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Sample records for psychopharmacology

  1. 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

  2. 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.

  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. Psychopharmacological Studies in Mice.

    PubMed

    Matsuda, Toshio

    2016-01-01

    Since 1998, when the laboratory of Medicinal Pharmacology was established in the Graduate School of Pharmaceutical Sciences, Osaka University, I have been interested in psychopharmacological research topics. During this period, we identified a number of novel regulatory mechanisms that control the prefrontal dopamine system through functional interaction between serotonin1A and dopamine D2 receptors or between serotonin1A and σ1 receptors. Our findings suggest that strategies that enhance the prefrontal dopamine system may have therapeutic potential in the treatment of psychiatric disorders. We also found that environmental factors during development strongly impact the psychological state in adulthood. Furthermore, we clarified the pharmacological profiles of the acetylcholinesterase inhibitors donepezil, galantamine, and rivastigmine, providing novel insights into their mechanisms of action. Finally, we developed the female encounter test, a novel method for evaluating motivation in mice. This simple method should help advance future psychopharmacological research. In this review, we summarize the major findings obtained from our recent studies in mice.

  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. [Research in Psychopharmacology].

    PubMed

    Ferrero, Alejandro

    2015-01-01

    Research in psychopharmacology began around 1950 with the description of antipsychotic effect of chlorpromazine followed shortly later with the mechanism of action of antidepressants. In these initial phases, pharmacy industry was open to knowledge and made efforts tending to the development to new drugs that showed efficacy and good safety profiles. In parallel development of theories attempting to find the etiology of psychiatric disorders acquired impulse. This review summarizes the new drugs for the treatment of psychiatric disorders currently under development and also presents a short list of the main biomarkers proposed for the diagnosis or the comprehension of the etiopathogeny in Psychiatry. Several questions arose when brain structures, biochemical pathways, proteins and genes began to be identified in the search for a better comprehension of etiopathogeny of mental disorders. Pharmaceutical industry virtually moved away from this field of research. Epistemological and methodological obstacles in psychopharmacological investigation together with the lack of priority given by industry to this field allow us to predict few advances for the treatment in Psychiatry in the short term.

  10. Psychopharmacology in adolescent medicine.

    PubMed

    Scharf, Michael A; Williams, Thomas P

    2006-02-01

    Psychopharmacology is a challenge for health care providers treating adolescents. A detailed and accurate assessment, including developmental issues relevant to adolescence in general and to the individual adolescent, guides clinicians in formulating thoughtful and effective treatment plans to meet the needs of each patient. Parents play an important role in providing family history regarding psychiatric diagnoses and the response to various drugs, in making decisions to initiate medication and to change a medication regimen, and in monitoring an adolescent's adherence to a prescribed regimen. The role of parents is especially important for younger patients. Following the biopsychosocial model, rarely should psychopharmacologic agents be used as the sole means to treat a psychiatric condition in adolescents. Pharmacologic agents described in this article are tools that have their effect in the biological domain of central neurotransmitters, but psychosocial interventions addressing the emotional and behavioral issues that are the indications for such medication are generally also required. The development of newer medications holds promise for more effective treatment of target symptoms with minimal side effects. PMID:16473299

  11. Psychopharmacological Studies in Mice.

    PubMed

    Matsuda, Toshio

    2016-01-01

    Since 1998, when the laboratory of Medicinal Pharmacology was established in the Graduate School of Pharmaceutical Sciences, Osaka University, I have been interested in psychopharmacological research topics. During this period, we identified a number of novel regulatory mechanisms that control the prefrontal dopamine system through functional interaction between serotonin1A and dopamine D2 receptors or between serotonin1A and σ1 receptors. Our findings suggest that strategies that enhance the prefrontal dopamine system may have therapeutic potential in the treatment of psychiatric disorders. We also found that environmental factors during development strongly impact the psychological state in adulthood. Furthermore, we clarified the pharmacological profiles of the acetylcholinesterase inhibitors donepezil, galantamine, and rivastigmine, providing novel insights into their mechanisms of action. Finally, we developed the female encounter test, a novel method for evaluating motivation in mice. This simple method should help advance future psychopharmacological research. In this review, we summarize the major findings obtained from our recent studies in mice. PMID:27150930

  12. 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.

  13. Psychopharmacology and memory

    PubMed Central

    Glannon, W

    2006-01-01

    Psychotropic and other drugs can alter brain mechanisms regulating the formation, storage, and retrieval of different types of memory. These include “off label” uses of existing drugs and new drugs designed specifically to target the neural bases of memory. This paper discusses the use of beta‐adrenergic antagonists to prevent or erase non‐conscious pathological emotional memories in the amygdala. It also discusses the use of novel psychopharmacological agents to enhance long term semantic and short term working memory by altering storage and retrieval mechanisms in the hippocampus and prefrontal cortex. Although intervention in the brain to alter memory as therapy or enhancement holds considerable promise, the long term effects of experimental drugs on the brain and memory are not known. More studies are needed to adequately assess the potential benefits and risks of these interventions. PMID:16446410

  14. Psychopharmacology in cancer.

    PubMed

    Thekdi, Seema M; Trinidad, Antolin; Roth, Andrew

    2015-01-01

    Depression, anxiety, delirium, and other psychiatric symptoms are highly prevalent in the cancer setting, and pharmacological intervention is an important component in the overall psychosocial care of the patient. Psychopharmacology is also used as a primary or adjuvant treatment for the management of cancer-related symptoms stemming from the disease itself and/or its treatment, including sleep disturbance, loss of appetite, neuropathic pain, nausea, fatigue, and hot flashes. Psychiatrists, oncologists, and palliative care physicians working as members of a multidisciplinary team have the opportunity to target multiple symptoms that negatively affect a patient's quality of life with the strategic use of psychotropic medications when deemed appropriate. This article aims to review the indications for use of antidepressants, psychostimulants, anxiolytics, antipsychotics, and mood stabilizers in oncology. An updated review of the relevant literature is discussed and referenced in each section.

  15. 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

  16. 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.

  17. Psychiatric pharmacogenomics in pediatric psychopharmacology.

    PubMed

    Wall, Christopher A; Croarkin, Paul E; Swintak, Cosima; Koplin, Brett A

    2012-10-01

    This article provides an overview of where psychiatric pharmacogenomic testing stands as an emerging clinical tool in modern psychotropic prescribing practice, specifically in the pediatric population. This practical discussion is organized around the state of psychiatric pharmacogenomics research when choosing psychopharmacologic interventions in the most commonly encountered mental illnesses in youth. As with the rest of the topics on psychopharmacology for children and adolescents in this publication, a clinical vignette is presented, this one highlighting a clinical case of a 16 year old genotyped during hospitalization for recalcitrant depression.

  18. 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…

  19. A Brief Update in Psychopharmacology

    PubMed Central

    Rapp, Morton S.

    1979-01-01

    Recent developments in psychopharmacology have changed the thinking on prescription of several psychoactive drugs. Also, several known facts about administration of these drugs have been underemphasized. The current knowledge about each class of psychoactive drug is briefly reviewed in this article. PMID:21297695

  20. The psychobiology and psychopharmacology of PTSD.

    PubMed

    Van Der Kolk, Bessel A.

    2001-01-01

    This paper reviews the currently available knowledge about the psychobiology and psychopharmacology of post-traumatic stress disorder (PTSD). It also reviews the various studies that have elucidated changes in brain function and structure in PTSD populations, including position emission tomography (PET), single photon emission computed tomography (SPECT), and event-related potential (ERP) studies. It then reviews the literature on catecholamine and hypothalamic-pituitary-adrenal (HPA) axis abnormalities in PTSD, and finally reviews the literature available on the psychopharmacology of PTSD. It discusses how the pathophysiology of PTSD determines the nature of psychopharmacological interventions. Psychopharmacological interventions in PTSD are largely limited to good studies on the effects of the selective serotonin reuptake inhibitors (SSRIs). In order to effectively intervene in PTSD, studies of other psychopharmacological agents are necessary, specifically of agents which affect limbic activation, decreased frontal lobe functioning, altered HPA activity, and other biological features of PTSD. Copyright 2001 John Wiley & Sons, Ltd.

  1. Evolutionary theory, psychiatry, and psychopharmacology.

    PubMed

    Stein, Dan J

    2006-07-01

    Darwin's seminal publications in the nineteenth century laid the foundation for an evolutionary approach to psychology and psychiatry. Advances in 20th century evolutionary theory facilitated the development of evolutionary psychology and psychiatry as recognized areas of scientific investigation. In this century, advances in understanding the molecular basis of evolution, of the mind, and of psychopathology, offer the possibility of an integrated approach to understanding the proximal (psychobiological) and distal (evolutionary) mechanisms of interest to psychiatry and psychopharmacology. There is, for example, growing interest in the question of whether specific genetic variants mediate psychobiological processes that have evolutionary value in specific contexts, and of the implications of this for understanding the vulnerability to psychopathology and for considering the advantages and limitations of pharmacotherapy. The evolutionary value, and gene-environmental mediation, of early life programming is potentially a particularly rich area of investigation. Although evolutionary approaches to psychology and to medicine face important conceptual and methodological challenges, current work is increasingly sophisticated, and may prove to be an important foundational discipline for clinicians and researchers in psychiatry and psychopharmacology.

  2. Dimensional psychopharmacology in somatising patients.

    PubMed

    Biondi, Massimo; Pasquini, Massimo

    2015-01-01

    Despite the recent DSM-5 review of somatoform disorders, which are now called somatic symptom and related disorders, the categorical definitions of these syndromes have inherent limitations because their causal mechanism or presumed aetiologies are still unknown. These limitations may affect everyday clinical practice and decision-making abilities. As a result, physicians have limited information at their disposal to treat these patients. Furthermore, the clinical presentations of somatic disorders may vary a lot. The purpose of this chapter is to illustrate a psychopathological dimensional approach to the somatising patient. This approach is constantly unconsciously applied in clinical practice using continuous variables, such as rating scales. Moreover, treatment strategies might be improved by adding a dimensional approach, simply recognising the prominent components of the presenting psychopathology of a given patient and addressing them with drugs according to their different mechanisms, targeting circuits and neurotransmitters. Some authors have proposed a shift from the nosological to functional application of psychotropic drugs, in which functional psychopharmacology will be dysfunction oriented and therefore inevitably geared towards utilising drug combinations. Here, we present a summary of the advantages of functional/dimensional psychopharmacology for the treatment of somatic symptoms and related disorders.

  3. 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

  4. 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.

  5. 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

  6. Teaching the Teachers of Clinical Psychopharmacology.

    PubMed

    Salzman, Carl; Glick, Ira D

    2015-08-01

    This commentary focuses on psychopharmacology teachers and their teaching. The authors offer broadly based pedagogic suggestions on how to deliver evidence-based and neurobiologically informed prescribing information to clinicians at all levels of experience. They argue that teaching essential psychopharmacology knowledge and practice must be up-to-date, accurate, and consistent with the reality of an individual patient's life experience and beliefs. They stress that educators must teach that nonpsychopharmacological factors in a patient's life may be as relevant to the treatment setting as the actual pharmacological basis of psychotropic drug therapeutics.

  7. 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…

  8. Individual differences and evidence-based psychopharmacology.

    PubMed

    Belmaker, Rh; Bersudsky, Yuly; Agam, Galila

    2012-09-27

    Individual differences in response to pharmacologic treatment limits the usefulness of mean data obtained from randomized controlled trials. These individual differences exist even in genetically uniform inbred mouse strains. While stratification can be of value in large studies, the individual patient history is the most effective currently available guide for personalized medicine in psychopharmacology.

  9. [Psychopharmacological treatments in childhood and adolescence].

    PubMed

    Libal, Gerhard; Schmeck, Klaus

    2009-06-01

    Compared to adults, the use of psychopharmacological substances in childhood and adolescence is significantly more controversial. Often sensation-seeking media reports on the negative effects of psychopharmacological treatments of children and adolescents intensify this controversy on a regular basis. In addition, even pharmacologically trained experts--though frequently without expertise in Child and Adolescent Psychiatry--question the seriousness and thus the demands for treatment of psychiatric disorders in childhood and adolescence. Considering this background evidence based treatment decisions in pediatric psychopharmacology are of utmost importance. Effective psychopharmacotherapy needs to be distinguished from ineffective treatments. The pros and cons of such evidence based treatment approaches ought to be weighted out carefully together with the patients and their families. The aim of this article is to provide a rational and concise foundation for the use of psychopharmacotherapy for clinicians treating children and adolescents as well as to point out the currently best evidence for psychopharmacological treatments of selected disorders in child and adolescent psychiatry.

  10. [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

  11. 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…

  12. 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…

  13. 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…

  14. 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…

  15. 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…

  16. 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.

  17. 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.

  18. [Interactions of 5 benzamides with ethanol on various psychopharmacology tests].

    PubMed

    Bourin, M; Colombel, M C; Larousse, C

    1985-03-01

    Benzamides interactions with ethanol was studied through five psychopharmacological tests. Ethanol given at 2 or 3 g/kg does not induce potentiation of benzamides effects on: motility, relaxation, dopaminergic effects induced by apomorphine (1 and 16 mg/kg).

  19. Informed consent & ethical issues in paediatric psychopharmacology.

    PubMed

    Malhotra, Savita; Subodh, B N

    2009-01-01

    Issues relating to informed consent and ethics in paediatric psychopharmacology limit research in this population. Children vary in their levels of cognitive development, and presence of psychiatric disorder may further impair their ability to give informed consent. In decisional impairment subjects, various methods used for consent are assent/dissent; inclusion of advance directives; and/or alternative decision-makers. India is emerging as a new market for clinical trials in recent years. Moreover, in India the sociocultural realities are different from those in the western countries making it necessary for professionals to be cautious in conducting drug trials. In this review, issues regarding informed consent in children and adolescent with psychiatric diagnosis are discussed for information, discussion and debate by professionals, parents, society and legal experts to create awareness and to facilitate development of guidelines that are appropriate and applicable to the Indian system.

  20. Psychopharmacology training in clinical psychology: a renewed call for action.

    PubMed

    Julien, Robert M

    2011-04-01

    Knowledge of psychopharmacology is essential for a clinical psychologist to practice his/her profession, regardless of whether one desires to become licensed to prescribe psychoactive medications. This commentary reiterates a call made almost 20 years ago for all practitioners to gain and utilize this knowledge. Without psychopharmacology knowledge, one is extremely limited in the ability to interact with medical prescribers and to optimally serve their patients as a valued member of the health care team.

  1. Piracetam interactions with neuroleptics in psychopharmacological tests.

    PubMed

    Bourin, M; Poisson, L; Larousse, C

    1986-01-01

    Two psychopharmacological tests which usually predict neuroleptic activity were conducted after joint administration of piracetam and three neuroleptics (haloperidol, fluphenazine and sulpiride) chosen for their different chemical classes and dopaminergic affinities. In these tests, specific doses of the neuroleptics were used to determine whether piracetam induced potentiation or antagonism of their action. Overall, piracetam increased neuroleptic action regardless of the administration timetable used, but the interaction of fluphenazine differed from that of the other two substances, because piracetam did not modify its action in a specific test of the presynaptic DA-2 dopaminergic receptors. This variation for fluphenazine may be explained by the fact that its pKa value is closer to that of piracetam, thus preventing better bioavailability of the neuroleptic, or its better affinity for DA-1 dopaminergic receptors. Nevertheless, the variation may have been due to a differing affinity for dopaminergic receptors, although this hypothesis is not completely satisfactory because it does not account for differences due to the administration timetable. It is thus suggested that action occurs on nonspecific sites and has the effect of increasing overall neuroleptic bioavailability.

  2. Unmet needs in paediatric psychopharmacology: Present scenario and future perspectives.

    PubMed

    Persico, Antonio M; Arango, Celso; Buitelaar, Jan K; Correll, Christoph U; Glennon, Jeffrey C; Hoekstra, Pieter J; Moreno, Carmen; Vitiello, Benedetto; Vorstman, Jacob; Zuddas, Alessandro

    2015-10-01

    Paediatric psychopharmacology holds great promise in two equally important areas of enormous biomedical and social impact, namely the treatment of behavioural abnormalities in children and adolescents, and the prevention of psychiatric disorders with adolescent- or adult-onset. Yet, in striking contrast, pharmacological treatment options presently available in child and adolescent psychiatry are dramatically limited. The most important currently unmet needs in paediatric psychopharmacology are: the frequent off-label prescription of medications to children and adolescents based exclusively on data from randomized controlled studies involving adult patients; the frequent lack of age-specific dose, long-term efficacy and tolerability/safety data; the lack of effective medications for many paediatric psychiatric disorders, most critically autism spectrum disorder; the scarcity and limitations of randomized placebo-controlled trials in paediatric psychopharmacology; the unexplored potential for the prevention of psychiatric disorders with adolescent- and adult-onset; the current lack of biomarkers to predict treatment response and severe adverse effects; the need for better preclinical data to foster the successful development of novel drug therapies; and the effective dissemination of evidence-based treatments to the general public, to better inform patients and families of the benefits and risks of pharmacological interventions during development. Priorities and strategies are proposed to overcome some of these limitations, including the European Child and Adolescent Clinical Psychopharmacology Network, as an overarching Pan-European infrastructure aimed at reliably carrying out much needed psychopharmacological trials in children and adolescents, in order to fill the identified gaps and improve overall outcomes.

  3. 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.

  4. 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

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  9. 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…

  10. 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…

  11. 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.…

  12. 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...

  13. 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...

  14. 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...

  15. 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…

  16. 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

  17. Practical clinical trials in psychopharmacology: a systematic review.

    PubMed

    Vitiello, Benedetto

    2015-04-01

    Practical clinical trials (PCTs) 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 to 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 during 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 4206 patients (in comparison with at least 46 PCTs 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. Practical clinical trials can constitute an important source of information for clinicians, patients, regulators, and policy makers but have been relatively underused in psychopharmacology. Electronic medical records and integrated practice research networks offer promising platforms for a more efficient conduct of PCTs.

  18. Traditional Chinese Medicine and Western Psychopharmacology: Building Bridges

    PubMed Central

    Shorter, Edward; Segesser, Kathryn

    2013-01-01

    This paper demonstrates that in the treatment of psychiatric disorders, there are striking similarities between the mechanisms of psychoactive agents used in Traditional Chinese Medicine (TCM) and those of western psychopharmacology. While western researchers search for new treatments and novel mechanisms of action, investigators in Asia are analyzing traditional remedies in order to understand the mechanisms responsible for their effectiveness. A review of contemporary pharmacologic studies of agents used in TCM for psychiatric indications reveals that virtually all of the active principles of drug action established in 20th century psychopharmacology were encountered empirically in Chinese herbal medicine over the past 2000 years. Building bridges between these two traditions may thus be of benefit to both cultures. In addition to providing western patients with a wider selection of treatment options, the effort may help Asian clinicians and researchers avoid some of the errors that have troubled their western counterparts. PMID:23418138

  19. 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

  20. Reflections on ethical issues in psychopharmacology: an American perspective.

    PubMed

    Gutheil, Thomas G

    2012-01-01

    Psychopharmacology has revolutionized psychiatric practice but raises a number of ethical issues. This review from an American perspective first describes ethics analyses and attempts to portray the ethical practitioner. Pressures that interfere with appropriate prescribing come from outside the prescriber and from within, including from insurers, other treatment staff and the prescriber's own will to act for the patient. Clinicians also face binds in which alternate choices seem to have merit and leave the prescriber feeling pulled in contradictory directions, frequently related to risk-benefit dilemmas. The ethics of psychopharmacology poses many questions that cannot yet be answered at the current state of the field. Pharmacology also seems to promote extremes of attitudes, such as "All such drugs are poisons" and the like. This review then provides some risk management principles, and concludes that such a review, though not comprehensive, may serve to open questions that are not always considered by clinicians.

  1. 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.

  2. Traditional Chinese medicine and Western psychopharmacology: building bridges.

    PubMed

    Shorter, Edward; Segesser, Kathryn

    2013-12-01

    This paper demonstrates that in the treatment of psychiatric disorders, there are striking similarities between the mechanisms of psychoactive agents used in Traditional Chinese Medicine (TCM) and those of western psychopharmacology. While western researchers search for new treatments and novel mechanisms of action, investigators in Asia are analyzing traditional remedies in order to understand the mechanisms responsible for their effectiveness. A review of contemporary pharmacologic studies of agents used in TCM for psychiatric indications reveals that virtually all of the active principles of drug action established in 20th century psychopharmacology were encountered empirically in Chinese herbal medicine over the past 2000 years. Building bridges between these two traditions may thus be of benefit to both cultures. In addition to providing western patients with a wider selection of treatment options, the effort may help Asian clinicians and researchers avoid some of the errors that have troubled their western counterparts.

  3. Psychobiology and psychopharmacology: issues in clinical research training.

    PubMed

    Janowsky, D S; Glick, I D; Lash, L; Mitnick, L; Klein, D F; Goodwin, F K; Hanin, I; Nemeroff, C; Robins, L

    1986-02-01

    Although the scope of basic studies in psychopharmacology and psychobiology has been expanding steadily for about 30 years, relatively few clinical psychiatrists, psychologists, and psychopharmacologists now choose to become researchers or teachers in these disciplines. Such training is crucial to the future vitality of both academic and private-practice psychiatry, and in view of increasing constraints on training funds, student researchers may well be an endangered species. With these concerns in mind, at its 1984 meeting, the American College of Neuropsychopharmacology's Education and Training Committee organized a symposium of investigators, administrators, and former trainees to explore aspects of effective clinical research training in psychobiology and psychopharmacology. Aspects discussed included mentoring, settings and content of training, depth versus breadth of curriculum, and the effect of a critical mass of colleagues at various stages of professional development. Following a brief overview, selected panelists addressed the issues from their individual perspectives.

  4. 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

  5. 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…

  6. 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…

  7. 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…

  8. Name that neurotransmitter: using music to teach psychopharmacology concepts.

    PubMed

    Hermanns, Melinda; Lilly, Mary LuAnne; Wilson, Kathy; Russell, Nathan Andrew

    2012-09-01

    The purpose of this article is to discuss the use of music (i.e., two original songs, "Neurotransmitter Twitter" and "Parkinson's Shuffle") to teach aspects of psychopharmacology to students in the course Psychiatric/Mental Health Nursing. Songs were incorporated in both the clinical and classroom settings. This innovative teaching method allowed students the opportunity to revisit the information through multiple exposures of the content for reinforcement and enhancement of student learning in a fun, creative approach. Brain-based research will be discussed, along with the process of development.

  9. Psychopharmacologic interventions for repetitive behaviors in autism spectrum disorders.

    PubMed

    Soorya, Latha; Kiarashi, Jessica; Hollander, Eric

    2008-10-01

    This article provides an overview of psychopharmacological treatments for repetitive behaviors in autism spectrum disorders (ASDs) in the context of current conceptualizations of this understudied core symptom domain. The available literature on the widely used selective serotonin reuptake inhibitors (SSRIs), including fluvoxamine, fluoxetine, citalopram, escitalopram, and sertraline, are reviewed. In addition to SSRIs, research on effects of other pharmacologic interventions such as divalproex sodium, risperidone, and the neuropeptide oxytocin are presented. To date, data are mixed for interventions commonly prescribed in clinical practice and suggest several areas of investigation in advancing research on the medication management of repetitive behaviors.

  10. 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

  11. The EU paediatric regulation: effects on paediatric psychopharmacology in Europe.

    PubMed

    Stoyanova-Beninska, Violeta V; Wohlfarth, Tamar; Isaac, Maria; Kalverdijk, Luuk J; van den Berg, Henk; Gispen-de Wied, Christine

    2011-08-01

    Child and adolescent psychiatry is a relatively young field and the recognition, classification, and treatment of disorders in children and adolescents lag behind those in adults. In recent years there is an increasing awareness of the differences between children and adults in psychopathology and pharmacology. Related to this new paediatric regulations have been introduced. This article reviews the regulatory and legislative measures that were adopted in the EU in 2007 and the subsequent impact of these measures on the field of paediatric psychopharmacology. The consequences of the paediatric regulation in the EU are reflected in several domains: regulatory, research aimed at drug development and clinical practices. In the regulatory domain, the consequences include: new paediatric indications, inclusion of special (class) warnings, specification of dose regimens, and information on safety specific to children and adolescents, and development of new medicinal formulations. The paediatric regulation leads to timely development of paediatric friendly formulations and better quality of the clinical evidence. In clinical practices, an increased awareness of the uniqueness of paediatric pharmacology is emerging among medical professionals, and subsequent improvement of medical care (i.e. correct doses, appropriate formulation, monitoring for expected adverse events). In addition, clinical guidelines will have to be revised more frequently in order to integrate the recently acquired knowledge. The new regulations stimulate transparency and discussions between academia, pharmaceutical industry, and regulators. The purpose is to optimize clinical research and obtain evidence for paediatric psychopharmacology, thereby providing adequate support for treatment.

  12. [Functional magnetic resonance imaging of psychopharmacological brain effects: an update].

    PubMed

    Braus, D F; Brassen, S; Weimer, E; Tost, H

    2003-02-01

    Functional magnetic resonance imaging (fMRI) is well established for the examination of functional activity in the living brain. The method permits the development of functional activation maps during perceptual, cognitive and emotional efforts with a high temporal and spatial resolution. As of late there has been growing interest in using this technique to investigate regionally specific brain activity following the administration of drugs such as nicotine, cocaine, lorazepam, scopolamine, antipsychotics or antidepressants. Studies in experimental animals investigate signal changes associated with the administration of psychopharmacological substances in different brain areas using a high magnetising field (> 4 Tesla). FMRI-studies in healthy human volunteers and psychiatric patients focus on cerebral activity following acute drug administration (single challenge) and on adaptive effects of the CNS due to long- term medication. Their results provide insights into brain physiology and neuropharmacological mechanisms which are in turn relevant for preclinical pharmacological studies, responder analyses and for the investigation of pathogenetic models in psychiatric diseases. However, with these new opportunities, additional methodological considerations and limitations emerge. Besides the need of controlling motion artefacts, the influence of interfering psychological variables, an exact specification of the experimental design, a standardised analysis for data adjustment and technical limitations have to be considered. This article provides an overview of the underlying model of brain function, present applications, future possibilities and methodological limitations of fMRI for the understanding of human psychopharmacology. PMID:12579470

  13. 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…

  14. 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.

  15. Pediatric psychopharmacology outside the U.S.A.

    PubMed

    Simeon, J; Utech, C; Simeon, S; Itil, T M

    1974-07-01

    To obtain information on the use of psychotropic drugs children outside the U.S.A., 251 questionnaires were mailed to institutions in 53 countries. Seventy-three responses from 34 countries were analyzed. The percentage of patients receiving drugs under the care of these respondents ranged from 0 to 100% (mean 39%). A total of 56 different drugs were selected for eleven psychiatric disorders. No regional differences were apparent, except for infrequently used drugs. Respondents differed widely in the number of drugs selected and maximum dosages. The most popular drugs used in most disorders were diazepam, thioridazine, chlorpromazine, chlordiazepoxide, imipramine, amitriptyline, haloperidol and methylphenidate. Highest agreements among respondents were for imipramine in enuresis, diazepam in anxiety, chlorpromazine in psychosis and thioridazine in hyperkinesis. The results of this survey illustrate important problems in interpreting cross-cultural data in pediatric psychopharmacology, and recommendations for future research are made.

  16. Cause versus association in observational studies in psychopharmacology.

    PubMed

    Andrade, Chittaranjan

    2014-08-01

    Hypotheses may be generated (and conclusions drawn) from observational studies in areas where information from randomized controlled trials (RCTs) is unavailable. However, observational studies can only establish that significant associations exist between predictor and outcome variables. Observational studies cannot establish that the associations identified represent cause-and-effect relationships. This article discusses examples of associations that were identified in observational studies and that were subsequently refuted in RCTs. Examples are also provided of associations that have yet to be confirmed or refuted but that are nevertheless influential in psychopharmacologic practice. Explanations are offered about how confounding might explain significant relationships between variables that are not related by cause and effect. As a conclusion of this exercise, clinicians are cautioned against placing too much reliance on the findings of observational research.

  17. Psychopharmacology of autism spectrum disorders: a selective review.

    PubMed

    Mohiuddin, Sarah; Ghaziuddin, Mohammad

    2013-11-01

    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. This selective review examines recent studies about the use of psychotropic medications in persons with autism spectrum disorder. The aim was to focus on randomized controlled trials conducted from 1990 to 2010 on this topic. A comprehensive literature search was performed using PubMed and Cochrane databases. Out of 105 studies identified for the review, only 24 were randomized controlled trials. Thus, despite the common use of these medications in autism spectrum disorder, more controlled studies are needed to determine their long-term efficacy and safety.

  18. 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.

  19. 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.

  20. Authenticity Anyone? The Enhancement of Emotions via Neuro-Psychopharmacology.

    PubMed

    Kraemer, Felicitas

    2011-04-01

    This article will examine how the notion of emotional authenticity is intertwined with the notions of naturalness and artificiality in the context of the recent debates about 'neuro-enhancement' and 'neuro-psychopharmacology.' In the philosophy of mind, the concept of authenticity plays a key role in the discussion of the emotions. There is a widely held intuition that an artificial means will always lead to an inauthentic result. This article, however, proposes that artificial substances do not necessarily result in inauthentic emotions. The literature provided by the philosophy of mind on this subject usually resorts to thought experiments. On the other hand, the recent literature in applied ethics on 'enhancement' provides good reasons to include real world examples. Such case studies reveal that some psychotropic drugs such as antidepressants actually cause people to undergo experiences of authenticity, making them feel 'like themselves' for the first time in their lives. Beginning with these accounts, this article suggests three non-naturalist standards for emotions: the authenticity standard, the rationality standard, and the coherence standard. It argues that the authenticity standard is not always the only valid one, but that the other two ways of assessing emotions are also valid, and that they can even have repercussions on the felt authenticity of emotions. In conclusion, it sketches some of the normative implications if not ethical intricacies that accompany the enhancement of emotions.

  1. 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

  2. Integrating psychosocial concepts into psychopharmacology training: a survey study of program directors and chief residents.

    PubMed

    Mallo, C Jason; Mintz, David L; Lewis, Katie C

    2014-06-01

    A growing body of evidence suggests that psychiatric medication outcomes are shaped significantly by psychological and social factors surrounding the prescribing process. Little, however, is known about the extent to which psychiatry programs integrate this evidence base into residency training or the methods by which this is accomplished. Psychiatry residency program directors and chief residents participated in an exploratory online survey to establish how psychosocial factors known to impact medication outcomes are integrated into psychopharmacology education. While participants highly valued the importance of psychosocial factors in the prescribing process, there was limited emphasis of these factors in psychopharmacology training. Additionally, some teaching methods that could advance understanding of complex interactions in the psychopharmacology relationship were found to be underutilized. Given that medication outcomes are significantly influenced by psychosocial factors, psychiatric educators have a responsibility to teach residents about the evidence base available. Residents exposed to this evidence base will be better equipped to manage the complexities of the psychopharmacology role. The results of this study offer clues as to how psychosocial factors may be more fully integrated into residency psychopharmacology training.

  3. The psychopharmacological treatment of depression in primary care in the Royal Navy.

    PubMed

    Coetzee, R H

    2014-01-01

    Depression is a common mental health condition in the UK Armed Forces. Although psychopharmacology is usually a second line intervention, there is a place for antidepressants in the management of depression in primary care. This article will examine the diagnosis of depression, the indications for starting antidepressants, the choice of anti-depressants and the occupational considerations in the Royal Navy. The aim is to equip General Practitioners (GPs) and General Duties Medical Officers (GDMOs) with the clinical information needed to initiate psychopharmacological treatment for depression where indicated.

  4. [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

  5. 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…

  6. 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

  7. 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…

  8. 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…

  9. 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…

  10. 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)…

  11. 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…

  12. Back to the future of psychopharmacology: A perspective on animal models in drug discovery.

    PubMed

    Hendriksen, Hendrikus; Groenink, Lucianne

    2015-07-15

    Psychopharmacology has had some bad publicity lately. Frankly, there have been some major problems along the way in developing new effective drugs for psychiatric disorders. After a prolonged period of high investments but low success rates, big pharmaceutical companies seem to retract their activities in the psychopharmacology field. Yet, the burden of mental disorders is likely to keep on growing in the next decades. In this position paper, we focus on drug development for depression and anxiety disorders, to narrow the scope of the assay. We describe the current situation of the psychopharmacology field, and analyse some of the methods and paradigms that have brought us here, but which should perhaps change to bring us even further. In addition, some of the factors contributing to the current stagnation in psychopharmacology are discussed. Finally, we suggest a number of changes that could lead to a more rational strategy for central nervous system drug development and which may circumvent some of the pitfalls leading to "me too" approaches. Central to the suggested changes, is the notion that mental disorders do not lead to several symptoms, but a network of causally related symptoms convolutes into a mental disorder. We call upon academia to put these changes in the early phases of drug development into effect.

  13. 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…

  14. 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…

  15. 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:…

  16. 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,…

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. 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

  3. Psychopharmacological boundaries of schizophrenia with comorbid cannabis use disorder: a critical review.

    PubMed

    Lazary, Judit

    2012-01-01

    Although cannabis use disorder is strongly related to schizophrenia and treatment of patients with double diagnosis provides serious problem, specific pharmacological, molecular and therapeutical data on this subgroup are poorly available. In this paper we present a critical review on psychopharmacological boundaries of schizophrenia with concurrent cannabis use. The relevant data available in the literature suggest that a weaker compliance, poorer therapy response and higher sensitivity for extrapyramidal side effects are key features of schizophrenia and comorbid cannabis use disorder and represent a clinical challenge. Because of paucity of available research in the field there is not enough evidence to clearly depict the exact psychopharmacological profile of cannabis related schizophrenia. Further investigations are needed to assess phenotypic characteristics of this entity and to tailor effective treatment options accordingly.

  4. Applying the principles of adult learning to the teaching of psychopharmacology: overview and finding the focus.

    PubMed

    Stahl, Stephen M; Davis, Richard L

    2009-04-01

    Medical education in psychopharmacology can be designed according to modern principles of adult learning. The goal is to go beyond merely exposing learners to novel content, to the documentation that learning has occurred and that behaviors have changed, namely the upgrading of skills in clinical practice. The many aspects of this approach to medical education are discussed in overview here. Future installments of "Trends in Psychopharmacology" will periodically deal with specific aspects of the best practices for medical educators outlined here only in brief. This article considers whether the focus of medical education instructors should be the medical content they present, the medical educator that does the presenting, or the learner. The perspective here is that the focus of medical education should be the learner, and that the content should be structured and executed in a manner that facilitates learning instead of inhibiting it.

  5. 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.

  6. [The century of the receptor, history of ideas that launched psychopharmacology].

    PubMed

    Serra, Héctor A; Fadel, Daniel O

    2012-01-01

    Nowadays, the term receptor is obvious in psychopharmacology. However, this was not so obvious a century ago. To try to explain how drugs act, European scientists began to develop theories that turned into deeds with the scientific progress. Thus, the receptor concept and their applications in medicine and psychiatry began to gain substance. In this paper we relate the facts that have led to the current knowledge of receptor, the cornerstone of pharmacology.

  7. Roland Kuhn—100th Birthday of an Innovator of Clinical Psychopharmacology

    PubMed Central

    Steinberg, Holger; Himmerich, Hubertus

    2012-01-01

    On the occasion of his 100th birthday this letter is to pay tribute to Swiss psychiatrist and psychopharmacologist Roland Kuhn (1912–2005), who established the antidepressant effects of imipramine starting in 1956. Since until now only monoaminergic-based antidepressants such as this substance found their way into psychopharmacological therapy, one can say that Kuhn established the lead antidepressant substance and has hence fundamentally changed clinical psychiatry and care for the mentally ill.

  8. 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

  9. Teaching all the evidence bases: reintegrating psychodynamic aspects of prescribing into psychopharmacology training.

    PubMed

    Mallo, C Jason; Mintz, David L

    2013-03-01

    The discipline of psychiatry appears poised at the edge of a paradigm shift. Enthusiasm about psychopharmacological treatments and neuroscientific understandings is giving way to a sobering recognition of the limitations of current biologically oriented approaches. Psychiatry training programs have both an opportunity and a responsibility to address the challenges presented by the evidence. Although the average psychiatrist would profess a biopsychosocial ideal, an examination of our practice, journals, and training curricula suggests that we still have a long way to go before we employ a truly integrated model. There is a compelling, though oft-neglected evidence base demonstrating that pharmacologic treatment outcomes are as dependent on psychological and interpersonal factors as on medical ones. In order to maximize our usefulness to patients, psychiatry must embrace more complex and integrated understandings, transcending reductionistic models that promote mind-body splits. This article explores some of the costs of a model that places disproportionate emphasis on a biological framework. Relevant evidence bases are reviewed that demonstrate the utility of emphasizing the psychology of psychopharmacology. Implications for psychiatric training are considered, and suggestions are made for better integrating meaning factors into psychopharmacology education.

  10. Psychopharmacological treatment of neurocognitive deficits in people with schizophrenia: a review of old and new targets.

    PubMed

    Ahmed, Anthony O; Bhat, Ishrat A

    2014-04-01

    Neurocognitive impairments significantly contribute to disability and the overall clinical picture in schizophrenia spectrum disorders. There has therefore been a concerted effort, guided by the discovery of neurotransmitter and synaptic systems in the central nervous system, to develop and test compounds that may ameliorate neurocognitive deficits. The current article summarizes the results of efforts to test neurocognitive-enhancing agents in schizophrenia. Overall, existing clinical trials provide little reason to be enthusiastic about the benefits of psychopharmacological agents at enhancing neurocognition in schizophrenia-a state of affairs that may reflect the inadequacy of single neurotransmitter or receptor models. The etiologic and phenomenological complexity of neurocognitive deficits in schizophrenia may be better served by psychopharmacological agents that (i) target neurotransmitter systems proximal in the causal chain to neurocognitive deficits; (ii) enhance distal survival processes in the central nervous system-neurogenesis, neuronal growth, synaptogenesis, and connectivity; and (iii) counteract the negative effects of aberrant neurodevelopment in schizophrenia, such as neuroinflammation and oxidative stress. Future efforts to develop psychopharmacological agents for neurocognitive impairment in schizophrenia should reflect the knowledge of its complex etiology by addressing aberrations along its causal chain. Clinical trials may benefit methodologically from (i) an appreciation of the phenomenological heterogeneity of neurocognitive deficits in schizophrenia; (ii) a characterization of the predictors of treatment response; and (iii) a recognition of issues of sample size, statistical power, treatment duration, and dosing.

  11. Attention deficit/hyperactivity disorder and psychopharmacologic treatments in the athlete.

    PubMed

    Conant-Norville, David O; Tofler, Ian R

    2005-10-01

    It is conjectured that attention deficit/hyperactivity disorder (ADHD) symptoms adversely impacting academics, family functioning, social relationships, and vocational performance might also negatively affect athletic and sport performance and enjoyment; this warrants further scientific inquiry. Children, adolescents, and adults participate in organized and impromptu sport activities, both team and individual. With the concern about an epidemic of obesity in the United States, barriers to participation in sport and exercise such as ADHD need to be better understood. This article approaches ADHD in sports by providing a brief introduction to ADHD, first reviewing general clinical findings, then discussing recreational youth sports and psychopharmacological treatment risks and benefits for the elite athlete.

  12. 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

  13. Theory and method in the quantitative analysis of "impulsive choice" behaviour: implications for psychopharmacology.

    PubMed

    Ho, M Y; Mobini, S; Chiang, T J; Bradshaw, C M; Szabadi, E

    1999-10-01

    Impulsive choice refers to the selection of small immediate gains in preference to larger delayed gains, or the selection of large delayed penalties in preference to smaller immediate penalties. Current theoretical interpretations of impulsive choice are reviewed, and a synthesis of these ideas, the "multiplicative hyperbolic model of choice", is presented. The model assumes that the value of a positive reinforcer increases as a hyperbolic function of its size, and decreases as a hyperbolic function of its delay and the odds against its occurrence. Each hyperbolic function contains a single discounting parameter which quantifies the organism's sensitivity to the variable in question. The hyperbolic discounting functions combine multiplicatively to determine the overall value of the reinforcer. Equivalent functions are postulated to govern the (negative) value of aversive events, the net value of an outcome reflecting the algebraic sum of the positive and negative values. The model gives rise to a quantitative methodology for studying impulsive choice, based on a family of linear indifference (null) equations, which describe performance under conditions of indifference, when the values of the reinforcers are assumed to be equal. This methodology may be used to identify individual differences in sensitivity to the magnitude, delay and probability of reinforcement. The methodology is also suitable for the quantitative evaluation of the effects of some pharmacological interventions on discounting parameters. Recent psychopharmacological studies of impulsive choice are reviewed, and the utility of indifference equations for extending this work, and developing a quantitative psychopharmacology of impulsive choice is discussed.

  14. Experience sampling and ecological momentary assessment studies in psychopharmacology: A systematic review.

    PubMed

    Bos, Fionneke M; Schoevers, Robert A; aan het Rot, Marije

    2015-11-01

    Experience sampling methods (ESM) and ecological momentary assessment (EMA) offer insight into daily life experiences, including symptoms of mental disorders. The application of ESM/EMA in psychopharmacology can be a valuable addition to more traditional measures such as retrospective self-report questionnaires because they may help reveal the impact of psychotropic medication on patients' actual experiences. In this paper we systematically review the existing literature on the use of ESM/EMA in psychopharmacology research. To this end, we searched the PsycInfo and Medline databases for all available ESM/EMA studies on the use of psychotropic medication in patients with DSM-III-R and DSM-IV disorders. Dissertations were excluded. We included 18 studies that applied ESM/EMA to study the effects of medication on patients with major depressive disorder, substance use disorder, attention-deficit hyperactivity disorder, psychotic disorder, and anxiety disorder. We found that ESM/EMA may allow researchers and clinicians to track patients during different phases of treatment: before treatment to predict outcome, during treatment to examine the effects of treatment on symptoms and different aspects of daily life experience, and after treatment to detect vulnerability for relapse. Moreover, ESM/EMA can potentially help determine how long and in what contexts medications are effective. Thus, ESM/EMA may benefit both researchers and clinicians and might prove to be an effective tool for improving the treatment of psychiatric patients.

  15. The psychopharmacology algorithm project at the Harvard South Shore Program: an update on schizophrenia.

    PubMed

    Osser, David N; Roudsari, Mohsen Jalali; Manschreck, Theo

    2013-01-01

    This article is an update of the algorithm for schizophrenia from the Psychopharmacology Algorithm Project at the Harvard South Shore Program. A literature review was conducted focusing on new data since the last published version (1999-2001). The first-line treatment recommendation for new-onset schizophrenia is with amisulpride, aripiprazole, risperidone, or ziprasidone for four to six weeks. In some settings the trial could be shorter, considering that evidence of clear improvement with antipsychotics usually occurs within the first two weeks. If the trial of the first antipsychotic cannot be completed due to intolerance, try another until one of the four is tolerated and given an adequate trial. There should be evidence of bioavailability. If the response to this adequate trial is unsatisfactory, try a second monotherapy. If the response to this second adequate trial is also unsatisfactory, and if at least one of the first two trials was with risperidone, olanzapine, or a first-generation (typical) antipsychotic, then clozapine is recommended for the third trial. If neither trial was with any these three options, a third trial prior to clozapine should occur, using one of those three. If the response to monotherapy with clozapine (with dose adjusted by using plasma levels) is unsatisfactory, consider adding risperidone, lamotrigine, or ECT. Beyond that point, there is little solid evidence to support further psychopharmacological treatment choices, though we do review possible options.

  16. 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.

  17. Issues in the psychopharmacologic assessment and treatment of the orthodox Jewish patient.

    PubMed

    Feinberg, S Shalom

    2005-12-01

    As with members of other cultural and religious groups, patients within the Orthodox Jewish community present with their own distinct clinical psychiatric issues related to their unique beliefs and practices. This article reviews the existing literature and anecdotal experience on the psychopharmacologic assessment and treatment of Orthodox Jewish patients. Specific aspects examined include this group's perceived intense stigma in receiving treatment, the priority this community places on cognitive functioning, and how the influence of Jewish laws on marriage and sexual practices impacts one's treatment decisions. The relevance of Jewish dietary laws, the Sabbath, and the community's interest in alternative treatments are also discussed. The limited ethno-psychopharmacology research related to Orthodox Jewish psychiatric patients is reviewed. We conclude that understanding issues such as these is critical if one is going to work within this cultural system in order to successfully address their mental health issues. However, the dearth of controlled research in this community needs to be addressed to provide more effective treatment.

  18. [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

  19. [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

  20. 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

  1. 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.

  2. 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

  3. [The new versus the old antidepressant drugs: a comparative study of their psychopharmacological profiles (author's transl)].

    PubMed

    Bourin, M; Puech, A J; Chermat, R; Doare, L; Poncelet, M; Simon, P

    1981-01-01

    We studied 13 known or potential antidepressants, choosen in different pharmacological classes: desipramine, imipramine, nialamide, dexamphetamine, AHR 1118, amineptine, iprindole, mianserine, nomifensine, salbutamol, TRH viloxazine, zimelidine. Each of these compounds was studied on 8 psychopharmacological tests: motor activity, reserpine induced hypothermia, reserpine induced ptosis, oxotremorine induced hypothermia, oxotremorine induced tremors, high doses apomorphine induced hypothermia, potentiation of toxic effects of yohimbine, behavioural despair. Clinical active compounds are efficient on yohimbine test and at least on one model of hypothermia; with a few exceptions, easy to explain, substances with a clearly demonstrated antidepressant activity in human have some common effects; these common effects can be used to predict, from animal experiments, an antidepressant effect in man.

  4. Cost of treatment as a placebo effect in psychopharmacology: importance in the context of generic drugs.

    PubMed

    Andrade, Chittaranjan

    2015-04-01

    Nonspecific factors have long been known in both psychotherapy and psychopharmacology. In recent years, 2 studies showed that placebo benefits were lower when the treated subjects were told that the placebo, presented as an active treatment, cost less. One of these studies had assessed motor and other outcomes in Parkinson disease patients; the other had assessed analgesia in paid, healthy volunteers to whom electric shocks were administered. The implication of the finding that lower treatment cost may diminish treatment gains is that patients who receive generic medicines may have lower expectations and may consequently derive less placebo-related benefit. This could be of concern in psychiatric disorders that are characterized by a large placebo response. Although the 2 "placebo cost" studies cannot be easily generalized to clinical and especially psychiatric contexts, clinicans should consider offering reassurance to patients receiving generic drugs that cost, per se, has no bearing on treatment-related benefit.

  5. 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

  6. 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

  7. A behavioral diagnostic paradigm for integrating behavior-analytic and psychopharmacological interventions for people with a dual diagnosis.

    PubMed

    Pyles, D A; Muniz, K; Cade, A; Silva, R

    1997-01-01

    Aberrant behaviors exhibited by people with developmental disabilities have been well documented. Often, psychotropic medications, especially neuroleptics, have been used to control behaviors such as self-injury, physical aggression, property destruction, and hyperactivity. Serious side effects of these medications have occurred, resulting in litigation and regulation of their use by courts, surveyors, and accrediting bodies. Rules and regulations have been developed requiring that behaviors/symptoms necessitating that medication usage be clearly delineated, that behavior programs be developed and implemented to reduce need, and that the interdisciplinary team approach be used to monitor effectiveness of interventions. Currently, little guidance exists on how behavioral and psychopharmacological interventions should be applied or combined. This paper presents a paradigm for integrating behavior-analytic and psychopharmacological treatment interventions in the treatment of persons with developmental disabilities that meets applicable standards. Our model is consistent with the least restrictive, yet effective treatment philosophy. Implications for research and treatment are presented.

  8. 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.

  9. Psychopharmacological profile of the selective serotonin reuptake inhibitor, paroxetine: implication of noradrenergic and serotonergic mechanisms.

    PubMed

    Redrobe, J P; Bourin, M; Colombel, M C; Baker, G B

    1998-01-01

    The present study was designed to evaluate the psychopharmacological profile of the selective serotonin reuptake inhibitor paroxetine, and thus assess potential noradrenergic and/or serotonergic activity. Paroxetine dose-dependently increased mobility time in the mouse forced swimming test (8, 16, 32 and 64 mg/kg, i.p.) and reduced spontaneous locomotor activity when administered at a high dose (64 mg/kg, i.p.). Prior administration of 8-hydroxy-2-(di-n-propylamino)tetralin (1 mg/kg, i.p.), (+/-) pindolol (32 mg/kg, i.p.) or 5-methoxy-3-(1,2,3,6-tetrahydro-4-pyridyl)-1H-indole (RU 24969) (1 mg/kg, i.p.) potentiated the antidepressant-like effects of subactive doses of paroxetine (1, 2 and 4 mg/kg, i.p.) in the mouse forced swimming test. These effects were antagonized by prior administration of 1-(2-methoxyphenyl)-4-[-(2-phthalimido)butyl]piperazine) (0.5 mg/kg, i.p.). Complementary studies suggested that RU24969-induced anti-immobility effects were a result of an increase in locomotor activity; other interactions were without increase/decrease in locomotor activity. Acute administration of paroxetine (8, 16, and 32 mg/kg, i.p.) antagonized the hypothermia induced by the D2/D1 receptor agonist, apomorphine (16 mg/kg, s.c.), while repeated treatment with paroxetine (32 mg/kg) attenuated clonidine-induced (0.5 mg/kg, i.p.) hypothermia. Pre-treatment with the serotonergic neurotoxin, para-chlorophenylalanine attenuated the anti-immobility effects of low doses of paroxetine (8 and 16 mg/kg, i.p.) in the forced swimming test, whereas a higher dose of paroxetine remained active (32 mg/kg, i.p.). The results of the present study indicated that paroxetine displayed both noradrenergic-like and serotonergic-like activity in the pre-clinical psychopharmacological tests employed.

  10. 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

  11. [The virtue of that precious balsam...: approach to Don Quixote from the psychopharmacological perspective].

    PubMed

    Lopez-Munoz, F; Garcia-Garcia, P; Alamo, C

    2007-01-01

    The most outstanding novel of the Spanish literature, Don Quixote, represents the source to which the different specialists who intend to deepen their knowledge of the late Renaissance society usually address. This masterpiece of Miguel de Cervantes has been frequently approached from the psychopathological perspective to obtain a psychiatric diagnosis of its main character, Alonso Quijano. Also, other clinical approaches from the traumatological and general therapeutical view (oils, ointments, balms and other pharmacy preparations) have been frequent. We have tackled Don Quixote from the psychopharmacological perspective, a barely explored field. In this work, we intend to study the therapeutical cures used during the Cervantine time for the treatment of insane and mentally disturbed people (sedatives like opium, laxatives like hellebore, tonics, irritants and surgical techniques like bloodlettings and ) and we analyze the limited and unspecific therapies, mainly of herbal origin (balms, purgatives and emetics), which Cervantes reveals to us in his novel. Among them, rhubarb root (Rumex alpinus), seeds of spurge (Euphorbia lathyris), St. John's Wort (Hypericum perforatum), main ingredient of Aparicio's oil, and rosemary (Rosmarinus officinalis), primary component of the famous balsam of Fierabras, should be highlighted. We have also examined the possible scientific influences which might have inspired Cervantes in this field, mainly the works of Juan Huarte de San Juan The examination of men's wits and the one of Andres Laguna Dioscorides' materia medica.

  12. 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.

  13. Innovative trends in the design of therapeutic trials in psychopharmacology and psychotherapy.

    PubMed

    Fava, Giovanni A; Tomba, Elena; Tossani, Eliana

    2013-01-10

    The standard randomized controlled trial design is still based on the acute disease model. This is in sharp contrast with the fact that the patient is likely to have experienced other treatments before, that may actually modify clinical course and responsiveness. The current standard of therapeutic trial in psychiatry is represented by the large, multi-center, controlled randomized trial with broad inclusion criteria, and little attention to other factors such as the clinical history of patients and comorbidity. The heterogeneous features of these patients would then affect the outcome of the trial. Conflicting results among randomized controlled trials can represent a spectrum of outcomes, based on different patient groups, more than bias or random variability. If a treatment is tested by a series of small trials with inclusion criteria for specific characteristics (including treatment history, subgroups and comorbidity), we may have a better knowledge of its indications and contraindications. Further, there is increasing need of expanding the content of customary clinical information, by including evaluation of variables such as stress, lifestyle, well-being, illness behavior and psychological symptoms. These joint strategies would actually constitute a paradigm shift in psychopharmacology and psychotherapy research.

  14. 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.

  15. Atypical Findings in Massive Bupropion Overdose: A Case Report and Discussion of Psychopharmacologic Issues.

    PubMed

    Zhu, Yuanjia; Kolawole, Tiwalola; Jimenez, Xavier F

    2016-09-01

    Bupropion is an atypical antidepressant that is structurally similar to amphetamines. Its primary toxic effects include seizure, sinus tachycardia, hypertension, and agitation; however, at higher amounts of ingestion, paradoxical cardiac effects are seen. We report the case of a 21-year-old woman who ingested 13.5 g of bupropion, a dose higher than any other previously reported. The patient presented with seizure, sinus tachycardia with prolonged QTc and QRS intervals, dilated pupils, and agitation. Four days after overdose, the patient's sinus tachycardia and prolonged QTc and QRS intervals resolved with symptomatic management, but she soon developed sinus bradycardia, hypotension, and mild transaminitis. With continued conservative management and close monitoring, her sinus bradycardia resolved 8 days after the overdose. The transaminitis resolved 12 days after the overdose. Our findings are consistent with previously reported toxic effects associated with common overdose amounts of bupropion. In addition, we have observed transient cardiotoxicity manifesting as sinus bradycardia associated with massive bupropion overdose. These findings are less frequently reported and must be considered when managing patients with massive bupropion overdose. We review the psychopharmacologic implications of this and comment on previous literature. PMID:27648505

  16. Psychopharmacological treatment and course in paranoid personality disorder: a case series.

    PubMed

    Birkeland, Søren F

    2013-09-01

    Little is known about the role of psychopharmacological treatment and course of illness in patients diagnosed with a paranoid personality disorder. This short communication provides a naturalistic study of a psychiatric hospital case series. Fifteen consecutive patients were retrospectively studied. The Clinical Global Impression was rated at first admission, at last psychiatric contact, and after a 6-week observation period with or without antipsychotic treatment. During psychiatric admissions, three patients improved markedly, eight showed only minor changes, and four worsened. In total, seven patients had been administered any antipsychotic medication. The median duration of treatment was 15 weeks (range 4 days-328 weeks). No major adverse effects were noted. Among patients with sixth-week observations available, four had received antipsychotics; they appeared to improve considerably compared with six patients who had not received antipsychotics. Although the findings should be interpreted with caution, they support the notion of the disorder being a relatively chronic condition, although antipsychotics appeared to be safe and possibly had an effect in the short term.

  17. How Human Electrophysiology Informs Psychopharmacology: from Bottom-up Driven Processing to Top-Down Control

    PubMed Central

    Kenemans, J Leon; Kähkönen, Seppo

    2011-01-01

    This review surveys human event-related brain potential (ERP) and event-related magnetic field (ERF) approaches to psychopharmacology and psychopathology, and the way in which they complement behavioral studies and other neuroimaging modalities. The major paradigms involving ERP/ERF are P50 suppression, loudness-dependent auditory evoked potential (LDAEP), mismatch negativity (MMN), P300, mental chronometry, inhibitory control, and conflict processing (eg, error-related negativity (ERN)). Together these paradigms cover a range of more bottom-up driven to more top-down controlled processes. A number of relationships between the major neurotransmitter systems and electrocortical mechanisms are highlighted. These include the role of dopamine in conflict processing, and perceptual processing vs motor preparation; the role of serotonin in P50 suppression, LDAEP, and MMN; glutamate/NMDA and MMN; and the role of acetylcholine in P300 generation and memory-related processes. A preliminary taxonomy for these relationships is provided, which should be helpful in attuning possible new treatments or new applications of existing treatments to various disorders. PMID:20927044

  18. 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

  19. Getting the timing right: experimental protocols for investigating time with functional neuroimaging and psychopharmacology.

    PubMed

    Coull, Jennifer T

    2014-01-01

    Functional Magnetic Resonance Imaging (fMRI) is an effective tool for identifying brain areas and networks implicated in human timing. But fMRI is not just a phrenological tool: by careful design, fMRI can be used to disentangle discrete components of a timing task and control for the underlying cognitive processes (e.g. sustained attention and WM updating) that are critical for estimating stimulus duration in the range of hundreds of milliseconds to seconds. Moreover, the use of parametric designs and correlational analyses allows us to better understand not just where, but also how, the brain processes temporal information. In addition, by combining fMRI with psychopharmacological manipulation, we can begin to uncover the complex relationship between cognition, neurochemistry and anatomy in the healthy human brain. This chapter provides an overview of some of the key findings in the functional imaging literature of both duration estimation and temporal prediction, and outlines techniques that can be used to allow timing-related activations to be interpreted more unambiguously. In our own studies, we have found that estimating event duration, whether that estimate is provided by a motor response or a perceptual discrimination, typically recruits basal ganglia, SMA and right inferior frontal cortex, and can be modulated by dopaminergic activity in these areas. By contrast, orienting attention to predictable moments in time in order to optimize behaviour, whether that is to speed motor responding or improve perceptual accuracy, recruits left inferior parietal cortex.

  20. 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.

  1. 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.

  2. Cannabinoid mitigation of neuronal morphological change important to development and learning: insight from a zebra finch model of psychopharmacology.

    PubMed

    Soderstrom, Ken; Gilbert, Marcoita T

    2013-03-19

    Normal CNS development proceeds through late-postnatal stages of adolescent development. The activity-dependence of this development underscores the significance of CNS-active drug exposure prior to completion of brain maturation. Exogenous modulation of signaling important in regulating normal development is of particular concern. This mini-review presents a summary of the accumulated behavioral, physiological and biochemical evidence supporting such a key regulatory role for endocannabinoid signaling during late-postnatal CNS development. Our focus is on the data obtained using a unique zebra finch model of developmental psychopharmacology. This animal has allowed investigation of neuronal morphological effects essential to establishment and maintenance of neural circuitry, including processes related to synaptogenesis and dendritic spine dynamics. Altered neurophysiology that follows exogenous cannabinoid exposure during adolescent development has the potential to persistently alter cognition, learning and memory.

  3. 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

  4. Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology.

    PubMed

    Barnes, Thomas R E

    2011-05-01

    These guidelines from the British Association for Psychopharmacology address the scope and targets of pharmacological treatment for schizophrenia. A consensus meeting, involving experts in schizophrenia and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from the participants and interested parties, and cover the pharmacological management and treatment of schizophrenia across the various stages of the illness, including first-episode, relapse prevention, and illness that has proved refractory to standard treatment. The practice recommendations presented are based on the available evidence to date, and seek to clarify which interventions are of proven benefit. It is hoped that the recommendations will help to inform clinical decision making for practitioners, and perhaps also serve as a source of information for patients and carers. They are accompanied by a more detailed qualitative review of the available evidence. The strength of supporting evidence for each recommendation is rated.

  5. 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

  6. [PROPOSAL OF INITIAL PSYCHOTERAPEUTIC AND PSYCHOPHARMACOLOGICAL APPROACH IN PATIENTS WITH DIAGNOSE OF 5 DIFFERENT SUBTYPES OF BORDERLINE PERSONALITY DISORDER].

    PubMed

    Colombo, María Cecilia; Hedderwick, Alejandro; Tauguinas, Natalia; Rodante, Demián

    2015-01-01

    The evidence shows that borderline personality disorder (BPD) is the most frequently diagnosed personality disorder. However, the diagnostic criteria are very heterogeneous, suggesting that very different patients may be included within a single construct. Despite its severity, there are no standardized treatments for this group of patients. We find the same problem in the Acute Mental Health Services. The numerous proposals that have been put forward are unclear and have not reached a final consensus. According to Oldham's classification, BPD can be divided into the following subtypes: Affective, Impulsive, Aggressive, Empty and Dependent. In this paper, we propose a psychotherapeutic initial approach from the Dialectical Behavioral Therapy (DBT) perspective and an initial psychopharmacological approach for each subtype of BPD.

  7. [Psychopharmacological properties of crude extract and essential oil of Lippia multiflora].

    PubMed

    Abena, A A; Atipo-Ebata, J K; Hondi Assah, T; Diatewa, M

    2001-01-01

    Psychopharmacological properties of crude extract and essential oil of Lippia multiflora (Lm), a verbenacea of african traditional pharmacopea were investigated in rat using classical methods. The extract of Lm is constituted by an infusion of dried leaves. The essential oil is obtained by hydrodistillation of the dried leaves of Lm with a yield of 0.6%. A dilution of 1% is realised with distilled water and the dose of 2 ml/kg of this solution was chosen for this study. The wistar rats of both sexes weighting between 150 and 250 g are used. Animal's behaviour is observed macroscopically for 12 hours. The spontaneous motor activity is appreciated by method of Martin et al. slightly modified. The number of squares jumped by animals in a rectangular cage is determined in ten minutes. The traction test which measures the time necessary for restoration of posterior paws of rat on metallic bar and the duration of pentobarbital sleeping are used for evaluation of muscle relaxant and sedative effects, respectively. The effects of the two preparations of Lm on apomorphin stereotypies and hypothermia are used to investigate the eventual neuroleptic or antidepressant activity. Analgesic property is evaluated by using acetic acid method. The results are expressed as mean +/- SEM. Data are analysed by using the Dunnett's test. A probability level of 0.05 or less was considered to be stalistically significant. The two preparations of Lm at the doses used are well tolerated by rats. No macroscopic difference is observed in behavioural of control and treated groups. Crude extract and essential oil:--does not modify a spontaneous motor activity: control: 45.00 +/- 5.63; crude extract of Lm: 31.00 +/- 5.63; essential oil of Lm: 28.00 +/- 7.62; diazepam 4 mg/kg: 23.80 +/- 5.27 (P < 0.05);--caused an increase of the time necessary for the restoration of paws on the metallic bar in the traction test: control 1.20 +/- 0.25 sec; crude extract of Lm 5.60 +/- 0.57 sec (P < 0.01), essential

  8. [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

  9. 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

  10. 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

  11. 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.

  12. Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2008 British Association for Psychopharmacology guidelines.

    PubMed

    Cleare, Anthony; Pariante, C M; Young, A H; Anderson, I M; Christmas, D; Cowen, P J; Dickens, C; Ferrier, I N; Geddes, J; Gilbody, S; Haddad, P M; Katona, C; Lewis, G; Malizia, A; McAllister-Williams, R H; Ramchandani, P; Scott, J; Taylor, D; Uher, R

    2015-05-01

    A revision of the 2008 British Association for Psychopharmacology evidence-based guidelines for treating depressive disorders with antidepressants was undertaken in order to incorporate new evidence and to update the recommendations where appropriate. A consensus meeting involving experts in depressive disorders and their management was held in September 2012. Key areas in treating depression were reviewed and the strength of evidence and clinical implications were considered. The guidelines were then revised after extensive feedback from participants and interested parties. A literature review is provided which identifies the quality of evidence upon which the recommendations are made. These guidelines cover the nature and detection of depressive disorders, acute treatment with antidepressant drugs, choice of drug versus alternative treatment, practical issues in prescribing and management, next-step treatment, relapse prevention, treatment of relapse and stopping treatment. Significant changes since the last guidelines were published in 2008 include the availability of new antidepressant treatment options, improved evidence supporting certain augmentation strategies (drug and non-drug), management of potential long-term side effects, updated guidance for prescribing in elderly and adolescent populations and updated guidance for optimal prescribing. Suggestions for future research priorities are also made.

  13. Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2008 British Association for Psychopharmacology guidelines.

    PubMed

    Cleare, Anthony; Pariante, C M; Young, A H; Anderson, I M; Christmas, D; Cowen, P J; Dickens, C; Ferrier, I N; Geddes, J; Gilbody, S; Haddad, P M; Katona, C; Lewis, G; Malizia, A; McAllister-Williams, R H; Ramchandani, P; Scott, J; Taylor, D; Uher, R

    2015-05-01

    A revision of the 2008 British Association for Psychopharmacology evidence-based guidelines for treating depressive disorders with antidepressants was undertaken in order to incorporate new evidence and to update the recommendations where appropriate. A consensus meeting involving experts in depressive disorders and their management was held in September 2012. Key areas in treating depression were reviewed and the strength of evidence and clinical implications were considered. The guidelines were then revised after extensive feedback from participants and interested parties. A literature review is provided which identifies the quality of evidence upon which the recommendations are made. These guidelines cover the nature and detection of depressive disorders, acute treatment with antidepressant drugs, choice of drug versus alternative treatment, practical issues in prescribing and management, next-step treatment, relapse prevention, treatment of relapse and stopping treatment. Significant changes since the last guidelines were published in 2008 include the availability of new antidepressant treatment options, improved evidence supporting certain augmentation strategies (drug and non-drug), management of potential long-term side effects, updated guidance for prescribing in elderly and adolescent populations and updated guidance for optimal prescribing. Suggestions for future research priorities are also made. PMID:25969470

  14. 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.

  15. 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

  16. 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.

  17. 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

  18. Development of military performance models for the assessment of psychopharmacological agent impact. Annual report (Final), 1 September 1984-30 September 1987

    SciTech Connect

    Laughery, K.D.; Drews, C.

    1987-11-01

    In time of war, the human operators of military systems may be exposed to harmful psychopharmacological agents. Certain pretreatment drugs are known to ward off the harmful effects of chemical agents, but these drugs have adverse side effects that may degrade a soldier's ability to perform an operation. This report describes the development of a task network modeling tool which is used to simulate the effect of drugs on human performance. This tool is a software package known as Micro SAINT. It runs on an IBM PC or compatible microcomputer. The construction of models is entirely menu-driven, and does not require knowledge of computer programming. This report contains recommended procedures for conducting simulation analysis. Micro SAINT is presently being used in over 55 government installations.

  19. 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

  20. 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

  1. 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

  2. Research barriers in psychopharmacology.

    PubMed

    Cole, J O

    1977-08-01

    The author discusses barriers to psychopahrmacological research, including attacks by vocal human rights groups, regulation by local review boards, and Department of Health, Education, and Welfare restrictions. He suggests that those patients least able to give informed consent are most in need of the benefits of research on new drugs.

  3. 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.

  4. 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…

  5. 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)

  6. [Psychopharmacological profile of venlafaxine].

    PubMed

    Bourin, M

    1999-06-01

    Venlafaxine is an antidepressant which blocks reuptake of noradrenaline and serotonin and, to a lesser extent, dopamine. These data have been confirmed by behavioral tests. It has been shown that by decreasing the overall cerebral quantity of 5-HT and NA, venlafaxine continued to have an antidepressant action in animal models. In addition, the drug has been shown to act preferentially on 5-HT1A and 5-HT1B receptors.

  7. Science, Mysticism and Psychopharmacology

    PubMed Central

    Hayman, Max

    1964-01-01

    Historically, psychopharmaceutical agents have been used to produce a mystical state with the religious connotation of “a union with Divine Nature” or of “oneness with God.” Such transcendental states are also known to occur in starvation, self-flagellation, Yoga and various psychoses. A common psychological origin is suggested for these states, in which there is a psychic regression to an early phase of development. This genetically is the phase wherein the infant is still united with the mother and has not yet established the boundaries between the “self” and the “not-self.” In a subtler form, the desire to regress to this phase may be a universal yearning which affects the physician, the investigator and even the manufacturer of drugs. Accordingly, we have a profusion of tranquilizers, euphoriants and ataractics the prescription or the investigation of which may give vicarious pleasure and relief of tension to the physician and scientist by a process of identification with the person receiving the drug. Mankind's quest for psychic development is difficult and precarious, alternately marked by progression and regression. Excesses in the use of drugs are indicated as regressive in nature. PMID:14201240

  8. 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…

  9. 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.

  10. 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

  11. The Sleep Elaboration-Awake Pruning (SEAP) theory of memory: long term memories grow in complexity during sleep and undergo selection while awake. Clinical, psychopharmacological and creative implications.

    PubMed

    Charlton, Bruce G; Andras, Peter

    2009-07-01

    , psychopharmacological and creative domains. For example, it would be predicted that states of insufficient alertness such as delirium would produce errors of commission (memory distortion and false memories, as with psychotic delusions), while sleep deprivation would produce errors of memory omission (memory loss). Ultimately, the main argument in favour of SEAP is that long term memory must be a complex adaptive system, and complex systems arise, are selected and sustained according to the principles of systems theory; and therefore LTM cannot be functioning in the way assumed by 'representation-consolidation' theories.

  12. Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology.

    PubMed

    Baldwin, David S; Anderson, Ian M; Nutt, David J; Allgulander, Christer; Bandelow, Borwin; den Boer, Johan A; Christmas, David M; Davies, Simon; Fineberg, Naomi; Lidbetter, Nicky; Malizia, Andrea; McCrone, Paul; Nabarro, Daniel; O'Neill, Catherine; Scott, Jan; van der Wee, Nic; Wittchen, Hans-Ulrich

    2014-05-01

    This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treatment, and further approaches for patients who have not responded to first-line interventions. A consensus meeting involving international experts in anxiety disorders reviewed the main subject areas and considered the strength of supporting evidence and its clinical implications. The guidelines are based on available evidence, were constructed after extensive feedback from participants, and are presented as recommendations to aid clinical decision-making in primary, secondary and tertiary medical care. They may also serve as a source of information for patients, their carers, and medicines management and formulary committees.

  13. 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

  14. 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

  15. The ethics of elective psychopharmacology.

    PubMed

    Mohamed, Ahmed D; Sahakian, Barbara J

    2012-05-01

    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.

  16. 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

  17. Neuroanatomical and psychopharmacological evidence for interaction between opioid and GABAergic neural pathways in the modulation of fear and defense elicited by electrical and chemical stimulation of the deep layers of the superior colliculus and dorsal periaqueductal gray matter.

    PubMed

    Eichenberger, G C D; Ribeiro, S J; Osaki, M Y; Maruoka, R Y; Resende, G C C; Castellan-Baldan, L; Corrêa, S A L; Da Silva, L A; Coimbra, N C

    2002-01-01

    The effects of central administration of opioid antagonists on the aversive responses elicited by electrical (at the freezing and escape thresholds) or chemical stimulation (crossings, rearings, turnings and jumps, induced by microinjections of bicuculline) of the midbrain tectum were determined. Central microinjections of naloxone and naltrexone in the mesencephalic tectum caused a significant increase in the freezing and escape thresholds elicited by electrical midbrain tectum stimulation. Furthermore, both opioid antagonists caused a significant decrease in the mean incidence of aversive behavioral responses induced by microinjections of bicuculline in the deep layers of the superior colliculus (DLSC) and in dorsal aspects of the periaqueductal gray matter (DPAG), as compared with controls. These findings suggest an opioid modulation of the GABAergic inhibitory inputs controlling the aversive behavior elicited by midbrain tectum stimulation. In fact, immunohistochemical evidence suggests that the dorsal mesencephalon is rich in beta-endorphin-containing neurons and fibers with varicosities. Iontophoretical microinjections of the neurotracer biodextran in the substantia nigra, pars reticulata (SNpr), show nigro-tectal pathways connecting SNpr with the same neural substrate of the DPAG rich in neuronal cells immunoreactive for opioid peptides. Labeled neurons of the DLSC and periaqueductal gray matter send inputs with varsicosities to ipsi- and contralateral DPAG and ipsilateral SNpr. These findings, in addition to the psychopharmacological evidence for the interaction between opioid and GABAergic mechanisms, offer a neuroanatomical basis of a possible presynaptic opioid inhibition of GABAergic nigro-tectal neurons modulating the fear in aversive structures of the cranial mesencephalon, in a short link, and maybe through a major neural circuit, also in GABA-containing perikarya of nigro-tectal neurons.

  18. [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.

  19. [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

  20. 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

  1. Principles of psychopharmacology for the adolescent patient.

    PubMed

    Reeve, Alya

    2013-08-01

    Physicians are presented with great challenges when attempting to integrate information from multiple sources, often with conflicting recommendations, to meet the present and future needs of adolescents and the expectations of their families and caregivers. For this reason, this article attempts to outline a general strategy in assessment and use of information. General history of presenting symptoms, results of examination details, and additional history from family or other contexts lead to the development of a reasoned hypothesis. The working hypothesis is the basis for subsequent treatment. Revisiting the ongoing data, including response to therapeutic intervention, leads to revised hypotheses that provide the basis for the new treatment formulation. Patients and their families become informed self-advocates and partners in achieving improved outcomes.

  2. 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.

  3. Glutamate-based antidepressants: preclinical psychopharmacology.

    PubMed

    Pilc, Andrzej; Wierońska, Joanna M; Skolnick, Phil

    2013-06-15

    Over the past 20 years, converging lines of evidence have both linked glutamatergic dysfunction to the pathophysiology of depression and demonstrated that the glutamatergic synapse presents multiple targets for developing novel antidepressants. The robust antidepressant effects of the N-methyl-D-aspartate receptor antagonists ketamine and traxoprodil provide target validation for this family of ionotropic glutamate receptors. This article reviews the preclinical evidence that it may be possible to develop glutamate-based antidepressants by not only modulating ionotropic (N-methyl-D-aspartate and alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid) and metabotropic glutamate (mGlu) receptors, including mGlu2/3, mGLu5 and mGlu7 receptors, but also by altering synaptic concentrations of glutamate via specialized transporters such as glial glutamate transporter 1 (excitatory amino-acid transporter 2).

  4. Perinatal depression and anxiety: beyond psychopharmacology.

    PubMed

    Brogan, Kelly

    2013-03-01

    A discussion of pharmacologic and nonpharmacologic management of mental disorders in the pregnant woman is presented, with the focus on alternative health approaches and nutrition awareness. The article explores some considerations of modifiable risk factors thought to play a role in epigenetic manifestations of infant and child illness. Several case examples show the potential for integrative medicine in patients of reproductive age.

  5. 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.

  6. An international perspective on pediatric psychopharmacology.

    PubMed

    Vitiello, Benedetto

    2008-04-01

    The use of pharmacotherapy for children and adolescents with mental disorders varies widely across countries. More than 80% of the world use of stimulant medications occurs in the USA. The use of antidepressants and antipsychotics is many times greater in the USA than in other countries. Factors likely to influence the pediatric use of psychotropic medications are here examined and discussed. Variability in use reflects differences in diagnostic systems, clinical practice guidelines, drug regulation, health services organization, availability and allocation of financial resources, and cultural attitudes towards childhood behavioral and emotional disturbances. Cultural context seems to exert a greater influence on the identification and management of psychiatric disorders than on other areas of medicine. It is currently unknown if the heterogeneity in treatment approaches results in differential clinical outcomes and prognosis. A better understanding of the factors underlying international variability may help clarify the process of diagnosis and treatment selection in child and adolescent psychiatry.

  7. A primer on confidence intervals in psychopharmacology.

    PubMed

    Andrade, Chittaranjan

    2015-02-01

    Research papers and research summaries frequently present results in the form of data accompanied by 95% confidence intervals (CIs). Not all students and clinicians know how to interpret CIs. This article provides a nontechnical, nonmathematical discussion on how to understand and glean information from CIs; all explanations are accompanied by simple examples. A statistically accurate explanation about CIs is also provided. CIs are differentiated from standard deviations, standard errors, and confidence levels. The interpretation of narrow and wide CIs is discussed. Factors that influence the width of a CI are listed. Explanations are provided for how CIs can be used to assess statistical significance. The significance of overlapping and nonoverlapping CIs is considered. It is concluded that CIs are far more informative than, say, mere P values when drawing conclusions about a result.

  8. 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…

  9. ASD: Psychopharmacologic Treatments and Neurophysiologic Underpinnings

    PubMed Central

    Kodish, Ian; Rockhill, Carol M.; Webb, Sara J.

    2014-01-01

    Autism Spectrum Disorder encompasses a range of neurodevelopmental disorders characterized by early deficits in social communication in addition to restricted and repetitive behaviors. Symptoms are increasingly understood to be associated with abnormalities in the coordination of neuronal assemblies responsible for processing information essential for early adaptive behaviors. Pharmacologic treatments carry evidence for clinically significant benefit of multiple impairing symptoms of ASD, yet these benefits are limited and range across a broad spectrum of medication classes, making it difficult to characterize associated neurochemical impairments. Increasing prevalence of both ASD and its pharmacologic management calls for greater understanding of the neurophysiologic basis of the disorder. This paper reviews underlying alterations in local brain regions and coordination of brain activation patterns during both resting state and task-related processes. We propose that new pharmacologic treatments may focus on realigning trajectories of network specialization across development by working in combination with behavioral treatments to enhance social and emotional learning by bolstering the impact of experience-induced plasticity on neuronal network connectivity. PMID:24683058

  10. Looking back to the future of psychopharmacology.

    PubMed

    Hirshbein, Laura

    2012-12-01

    In 1967, select members of the American College of Neuropsychopharmacology (ACNP) met to discuss the future of the field. In their publication from this meeting, Psychotropic Drugs in the Year 2000, in 1971, the group imagined wild possibilities for chemical alteration of human behaviors and experience. These men thought that drugs could be used to solve social problems for all people. Not surprisingly, few of the predictions came true because the ACNP members could not have foreseen changes in American society and politics, a separation between street drugs and prescribed medications, and the increasing power of the pharmaceutical industry.

  11. 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,…

  12. 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

  13. The impact of psychopharmacology on contemporary clinical psychiatry.

    PubMed

    Vázquez, Gustavo H

    2014-08-01

    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.

  14. 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.…

  15. 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.

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

    PubMed

    Gebicke-Haerter, Peter J

    2016-03-22

    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.

  17. 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…

  18. Pediatric psychopharmacology in primary care: a conceptual framework.

    PubMed

    Riddle, Mark A; dosReis, Susan; Reeves, Gloria M; Wissow, Lawrence S; Pruitt, David B; Foy, Jane Meschan

    2013-08-01

    In a 2009 policy statement focused on children's mental health, the American Academy of Pediatrics recommended that pediatric primary care physicians achieve competence in initiating care for children with attention-deficit/hyperactivity disorder (ADHD), anxiety, depression, and substance use/abuse. Because treatment for 3 of these conditions--ADHD, anxiety, and depression--may, under certain conditions, include medication, the primary purpose of this article is to offer guidance to assist primary care physicians in decision-making about their use of psychotropic medications for these conditions. A few medications with proven efficacy and safety are emphasized. Secondarily, other medications that may be useful for other disorders are noted.

  19. 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,…

  20. A schematic representation of the psychopharmacological profile of antidepressants.

    PubMed

    Bourin, M; Redrobe, J P; Hascoet, M; Baker, G B; Colombel, M C

    1996-11-01

    1. Using simple animal tests, "behavioural" and "biochemical" aspects of depression, anxiolysis, disinhibition, psychostimulation and sedation were investigated in mice using a variety of antidepressant drugs. 2. Dothiepin and mianserin (16 and 32 mg/kg), fluoxetine (32 and 64 mg/kg), maprotiline and imipramine (16, 32 and 64 mg/kg) and viloxazine (16 mg/kg) significantly potentiated mortality following acute administration with yohimbine. 3. Dothiepin and imipramine (32 mg/kg), fluoxetine (16 and 32 mg/kg), viloxazine (8 and 16 mg/kg), maprotiline (32 mg/kg) and mianserin (32 mg/kg) reduced immobility time in the forced swimming test. 4. In the black and white box, dothiepin (32 mg/kg) significantly increased the time spent in the bright compartment: Fluoxetine (8 and 16 mg/kg) significantly increased the number of crossings between compartments, an effect indicative of desinhibition. 5. It can be concluded that dothiepin possesses both antidepressant and anxiolytic properties in these animal models. The present procedure is useful not only for the screening of compounds that may possess antidepressant properties, but is also of value in determining other properties that may contribute to the overall clinical efficacy of the drugs.

  1. The value of the reserpine test in psychopharmacology.

    PubMed

    Bourin, M; Poncelet, M; Chermat, R; Simon, P

    1983-01-01

    Numerous tests have been proposed to search for a possible antidepressive action. Many of these tests are based on a reversal of different reserpine effects, an approach justified mainly by the use of most the classic or new antidepressants. Three effects of reserpine were examined in mice: hypothermia, ptosis and akinesia. All tests were performed with reserpine 2.5 mg/kg, and the drugs were injected 4 h after reserpine administration. In these three models, we studied the relatively specific effects of 21 drugs known for their influence on the metabolism or action of norepinephrine (noradrenaline), serotonin and dopamine. Our results suggest that hypothermia antagonism is only obtained with drugs stimulating beta-adrenergic receptors directly or indirectly, ptosis antagonism with those stimulating alpha-adrenergic or serotonergic receptors, and akinesia antagonism with those stimulating dopaminergic receptors.

  2. 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…

  3. Treatment of Cognitive Deficits in Alzheimer's disease: A psychopharmacological review.

    PubMed

    Campos, Carlos; Rocha, Nuno Barbosa; Vieira, Renata Teles; Rocha, Susana A; Telles-Correia, Diogo; Paes, Flávia; Yuan, Tifei; Nardi, Antonio Egidio; Arias-Carrión, Oscar; Machado, Sergio; Caixeta, Leonardo

    2016-03-01

    The growing and aging population has contributed to the increased prevalence of Alzheimer's disease (AD) and other types of dementia in the world. AD is a progressive and degenerative brain disease with an onset characterized by episodic memory impairments, although progressive deficits can be observed in several domains including language, executive functions, attention and working memory. The relationship between cognitive impairments and the topography and progression of brain neuropathology is well established. The pathophysiologic mechanisms and processes that underline the course of cognitive and clinical decline have been the theoretical support for the development of pharmacological treatments for AD. Cholinesterase inhibitors (ChEIs) and N-methyl-D-aspartate (NMDA) antagonists are the main drugs used in the management of global cognitive impairment and several studies also explore the effects of both in specific cognitive measures. Recent research trends also examine the effects of combination therapy using both compounds. This review aims to update practical recommendations for the treatment of global cognitive functioning and specific neurocognitive deficits in AD using ChEIs, NMDA antagonists and combination therapy with both drugs. PMID:26938815

  4. Psychopharmacology of topiramate: from epilepsy to bipolar disorder

    PubMed Central

    Mula, Marco; Cavanna, Andrea E; Monaco, Francesco

    2006-01-01

    Topiramate (TPM) is one of the novel antiepileptic drugs and exhibits a wide range of mechanisms of action. Efficacy of TPM has been demonstrated in partial-onset seizures and primary generalized seizures in adults and children, as both monotherapy and adjunctive therapy. More recently, TPM has been proposed as an add-on treatment for patients with lithium-resistant bipolar disorder, especially those displaying rapid-cycling and mixed states. This paper reviews the multiple mechanisms of action and the tolerability profile of TPM in the light of its therapeutic potential in affective disorders. Studies of TPM in bipolar disorder are evaluated, and the efficacy and tolerability issues as a mood stabilizing agent are discussed. PMID:19412496

  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.

  6. Psychopharmacological screening of Pfaffia glomerata Spreng. (Amarathanceae) in rodents.

    PubMed

    de-Paris, F; Neves, G; Salgueiro, J B; Quevedo, J; Izquierdo, I; Rates, S M

    2000-11-01

    The alcoholic extract of Pfaffia glomerata roots (100, 500, 1000 mg/kg, intraperitoneally (i.p.), and 500, 1000, 1500 mg/kg, per os) was studied in several behavioral animal models for the evaluation of central activity: open field, barbiturate sleeping time, pentilenotetrazole (PTZ)-induced convulsions, elevated plus-maze, step-down inhibitory avoidance and forced swimming test. The acute treatment (500 mg/kg, i.p.) interfered with the open-field habituation, decreased sleep latency and increased barbiturate-induced sleeping time, protected partially the animals of PTZ-induced convulsions, decreased the memory retention in step-down inhibitory avoidance, and did not have an important effect in the elevated plus-maze test and forced swimming test. The same extract at 1000 mg/kg per os did not cause any effect in barbiturate sleeping time and pentilenotetrazole-induced convulsions models. Thus, the effect on the memory was deeper evaluated in the step-down inhibitory avoidance task. When administered by intraperitoneal route, the extract showed a dose-dependent effect causing full amnesia at 1000 mg/kg. On the other hand, when it was given by oral route at 500, 1000 and 1500 mg/kg, no influence on the memory retention was observed. These results suggest that the alcoholic extract of P. glomerata roots presents different effects depending on the route of administration: by i.p route, it seems to be a central nervous system depressant agent; by oral route, it seems to be ineffective, at least in the tested doses.

  7. 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

  8. 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

  9. Human psychopharmacology of Ecstasy (MDMA): a review of 15 years of empirical research.

    PubMed

    Parrott, A. C.

    2001-12-01

    MDMA (3,4-methylenedioxymethamphetamine) or 'Ecstasy' was scheduled as an illegal drug in 1986, but since then its recreational use has increased dramatically. This review covers 15 years of research into patterns of use, its acute psychological and physiological effects, and the long-term consequences of repeated use. MDMA is an indirect monoaminergic agonist, stimulating the release and inhibiting the reuptake of serotonin (5-HT) and, to a lesser extent, other neurotransmitters. Single doses of MDMA have been administered to human volunteers in double-blind placebo-controlled trials, although most findings are based upon recreational MDMA users. The 'massive' boost in neurotransmitter activity can generate intense feelings of elation and pleasure, also hyperactivity and hyperthermia. This psychophysiological arousal may be exacerbated by high ambient temperatures, overcrowding, prolonged dancing and other stimulant drugs. Occasionally the 'serotonin syndrome' reactions may prove fatal. In the days after Ecstasy use, around 80% of users report rebound depression and lethargy, due probably to monoaminergic depletion. Dosage escalation and chronic pharmacodynamic tolerance typically occur in regular users. Repeated doses of MDMA cause serotonergic neurotoxicity in laboratory animals, and there is extensive evidence for long-term neuropsychopharmacological damage in humans. Abstinent regular Ecstasy users often display reduced levels of 5-HT, 5-HIAA, tryptophan hydroxylase and serotonin transporter density; functional deficits in learning/memory, higher cognitive processing, sleep, appetite and psychiatric well-being, and, most paradoxically, 'loss of sexual interest/pleasure'. These psychobiological deficits are greatest in heavy Ecstasy users and may reflect serotonergic axonal loss in the higher brain regions, especially the frontal lobes, temporal lobes and hippocampus. These problems seem to remain long after the recreational use of Ecstasy has ceased, suggesting that the neuropharmacological damage may be permament. Copyright 2001 John Wiley & Sons, Ltd.

  10. 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.

  11. 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…

  12. Patient Management and Psychopharmacological Treatment Associated to Smoking Ban in an Acute Psychiatric Unit.

    PubMed

    Bergé, Daniel; Mané, Anna; Fonseca, Francina; Toll, Alba; Merino, Ana; Pérez, Victor; Bulbena, Antoni

    2015-08-01

    This study investigates differences in terms of clinical and treatment management in psychiatric hospitalization associated to smoking ban. We collected data regarding medication, socio-demographic and admission characteristics from all patients admitted to an acute psychiatric hospital before and after a smoking ban was in force. We also assessed a limited sample of patients before and after the ban regarding nicotine dependence, motivation to quit smoking and attitudes towards the ban. More number of leaves of absence and movement restrictions during the ban period occurred in comparison to the pre-ban period. On the contrary a lack of significant differences in terms of hospital stay (duration, rate of voluntary admissions and voluntary discharges), use of sedatives and doses of antipsychotics was found. A period of adjustment regarding the deal with leave of access and facilitate nicotine replacement treatment may help future psychiatric facilities planning smoking free policies.

  13. Psychopharmacology of the negative symptoms: current status and prospects for progress.

    PubMed

    Davis, Michael C; Horan, William P; Marder, Stephen R

    2014-05-01

    The past decade has witnessed a resurgence of interest in the development of novel pharmacological agents to treat the negative symptoms of schizophrenia. This review provides an overview of pharmacological approaches that have been evaluated as potential treatments and describes the emergence of several promising new approaches. First, we briefly describe recent methodological developments, including consensus-based clinical trial guidelines for patient selection criteria, symptom assessment, and trial duration. Next, we overview mono- and adjunctive-therapies that have been evaluated, including first- and second-generation antipsychotics, antidepressants, psychostimulants, molecules targeting cholinergic and glutamatergic systems, and hormones. We highlight the most promising pharmacological agents on the horizon, including glycine transporter-1 inhibitors, α7-nicotinic receptor positive allosteric modulators, and oxytocin, as well as non-pharmacological electromagnetic stimulation approaches. Further investigations, using optimal clinical trial design, hold considerable promise for discovering effective treatments for these functionally disabling symptoms in the near future.

  14. 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…

  15. 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.

  16. 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…

  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. 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…

  19. 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.

  20. 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

  1. Psychopharmacology Today: Where are We and Where Do We Go From Here?

    PubMed Central

    Schwartz, Thomas L.

    2010-01-01

    Since the 1950s we have had the same three neurotransmitters to work with to treat depression, one transmitter for psychoses, three for anxiety. We have developed newer drugs that are more tolerable, but we have not developed drugs that are better in efficacy. The last 50-60 years should be considered the decades that allowed us to treat a greater number of patients with safer and more tolerable drugs. We have also decreased stigma and allowed primary care clinicians to become more comfortable treating the mentally ill. We clearly treat more patients than before, and sometimes are now accused of over-prescribing wantonly as our drugs are safer. Without any clear blockbuster new drug ready to be added to our armamentarium, what can we do as psychopharmacologists today, and tomorrow, to obtain better results? This introductory manuscript will attempt to provide an overview of ideas so that an adept, well-rounded clinician might be able to obtain better outcomes despite using neurotransmitter pharmacodynamics that have been around since the 1950s. Finally, I will comment on the psychotropic pipeline, which may be added to our armamentarium in the future. PMID:21327167

  2. 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

  3. 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)

  4. [Biological treatment strategies of depression--psychopharmacology and non-pharmacological methods].

    PubMed

    Hatzinger, Martin

    2010-11-01

    Biological treatment procedures are based on evidence-based guidelines. According to all of them, a correct diagnosis of depression is required before starting therapy. Within recent years many different types of antidepressants have been introduced to the pharmacotherapeutic armamentarium. The "newer" antidepressants were developed with a view to reduced side effects. However, the classes of antidepressants currently available differ little in their antidepressant efficacy, thus, all producing treatment responses of 50 - 75 %. Therefore, the selection of a particular antidepressant for the individual patient depends on various factors: patient's prior experience with medication, concurrent medical conditions that may be worsened by selected antidepressants, concomitant use of non-psychiatric medications that may lead to negative drug-drug interactions, a drug's short and long-term side effects, physician's experience with the medication and patient's history of adherence to medication. Importantly, if the patient does not show any improvement after two to four weeks of treatment with an antidepressant dose at the upper level of the standard dose, it becomes less likely that he will respond to this particular medication later. When a partial or non-response is present, several therapeutic options are available: (1) combining two antidepressants from different classes, (2) switch to new antidepressant from a different or the same pharmacological class and (3) augmentation strategies. For patients who are reluctant to take traditional antidepressants, herbal remedies such as hypericum perforatum (St. John's Wort) provide an alternative for treatment of mild to moderate depression. Besides pharmacological treatment options non pharmacological biological interventions are available. Electroconvulsive therapy and partial sleep deprivation are very effective in the treatment of acute depression. Especially for seasonal affective disorders light therapy is a well established treatment alternative. Further new biological treatment approaches such as rapid transcranial magnetic stimulation (rTMS) showed inconsistent results. PMID:21043020

  5. The use of magnetoencephalography in the study of psychopharmacology (pharmaco-MEG).

    PubMed

    Muthukumaraswamy, Suresh D

    2014-09-01

    Magnetoencephalography (MEG) is a neuroimaging technique that allows direct measurement of the magnetic fields generated by synchronised ionic neural currents in the brain with moderately good spatial resolution and high temporal resolution. Because chemical neuromodulation can cause changes in neuronal processing on the millisecond time-scale, the combination of MEG with pharmacological interventions (pharmaco-MEG) is a powerful tool for measuring the effects of experimental modulations of neurotransmission in the living human brain. Importantly, pharmaco-MEG can be used in both healthy humans to understand normal brain function and in patients to understand brain pathologies and drug-treatment effects. In this paper, the physiological and technical basis of pharmaco-MEG is introduced and contrasted with other pharmacological neuroimaging techniques. Ongoing developments in MEG analysis techniques such as source-localisation, functional and effective connectivity analyses, which have allowed for more powerful inferences to be made with recent pharmaco-MEG data, are described. Studies which have utilised pharmaco-MEG across a range of neurotransmitter systems (GABA, glutamate, acetylcholine, dopamine and serotonin) are reviewed.

  6. 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

  7. [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.

  8. Clinical Psychopharmacology Update: Additional Safety Concerns for Using Varenicline (Chantix) for Smoking Cessation Treatment.

    PubMed

    Tobin, Thomas J; Tobin, Mary L

    2015-01-01

    Smoking cessation remains a positive therapeutic goal and should be encouraged for the millions of individuals who continue to smoke and struggle to quit. While psychiatric nurses should encourage patients to start or continue smoking cessation therapies, they must be aware of the additional safety concerns relating to the use of varenicline (Chantix). Research published subsequent to the last clinical update in this journal (Tobin, 2007 ) has prompted additional warnings from the Food and Drug Administration concerning varenicline for smoking cessation therapy. In particular, clinicians need to be aware of increased concerns about varenicline's association with neuropsychiatric side effects, seizures, and alcohol interactions. PMID:26514264

  9. 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

  10. 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

  11. 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…

  12. 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

  13. Attitudes toward psychopharmacology among hospitalized patients from diverse ethno-cultural backgrounds

    PubMed Central

    Thorens, Gabriel; Gex-Fabry, Marianne; Zullino, Daniele F; Eytan, Ariel

    2008-01-01

    Background Biological factors influencing individual response to drugs are being extensively studied in psychiatry. Strikingly, there are few studies addressing social and cultural differences in attitudes toward psychotropic medications. The objective of this study was to investigate ethno-culturally determined beliefs, expectations and attitudes toward medication among a sample of hospitalized psychiatric patients. Methods An ad hoc questionnaire was designed to assess patients' expectations, attitudes and prejudice toward medication. The study included 100 adult patients hospitalized in Geneva, Switzerland. Results Patients were in majority male (63%), originated from Switzerland (54%) and spoke the local language fluently (93%). They took on the average 3 different psychotropic drugs. Sixty-eight percent of patients expected side effects and 60% were ready to stop medication because of them. Thirty percent of patients expected negative personal changes with treatment and 34% thought that their mental disorder could have been treated without drugs. Thirty six percent of the sample used alternative or complementary medicines. 35% of immigrant patients believed that medication had different effects on them than on local patients. When compared with Swiss patients, they more often reported that significant others had an opinion about medication (p = 0.041) and more frequently valued information provided by other patients about treatment (p = 0.010). Conclusion Patients' attitudes toward medication should be investigated in clinical practice, as specific expectations and prejudice exist. Targeted interventions, especially for immigrant patients, might improve adherence. PMID:18613960

  14. 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

  15. 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…

  16. [A role of motivation for treatment in the structure of compliance in psychopharmacologically treated patients].

    PubMed

    Sorokin, M Yu; Lutova, N B; Vid, V D

    2016-01-01

    Цель исследования. Выявление взаимоотношения структуры мотивации к лечению и комплаенса у больных психиатрического стационара. Материал и методы. С использованием опросника оценки мотивации к лечению и шкалы комплаенса обследованы 104 пациента отделения интегративной фармако- и психотерапии. Среди них были 67 больных шизофренией и расстройствами шизофренического спектра, 15 — с аффективными расстройствами, 13 — с расстройст­вами личности и невротическими расстройствами и 9 — с органическими нарушениями. Результаты и заключение. Ключевую роль в формировании общего уровня приверженности лечению играет мотивационный механизм, основанный на субъективно переживаемом страдании от заболевания. Распространение амотивационного синдрома пагубно сказывается на формировании комплаенса. Пассивное согласие больного на лечение приводит к снижению терапевтического альянса, что усугубляется когнитивным дефицитом больных и ухудшением осознания заболевания. Преобладание внешней мотивации к лечению, определяемой давлением близкого окружения больного, также негативно влияет на подсистему комплаенса, связанную с окружением. Здесь зачастую давление родственников не трансформируется в адекватную социальную поддержку. Экстремально низкие значения внутренней мотивации, основанной на понимании характера заболевания, приводят к снижению комплаенса, связанного с отношением к медикаментозной терапии.

  17. 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

  18. 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…

  19. An archetype of the collaborative efforts of psychotherapy and psychopharmacology in successfully treating dissociative identity disorder with comorbid bipolar disorder.

    PubMed

    Lakshmanan, Manu N; Meier, Stacey L Colton; Meier, Robert S; Lakshmanan, Ramaswamy

    2010-07-01

    We present a case where dissociative identity disorder was effectively treated with memory retrieval psychotherapy. However, the patient's comorbid bipolar disorder contributed to the patient's instability and fortified the amnesiac barriers that exist between alter personality states in dissociative identity disorder, which made memory retrieval difficult to achieve. Implications from this case indicate that a close collaboration between psychologist and psychiatrist focused on carefully diagnosing and treating existing comorbid conditions may be the most important aspect in treating dissociative identity disorder. We present our experience of successfully treating a patient with dissociative identity disorder and bipolar disorder using this collaborative method.

  20. Psychopharmacology decision-making among pregnant and postpartum women and health providers: informing compassionate and collaborative care women's health.

    PubMed

    Price, Sarah Kye; Bentley, Kia J

    2013-01-01

    Psychopharmaceutical use by pregnant and postpartum women is complicated by the complexity of prescribing as well as the sociocultural context in which medication-related decisions are made. This study sought to advance understanding of decision-making processes and communication experiences regarding use of psychopharmaceuticals during pregnancy by considering both provider and consumer perspectives. An electronic survey was conducted with health care providers (N = 88) and women consumers (N = 83) from July 2010 through October 2011 regarding the perceived costs and benefits of taking mental health medication during and around the time of pregnancy. Descriptive analysis compared and contrasted experiences between the two groups regarding consumer-provider communication, critical incidents and triggers in decision-making, and response to case scenarios crafted around hypothetical client experiences. Both similarities and differences were evident among health care provider and women consumer responses regarding costs, benefits, communication experiences, and case scenario responses. Both quantitative and qualitative survey results indicated the need for more accurate, unbiased, and complete information exchange around mental health and medication. Study results suggested the centrality of the client-provider milieu to guide decision-making and emphasized the expressed need within both groups to create a shared decision-making practice environment characterized by authenticity, non-judgmental decision-making, compassion, humaneness, and reciprocity.

  1. 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.

  2. 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

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

    PubMed

    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.

  4. Is it possible to predict the activity of a new antidepressant in animals with simple psychopharmacological tests?

    PubMed

    Bourin, M

    1990-01-01

    Behavioural tests for predicting antidepressant activity in the animal provide a closer approximation than other tests of states of depression in man but are often long and costly to perform (except the behavioural despair test). The tests proposed here presuppose a pharmacological interaction (except the Porsolt test) but are simple enough to allow screening: included are antagonism of reserpine hypothermia, ptosis and akinesia; antagonism of effects induced by oxotremorine; antagonism of high-dose apomorphine; and potentiation of yohimbine toxicity. In combination with the study of motor activity in the mouse, these tests allow assessment of the specificity of antidepressant activity by establishing a ratio between the "antidepressant" dose and the "stimulant" or "sedative" dose. It can be predicted that a substance will be antidepressant and sedative or stimulant at the same dose if the ratio is close to 1; if the ratio is less than 1, at antidepressant doses the substance will be very sedative or stimulant according to the case. The specificity of the tests discussed can be debatable. Antagonism of reserpine-induced hypothermia indicates substances with direct or indirect beta-mimetic activity, ptosis antagonism, substances with alpha-adrenergic (not antidepressants) or serotoninergic (possibly antidepressants) activity; and akinesia antagonism, a direct or indirect dopaminergic activity (sometimes found in antidepressants) with psychostimulant activity. The oxotremorine test is related to the anticholinergic activity of substances, except in the case of hypothermia antagonism. The high-dose apomorphine test seems to be specific for substances inhibiting norepinephrine reuptake. The yohimbine test is simple to carry out, relatively inexpensive and does not fail to screen any molecule known to be effective to-date. The behavioural despair test is a good complement for screening except for drugs having a beta-agonist activity, it appears that this test is dependent on functional relationships between alpha 2 and serotonergic systems.

  5. Psychopharmacological evidences for the involvement of muscarinic and nicotinic cholinergic receptors on sweet substance-induced analgesia in Rattus norvegicus.

    PubMed

    Irusta, A E; Savoldi, M; Kishi, R; Resende, G C; Freitas, R L; Carvalho, A D; Coimbra, N C

    2001-06-01

    In order to investigate the effects of sweet substance intake on pain modulation, male albino Wistar rats weighing 180-200 g received either tap water or sucrose solutions (250 g/l) for 14 days as their only source of liquid. Each rat consumed an average of 15.6 g sucrose/day. Their tail withdrawal latencies in the tail-flick test (probably a spinal reflex) were measured immediately before and after this treatment. An analgesia index was calculated from the withdrawal latencies before and after treatment. The index (mean +/- SEM, N = 8) for the groups receiving sucrose solution plus saline (NaCl; 0.9%) for 14 days was 0.70 +/- 0.01. Atropine (1 and 2 mg/kg)-treated rats (N = 8) after intake of sucrose exhibited an analgesia index of 0.39 +/- 0.09 and 0.39 +/- 0.08, respectively, while mecamylamine (1 and 2 mg/kg)-treated rats (N = 10) after intake of sucrose had an index of -0.02 +/- 0.07 and 0.03 +/- 0.07, respectively. These results indicate that the effect of sucrose intake on nociceptive thresholds is controlled by neurotransmission of acetylcholine and depends on the nicotinic cholinergic receptors for its major analgesic effect, although muscarinic receptors were also involved in this antinociceptive process.

  6. 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

  7. The role of the noradrenergic system in the exploration-exploitation trade-off: a psychopharmacological study.

    PubMed

    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.

  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. 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.

  11. Chemical neuroanatomical and psychopharmacological evidence that κ receptor-mediated endogenous opioid peptide neurotransmission in the dorsal and ventral mesencephalon modulates panic-like behaviour.

    PubMed

    da Silva, Juliana Almeida; de Freitas, Renato Leonardo; Eichenberger, Gustavo Cavalcanti Dutra; Padovan, Cláudia Maria; Coimbra, Norberto Cysne

    2013-01-01

    The chemical neuroanatomy and the effects of central administration of opioid antagonists on the innate fear-induced responses elicited by electrical (at escape behaviour threshold) stimulation of the midbrain tectum were determined. The aim of the present work was to investigate the interaction between the tecto-nigral endogenous opioid peptide-mediated disinhibitory pathways and nigro-tectal inhibitory links in the control of panic-like behaviour and their organisation in the continuum comprised by the deep layers of the superior colliculus (dlSC) and the dorsolateral columns of the periaqueductal grey matter (dlPAG). Beta-endorphin-labelled neurons and fibres were found in the dorsal midbrain and also in the substantia nigra. Opioid varicose fibres and terminal buttons were widely distributed in PAG columns and in all substantia nigra subdivisions. Microinjections of naltrexone (a non-selective opioid receptor antagonist; 5.0 μg/0.2 μl) or nor-binaltorphimine (a selective κ-opioid receptor antagonist; 5.0 μg/0.2 μl) in the dlSC/dlPAG continuum, in independent groups of animals, induced significant increases in the escape thresholds for midbrain tectum electrical stimulation. The microinjection of naltrexone or nor-binaltorphimine into the SNpr also increased the escape behaviour threshold for electrical stimulation of dlSC/dlPAG. These morphological and neuropharmacological findings support previous evidence from our team for the role played by the interaction between opioidergic and GABAergic mechanisms in the modulation of innate fear-induced responses. The present data offer a neuroanatomical basis for both intratectal axo-axonic/pre-synaptic and tecto-nigral axo-somatic opioid inhibition of GABAergic nigro-tectal neurons that modulate the dorsal midbrain neurons related to the organisation of fear-related emotional responses.

  12. 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…

  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. 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…

  15. 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…

  16. 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.

  17. 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)

  18. [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

  19. 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

  20. 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.

  1. [Psychopharmaceutical drugs in the mass media. Results of a systematic analysis of text contents and images].

    PubMed

    Hillert, A; Sandmann, J; Ehmig, S C; Weisbecker, H; Sobota, K; Kepplinger, H M; Benkert, O

    1995-11-01

    Mental diseases and psychopharmacological drugs are frequently discussed in newspapers and popular magazines. The representations are supposed to have a great impact on people's opinions on the subject. From 1 August 1991 to 31 July 1992 all articles about psychopharmacological drugs and cardiac drugs in 19 German newspapers were collected. All statements, effects and side effects, the reason for prescription, individual details about the patient and, according to this procedure, subjects and implications of the illustrations, were registered and classified according to a code book. In contrast to the articles about cardiac drugs, half of the psychopharmacological drug reports primarily deal with the problems of side effects the drugs may produce. There was much more critical comment and emotional emphasis used to characterize the psychopharmacological drugs. Only in 9% was their therapeutic efficacy mentioned. Cardiac drugs are generally discussed objectively in a medical context and their efficacy is emphasized. Psychopharmacological drugs are often mentioned in stories about prominent persons having a life crisis, taking drugs, or turning to alcoholism, in the sense of social decline. In only 3% of these articles could a serious mental diseases be identified as the reason for the prescription. Corresponding to the more prominent emotional emphasis of these articles, compared to the articles about cardiac drugs, more pictures, mainly of prominent persons or patients are used. However, the illustration seldom adds to information provided. The reasons for and implications of these findings and the significant differences between the distinct groups of newspapers are discussed. PMID:8532100

  2. [Use of psychotropic drugs in children].

    PubMed

    Purper-Ouakil, D

    2008-12-01

    The need for specific psychopharmacology trials in the pediatric population has been recognized and promoted by clinicians and regulatory instances. There are indeed specificities in symptom expression and pharmacological characteristics in this population, and recent studies showed that extrapolation from adult data is not always possible. Available results are insufficient to provide effective guidance for prescription and long-term evaluation of risk/benefit ratio in most indications. The aim of this article is to give an overview of efficacy and safety data in pediatric psychopharmacology.

  3. 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.

  4. 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

  5. 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)

  6. 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"…

  7. The Effectiveness of Antipsychotic Medication in the Management of Behaviour Problems in Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Deb, S.; Sohanpal, S. K.; Soni, R.; Lenotre, L.; Unwin, G.

    2007-01-01

    Background: Psychopharmacological intervention in the management of behaviour problems in adults with intellectual disabilities (ID) has become a common treatment strategy. This has become a cause for concern, given that the evidence for its effectiveness is uncertain and most drugs are not licensed for this use. Methods: A comprehensive…

  8. 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…

  9. 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…

  10. 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…

  11. 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.…

  12. 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…

  13. 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)

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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.…

  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. 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…

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  9. 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…

  10. 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…

  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. 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…

  13. 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…

  14. 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…

  15. 75 FR 78705 - Medicare Program; Request for Nominations for Members for the Medicare Evidence Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... trial methodology; knee, hip, and other joint replacement surgery; ophthalmology; psychopharmacology... in the Federal Register (63 FR 68780) announcing establishment of the Medicare Coverage Advisory... November 24, 1998. On January 26, 2007 the Secretary published a notice in the Federal Register (72 FR...

  16. [The "small penis": considerations about subjective penile deficiency].

    PubMed

    Rosso, C; Ostacoli, L; Garbolino, S; Furlan, M P

    1998-12-01

    In sexology clinical practice you can see quite frequently patients who make complaints about their penis not being big enough. The Authors suggest that the subjective feeling of penis deficiency is a symptom which needs to be properly diagnosed and understood, in order to be able to make effective therapeutic interventions, from a psychotherapeutic, psychopharmacologic or surgical point of view.

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. 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.…

  3. 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,…

  4. 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…

  5. [The "small penis": considerations about subjective penile deficiency].

    PubMed

    Rosso, C; Ostacoli, L; Garbolino, S; Furlan, M P

    1998-12-01

    In sexology clinical practice you can see quite frequently patients who make complaints about their penis not being big enough. The Authors suggest that the subjective feeling of penis deficiency is a symptom which needs to be properly diagnosed and understood, in order to be able to make effective therapeutic interventions, from a psychotherapeutic, psychopharmacologic or surgical point of view. PMID:9882904

  6. A Model for Psychiatric Consultation in Systemic Therapy.

    ERIC Educational Resources Information Center

    Griffith, James L.; And Others

    1991-01-01

    Discusses metaphors used to describe problems when family therapy and psychopharmacology are employed together. Identifies coupling metaphors that support both therapies as valid treatments and exclusionary metaphors that invalidate one approach. Presents consultation model for psychiatrists consulting to family therapists wherein the psychiatrist…

  7. 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…

  8. 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…

  9. Academic, Behavioral, and Psychological Responses of Hyperactive Children to Stimulant Medication.

    ERIC Educational Resources Information Center

    Bradley, Eunice

    The paper reviews educational, medical, and psychopharmacological research concerning the academic, behavioral, and psychological responses of hyperactive children to stimulant medication. In Chapter 1 on the problem and plan of study, brief sections are included on the educational community's lack of knowledge regarding stimulant medication, the…

  10. 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…

  11. 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

  12. 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.

  13. Sex offending and sexual appetite: the clinical and theoretical relevance of hypersexual desire.

    PubMed

    Kafka, Martin P

    2003-08-01

    Disinhibited sexual desire, clinically manifested as hypersexual desire disorders, can be operationally defined by considering three behavioral domains associated with sexual motivation or appetitive behavior: (a) sexual preoccupation (time/day consumed by fantasies, urges, and activities), (b) the repetitive frequency of enacted sexual behavior (total sexual outlet/week), and (c) adverse consequences associated with repetitive sexual behavior: Data are presented suggesting that clinical samples of males with paraphilias, paraphilia-related disorders, and sexual coercion may be associated with disinhibited sexual appetite. These conditions need to be addressed by an integrated combination of psychotherapeutic and psychopharmacologic interventions that specifically target disinhibited sexual appetitive behaviors, their antecedents, and consequences. Although combination therapies (empirically based specific psychotherapies in conjunction with psychopharmacological treatments) have demonstrated superior efficacy in many Axis I psychiatric disorders, such combination therapies to reduce paraphilias, paraphilia-related disorders, and adult sexual coercion are currently underutilized in both North and South America and Europe.

  14. A barbital derivative as an atypical antidepressant drug in mice.

    PubMed

    Bourin, M; Menez, J F; Colombel, M C; Larousse, C

    1987-05-01

    An isopropyl derivative of barbital (5,5-diethyl-2-(isopropyloxy)pyrimidine-4,6-dione, O2IB) was administered intraperitoneally 30 min before tests in mice. Former experimental investigations have shown that O2IB has an antidepressant psychopharmacological spectrum. It increases toxicity of yohimbine in mice at 175 mg/kg, antagonises from 50 mg/kg on hypothermia induced by a high dose of apomorphine and is active on the behavioural despair test at 125 mg/kg. These effects are those observed with classical antidepressants. Since phenytoin has an antidepressant profile in mice, carbamazepine is active on manic-depressive illness and beta-mimetic drugs are antidepressants, the question presents itself whether isopropylation or anticonvulsive activity is more important for the antidepressant psychopharmacological spectrum, or whether both are of equal importance.

  15. [Effects of psychiatric drugs on the fetus and newborn children. Consequences of the treatment of psychiatric disorders during pregnancy and lactation].

    PubMed

    Mazaira, Silvina

    2005-01-01

    The management of mental disorders during pregnancy and the postpartum period confronts the psychiatrist to a complex clinical situation. The cero risk utopia should be changed for a more realistic approach which considers the risks of having a conservative conduct (assuming the consequences of the untreated mental disorders) or making a psychopharmacological intervention knowing the expectable effects on the fetus and the offspring. The antidepressants and the conventional antipsychotics seem to be safe drugs in the first trimester of pregnancy. The benzodiazepines and the mood stabilizers are linked with the appearance of teratogenic malformations after the first trimester exposure. In the present article, the pharmacokinetic peculiarities of the pregnancy and the newborn and the general considerations of the psychopharmacological management of this kind of patients are described. At last, there is a review of the literature about the effects of the different groups of psychiatric drugs on the fetal growth, their passage to maternal milk and their impact on the newborn.

  16. ‘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

  17. Treatment of Anxiety in Children and Adolescents: Using the Child and Adolescent Anxiety Psychodynamic Psychotherapy (CAPP) Therapy Gabrielle Silver, Theodore Shapiro, Barbara Milrod

    PubMed Central

    Silver, Gabrielle; Shapiro, Theodore; Milrod, Barbara

    2015-01-01

    Synopsis Information is presented here on CAPP – child and adolescent psychodynamic psychotherapy. Following a definition of anxiety, the authors present study outcomes of non-psychodynamic treatment approaches, alone and in combination with psychopharmacologic treatment, then explore psychodynamic approaches. A detailed overview of psychodynamic psychotherapy is presented, along with two cases illustrating the use of CAPP with young patients with anxiety. The authors also present tables and boxes summarizing CAPP therapeutic processes and strategies as intervention for anxious youth. PMID:23164129

  18. Book reviews.

    PubMed

    Burns, A; Cookson, J

    1998-01-01

    Organic Psychiatry: Psychological Consequences of Cerebral Disorder. 3rd edition: William Alwyn Lishman Oxford: Blackwell Science. 1997. Pp 922. £89.50 (Hardback) (ISBN 0-86542-842-5) £55.00 (Paperback) (ISBN 0-86542-820-4) Psychopharmacology of Antidepressants: Stephen M Stahl London: Martin Dunitz. 1997. Pp 114. Paperback £12.95 (ISBN 1-85317-513-7). PMID:24940985

  19. Ask the Experts: What do we know (and not know) about prescription opioid misuse in the context of chronic pain management?

    PubMed

    Zacny, James

    2011-09-01

    James Zacny received his PhD in Psychology at West Virginia University (WV, USA) in 1984. From 1984 to 1986 he did a postdoctoral fellowship at The Johns Hopkins University School of Medicine (MD, USA) in the Behavioral Pharmacology Research Unit of the Department of Psychiatry and Behavioral Sciences. He then became Research Associate in the Department of Psychiatry at the University of Chicago (IL, USA) and conducted both preclinical and human psychopharmacology studies. In 1992 he joined the faculty in the Department of Anesthesia & Critical Care at the University where he is currently Professor. His two primary research interests have been in studying the psychopharmacological effects of drugs used in anesthesiology, chiefly inhaled and intravenous general anesthetics at subanesthestic doses, and opioid analgesics, in healthy nondrug-abusing volunteers. The unique research environment he is in fostered a large body of research that systematically characterized the subjective, psychomotor and reinforcing (rewarding) effects of a number of different anesthetic and analgesic agents. Dr Zacny's primary source of funding is through the National Institute on Drug Abuse and in 1999 was presented with a MERIT award for his research on opioids. In 2001 he focused his efforts on prescription opioids at about the same time that warning signs started to emerge indicating that prescription opioid abuse was on the rise. He has characterized the psychopharmacological effects of a number of prescription opioids, as well as investigated possible factors that might modulate their positive (as well as negative) subjective effects including gender, sensation seeking and alcohol. He has also written guest editorials on the psychomotor effects of opioids in relation to the ability of chronic pain patients on long-term opioid therapy to drive. He is an elected member of the College on Problems of Drug Dependence and of the Association of University Anesthesiologists, and served as

  20. A review of obsessive-compulsive disorder in children and adolescents.

    PubMed

    Boileau, Bernard

    2011-01-01

    This article is a review of recent literature on obsessive-compulsive disorder in the pediatric population. Areas covered include: a brief historical perspective, clinical presentation in relation to symptoms found in different age groups, epidemiology, psychiatric comorbidity, etiology (with regards to genetics, neuroimaging, and familial factors), clinical course and prognosis, and treatment, with special emphasis on individual and family-based cognitive-behavioral therapy and psychopharmacology. PMID:22275846

  1. Psychotropic Drugs in Children: A Guide for the Family Physician

    PubMed Central

    Goldberg, Benjamin

    1989-01-01

    Pediatric psychopharmacology, an emerging field, is a field fraught with potential abuses, about which consumer groups are concerned. These concerns have initiated legislation in some jurisdictions of Canada. Abuse is most likely to occur in the absence of other professional services, such as psychology, education, or social services. After careful assessment, diagnosis, and consultation, if necessary, the family physician can prescribe these medications responsibly, sharing the decision-making with the child and parent. PMID:20469507

  2. 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.

  3. 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

  4. 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

  5. [Drug treatment of anorexia nervosa and bulimia nervosa. A review].

    PubMed

    Fichter, M M

    1993-01-01

    With the apparent increase in prevalence of anorexic and bulimic eating disorders, the search for effective treatments for these disorders has been intensified in recent years. In this review the results of psychopharmacological studies of patients with anorexia or bulimia nervosa are presented and analysed. The focus of this review is on controlled studies. Although a variety of psychopharmacological substances has been tested in patients with anorexia nervosa, the outcome of controlled studies has been generally disappointing. A possible differential therapy effect of cyproheptadine needs replication: in one study it enhanced body weight gain in non-bulimic anorexics, while it appeared to hinder weight gain in bulimic anorexics. The issue of prophylaxis of osteoporosis in chronic low-weight anorexics has received increasing attention in recent years, and pharmacological prophylaxis appears indicated in this patient group. The results of psychopharmacological treatment studies of patients with bulimia nervosa have overall been more favourable than those of anorexic patients. Statistically significant effects concerning the reduction of bulimic or depressive symptoms in bulimia nervosa has been demonstrated for tricyclic antidepressants (imipramine, desipramine), serotonergic agents (fluoxetine, d-fenfluramine), non-selective monoamine-oxydase-inhibitors (isocarboxazide, phenelzine) and trazodone. The antibulimic effect appears not to be associated with the antidepressant effect. Theoretical, methodological and practical issues concerning pharmacological treatment of anorexic and bulimic eating disorders are presented and discussed.

  6. The effect of orbital prefrontal cortex lesions on performance on a progressive ratio schedule: implications for models of inter-temporal choice.

    PubMed

    Kheramin, S; Body, S; Herrera, F Miranda; Bradshaw, C M; Szabadi, E; Deakin, J F W; Anderson, I M

    2005-01-01

    In a previous experiment [Kheramin S, Body S, Mobini S, Ho M-Y, Velazquez-Martinez DN, Bradshaw CM, et al. Effects of quinolinic acid-induced lesions of the orbital prefrontal cortex on inter-temporal choice: a quantitative analysis. Psychopharmacology 2002;165: 9-17], destruction of the orbital prefrontal cortex (OPFC) in rats altered choice between two delayed food reinforcers, enhancing preference for the larger reinforcer. Theoretical analysis based on a quantitative model of inter-temporal choice [Ho M-Y, Mobini S, Chiang T-J, Bradshaw CM, Szabadi E. Theory and method in the quantitative analysis of 'impulsive choice' behaviour: implications for psychopharmacology. Psychopharmacology 1999;146:362-72] indicated that the lesion had increased the relative value of the larger of the two reinforcers due to a general reduction of absolute reinforcer value. The present experiment tested this hypothesis using a reinforcement schedule that did not entail either explicit choice or delayed reinforcement. Ten rats received quinolinic acid-induced lesions of the OPFC, and ten rats received sham lesions. The rats were trained under a progressive-ratio schedule of food reinforcement for 60 daily sessions. Response rates in successive ratios were a bitonic (inverted-U) function of ratio size. Analysis of the data using a three-parameter equation derived from a quantitative model of ratio schedule performance [Killeen PR. Mathematical principles of reinforcement. Behav. Brain Sci. 1994;17:105-72] revealed that the parameter specifying hypothetical reinforcer value was significantly lower in the OPFC-lesioned group than in the sham-lesioned group, consistent with the hypothesis that destruction of the OPFC resulted in devaluation of the food reinforcer.

  7. 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

  8. Availability of psychiatric medication in an urban area of The Gambia/West Africa.

    PubMed

    Thome, Johannes; Marenah, Essa; Moraru, Diana; Höppner, Jacqueline; Nyan, Ousman

    2011-09-01

    The use of a wide and differentiated arsenal of psychopharmacological substances is integral part of modern psychiatric treatment in addition to non-pharmacological interventions (e.g., psychotherapy). However, worldwide the access to such medication can vary considerably. In this study, access to a wide range of psychiatric medication including antidepressants, antipsychotics, tranquilisers, mood stabilisers and ADHD medication was analysed for the Western African country of The Gambia by surveying private pharmacies within the urban and sub-urban areas of Banjul, the country's capital. The results show that most of these pharmacies tend to keep a very limited range of psychiatric drugs in stock. In many instances only a tricyclic antidepressant (e.g., amitriptyline), the neuroleptic haloperidol and the benzodiazepine diazepam were readily available. None of the pharmacies kept ADHD medication in stock, and only very few had mood stabilisers. However, several pharmacies reported to be able to obtain at request most of the drugs from international sources, including atypical antipsychotics, SSRIs, and dual-acting antidepressants. Therefore, it can be concluded that in rapidly growing urban centres of developing countries exemplified by Banjul, the infrastructure for modern psychopharmacotherapy is well established, and that the lack of immediate access to modern psychopharmacological compounds represents not so much a genuine lack of availability, but rather a lack of demand which may be associated with the considerable cost-implications of such treatment and the absence of prescribers (i.e. psychiatrists and other doctors with an expertise in modern psychopharmacotherapy). To our knowledge this is the first such study for The Gambia and results might be representative for the wider Western African region. It also exemplifies the challenges psychiatry is facing in developing countries worldwide. It is essential that government-sponsored so-called "essential

  9. [Psychopharmacotherapy improves psychosocial functioning in adolescents with borderline personality disorder].

    PubMed

    Wöckel, Lars; Goth, Kirstin; Zepf, Florian Daniel; Matic, Nina; Holtmann, Martin; Herpertz-Dahlmann, Beate; Poustka, Fritz

    2010-01-01

    Treatment of patients with borderline personality disorder (BPD) has undergone significant changes within the last decades. Although there is no specific pharmacological treatment approach for BPD per se, there is evidence for a beneficial effect of psychopharmacological treatment in adults. As there is a significant lack of data regarding such treatment in adolescents we aim to investigate the effects of psychopharmacological treatment retrospectively focusing on the first period of treatment. The study sample comprised 2,778 subjects (inpatients and outpatients) from a population on demand of psychiatric services referred to our department, with 39 patients (aged 16,2 +/- 1,7 yrs.) having a diagnosis of BPD. Psychosocial functioning as indexed on axis VI was assessed within the BADO documentation algorithm before and after treatment. Effects of treatment in terms of improved psychosocial functioning under different medications as well as different risk variables were assessed. Moreover, medicated and un-medicated patients were compared as regards effects of treatment. Upon admission inpatients showed a significantly higher impairment in their psychosocial functioning compared with outpatients. There was no significant difference between medicated and un-medicated patients with respect to the different risk variables assessed. Psychosocial functioning improved under pharmacological treatment, with this effect being unrelated to in- or outpatient status. About 80% of the prescribed medications were antidepressants and neuroleptics, with a combination of two drugs being the most frequent treatment approach to be observed. The data of the present study indicate that psychopharmacological treatment of adolescents with BPD can improve psychosocial functioning. PMID:20491428

  10. 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

  11. Can cannabis cause psychosis?

    PubMed

    Michaels, Timothy I; Novakovic, Vladan

    2015-01-01

    In recent years, increasing popular support for the medicinal and recreational use of cannabis has led to legalization for both medicinal and recreational purposes in the United States. To the extent that these changes in policy lead to increase widespread use, it is important to consider the association between heavy chronic cannabis use and the onset of psychotic illnesses, such as schizophrenia. This article provides a brief review of evidence that support cannabis use as a risk factor in the complex etiology of psychotic illness. In addition to reviewing psychopharmacology, longitudinal research, and clinical studies, the article addresses the potential implications of current research on public health policy. PMID:25768856

  12. New Drugs of Abuse and Withdrawal Syndromes.

    PubMed

    Andrabi, Sara; Greene, Spencer; Moukaddam, Nidal; Moukkadam, Nidal; Li, Benjamin

    2015-11-01

    New drugs of abuse continue to emerge, including synthetic cannabinoids, synthetic cathinones, and hallucinogens. It is important to recognize their individual psychopharmacologic properties, symptoms of intoxication, and symptoms of withdrawal. Providers must be vigilant of acute medical or psychiatric complications that may arise from use of these substances. Treatment of the patient also includes recognition of any substance use disorders as well as comorbid psychiatric disorders. Although pharmacologic treatments for substance use disorder (of the drugs included in this article) are limited, there are a variety of psychotherapeutic modalities that may be of some benefit.

  13. 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

  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. Mood disorders in youth: exercise, light therapy, and pharmacologic complementary and integrative approaches.

    PubMed

    Popper, Charles W

    2013-07-01

    The therapeutic value of physical exercise, bright light therapy and dawn simulation, and several pharmacologic treatments, including hypericum (St. John's wort), S-adenosylmethionine, and 5-hydroxytryptophan, are reviewed, with a focus on their use for treating major depressive disorder in children and adolescents and also for alleviating depressed mood in the general (nonclinical) population of youth. For each treatment discussed, all published randomized, double-blind, placebo-controlled trials are summarized, along with some additional selected studies. Nutritional psychopharmacology and several other approaches to treating depression will be presented in an upcoming volume in the Child and Adolescent Psychiatric Clinics of North America.

  16. Overview of the Evidence Base for Family Interventions in Child Psychiatry.

    PubMed

    Sharma, Neha; Sargent, John

    2015-07-01

    This article provides updated information about evidence-based family interventions for child and adolescent mental health issues. The article reviews randomized controlled trials for family-based interventions carried out over the last 15 years. The studies were selected from an evidence-based clearinghouse search for family therapy, and specific child and adolescent psychiatric disorders. It is hoped this review guides clinical treatment and encourages clinicians to consider family involvement in treatment. This is specifically necessary when there is a limited response to psychopharmacologic and individual or group psychotherapy treatment.

  17. 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

  18. [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.

  19. 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

  20. Coca-Cola, caffeine, and mental deficiency: Harry Hollingworth and the Chattanooga trial of 1911.

    PubMed

    Benjamin, L T; Rogers, A M; Rosenbaum, A

    1991-01-01

    Harry Hollingworth's 1911 investigation of the behavioral effects of caffeine is one of the earliest examples of psychological research contracted by a large corporation. The research was necessitated by a federal government suit against the Coca-Cola Company for marketing a beverage with a deleterious ingredient, namely, caffeine. Although Hollingworth's research played little role in the outcome of the Coca-Cola trials, it was important as a model of sophistication in experimental design. As such, it set a standard for psychopharmacological research. It also was particularly important in directing Hollingworth toward a life-long career in applied psychology.

  1. 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

  2. “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

  3. Severe impulsiveness as the primary manifestation of multiple sclerosis in a young female.

    PubMed

    Lopez-Meza, Elmer; Corona-Vazquez, Teresa; Ruano-Calderon, Luis A; Ramirez-Bermudez, Jesus

    2005-12-01

    Severe impulsiveness in the absence of apparent neurological signs has rarely been reported as a clinical presentation of multiple sclerosis (MS). An 11-year-old female developed progressive and sustained personality disturbances including disinhibition, hypersexuality, drug abuse, aggressiveness and suicide attempts, without neurological signs. She was given several unsuccessful psychopharmacological and psychotherapeutic interventions. At age 21, a diagnosis of MS was made, confirmed by imaging, laboratory and neurophysiological studies. Although unusual, MS may produce pure neurobehavioral disturbances. In the present case, widespread demyelinization produced a complex behavioral disorder, with features compatible with orbitofrontal and Klüver-Bucy syndromes.

  4. Hemicrania Continua Headache in a Veteran with Posttraumatic Stress Disorder and Major Depressive Disorder without Traumatic Brain Injury.

    PubMed

    Kohrt, Brandon A; Duncan, Erica

    2012-01-01

    Hemicrania continua is a headache characterized by chronic unremitting unilateral pain associated with ipsilateral autonomic findings. This type of headache responds to high-flow oxygen and indomethacin. This case report describes a male veteran with posttraumatic stress disorder (PTSD) and major depressive disorder who suffers from comorbid hemicrania continua. The psychiatric symptoms were recalcitrant to psychopharmacological intervention. However, when the patient's hemicrania continua was treated appropriately, the patient's psychiatric symptoms also abated. This case demonstrates the need to address physical comorbidities that may exacerbate psychiatric disorders, such as PTSD.

  5. The Subjective Experience of Youth Psychotropic Treatment

    PubMed Central

    Floersch, Jerry

    2009-01-01

    Summary The psychotropic treatment of youth is increasing dramatically. This article examines child and adolescent psychopharmacological research and argues that social work practice and research must examine the complex relationships, social and psychological, in youth pharmacologic treatment. Regarding identity formation, this article explores the developmental consequences when youth adopt an illness narrative to make sense of everyday medication treatment. A conceptual framework for mapping the socio-cultural context of youth medication management is outlined. In the conclusion, youth psychotropic treatment is connected to a perplexing ‘interpretive gap,’ which highlights the subjective quality of medication treatment. PMID:20352031

  6. [Bipolar disorder in childhood and adolescence].

    PubMed

    Fu-I, Lee

    2004-10-01

    Many advances in the knowledge of childhood- and adolescent-onset bipolar disorder have been seen over the last 15 years. Current efforts focus on investigating clinical features, developing more instruments for early diagnosis and improving treatment research. The present study aims to present the main clinical characteristic of the disorder in children and adolescents, as well as the nomenclature, description of clinical phenotypes and the most common cycling pattern in youths. A discussion of comorbidity, differential diagnosis and advances in psychopharmacological treatment will also be presented.

  7. 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

  8. 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.

  9. [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

  10. 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.

  11. Optimizing the design and analysis of clinical functional magnetic resonance imaging research studies.

    PubMed

    Carter, Cameron S; Heckers, Stephan; Nichols, Thomas; Pine, Daniel S; Strother, Stephen

    2008-11-15

    With the widespread availability of functional magnetic resonance imaging (fMRI), there has been rapid progress in identifying neural correlates of cognition and emotion in the human brain. In conjunction with basic research studies, fMRI has been increasingly applied in clinical disorders, making it a central research tool in human psychopathology, psychopharmacology, and genetics. In the present article, we discuss a number of conceptual and methodological challenges that confront the implementation of fMRI in clinical and translational research, and we offer a set of recommendations intended to enhance the interpretability and reproducibility of results in clinical fMRI.

  12. 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

  13. Paranoid personality disorder and the schizophrenia spectrum-Where to draw the line?

    PubMed

    Birkeland, Søren Fryd

    2013-08-01

    By means of a case vignette, this study explores the clinical intersection between paranoid personality disorder and other schizophrenia-spectrum illness. Even though the patient described had paramount signs of a paranoid personality disorder and was diagnosed as such, psychopathological symptoms extended considerably beyond the common concept and diagnostic criteria of the disorder. Management strategies included psychopharmacological and non-pharmacological interventions, yet psychosocial functioning permanently appeared defective. While there is a persistent need for an opportunity to distinguish the characteristic syndromal pattern of paranoid personality attributes, the case exemplifies the challenges associated with classifying some largely suspicious and distrustful eccentrics within the schizophrenia spectrum.

  14. Polypharmacy In Psychiatry: A Review

    PubMed Central

    Kukreja, Sanjay; Kalra, Gurvinder; Shah, Nilesh; Shrivastava, Amresh

    2013-01-01

    Psychiatric polypharmacy refers to the prescription of two or more psychiatric medications concurrently to a patient. It can be categorised as same-class, multi-class, adjunctive, augmentation and total polypharmacy. Despite advances in psychopharmacology and a better understanding of the principles of therapeutics, its practice is increasing rapidly. The prevalence of polypharmacy in psychiatry varies between 13%-90%. There are various clinical and pharmaco-economic factors associated with it. Dealing with polypharmacy requires an understanding of its associated factors. Education, guidelines and algorithms for the appropriate management of various conditions are effective ways to avoid irrational polypharmacy. PMID:23678240

  15. Personal Computer Applications for Psychiatry and Psychology

    PubMed Central

    Green, Rex S.; Gastfriend, David R.; Kolodner, Robert M.; Fowler, Raymond D.

    1984-01-01

    Many different types of mental health computer applications are reviewed by this panel of experts. The availability of the applications software for personal computers is noted. An overview of the many application areas is followed by more specific comments covering psychopharmacology, psychiatry, and psychological testing. Rapid improvements in personal computer hardware are broadening the uses of these models. Most application programs can now be run on desk-top model equipment. Consequently, it is likely that future applications will be developed first for personal computers, then disseminated to other sizes of computers.

  16. 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

  17. [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

  18. Psychological and pharmacologic treatment of youth with posttraumatic stress disorder: an evidence-based review.

    PubMed

    Keeshin, Brooks R; Strawn, Jeffrey R

    2014-04-01

    This article reviews the evidence for the treatment of children and adolescents with posttraumatic stress disorder (PTSD). Treatment strategies are discussed along with clinically relevant considerations with regard to choosing a modality, working with parents, and adaptations for specific populations. Current data suggest the efficacy of trauma-focused psychotherapies for the treatment of pediatric PTSD. Limited data from psychopharmacologic trials suggest that several classes of medications may have efficacy in youth with PTSD. The extant treatment studies in pediatric patients with PTSD and consensus recommendations suggest that treatment should be based on the individual child's most distressing and functionally impairing symptoms.

  19. Determining adolescents' suitability for inpatient psychotherapy: utility of the clinician-rated Readiness for Inpatient Psychotherapy Scale with an adolescent inpatient sample.

    PubMed

    Haggerty, Greg; Siefert, Caleb; Stoycheva, Valentina; Sinclair, Samuel Justin; Baity, Matthew; Zodan, Jennifer; Mehra, Ashwin; Chand, Vijay; Blais, Mark A

    2014-01-01

    Growing economic pressure on inpatient services for adolescents has resulted in fewer clinicians to provide individual psychotherapy. As a result, inpatient treatment trends have favored group psychotherapy modalities and psychopharmacological interventions. Currently, no clinician-rated measures exist to assist clinicians in determining who would be able to better utilize individual psychotherapy on inpatient units. The current study sought to demonstrate the utility of the Readiness for Inpatient Psychotherapy Scale with an adolescent inpatient sample. This study also used the RIPS as it is intended to be used in everyday practice. Results from the authors' analyses reveal that the RIPS demonstrates good psychometrics and interrater reliability, as well as construct validity.

  20. The decade 1989-1998 in Spanish psychology: an analysis of research in psychobiology.

    PubMed

    Herreros de Tejada, P; Muñoz Tedó, C

    2001-11-01

    In this paper, we present an analysis of the research published during the 1989-1998 decade by tenured Spanish faculty members from the area of psychobiology. Database search and direct correspondence with the 110 faculty members rendered a list of 904 psychobiological papers. Classification and analysis of these papers led to the definition of at least 70 different research trends. Topics are grouped into several specific research areas: Learning and Memory; Development and Neural Plasticity; Emotion and Stress; Ethology; Neuropsychology; Sensory Processing; and Psychopharmacology. The international dissemination of this research, published in journals of high impact index, and the increasing number of papers are two noteworthy features.

  1. What is a balanced program?

    PubMed

    Mohl, P C

    1995-06-01

    "Balance" has become the watchword of psychiatry programs. It seems that almost all residency training programs claim to be balanced. But what do we mean by this term? This article summarizes the author's evolving thinking about what makes for a balanced program and suggests that diversity may be a better term. The author advocates that balance is not as simple as teaching both psychodynamics and biological psychiatry. Instead, it entails a considered, intellectual approach that involves long-term vs. other psychotherapies, neuro-science vs. psychopharmacology, theoretical pharmacology vs. practical pharmacology, social psychiatry vs. treating minority patients, representing all viewpoints in psychiatry vs. integrating them. PMID:24442525

  2. [Treatment of patients with coronary heart disease and depressive disorders in rehabilitation].

    PubMed

    Barth, Jürgen; Härter, Martin; Paul, Juliane; Bengel, Jürgen

    2005-01-01

    Depressive disorders in patients with coronary heart disease (CHD) are connected with negative effects on the course of the cardiac disease. Until today there has been no clear etiological model to explain the interaction of depressive disorders and cardiac risk parameters. Both, somatic and behavioural aspects seem to be important. Depressive symptoms are a serious risk factor for CHD-patients demanding for a broad bio-psychosocial treatment conception in cardiac rehabilitation. Most intervention studies have mainly focussed on the reduction of depressive and anxious symptoms in CHD-patients without co-morbid mental disorders. However, for CHD-patients with a co-morbid depressive disorder specific psychotherapeutic and psychopharmacological treatments have proved a reduction in depressive symptoms. This reduction in depression was -- unexpectedly -- not associated with an improved cardiac prognosis. Based on these previous studies the present paper introduces the concept of a combined psychotherapeutic and psychopharmacological intervention for depressed patients in cardiac rehabilitation. Specific characteristics of the patients and of the health care system are taken into consideration. Anticipated difficulties in the psychotherapeutic treatment of depressive CHD-patients are addressed and possible solutions are indicated.

  3. Piecing together the puzzle of acetaldehyde as a neuroactive agent.

    PubMed

    Correa, Mercè; Salamone, John D; Segovia, Kristen N; Pardo, Marta; Longoni, Rosanna; Spina, Liliana; Peana, Alessandra T; Vinci, Stefania; Acquas, Elio

    2012-01-01

    Mainly known for its more famous parent compound, ethanol, acetaldehyde was first studied in the 1940s, but then research interest in this compound waned. However, in the last two decades, research on acetaldehyde has seen a revitalized and uninterrupted interest. Acetaldehyde, per se, and as a product of ethanol metabolism, is responsible for many pharmacological effects which are not clearly distinguishable from those of its parent compound, ethanol. Consequently, the most recent advances in acetaldehyde's psychopharmacology have been inspired by the experimental approach to test the hypothesis that some of the effects of ethanol are mediated by acetaldehyde and, in this regard, the characterization of metabolic pathways for ethanol and the localization within discrete brain regions of these effects have revitalized the interest on the role of acetaldehyde in ethanol's central effects. Here we present and discuss a wealth of experimental evidence that converges to suggest that acetaldehyde is an intrinsically active compound, is metabolically generated in the brain and, finally, mediates many of the psychopharmacological properties of ethanol.

  4. 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

  5. Psychiatry and fads: why is this field different from all other fields?

    PubMed

    Shorter, Edward

    2013-10-01

    Fads in psychiatry are little more than bad ideas with short half-lives. They have arisen because of the great discontinuities that have swept psychiatry unlike other specialties in the 20th century: the transition in the 1920s from asylum-based biological psychiatry to psychoanalysis, and the transition in the 1960s from psychoanalysis to a biological model based on psychopharmacology. In no other medical specialty has the knowledge base been scrapped and rebuilt, and then again scrapped and rebuilt. In these great transitions, when psychiatry each time has had to reconstruct from scratch, bad ideas have crept in with good. Psychiatry, in its heavy use of consensus conferences, is often unable to employ science as a means of discarding fads, which, once installed, are often difficult to remove. Each of the great paradigms of psychiatry in the last hundred years has given rise to fads, and psychopharmacology is no exception, with faddish uses of neurotransmitter doctrine claiming centre stage. Only when psychiatry becomes firmly linked to the neurosciences will its subjugation to the turbulence of faddism be moderated.

  6. Pharmaceutical virtue.

    PubMed

    Martin, Emily

    2006-06-01

    In the early history of psychopharmacology, the prospect of developing technologically sophisticated drugs to alleviate human ills was surrounded with a fervor that could be described as religious. This paper explores the subsequent history of the development of psychopharmacological agents, focusing on the ambivalent position of both the industry and its employees. Based on interviews with retired pharmaceutical employees who were active in the industry in the 1950s and 1960s when the major breakthroughs were made in the development of MAOIs and SSRIs, the paper explores the initial development of educational materials for use in sales campaigns. In addition, based on interviews with current employees in pharmaceutical sales and marketing, the paper describes the complex perspective of contemporary pharmaceutical employees who must live surrounded by the growing public vilification of the industry as rapacious and profit hungry and yet find ways to make their jobs meaningful and dignified. The paper will contribute to the understudied problem of how individuals function in positions that require them to be part of processes that on one description constitute a social evil, but on another, constitute a social good.

  7. 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

  8. Clonidine treatment of hyperactive and impulsive children with autistic disorder.

    PubMed

    Jaselskis, C A; Cook, E H; Fletcher, K E; Leventhal, B L

    1992-10-01

    Many autistic children have associated problems of inattention, impulsivity, and hyperactivity that limit the effectiveness of educational and behavioral interventions. Few controlled psychopharmacologic trials have been conducted in autistic children to determine which agents may be effective for these associated features. Eight male children (8.1 +/- 2.8 years) with autistic disorder, diagnosed by DSM-III-R criteria, completed a placebo-controlled, double-blind crossover trial of clonidine. Subjects were included in the study if they had inattention, impulsivity, and hyperactivity that was excessive for their developmental level. Subjects had not tolerated or responded to other psychopharmacologic treatments (neuroleptics, methylphenidate, or desipramine). Teacher ratings on the Aberrant Behavior Checklist irritability, stereotypy, hyperactivity, and inappropriate speech factors were lower during treatment with clonidine than during treatment with placebo. Attention deficit disorder with hyperactivity: Comprehensive Teacher's Rating Scale ratings were not significantly improved during the study, except for oppositional behavior. Parent Conners Abbreviated Parent-Teacher Questionnaire ratings significantly improved during clonidine treatment. Clonidine led to increased ratings of the side effects of drowsiness and decreased activity. Clinician ratings (Children's Psychiatric Rating Scale Autism, Hyperactivity, Anger and Speech Deviance factors; Children's Global Assessment Scale; Clinical Global Impressions efficacy) of videotaped sessions were not significantly different between clonidine and placebo. Clonidine was modestly effective in the short-term treatment of irritability and hyperactivity in some children with autistic disorder.

  9. 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

  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.

  11. 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.

  12. 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

  13. 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

  14. Current management of bipolar affective disorder: is it reflective of the BAP guidelines?

    PubMed

    Farrelly, N; Dibben, C; Hunt, N

    2006-01-01

    In October 2003 the British Association of Psychopharmacology (BAP) published evidence-based guidelines on the management of bipolar disorder. The aim of this study was to assess whether the guidelines could provide the basis for examining clinical decisions and the extent to which practice accords with these guidelines. Case notes of out patients with bipolar disorder were reviewed. Demographic details, and treatment recommendations were determined. The management of affective episodes was evaluated and compared with BAP guidelines. In 84 subjects, 224 affective episodes were identified. Treatment was consistent with BAP guidelines in 72% of episodes. Mania was more likely to be managed in accordance with guidelines than depression or mixed episodes. The use of antidepressant medication was the most likely intervention to deviate from recommendations. Reasons for treatments at odds with the guidelines were identified. Our study demonstrates that clinical practice among a range of psychiatrists broadly reflects the guidelines that have been issued by the British Association of Psychopharmacology (BAP). The BAP guidelines offer a practical and auditable basis for the short- and long-term treatment of bipolar affective disorder.

  15. [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.

  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. 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.].

  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. Psychiatry residents and dynamic psychiatry: two narratives, a survey, and some ideas to enhance recruitment.

    PubMed

    Katz, Debra A; Tuttle, Jeffrey P; Housman, Beth T

    2011-01-01

    Psychiatric residency has undergone a major shift over the past 50 years with increasing emphasis on psychopharmacology evidence-based treatments, and competency-based requirements which has led to concerns that psychodynamic knowledge and skills are in jeopardy. Narratives of two residents who developed strong interest in psychodynamic psychotherapy and psychoanalytic training are presented to illustrate the important influences on their identities as psychodynamically oriented psychiatrists. Results from a recent survey of U.S. residents regarding psychodynamic psychiatry indicate that they value psychodynamic psychotherapy, want to incorporate psychotherapy into their careers as psychiatrists, and strongly endorse personal psychotherapy but view their psychodynamic skills as weak. Recommendations about how to enhance education and interest include (1) building or strengthening relationships with mentors, supervisors, and teachers, (2) emphasizing the importance of psychodynamic understanding of patients whether or not the resident is functioning as a therapist, (3) using psychopharmacology to engage residents in thinking psychodynamically, (4) encouraging personal psychotherapy for residents and helping find ways to make it affordable, (5) utilizing awards, visiting scholars, specialized programs, and distance learning, especially for programs without adequate resources, and (6) encouraging clinicians to become familiar with the research base in psychodynamic psychotherapy to correct biases and misperceptions. PMID:21434747

  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.

  1. 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.

  2. 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

  3. 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.

  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. The current and potential impact of genetics and genomics on neuropsychopharmacology.

    PubMed

    Harrison, Paul J

    2015-05-01

    One justification for the major scientific and financial investments in genetic and genomic studies in medicine is their therapeutic potential, both for revealing novel targets for drugs which treat the disease process, as well as allowing for more effective and safe use of existing medications. This review considers the extent to which this promise has yet been realised within psychopharmacology, how things are likely to develop in the foreseeable future, and the key issues involved. It draws primarily on examples from schizophrenia and its treatments. One observation is that there is evidence for a range of genetic influences on different aspects of psychopharmacology in terms of discovery science, but far less evidence that meets the standards required before such discoveries impact upon clinical practice. One reason is that results reveal complex genetic influences that are hard to replicate and usually of very small effect. Similarly, the slow progress being made in revealing the genes that underlie the major psychiatric syndromes hampers attempts to apply the findings to identify novel drug targets. Nevertheless, there are some intriguing positive findings of various kinds, and clear potential for genetics and genomics to play an increasing and major role in psychiatric drug discovery.

  6. 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.

  7. [Reconsideration of nicotine and other substance dependence: a clue from dependence-related mentation including reward, motivation, learning, delusion and hallucination toward understanding the concept of non-substance-related addiction].

    PubMed

    Miyata, Hisatsugu

    2013-11-01

    Nicotine produces core symptoms of substance dependence (craving and withdrawal) without any psychotic symptoms. The psychopharmacological structure of craving is hypothesized to be constituted by three components: the primary reinforcing property of a substance, the secondary reinforcing property of that substance (conditioned aspects of the environment, such as contextual or specific cues associated with substance taking), and the negative affective motivational property during withdrawal (i.e. the desire to avoid the dysphoric withdrawal symptoms elicits craving). Among the three components, the primary reinforcing property of a substance forms the most fundamental factor for establishing substance dependence. Sensitization or reverse tolerance observed in locomotor activity of animals, which had been believed to be a methamphetamine psychosis model, is demonstrated to reflect the establishment of conditioned reinforcement. Finally, non-substance-related addiction such as gambling, internet, and sex is discussed. From the aspect of the above hypothetical psychopharmacological structure of craving, the most significant difference between substance dependence and non-substance-related addiction is that the primary reinforcing property of non-substance reward is relatively intangible in comparison with that of a substance of abuse.

  8. [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

  9. "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

  10. 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

  11. The Scientific Status of Psychiatry Within Medicine

    PubMed Central

    Nickens, Herbert W.

    1984-01-01

    Psychiatry is in ferment. In the present sluggish economy nonphysician psychotherapists, often charging lower fees, are competing with psychiatrists for patients. At the same time theories and therapies that can be characterized as psychodynamic appear to be on the defensive, increasingly challenged by those with behavioral or psychopharmacologic foundations. A growing emphasis on statistical rigor in research increases this phenomenon. One general response to all of this by the psychiatric profession has been a reassertion of psychiatry's connections and identification with medicine and with science. The author contends that although this response is understandable and may provide some support for the prestige of psychiatry, the issue at hand is fundamentally an epistemologic one. It is a deeply rooted and structural dilemma. PMID:6471110

  12. [A comparison of the effects of single and chronic microinjections of GABA and picrotoxin into the caudate nucleus on the conditioned reflexes of dogs].

    PubMed

    Iakimovskiĭ, A F

    1990-01-01

    The effects on Pavlovian alimentary conditioned reflexes realization of two methods of intrastriatal microinjections--acute (separate) and long-term (chronic) one--are compared in experiments on dogs. Bilateral acute administration and the first week of chronic injection of 45 mcg of GABA into the caudate nuclei produced in dogs a manifest improvement of parameters of the conditioned differentiation inhibition, but only in the next period of chronic treatment an improvement of the positive Pavlovian alimentary conditioned reflex was obtained. The both ways of picrotoxin treatment impaired conditioned behaviour, and this effect was observed after the end of injection. No withdrawal effects were recorded. The data obtained give ground for discussion of the role of striatal GABAergic system in the positive modulation of adaptive alimentary behaviour. The application of novel psychopharmacological method in experimental and clinical fields of investigation is discussed.

  13. 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

  14. [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

  15. The social worker as primary psychiatric consultant to the general hospital emergency room.

    PubMed

    Wallace, S R; Ward, J T; Goldberg, R J; Slaby, A E

    1985-01-01

    Providing coverage for the increasing number of psychiatric and social crises presenting in general hospital emergency rooms presents a challenge during this era of economic contraction. A model is presented for the development of a crisis team without additional funding, utilizing half-day shifts contributed by clinical social workers who hold full-time positions elsewhere in the hospital. Effective and efficient emergency clinical work required that the social workers be taught about biomedical issues pertinent to presentations, along with instruction as to why and when to seek consultation from backup psychiatrists. Quality of care and continued skill development are addressed through the use of a systematic data base and interdisciplinary case conferences using the psychiatrist as a consultant regarding psychopharmacological and diagnostic issues.

  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. Neuropsychiatrie of biologische psychiatrie; een toekomstvisie in historisch perspectief.

    PubMed

    Verhoeven, W M; Tuinier, S

    1999-06-01

    Neuropsychiatry or Biological Psychiatry There is an urgent need to reconsider the position of psychiatry within the neurosciences because of the exploding knowledge about the relationship between brain and behaviour and the delay in implementation of new findings due to the separation of neurology and psychiatry. Biological psychiatry and psychopharmacology originate from the discovery by chance of psycho-active compounds in the early fifties and have contributed to the scientification of psychiatry. The impact of biological psychiatry for the pathophysiology of psychiatric disorders, however, is limited as a result of its biased orientation on neurotransmitters and receptors. The neuropsychiatric paradigm integrates knowledge from several domains, such as functional neuroanatomy, genetics and endocrinology and opens new vistas for the involvement of neuronal circuits in the initiation and maintenance of behavioural disturbances. In addition, novel and more specific treatment modalities may emerge.

  18. 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

  19. 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

  20. 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.

  1. What’s in the pipeline? Drugs in development for autism spectrum disorder

    PubMed Central

    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

  2. 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.

  3. 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.

  4. 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

  5. [Nonsuicidal self-injury in adolescence].

    PubMed

    Plener, Paul Lukas; Brunner, Romuald; Resch, Franz; Fegert, Jörg Michael; Libal, Gerhard

    2010-03-01

    Nonsuicidal self-injury (NSSI) usually starts in adolescence. International studies report prevalence rates between 3 and 37% (for Germany between 15 and 26%) in adolescents. From a neurobiological perspective, there is evidence that primarily the serotonergic system is involved in the origin and maintenance of this behaviour. NSSI is often used by adolescents to influence aversive affective states, but sometimes serves other functions as well, such as self-punishment or anti-dissociation. To date there are many assessment instruments, some of which are available in a German translation. Regarding psychotherapeutic interventions there is evidence for a good efficacy of dialectical behavioral therapy for adolescents (DBT-A). There is little evidence for psychopharmacological interventions in childhood and adolescence; thus treatment should focus on psychotherapeutic interventions.

  6. 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.

  7. [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

  8. [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.

  9. Modalities of psychotherapy with the elderly.

    PubMed

    Karpf, R J

    1980-08-01

    Emphasized is the view that geriatric psychotherapy can be effectively administered only with knowledge of the biology, psychology, and sociology of old age. The concepts of transference, countertransference, interpretation, conflict and defense mechanisms are crucial for understanding the various treatment modalities. Five intervention patterns are offered for the therapeutic approaches, i.e., interpretation, suggestion, reinforcement, confrontation, and clarification. The different modalities of geriatric psychotherapy may be viewed as variations of different clusters of these interventions, e.g., psychoanalysis makes most use of interpretation whereas group therapy makes most use of confrontation and clarification. For the psychologic treatment of disorders in late life, there are five basic modalities and one adjunct. The basic psychotherapies are classified as psychoanalytic, supportive, group, family, and behavioral; the adjunct is psychopharmacologic treatment, which is not a substitute for effective psychotherapy. Much semantic confusion has centered around this adjunctive treatment. Conceptual confusions about the meaning of the word "cure" are discussed.

  10. 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.

  11. [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

  12. [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

  13. [Quantification in psychiatry: from psychometrics to quantitative psychiatry].

    PubMed

    Pichot, P

    1994-01-01

    The development of quantitative techniques to analyse psychopathological states is reviewed from the XVIIIth Century till today. As far as back as the XIXth Century, Quetelet, Louis and Galton introduced and advocated the use of quantitative methods in medical and psychological sciences. The advent of psychometry dates back 1905, when Alfred Binet published his Intelligence Scale. The construction of instruments like Wechsler and MMPI scales in the forties starts using psychometry in psychiatry. At end of World War II, historical factors (selection and guidance of military recruits) in conjunction with technical advancements (beginning of psychopharmacology, multivariate statistics development and first computers arrival) favor the growth of quantitative psychopathology that further takes four great different courses: 1. Psychometry proper, 2. Symptom-quantifying assessment scales such as BPRS or Hamilton scales, 3. New nosological models constructed using quantified psychopathological data and mathematical procedures, 4. Diagnostic systems relying on operationalized criteria based on psychopathological quantification, such as DSM III.

  14. Somatic Treatments for Mood Disorders

    PubMed Central

    Rosa, Moacyr A; Lisanby, Sarah H

    2012-01-01

    Somatic treatments for mood disorders represent a class of interventions available either as a stand-alone option, or in combination with psychopharmacology and/or psychotherapy. Here, we review the currently available techniques, including those already in clinical use and those still under research. Techniques are grouped into the following categories: (1) seizure therapies, including electroconvulsive therapy and magnetic seizure therapy, (2) noninvasive techniques, including repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and cranial electric stimulation, (3) surgical approaches, including vagus nerve stimulation, epidural electrical stimulation, and deep brain stimulation, and (4) technologies on the horizon. Additionally, we discuss novel approaches to the optimization of each treatment, and new techniques that are under active investigation. PMID:21976043

  15. 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.

  16. A dysbiotic subpopulation of alcohol-dependent subjects.

    PubMed

    de Timary, Philippe; Leclercq, Sophie; Stärkel, Peter; Delzenne, Nathalie

    2015-01-01

    The vast majority of studies that assessed the importance of biological factors for the development of psychiatric disorders focused on processes occurring at the brain level. Alcohol-dependence is a very frequent psychiatric disorder where psycho-pharmacological interventions are only of moderate efficacy. Our laboratory has recently described that a subpopulation of alcohol-dependent subjects, that accounted for approximately 40% of individuals tested, presented with an increased intestinal permeability, with a dysbiosis, with alterations in the metabolomic content of faeces--that could play a role in the increased permeability--and finally with a more severe profile of alcohol-dependence than the other non-dysbiotic subpopulation. In this addendum, we discuss the implications of our observations for the pathophysiology of alcohol dependence where we try to discriminate which addiction dimensions are likely related to the gut microbiota alterations and whether these alterations are the cause or the consequence of drinking habits. PMID:26727422

  17. Neuropsychological assessment of adult patients with attention-deficit/hyperactivity disorder.

    PubMed

    Müller, Bernhard W; Gimbel, Karla; Keller-Pliessnig, Anett; Sartory, Gudrun; Gastpar, Markus; Davids, Eugen

    2007-03-01

    Adults with persistent attention-deficit/hyperactivity disorder (ADHD) may show cognitive deficits as compared to healthy control subjects. The aim of this study was to compare a sample of adult outpatients with ADHD on medication to healthy controls on a comprehensive neuropsychological assessment battery. Thirty adults with ADHD under stable psychopharmacological treatment and 27 healthy controls matched for age, gender, and IQ were assessed with ten tests measuring performance with regard to attention, memory, executive function, and fine motor control. Lower performance in patients as compared to controls was found in tests of verbal and visual memory, speed of visuo-motor search, set shifting, and divided attention. Indicators of response inhibition and simple response speed were less affected. Adults with ADHD show indicators of lowered cognitive performance under medication. These are related more to memory and attention under high mental load than to response inhibition or simple attention or motor performance.

  18. 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

  19. [Social phobia].

    PubMed

    Bandelow, B; Wedekind, D

    2014-05-01

    With a lifetime prevalence of 13% social phobia (social anxiety disorder) is a common and serious condition that should not be played down because of the burden associated with the disorder, an increased suicide rate and the frequent comorbidity with substance abuse disorders. Social phobia is characterized by the excessive and unrealistic fear of being scrutinized or criticized by others. The disorder often begins in adolescence.Symptoms of social phobia can be effectively treated with evidence-based treatment, including cognitive behavior therapy (CBT) and psychopharmacological medications. In the present paper, treatment recommendations are given, which are based on a systematic review of all available randomized trials for the treatment of social phobia. Among psychological therapies, variants of CBT have been proven to be effective in controlled studies. Selective serotonin reuptake inhibitors (SSRIs) and the selective serotonin norepinephrine reuptake inhibitor (SNRI) venlafaxine are among the drugs of first choice.

  20. [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.

  1. 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

  2. Dreaming and hallucinations - continuity or discontinuity? Perspectives from dementia with Lewy bodies.

    PubMed

    Collerton, Daniel; Perry, Elaine

    2011-12-01

    Comparing the phenomenology, neurochemical pathology, and psychopharmacology of hallucinations and dreaming is limited by the available data. Evidence to date reveals no simple correspondence between the two states. Differences in the phenomenology of visual hallucinations and the visual component of dreams may reflect variations in visual context acting on the same underlying mechanism - the minimal visual input during dreaming contrasts with the more substantial perceived context in hallucinations. Variations in cholinergic, dopaminergic and serotonergic neurotransmitter function during sleep and during hallucinations in Lewy body dementias, together with relevant drug effects suggest that, on the whole, different, potentially opposite, changes characterise the two states. A similar analysis of other psychotic features in Lewy body dementia and other disorders suggests that, in contrast to hallucinations, there may be more convincing parallels between dreaming and delusional states.

  3. Pseudopheochromocytoma Associated with Domestic Assault

    PubMed Central

    Le, H. M.; Carbutti, G.; Ilisei, D.; Bouccin, E.

    2016-01-01

    Pseudopheochromocytoma has a clinical presentation that is similar to pheochromocytoma. It manifests itself with paroxysmal hypertension crises, associated with various symptoms such as headaches, chest pain, nausea, palpitations, and dizziness. Patients are usually asymptomatic in between the crises. Unlike pheochromocytoma, there is no catecholamines overproduction in this pathology: hypertensive peaks are caused by a hyperactivation of the sympathetic nervous system, which is often triggered by a psychological trauma in the past. Treatment of pseudopheochromocytoma can be challenging due to normal blood pressure values in between the hypertensive peaks; it includes alpha- and beta-blockers for moderate crises and prevention and must be combined with psychopharmacologic agents such as anxiolytics or antidepressant drugs. Psychotherapy and dietetic treatment are also crucial in pseudopheochromocytoma management. PMID:27738531

  4. [Postpartum depression: we know the risks, can it be prevented?].

    PubMed

    Zinga, Dawn; Phillips, Shauna Dae; Born, Leslie

    2005-10-01

    In the past 20 years, there has been increasing recognition that for some women, pregnancy may be burdened with mood problems, in particular depression, that may impact both mother and child. With identification of risk factors for postpartum depression and a growing knowledge about a biologic vulnerability for mood change following delivery, research has accumulated on attempts to prevent postpartum depression using various psychosocial, psychopharmacologic, and hormonal strategies. The majority of psychosocial and hormonal strategies have shown little effect on postpartum depression. Notwithstanding, results from preliminary trials of interpersonal therapy, cognitive-behavioural therapy, and antidepressants indicate that these strategies may be of benefit. Information on prevention of postpartum depression using dietary supplements is sparse and the available evidence is inconclusive. Although a few studies show promising results, more rigorous trials are required. The abounding negative evidence in the literature indicates that postpartum depression cannot be easily prevented, yet.

  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. ["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

  7. How to increase treatment effectiveness and efficiency in psychiatry: creative psychopharmacotherapy - part 1: definition, fundamental principles and higher effectiveness polypharmacy.

    PubMed

    Jakovljević, Miro

    2013-09-01

    Psychopharmacotherapy is a fascinating field that can be understood in many different ways. It is both a science and an art of communication with a heavily subjective dimension. The advent of a significant number of the effective and well tolerated mental health medicines during and after 1990s decade of the brain has increased our possibilities to treat major mental disorders in more successful ways with much better treatment outcome including full recovery. However, there is a huge gap between our possibilities for achieving high treatment effectiveness and not satisfying results in day-to-day clinical practice. Creative approach to psychopharmacotherapy could advance everyday clinical practice and bridge the gap. Creative psychopharmacotherapy is a concept that incorporates creativity as its fundamental tool. Creativity involves the intention and ability to transcend limiting traditional ideas, rules, patterns and relationships and to create meaningful new ideas, interpretations, contexts and methods in clinical psychopharmacology.

  8. Pediatric Neuromodulation Comes of Age.

    PubMed

    Croarkin, Paul E; Rotenberg, Alexander

    2016-09-01

    This special issue surveys recent work and underscores the challenges of psychiatric brain stimulation research with child and adolescent populations. The field of child and adolescent psychopharmacology is replete with examples of potential pitfalls in the assumption that "children are little adults." Arguably, younger age portends more neurobiological and descriptive heterogeneity in research pursuits and clinical practice. For existing brain stimulation modalities, there are a paucity of translational models to design studies for youth and no well-studied dosing schemes. The long-term positive and negative effects of neuromodulation interventions in youth are unknown. Inherent pragmatic and ethical limitations often present barriers for participant recruitment and will necessitate innovative approaches to study design and team efforts. These challenges are not insurmountable, and sustained efforts will advance the growing field of pediatric neuromodulation. PMID:27604043

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. The Place of Psychotherapy in Contemporary Psychiatry

    PubMed Central

    Tavakoli, Saman

    2014-01-01

    Psychotherapy has long been an essential component of clinical psychiatry and many young physicians choose to train in psychiatry residency programs in order to acquire necessary knowledge and skills, and become competent psychotherapists. Recent advances in psychopharmacology and neuroscience, and growing dominance of managed care and evidence-based medicine have had dramatic impacts on health care delivery systems and clinical psychiatry practice. Despite these changes in the field of mental health, psychotherapy still remains a crucial part of clinical psychiatry and comprises a great proportion of psychiatrists’ clinical practice. Hence, accreditation agencies and regulatory bodies determine compulsory minimum requirements for psychiatry residency programs to ensure that residents, at the end of their specialty training, can demonstrate competence in managing their patients through applying different approaches of psychotherapy. PMID:25798167

  14. Zebrafish models of major depressive disorders.

    PubMed

    Fonseka, Trehani M; Wen, Xiao-Yan; Foster, Jane A; Kennedy, Sidney H

    2016-01-01

    The zebrafish (Danio rerio) has emerged as a model species for translational research in various neuroscience areas, including depressive disorders. Because of their physiological (neuroanatomical, neuroendocrine, neurochemical) and genetic homology to mammals, robust phenotypes, and value in high-throughput genetic and chemical genetic screens, zebrafish are ideal for developing valid experimental models of major depression and discovering novel therapeutics. Behavioral testing approaches, such as approach-avoidance, cognitive, and social paradigms, are available in zebrafish and have utility in identifying depression-like indices in zebrafish in response to physiological, genetic, environmental, and/or psychopharmacological alterations. In addition, the high sensitivity of zebrafish to commonly prescribed psychotropic drugs supports the use of this model as an invaluable tool for pharmacological research and drug screening. This Review outlines the benefits of using the zebrafish model for depression studies and summarizes the current research in this field.

  15. 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

  16. The shaping of personality: genes, environments, and chance encounters.

    PubMed

    Zuckerman, Marvin

    2004-02-01

    I started my career as a clinical psychologist with an interest in personality assessment. But a loss of faith in psychoanalytic theory, projective tests, and clinical case studies in general led to a shift in my interests to personality research. Subsequent jobs at research institutes and universities allowed me to indulge in science. I developed the trait-state concept and its application in tests for affect measurement. For 10 years I did experimental research in the field of sensory deprivation. The sensation seeking idea and tests evolved from this work but soon expanded to many other areas. Research in the biological basis of sensation seeking started with genetic and psychophysiological research, but research conducted in other laboratories also pointed to a psychopharmacological basis for the trait. Over the last several decades, I have formulated a psychobiological model for personality. I have used factor analysis and the biosocial model to develop an "alternative-five" factorial trait structure for personality.

  17. [Personalized Internet-based treatment services for posttraumatic stress disorder].

    PubMed

    Maercker, A; Hecker, T; Heim, E

    2015-11-01

    Among the most important innovations within the psychotherapeutic care system are the new opportunities in the field of e-mental health. During the past decade, Internet-based and other e-mental health approaches for the treatment of post-traumatic stress disorder and related stress-associated symptoms have been developed in great variety. Solely Internet-based self-help programs are the lowest-threshold approaches in a stepped-care system. By contrast, individualized online psychotherapy and virtual reality programs are at the opposite pole of the spectrum. Approaches in the field of m(obile)-mental health complement these new developments in psychotherapy. The existing evidence supports the clinical efficacy of all the described approaches, although not all have been tested rigorously analog to phase III studies in psychopharmacology. Nonetheless, e-mental health approaches will shape our field more and more in the future.

  18. A 2-amino-2-oxazoline derivative as an antidepressant in mice.

    PubMed

    Bourin, M; Creuzet, M H; Jarry, C; Colombel, M C

    1988-05-01

    2-Amino-2-oxazolines are heterocyclic compounds with interesting pharmacological properties. Several derivatives of this chemical series were studied in psychopharmacological tests. One derivative 4,5-dihydro-5-[methyl(4-phenyl-1-piperazinyl)]-2-oxazolamine (COR 32-24), had an antidepressant profile. Its structure can be compared to trazodone in its phenylpiperazine group and to toloxatone in its oxazoline group. This molecule antagonized reserpine-induced hypothermia and ptosis, oxotremorine-induced hypothermia and high-dose apomorphine-induced hypothermia. It also potentiated yohimbine-induced sublethality and decreased the immobility of forced swimming. It had no monoamine oxidase inhibitory activity. These results suggest a profile close to that of viloxazine and to that of a classic antidepressant.

  19. The intellectual crisis of psychiatric research.

    PubMed

    Fava, Giovanni A

    2006-01-01

    The aim of this paper was to examine the intellectual crisis and the potential sources of reveille in clinical research in psychiatry. Current prevailing conceptual models in psychiatry are critically examined, with particular reference to neurobiology, clinical psychopharmacology, assessment, and the therapeutic process. Biological reductionism, neglect of individual responses to treatment, massive propaganda from the pharmaceutical industry, misleading effects of psychometric theory on clinical assessment, and lack of consideration of multiple therapeutic ingredients and of the role of psychological well-being are identified as major sources of an intellectual crisis in psychiatric research. The conceptual crisis of psychiatry is shared by other areas of clinical medicine and stems from a narrow concept of science that neglects clinical observation, the basic method of medicine. A unified concept of health and disease may yield new clinical insights in psychiatric disorders, and may result in therapeutic efforts of more enduring quality than current strategies.

  20. Sex differences in drug abuse: Etiology, prevention, and treatment.

    PubMed

    Evans, Suzette M; Reynolds, Brady

    2015-08-01

    This special issue exemplifies one of the major goals of the current editor of Experimental and Clinical Psychopharmacology (Dr. Suzette Evans): to increase the number of manuscripts that emphasize females and address sex differences. Taken together, these articles represent a broad range of drug classes and approaches spanning preclinical research to treatment to better understand the role of sex differences in drug abuse. While not all studies found sex differences, we want to emphasize that finding no sex difference is just as important as confirming one, and should be reported in peer-reviewed journals. It is our intention and hope that this special issue will further advance scientific awareness about the importance of accounting for sex differences in the study of substance abuse. Participant sex is an essential variable to consider in developing a more comprehensive understanding of substance abuse. Rather than viewing investigating sex differences as burdensome, investigators should seize this opportune area ripe for innovative research that is long overdue.

  1. Depression in adolescents and young adults with cancer.

    PubMed

    Park, Eliza M; Rosenstein, Donald L

    2015-06-01

    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.

  2. 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

  3. Child rights and Child and Adolescent Mental Health Services (CAMHS) in Ireland.

    PubMed

    Damodaran, J; Sherlock, C

    2013-12-01

    This paper explores children's rights in the child and adolescent mental health arena in Ireland. It begins by outlining the legal and policy contexts of both children's services and mental health policy and practice. It specifically focuses on the notion of participation as a key factor in addressing rights-based approaches in the provision of services. The article explores current practice in Child and Adolescent Mental Health Services, highlights some of the disparities in services, which result in questions about human rights. Mainly reflective in its approach, it does, however, provide data from a small scale qualitative study carried out in relation to young people diagnosed with ADHD and their perceptions of psychopharmacological approach. The issue of consent is explored as an example of how current practice approaches fall short of a rights-based framework. It concludes with recommendations for changes incorporating a more participatory and collaborative approach. PMID:23512493

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

    PubMed Central

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

    2011-01-01

    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

  5. Catatonia in the History of Psychiatry: Construction and Deconstruction of a Disease Concept.

    PubMed

    Tang, Victor Mark; Duffin, Jacalyn

    2014-01-01

    Catatonia is a psychomotor disorder that has gone through numerous descriptions since 1874, reflecting the many changes in psychiatric disease conceptualization that have occurred within that time frame. Catatonia has been variously described as a distinct disease entity, as a part of schizophrenia, and as a nonspecific manifestation of many disorders. Because of its association with schizophrenia, the description of catatonia was particularly affected by the psychopharmacological era, beginning in the 1950s, and by the development of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Changing trends in psychiatric research--especially the brain-based disease model, research methods favoured by the evidence-based medicine movement, and the codes and categories of the DSM--also profoundly influenced the evolving concept of catatonia. This paper discusses these important factors that affected recognition, treatment, and study of catatonia in order to reveal the biases and assumptions made when constructing a disease concept.

  6. 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

  7. Adapting social neuroscience measures for schizophrenia clinical trials, Part 1: ferrying paradigms across perilous waters.

    PubMed

    Green, Michael F; Lee, Junghee; Ochsner, Kevin N

    2013-11-01

    Social cognitive impairment is prominent in schizophrenia, and it is closely related to functional outcome. Partly for these reasons, it has rapidly become a target for both training and psychopharmacological interventions. However, there is a paucity of reliable and valid social cognitive endpoints that can be used to evaluate treatment response in clinical trials. Also, clinical studies in schizophrenia have benefited rather little from the surge of activity and knowledge in nonclinical social neuroscience. The National Institute of Mental Health-sponsored study, "Social Cognition and Functioning in Schizophrenia" (SCAF), attempted to address this translational challenge by selecting paradigms from social neuroscience that could be adapted for use in schizophrenia. The project also evaluated the psychometric properties and external validity of the tasks to determine their suitability for multisite clinical trials. This first article in the theme section presents the goals, conceptual background, and rationale for the SCAF project.

  8. 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

  9. 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.

  10. [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

  11. 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

  12. [Bulimia nervosa].

    PubMed

    Zeeck, A; Hartmann, A; Sandholz, A; Joos, A

    2006-08-01

    Bulimia nervosa is characterized by episodes of binge eating and compensatory behaviours (self-induced vomiting, laxative misuse, dietary restriction). It has a complex aetiology and is mostly found in young women. Bulimia leads to substantial physical and psychosocial morbidity. Bulimia nervosa needs specialized psychotherapeutic treatment. In most cases outpatient treatment is sufficient, but comorbidity with other psychiatric disturbances has to be taken into account. Additional psychopharmacological interventions might be helpful. After 5 to 10 years about 50% of the patients show complete remissions, 30% partial remissions and about 20% a chronic course of the illness. General practitioners, dentists and gynaecologists should be informed about typical signs of the disorder that is often hidden by the patients.

  13. 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

  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. Hallucinogens as hard science: the adrenochrome hypothesis for the biogenesis of schizophrenia.

    PubMed

    Mills, John A

    2010-05-01

    Working in a psychiatrically innovative environment created by the Government of Saskatchewan, Canada, Abram Hoffer and Humphry F. Osmond enunciated the adrenochrome hypothesis for the biogenesis of schizophrenia in 1952, slightly later proposing and, apparently, demonstrating, in a double-blind study, that the symptoms of the illness could be reversed by administering large doses of niacin. After placing the hypothesis within its ideological framework, the author describes its emergence and elaboration and discusses the empirical evidence brought against it. Hoffer's idiosyncratic diagnostic procedures, especially his creation and use of a supposed biochemical marker for schizophrenia, are examined. The author argues that Hoffer's conceptualization of schizophrenia, as well as his treatment approach, depended on a tautology. Following David Healy, the author treats the adrenochrome hypothesis as a version of a transmethylation theory, thus incorporating it into mainstream psychopharmacology.

  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. BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP.

    PubMed

    Lingford-Hughes, A R; Welch, S; Peters, L; Nutt, D J

    2012-07-01

    The British Association for Psychopharmacology guidelines for the treatment of substance abuse, harmful use, addiction and comorbidity with psychiatric disorders primarily focus on their pharmacological management. They are based explicitly on the available evidence and presented as recommendations to aid clinical decision making for practitioners alongside a detailed review of the evidence. A consensus meeting, involving experts in the treatment of these disorders, reviewed key areas and considered the strength of the evidence and clinical implications. The guidelines were drawn up after feedback from participants. The guidelines primarily cover the pharmacological management of withdrawal, short- and long-term substitution, maintenance of abstinence and prevention of complications, where appropriate, for substance abuse or harmful use or addiction as well management in pregnancy, comorbidity with psychiatric disorders and in younger and older people.

  18. The First Report of Fetal Alcohol Effect in a 12 Year-Old Child in Korea

    PubMed Central

    Ahn, Dong Hyun; Lee, Young Jin; An, Ho Young; Ahn, Joon Ho

    2009-01-01

    We present the first report of fetal alcohol effect in a 12 year-old child in Korea. The mother had consumed 162 g of alcohol per week continuously during pregnancy. His first febrile seizure occurred before he was 1 year old, and became more frequent 2 years later. He started showing signs of right paraplegia when he was 3.5 years old and brain MRI revealed periventricular leucomalacia near the left ventricle. He was microcephalic and his growth was retarded. He was irritable, impatient, impulsive, and inattentive, and showed disinterest in school activities and aggressive and dangerous behavior. After the diagnosis of attention deficit/hyperactivity disorder was made, psychopharmacological treatment and family support was initiated. After 10 months, he still had intermittent ideas of reference, although the aggressive behavior, inattentiveness, and impulsivity had improved. Using this case study, we stress the importance of maternal alcohol history in patients with these characteristics. PMID:20046374

  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. [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.

  1. History of psychiatry

    PubMed Central

    Shorter, Edward

    2013-01-01

    Purpose of review The present review examines recent contributions to the evolving field of historical writing in psychiatry. Recent findings Interest in the history of psychiatry continues to grow, with an increasing emphasis on topics of current interest such as the history of psychopharmacology, electroconvulsive therapy, and the interplay between psychiatry and society. The scope of historical writing in psychiatry as of 2007 is as broad and varied as the discipline itself. Summary More than in other medical specialties such as cardiology or nephrology, treatment and diagnosis in psychiatry are affected by trends in the surrounding culture and society. Studying the history of the discipline provides insights into possible alternatives to the current crop of patent-protected remedies and trend-driven diagnoses. PMID:18852567

  2. 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

  3. From efficacy to effectiveness: the trajectory of the treatment literature for children with PTSD.

    PubMed

    Nikulina, Valentina; Hergenrother, Jeanean M; Brown, Elissa J; Doyle, Megan E; Filton, Beryl J; Carson, Gabrielle S

    2008-08-01

    This review summarizes efficacious treatments for preschoolers, children and adolescents with post-traumatic stress disorder, with a focus on the advances made within the last 5 years. There is considerable support for the use of trauma-specific cognitive-behavioral interventions, in both individual and group formats. The research on psychopharmacological treatments lags behind that of psychotherapy and is currently inconclusive. Limitations of the studies are discussed and treatments that warrant further consideration are reviewed. The authors also review current advances in effectiveness and suggest future directions that are important in generalizing the interventions to underserved and hard to reach populations. The article concludes with the authors' projections for the evolution of the field within the upcoming 5 years.

  4. Pediatric Neuromodulation Comes of Age.

    PubMed

    Croarkin, Paul E; Rotenberg, Alexander

    2016-09-01

    This special issue surveys recent work and underscores the challenges of psychiatric brain stimulation research with child and adolescent populations. The field of child and adolescent psychopharmacology is replete with examples of potential pitfalls in the assumption that "children are little adults." Arguably, younger age portends more neurobiological and descriptive heterogeneity in research pursuits and clinical practice. For existing brain stimulation modalities, there are a paucity of translational models to design studies for youth and no well-studied dosing schemes. The long-term positive and negative effects of neuromodulation interventions in youth are unknown. Inherent pragmatic and ethical limitations often present barriers for participant recruitment and will necessitate innovative approaches to study design and team efforts. These challenges are not insurmountable, and sustained efforts will advance the growing field of pediatric neuromodulation.

  5. The token economy for schizophrenia: review of the literature and recommendations for future research.

    PubMed

    Dickerson, Faith B; Tenhula, Wendy N; Green-Paden, Lisa D

    2005-06-15

    The token economy is a treatment intervention based on principles of operant conditioning and social learning. Developed in the 1950s and 1960s for long-stay hospital patients, the token economy has fallen out of favor since that time. The current review was undertaken as part of the 2003 update of the schizophrenia treatment recommendations of the Patient Outcomes Research Team (PORT). A total of 13 controlled studies of the token economy were reviewed. As a group, the studies provide evidence of the token economy's effectiveness in increasing the adaptive behaviors of patients with schizophrenia. Most of the studies are limited, however, by methodological shortcomings and by the historical context in which they were performed. More research is needed to determine the specific benefits of the token economy when administered in combination with contemporary psychosocial and psychopharmacological treatments.

  6. 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

  7. Pharmacological treatment of negative symptoms in schizophrenia.

    PubMed

    Möller, Hans-Jürgen; Czobor, Pal

    2015-10-01

    Effective treatment of negative symptoms is one of the most important unmet needs in schizophrenic disorders. Because the evidence on current psychopharmacological treatments is unclear, the authors reviewed the findings published to date by searching PubMed with the keywords negative symptoms, antipsychotics, antidepressants, glutamatergic compounds, monotherapy and add-on therapy and identifying additional articles in the reference lists of the resulting publications. The findings presented here predominantly focus on results of meta-analyses. Evidence for efficacy of current psychopharmacological medications is difficult to assess because of methodological problems and inconsistent results. In general, the second-generation antipsychotics (SGAs) do not appear to have good efficacy in negative symptoms, although some show better efficacy than first-generation antipsychotics, some of which also demonstrated efficacy in negative symptoms. Specific trials on predominant persistent negative symptoms are rare and have been performed with only a few SGAs. More often, trials on somewhat persistent negative symptoms evaluate add-on strategies to ongoing antipsychotic treatment. Such trials, mostly on modern antidepressants, have demonstrated some efficacy. Several trials with small samples have evaluated add-on treatment with glutamatergic compounds, such as the naturally occurring amino acids glycine and D-serine and new pharmacological compounds. The results are highly inconsistent, although overall efficacy results appear to be positive. The unsatisfactory and inconsistent results can be partially explained by methodological problems. These problems need to be solved in the future, and the authors propose some possible solutions. Further research is required to identify effective treatment for the negative symptoms of schizophrenia. PMID:25895634

  8. 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.

  9. 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

  10. 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

  11. 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

  12. 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

  13. Differential sensitivity of ethanol-elicited ERK phosphorylation in nucleus accumbens of Sardinian alcohol-preferring and -non preferring rats.

    PubMed

    Rosas, Michela; Zaru, Alessandro; Sabariego, Marta; Giugliano, Valentina; Carboni, Ezio; Colombo, Giancarlo; Acquas, Elio

    2014-08-01

    Sardinian alcohol-preferring (sP) and -non preferring (sNP) rats have been selectively bred for opposite ethanol preference and consumption; sP rats represent a validated experimental tool to model several aspects of excessive ethanol drinking in humans. Phosphorylated Extracellular signal-Regulated Kinase (pERK) in dopamine-rich terminal areas plays a critical role in several psychopharmacological effects of addictive drugs, including ethanol. This study was aimed at investigating whether ethanol-elicited ERK activation may differ in key brain areas of ethanol-naïve sP and sNP rats. To this end, the effects of ethanol (0, 0.5, 1, and 2 g/kg, administered intra-gastrically [i.g.]) on ERK phosphorylation were assessed by pERK immunohistochemistry in the shell (AcbSh) and core (AcbC) of the nucleus accumbens (Acb) as well as in the prelimbic (PrL) and infralimbic (IL) prefrontal cortex (PFCx), in the bed nucleus of stria terminalis (BSTL) and in the central nucleus of the amygdala (CeA). Ethanol (1 g/kg) significantly increased pERK immunoreactivity in AcbSh and AcbC of sP but not sNP rats. Conversely, ethanol failed to affect pERK expression in PrL and IL PFCx as well as in BSTL and CeA of both sP and sNP rats. These results suggest that selective breeding of these rat lines results in differential effects of acute ethanol on ERK phosphorylation in brain regions critical for the psychopharmacological effects of ethanol.

  14. Pharmacological treatment of negative symptoms in schizophrenia.

    PubMed

    Möller, Hans-Jürgen; Czobor, Pal

    2015-10-01

    Effective treatment of negative symptoms is one of the most important unmet needs in schizophrenic disorders. Because the evidence on current psychopharmacological treatments is unclear, the authors reviewed the findings published to date by searching PubMed with the keywords negative symptoms, antipsychotics, antidepressants, glutamatergic compounds, monotherapy and add-on therapy and identifying additional articles in the reference lists of the resulting publications. The findings presented here predominantly focus on results of meta-analyses. Evidence for efficacy of current psychopharmacological medications is difficult to assess because of methodological problems and inconsistent results. In general, the second-generation antipsychotics (SGAs) do not appear to have good efficacy in negative symptoms, although some show better efficacy than first-generation antipsychotics, some of which also demonstrated efficacy in negative symptoms. Specific trials on predominant persistent negative symptoms are rare and have been performed with only a few SGAs. More often, trials on somewhat persistent negative symptoms evaluate add-on strategies to ongoing antipsychotic treatment. Such trials, mostly on modern antidepressants, have demonstrated some efficacy. Several trials with small samples have evaluated add-on treatment with glutamatergic compounds, such as the naturally occurring amino acids glycine and D-serine and new pharmacological compounds. The results are highly inconsistent, although overall efficacy results appear to be positive. The unsatisfactory and inconsistent results can be partially explained by methodological problems. These problems need to be solved in the future, and the authors propose some possible solutions. Further research is required to identify effective treatment for the negative symptoms of schizophrenia.

  15. 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.

  16. Evidence-based clinical practice guidelines for irritable bowel syndrome.

    PubMed

    Fukudo, Shin; Kaneko, Hiroshi; Akiho, Hirotada; Inamori, Masahiko; Endo, Yuka; Okumura, Toshikatsu; Kanazawa, Motoyori; Kamiya, Takeshi; Sato, Ken; Chiba, Toshimi; Furuta, Kenji; Yamato, Shigeru; Arakawa, Tetsuo; Fujiyama, Yoshihide; Azuma, Takeshi; Fujimoto, Kazuma; Mine, Tetsuya; Miura, Soichiro; Kinoshita, Yoshikazu; Sugano, Kentaro; Shimosegawa, Tooru

    2015-01-01

    New strategies for the care of irritable bowel syndrome (IBS) are developing and several novel treatments have been globally produced. New methods of care should be customized geographically because each country has a specific medical system, life style, eating habit, gut microbiota, genes and so on. Several clinical guidelines for IBS have been proposed and the Japanese Society of Gastroenterology (JSGE) subsequently developed evidence-based clinical practice guidelines for IBS. Sixty-two clinical questions (CQs) comprising 1 definition, 6 epidemiology, 6 pathophysiology, 10 diagnosis, 30 treatment, 4 prognosis, and 5 complications were proposed and statements were made to answer to CQs. A diagnosis algorithm and a three-step treatment was provided for patients with chronic abdominal pain or abdominal discomfort and/or abnormal bowel movement. If more than one alarm symptom/sign, risk factor and/or routine examination is positive, colonoscopy is indicated. If all of them, or the subsequent colonoscopy, are/is negative, Rome III or compatible criteria is applied. After IBS diagnosis, step 1 therapy consisting of diet therapy, behavioral modification and gut-targeted pharmacotherapy is indicated for four weeks. Non-responders to step 1 therapy proceed to the second step that includes psychopharmacological agents and simple psychotherapy for four weeks. In the third step, for patients non-responsive to step 2 therapy, a combination of gut-targeted pharmacotherapy, psychopharmacological treatments and/or specific psychotherapy is/are indicated. Clinical guidelines and consensus for IBS treatment in Japan are well suited for Japanese IBS patients; as such, they may provide useful insight for IBS treatment in other countries around the world. PMID:25500976

  17. 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.

  18. The human frontal lobes and frontal network systems: an evolutionary, clinical, and treatment perspective.

    PubMed

    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

  19. 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

  20. [Madness is Conforming to One's Own Norms, and No Others: Psychiatry in Post-war Quebec].

    PubMed

    Perreault, Isabelle

    2015-01-01

    In the early 1950s, both the publication of the first Diagnostic and Statistical Manual (DSM-I) and the advent of psychopharmacology - particularly the development of chlorpromazine (Thorazine - RP4650) - set the stage for models of psychiatric thought, research and practice that remain dominant today. It was during this pivotal period, in 1955, that the Département de psychiatrie de l'Université de Montréal was founded by a cohort of young researchers newly arrived from well-known universities in France and the northeastern United States. This influential group quickly became staunch critics of the province's religion-based asylum system and lobbied for a government review that culminated into the 1962 Commission d'étude des hôpitaux psychiatriques (popularly known as the Bédard Report). What followed in Quebec between 1965 and 1975 was the secularization of psychiatric institutions and widespread deinstitutionalization. This paper illuminates cultural changes and intellectual shifts that have been overlooked in historical studies of post-war psychiatry by exploring the expansion of such "anti-psychiatry" schools of thought in Quebec in this period. PMID:26559205

  1. Beyond neural cubism: promoting a multidimensional view of brain disorders by enhancing the integration of neurology and psychiatry in education.

    PubMed

    Taylor, Joseph J; Williams, Nolan R; George, Mark S

    2015-05-01

    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 stemmed 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.

  2. The Microbiome and Mental Health: Looking Back, Moving Forward with Lessons from Allergic Diseases

    PubMed Central

    Logan, Alan C.; Jacka, Felice N.; Craig, Jeffrey M.; Prescott, Susan L.

    2016-01-01

    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

  3. 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

  4. 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

  5. Addressing risk factors of cognitive impairment in adults aging with HIV: a social work model.

    PubMed

    Vance, David E; Struzick, Thomas C

    2007-01-01

    With advances in life-extending medications and later- life infections, the number of older adults with HIV is increasing. Unfortunately, the synergistic effects of aging with HIV may place many people at risk of developing cognitive impairments which can disrupt everyday functioning. Fortunately, cognitive reserve may be maintained, or in some cases improved, by taking action to prevent or mitigate such loss. Preventative and treatment strategies that support biopsychosocial aspects of cognition include reducing alcohol and substance use; improving nutrition; diminishing the effects of comorbidities; increasing social contact; reducing depression and stress levels; engaging in cognitively stimulating activities; applying cognitive remediation therapies; and incorporating psychopharmacological interventions. Such strategies can improve the physiological integrity and health of the brain, thus supporting neuroplasticity and increasing cognitive reserve. Social workers are in a favorable position to recognize cognitive decline in clients and recommend or administer solutions to address such problems. A model for social workers advocating for older clients with HIV who have cognitive problems is provided. PMID:17953062

  6. [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.

  7. Psychoneuroimmunology of psychological stress and atopic dermatitis: pathophysiologic and therapeutic updates.

    PubMed

    Suárez, Andrea L; Feramisco, Jamison D; Koo, John; Steinhoff, Martin

    2012-01-01

    Atopic dermatitis is a chronic inflammatory skin disease characterized by impaired epidermal barrier function, inflammatory infiltration, extensive pruritus and a clinical course defined by symptomatic flares and remissions. The mechanisms of disease exacerbation are still poorly understood. Clinical occurrence of atopic dermatitis is often associated with psychological stress. In response to stress, upregulation of neuropeptide mediators in the brain, endocrine organs, and peripheral nervous system directly affect immune and resident cells in the skin. Lesional and non-lesional skin of patients with atopic dermatitis demonstrates increased mast cells and mast cell-nerve fiber contacts. In the setting of stress, sensory nerves release neuromediators that regulate inflammatory and immune responses, as well as barrier function. Progress towards elucidating these neuroimmune connections will refine our understanding of how emotional stress influences atopic dermatitis. Moreover, psychopharmacologic agents that modulate neuronal receptors or the amplification circuits of inflammation are attractive options for the treatment of not only atopic dermatitis, but also other stress-mediated inflammatory skin diseases.

  8. 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

  9. 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

  10. The neurobiology of depression and antidepressant action.

    PubMed

    Willner, Paul; Scheel-Krüger, Jørgen; Belzung, Catherine

    2013-12-01

    We present a comprehensive overview of the neurobiology of unipolar major depression and antidepressant drug action, integrating data from affective neuroscience, neuro- and psychopharmacology, neuroendocrinology, neuroanatomy, and molecular biology. We suggest that the problem of depression comprises three sub-problems: first episodes in people with low vulnerability ('simple' depressions), which are strongly stress-dependent; an increase in vulnerability and autonomy from stress that develops over episodes of depression (kindling); and factors that confer vulnerability to a first episode (a depressive diathesis). We describe key processes in the onset of a 'simple' depression and show that kindling and depressive diatheses reproduce many of the neurobiological features of depression. We also review the neurobiological mechanisms of antidepressant drug action, and show that resistance to antidepressant treatment is associated with genetic and other factors that are largely similar to those implicated in vulnerability to depression. We discuss the implications of these conclusions for the understanding and treatment of depression, and make some strategic recommendations for future research.

  11. Naturally-occurring tetrahydro-β-carboline alkaloids derived from tryptophan are oxidized to bioactive β-carboline alkaloids by heme peroxidases.

    PubMed

    Herraiz, Tomás; Galisteo, Juan

    2014-08-15

    β-Carbolines are indole alkaloids that occur in plants, foods, and endogenously in mammals and humans, and which exhibit potent biological, psychopharmacological and toxicological activities. They form from naturally-occurring tetrahydro-β-carboline alkaloids arising from tryptophan by still unknown way and mechanism. Results in this research show that heme peroxidases catalyzed the oxidation of tetrahydro-β-carbolines (i.e. 1,2,3,4-tetrahydro-β-carboline-3-carboxylic acid and 1-methyl-1,2,3,4-tetrahydro-β-carboline-3-carboxylic acid) into aromatic β-carbolines (i.e. norharman and harman, respectively). This oxidation followed a typical catalytic cycle of peroxidases through redox intermediates I, II, and ferric enzyme. Both, plant peroxidases (horseradish peroxidase, HRP) and mammalian peroxidases (myeloperoxidase, MPO and lactoperoxidase, LPO) catalyzed the oxidation in an efficient manner as determined by kinetic parameters (VMAX and KM). Oxidation of tetrahydro-β-carbolines was inhibited by peroxidase inhibitors such as sodium azide, ascorbic acid, hydroxylamine and excess of H2O2. The formation of aromatic β-carbolines by heme peroxidases can help to explain the presence and activity of these compounds in biological systems.

  12. Professional ethics in context: practising rural Canadian psychologists.

    PubMed

    Malone, Judi L

    2012-12-01

    The complexities of professional ethics are best understood and interpreted within their sociohistorical context. This paper focuses on the experience of 20 rural psychologists from across Canada, a context rife with demographic and practice characteristics that may instigate ethical issues. Employing hermeneutic phenomenology, these qualitative research results are indicative of professional struggles that impacted the participants' experience of professional ethics and raised key questions about policy and practise. Concerns regarding competition highlight potential professional vulnerability, beget the idea of fostering general psychological practice, and question the role of professional bodies in addressing rural shortages. Dependency on government funding models and decisions highlights the benefits and medical cost-offset effect of psychological services' role in funded medical care. The controversial prescriptive authority debate for psychologists raises myriad concerns that are particularly salient to rural practitioners. These include changes to training and practice, with risks of psychopharmacology gaining prominence over behavioural health interventions. National inconsistencies in level of registration add to the growing shortage of practitioners. Finally, the results illuminate the need for advocacy to move beyond the literature and into public policy to increase public awareness, decrease the stigma of mental illness, and develop rural Canadian psychology. Although limited to this study, these results allowed for a fuller and more robust understanding of rural practice in consideration of professional ethics, which may inform policy, science, or ethical clinical practice.

  13. 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

  14. 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

  15. A Framework for Developing a Curriculum Regarding Autism Spectrum Disorders for Primary Care Providers

    PubMed Central

    Lillystone, David; Dossetor, David; Wilkinson, Helen; Kefford, Carolyn; Eastwood, John; Liaw, Siaw Teng

    2015-01-01

    Introduction The prevalence of Autism Spectrum Disorders (ASDs) has increased and varies across age groups. Thus there is an increasing need for educational opportunities for General Practitioners (GPs) and other Primary Care providers to help in early identification and referral to specialist services. An earlier survey of GPs in New South Wales (Australia) demonstrated two broad domains for educational activities: (1) a general knowledge (important for early identification and referral) and (2) surveillance (important for ongoing management). Aim To seek further evidence to these domains and synthesize the important contents for educational programs for GPs. Materials and Methods We conducted a (1) Confirmatory Factor Analysis (CFA) on our original survey data and (2) systematic review of the literature to identify important educational topics, using a life cycle approach. Results CFA and literature review support theoretical framework of two domains. Alerts and red flags for ASDs, knowledge of simple surveillance tools, communication of diagnosis with parents, referral pathways particularly to speech pathologists before a formal diagnosis is confirmed, and appreciation of vulnerabilities for identifying supports were important in the general knowledge domain, while supporting the families through transition points such as from pre-school to school entry, secondary school and adolescence, role of psychopharmacology such as medications for sleep issues, and for common co-morbidities of anxiety were important in the surveillance dimension. Conclusion GP supervisors and medical and nursing educators can use findings from this paper for developing structured learning activities for training primary health care workforce regarding ASD’s. PMID:26557583

  16. The successful psychoanalytic therapy of a schizophrenic woman.

    PubMed

    Robbins, Michael

    2012-12-01

    The prevalent sociocultural belief about the psychoses and schizophrenia is that intensive psychoanalytic therapy is ineffective if not destructive and contraindicated, and that the treatment of choice is a combination of psychopharmacology and educational techniques designed to provide symptom relief and rehabilitation. The literature contains few detailed reports of successful intensive psychotherapy that might contradict these beliefs. The psychoanalytic psychotherapy of a woman I shall call Sara, who met DSM criteria for chronic paranoid schizophrenia, is presented in detail. Its success in bringing about a fundamental personality transformation from a seriously self-destructive state in which she was unable to care for herself to one in which she became a mature creative person is confirmed by a follow up two decades after termination. The therapy transpired over an 11-year period and was conducted for the most part four times per week. It was supported by numerous hospitalizations in the early years as well as pharmacotherapy which she was able to relinquish prior to termination. During treatment Sara separated both physically and psychologically from an undifferentiated destructive relationship with her mother, internalized the capacity to think and represent emotions, and integrated disparate elements of personality to form a cohesive self. She developed psychosexually and formed a mature gender identity. She achieved the capacity for intimacy and motherhood, and had a successful career.

  17. The pharmacological treatment of anxiety disorders in children and adolescents.

    PubMed

    Nash, Lawrence T; Hack, Sabine

    2002-05-01

    As the recognition of paediatric and adolescent anxiety disorders improves, so does the number of recommended treatments. Newer medications (chiefly serotonergic antidepressants) have emerged as the pharmacological treatment of choice and have largely replaced benzodiazepines and tricyclic antidepressants (TCAs) for these disorders. This review will focus on placebo-controlled and open-label studies concerning the treatment of anxiety in children and adolescents, comparing data from newer antidepressant medications (plus buspirone) with data on TCAs and benzodiazepines in this population. There are few randomised, placebo-controlled trials of medications for anxiety in children and adolescents, with most data coming from open-label trials and case series. Moreover, there are no studies comparing pharmacological versus behavioural treatments. Most recent data concerning the efficacy of selective serotonin reuptake inhibitors suggests that these agents will be effective and safe in the treatment of paediatric anxiety disorders. The potential side effect profiles of these newer agents also makes them an attractive first choice for anxiety when compared to the benzodiazepines or TCAs, each of which poses its own potentially serious adverse effects. More research is needed in the area of psychopharmacological treatments for paediatric and adolescent anxiety, not only to substantiate the current beliefs that serotonergic agents are effective and safe but to pinpoint the factors that might predict responses to particular agents or classes of medications. Future investigations should focus on treatments which have already proven effective for adult anxiety disorders (both medications and psychotherapies), given the apparent links between paediatric and adult anxiety disorders.

  18. Pediatric psychotropic medication compliance: a literature review and research-based suggestions for improving treatment compliance.

    PubMed

    Hack, S; Chow, B

    2001-01-01

    Without good compliance the best psychiatric treatment is ineffective. This article reviews what is known or can be inferred about compliance with psychiatric medications in the pediatric population. The review includes discussions of assessment techniques, risk and protective factors, the relevant research literature, and research-based practical techniques to improve compliance. A Medline search surveying the years from 1966 to August 2000 yielded only seven peer-reviewed papers reporting on compliance with pediatric psychopharmacology. All seven studies looked at stimulant compliance among children with attention deficit hyperactivity disorder. Reported levels of compliance range from 56% to 75%. These rates, although low, are likely to be overestimates of actual compliance. We review two related areas of research for which there are small but significant bodies of knowledge: pharmacological compliance studies among adult psychiatric populations and pediatric medical populations. This literature supports the idea that medication compliance is a significant obstacle to the effective treatment of patients. Because compliance rates are lower for children as compared to adults and psychiatric patients as compared to medical patients, we suspect that children with psychiatric illness may be at great risk for poor medication compliance. Fortunately, the research literature demonstrates several simple techniques that clinicians can use to improve medication compliance among their patients. The treatment alliance; education; and medication duration, dosing, palatability, and cost can all be tailored to improve medication compliance.

  19. 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

  20. 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

    2014-10-21

    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.