local and Global Resting State Activity in the Noradrenergic and Dopaminergic Pathway Modulated by Reboxetine and Amisulpride in Healthy Subjects

    PubMed Central

    Wiegers, Maike; Walter, Martin; Abler, Birgit; Graf, Heiko

    2016-01-01

    Background: Various psychiatric populations are currently investigated with resting state fMRI, with the aim of individualizing diagnostics and treatment options and improving treatment outcomes. Many of these studies are conducted in large naturalistic samples, providing rich insights regarding disease-related neural alterations, but with the common psychopharmacological medication limiting interpretations of the results. We therefore investigated the effects of common noradrenergic and anti-dopaminergic medications on local and global resting state activity (rs-activity) in healthy volunteers to further the understanding of the respective effects independent from disease-related alterations. Methods: Within a randomized, double-blind, placebo-controlled crossover design, we investigated 19 healthy male subjects by resting state fMRI after the intake of reboxetine (4mg/d), amisulpride (200mg/d), and placebo for 7 days each. Treatment-related differences in local and global rs-activity were measured by the fractional amplitude of low frequency fluctuations (fALFF) and resting state functional connectivity (rs-FC). Results: fALFF revealed alterations of local rs-activity within regions of the core noradrenergic pathway, including the locus coeruleus under reboxetine, correlated with its plasma levels. Moreover, reboxetine led to increased rs-FC between regions within this pathway, i.e. the locus coeruleus, tectum, thalamus, and amygdala. Amisulpride modulated local rs-activity of regions within the dopaminergic pathway, with the altered signal in the putamen correlating with amisulpride plasma levels. Correspondingly, amisulpride increased rs-FC between regions of the dopaminergic pathway comprising the substantia nigra and putamen. Conclusion: Our data provide evidence of how psychopharmacological agents alter local and global rs-activity within the respective neuroanatomical pathways in healthy subjects, which may help with interpreting data in psychiatric

  7. Empirical estimation of consistency parameter in intertemporal choice based on Tsallis’ statistics

    NASA Astrophysics Data System (ADS)

    Takahashi, Taiki; Oono, Hidemi; Radford, Mark H. B.

    2007-07-01

    Impulsivity and inconsistency in intertemporal choice have been attracting attention in econophysics and neuroeconomics. Although loss of self-control by substance abusers is strongly related to their inconsistency in intertemporal choice, researchers in neuroeconomics and psychopharmacology have usually studied impulsivity in intertemporal choice using a discount rate (e.g. hyperbolic k), with little effort being expended on parameterizing subject's inconsistency in intertemporal choice. Recent studies using Tsallis’ statistics-based econophysics have found a discount function (i.e. q-exponential discount function), which may continuously parameterize a subject's consistency in intertemporal choice. In order to examine the usefulness of the consistency parameter (0⩽q⩽1) in the q-exponential discounting function in behavioral studies, we experimentally estimated the consistency parameter q in Tsallis’ statistics-based discounting function by assessing the points of subjective equality (indifference points) at seven delays (1 week-25 years) in humans (N=24). We observed that most (N=19) subjects’ intertemporal choice was completely inconsistent ( q=0, i.e. hyperbolic discounting), the mean consistency (0⩽q⩽1) was smaller than 0.5, and only one subject had a completely consistent intertemporal choice ( q=1, i.e. exponential discounting). There was no significant correlation between impulsivity and inconsistency parameters. Our results indicate that individual differences in consistency in intertemporal choice can be parameterized by introducing a q-exponential discount function and most people discount delayed rewards hyperbolically, rather than exponentially (i.e. mean q is smaller than 0.5). Further, impulsivity and inconsistency in intertemporal choice can be considered as separate behavioral tendencies. The usefulness of the consistency parameter q in psychopharmacological studies of addictive behavior was demonstrated in the present study.

  8. Novel Primate Model of Serotonin Transporter Genetic Polymorphisms Associated with Gene Expression, Anxiety and Sensitivity to Antidepressants.

    PubMed

    Santangelo, Andrea M; Ito, Mitsuteru; Shiba, Yoshiro; Clarke, Hannah F; Schut, Evelien Hs; Cockcroft, Gemma; Ferguson-Smith, Anne C; Roberts, Angela C

    2016-08-01

    Genetic polymorphisms in the repeat upstream region of the serotonin transporter gene (SLC6A4) are associated with individual differences in stress reactivity, vulnerability to affective disorders, and response to pharmacotherapy. However, the molecular, neurodevelopmental and psychopharmacological mechanisms underlying the link between SLC6A4 polymorphisms and the emotionally vulnerable phenotype are not fully understood. Thus, using the marmoset monkey Callithrix jacchus we characterize here a new neurobiological model to help to address these questions. We first sequenced the marmoset SLC6A4 promoter and identified a double nucleotide polymorphism (-2053AC/CT) and two single-nucleotide polymorphisms (-2022C/T and -1592G/C) within the repeat upstream region. We showed their association with gene expression using in vivo quantitative PCR and with affective behavior using a primate test of anxiety (human intruder test). The low-expressing haplotype (AC/C/G) was linked with high anxiety while the high-expressing one (CT/T/C) was associated with an active coping strategy in response to threat. Pharmacological challenge with an acute dose of the selective serotonin reuptake inhibitor, citalopram, revealed a genotype-dependent behavioral response. While individuals homozygous for the high anxiety-related haplotype AC/C/G exhibited a dose-dependent, anxiogenic response, individuals homozygous for the low anxiety-related haplotype CT/T/C showed an opposing, dose-dependent anxiolytic effect. These findings provide a novel genetic and behavioral primate model to study the molecular, neurodevelopmental, and psychopharmacological mechanisms that underlie genetic variation-associated complex behaviors, with specific implications for the understanding of normal and abnormal serotonin actions and the development of personalized pharmacological treatments for psychiatric disorders. PMID:26997299

  9. Novel Primate Model of Serotonin Transporter Genetic Polymorphisms Associated with Gene Expression, Anxiety and Sensitivity to Antidepressants

    PubMed Central

    Santangelo, Andrea M; Ito, Mitsuteru; Shiba, Yoshiro; Clarke, Hannah F; Schut, Evelien HS; Cockcroft, Gemma; Ferguson-Smith, Anne C; Roberts, Angela C

    2016-01-01

    Genetic polymorphisms in the repeat upstream region of the serotonin transporter gene (SLC6A4) are associated with individual differences in stress reactivity, vulnerability to affective disorders, and response to pharmacotherapy. However, the molecular, neurodevelopmental and psychopharmacological mechanisms underlying the link between SLC6A4 polymorphisms and the emotionally vulnerable phenotype are not fully understood. Thus, using the marmoset monkey Callithrix jacchus we characterize here a new neurobiological model to help to address these questions. We first sequenced the marmoset SLC6A4 promoter and identified a double nucleotide polymorphism (−2053AC/CT) and two single-nucleotide polymorphisms (−2022C/T and −1592G/C) within the repeat upstream region. We showed their association with gene expression using in vivo quantitative PCR and with affective behavior using a primate test of anxiety (human intruder test). The low-expressing haplotype (AC/C/G) was linked with high anxiety while the high-expressing one (CT/T/C) was associated with an active coping strategy in response to threat. Pharmacological challenge with an acute dose of the selective serotonin reuptake inhibitor, citalopram, revealed a genotype-dependent behavioral response. While individuals homozygous for the high anxiety-related haplotype AC/C/G exhibited a dose-dependent, anxiogenic response, individuals homozygous for the low anxiety-related haplotype CT/T/C showed an opposing, dose-dependent anxiolytic effect. These findings provide a novel genetic and behavioral primate model to study the molecular, neurodevelopmental, and psychopharmacological mechanisms that underlie genetic variation-associated complex behaviors, with specific implications for the understanding of normal and abnormal serotonin actions and the development of personalized pharmacological treatments for psychiatric disorders. PMID:26997299

  10. State of the art of the neurotrophin hypothesis in psychiatric disorders: implications and limitations.

    PubMed

    Lang, U E; Jockers-Scherübl, M C; Hellweg, R

    2004-03-01

    The neurotrophin hypothesis proposes that repetitive neuronal activity enhances the expression, secretion and actions of neurotrophins to modify synaptic transmission and connectivity thereby providing a connection between neuronal activity and synaptic plasticity. Moreover, there is ample evidence that neurotrophins have numerous neuroprotective effects under pathological conditions, which might be important in particular for neurodegenerative diseases such as Alzheimer' disease. Current research postulates that effects during brain development lead to defective neural connectivity and altered biochemical functioning resulting in cognitive, emotional and intentional dysfunction later in life. This implicates a possible role in most psychiatric diseases including affective and schizophrenic disorders. This hypothesis is mainly based on new experimental evidence showing that psychiatric disorders are associated with neuronal atrophy and cell loss, impairments of structural plasticity and cellular resilience due to neurodevelopmental disturbances and morphological abnormalities of the brain. Thus, the potential role of neurotrophins in psychiatric disorders has been studied in different ways. Animal studies indicate the involvement of neurotrophins in psychopharmacological therapies and they show that gene expression of cerebral neurotrophins is changed in animal models of several psychiatric disorders. Whether such alterations are causatively associated with increased neural plasticity, improved cognitive function and decreased depressive mood states remains to be elucidated in further studies including man (e.g. in postmortem studies of patients). Association studies tried to link different variants in genes coding for neurotrophins, they have not been conclusive however. They partially allow to separate different subgroups of patients with differing therapy response profiles or indicate an increased vulnerability for a specific disorder. Finally, neurotrophin

  11. Effects of American ginseng (Panax quinquefolius) on neurocognitive function: an acute, randomised, double-blind, placebo-controlled, crossover study

    PubMed Central

    Ossoukhova, Anastasia; Owen, Lauren; Ibarra, Alvin; Pipingas, Andrew; He, Kan; Roller, Marc; Stough, Con

    2010-01-01

    Rationale Over the last decade, Asian ginseng (Panax ginseng) has been shown to improve aspects of human cognitive function. American ginseng (Panax quinquefolius) has a distinct ginsenoside profile from P. ginseng, promising cognitive enhancing properties in preclinical studies and benefits processes linked to human cognition. Objectives The availability of a highly standardised extract of P. quinquefolius (Cereboost™) led us to evaluate its neurocognitive properties in humans for the first time. Methods This randomised, double-blind, placebo-controlled, crossover trial (N = 32, healthy young adults) assessed the acute mood, neurocognitive and glycaemic effects of three doses (100, 200 400 mg) of Cereboost™ (P. quinquefolius standardised to 10.65% ginsenosides). Participants' mood, cognitive function and blood glucose were measured 1, 3 and 6 h following administration. Results There was a significant improvement of working memory (WM) performance associated with P. quinquefolius. Corsi block performance was improved by all doses at all testing times. There were differential effects of all doses on other WM tasks which were maintained across the testing day. Choice reaction time accuracy and ‘calmness’ were significantly improved by 100 mg. There were no changes in blood glucose levels. Conclusions This preliminary study has identified robust working memory enhancement following administration of American ginseng. These effects are distinct from those of Asian ginseng and suggest that psychopharmacological properties depend critically on ginsenoside profiles. These results have ramifications for the psychopharmacology of herbal extracts and merit further study using different dosing regimens and in populations where cognition is fragile. PMID:20676609

  12. Antipsychotic Management of Schizoaffective Disorder: A Review.

    PubMed

    Lindenmayer, Jean-Pierre; Kaur, Amandeep

    2016-04-01

    Schizoaffective disorder (SAD) is an incapacitating illness that presents clinicians with challenges in terms of both its diagnosis and its psychopharmacological management. Most studies conducted on the psychopharmacological treatment of SAD also include patients with schizophrenia or other psychotic illnesses, thereby providing an unspecific view to the clinician as to the best way of treating patients with SAD. The objective of this article is to review studies on evidence-based treatment of patients with SAD. We conducted a systematic literature search in MEDLINE/PubMed for full-text studies in the English language using the terms 'Schizoaffective and treatment' or 'antipsychotic schizoaffective'. Our review found relatively few studies with either an active comparator or placebo that examined the efficacy of antipsychotics for patients with SAD without an admixture of patients with schizophrenia. Only oral paliperidone extended release (ER), paliperidone long-acting injection (LAI), and risperidone have been shown to be effective and safe in reducing psychotic as well as affective components in acutely ill SAD patients in controlled studies. Paliperidone ER and LAI have also been shown to be efficacious in the maintenance treatment phase of SAD patients. While no supportive data exist, it is possible that other atypical antipsychotics may have similar efficacy to the two mentioned above. We conclude with a number of research recommendations for the study of treatment options for patients with SAD. First, there is a need for studies with patients specifically diagnosed with SAD for both the acute and the maintenance phase. The sample size needs to be adequate to allow a primary analysis of efficacy and to allow for analysis of the SAD subtypes: depressed and bipolar. Another recommendation is the need for studies of patients with SAD stratified into patients with and without mood stabilizers or antidepressants to allow the examination of the adjunctive role of

  13. The application of a computerized measurement of the content analysis of natural language to the assessment of the effects of psychoactive drugs.

    PubMed

    Gottschalk, L A

    1999-03-01

    This article aims to answer the question whether developing technology is now capable of measuring objectively and accurately the effects of psychoactive pharmacological agents by means of computerized assessments of psychological states and traits through the analysis of content and form of people's speech. At the present time, psychopharmacological researchers involved in clinical trials rely on DSM-IV criteria and standardized self-report measures and observer rating scales to assess psychoactive drug effects. Attention is drawn to the potentially unrecognized measurement errors and relatively low interrater reliability by these methods--for example, all raters are not free of observer bias and every subject administered a drug is not equally and accurately well-informed about the self. The computerized content analysis methods tend to avoid these biases and measurement errors. A review is provided describing the Gottschalk-Gleser method of measuring psychobiological dimensions from the form and content of short (usually five-minute) speech samples of verbal behavior, generally elicited by standardized and purposely ambiguous instructions to talk about any interesting or dramatic personal life experiences. Norms have been obtained by this method of speech elicitation, adjusted for age, sex and educational level. Sections are provided covering cross-cultural and language validation research on the Gottschalk-Gleser content analysis method, the influence of medical or psychiatric illness as well as psychoactive drugs on verbal content analysis-derived scores, and the research carried out for more than 20 years computerizing this content analysis procedure through the development of artificial intelligence software enabling these measurements to be done from typescripts of speech samples on computer diskettes. A brief review deals with the general applications of this method of measurement to basic and clinical psychiatry, psychosomatic medicine, neuropsychology

  14. Pharmacotherapy of Acute Bipolar Depression in Adults: An Evidence Based Approach.

    PubMed

    Muneer, Ather

    2016-05-01

    In the majority of cases of bipolar disorder, manic episodes are usually brief and typically responsive to currently available psychopharmacological agents. In contrast, depressive manifestations are more prevalent and persistent, and can present as major depressive/mixed episodes or residual interepisode symptoms. The depressive phase is often associated with other neuropsychiatric conditions, such as anxiety spectrum disorders, substance use disorders, stressor-related disorders, and eating disorders. It is viewed as a systemic disease with associated ailments such as metabolic syndrome, diabetes mellitus, and cardiovascular disease. There is an increased rate of mortality not only from suicide, but also from concomitant physical illness. This scenario is made worse by the fact that depressive symptoms, which represent the main disease burden, are often refractory to existing psychotropic drugs. As such, there is a pressing need for novel agents that are efficacious in acute depressive exacerbations, and also have applicable value in preventing recurrent episodes. The rationale of the present review is to delineate the pharmacotherapy of the depressive phase of bipolar disorder with medications for which there is evidence in the form of observational, open-label, or double-blind randomized controlled studies. In the treatment of acute bipolar depression in adults, a comprehensive appraisal of the extant literature reveals that among mood stabilizers, the most robust proof of efficacy exists for divalproex sodium; while atypical antipsychotics, which include olanzapine, quetiapine, lurasidone, and cariprazine, are also effective, as demonstrated in controlled trials. PMID:27274384

  15. Extinction retention and the menstrual cycle: Different associations for women with posttraumatic stress disorder.

    PubMed

    Pineles, Suzanne L; Nillni, Yael I; King, Matthew W; Patton, Samantha C; Bauer, Margaret R; Mostoufi, Sheeva M; Gerber, Megan R; Hauger, Richard; Resick, Patricia A; Rasmusson, Ann M; Orr, Scott P

    2016-04-01

    The propensity to acquire and retain conditioned fear responses may contribute to the risk of developing and maintaining posttraumatic stress disorder (PTSD) following a traumatic event. There is growing evidence that the gonadal hormones estrogen and progesterone are associated with how well women retain extinction of previously conditioned fear responses. Thus, sex steroid effects may contribute to the increased prevalence of PTSD in women. For the current study, 32 nonmedicated female trauma survivors with and without PTSD completed a differential fear conditioning task both during the early follicular phase of the menstrual cycle when estradiol and progesterone levels are low, and during the midluteal phase when estradiol and progesterone levels are high. Skin conductance served as the measure of conditioned fear. Women with PTSD, compared to those without, showed impaired retention of extinction learning in the midluteal phase of the menstrual cycle. Therefore, the impact of menstrual phase on extinction retention may differ between women with and without PTSD. These findings raise potential considerations regarding the coordination of psychopharmacologic and trauma exposure-based treatments for PTSD with specific phases of the menstrual cycle. (PsycINFO Database Record PMID:26866677

  16. Pharmacologic management of borderline personality disorder: a case study.

    PubMed

    Links, Paul S; Cook, Michele; Quastel, Adam

    2005-01-01

    General principles of the "outcome-focused" model of psychopharmacologic management of patients with BPD are illustrated using the case of Ms. A, a patient with borderline personality disorder (BPD) experiencing impulsivity such as suicidal behavior, chronic insomnia and concurrent substance abuse. The model includes (1) measurement of specific behavioral outcomes related to functioning; (2) assessment of the role of substance use/abuse in patients with BPD; (3) consideration of interventions to clarify and strengthen the boundaries of the therapeutic relationship-including short lengths of time between prescription refills, medication contracts outlining consequences if substances are obtained outside of the relationship, and urine testing to ascertain compliance; (4) an understanding of the psychodynamic meanings attributed to medication while positive and negative medication effects are monitored with treatment response or transference issues, and; (5) use of the N-of-1 approach to test the new medication vs previous medications using patient specific outcomes that are anticipated to change with the pharmacologic management. PMID:16459755

  17. Parenteral nanoemulsions as promising carriers for brain delivery of risperidone: Design, characterization and in vivo pharmacokinetic evaluation.

    PubMed

    Đorđević, Sanela M; Cekić, Nebojša D; Savić, Miroslav M; Isailović, Tanja M; Ranđelović, Danijela V; Marković, Bojan D; Savić, Saša R; Timić Stamenić, Tamara; Daniels, Rolf; Savić, Snežana D

    2015-09-30

    This paper describes design and evaluation of parenteral lecithin-based nanoemulsions intended for brain delivery of risperidone, a poorly water-soluble psychopharmacological drug. The nanoemulsions were prepared through cold/hot high pressure homogenization and characterized regarding droplet size, polydispersity, surface charge, morphology, drug-vehicle interactions, and physical stability. To estimate the simultaneous influence of nanoemulsion formulation and preparation parameters--co-emulsifier type, aqueous phase type, homogenization temperature--on the critical quality attributes of developed nanoemulsions, a general factorial experimental design was applied. From the established design space and stability data, promising risperidone-loaded nanoemulsions (mean size about 160 nm, size distribution <0.15, zeta potential around -50 mV), containing sodium oleate in the aqueous phase and polysorbate 80, poloxamer 188 or Solutol(®) HS15 as co-emulsifier, were produced by hot homogenization and their ability to improve risperidone delivery to the brain was assessed in rats. Pharmacokinetic study demonstrated erratic brain profiles of risperidone following intraperitoneal administration in selected nanoemulsions, most probably due to their different droplet surface properties (different composition of the stabilizing layer). Namely, polysorbate 80-costabilized nanoemulsion showed increased (1.4-7.4-fold higher) risperidone brain availability compared to other nanoemulsions and drug solution, suggesting this nanoemulsion as a promising carrier worth exploring further for brain targeting. PMID:26209070

  18. Clinical predictors of antipsychotic use in children and adolescents with autism spectrum disorders: a historical open cohort study using electronic health records.

    PubMed

    Downs, Johnny; Hotopf, Matthew; Ford, Tamsin; Simonoff, Emily; Jackson, Richard G; Shetty, Hitesh; Stewart, Robert; Hayes, Richard D

    2016-06-01

    Children with autism spectrum disorders (ASD) are more likely to receive antipsychotics than any other psychopharmacological medication, yet the psychiatric disorders and symptoms associated with treatment are unclear. We aimed to determine the predictors of antipsychotic use in children with ASD receiving psychiatric care. The sample consisted of 3482 children aged 3-17 with an ICD-10 diagnosis of ASD referred to mental health services between 2008 and 2013. Antipsychotic use outcome, comorbid diagnoses, and other clinical covariates, including challenging behaviours were extracted from anonymised patient records. Of the 3482 children (79 % male) with ASD, 348 (10 %) received antipsychotic medication. The fully adjusted model indicated that comorbid diagnoses including hyperkinetic (OR 1.44, 95 %CI 1.01-2.06), psychotic (5.71, 3.3-10.6), depressive (2.36, 1.37-4.09), obsessive-compulsive (2.31, 1.16-4.61) and tic disorders (2.76, 1.09-6.95) were associated with antipsychotic use. In addition, clinician-rated levels of aggression, self-injurious behaviours, reduced adaptive function, and overall parental concern for their child's presenting symptoms were significant risk factors for later antipsychotic use. In ASD, a number of comorbid psychiatric disorders are independent predictors for antipsychotic treatment, even after adjustment for familial, socio-demographic and individual factors. As current trial evidence excludes children with comorbidity, more pragmatic randomised controlled trials with long-term drug monitoring are needed. PMID:26472118

  19. [TRH analogs at Gedeon Richter Ltd.: highlights of experimental and clinical efficacy of posatirelin].

    PubMed

    Sarkadi, Adám; Kárpáti, Egon

    2002-01-01

    The chemical research for dissociation of the central nervous system effects of thyrotropin-releasing hormone (TRH) from its hormonal activity resulted in the selection of RGH-2202 (posatirelin) for further development. Posatirelin showed stronger vigilance enhancing effect than TRH in a variety of commonly used neuro-psychopharmacological model in mice, rats and cats. This drug had positive effects in animal models of disturbed consciousness, and counteracted the decline of learning and memory capacity shown by aged or memory impaired rats. Posatirelin had a trophic effect on neurons both 'in vitro' and 'in vivo' as well. Activation of various neurotransmission systems has been demonstrated, but the "modulatory" action of this neuropeptide-like compound is too complex to be explained by a single mechanism. Posatirelin practically had no hormonal activity or other significant side effects either in animal studies or in clinical trials. The arousal level increasing and the neuronotrophic effects appeared in part in trials of human brain injuries and cerebral infarction. Patients suffering in dementia syndromes of either vascular or degenerative origin and treated chronically with posatirelin showed significant improvement in intellectual performance, in orientation, motivation and memory function in all well controlled trials. PMID:12426788

  20. The prevalence and clinical characteristics associated with Diagnostic and Statistical Manual Version-5-defined anxious distress specifier in adults with major depressive disorder: results from the International Mood Disorders Collaborative Project

    PubMed Central

    McIntyre, Roger S.; Woldeyohannes, Hanna O.; Soczynska, Joanna K.; Vinberg, Maj; Cha, Danielle S.; Lee, Yena; Gallaugher, Laura A.; Dale, Roman S.; Alsuwaidan, Mohammad T.; Mansur, Rodrigo B.; Muzina, David J.; Carvalho, Andre; Kennedy, Sidney

    2016-01-01

    Objectives: The aim of the study was to evaluate the prevalence of and illness characteristics in adults with major depressive disorder (MDD) with anxious distress specifier (ADS) enrolled in the International Mood Disorders Collaborative Project, which is a collaborative research platform at the Mood Disorders Psychopharmacology Unit, University of Toronto, Canada and the Cleveland Clinic, Cleveland, Ohio, USA. Methods: Data from participants who met criteria for a current major depressive episode as part of MDD (n = 830) were included in this post hoc analysis. Diagnostic and Statistical Manual Version-5-defined ADS was operationalized as the presence of at least two out of three proxy items instead of two out of five specifiers. Results: A total of 464 individuals (i.e. 56%) met criteria for ADS. There were no between-group differences in sociodemographic variables (e.g. gender, employment, marital status). Greater severity of illness was observed in adults with ADS as evidenced by a higher number of hospitalizations, higher rates of suicidal ideation, greater depressive symptom severity, greater workplace impairment, decreased quality of life, and greater self-reported cognitive impairment. Conclusions: Our findings underscore the importance of evaluating ADS in adults with MDD as its presence identifies a subpopulation with greater illness-associated burden and hazards. PMID:27347362

  1. Rethinking psychopharmacotherapy: The role of treatment context and brain plasticity in antidepressant and antipsychotic interventions.

    PubMed

    Rief, W; Barsky, A J; Bingel, U; Doering, B K; Schwarting, R; Wöhr, M; Schweiger, U

    2016-01-01

    Emerging evidence indicates that treatment context profoundly affects psychopharmacological interventions. We review the evidence for the interaction between drug application and the context in which the drug is given both in human and animal research. We found evidence for this interaction in the placebo response in clinical trials, in our evolving knowledge of pharmacological and environmental effects on neural plasticity, and in animal studies analyzing environmental influences on psychotropic drug effects. Experimental placebo research has revealed neurobiological trajectories of mechanisms such as patients' treatment expectations and prior treatment experiences. Animal research confirmed that "enriched environments" support positive drug effects, while unfavorable environments (low sensory stimulation, low rates of social contacts) can even reverse the intended treatment outcome. Finally we provide recommendations for context conditions under which psychotropic drugs should be applied. Drug action should be steered by positive expectations, physical activity, and helpful social and physical environmental stimulation. Future drug trials should focus on fully controlling and optimizing such drug×environment interactions to improve trial sensitivity and treatment outcome. PMID:26616735

  2. The influence of atypical antipsychotic drugs on sexual function

    PubMed Central

    Just, Marek J

    2015-01-01

    Human sexuality is contingent upon many biological and psychological factors. Such factors include sexual drive (libido), physiological arousal (lubrication/erection), orgasm, and ejaculation, as well as maintaining normal menstrual cycle. The assessment of sexual dysfunction can be difficult due to the intimate nature of the problem and patients’ unwillingness to discuss it. Also, the problem of dysfunction is often overlooked by doctors. Atypical antipsychotic treatment is a key component of mental disorders’ treatment algorithms recommended by the National Institute of Health and Clinical Excellence, the American Psychiatric Association, and the British Society for Psychopharmacology. The relationship between atypical antipsychotic drugs and sexual dysfunction is mediated in part by antipsychotic blockade of pituitary dopamine D2 receptors increasing prolactin secretion, although direct correlations have not been established between raised prolactin levels and clinical symptoms. Variety of mechanisms are likely to contribute to antipsychotic-related sexual dysfunction, including hyperprolactinemia, sedation, and antagonism of a number of neurotransmitter receptors (α-adrenergic, dopaminergic, histaminic, and muscarinic). Maintaining normal sexual function in people treated for mental disorders can affect their quality of life, mood, self-esteem, attitude toward taking medication, and compliance during therapy. PMID:26185449

  3. α7 Nicotinic Receptor Agonists: Potential Therapeutic Drugs for Treatment of Cognitive Impairments in Schizophrenia and Alzheimer’s Disease

    PubMed Central

    Toyohara, Jun; Hashimoto, Kenji

    2010-01-01

    Accumulating evidence suggests that α7 nicotinic receptors (α7 nAChRs), a subtype of nAChRs, play a role in the pathophysiology of neuropsychiatric diseases, including schizophrenia and Alzheimer’s disease (AD). A number of psychopharmacological and genetic studies shown that α7 nAChRs play an important role in the deficits of P50 auditory evoked potential in patients with schizophrenia, and that (α nAChR agonists would be potential therapeutic drugs for cognitive impairments associated with P50 deficits in schizophrenia. Furthermore, some studies have demonstrated that α7 nAChRs might play a key role in the amyloid-β (Aβ)-mediated pathology of AD, and that α7 nAChR agonists would be potential therapeutic drugs for Aβ deposition in the brains of patients with AD. Interestingly, the altered expression of α7 nAChRs in the postmortem brain tissues from patients with schizophrenia and AD has been reported. Based on all these findings, selective α7 nAChR agonists can be considered potential therapeutic drugs for cognitive impairments in both schizophrenia and AD. In this article, we review the recent research into the role of α7 nAChRs in the pathophysiology of these diseases and into the potential use of novel α7 nAChR agonists as therapeutic drugs. PMID:21249164

  4. Candidates for liver transplantation with alcoholic liver disease: Psychosocial aspects

    PubMed Central

    Telles-Correia, Diogo; Mega, Inês

    2015-01-01

    In Europe, 30% to 50% of liver transplantations are currently due to alcoholic liver disease (ALD). In the United States, this percentage is 17.2%. Post-transplant survival and other predictors of clinical course do not differ significantly from those in other types of transplanted patients, as long as there is no relapse of drinking. However, 20%-25% of these patients lapse or relapse to heavy drinking post-operatively, which has been associated with an increased risk of liver damage and mortality. It is therefore crucial to design specific selection and follow-up strategies aimed at this particular type of patient. Several good and poor prognosis factors that could help to predict a relapse have been suggested, among them the duration of abstinence, social support, a family history of alcoholism, abuse diagnosis versus alcohol dependence, non-acceptance of diagnosis related to alcohol use, presence of severe mental illness, non-adherence in a broad sense, number of years of alcoholism, and daily quantity of alcohol consumption. In this article, we discuss these and other, more controversial factors in selecting ALD patients for liver transplantation. Abstinence should be the main goal after transplantation in an ALD patient. In this article, we review the several definitions of post-transplant relapse, its monitoring and the psychopharmacological and psychotherapeutic treatment. PMID:26494959

  5. The legacy of the benzodiazepine receptor: from flumazenil to enhancing cognition in Down syndrome and social interaction in autism.

    PubMed

    Möhler, Hanns

    2015-01-01

    The study of the psychopharmacology of benzodiazepines continues to provide new insights into diverse brain functions related to vigilance, anxiety, mood, epileptiform activity, schizophrenia, cognitive performance, and autism-related social behavior. In this endeavor, the discovery of the benzodiazepine receptor was a key event, as it supplied the primary benzodiazepine drug-target site, provided the molecular link to the allosteric modulation of GABAA receptors and, following the recognition of GABAA receptor subtypes, furnished the platform for future, more selective drug actions. This review has two parts. In a retrospective first part, it acknowledges the contributions to the field made by my collaborators over the years, initially at Hoffmann-La Roche in Basle and later, in academia, at the University and the ETH of Zurich. In the second part, the new frontier of GABA pharmacology, targeting GABAA receptor subtypes, is reviewed with special focus on nonsedative anxiolytics, antidepressants, analgesics, as well as enhancers of cognition in Down syndrome and attenuators of symptoms of autism spectrum disorders. It is encouraging that a clinical trial has been initiated with a partial inverse agonist acting on α5 GABAA receptors in an attempt to alleviate the cognitive deficits in Down syndrome. PMID:25600365

  6. Neuroscience, power and culture: an introduction.

    PubMed

    Vrecko, Scott

    2010-01-01

    In line with their vast expansion over the last few decades, the brain sciences -- including neurobiology, psychopharmacology, biological psychiatry, and brain imaging -- are becoming increasingly prominent in a variety of cultural formations, from self-help guides and the arts to advertising and public health programmes. This article, which introduces the special issue of "History of the Human Science" on "Neuroscience, Power and Culture," considers the ways that social and historical research can, through empirical investigations grounded in the observation of what is actually happening and has already happened in the sciences of mind and brain, complement speculative discussions of the possible social implications of neuroscience that now appear regularly in the media and in philosophical bioethics. It suggests that the neurosciences are best understood in terms of their lineage within the "psy"-disciplines, and that, accordingly, our analyses of them will be strengthened by drawing on existing literatures on the history and politics of psychology -- particularly those that analyze formations of knowledge, power and subjectivity associated with the discipline and its practical applications. Additionally, it argues against taking today's neuroscientific facts and brain-targetting technologies as starting points for analysis, and for greater recognition of the ways that these are shaped by historical, cultural and political-economic forces. PMID:20514752

  7. Improving Interference Control in ADHD Patients with Transcranial Direct Current Stimulation (tDCS)

    PubMed Central

    Breitling, Carolin; Zaehle, Tino; Dannhauer, Moritz; Bonath, Björn; Tegelbeckers, Jana; Flechtner, Hans-Henning; Krauel, Kerstin

    2016-01-01

    The use of transcranial direct current stimulation (tDCS) in patients with attention deficit hyperactivity disorder (ADHD) has been suggested as a promising alternative to psychopharmacological treatment approaches due to its local and network effects on brain activation. In the current study, we investigated the impact of tDCS over the right inferior frontal gyrus (rIFG) on interference control in 21 male adolescents with ADHD and 21 age matched healthy controls aged 13–17 years, who underwent three separate sessions of tDCS (anodal, cathodal, and sham) while completing a Flanker task. Even though anodal stimulation appeared to diminish commission errors in the ADHD group, the overall analysis revealed no significant effect of tDCS. Since participants showed a considerable learning effect from the first to the second session, performance in the first session was separately analyzed. ADHD patients receiving sham stimulation in the first session showed impaired interference control compared to healthy control participants whereas ADHD patients who were exposed to anodal stimulation, showed comparable performance levels (commission errors, reaction time variability) to the control group. These results suggest that anodal tDCS of the right inferior frontal gyrus could improve interference control in patients with ADHD. PMID:27147964

  8. [Nutrition and dietary supplements in psychiatric diseases].

    PubMed

    Himmerich, H; Erbguth, F

    2014-12-01

    Nutrition and specific nutritional supplements can have prophylactic or therapeutic properties with respect to certain psychiatric disorders. A traditional Mediterranean diet, for example, seems to have prophylactic benefits against depression and dementia, whereas overeating and obesity increase the risk for both.Although evidence for nutritional supplements in the treatment of psychiatric disorders is not sufficient for general recommendations, data from observational studies and randomized controlled trials (RCT) seem to point to their use for specific indications. Folate, S-adenosylmethionine (SAM) and eicosapentaenoic acid (EPA), for instance, seem to have antidepressant properties, zinc may be beneficial in attention deficit hyperactivity disorder (ADHD), vitamin B6 (pyridoxine) could reduce extrapyramidal side effects of antipsychotics and N-acetylcysteine (NAC) seems to be effective against negative symptoms, abnormal movements and akathisia in schizophrenia.Psychiatric disorders, in turn, may lead to deficiency of mineral nutrients and vitamins. For instance, vitamin B1 (thiamine) deficiency is common in alcohol-dependent patients and should therefore be considered during withdrawal treatment. Although vitamin malnutrition is uncommon in developed countries, vitamin deficiency syndromes, such as pernicious anemia or Wernicke's encephalopathy are still relevant differential diagnoses.Some psychopharmacological drugs may additionally change the nutritional habits of the patients in an unfavorable way leading to weight gain and obesity and the risk for further psychiatric problems. PMID:25421417

  9. Pathological Gambling: Neuropsychopharmacology and Treatment

    PubMed Central

    Bullock, Scott A.; Potenza, Marc N.

    2013-01-01

    Pathological gambling (PG) affects about 0.2–2% of adults and the impact extends to family members, employers and society as a whole. Recent research has identified similarities in the pathophysiologies of PG and substance use disorders (SUDs). As such, findings regarding SUDs provide a framework for investigating PG. The aims of the manuscript are two-fold. First, we will briefly revivew neural systems implicated in PG. Cortico-limbic circuitry involving the ventral striatum, ventromedial prefrontal cortex, anterior cingulate cortex, and dorsolateral prefrontal cortex are discussed as are the neurotransmitters norepinephrine, serotonin, dopamine, opioids, glutamate, and gamma-aminobutyric acid (GABA). This background will provide a framework for reviewing the psychopharmacological treatments that have been tested for efficacy and safety in treating PG. Of medications, the strongest data suggest the efficacy and tolerability of opioid antagonists in the treatment of PG, and other agents have varying degree of empirical support. As behavioral therapies have also shown efficacy, they will be briefly considered as well. Future research is needed to understand how treatments work in PG and for whom specific treatments might work best. PMID:24349964

  10. Antidepressants and food restriction cycles: evidence for multiple pacemakers in rodents.

    PubMed

    McEachron, D L

    1987-01-01

    Studies involving the suprachiasmatic nuclei (SCN) provide insufficient evidence to support the SCN as master pacemaker(s) in the rodent circadian system. Restricted feeding (RF) cycles act as strong zeitgebers for activity and corticosterone rhythms and provide support for the existence of important secondary pacemakers. These proposed pacemakers show anticipatory behavior, a limited range of entertainment for RF cycles, and prolonged free runs under certain circumstances. Additional evidence supporting a multiple pacemaker model of rodent circadian organization comes from studies involving antidepressants. Lithium treatment lengthens the free-running tau of rat activity rhythms and shifts the range of entrainment towards longer zeitgeber cycles. Lithium also phase delays many rodent rhythms but does not appear to affect the SCN-pineal axis. These data are difficult to explain without involving more than one pacemaker. Models of the rodent system can be developed incorporating multiple pacemakers. To test these models, a multivariate approach will be required. Combining the labeled 2-deoxyglucose method for metabolic mapping and the procedures of fractional desynchronization with antidepressant psychopharmacology and RF cycles may prove to be an important multivariate approach. PMID:3306700

  11. Treatment of Anxiety and Depression in the Preschool Period

    PubMed Central

    Luby, Joan L.

    2013-01-01

    Objective Empirical studies have now established that clinical anxiety and depressive disorders may arise in preschool children as early as age 3.0. As empirical studies validating and characterizing these disorders in preschoolers are relatively recent, less work has been done on the development and testing of age-appropriate treatments. Method A comprehensive literature search revealed several small randomized controlled trials (RCTs) of psychotherapeutic treatments for preschool anxiety and depression. The literature also contains case series of behavioral and psychopharmacologic interventions for specific anxiety disorders. However, to date, no large-scale RCTs of treatment for any anxiety or depressive disorder specifically targeting preschool populations have been published. Results Several age-adapted forms of cognitive behavioral therapy have been developed and preliminarily tested in small RCTs, and appear promising for a variety of forms of preschool anxiety disorders. Notably, these adaptations centrally involve primary caregivers and utilize age-adjusted methodology such as cartoon-based materials and co-constructed drawing or narratives. Modified forms of Parent Child Interaction Therapy (PCIT) have been tested and appear promising for both anxiety and depression. While preventive interventions that target parenting have shown significant promise in anxiety, these methods have not been explored in area of early childhood depression. Studies of the impact of parental treatment on infants suggest that direct treatment of the youngest children may be necessary to affect long-term change. Conclusions Recommendations are made for clinical treatment of these disorders where psychotherapy is the first line of intervention. PMID:23582866

  12. Psychopathology, trauma and delinquency: subtypes of aggression and their relevance for understanding young offenders

    PubMed Central

    2011-01-01

    Objective To examine the implications of an ontology of aggressive behavior which divides aggression into reactive, affective, defensive, impulsive (RADI) or "emotionally hot"; and planned, instrumental, predatory (PIP) or "emotionally cold." Recent epidemiological, criminological, clinical and neuroscience studies converge to support a connection between emotional and trauma related psychopathology and disturbances in the emotions, self-regulation and aggressive behavior which has important implications for diagnosis and treatment, especially for delinquent populations. Method Selective review of preclinical and clinical studies in normal, clinical and delinquent populations. Results In delinquent populations we observe an increase in psychopathology, and especially trauma related psychopathology which impacts emotions and self-regulation in a manner that hotly emotionally charged acts of aggression become more likely. The identification of these disturbances can be supported by findings in cognitive neuroscience. These hot aggressive acts can be delineated from planned or emotionally cold aggression. Conclusion Our findings support a typology of diagnostic labels for disruptive behaviors, such as conduct disorder and oppositional defiant disorder, as it appears that these acts of hot emotional aggression are a legitimate target for psychopharmacological and other trauma specific interventions. The identification of this subtype of disruptive behavior disorders leads to more specific clinical interventions which in turn promise to improve hitherto unimpressive treatment outcomes of delinquents and patients with disruptive behavior. PMID:21714905

  13. Executive Attention Impairment in Adolescents With Major Depressive Disorder.

    PubMed

    Sommerfeldt, Sasha L; Cullen, Kathryn R; Han, Georges; Fryza, Brandon J; Houri, Alaa K; Klimes-Dougan, Bonnie

    2016-01-01

    Neural network models that guide neuropsychological assessment practices are increasingly used to explicate depression, though a paucity of work has focused on regulatory systems that are under development in adolescence. The purpose of this study was to evaluate subsystems of attention related to executive functioning including alerting, orienting, and executive attention networks, as well as sustained attention with varying working memory load, in a sample of depressed and well adolescents. Neuropsychological functioning in 99 adolescents diagnosed with major depressive disorder (MDD) and 63 adolescent healthy controls (M = 16.6 years old) was assessed on the Attention Network Test (ANT) and the Continuous Performance Test, Identical Pairs. Adolescents with MDD, particularly those who were not medicated, were slower to process conflict (slower reaction time on the Executive Attention scale of the ANT) compared to controls, particularly for those who were not undergoing psychopharmacological treatment. Tentative evidence also suggests that within the MDD group, orienting performance was more impaired in those with a history of comorbid substance use disorder, and alerting was more impaired in those with a history of a suicide attempt. Adolescents with depression showed impaired executive attention, although cognitive performance varied across subgroups of patients. These findings highlight the importance of examining neurocognitive correlates associated with features of depression and suggest an avenue for future research to help guide the development of interventions. PMID:26566871

  14. Linking neuroscience with modern concepts of impulse control disorders in Parkinson’s disease

    PubMed Central

    Napier, T. Celeste; Corvol, Jean-Christophe; Grace, Anthony A.; Roitman, Jamie D.; Rowe, James; Voon, Valerie; Strafella, Antonio P.

    2014-01-01

    Patients with Parkinson’s disease (PD) may experience impulse control disorders (ICDs) when on dopamine agonist therapy for their motor symptoms. In the last few years, there has been a rapid growth of interest for the recognition of these aberrant behaviors and their neurobiological correlates. Recent advances in neuroimaging are helping to identify the neuroanatomical networks responsible for these ICDs, and together with psychopharmacological assessments are providing new insights into the brain status of impulsive behavior. The genetic associations that may be unique to ICDs in PD are also being identified. Complementing human studies, electrophysiological and biochemical studies in animal models are providing insights into neuropathological mechanisms associated with these disorders. New animal models of ICDs in PD patients are being implemented that should provide critical means to identify efficacious therapies for PD-related motor deficits while avoiding ICD side effects. Here, we provide an overview of these recent advances, with a particular emphasis on the neurobiological correlates reported in animal models and patients along with their genetic underpinnings. PMID:25476402

  15. Evaluation of anti-depressant and anxiolytic activity of Rasayana Ghana Tablet (A compound Ayurvedic formulation) in albino mice

    PubMed Central

    Deole, Yogesh S.; Chavan, Sulakshan S.; Ashok, B. K.; Ravishankar, B.; Thakar, A. B.; Chandola, H. M.

    2011-01-01

    In recent years, many Ayurvedic formulations are being researched to provide an effective antidepressant and anxiolytic drug in the field of psycho-pharmacology. The present study was planned to evaluate the anti-depressant and anxiolytic activity of Rasayana Ghana Tablet comprising three herbs Guduchi (Tinospora cordifolia Miers), Aamalaki (Emblica officinalis Garten) (RGT) and Gokshura (Tribulus terrestris Linn). Swiss albino mice were divided into four groups of six animals each, comprising of both male and female in each group. Group I received water served as normal control (WC), group II received vehicle and served as vehicle control (VC), group III received Rasayana Ghana tablet and group IV received standard drug diazepam (2 mg/kg) for anxiolytic study in elevated plus maze and standard antidepressant imipramine (5 mg/kg) for anti-depressant activity in behavior despair test. Rasayana Ghana tablet along with ghee and honey as vehicle is found to be having antidepressant and anxiolytic activity in experimental animals. Thus, this formulation can be used in prevention and treatment of depression and anxiety. PMID:22529654

  16. Double-blind versus open evaluations of stimulant drug response in children with attention-deficit hyperactivity disorder.

    PubMed

    Sprafkin, J; Gadow, K D

    1996-01-01

    Although placebo controls and double-blind conditions are considered to be essential for the unbiased scientific assessment of drug effects, there is very little research on these procedures in the pediatric psychopharmacology literature. To examine the impact of controlled assessment procedures on the magnitude of observed drug effects, two groups of children with attention-deficit hyperactivity disorder (ADHD) were evaluated for response to methylphenidate under two different assessment procedures. One group (n = 33) was part of a placebo-controlled, double-blind crossover research protocol, with randomized dose sequences, compliance checks, numerous dependent measures, written informed consent, and a considerable amount of staff involvement. The other group (n = 43) received pharmacotherapy at a community-based child psychiatry outpatient service where they were followed in a routine clinical manner, with "no treatment" as the only control condition, standard fixed-dose titration, parental responsibility for data collection, use of form letters, and minimal staff involvement. Each individual in both groups received divided doses of 0.3 and 0.5/0.6 mg/kg daily for a minimum of 1 week at each dose. Comparisons of teacher ratings obtained for the two assessment procedures revealed highly similar findings. The results of this study are discussed with regard to both their methodological and clinical implications. PMID:9231315

  17. The Microbiome and Mental Health: Looking Back, Moving Forward with Lessons from Allergic Diseases.

    PubMed

    Logan, Alan C; Jacka, Felice N; Craig, Jeffrey M; Prescott, Susan L

    2016-05-31

    Relationships between gastrointestinal viscera and human emotions have been documented by virtually all medical traditions known to date. The focus on this relationship has waxed and waned through the centuries, with noted surges in interest driven by cultural forces. Here we explore some of this history and the emerging trends in experimental and clinical research. In particular, we pay specific attention to how the hygiene hypothesis and emerging research on traditional dietary patterns has helped re-ignite interest in the use of microbes to support mental health. At present, the application of microbes and their structural parts as a means to positively influence mental health is an area filled with promise. However, there are many limitations within this new paradigm shift in neuropsychiatry. Impediments that could block translation of encouraging experimental studies include environmental forces that work toward dysbiosis, perhaps none more important than westernized dietary patterns. On the other hand, it is likely that specific dietary choices may amplify the value of future microbial-based therapeutics. Pre-clinical and clinical research involving microbiota and allergic disorders has predated recent work in psychiatry, an early start that provides valuable lessons. The microbiome is intimately connected to diet, nutrition, and other lifestyle variables; microbial-based psychopharmacology will need to consider this contextual application, otherwise the ceiling of clinical expectations will likely need to be lowered. PMID:27121424

  18. Schizotypy--do not worry, it is not all worrisome.

    PubMed

    Mohr, Christine; Claridge, Gordon

    2015-03-01

    A long-standing tradition in personality research in psychology, and nowadays increasingly in psychiatry, is that psychotic and psychotic-like thoughts are considered common experiences in the general population. Given their widespread occurrence, such experiences cannot merely reflect pathological functioning. Moreover, reflecting the multi-dimensionality of schizotypy, some dimensions might be informative for healthy functioning while others less so. Here, we explored these possibilities by reviewing research that links schizotypy to favorable functioning such as subjective wellbeing, cognitive functioning (major focus on creativity), and personality correlates. This research highlights the existence of healthy people with psychotic-like traits who mainly experience positive schizotypy (but also affective features mapping onto bipolar disorder). These individuals seem to benefit from a healthy way to organize their thoughts and experiences, that is, they employ an adaptive cognitive framework to explain and integrate their unusual experiences. We conclude that, instead of focusing only on the pathological, future studies should explore the behavioral, genetic, imaging, and psychopharmacological correlates that define the healthy expression of psychotic-like traits. Such studies would inform on protective or compensatory mechanisms of psychosis-risk and could usefully inform us on the evolutionary advantages of the psychosis dimension. PMID:25810058

  19. Efficacy of Electroconvulsive Therapy in Bipolar Disorder with Mixed Features

    PubMed Central

    Ferreira, Berta; Borja-Santos, Nuno; Trancas, Bruno; Monteiro, Céu; Cardoso, Graça

    2016-01-01

    Introduction. Mixed states represent a frequent presentation of bipolar disorder, associated with higher resistance to psychopharmacology. Limited evidence supports the use of ECT in these patients. We aim to report our experience on treating bipolar mixed states with ECT. Methods. Retrospective data were collected from all bipolar patients submitted to acute ECT treatment, between June 2006 and June 2011. Three groups were created in terms of affective polarity of the episode. CGI rating was used to establish clinical remission and demographic and clinical variables were compared among groups. Long-term outcome was assessed through readmission measures, considering the use of continuation or maintenance ECT. Results. During the study time frame, a total of 50 ECT course treatments were performed on 41 bipolar patients. All affective episodes, except one mixed state, showed a positive clinical response. Patients with mixed state presentation tended to be younger and have an earlier first hospitalization than depressed patients. No differences were found in terms of ECT sessions performed, length of hospital admission, referral to continuation ECT treatment, number of readmissions, and time until next readmission. Conclusions. Our results support the effectiveness of ECT in patients experiencing a mixed affective state. PMID:26881069

  20. Automated analysis of antidepressants' effect in the forced swim test.

    PubMed

    Kulikov, Alexander V; Morozova, Maryana V; Kulikov, Viktor A; Kirichuk, Valeri S; Popova, Nina K

    2010-08-15

    The forced swim test (FST) is a commonly used procedure of preclinical screening of drugs for the antidepressant activity. It has high predictive validity for a large group of antidepressant drugs blocking serotonin and noradrenaline reuptakes and improvement of immobility time evaluation in the FST is an important problem of preclinical psychopharmacology. Here a new automated version of the FST was developed. This version includes 4 inventions: (1) transmitted lighting instead of reflected lighting, (2) mouse silhouette tracking, (3) automated choice of immobility threshold and (4) the permutation test of drug's effect. Experiment was carried out on adult males of C57BL/6J and BALB/cJ mouse strains. The mice were treated with tricyclic antidepressant imipramine (15 and 30 mg/kg, i.p.). Mouse was placed in water tank, its movements were recorded by a rater and the silhouette alterations were automatically tracked. The sequence of silhouette alterations was scanned for immobility bouts with a threshold algorithm. Threshold was gradually altered and the value which maximized the difference between control and treated groups was chosen. The immobility values obtained with the procedure were compared with the permutation test. The data obtained with this procedure did not differ from those obtained by the rater. Imipramine dose dependently attenuated immobility time in C57BL/6 mice without any effect on BALB/c mice. The new procedure has been implemented in the EthoStudio software. It provides an objective automated evaluation of immobility time in the FST. PMID:20566352

  1. Social phobia: diagnosis and epidemiology, neurobiology and pharmacology, comorbidity and treatment.

    PubMed

    Brunello, N; den Boer, J A; Judd, L L; Kasper, S; Kelsey, J E; Lader, M; Lecrubier, Y; Lepine, J P; Lydiard, R B; Mendlewicz, J; Montgomery, S A; Racagni, G; Stein, M B; Wittchen, H U

    2000-10-01

    Social phobia is a common disorder associated with significant psychosocial impairment, representing a substantial public health problem largely determined by the high prevalence, and the lifelong chronicity. Social phobia starts in early childhood or adolescence and is often comorbid with depression, other anxiety disorders, alcohol and substance abuse or eating disorders. This cascade of comorbidity, usually secondary to social phobia, increases the disability associated with the condition. The possibility that social phobia may be a trigger for later developing comorbid disorders directs attention to the need for early effective treatment as a preventive measure. The most recent drug class to be investigated for the psychopharmacological treatment of social phobia is the SSRI group for which there is growing support. The other drug classes that have been evaluated are monoamine oxidase inhibitors (MAOIs), benzodiazepines, and beta-blockers. The SSRIs represent a new and attractive therapeutic choice for patients with generalized social phobia. Recently the first, large scale, placebo-controlled study to assess the efficacy of drug treatment in generalized social phobia has been completed with paroxetine. Paroxetine was more effective in reducing the symptoms than placebo and was well tolerated. Many now regard SSRIs as the drugs of choice in social phobia because of their effectiveness and because they avoid the problems of treatment with benzodiazepines or classical MAOIs. PMID:10940449

  2. [Neuroimaging of psychiatric and pedopsychiatric disorders].

    PubMed

    Martinot, Jean-Luc; Mana, Stéphanie

    2011-01-01

    Over the last two decades, imaging techniques have allowed to establish the cerebral neurophysiologic correlates of psychiatric disorders and have highlighted the impact of psychopathologic events, therapeutic drugs, addictions, on the growth and plasticity of brain. In this review, we intend to illustrate how neuroimaging has improved our knowledge of such alterations in brain maturation (schizophrenia, autistic disorders), fronto-limbic (depressive syndromes) or fronto-striatal (compulsive disorders) regions in psychiatric illnesses, but also in psychopharmacology, or pedopsychiatry. Statistically significant alterations in the structure and/or function of brain are detected in all psychiatric disorders and these are often detectable already during childhood or teenage. Furthermore, neuroimaging has allowed to underline the importance of cerebral networks specific to each disorder, but also to uncover those which are common to different diseases provided that they share common clinical or cognitive features. Besides their value in basic research, neuroimaging findings have been key in changing the perception that society has of these diseases which contributed to their therapeutic approach. PMID:21718649

  3. Special Supplement Introduction: The Fourth Kraepelin Symposium-Cognitive Dysfunction in Schizophrenia: Origins and Innovative Treatment.

    PubMed

    Schaub, Annette; Falkai, Peter

    2016-07-01

    This Special Supplement presents reports from working groups meeting at the Fourth Kraepelin Symposium in Munich, Germany, in September 2014. It covers the origins and therapy of cognitive dysfunction in schizophrenia. Cognitive deficits are core symptoms of schizophrenia being decisive for the long-term prognosis only improved moderately by antipsychotic treatment, however, showing more evidence for cognitive remediation. The authors refer to neurobiological and psychological underpinnings of cognitive deficits and to innovative treatment interventions aimed at improving cognitive dysfunction in order to improve outcome and to support coping with the illness. Therapeutic approaches include aerobic exercise, cognitive training, psychoeducation, cognitive therapy, noninvasive brain stimulation and pharmacotherapy in acute to post-acute patients. The supplement also presents novel diagnostic tools for early recognition, such as biomarkers, as well as cognitive training to prevent worsening of symptoms in individuals at clinical high risk for psychosis. In recent years there has been progress in basic science and outcomes research as well as psychopharmacological and psychological treatment options. Despite of this, treatment of cognitive deficits needs significant improvement and further research is needed. PMID:27460613

  4. Enhancing and Promoting Recovery In Attentionally Impaired People Diagnosed With Schizophrenia: Results From A Randomized Controlled Trial Of Attention Shaping In A Partial Hospital Program

    PubMed Central

    Silverstein, Steven M.; Roché, Matthew W.; Khan, Zaynab; Carson, Sarah J.; Malinovsky, Igor; Newbill, William A.; Menditto, Anthony A.; Wilkniss, Sandra M.

    2014-01-01

    The attentional impairments associated with schizophrenia are well-documented and profound. Psychopharmacological and most psychosocial interventions have been shown to have limited effect in improving attentional capacity. That said, one form of psychosocial treatment, attention shaping procedures (ASP), has been repeatedly demonstrated to produce significant and meaningful change in various aspects of participant attentiveness behaviors. To date, studies of ASP have been limited in that they have been conducted primarily with inpatients, have not assessed the generalizability of ASP's effects, and have not explored whether reinforcement is required to be contingent on performance of attentive behaviors. To address these limitations we conducted the first randomized clinical trial of ASP with people diagnosed with schizophrenia who are being treated in a partial hospital program. Our results indicate that ASP is effective in improving attention in people with schizophrenia in these types of programs, the effects of ASP generalize outside of the immediate treatment context to both other treatment groups and real world functioning, and contingent reinforcement is a critical ingredient of ASP. This project provides further evidence for the benefits of use of ASP in the recovery-oriented treatment of people diagnosed with schizophrenia who have significant attentional impairments. PMID:25264432

  5. If I Could Just Stop Loving You: Anti-Love Biotechnology and the Ethics of a Chemical Breakup

    PubMed Central

    Earp, Brian D.; Wudarczyk, Olga A.; Sandberg, Anders; Savulescu, Julian

    2013-01-01

    “Love hurts”—as the saying goes—and a certain amount of pain and difficulty in intimate relationships is unavoidable. Sometimes it may even be beneficial, since adversity can lead to personal growth, self-discovery, and a range of other components of a life well-lived. But other times, love can be downright dangerous. It may bind a spouse to her domestic abuser, draw an unscrupulous adult toward sexual involvement with a child, put someone under the insidious spell of a cult leader, and even inspire jealousy-fueled homicide. How might these perilous devotions be diminished? The ancients thought that treatments such as phlebotomy, exercise, or bloodletting could “cure” an individual of love. But modern neuroscience and emerging developments in psychopharmacology open up a range of possible interventions that might actually work. These developments raise profound moral questions about the potential uses—and misuses—of such anti-love biotechnology. In this article, we describe a number of prospective love-diminishing interventions, and offer a preliminary ethical framework for dealing with them responsibly should they arise. PMID:24161170

  6. Neurodevelopment in Schizophrenia: The Role of the Wnt Pathways

    PubMed Central

    Panaccione, Isabella; Napoletano, Flavia; Forte, Alberto Maria; Kotzalidis, Giorgio D.; Del Casale, Antonio; Rapinesi, Chiara; Brugnoli, Chiara; Serata, Daniele; Caccia, Federica; Cuomo, Ilaria; Ambrosi, Elisa; Simonetti, Alessio; Savoja, Valeria; De Chiara, Lavinia; Danese, Emanuela; Manfredi, Giovanni; Janiri, Delfina; Motolese, Marta; Nicoletti, Ferdinando; Girardi, Paolo; Sani, Gabriele

    2013-01-01

    Objectives. To review the role of Wnt pathways in the neurodevelopment of schizophrenia. Methods: Systematic PubMed search, using as keywords all the terms related to the Wnt pathways and crossing them with each of the following areas: normal neurodevelopment and physiology, neurodevelopmental theory of schizophrenia, schizophrenia, and antipsychotic drug action. Results: Neurodevelopmental, behavioural, genetic, and psychopharmacological data point to the possible involvement of Wnt systems, especially the canonical pathway, in the pathophysiology of schizophrenia and in the mechanism of antipsychotic drug action. The molecules most consistently found to be associated with abnormalities or in antipsychotic drug action are Akt1, glycogen synthase kinase3beta, and beta-catenin. However, the extent to which they contribute to the pathophysiology of schizophrenia or to antipsychotic action remains to be established. Conclusions: The study of the involvement of Wnt pathway abnormalities in schizophrenia may help in understanding this multifaceted clinical entity; the development of Wnt-related pharmacological targets must await the collection of more data. PMID:24403877

  7. Cholinergic Stimulation Enhances Bayesian Belief Updating in the Deployment of Spatial Attention

    PubMed Central

    Bauer, Markus; Mathys, Christoph; Adams, Rick A.; Dolan, Raymond J.; Stephan, Klaas E.; Friston, Karl J.

    2014-01-01

    The exact mechanisms whereby the cholinergic neurotransmitter system contributes to attentional processing remain poorly understood. Here, we applied computational modeling to psychophysical data (obtained from a spatial attention task) under a psychopharmacological challenge with the cholinesterase inhibitor galantamine (Reminyl). This allowed us to characterize the cholinergic modulation of selective attention formally, in terms of hierarchical Bayesian inference. In a placebo-controlled, within-subject, crossover design, 16 healthy human subjects performed a modified version of Posner's location-cueing task in which the proportion of validly and invalidly cued targets (percentage of cue validity, % CV) changed over time. Saccadic response speeds were used to estimate the parameters of a hierarchical Bayesian model to test whether cholinergic stimulation affected the trial-wise updating of probabilistic beliefs that underlie the allocation of attention or whether galantamine changed the mapping from those beliefs to subsequent eye movements. Behaviorally, galantamine led to a greater influence of probabilistic context (% CV) on response speed than placebo. Crucially, computational modeling suggested this effect was due to an increase in the rate of belief updating about cue validity (as opposed to the increased sensitivity of behavioral responses to those beliefs). We discuss these findings with respect to cholinergic effects on hierarchical cortical processing and in relation to the encoding of expected uncertainty or precision. PMID:25411501

  8. The many faces of dissociation: opportunities for innovative research in psychiatry.

    PubMed

    Şar, Vedat

    2014-12-01

    It has been claimed that the progress of psychiatry has lagged behind that of other medical disciplines over the last few decades. This may suggest the need for innovative thinking and research in psychiatry, which should consider neglected areas as topics of interest in light of the potential progress which might be made in this regard. This review is concerned with one such field of psychiatry: dissociation and dissociative disorders. Dissociation is the ultimate form of human response to chronic developmental stress, because patients with dissociative disorders report the highest frequency of childhood abuse and/or neglect among all psychiatric disorders. The cardinal feature of dissociation is a disruption in one or more mental functions. Dissociative amnesia, depersonalization, derealization, identity confusion, and identity alterations are core phenomena of dissociative psychopathology which constitute a single dimension characterized by a spectrum of severity. While dissociative identity disorder (DID) is the most pervasive condition of all dissociative disorders, partial representations of this spectrum may be diagnosed as dissociative amnesia (with or without fugue), depersonalization disorder, and other specified dissociative disorders such as subthreshold DID, dissociative trance disorder, acute dissociative disorders, and identity disturbances due to exposure to oppression. In addition to constituting disorders in their own right, dissociation may accompany almost every psychiatric disorder and operate as a confounding factor in general psychiatry, including neurobiological and psycho-pharmacological research. While an anti- dissociative drug does not yet exist, appropriate psychotherapy leads to considerable improvement for many patients with dissociative disorders. PMID:25598819

  9. Obesity in Children with Autism Spectrum Disorders

    PubMed Central

    Curtin, Carol; Jojic, Mirjana; Bandini, Linda G.

    2014-01-01

    Research suggests that children with autism spectrum disorders (ASD) have a prevalence of obesity at least as high as that seen in typically developing (TD) children. Many of the risk factors for children with ASD are likely the same as for TD children, especially within the context of today's obesogenic environment. However, the unique needs and challenges that this population faces may also render them more susceptible to the adverse effects of typical risk factors, and they may also be vulnerable to additional risk factors not shared by children in the general population. Psychopharmacological treatment, genetics, disordered sleep, atypical eating patterns, and challenges for engaging in sufficient physical activity may be uniquely associated with the development of obesity in children with ASD. Obesity and its associated sequelae potentially represent a significant threat to independent living, self-care, quality of life, and health for individuals with ASD. This article provides a summary of the literature on the prevalence of obesity in children with ASD and the putative obesity risk factors that this population may experience. PMID:24614764

  10. Eating behavior in anorexia nervosa--an excess of both orexigenic and anorexigenic signalling?

    PubMed

    Inui, A

    2001-11-01

    Anorexia nervosa (AN) is a disorder characterized by abnormal eating behavior, weight regulation, and disturbances in attitudes and perceptions toward body weight and shape. Although progress has been made in the treatment of AN, a substantial portion of patients have a limited response to treatment. Multiple endocrine and metabolic changes occur after prolonged starvation, conserving energy and protein. A number of the endocrine findings in patients with AN may be secondary to adaptive mechanisms. However, AN differs from simple starvation in that excess of both feeding-stimulatory (orexigenic) and feeding-inhibitory (anorexigenic) signalling is characteristic, producing the "mixed" signal about satiety and desire to feed. This leads to a failure of the adaptive feeding response that is initiated by a decrease in leptin, an adiposity signal from fat tissue, and the resultant increase and decrease of orexigenic and anorexigenic signalling, respectively. The hypothesis of unbalanced shift of feeding-regulatory circuitry places anorexigenic corticotropin-releasing factor and orexigenic neuropeptide Y in the final common neurobiological substrate for AN. Therapeutic intervention using such receptor antagonists may lead to more successful and targeted psychopharmacological treatment. PMID:11673789

  11. Uncaria tomentosa (Willd. ex. Roem. & Schult.) DC. and Eucalyptus globulus Labill. interactions when administered with diazepam.

    PubMed

    Quílez, A M; Saenz, M T; García, M D

    2012-03-01

    The safety of natural drugs is defined by their side effects and toxicity as well as any interactions that may occur if taken together with other drugs. In particular, it is essential to identify synergies, antagonisms and other types of interference with other drugs so that the correct choice can be made from the range of phytomedicines available. The aim of this work was to investigate changes in the pharmacological effect of diazepam (2 mg/kg) on the CNS when administered together with a medicinal plant: Eucalyptus globulus Labill. (eucalyptus 6 mg/kg and 3.25 mg/kg) or Uncaria tomentosa (Willd. ex Roem. & Schult). DC. (cat's claw, 7.14 mg/kg and 3.54 mg/kg). Various different psychopharmacological effects were evaluated through assessing exploratory behavior, muscle relaxation and spontaneous motor activity. Both phytodrugs interacted with the benzodiazepine. Eucalyptus had an inhibitory effect at both doses and could be useful at the highest dose in cases where the desired effect of the depressant is moderate anxiolytic activity without marked muscle relaxation. Cat's claw, at both doses, enhanced the action of diazepam on spontaneous motor activity and, at the lowest dose, exploratory ability. These herbal drugs could be useful for their antiinflammatory activity in musculoskeletal pathologies treated with benzodiazepines. PMID:21928376

  12. Multiple receptors contribute to the behavioral effects of indoleamine hallucinogens

    PubMed Central

    Halberstadt, Adam L.; Geyer, Mark A.

    2011-01-01

    Serotonergic hallucinogens produce profound changes in perception, mood, and cognition. These drugs include phenylalkylamines such as mescaline and 2,5-dimethoxy-4-methylamphetamine (DOM), and indoleamines such as (+)-lysergic acid diethylamide (LSD) and psilocybin. Despite their differences in chemical structure, the two classes of hallucinogens produce remarkably similar subjective effects in humans, and induce cross-tolerance. The phenylalkylamine hallucinogens are selective 5-HT2 receptor agonists, whereas the indoleamines are relatively non-selective for serotonin (5-HT) receptors. There is extensive evidence, from both animal and human studies, that the characteristic effects of hallucinogens are mediated by interactions with the 5-HT2A receptor. Nevertheless, there is also evidence that interactions with other receptor sites contribute to the psychopharmacological and behavioral effects of the indoleamine hallucinogens. This article reviews the evidence demonstrating that the effects of indoleamine hallucinogens in a variety of animal behavioral paradigms are mediated by both 5-HT2 and non-5-HT2 receptors. PMID:21256140

  13. Strategies for the long-term treatment of schizophrenia: real-world lessons from the CATIE trial.

    PubMed

    Meyer, Jonathan M

    2007-01-01

    Patients with schizophrenia have a chronic illness necessitating a biopsychosocial model of care that addresses the multiple dimensions of the disease, including coordinated primary care. Current research, including the lessons learned from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study, shows that in addition to education, adherence, and minimizing adverse effects of psychopharmacologic agents, multimodal long-term treatment strategies are needed to address medical comorbidities, substance abuse, and both cognitive and social deficits. Health care professionals have the responsibility to monitor and help prevent adverse medical outcomes related to treatment with antipsychotics, in light of evidence that patients with schizophrenia are at risk for metabolic disorders and are undertreated for highly prevalent cardiovascular risk factors. These medical problems are particularly challenging in this population due to the chronicity of symptoms, cognitive limitations, social and financial challenges, and compliance issues with recommended medication treatment and therapeutic lifestyle changes. Mental health providers in the United States are now studying models that support the integration of psychiatric and nonpsychiatric medical treatment to address the complexity of multimodal schizophrenia care. PMID:17286525

  14. Fragile X Premutation Disorders – Expanding the Psychiatric Perspective

    PubMed Central

    Bourgeois, James; Coffey, Sarah; Rivera, Susan M.; Hessl, David; Gane, Louise W.; Tassone, Flora; Greco, Claudia; Finucane, Brenda; Nelson, Lawrence; Berry-Kravis, Elizabeth; Grigsby, Jim; Hagerman, Paul J.; Hagerman, Randi J.

    2008-01-01

    Objective: Fragile X premutation conditions are associated with a significant degree of psychopathology and thus are of interest to the psychiatrist. Remarkable advances at the molecular level have enhanced our understanding of fragile X premutation disorders. Methods: The authors review the genetic, molecular, neuroimaging, and clinical (systemic, neurologic, and psychiatric) manifestations of the premutation carrier state (55-200 CGG repeats) of the fragile X mental retardation 1 (FMR1) gene. Results: Clinical manifestations of psychiatric illness in premutation carriers include cognitive, mood, anxiety, and other psychiatric disorders. Fragile X premutation-associated conditions are part of the clinical differential diagnosis of several psychiatric syndromes, particularly in pedigrees with known fragile X syndrome (FXS) cases. Conclusions: Fragile X-associated psychiatric manifestations serve as a useful model for a molecular genesis of neuropsychiatric illness. Because of the multigenerational expression of fragile X-associated neuropsychiatric illness, there is a prominent role for genetic testing and genetic counseling of patients and their relatives. Genetic testing is confirmatory of the FMR1 premutation and is an essential component of the clinical evaluation. Psychopharmacological and psychotherapeutic treatment of fragile X-associated psychiatric illnesses may improve patient function and assist in adaptation to the burden of a genetic neuropsychiatric illness. PMID:19422761

  15. Use of a portable biofeedback device to improve insomnia in a combat zone, a case report.

    PubMed

    McLay, Robert N; Spira, James L

    2009-12-01

    Insomnia is a common problem in situations of stress. Some forms of stress, however, may contraindicate the use of traditional, pharmacological interventions. Working in a combat zone is such a situation. Alternative means of improving sleep are clearly needed for Service Members. We report a case involving a medical provider who was serving in a military, emergency-services facility in Iraq, and who presented with anxiety, depressed mood, and insomnia. Symptoms were sub-threshold for major depressive disorder or acute stress disorder. Mood and anxiety symptoms responded to traditional therapy techniques, but problems with insomnia remained. The patient was given a portable biofeedback device that employs an infrared sensor photoplethysmograph to measure heart rate variability (HRV) from peripheral finger pulse. One week later, sleep was significantly improved. Symptom improvement lasted to at least 6 weeks while in theater. One year later, a check-in with the patient revealed that after returning home, he had been diagnosed with post traumatic stress disorder (PTSD). PTSD symptoms had resolved after 6 months of psychopharmacology and cognitive behavioral therapy. These results indicate that biofeedback may be a useful means of improving sleep in a combat zone, but that such improvements may not necessarily prevent the development of more serious symptoms later. No clear causality can be inferred from a single case, and further study is needed to determine if this finding have wider applicability. PMID:19655243

  16. Technology-Enhanced Stepped Collaborative Care Targeting Posttraumatic Stress Disorder and Comorbidity After Injury: A Randomized Controlled Trial.

    PubMed

    Zatzick, Douglas; O'Connor, Stephen S; Russo, Joan; Wang, Jin; Bush, Nigel; Love, Jeff; Peterson, Roselyn; Ingraham, Leah; Darnell, Doyanne; Whiteside, Lauren; Van Eaton, Erik

    2015-10-01

    Posttraumatic stress disorder (PTSD) and its comorbidities are endemic among injured trauma survivors. Previous collaborative care trials targeting PTSD after injury have been effective, but they have required intensive clinical resources. The present pragmatic clinical trial randomized acutely injured trauma survivors who screened positive on an automated electronic medical record PTSD assessment to collaborative care intervention (n = 60) and usual care control (n = 61) conditions. The stepped measurement-based intervention included care management, psychopharmacology, and psychotherapy elements. Embedded within the intervention were a series of information technology (IT) components. PTSD symptoms were assessed with the PTSD Checklist at baseline prerandomization and again, 1-, 3-, and 6-months postinjury. IT utilization was also assessed. The technology-assisted intervention required a median of 2.25 hours (interquartile range = 1.57 hours) per patient. The intervention was associated with modest symptom reductions, but beyond the margin of statistical significance in the unadjusted model: F(2, 204) = 2.95, p = .055. The covariate adjusted regression was significant: F(2, 204) = 3.06, p = .049. The PTSD intervention effect was greatest at the 3-month (Cohen's effect size d = 0.35, F(1, 204) = 4.11, p = .044) and 6-month (d = 0.38, F(1, 204) = 4.10, p = .044) time points. IT-enhanced collaborative care was associated with modest PTSD symptom reductions and reduced delivery times; the intervention model could potentially facilitate efficient PTSD treatment after injury. PMID:26467327

  17. Detecting a signal in the noise: monitoring the global spread of novel psychoactive substances using media and other open-source information†

    PubMed Central

    Young, Matthew M; Dubeau, Chad; Corazza, Ornella

    2015-01-01

    Objective To determine the feasibility and utility of using media reports and other open-source information collected by the Global Public Health Intelligence Network (GPHIN), an event-based surveillance system operated by the Public Health Agency of Canada, to rapidly detect clusters of adverse drug events associated with ‘novel psychoactive substances’ (NPS) at the international level. Methods and Results Researchers searched English media reports collected by the GPHIN between 1997 and 2013 for references to synthetic cannabinoids. They screened the resulting reports for relevance and content (i.e., reports of morbidity and arrest), plotted and compared with other available indicators (e.g., US poison control center exposures). The pattern of results from the analysis of GPHIN reports resembled the pattern seen from the other indicators. Conclusions The results of this study indicate that using media and other open-source information can help monitor the presence, usage, local policy, law enforcement responses, and spread of NPS in a rapid effective way. Further, modifying GPHIN to actively track NPS would be relatively inexpensive to implement and would be highly complementary to current national and international monitoring efforts. © 2015 The Authors. Human Psychopharmacology: Clinical and Experimental published by John Wiley & Sons, Ltd. PMID:26216568

  18. Novelty Seeking and Drug Addiction in Humans and Animals: From Behavior to Molecules.

    PubMed

    Wingo, Taylor; Nesil, Tanseli; Choi, Jung-Seok; Li, Ming D

    2016-09-01

    Global treatment of drug addiction costs society billions of dollars annually, but current psychopharmacological therapies have not been successful at desired rates. The increasing number of individuals suffering from substance abuse has turned attention to what makes some people more vulnerable to drug addiction than others. One personality trait that stands out as a contributing factor is novelty seeking. Novelty seeking, affected by both genetic and environmental factors, is defined as the tendency to desire novel stimuli and environments. It can be measured in humans through questionnaires and in rodents using behavioral tasks. On the behavioral level, both human and rodent studies demonstrate that high novelty seeking can predict the initiation of drug use and a transition to compulsive drug use and create a propensity to relapse. These predictions are valid for several drugs of abuse, such as alcohol, nicotine, cocaine, amphetamine, and opiates. On the molecular level, both novelty seeking and addiction are modulated by the central reward system in the brain. Dopamine is the primary neurotransmitter involved in the overlapping neural substrates of both parameters. In sum, the novelty-seeking trait can be valuable for predicting individual vulnerability to drug addiction and for generating successful treatment for patients with substance abuse disorders. PMID:26481371

  19. Multiple receptors contribute to the behavioral effects of indoleamine hallucinogens.

    PubMed

    Halberstadt, Adam L; Geyer, Mark A

    2011-09-01

    Serotonergic hallucinogens produce profound changes in perception, mood, and cognition. These drugs include phenylalkylamines such as mescaline and 2,5-dimethoxy-4-methylamphetamine (DOM), and indoleamines such as (+)-lysergic acid diethylamide (LSD) and psilocybin. Despite their differences in chemical structure, the two classes of hallucinogens produce remarkably similar subjective effects in humans, and induce cross-tolerance. The phenylalkylamine hallucinogens are selective 5-HT(2) receptor agonists, whereas the indoleamines are relatively non-selective for serotonin (5-HT) receptors. There is extensive evidence, from both animal and human studies, that the characteristic effects of hallucinogens are mediated by interactions with the 5-HT(2A) receptor. Nevertheless, there is also evidence that interactions with other receptor sites contribute to the psychopharmacological and behavioral effects of the indoleamine hallucinogens. This article reviews the evidence demonstrating that the effects of indoleamine hallucinogens in a variety of animal behavioral paradigms are mediated by both 5-HT(2) and non-5-HT(2) receptors. PMID:21256140

  20. Age-related changes of adaptive and neuropsychological features in persons with Down Syndrome.

    PubMed

    Ghezzo, Alessandro; Salvioli, Stefano; Solimando, Maria Caterina; Palmieri, Alice; Chiostergi, Chiara; Scurti, Maria; Lomartire, Laura; Bedetti, Federica; Cocchi, Guido; Follo, Daniela; Pipitone, Emanuela; Rovatti, Paolo; Zamberletti, Jessica; Gomiero, Tiziano; Castellani, Gastone; Franceschi, Claudio

    2014-01-01

    Down Syndrome (DS) is characterised by premature aging and an accelerated decline of cognitive functions in the vast majority of cases. As the life expectancy of DS persons is rapidly increasing, this decline is becoming a dramatic health problem. The aim of this study was to thoroughly evaluate a group of 67 non-demented persons with DS of different ages (11 to 66 years), from a neuropsychological, neuropsychiatric and psychomotor point of view in order to evaluate in a cross-sectional study the age-related adaptive and neuropsychological features, and to possibly identify early signs predictive of cognitive decline. The main finding of this study is that both neuropsychological functions and adaptive skills are lower in adult DS persons over 40 years old, compared to younger ones. In particular, language and short memory skills, frontal lobe functions, visuo-spatial abilities and adaptive behaviour appear to be the more affected domains. A growing deficit in verbal comprehension, along with social isolation, loss of interest and greater fatigue in daily tasks, are the main features found in older, non demented DS persons evaluated in our study. It is proposed that these signs can be alarm bells for incipient dementia, and that neuro-cognitive rehabilitation and psycho-pharmacological interventions must start as soon as the fourth decade (or even earlier) in DS persons, i.e. at an age where interventions can have the greatest efficacy. PMID:25419980

  1. Efficacy of Electroconvulsive Therapy in Bipolar Disorder with Mixed Features.

    PubMed

    Palma, Miguel; Ferreira, Berta; Borja-Santos, Nuno; Trancas, Bruno; Monteiro, Céu; Cardoso, Graça

    2016-01-01

    Introduction. Mixed states represent a frequent presentation of bipolar disorder, associated with higher resistance to psychopharmacology. Limited evidence supports the use of ECT in these patients. We aim to report our experience on treating bipolar mixed states with ECT. Methods. Retrospective data were collected from all bipolar patients submitted to acute ECT treatment, between June 2006 and June 2011. Three groups were created in terms of affective polarity of the episode. CGI rating was used to establish clinical remission and demographic and clinical variables were compared among groups. Long-term outcome was assessed through readmission measures, considering the use of continuation or maintenance ECT. Results. During the study time frame, a total of 50 ECT course treatments were performed on 41 bipolar patients. All affective episodes, except one mixed state, showed a positive clinical response. Patients with mixed state presentation tended to be younger and have an earlier first hospitalization than depressed patients. No differences were found in terms of ECT sessions performed, length of hospital admission, referral to continuation ECT treatment, number of readmissions, and time until next readmission. Conclusions. Our results support the effectiveness of ECT in patients experiencing a mixed affective state. PMID:26881069

  2. Novel mechanisms and treatment approaches in autism spectrum disorder.

    PubMed

    Brian, Jessica; Doyle-Thomas, Krissy; Baribeau, Danielle; Anagnostou, Evdokia

    2016-08-01

    Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by marked heterogeneity in biology, expression, and response to treatment. The past decade has yielded considerable progress in understanding the underlying biological mechanisms, in characterizing the earliest behavioral phenotype(s), and in developing and evaluating effective treatments for ASD. This review highlights recent research advances in genetics and neuroimaging, as well as in novel behavioral and psychopharmacological treatment approaches, arguing for the value of trans-disciplinary initiatives to move the field forward exponentially. Despite considerable complexity, patterns are beginning to emerge that can inform the identification of novel treatment targets and approaches. The next generation of major innovations in ASD research will involve collaborations across genetics/genomics, neuroimaging, and intervention science. Such efforts, currently under way, hold tremendous promise for exponentially increasing our capacity to understand the mechanisms that contribute to the emergence of ASD and to develop and evaluate personalized interventions that yield maximal impact in a meaningful way. PMID:27585230

  3. Horizon 2020 priorities in clinical mental health research: results of a consensus-based ROAMER expert survey.

    PubMed

    Elfeddali, Iman; van der Feltz-Cornelis, Christina M; van Os, Jim; Knappe, Susanne; Vieta, Eduard; Wittchen, Hans-Ulrich; Obradors-Tarragó, Carla; Haro, Josep Maria

    2014-01-01

    Within the ROAMER project, which aims to provide a Roadmap for Mental Health Research in Europe, a two-stage Delphi survey among 86 European experts was conducted in order to identify research priorities in clinical mental health research. Expert consensus existed with regard to the importance of three challenges in the field of clinical mental health research: (1) the development of new, safe and effective interventions for mental disorders; (2) understanding the mechanisms of disease in order to be able to develop such new interventions; and (3) defining outcomes (an improved set of outcomes, including alternative outcomes) to use for clinical mental health research evaluation. Proposed actions involved increasing the utilization of tailored approaches (personalized medicine), developing blended eHealth/mHealth decision aids/guidance tools that help the clinician to choose between various treatment modalities, developing specific treatments in order to better target comorbidity and (further) development of biological, psychological and psychopharmacological interventions. The experts indicated that addressing these priorities will result in increased efficacy and impact across Europe; with a high probability of success, given that Europe has important strengths, such as skilled academics and a long research history. Finally, the experts stressed the importance of creating funding and coordinated networking as essential action needed in order to target the variety of challenges in clinical mental health research. PMID:25337940

  4. The behavioral pharmacology of hallucinogens

    PubMed Central

    Fantegrossi, William E.; Murnane, Aeneas C.; Reissig, Chad J.

    2008-01-01

    Until very recently, comparatively few scientists were studying hallucinogenic drugs. Nevertheless, selective antagonists are available for relevant serotonergic receptors, the majority of which have now been cloned, allowing for reasonably thorough pharmacological investigation. Animal models sensitive to the behavioral effects of the hallucinogens have been established and exploited. Sophisticated genetic techniques have enabled the development of mutant mice, which have proven useful in the study of hallucinogens. The capacity to study post-receptor signaling events has lead to the proposal of a plausible mechanism of action for these compounds. The tools currently available to study the hallucinogens are thus more plentiful and scientifically advanced than were those accessible to earlier researchers studying the opioids, benzodiazepines, cholinergics, or other centrally active compounds. The behavioral pharmacology of phenethylamine, tryptamine, and ergoline hallucinogens are described in this review, paying particular attention to important structure activity relationships which have emerged, receptors involved in their various actions, effects on conditioned and unconditioned behaviors, and in some cases, human psychopharmacology. As clinical interest in the therapeutic potential of these compounds is once again beginning to emerge, it is important to recognize the wealth of data derived from controlled preclinical studies on these compounds. PMID:17977517

  5. Current Diagnosis and Treatment of Anxiety Disorders

    PubMed Central

    Bystritsky, Alexander; Khalsa, Sahib S.; Cameron, Michael E.; Schiffman, Jason

    2013-01-01

    Anxiety disorders are the most prevalent mental health conditions. Although they are less visible than schizophrenia, depression, and bipolar disorder, they can be just as disabling. The diagnoses of anxiety disorders are being continuously revised. Both dimensional and structural diagnoses have been used in clinical treatment and research, and both methods have been proposed for the new classification in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-5). However, each of these approaches has limitations. More recently, the emphasis in diagnosis has focused on neuroimaging and genetic research. This approach is based partly on the need for a more comprehensive understanding of how biology, stress, and genetics interact to shape the symptoms of anxiety. Anxiety disorders can be effectively treated with psychopharmacological and cognitive–behavioral interventions. These inter ventions have different symptom targets; thus, logical combinations of these strategies need to be further studied in order to improve future outcomes. New developments are forthcoming in the field of alternative strategies for managing anxiety and for treatment-resistant cases. Additional treatment enhancements should include the development of algorithms that can be easily used in primary care and with greater focus on managing functional impairment in patients with anxiety. PMID:23599668

  6. Everolimus and intensive behavioral therapy in an adolescent with tuberous sclerosis complex and severe behavior☆☆☆★

    PubMed Central

    Gipson, Tanjala T.; Jennett, Heather; Wachtel, Lee; Gregory, Mary; Poretti, Andrea; Johnston, Michael V.

    2013-01-01

    Background Self-injury and aggression have been reported in individuals with TSC (tuberous sclerosis complex), yet few data exist about treatment. Everolimus, an mTOR inhibitor, has been FDA-approved for subependymal giant cell astrocytomas (SEGAs) and renal angiomyolipomas in TSC. However, clinical use of everolimus with direct, real-time observations of self-injury and aggression in an individual with TSC has not been reported. Methods During an inpatient admission to a neurobehavioral unit, real-time measurements of behaviors and seizures were recorded. An interdisciplinary team used these data to make treatment decisions and applied behavioral and pharmacological treatments, one at a time, in order to evaluate their effects. Results Aggression and self-injury improved with applied behavioral analysis (ABA), lithium, and asenapine. Improvements in SEGA size, facial angiofibromas, seizures, and the most stable low rates of self-injury were observed during the interval of treatment with everolimus. Conclusion Mechanism-based treatments in the setting of an evidence-based behavioral and psychopharmacological intervention program may be a model with utility for characterization and treatment of individuals with severe behavior and TSC. PMID:25667844

  7. Gender-related features of persistent delusional disorders.

    PubMed

    Wustmann, Tobias; Pillmann, Frank; Marneros, Andreas

    2011-02-01

    This paper presents gender-related features of Delusional Disorder. It is part of the Halle Delusional Syndromes Study (HADES-Study). All inpatients fulfilling the DSM-IV/ICD-10 criteria of Delusional Disorder/Persistent Delusional Disorder (DD) during a 14-year period were included and followed up for an average of 10.8 years. Gender distribution was almost equal, women became ill significantly later than men, and almost all women had a stable diagnosis-in contrast to men. The great majority of women, at the end of the follow-up period, had an unremitted DD. Women more frequently had low social functioning at admission, but then were more compliant and received more frequently pharmacological medication. There were no differences in the delusional topic and no differences regarding long-term disability and autarky. In spite of previous reports, the HADES-Study found no gender difference in the frequency of DD. However, men tended more frequently to change into schizophrenia and schizoaffective disorder. In these cases, the DD might have been a prodrome of schizophrenia or schizoaffective disorder, which manifests later in life. Although in both female and male DD patients, the majority remained unremitted, almost none of them lost their autarky (independent living). While women more frequently received psychopharmacological medication, their DD was usually found to be unremitted. PMID:20700601

  8. Post-traumatic stress disorder in Asian refugees.

    PubMed

    Ton-That, N

    1998-12-01

    This study profiles 127 cases of Vietnamese, Cambodian, Laotian and Chinese refugee outpatients diagnosed with post-traumatic stress disorder (PTSD). Traumatic etiologies included victims of wars such as political refugees, concentration camp prisoners and victims of rape, severe personal losses (property or human lives). These traumata were experienced by our subjects during the period between the end of the Vietnam war in April 1975 and recent times, when they finally arrived in the USA. Clinical symptoms of these subjects reflected many influences of their oriental culture background and are characterized by internalization that needs to be overcome for assessment as well as for therapy. Symptomatic treatment with psychopharmacology and supportive therapy are helpful while cultural approaches have been adopted by many patients to reach the inner self pathology that could be of both mental and organic in nature. These facts need to be taken into consideration in the future description of the PTSD clinical picture. Recommendations are made for future PTSD studies in Vietnam, Cambodia and Laos, and to promote a global movement for prevention of any socio-political situation that may generate PTSD. PMID:9895199

  9. Age-Related Changes of Adaptive and Neuropsychological Features in Persons with Down Syndrome

    PubMed Central

    Ghezzo, Alessandro; Salvioli, Stefano; Solimando, Maria Caterina; Palmieri, Alice; Chiostergi, Chiara; Scurti, Maria; Lomartire, Laura; Bedetti, Federica; Cocchi, Guido; Follo, Daniela; Pipitone, Emanuela; Rovatti, Paolo; Zamberletti, Jessica; Gomiero, Tiziano; Castellani, Gastone; Franceschi, Claudio

    2014-01-01

    Down Syndrome (DS) is characterised by premature aging and an accelerated decline of cognitive functions in the vast majority of cases. As the life expectancy of DS persons is rapidly increasing, this decline is becoming a dramatic health problem. The aim of this study was to thoroughly evaluate a group of 67 non-demented persons with DS of different ages (11 to 66 years), from a neuropsychological, neuropsychiatric and psychomotor point of view in order to evaluate in a cross-sectional study the age-related adaptive and neuropsychological features, and to possibly identify early signs predictive of cognitive decline. The main finding of this study is that both neuropsychological functions and adaptive skills are lower in adult DS persons over 40 years old, compared to younger ones. In particular, language and short memory skills, frontal lobe functions, visuo-spatial abilities and adaptive behaviour appear to be the more affected domains. A growing deficit in verbal comprehension, along with social isolation, loss of interest and greater fatigue in daily tasks, are the main features found in older, non demented DS persons evaluated in our study. It is proposed that these signs can be alarm bells for incipient dementia, and that neuro-cognitive rehabilitation and psycho-pharmacological interventions must start as soon as the fourth decade (or even earlier) in DS persons, i.e. at an age where interventions can have the greatest efficacy. PMID:25419980

  10. Cognitive Remediation: Potential Novel Brain-Based Treatment for Bipolar Disorder in Children and Adolescents

    PubMed Central

    Dickstein, Daniel P.; Cushman, Grace K.; Kim, Kerri L.; Weissman, Alexandra B.; Wegbreit, Ezra

    2015-01-01

    Bipolar disorder (BD) is among the most impairing psychiatric disorders affecting children and adolescents, despite our best psychopharmacological and psychotherapeutic treatments. Cognitive remediation, defined as a behavioral intervention designed to improve cognitive functions so as to reduce psychiatric illness, is an emerging brain-based treatment approach that has thus far not been studied in pediatric BD. The present article reviews the basic principles of cognitive remediation, describes what is known about cognitive remediation in psychiatric disorders, and delineates potential brain/behavior alterations implicated in pediatric BD that might be targets for cognitive remediation. Emerging data shows that cognitive remediation may be useful in children and adults with schizophrenia, ADHD, and anxiety disorders, and in adults with BD. Potential targets for cognitive remediation in pediatric BD include face processing, response inhibition, frustration, and cognitive flexibility. Further study is warranted to determine if cognitive remediation for these targets, or others, may serve as a novel, brain-based treatment for pediatric BD. PMID:26135596

  11. Lytic effector cell function in schizophrenia and depression.

    PubMed

    Urch, A; Müller, C; Aschauer, H; Resch, F; Zielinski, C C

    1988-07-01

    Natural killer (NK) cell activity and antibody-dependent cellular cytotoxicity (ADCC) were tested in patients with schizophrenia or depression. It was found that NK activity as well as ADCC were significantly lower in both groups, as compared to healthy control individuals (P less than 0.001). Psychopharmacologic treatment with neuroleptics and antidepressives resulted in a significant increase in NK activity and ADCC (P less than 0.005) in patients with schizophrenia but not in treated patients with depression. In patients with schizophrenia, no correlation could be established between the dose of neuroleptic given and the increase in NK activity. Lithium also did not produce an increase in NK activity and ADCC. The addition of serum, derived from untreated patients with schizophrenia, to cell cultures in concentrations of 10 and 20% had an inhibitory effect upon the ADCC and, to a lesser degree, upon NK activity (20% serum concentration only); sera from treatment schizophrenics produced no inhibition of NK activity, but did affect ADCC. No serum-derived inhibitory effect upon either NK activity or ADCC was found to be present in sera from patients with depression. We conclude that lytic effector mechanisms are impaired in patients with schizophrenia or depression and that this defect is reversed in schizophrenic patients on treatment, but not in depressives on therapy. Patients with schizophrenia also tend to have a reversible serum-mediated inhibition of NK activity which is absent in patients with depression. PMID:2898486

  12. Methylphenidate and emotional-motivational processing in attention-deficit/hyperactivity disorder.

    PubMed

    Conzelmann, Annette; Woidich, Eva; Mucha, Ronald F; Weyers, Peter; Müller, Mathias; Lesch, Klaus-Peter; Jacob, Christian P; Pauli, Paul

    2016-08-01

    In line with the assumption that emotional-motivational deficits are one core dysfunction in ADHD, in one of our previous studies we observed a reduced reactivity towards pleasant pictures in adult ADHD patients as compared to controls. This was indicated by a lack of attenuation of the startle reflex specifically during pleasant pictures in ADHD patients. The first choice medical agents in ADHD, methylphenidate (MPH), is discussed to normalize these dysfunctions. However, experimental evidence in the sense of double-blind placebo-controlled study designs is lacking. Therefore, we investigated 61 adult ADHD patients twice, one time with placebo and one time with MPH with the same experimental design as in our study previously and assessed emotion processing during the presentation of pleasant, neutral and unpleasant pictures. We obtained startle reflex data as well as valence and arousal ratings in association with the pictures. As previously shown, ADHD patients showed a diminished startle attenuation during pleasant pictures while startle potentiation during unpleasant pictures was normal. Valence and arousal ratings unsuspiciously increased with increasing pleasantness and arousal of the pictures, respectively. There were no significant influences of MPH. The study replicates that ADHD patients show a reduced reactivity towards pleasant stimuli. MPH did not normalize this dysfunction. Possibly, MPH only influences emotions during more complex behavioural tasks that involve executive functions in adults with ADHD. Our results emphasize the importance for the use of double-blind placebo-controlled designs in psychopharmacological research. PMID:26852138

  13. Integrating Neuroscience Knowledge and Neuropsychiatric Skills Into Psychiatry: The Way Forward.

    PubMed

    Schildkrout, Barbara; Benjamin, Sheldon; Lauterbach, Margo D

    2016-05-01

    Increasing the integration of neuroscience knowledge and neuropsychiatric skills into general psychiatric practice would facilitate expanded approaches to diagnosis, formulation, and treatment while positioning practitioners to utilize findings from emerging brain research. There is growing consensus that the field of psychiatry would benefit from more familiarity with neuroscience and neuropsychiatry. Yet there remain numerous factors impeding the integration of these domains of knowledge into general psychiatry.The authors make recommendations to move the field forward, focusing on the need for advocacy by psychiatry and medical organizations and changes in psychiatry education at all levels. For individual psychiatrists, the recommendations target obstacles to attaining expanded neuroscience and neuropsychiatry education and barriers stemming from widely held, often unspoken beliefs. For the system of psychiatric care, recommendations address the conceptual and physical separation of psychiatry from medicine, overemphasis on the Diagnostic and Statistical Manual of Mental Disorders and on psychopharmacology, and different systems in medicine and psychiatry for handling reimbursement and patient records. For psychiatry residency training, recommendations focus on expanding neuroscience/neuropsychiatry faculty and integrating neuroscience education throughout the curriculum.Psychiatry traditionally concerns itself with helping individuals construct meaningful life narratives. Brain function is one of the fundamental determinants of individuality. It is now possible for psychiatrists to integrate knowledge of neuroscience into understanding the whole person by asking, What person has this brain? How does this brain make this person unique? How does this brain make this disorder unique? What treatment will help this disorder in this person with this brain? PMID:26630604

  14. Evaluation of Behavioral and Pharmacological Effects of Hydroalcoholic Extract of Valeriana prionophylla Standl. from Guatemala

    PubMed Central

    Holzmann, Iandra; Cechinel Filho, Valdir; Mora, Ticiana C.; Cáceres, Armando; Martínez, Jose Vicente; Cruz, Sully M.; de Souza, Márcia Maria

    2011-01-01

    There are few studies on the pharmacological properties of Valeriana prionophylla Standl. (VP), known as “Valeriana del monte”, and used in Mesoamerican folk medicine to treat sleep disorders. This study examines the pharmacological effects of the hydroalcoholic extract of the dry rhizome using the open field, rota rod, elevated plus-maze (EPM), forced swimming (FST), strychnine- and pentobarbital-induced sleeping time, PTZ-induced seizures, and the inhibitory avoidance tests. VP did not show any protective effect against PTZ-induced convulsions. In the EPM, exhibited an anxiolytic-like effect through the effective enhancement of the entries (38.5%) and time spent (44.7%) in the open arms, when compared with control group. Time spent and the numbers of entrances into the enclosed arms were decreased, similar to those effects observed with diazepam. In the FST, acute treatment with VP, produced a dose-dependent decrease in immobility time, similarly to imipramine. VP also produced a significant dose-dependent decrease in the latency of sleeping time, while producing an increase in total duration of sleep; influenced memory consolidation of the animals only at lower doses, unlike those that produced anti-depressant and anxiolytic effects. In summary, the results suggest that VP presents several psychopharmacological activities, including anxiolytic, antidepressant, and hypno-sedative effects. PMID:21754942

  15. [Anxiety and panic in emergency medicine--the right diagnosis and treatment].

    PubMed

    Berzewski, Horst

    2011-04-01

    Fearful patients are in emergency situation often inattentive, unable to concentrate, agitated or even aroused. They show reduced perception and restricted willingness to cooperate. In severe conditions these patients are strongly tending towards more hazardous behavior: refusal of necessary therapy, break out or even high suicidal risk. Within disaster situations (mass accidents, fires) fearful patients with their agitated and persuasive behavior can influence other victims and with that trigger a situation of mass panic that has to be avoided at any cost. Therefore these patients must be swiftly identified and separated from the event. A diligent diagnosis process including physical-neurological examination is necessary. The recommended treatment within the emergency situation consists of a close continuous personal contact through assuring and encouraging conversations. A sense of security should be created by explaining the planned therapeutic interventions in simple, easy-to-follow and understandable words. If this necessary psycho-therapeutic intervention can not be applied a short term psychopharmacological treatment is required preferably with Benzodiazepines. Still a longterm specific therapy is highly advised, since these disturbances, if left untreated, will lead to a chronic manifestation and with that to considerable psychosocial impairments. PMID:21484618

  16. Pattern of healthcare resource utilization and direct costs associated with manic episodes in Spain

    PubMed Central

    2010-01-01

    Background Although some studies indicate that bipolar disorder causes high health care resources consumption, no study is available addressing a cost estimation of bipolar disorder in Spain. The aim of this observational study was to evaluate healthcare resource utilization and the associated direct cost in patients with manic episodes in the Spanish setting. Methods Retrospective descriptive study was carried out in a consecutive sample of patients with a DSM-IV diagnosis of bipolar type I disorder with or without psychotic symptoms, aged 18 years or older, and who were having an active manic episode at the time of inclusion. Information regarding the current manic episode was collected retrospectively from the medical record and patient interview. Results Seven hundred and eighty-four evaluable patients, recruited by 182 psychiatrists, were included in the study. The direct cost associated with healthcare resource utilization during the manic episode was high, with a mean cost of nearly €4,500 per patient, of which approximately 55% corresponded to the cost of hospitalization, 30% to the cost of psychopharmacological treatment and 10% to the cost of specialized care. Conclusions Our results show the high cost of management of the patient with a manic episode, which is mainly due to hospitalizations. In this regard, any intervention on the management of the manic patient that could reduce the need for hospitalization would have a significant impact on the costs of the disease. PMID:20426814

  17. Is Oxytocin Application for Autism Spectrum Disorder Evidence-Based?

    PubMed Central

    Lee, Seung Yup; Lee, Ah Rah; Hwangbo, Ram; Han, Juhee; Hong, Minha

    2015-01-01

    Autism spectrum disorder (ASD) is characterized by persistent deficits within two core symptom domains: social communication and restricted, repetitive behaviors. Although numerous studies have reported psychopharmacological treatment outcomes for the core symptom domains of ASD, there are not enough studies on fundamental treatments based on the etiological pathology of ASD. Studies on candidate medications related to the pathogenesis of ASD, such as naltrexone and secretin, were conducted, but the results were inconclusive. Oxytocin has been identified as having an important role in maternal behavior and attachment, and it has been recognized as a key factor in the social developmental deficit seen in ASD. Genetic studies have also identified associations between ASD and the oxytocin pathway. As ASD has its onset in infancy, parents are willing to try even experimental or unapproved treatments in an effort to avoid missing the critical period for diagnosis and treatment, which can place their child in an irreversible state. While therapeutic application of oxytocin for ASD is in its early stages, we have concluded that oxytocin would be a promising therapeutic substance via a thorough literature review focusing on the following: the relationship between oxytocin and sociality; single nucleotide polymorphisms as a biological marker of ASD; and validity verification of oxytocin treatment in humans. We also reviewed materials related to the mechanism of oxytocin action that may support its potential application in treating ASD. PMID:26713079

  18. Beyond Neural Cubism: Promoting a Multidimensional View of Brain Disorders by Enhancing the Integration of Neurology and Psychiatry in Education

    PubMed Central

    Taylor, Joseph J.; Williams, Nolan R.; George, Mark S.

    2014-01-01

    Cubism was an influential early 20th century art movement characterized by angular, disjointed imagery. The two-dimensional appearance of Cubist figures and objects is created through juxtaposition of angles. The authors posit that the constrained perspectives found in Cubism may also be found in the clinical classification of brain disorders. Neurological disorders are often separated from psychiatric disorders as if they stem from different organ systems. Maintaining two isolated clinical disciplines fractionalizes the brain in the same way that Pablo Picasso fractionalized figures and objects in his Cubist art. This Neural Cubism perpetuates a clinical divide that does not reflect the scope and depth of neuroscience. All brain disorders are complex and multidimensional, with aberrant circuitry and resultant psychopharmacology manifesting as altered behavior, affect, mood or cognition. Trainees should receive a multidimensional education based on modern neuroscience, not a partial education based on clinical precedent. The authors briefly outline the rationale for increasing the integration of neurology and psychiatry and discuss a nested model with which clinical neuroscientists (neurologists and psychiatrists) can approach and treat brain disorders. PMID:25340364

  19. Prepulse inhibition and latent inhibition deficits in Roman high-avoidance vs. Roman low-avoidance rats: Modeling schizophrenia-related features.

    PubMed

    Esnal, Aitor; Sánchez-González, Ana; Río-Álamos, Cristóbal; Oliveras, Ignasi; Cañete, Toni; Blázquez, Gloria; Tobeña, Adolf; Fernández-Teruel, Alberto

    2016-09-01

    The aim of the present study was to obtain further evidence supporting the validity of a new genetically-based rat model for the study of schizophrenia-relevant symptoms. The Roman high- (RHA-I) and low-avoidance (RLA-I) inbred rats have been psychogenetically selected for their rapid versus extremely poor acquisition of the two-way avoidance task in the shuttle box and present two well-differentiated profiles regarding several traits related to anxiety, impulsivity and sensitivity to (dopaminergic) psychostimulants. In this study we have tested animals from both strains in two behavioral paradigms that are related to schizophrenia, i.e. prepulse inhibition (PPI) and latent inhibition (LI) of fear-potentiated startle (FPS). The results show that while RLA-I rats display good PPI and LI to the context, RHA-Is show an impairment of PPI and no sign of an LI effect, which goes in the direction of the results obtained in schizophrenic patients. Therefore, although further behavioral and psychopharmacological work needs to be done, the present findings and previous studies carried out in our laboratory and others allow us to propose the RHA-I rat strain as a putative genetic rat model of differential schizophrenia-related features. PMID:27184235

  20. A funny thing happened to us on the way to the latent entities.

    PubMed

    Meehl, P E

    1979-12-01

    Inferred latent entities, whether those of psychoanalysis, factor analysis, or cluster analysis, have declined in value for many clinical psychologists, both as tools of practice and as objects of theoretical interest. Behavior modification, rational-emotive therapy, crisis intervention, psycho-pharmacology, and actuarial prediction all tend to minimize reliance on latent entities in favor of purely dispositional concepts. Behavior genetics is, however, a powerful movement to the contrary. As regards categorical entities (types, taxa, syndromes, diseases), history reveals no impressive examples of their discovery by cluster algorithms; whereas organic medicine and psychopathology have both discovered many taxonic entities without reliance on formal (statistical) cluster methods. I offer eight reasons for this strange condition, with associated suggestions for ameliorating it. Adopting a realist instead of a fictionist approach to taxonomy, I give high priority to theory-based mathematical derivation of quantitative consistency tests for all taxometric results. I urge a large scale cooperative survey of taxometric methods based on Monte Carlo runs, biological pseudoproblems where the true axon is independently known, and live problem in genetics, organic medicine, and psychopathology. An empirical example of taxometric bootstrapping and consistency testing was presented from my own current research on schizotypy. PMID:521886

  1. Gene Targeting Using Homologous Recombination in Embryonic Stem Cells: The Future for Behavior Genetics?

    PubMed Central

    Gerlai, Robert

    2016-01-01

    Gene targeting with homologous recombination in embryonic stem cells created a revolution in the analysis of the function of genes in behavioral brain research. The technology allowed unprecedented precision with which one could manipulate genes and study the effect of this manipulation on the central nervous system. With gene targeting, the uncertainty inherent in psychopharmacology regarding whether a particular compound would act only through a specific target was removed. Thus, gene targeting became highly popular. However, with this popularity came the realization that like other methods, gene targeting also suffered from some technical and principal problems. For example, two decades ago, issues about compensatory changes and about genetic linkage were raised. Since then, the technology developed, and its utility has been better delineated. This review will discuss the pros and cons of the technique along with these advancements from the perspective of the neuroscientist user. It will also compare and contrast methods that may represent novel alternatives to the homologous recombination based gene targeting approach, including the TALEN and the CRISPR/Cas9 systems. The goal of the review is not to provide detailed recipes, but to attempt to present a short summary of these approaches a behavioral geneticist or neuroscientist may consider for the analysis of brain function and behavior. PMID:27148349

  2. Scopolamine effects on functional brain connectivity: a pharmacological model of Alzheimer's disease.

    PubMed

    Bajo, R; Pusil, S; López, M E; Canuet, L; Pereda, E; Osipova, D; Maestú, F; Pekkonen, E

    2015-01-01

    Scopolamine administration may be considered as a psychopharmacological model of Alzheimer's disease (AD). Here, we studied a group of healthy elderly under scopolamine to test whether it elicits similar changes in brain connectivity as those observed in AD, thereby verifying a possible model of AD impairment. We did it by testing healthy elderly subjects in two experimental conditions: glycopyrrolate (placebo) and scopolamine administration. We then analyzed magnetoencephalographic (MEG) data corresponding to both conditions in resting-state with eyes closed. This analysis was performed in source space by combining a nonlinear frequency band-specific measure of functional connectivity (phase locking value, PLV) with network analysis methods. Under scopolamine, functional connectivity between several brain areas was significantly reduced as compared to placebo, in most frequency bands analyzed. Besides, regarding the two complex network indices studied (clustering and shortest path length), clustering significantly decreased in the alpha band while shortest path length significantly increased also in alpha band both after scopolamine administration. Overall our findings indicate that both PLV and graph analysis are suitable tools to measure brain connectivity changes induced by scopolamine, which causes alterations in brain connectivity apparently similar to those reported in AD. PMID:26130273

  3. A pilot effectiveness study: placebo-controlled trial of adjunctive L-triiodothyronine (T3) used to accelerate and potentiate the antidepressant response.

    PubMed

    Posternak, Michael; Novak, Scott; Stern, Robert; Hennessey, James; Joffe, Russell; Prange, Arthur; Zimmerman, Mark

    2008-02-01

    The aim was to evaluate whether adjunctive T3 can help accelerate the antidepressant response and improve overall outcomes when used under naturalistic conditions. Fifty consecutive psychiatric outpatients diagnosed with major depressive disorder who were initiated on antidepressant therapy were randomized to receive adjunctive T3 or placebo in a double-blind manner over the course of 6 wk. There were no restrictions placed on the selection of antidepressant agent, dosing, ancillary medications, or psychotherapy, and there were few exclusion criteria. A positive response was defined as a > or = 50% reduction in Montgomery-Asberg Depression Rating Scale scores. Response rates were higher for the adjunctive T3 cohort compared to the adjunctive placebo cohort after 1 wk (45% vs. 24%) and 2 wk (57% vs. 33%) of treatment. The likelihood of experiencing a positive response at any point over the 6-wk trial was 4.5 times greater in the adjunctive T3 cohort (95% CI 1.3-15.7). The study provides preliminary evidence that T3 can successfully be used in clinical practice to accelerate the antidepressant response and improve overall outcomes. The effectiveness model may be an untapped mechanism for evaluating the value of psychopharmacological agents. PMID:17352847

  4. Bipolar disorder

    PubMed Central

    Goodwin, Frederick K.; Ghaemi, S. Nassir

    1999-01-01

    Bipolar disorder's unique combination of three characteristics - clear genetic diathesis, distinctive clinical features, early availability of an effective treatment (lithium) - explains its special place in the history of psychiatry and its contribution to the current explosive growth of neuroscience. This article looks at the state of the art in bipolar disorder from the vantage point of: (i) genetics (possible linkages on chromosomes 18 and 21q, polygenic hypothesis, research into genetic markers); (ii) diagnosis (new focus on the subjective aspects of bipolar disorder to offset the current trend of underdiagnosis due to overreliance on standardized interviews and rating scales); (iii) outcome (increase in treatment-resistant forms signaling a change in the natural history of bipolar disorder); (iv) pathophysiology (research into circadian biological rhythms and the kindling hypothesis to explain recurrence); (v) treatment (emergence of the anticonvulsants, suggested role of chronic antidepressant treatment in the development of treatment resistance); (vi) neurobiology (evaluation of regulatory function in relation to affective disturbances, role of postsynaptic second-messenger mechanisms, advances in functional neuroimaging); and (vii) psychosocial research (shedding overly dualistic theories of the past to understand the mind and brain as an entity, thus emphasizing the importance of balancing the psychopharmacological and psychotherapeutic approaches). Future progress in the understanding and treatment of bipolar disorder will rely on successful integration of the biological and psychosocial lines of investigation. PMID:22033232

  5. Antidepressant efficacy and side-effect burden: a quick guide for clinicians

    PubMed Central

    Santarsieri, Daniel; Schwartz, Thomas L

    2015-01-01

    Prescribing of antidepressant treatment (ADT) for major depressive disorder (MDD) has increased in quantity and popularity over the last two decades. This is likely due to the approval of safer medications, better education of clinicians and their patients, direct-to-consumer marketing practices, and less stigma associated with those taking ADT. This trend has also been met with some controversy, however, as the ongoing safety and effectiveness of these treatments have at times been called into question. This paper discusses the differing levels of evidence that support the use of ADT based on (A) Food and Drug Administration approvals, (B) data from randomized controlled trials or meta-analyses and, where these are not available, the authors discuss and apply, (C) theoretical pharmacodynamic principles to justify antidepressant choice in the treatment of MDD patients. The final section discusses standard psychopharmacology guideline approaches to better alert the reader as to which practices are commonplace compared with those which are more outside of the standard of care. PMID:26576188

  6. Delay discounting in rhesus monkeys: equivalent discounting of more and less preferred sucrose concentrations.

    PubMed

    Freeman, Kevin B; Nonnemacher, J Emily; Green, Leonard; Myerson, Joel; Woolverton, William L

    2012-03-01

    Humans discount larger amounts of a delayed reinforcer less steeply than smaller amounts, but studies with pigeons and rats have yet to reveal such a magnitude effect, suggesting that the effect may be unique to humans. The present study examined whether the magnitude effect is observed in a species phylogenetically closer to humans, by comparing the rates at which rhesus monkeys discounted 10% and 20% concentrations of sucrose. There were no systematic differences in the rates at which the monkeys discounted the two sucrose concentrations, despite the fact that they strongly preferred the 20% concentration. Interestingly, the monkeys discounted delayed sucrose at a rate higher than was observed with delayed cocaine, and lower than was observed with delayed saccharin in previous studies (Freeman et al. Behavioural Processes, 82, 214-218, 2009; Woolverton et al. Experimental and Clinical Psychopharmacology, 15, 238-244, 2007). Taken together, these findings suggest that although both quantitative and qualitative differences can affect monkeys' preferences between immediate reinforcers, qualitative differences between types of reinforcers (e.g., sucrose vs. cocaine) can affect monkeys' discounting rates in a way that quantitative differences within a reinforcer (e.g., 10% vs. 20% sucrose) do not. PMID:21870212

  7. Treating depressed children with antidepressants: more harm than benefit?

    PubMed

    Antonuccio, David

    2008-06-01

    Since the FDA held hearings in February 2004 on the safety of antidepressants in children, there has been a great deal of controversy regarding the use of antidepressants in children, culminating in the well publicized black box warnings about increased risk of suicidal behavior in children and young adults (up to age 25) caused by these medications. Using questions that a parent might ask, the current article attempts to summarize the efficacy and safety data on the use of antidepressants in children so that psychologists, with or without prescription privileges, may be able to inform parents of young patients about the science behind this treatment. This article is based on a presentation at the 2007 American Psychological Association conference by the author in acceptance of the 2006 APAHC Bud Orgel Award for Distinguished Achievement in Research. Much of the information described in this article is drawn from the recent APA Report of the Working Group on Psychoactive Medications for Children and Adolescents. (Brown et al. 2006; available at www.apa.org/pi/cyf/childmeds.pdf ) culminating in a book by the same authors (Brown et al., Childhood mental health disorders: Evidence base and contextual factors for psychosocial, psychopharmacological, and combined interventions 2007). PMID:19104973

  8. Monoterpenoid Terpinen-4-ol Exhibits Anticonvulsant Activity in Behavioural and Electrophysiological Studies

    PubMed Central

    Nóbrega, Franklin F. F.; Salvadori, Mirian G. S. S.; Masson, Cintia J.; Mello, Carlos F.; Nascimento, Tiago S.; Leal-Cardoso, José H.; de Sousa, Damião P.; Almeida, Reinaldo N.

    2014-01-01

    Terpinen-4-ol (4TRP) is a monoterpenoid alcoholic component of essential oils obtained from several aromatic plants. We investigated the psychopharmacological and electrophysiological activities of 4TRP in male Swiss mice and Wistar rats. 4TRP was administered intraperitoneally (i.p.) at doses of 25 to 200 mg/kg and intracerebroventricularly (i.c.v.) at concentrations of 10, 20, and 40 ng/2 μL. For in vitro experiments, 4TRP concentrations were 0.1 mM and 1.0 mM. 4TRP (i.p.) inhibited pentylenetetrazol- (PTZ-) induced seizures, indicating anticonvulsant effects. Electroencephalographic recordings showed that 4TRP (i.c.v.) protected against PTZ-induced seizures, corroborating the behavioural results. To determine whether 4TRP exerts anticonvulsant effects via regulation of GABAergic neurotransmission, we measured convulsions induced by 3-mercapto-propionic acid (3-MP). The obtained results showed involvement of the GABAergic system in the anticonvulsant action exerted by 4TRP, but flumazenil, a selective antagonist of the benzodiazepine site of the GABAA receptor, did not reverse the anticonvulsant effect, demonstrating that 4TRP does not bind to the benzodiazepine-binding site. Furthermore, 4TRP decreased the sodium current through voltage-dependent sodium channels, and thus its anticonvulsant effect may be related to changes in neuronal excitability because of modulation of these channels. PMID:25180069

  9. Pharmacotherapy of Acute Bipolar Depression in Adults: An Evidence Based Approach

    PubMed Central

    2016-01-01

    In the majority of cases of bipolar disorder, manic episodes are usually brief and typically responsive to currently available psychopharmacological agents. In contrast, depressive manifestations are more prevalent and persistent, and can present as major depressive/mixed episodes or residual interepisode symptoms. The depressive phase is often associated with other neuropsychiatric conditions, such as anxiety spectrum disorders, substance use disorders, stressor-related disorders, and eating disorders. It is viewed as a systemic disease with associated ailments such as metabolic syndrome, diabetes mellitus, and cardiovascular disease. There is an increased rate of mortality not only from suicide, but also from concomitant physical illness. This scenario is made worse by the fact that depressive symptoms, which represent the main disease burden, are often refractory to existing psychotropic drugs. As such, there is a pressing need for novel agents that are efficacious in acute depressive exacerbations, and also have applicable value in preventing recurrent episodes. The rationale of the present review is to delineate the pharmacotherapy of the depressive phase of bipolar disorder with medications for which there is evidence in the form of observational, open-label, or double-blind randomized controlled studies. In the treatment of acute bipolar depression in adults, a comprehensive appraisal of the extant literature reveals that among mood stabilizers, the most robust proof of efficacy exists for divalproex sodium; while atypical antipsychotics, which include olanzapine, quetiapine, lurasidone, and cariprazine, are also effective, as demonstrated in controlled trials. PMID:27274384

  10. [Mixed states: evolution of classifications].

    PubMed

    Pringuey, D; Cherikh, F; Giordana, B; Fakra, E; Dassa, D; Cermolacce, M; Belzeaux, R; Maurel, M; Azorin, J-M

    2013-12-01

    The nosological position of mixed states has followed the course of classifying methods in psychiatry, the steps of the invention of the clinic, progress in the organization of care, including the discoveries of psychopharmacology. The clinical observation of a mixture of symptoms emerging from usually opposite clinical conditions is classical. In the 70s, a syndromic specification fixed the main symptom combinations but that incongruous assortment failed to stabilize the nosological concept. Then stricter criteriology was proposed. To be too restrictive, a consensus operates a dimensional opening that attempts to meet the pragmatic requirements of nosology validating the usefulness of the class system. This alternation between rigor of categorization and return to a more flexible criteriological option reflects the search for the right balance between nosology and diagnosis. The definition of mixed states is best determined by their clinical and prognostic severity, related to the risk of suicide, their lower therapeutic response, the importance of their psychiatric comorbidities, anxiety, emotional lability, alcohol abuse. Trying to compensate for the lack of categorical definitions and better reflecting the clinical field problems, new definitions complement criteriology with dimensional aspects, particularly taking into account temperaments. PMID:24359850

  11. Linking neuroscience with modern concepts of impulse control disorders in Parkinson's disease.

    PubMed

    Napier, T Celeste; Corvol, Jean-Christophe; Grace, Anthony A; Roitman, Jamie D; Rowe, James; Voon, Valerie; Strafella, Antonio P

    2015-02-01

    Patients with Parkinson's disease (PD) may experience impulse control disorders (ICDs) when on dopamine agonist therapy for their motor symptoms. In the last few years, a rapid growth of interest for the recognition of these aberrant behaviors and their neurobiological correlates has occurred. Recent advances in neuroimaging are helping to identify the neuroanatomical networks responsible for these ICDs, and together with psychopharmacological assessments are providing new insights into the brain status of impulsive behavior. The genetic associations that may be unique to ICDs in PD are also being identified. Complementing human studies, electrophysiological and biochemical studies in animal models are providing insights into neuropathological mechanisms associated with these disorders. New animal models of ICDs in PD patients are being implemented that should provide critical means to identify efficacious therapies for PD-related motor deficits while avoiding ICD side effects. Here, we provide an overview of these recent advances, with a particular emphasis on the neurobiological correlates reported in animal models and patients along with their genetic underpinnings. PMID:25476402

  12. Psychedelics and Immunomodulation: Novel Approaches and Therapeutic Opportunities.

    PubMed

    Szabo, Attila

    2015-01-01

    Classical psychedelics are psychoactive substances, which, besides their psychopharmacological activity, have also been shown to exert significant modulatory effects on immune responses by altering signaling pathways involved in inflammation, cellular proliferation, and cell survival via activating NF-κB and mitogen-activated protein kinases. Recently, several neurotransmitter receptors involved in the pharmacology of psychedelics, such as serotonin and sigma-1 receptors, have also been shown to play crucial roles in numerous immunological processes. This emerging field also offers promising treatment modalities in the therapy of various diseases including autoimmune and chronic inflammatory conditions, infections, and cancer. However, the scarcity of available review literature renders the topic unclear and obscure, mostly posing psychedelics as illicit drugs of abuse and not as physiologically relevant molecules or as possible agents of future pharmacotherapies. In this paper, the immunomodulatory potential of classical serotonergic psychedelics, including N,N-dimethyltryptamine (DMT), 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT), lysergic acid diethylamide (LSD), 2,5-dimethoxy-4-iodoamphetamine, and 3,4-methylenedioxy-methamphetamine will be discussed from a perspective of molecular immunology and pharmacology. Special attention will be given to the functional interaction of serotonin and sigma-1 receptors and their cross-talk with toll-like and RIG-I-like pattern-recognition receptor-mediated signaling. Furthermore, novel approaches will be suggested feasible for the treatment of diseases with chronic inflammatory etiology and pathology, such as atherosclerosis, rheumatoid arthritis, multiple sclerosis, schizophrenia, depression, and Alzheimer's disease. PMID:26236313

  13. The serotonergic system in the neurobiology of depression: Relevance for novel antidepressants.

    PubMed

    Köhler, Stephan; Cierpinsky, Katharina; Kronenberg, Golo; Adli, Mazda

    2016-01-01

    The monoamine hypothesis of depression posits that an imbalance in monoaminergic neurotransmission is causally related to the clinical features of depression. Antidepressants influencing serotonin mainly aim at raising serotonin concentrations, thereby increasing serotonergic transmission at the level of the synapse, for example by inhibiting the serotonin transporter. However, the serotonin system is multifaceted. Different serotonin receptor subtypes turn the serotonergic system into a complex neurochemical arrangement that influences diverse neurotransmitters in various brain regions. Classical antidepressants as well as other psychopharmacological agents have various crucial effects on serotonin receptors. We aim at providing a clinically useful characterization of serotonin receptor subtypes in the treatment of depression. Clarifying the mode of action and the interplay of serotonin receptors with pharmacological agents should help antidepressant mechanisms and typical side effects to be better understood. Against this background, we feature the novel antidepressants vortioxetine, vilazodone and milnacipran/levomilnacipran with regard to their serotonin receptor targets such as the 5-HT1A, 5-HT3 and 5-HT7 which may account for their specific effects on certain symptoms of depression (e.g. cognition and anxiety) as well as a characteristic side-effect profile. PMID:26464458

  14. Altruism, personal benefit, and anxieties: a phenomenological study of healthy volunteers' experiences in a placebo‐controlled trial of duloxetine

    PubMed Central

    Kwakye, Isaac N.; Garner, Matthew; Baldwin, David S.; Bamford, Susan; Pinkney, Verity

    2016-01-01

    Objective The objective of this study was to develop an in‐depth understanding of healthy volunteers' experiences of mental health trials. Methods A qualitative study was nested within a healthy volunteer placebo‐controlled trial of duloxetine, a psychotropic drug used for treating patients with major depression and generalized anxiety disorder. Eight participants were interviewed, and data were analyzed using interpretative phenomenological analysis. Results Interviewees described volunteering for the trial because they were interested in research, wanted the monetary incentive, wanted to help researchers, and wanted to be part of something. On entering the trial, participants considered the possible risks and described feeling anxious, excited, and determined; they had some clear expectations and some loosely held hopes about what would happen. During the trial, participants were curious about whether they were taking duloxetine or placebo, self‐monitored their bodies' reactions, and guessed which treatment they received. On being un‐blinded to treatment allocation after completing the trial, some participants' guesses were confirmed, but others were surprised, and a few were disappointed. Conclusions Small changes to advertising/consent materials to reflect volunteers' motivations could improve recruitment rates to similar trials; “active” placebos might be particularly useful for maintaining blinding in healthy volunteer trials; and sensitive procedures are needed for un‐blinding participants to treatment allocation. © 2016 The Authors. Human Psychopharmacology: Clinical and Experimental published by John Wiley & Sons, Ltd. PMID:27378326

  15. [Cognitive Behavioral Therapy and the Treatment of ADHD in Adults].

    PubMed

    Auclair, Vickie; Harvey, Philippe-Olivier; Lepage, Martin

    2016-01-01

    Background The international prevalence of adult attention deficit hyperactivity disorder (ADHD) is estimated at 2.5%. ADHD is associated with serious impairment in academic, occupational, social and emotional functioning. Despite the debilitating nature of this disorder, few individuals with ADHD receive appropriate help. Further, although psychopharmacology is considered the first-line treatment of adults with ADHD, it is now recognized that medication alone may be insufficient. Thus, cognitive behavioral therapy (CBT) is a promising approach.Objectives This study aimed to review literature and investigate the efficacy of CBT, in reducing ADHD symptoms and comorbid conditions such anxiety and depression for adults with ADHD, by several studies through a meta-analysis.Methods We searched the literature from 1946 through 2015 using especially MEDLINE, EMBASE and PsycINFO. We used a random-effects model, Odds Ratios (OR) and Hedge's g.Results Data from 12 randomized controlled studies were included, totaling 575 subjects. The results showed a significant reduction in ADHD symptoms (Hedge's g = 0.95) and comorbid anxiety (Hedge's g = 0.39) and depression (Hedge's g = 0.30) for the CBT group in comparison with controls. Following the end of treatment, ADHD symptoms continue to improve, but not the comorbid conditions.Conclusion In summary, in adults with ADHD, CBT appears to be a promising treatment. PMID:27570962

  16. [Responsible gambling: is it an alternative for prevention and treatment of pathological gambling?].

    PubMed

    Echeburua, Enrique; de Corral, Paz

    2008-01-01

    This paper deals with the new development of controlled gambling embedded in a harm-reduction context as a viable solution both for primary prevention at school and for treatment of some kinds of problematic gamblers. Pathological gambling significantly improves with psychological therapies, such as stimulus control and in vivo exposure with response prevention or cognitive interventions. In some cases psychopharmacological therapy may complement the benefits of treatment for pathological gambling when patients have comorbid depression or high impulsivity. However, in this mental disorder the goal of treatment (total abstinence or controlled gambling) is currently a controversial issue. Controlled gambling may be a therapeutic option for young gamblers or patients without severe dependence. Furthermore, controlled gambling may be a relevant issue for health education in schools, with a view to teaching teenagers how to cope with actual and virtual exposure to gambling. Likewise, the gambling industry and governments are involved in harm minimization initiatives. Thus, it is necessary to coordinate a program of research that includes the industry, science, and public representatives, based on cooperative research that will permit the introduction of controlled gambling within a global strategic framework. We discuss the relevance of this review for clinical practice and for future research, as well as the unsolved problems in this field. PMID:19115019

  17. Phenibut (beta-phenyl-GABA): a tranquilizer and nootropic drug.

    PubMed

    Lapin, I

    2001-01-01

    Phenibut (beta-phenyl-gamma-aminobutyric acid HCl) is a neuropsychotropic drug that was discovered and introduced into clinical practice in Russia in the 1960s. It has anxiolytic and nootropic (cognition enhancing) effects. It acts as a GABA-mimetic, primarily at GABA(B) and, to some extent, at GABA(A) receptors. It also stimulates dopamine receptors and antagonizes beta-phenethylamine (PEA), a putative endogenous anxiogenic. The psychopharmacological activity of phenibut is similar to that of baclofen, a p-Cl-derivative of phenibut. This article reviews the structure-activity relationship of phenibut and its derivatives. Emphasis is placed on the importance of the position of the phenyl ring, the role of the carboxyl group, and the activity of optical isomers. Comparison of phenibut with piracetam and diazepam reveals similarities and differences in their pharmacological and clinical effects. Phenibut is widely used in Russia to relieve tension, anxiety, and fear, to improve sleep in psychosomatic or neurotic patients; as well as a pre- or post-operative medication. It is also used in the therapy of disorders characterized by asthenia and depression, as well as in post-traumatic stress, stuttering and vestibular disorders. PMID:11830761

  18. Schizophrenia proteomics: biomarkers on the path to laboratory medicine?

    PubMed Central

    Lakhan, Shaheen Emmanuel

    2006-01-01

    Over two million Americans are afflicted with schizophrenia, a debilitating mental health disorder with a unique symptomatic and epidemiological profile. Genomics studies have hinted towards candidate schizophrenia susceptibility chromosomal loci and genes. Modern proteomic tools, particularly mass spectrometry and expression scanning, aim to identify both pathogenic-revealing and diagnostically significant biomarkers. Only a few studies on basic proteomics have been conducted for psychiatric disorders relative to the plethora of cancer specific experiments. One such proteomic utility enables the discovery of proteins and biological marker fingerprinting profiling techniques (SELDI-TOF-MS), and then subjects them to tandem mass spectrometric fragmentation and de novo protein sequencing (MALDI-TOF/TOF-MS) for the accurate identification and characterization of the proteins. Such utilities can explain the pathogenesis of neuro-psychiatric disease, provide more objective testing methods, and further demonstrate a biological basis to mental illness. Although clinical proteomics in schizophrenia have yet to reveal a biomarker with diagnostic specificity, methods that better characterize the disorder using endophenotypes can advance findings. Schizophrenia biomarkers could potentially revolutionize its psychopharmacology, changing it into a more hypothesis and genomic/proteomic-driven science. PMID:16846510

  19. [The changes in values and beliefs through the first 50 years of the department of Psychiatry at the University of Montreal].

    PubMed

    Borgeat, François; Dongier, Maurice

    2015-01-01

    This essay attempts to describe and discuss the major changes in values and fundamental beliefs related to clinical practice within the Département de psychiatrie de l'Université de Montréal since its creation fifty years ago.Being an essay, the methods include shared recollections, discussions with colleagues, especially between the co-authors, and the study of some documents related to the practice of psychiatry 40 to 50 years ago.Five major axes of change are proposed: 1- From psychoanalysis to brain diseases, 2- From "Can a non-physician practice psychoanalysis?" to "Can a psychiatrist still perform psychotherapy?" 3- From continuity of care to episodes of treatment, 4- From treatment first to repeated assessments of patients, 5- From love that can heal and repair to a taboo of love.Finally it is suggested that the increasing emphasis on psychopharmacology and on DSM classifications has contributed to a shift from attempts to understand the intimate nature of symptoms and suffering to a priority given to rather mechanical clinical assessments in search of "objective" criteria. PMID:26559213

  20. Depression and Chronic Diseases: It Is Time for a Synergistic Mental Health and Primary Care Approach

    PubMed Central

    Richie, William D.; Bailey, Rahn K.

    2013-01-01

    Objective: To identify the growing significance of depression as a global leading cause of years lost to disability and its role as a major independent risk factor in many chronic illnesses. The distinct effects of depression on morbidity and mortality in cancer, diabetes, heart disease, and stroke are investigated, including behavioral factors and plausible biological mechanisms (psychoneuroimmunology of depression). Data Sources: PubMed articles in English were searched from 1992 to 2012 (20-year span) using the following search criteria: psychoneuroimmunology of depression, immune-mediated inflammation, depression treatment recommendations, depression screening, years lost to disability, underserved populations and depression, chronic illnesses and depression, and selective serotonin reuptake inhibitors and immune system. Data Synthesis: Evidence of the robust bidirectional relationship between depression and individual chronic diseases is presented and discussed. A brief overview of currently recommended psychotherapeutic and psychopharmacologic treatment approaches in regard to depression in chronic diseases is provided. Results: Discordance between mental health and primary care within the US public health system is a systematic problem that must be addressed. This situation leads to a potentially high hidden prevalence of underdiagnosed and undertreated depression, especially in the underserved populations. Conclusion: Measures must be implemented across the communities of mental health and primary care practitioners in order to achieve a synergistic approach to depression. PMID:23930236

  1. Harmol induces apoptosis by caspase-8 activation independently of Fas/Fas ligand interaction in human lung carcinoma H596 cells.

    PubMed

    Abe, Akihisa; Yamada, Hiroyuki

    2009-06-01

    The beta-carboline alkaloids are naturally existing plant substances. It is known that these alkaloids have a wide spectrum of neuropharmacological, psychopharmacological, and antitumor effects. Therefore, they have been traditionally used in oriental medicine for the treatment of various diseases including cancers and malaria. In this study, harmol and harmalol, which are beta-carboline alkaloids, were examined for their antitumor effect on human lung carcinoma cell lines, and structure-activity relationship was also investigated. H596, H226, and A549 cells were treated with harmol and harmalol, respectively. Apoptosis was induced by harmol only in H596 cells. In contrast, harmalol had negligible cytotoxicity in three cell lines. Harmol induced caspase-3, caspase-8, and caspase-9 activities and caspase-3 activities accompanied by cleavage of poly-(ADP-ribose)-polymerase. Furthermore, harmol treatment decreased the native Bid protein, and induced the release of cytochrome c from mitochondria to cytosol. The apoptosis induced by harmol was completely inhibited by caspase-8 inhibitor and partially inhibited by caspase-9 inhibitor. The antagonistic antibody ZB4 blocked Fas ligand-induced apoptosis, but had no effect on harmol-induced apoptosis. Harmol had no significant effect on the expression of Fas. In conclusion, our results showed that the harmol could cause apoptosis-inducing effects in human lung H596 cells through caspase-8-dependent pathway but independent of Fas/Fas ligand interaction. PMID:19318910

  2. Telemental health: A status update.

    PubMed

    Aboujaoude, Elias; Salame, Wael; Naim, Lama

    2015-06-01

    A rather large body of literature now exists on the use of telemental health services in the diagnosis and management of various psychiatric conditions. This review aims to provide an up-to-date assessment of telemental health, focusing on four main areas: computerized CBT (cCBT), Internet-based CBT (iCBT), virtual reality exposure therapy (VRET), and mobile therapy (mTherapy). Four scientific databases were searched and, where possible, larger, better-designed meta-analyses and controlled trials were highlighted. Taken together, published studies support an expanded role for telepsychiatry tools, with advantages that include increased care access, enhanced efficiency, reduced stigma associated with visiting mental health clinics, and the ability to bypass diagnosis-specific obstacles to treatment, such as when social anxiety prevents a patient from leaving the house. Of technology-mediated therapies, cCBT and iCBT possess the most efficacy evidence, with VRET and mTherapy representing promising but less researched options that have grown in parallel with virtual reality and mobile technology advances. Nonetheless, telepsychiatry remains challenging because of the need for specific computer skills, the difficulty in providing patients with a deep understanding or support, concerns about the "therapeutic alliance", privacy fears, and the well documented problem of patient attrition. Future studies should further test the efficacy, advantages and limitations of technology-enabled CBT, as well as explore the online delivery of other psychotherapeutic and psychopharmacological modalities. PMID:26043340

  3. Nonadherence to antipsychotics: the role of positive attitudes towards positive symptoms.

    PubMed

    Moritz, Steffen; Hünsche, Alexandra; Lincoln, Tania M

    2014-11-01

    Approximately 50-75% of all patients do not take their antipsychotic medication as prescribed. The current study examined reasons why patients continue versus discontinue antipsychotic medication. We were particularly interested to which extent positive attitudes towards psychotic symptoms foster medication nonadherence. An anonymous online questionnaire was set up to decrease response biases. After a strict selection process, 91 participants with schizophrenia spectrum disorders were retained for the final analyses. On average, 6.2 different reasons for nonadherence were reported. Side-effects (71.4%), sudden subjective symptom improvement (52.4%) and forgetfulness (33.3%) emerged as the most frequent reasons for drug discontinuation. Approximately one fourth of all participants (27.3%) reported at least one positive aspect of psychosis as a reason for nonadherence. In contrast, patients reported on average 3.5 different reasons for adherence (e.g., want to live a normal life (74.6%) and fear of psychotic symptoms (49.3%)). The belief that paranoia represents a survival strategy (subscale derived from the Beliefs about Paranoia Scale) was significantly associated with nonadherence. Patients' attitudes toward medication and the individual illness model need to be carefully considered when prescribing medication. In particular for patients who are likely to discontinue psychopharmacological treatment complementary or alternative psychological treatment should be sought because of a largely increased risk of relapse in the case of sudden drug discontinuation. PMID:25444234

  4. Weight Gain and Metabolic Changes During Treatment with Antipsychotics and Antidepressants.

    PubMed

    Himmerich, Hubertus; Minkwitz, Juliane; Kirkby, Kenneth C

    2015-01-01

    Weight gain and metabolic disturbances are common side effects during psychopharmacological treatment with specific antipsychotics and antidepressants. The antipsychotics clozapine and olanzapine, and antidepressants tricyclics and mirtazapine have a high risk of inducing weight gain. Recently discovered pathophysiological mechanisms include antihistaminergic effects, activation of hypothalamic adenosine monophosphate-activated protein kinase (AMPK), modulation of hormonal signaling of ghrelin and leptin, changes in the production of cytokines such as tumor necrosis factor-alpha (TNF)-alpha and adipokines such as adiponektin, and the impact of genes, in particular the melanocortin 4 receptor (MC4R), serotonin 2C receptor (HTR2C), leptin, neuropeptide Y (NPY) and cannabinoid receptor 1 (CNR1) genes. Metabolic changes associated with weight gain include disturbances of glucose and lipid metabolism. Clozapine and olanzapine may, in addition to mechanisms resulting from weight gain, impair glucose metabolism by blockade of the muscarinic M3 receptor (M3R). Antidepressants associated with weight gain appear to have fewer unfavourable effects on glucose and lipid metabolism than the second-generation antipsychotics clozapine and olanzapine. To assess the risk of weight gain and its consequences for the patient's health, assessing body weight changes and metabolic monitoring in the first week of treatment as well as in long-term treatment is recommended. PMID:26100432

  5. Telemental health: A status update

    PubMed Central

    Aboujaoude, Elias; Salame, Wael; Naim, Lama

    2015-01-01

    A rather large body of literature now exists on the use of telemental health services in the diagnosis and management of various psychiatric conditions. This review aims to provide an up-to-date assessment of telemental health, focusing on four main areas: computerized CBT (cCBT), Internet-based CBT (iCBT), virtual reality exposure therapy (VRET), and mobile therapy (mTherapy). Four scientific databases were searched and, where possible, larger, better-designed meta-analyses and controlled trials were highlighted. Taken together, published studies support an expanded role for telepsychiatry tools, with advantages that include increased care access, enhanced efficiency, reduced stigma associated with visiting mental health clinics, and the ability to bypass diagnosis-specific obstacles to treatment, such as when social anxiety prevents a patient from leaving the house. Of technology-mediated therapies, cCBT and iCBT possess the most efficacy evidence, with VRET and mTherapy representing promising but less researched options that have grown in parallel with virtual reality and mobile technology advances. Nonetheless, telepsychiatry remains challenging because of the need for specific computer skills, the difficulty in providing patients with a deep understanding or support, concerns about the “therapeutic alliance”, privacy fears, and the well documented problem of patient attrition. Future studies should further test the efficacy, advantages and limitations of technology-enabled CBT, as well as explore the online delivery of other psychotherapeutic and psychopharmacological modalities. PMID:26043340

  6. The medicalisation of revolt: a sociological analysis of medical cannabis users.

    PubMed

    Pedersen, Willy; Sandberg, Sveinung

    2013-01-01

    In a qualitative study, we investigated the medical motives of 100 Norwegian cannabis users, none of whom had legal access to medical cannabis. Cannabis was used therapeutically for conditions such as multiple sclerosis, attention deficit hyperactivity disorder and rheumatism, as well as for quality of life conditions such as quality of sleep, relaxation and wellbeing. The borders between medical and recreational cannabis use were blurred. This article identifies strategies of medical cannabis users to gain social acceptance. Several respondents downplayed effects such as intoxication and euphoria. Others used the language of medicine and knowledge of current research in psychopharmacology. Cannabis was contrasted with the potential for abuse of prescription medicines. The medical cannabis movement has had little success in Norway. Medical professionals are unable to accept that users may be more knowledgeable than experts and medical users cannot discard the values of traditional cannabis culture. Calls for medical cannabis use are thus perceived as a gambit in attempts to have cannabis legalised. We argue that, despite having had little effect on health authorities, the medical cannabis movement may be having the unintended effect of medicalising cannabis use and using it as a cure for everyday problems. PMID:22827932

  7. [Malignant hyperthermia syndrome in the intensive care unit : Differential diagnosis and acute measures].

    PubMed

    Grander, W

    2016-06-01

    Malignant hyperthermia is a life-threatening disease caused by derangement of the autonomic nerve system and hypermetabolism of the peripheral musculature. Commonly body core temperatures of more than 40 °C will be found in this disease which is caused mostly by psychopharmacological drugs like antidepressants, neuroleptics but also antibiotics, pain killers, anti-Parkinson drugs, and volatile anesthetics. The inducers of malignant hyperthermia interact with postsynaptic receptors (serotonin, anticholinergics) or muscular intracellular structures responsible for calcium utilization (volatile anesthetics, succinylcholine). Rarely malignant hyperthermia is a consequence of mental stress or vigorous exercise and or heat. Malignant hyperthermic syndromes lead to a severe dysbalance of the autonomic nerve system accompanied by rhabdomyolysis, disseminated intravascular coagulopathy, and finally multi-organ failure. Accordingly, medical management is primarily directed to stabilize vital functions, withdrawal of the causing drug, and if possible antagonizing toxic substances. The leading symptom hyperthermia needs to be treated physically with available cooling systems. PMID:27272514

  8. The Human Frontal Lobes and Frontal Network Systems: An Evolutionary, Clinical, and Treatment Perspective

    PubMed Central

    Hoffmann, Michael

    2013-01-01

    Frontal lobe syndromes, better termed as frontal network systems, are relatively unique in that they may manifest from almost any brain region, due to their widespread connectivity. The understandings of the manifold expressions seen clinically are helped by considering evolutionary origins, the contribution of the state-dependent ascending monoaminergic neurotransmitter systems, and cerebral connectivity. Hence, the so-called networktopathies may be a better term for the syndromes encountered clinically. An increasing array of metric tests are becoming available that complement that long standing history of qualitative bedside assessments pioneered by Alexander Luria, for example. An understanding of the vast panoply of frontal systems' syndromes has been pivotal in understanding and diagnosing the most common dementia syndrome under the age of 60, for example, frontotemporal lobe degeneration. New treatment options are also progressively becoming available, with recent evidence of dopaminergic augmentation, for example, being helpful in traumatic brain injury. The latter include not only psychopharmacological options but also device-based therapies including mirror visual feedback therapy. PMID:23577266

  9. Cost of treating mental illness from a managed care perspective.

    PubMed

    Docherty, J P

    1999-01-01

    The issue of cost-effectiveness in the pharmacoeconomics of mental illness is a new concept. As methodologies for exploring this subject unfold, the most fundamental objective for health care professionals and managed care officials is to find ways in which currently available resources can be used most effectively. The managed care perspective is highly cost-based within the market it serves. In addition to cost, other factors that influence the managed care perspective are a short-term focus, segmentation of budgets, and measurable indicators of outcome, cost, and quality of care. The cost of new psychopharmacology--especially antidepressants and antipsychotics--may be many times that of traditional drugs, and concern about increased drug costs is present in many managed care organizations. Several issues must be addressed to prevent restriction of pharmacotherapeutics in managed care settings. For example, a focus on both outcomes and practice guidelines is needed to help allocate limited resources fairly. This article suggests ways in which available resources can be used more effectively to treat mental illness within the present health care system. PMID:10073378

  10. beta-Carboline alkaloids in Peganum harmala and inhibition of human monoamine oxidase (MAO).

    PubMed

    Herraiz, T; González, D; Ancín-Azpilicueta, C; Arán, V J; Guillén, H

    2010-03-01

    Peganum harmala L. is a multipurpose medicinal plant increasingly used for psychoactive recreational purposes (Ayahuasca analog). Harmaline, harmine, harmalol, harmol and tetrahydroharmine were identified and quantified as the main beta-carboline alkaloids in P. harmala extracts. Seeds and roots contained the highest levels of alkaloids with low levels in stems and leaves, and absence in flowers. Harmine and harmaline accumulated in dry seeds at 4.3% and 5.6% (w/w), respectively, harmalol at 0.6%, and tetrahydroharmine at 0.1% (w/w). Roots contained harmine and harmol with 2.0% and 1.4% (w/w), respectively. Seed extracts were potent reversible and competitive inhibitors of human monoamine oxidase (MAO-A) with an IC(50) of 27 microg/l whereas root extracts strongly inhibited MAO-A with an IC(50) of 159 microg/l. In contrast, they were poor inhibitors of MAO-B. Inhibition of MAO-A by seed extracts was quantitatively attributed to harmaline and harmine whereas inhibition by root extracts came from harmine with no additional interferences. Stems and leaves extracts were poor inhibitors of MAO. The potent inhibition of MAO-A by seed and root extracts of P. harmala containing beta-carbolines should contribute to the psychopharmacological and toxicological effects of this plant and could be the basis for its purported antidepressant actions. PMID:20036304

  11. Daily Emotional Dynamics in Depressed Youth: A Cell-Phone Ecological Momentary Assessment Study

    PubMed Central

    Silk, Jennifer S.; Forbes, Erika E.; Whalen, Diana J.; Jakubcak, Jennifer L.; Thompson, Wesley K.; Ryan, Neal D.; Axelson, David A.; Birmaher, Boris; Dahl, Ronald E.

    2010-01-01

    This study utilized a new cellular phone ecological momentary assessment approach to investigate daily emotional dynamics in 47 youth with Major Depressive Disorder (MDD) and 32 no psychopathology controls (CON), ages 7 – 17. Information about emotional experience in the natural environment was obtained using answer-only cellular phones while MDD youth received an 8 week course of cognitive behavioral therapy and/or psychopharmacological treatment. Compared to CON youth, MDD youth reported more intense and labile global negative affect, greater sadness, anger, and nervousness, and a lower ratio of positive to negative affect. These differences increased with pubertal maturation. MDD youth spent more time alone and less time with their families than CON youth. Although differences in emotional experiences were found across social contexts, MDD youth were more negative than CON youth in all contexts examined. As the MDD participants progressed through treatment, diagnostic group differences in the intensity and lability of negative affect decreased, but there were no changes in the ratio of positive to negative affect or measures of social context. We discuss methodological innovations and advantages of this approach, including improved ecological validity and access to information about variability in emotions, change in emotions over time, the balance of positive and negative emotions, and the social context of emotional experience. PMID:21112595

  12. Executive Attention Impairment in Adolescents with Major Depressive Disorder

    PubMed Central

    Sommerfeldt, Sasha L.; Cullen, Kathryn R.; Han, Georges; Fryza, Brandon J.; Houri, Alaa K.; Klimes-Dougan, Bonnie

    2015-01-01

    Objective Neural network models that guide neuropsychological assessment practices are increasingly used to explicate depression, though a paucity of work has focused on regulatory systems that are under development in adolescence. The purpose of this study was to evaluate subsystems of attention related to executive functioning including alerting, orienting, and executive attention networks, as well as sustained attention with varying working memory load, in a sample of depressed and well adolescents. Method Neuropsychological functioning in 99 adolescents diagnosed with major depressive disorder (MDD) and 63 adolescent healthy controls (M = 16.6 years old) was assessed on the Attention Network Task (ANT) and the Continuous Performance Test, Identical Pairs (CPT). Results Adolescents with MDD, particularly those who were not medicated, were slower to process conflict (slower reaction time on the executive attention scale of the ANT) compared to controls, particularly for those who were not undergoing psychopharmacological treatment. Tentative evidence also suggests that within the MDD group, orienting performance was more impaired in those with a history of comorbid substance use disorder, and alerting was more impaired in those with a history of a suicide attempt. Conclusions Adolescents with depression showed impaired executive attention, although cognitive performance varied across subgroups of patients. These findings highlight the importance of examining neurocognitive correlates associated with features of depression and suggest an avenue for future research to help guide the development of interventions. PMID:26566871

  13. Current clinical advances and future perspectives in the psychiatry/mental health field of Latin America.

    PubMed

    Cía, Alfredo H; Rojas, Rodrigo Córdoba; Adad, Miguel Abib

    2010-01-01

    The history of Mental Health in Latin America is relatively young. It dates back to the mid nineteenth century and widely developed during the twentieth century, with formidable scientific, social, political, and ethical challenges. Latin American psychiatry has contributed in the fields of epidemiology, phenomenology, social psychiatry, psychiatric and epistemological research, and clinical genetics as well. More recent advances can also be seen in clinical psychotherapy and psychopharmacology. Now, there is a formal and informal recognition of various areas of expertise, such as children and adolescents, addictions, anxiety disorders, among others. However, we need to solve the health problems resulting from mental illnesses as well as the disorders related to the social, environmental, political, and economic factors of a continent marked by the precariousness of underdevelopment, which have a high impact on population health. Therefore, considering and trying to minimize the impact of those factors, contributing to the destigmatization of mental illnesses and their consequences, together with the growing number of non-governmental organizations (NGOs), human rights defenders, public figures, etc., and collaborating in building a society that guarantees the right to mental health and adequate treatment and rehabilitation are part of our present challenges in Latin America. PMID:20874063

  14. EPA guidance on improving the image of psychiatry.

    PubMed

    Möller-Leimkühler, A M; Möller, H-J; Maier, W; Gaebel, W; Falkai, P

    2016-03-01

    This paper explores causes, explanations and consequences of the negative image of psychiatry and develops recommendations for improvement. It is primarily based on a WPA guidance paper on how to combat the stigmatization of psychiatry and psychiatrists and a Medline search on related publications since 2010. Furthermore, focussing on potential causes and explanations, the authors performed a selective literature search regarding additional image-related issues such as mental health literacy and diagnostic and treatment issues. Underestimation of psychiatry results from both unjustified prejudices of the general public, mass media and healthcare professionals and psychiatry's own unfavourable coping with external and internal concerns. Issues related to unjustified devaluation of psychiatry include overestimation of coercion, associative stigma, lack of public knowledge, need to simplify complex mental issues, problem of the continuum between normality and psychopathology, competition with medical and non-medical disciplines and psychopharmacological treatment. Issues related to psychiatry's own contribution to being underestimated include lack of a clear professional identity, lack of biomarkers supporting clinical diagnoses, limited consensus about best treatment options, lack of collaboration with other medical disciplines and low recruitment rates among medical students. Recommendations are proposed for creating and representing a positive self-concept with different components. The negative image of psychiatry is not only due to unfavourable communication with the media, but is basically a problem of self-conceptualization. Much can be improved. However, psychiatry will remain a profession with an exceptional position among the medical disciplines, which should be seen as its specific strength. PMID:26874959

  15. Antidepressant efficacy and side-effect burden: a quick guide for clinicians.

    PubMed

    Santarsieri, Daniel; Schwartz, Thomas L

    2015-01-01

    Prescribing of antidepressant treatment (ADT) for major depressive disorder (MDD) has increased in quantity and popularity over the last two decades. This is likely due to the approval of safer medications, better education of clinicians and their patients, direct-to-consumer marketing practices, and less stigma associated with those taking ADT. This trend has also been met with some controversy, however, as the ongoing safety and effectiveness of these treatments have at times been called into question. This paper discusses the differing levels of evidence that support the use of ADT based on (A) Food and Drug Administration approvals, (B) data from randomized controlled trials or meta-analyses and, where these are not available, the authors discuss and apply, (C) theoretical pharmacodynamic principles to justify antidepressant choice in the treatment of MDD patients. The final section discusses standard psychopharmacology guideline approaches to better alert the reader as to which practices are commonplace compared with those which are more outside of the standard of care. PMID:26576188

  16. Rosa damascena oil improves SSRI-induced sexual dysfunction in male patients suffering from major depressive disorders: results from a double-blind, randomized, and placebo-controlled clinical trial

    PubMed Central

    Farnia, Vahid; Shirzadifar, Mehdi; Shakeri, Jalal; Rezaei, Mansour; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Brand, Serge

    2015-01-01

    Background A substantial disadvantage of psychopharmacological treatment of major depressive disorder (MDD) with selective serotonin-reuptake inhibitors (SSRIs) is the impact on sexual dysfunction. The aim of the present study was to investigate whether the oil of Rosa damascena can have a positive influence on SSRI-induced sexual dysfunction (SSRI-I SD) of male patients who are suffering from MDD and are being treated with SSRIs. Method In a double-blind, randomized, and placebo-controlled clinical trial, a total of 60 male patients treated with an SSRI and suffering from MDD (mean age =32 years) and SSRI-I SD were randomly assigned to take either verum (R. damascena oil) or a placebo. Patients completed self-ratings of depression and sexual function at baseline, at 4 weeks later, and at the end of the study, 8 weeks after it started. Results Over time, sexual dysfunction improved more in the verum group than in the control group. Improvements were observed in the verum group from week 4 to week 8. Self-rated symptoms of depression reduced over time in both groups, but did so more so in the verum group than in the control group. Conclusion This double-blind, randomized, and placebo-controlled clinical trial showed that the administration of R. damascena oil ameliorates sexual dysfunction in male patients suffering from both MDD and SSRI-I SD. Further, the symptoms of depression reduced as sexual dysfunction improved. PMID:25834441

  17. Schizotypy—Do Not Worry, It Is Not All Worrisome

    PubMed Central

    Mohr, Christine; Claridge, Gordon

    2015-01-01

    A long-standing tradition in personality research in psychology, and nowadays increasingly in psychiatry, is that psychotic and psychotic-like thoughts are considered common experiences in the general population. Given their widespread occurrence, such experiences cannot merely reflect pathological functioning. Moreover, reflecting the multi-dimensionality of schizotypy, some dimensions might be informative for healthy functioning while others less so. Here, we explored these possibilities by reviewing research that links schizotypy to favorable functioning such as subjective wellbeing, cognitive functioning (major focus on creativity), and personality correlates. This research highlights the existence of healthy people with psychotic-like traits who mainly experience positive schizotypy (but also affective features mapping onto bipolar disorder). These individuals seem to benefit from a healthy way to organize their thoughts and experiences, that is, they employ an adaptive cognitive framework to explain and integrate their unusual experiences. We conclude that, instead of focusing only on the pathological, future studies should explore the behavioral, genetic, imaging, and psychopharmacological correlates that define the healthy expression of psychotic-like traits. Such studies would inform on protective or compensatory mechanisms of psychosis-risk and could usefully inform us on the evolutionary advantages of the psychosis dimension. PMID:25810058

  18. Long-term monitoring and evaluation of a new system of community-based psychiatric care. Integrating research, teaching and practice at the University of Verona.

    PubMed

    Amaddeo, Francesco; Burti, Lorenzo; Ruggeri, Mirella; Tansella, Michele

    2009-01-01

    The South-Verona community psychiatric service (CPS) was implemented in 1978, according to Law 180, by the Department of Psychiatry of the University of Verona. Since then this CPS provides prompt, comprehensive and coherent answers to patients' needs, psychological and social, as well as practical, while trying to decrease and control symptoms. Special emphasis is given to integrating different interventions, such as medication, rehabilitation, family support, and social work. The South-Verona experience was from the beginning associated with a long-term research project of monitoring and evaluating the new system of care. The research team has grown and expanded over the years and presently includes the following research units: a) environmental, clinical and genetic determinants of the outcome of mental disorders; b) psychiatric register, economics and geography of mental health; c) clinical psychopharmacology and drug epidemiology; d) brain imaging and neuropsychology; e) clinical psychology and communication in medicine; and f) physical comorbidity and health promotion in psychiatric patients. This paper summarises the main results of the coordinated, long-term evaluative studies conducted so far. PMID:19567978

  19. Animal Models of Nicotine Exposure: Relevance to Second-Hand Smoking, Electronic Cigarette Use, and Compulsive Smoking

    PubMed Central

    Cohen, Ami; George, Olivier

    2013-01-01

    Much evidence indicates that individuals use tobacco primarily to experience the psychopharmacological properties of nicotine and that a large proportion of smokers eventually become dependent on nicotine. In humans, nicotine acutely produces positive reinforcing effects, including mild euphoria, whereas a nicotine abstinence syndrome with both somatic and affective components is observed after chronic nicotine exposure. Animal models of nicotine self-administration and chronic exposure to nicotine have been critical in unveiling the neurobiological substrates that mediate the acute reinforcing effects of nicotine and emergence of a withdrawal syndrome during abstinence. However, important aspects of the transition from nicotine abuse to nicotine dependence, such as the emergence of increased motivation and compulsive nicotine intake following repeated exposure to the drug, have only recently begun to be modeled in animals. Thus, the neurobiological mechanisms that are involved in these important aspects of nicotine addiction remain largely unknown. In this review, we describe the different animal models available to date and discuss recent advances in animal models of nicotine exposure and nicotine dependence. This review demonstrates that novel animal models of nicotine vapor exposure and escalation of nicotine intake provide a unique opportunity to investigate the neurobiological effects of second-hand nicotine exposure, electronic cigarette use, and the mechanisms that underlie the transition from nicotine use to compulsive nicotine intake. PMID:23761766

  20. Attention to advertising and memory for brands under alcohol intoxication.

    PubMed

    Orquin, Jacob L; Jeppesen, Heine B; Scholderer, Joachim; Haugtvedt, Curtis

    2014-01-01

    In an attempt to discover new possibilities for advertising in uncluttered environments marketers have recently begun using ambient advertising in, for instance, bars and pubs. However, advertising in such licensed premises have to deal with the fact that many consumers are under the influence of alcohol while viewing the ad. This paper examines the effect of alcohol intoxication on attention to and memory for advertisements in two experiments. Study 1 used a forced exposure manipulation and revealed increased attention to logos under alcohol intoxication consistent with the psychopharmacological prediction that alcohol intoxication narrows attention to the more salient features in the visual environment. Study 2 used a voluntary exposure manipulation in which ads were embedded in a magazine. The experiment revealed that alcohol intoxication reduces voluntary attention to ads and leads to a significant reduction in memory for the viewed ads. In popular terms consuming one or two beers reduces brand recall from 40 to 36% while being heavily intoxicated further reduces brand recall to 17%. PMID:24723899