Effects Of Psychotropic Drugs Research Articles

Should patients be informed about the side effects of psychotropic drugs? According to us: Yes

BackgroundIn our daily clinical practice, we observe that patients who were informed about the probable side effects of any medication experience less side effects. For this reason, we decided to examine this in a systematic investigation. MethodsWe divided patients into two groups, the informed and uninformed one about side effects of the drugs. During the control examination, tolerability of the drugs given was questioned in detail. ResultsAt the end of one month, the mean total UKU score was statistically significantly lower in patients from the informed group compared to that of the uninformed one (p < 0.05). The proportion of patients who discontinued the drug during the one month-period was statistically significantly higher in the uninformed group compared to informed group 9% in the informed group vs. 25% in the uninformed group) (p < 0.05). ConclusionsFinally, we found that giving information about the side effects of a psychopharmacological agent seems to be useful and to provide beneficial effects on the tolerability of the drug, independent of the kind of psychotropic agent.

Expression of alternatively spliced variants of the Dclk1 gene is regulated by psychotropic drugs

BackgroundThe long-term effects of psychotropic drugs are associated with the reversal of disease-related alterations through the reorganization and normalization of neuronal connections. Molecular factors that trigger drug-induced brain plasticity remain only partly understood. Doublecortin-like kinase 1 (Dclk1) possesses microtubule-polymerizing activity during synaptic plasticity and neurogenesis. However, the Dclk1 gene shows a complex profile of transcriptional regulation, with two alternative promoters and exon splicing patterns that suggest the expression of multiple isoforms with different kinase activities.ResultsHere, we applied next-generation sequencing to analyze changes in the expression of Dclk1 gene isoforms in the brain in response to several psychoactive drugs with diverse pharmacological mechanisms of action. We used bioinformatics tools to define the range and levels of Dclk1 transcriptional regulation in the mouse nucleus accumbens and prefrontal cortex. We also sought to investigate the presence of DCLK1-derived peptides using mass spectrometry. We detected 15 transcripts expressed from the Dclk1 locus (FPKM > 1), including 2 drug-regulated variants (fold change > 2). Drugs that act on serotonin receptors (5-HT2A/C) regulate a subset of Dclk1 isoforms in a brain-region-specific manner. The strongest influence was observed for the mianserin-induced expression of an isoform with intron retention. The drug-activated expression of novel alternative Dclk1 isoforms was validated using qPCR. The drug-regulated isoform contains genetic variants of DCLK1 that have been previously associated with schizophrenia and hyperactivity disorder in humans. We identified a short peptide that might originate from the novel DCLK1 protein product. Moreover, protein domains encoded by the regulated variant indicate their potential involvement in the negative regulation of the canonical DCLK1 protein.ConclusionsIn summary, we identified novel isoforms of the neuroplasticity-related gene Dclk1 that are expressed in the brain in response to psychotropic drug treatments.

Differential effects of psychotropic drugs on microbiome composition and gastrointestinal function.

Growing evidence supports a role for the microbiota in regulating gut-brain interactions and, thus, psychiatric disorders. Despite substantial scientific efforts to delineate the mechanism of action of psychotropic medications at a central nervous system (CNS) level, there remains a critical lack of understanding on how these drugs might affect the microbiota and gut physiology. We investigated the antimicrobial activity of psychotropics against two bacterial strain residents in the human gut, Lactobacillus rhamnosus and Escherichia coli. In addition, we examined the impact of chronic treatment with these drugs on microbiota and intestinal parameters in the rat. In vitro fluoxetine and escitalopram showed differential antimicrobial effects. Lithium, valproate and aripiprazole administration significantly increased microbial species richness and diversity, while the other treatments were not significantly different from controls. At the genus level, several species belonging to Clostridium, Peptoclostridium, Intestinibacter and Christenellaceae were increased following treatment with lithium, valproate and aripiprazole when compared to the control group. Animals treated with escitalopram, venlafaxine, fluoxetine and aripiprazole exhibited an increased permeability in the ileum. These data show that psychotropic medications differentially influence the composition of gut microbiota in vivo and that fluoxetine and escitalopram have specific antimicrobial activity in vitro. Interestingly, drugs that significantly altered gut microbial composition did not increase intestinal permeability, suggesting that the two factors are not causally linked. Overall, unravelling the impact of psychotropics on gastrointestinal and microbiota measures offers the potential to provide critical insight into the mechanism of action and side effects of these medications.

Cortical thickness and subcortical volumes alterations in euthymic bipolar I patients treated with different mood stabilizers.

Reported structural abnormalities of patients with bipolar disorder (BD) are inconsistent and the use of psychotropic medication is one of the sources of heterogeneity. A fairly small number of morphometric studies have involved comparison of BD on different mood stabilizers. Here in this study, we aimed to investigate the cortical thickness and subcortical volumes in euthymic BD patients on lithium and valproate and healthy controls (HC), and to elucidate the relationship between the use of medication and brain structure variations. We acquired structural magnetic resonance imaging data from 35 BD patients (19/valproate;16/lithium) and 30 HC subjects. Cortical thickness was compared in multiple locations across the continuous cortical surface, and subcortical volumes were compared on a structure-by-structure basis. Group analyses revealed widespread thinning of the prefrontal cortex in BD. Compared with BD on valproate, BD on lithium showed significant increased cortical thickness of the left rostral middle frontal cortex and right superior frontal cortex, while cortical thickness was not significantly different between BD on lithium and HC in the bilateral rostral middle frontal cortex. Moreover, no significant difference was observed in subcortical volume. Limitations of this study comprise the possible effect of other psychotropic drugs, small sample size and the cross-sectional design. Therefore, the results suggest medication-related neurobiological difference between BD patients on different mood stabilizers, but no casual role can be proposed. Our findings provided new evidence about the effects of psychotropic medication upon neuroanatomy in BD, and could help to explain the inconsistency of existing studies as well as contribute to the extraction of reliable neuroimaging biomarkers in BD.

Monitoring of somatic parameters at outpatient departments for mood and anxiety disorders.

IntroductionSomatic complications account for the majority of the 13–30 years shortened life expectancy in psychiatric patients compared to the general population. The study aim was to assess to which extent patients visiting outpatient departments for mood and anxiety disorders were monitored for relevant somatic comorbidities and (adverse) effects of psychotropic drugs–more specifically a) metabolic parameters, b) lithium safety and c) ECGs—during their treatment.MethodsWe performed a retrospective clinical records review and cross-sectional analysis to assess the extent of somatic monitoring at four outpatient departments for mood and anxiety disorders in The Netherlands. We consecutively recruited adult patients visiting a participating outpatient department between March and November 2014. The primary outcome was percentage of patients without monitoring measurements. Secondary outcomes were number of measurements per parameter per patient per year and time from start of treatment to first measurement.ResultsWe included 324 outpatients, of whom 60.2% were female. Most patients were treated for depressive disorders (39.8%), anxiety disorders (16.7%) or bipolar or related disorders (11.7%) and 198 patients (61.1%) used at least one psychotropic drug. For 186 patients (57.4%), no monitoring records were recorded (median treatment period 7.3 months, range 0–55.6). The median number of measurements per parameter per year since the start of outpatient treatment for patients with monitoring measurements was 0.31 (range 0.0–12.9). The median time to first monitoring measurement per parameter for patients with monitoring measurements was 3.8 months (range 0.0–50.7).DiscussionSomatic monitoring in outpatients with mood and anxiety disorders is not routine clinical practice. Monitoring practices need to be improved to prevent psychiatric outpatients from undetected somatic complications.

Evaluation method regarding the effect of psychotropic drugs on driving performance: A literature review.

Although automobile driving is necessary for many people, including patients with mental disorders, the influence of psychotropic drugs on driving performance remains unclear and requires scientific verification. Therefore, the objective of this study was to conduct a review of the literature in order to aid the development of a valid evaluation method regarding the influence of medication on driving performance. We conducted a literature search using two sets of terms on PubMed. One set was related to psychotropic drugs, and the other to driving tests. We excluded reviews and case studies and added literature found on other sites. A total of 121 relevant reports were found. The experiments were roughly divided into on-the-road tests (ORT) and driving simulators (DS). Although highway driving tests in ORT are most often used to evaluate driving performance, DS are becoming increasingly common because of their safety and low cost. The validity of evaluation methods for alcohol should be verified; however, we found that there were few validated tests, especially for DS. The scenarios and measurement indices of each DS were different, which makes it difficult to compare the results of DS studies directly. No evaluation indices, except for SD of lateral position, were sufficiently validated. Although highway ORT are the gold standard, DS were shown to have an increasing role in evaluating driving performance. The reliability of DS needs to be established, as does their validation with alcohol in order to accumulate more high-quality evidence.

Learning the effects of psychotropic drugs during pregnancy using real-world safety data: a paradigm shift toward modern pharmacovigilance

The growing evidence on psychotropic drug safety in pregnancy has been possible thanks to the increasing availability of real-world data, i.e. data not collected in conventional randomised controlled trials. Use of these data is a key to establish psychotropic drug effects on foetal, child, and maternal health. Despite the inherent limitations and pitfalls of observational data, these can still be informative after a critical appraisal of the collective body of evidence has been done. By valuing real-world safety data, and making these a larger part of the regulatory decision-making process, we move toward a modern pregnancy pharmacovigilance. The recent uptake of real-world safety data by health authorities has set the basis for an important paradigm shift, which is integrating such data into drug labelling. The recent safety assessment of sodium valproate in pregnant and childbearing women is probably one of the first examples of modern pregnancy pharmacovigilance.

Effect of psychotropic drugs on fetal behavior in the third trimester of pregnancy.

To assess the effect of psychotropic drugs on fetal behavior using four-dimensional (4D) ultrasound in the third trimester of pregnancy. Fetal behavior was assessed using Kurjak's antenatal neurodevelopmental test (KANET) using 4D ultrasound between 28 and 36 weeks of gestation. Thirty healthy (control group) and 10 psychotropic-drug-administered pregnant (case group) women were studied. The total value of the KANET score and values of each parameter (eight parameters) were compared between the two groups. The total KANET score was normal (except for one fetus in the case group: total score of 9) in both groups, and there was no significant difference in the total KANET score. When individual KANET parameters were compared, no significant differences were noted in any of the eight parameters. Our results showed that there is no difference in fetal behavior between fetuses of normal pregnant women and those of psychotropic-drug-administered pregnant women in the third trimester of pregnancy. These results suggest that psychotropic drugs may not affect fetal behavioral development in utero. However, the data and their interpretation in the present study should be taken with some degree of caution because of the small number of subjects studied. Further studies involving a larger sample size are needed to assess the effect of psychotropic drugs on fetal neurobehavior during pregnancy.

S201. RELATION BETWEEN PSYCHOTROPIC DRUGS AND SEIZURE THRESHOLD IN ELECTROCONVULSIVE THERAPY

BackgroundElectroconvulsive therapy (ECT) is the most popular way to stimulate brain for achieving therapeutic effects. The therapeutic effect of ECT results from the induction of a generalized seizure. The minimal amount of electrical energy needed to induce seizures is known as the seizure threshold (ST). It is commonly believed that treatment efficacy is related to stimulus dose relative to ST, but higher stimuli usually also increase unwanted side effects. Therefore, ST is an important issue in conducting ECT. Most patients including schizophrenics undergoing ECT take concomitant psychotropic drugs, but little information is available on how these drugs affect ST. Our study aimed to analyze the relationship between ST and psychotropic drugs in patients treated with ECT.MethodsWe retrospectively reviewed the medical charts of 43 patients who received ECT at Korea University Guro Hospital between February 2009 and June 2015. Patients with a history of seizure disorders or other medical emergent conditions were excluded. A total of fifty-eight subjects received ECT during the study period. Patients were excluded if treatment was aborted due to side effects or any other reasons before the 10th session (n=12) because we intended to investigate the ST shift during the course of consecutive ECT sessions. We included 43 subjects in the final data analysis. Patients’ psychiatric disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R) by at least two experienced psychiatrists. ECT was administrated with concurrent antipsychotics and antidepressants.67.4 percent of subjects were diagnosed as schizophrenia and 20.9 percent of subjects were diagnosed as major depressive disorder. We used stepwise multivariate correlation analyses for examining the associations between ST and psychotropic drugs. Data are presented as initial ST, the difference in ST between the first and 10th sessions (ΔST10th), and the mean difference in ST between the first and last sessions (mean ΔSTlast). We used chlorpromazine-equivalent dose for antipsychotics and fluoxetine-equivalent dose for antidepressants.ResultsOf the 43 patients included in the study, 20 were male, and the other 23 were female. The mean age of all participants was 41.44 years (SD=15.89). Patients were taking the following antipsychotics and antidepressants: clozapine (n=6), amisulpride (n=9), aripiprazole (n=5), olanzapine (n=18), risperidone (n=1), quetiapine (n=20), haloperidol (n=1), paliperidone (n=5), chlorpromazine (n=1), blonanserin (n=1), escitalopram (n=7), sertraline (n=1), mirtazapine (n=2), duloxetine (n=1), venlafaxine (n=3), amitriptyline (n=1), trazodone (n=1), bupropion (n=1). Participants took an average of 1.91 (SD=1.02, range 0–5) different psychotropic drugs during ECT. The mean number of types of antipsychotics and antidepressants used were 1.53 (SD=0.74, range 0–3) and 0.37 (SD=0.76, range 0–4), respectively. Multivariate regression analyses showed positive correlations between initial ST and the total chlorpromazine-equivalent dose of antipsychotics (β = 0.363, p < 0.05). The total fluoxetine-equivalent dose of antidepressants was positively correlated to ΔST10th (β = 0.486, p < 0.05) and mean ΔSTlast (β = 0.472, p < 0.01).DiscussionOur study elucidated possible effects of psychotropic drugs on ST in patients undergoing ECT. We revealed that larger doses of antipsychotics are associated with higher initial ST, whereas higher doses of antidepressants are associated with stronger shifts of ST during the course of treatment. We believe that our findings provide a basis for creating safer and more efficient ECT protocols.

Erectile dysfunction in patients taking psychotropic drugs and treated with phosphodiesterase-5 inhibitors.

The aim of this study was to assess the prevalence of patients with Erectile Dysfunction (ED) receiving psychotropic drugs, the impact of these drugs on hormonal profile, and the efficacy of PDE5-i in these patients. We recruited 1872 patients referring for ED to our Andrology Unit. Assessment included serum testosterone, gonadotropins, TSH, prolactin, and PSA, and the IIEF-5 questionnaire for ED diagnosis. Inclusion criteria were age 21-75 years and IIEF-5 total score ≤ 21; exclusion criteria included hypogonadism, diabetes mellitus, previous prostatectomy, other medication intake, and ED diagnosis prior to psychotropic drug treatment. Efficacy was rated with the IIEF-5 (remission: total score ≥ 22). The prevalence of ED patients treated with psychotropic drugs since ≥ 3 months was 9.5% (178/1872), subdivided according to the drugs used into: Group A, 16 patients treated with atypical antipsychotics (9.0%); Group B, 55 patients with benzodiazepines (30.9%); Group C, 33 patients with antidepressant drugs (18.5%); and Group D, 74 patients with multiple psychotropic drugs (41.6%). Patients in Group A were significantly younger than other groups (p < 0.05). The hormonal profile presented only higher prolactin level in patients treated with antipsychotics, alone or in combination (p < 0.05). Overall, 146 patients received PDE5-i. Remission rate, after three months of treatment, was significantly higher in Group B compared to C and D groups (p < 0.05). A substantial portion of patients receiving psychotropic drugs show ED. Sexual performance in these patients benefits from PDE5-i. Age, effects of psychiatric disorders, psychotropic drugs, and PDE5-i treatment modality accounted for variability of response in this sample.

P.1.014 - Investigating the effect of central nervous system drugs on leukocyte elastase activity in vitro

Participation of immune reactions in the pathogenesis of mental diseases is widely studied. A variety of molecules are involved in the development of inflammatory reactions, one of the analyzed biochemical markers of inflammation is the activity of leukocyte elastase (LE), an enzyme secreted by neutrophils. Due to proteolytic activity towards elastin and collagen, LE is able to disrupt the integrity of the vessels and increase permeability of the blood-brain barrier in case of various brain diseases [1]. The effect of drugs used to treat mental illness (or lack thereof) on the inflammatory component of the pathogenesis of mental diseases seems to be poorly understood. Aim This study was а comparative assessment of the effect of psychotropic (chlorpromazine, imipramine) and nootropic (cerebrolysin, ceretone) drugs on LE activity in an in vitro experiment. Material and Methods LE activity was measured in a pool of blood plasma of healthy people with solutions of drugs: chlorpromazine; imipramine; choline alphoscerate; cerebrolysin in different concentrations, including therapeutic ones. Enzymatic activity of LE was determined by spectrophotometric method. Statistical comparison of multiple groups was carried out using ANOVA and Newman-Keuls test, values of p Results А dose-dependent inhibitory effect of chlorpromazine was revealed. In the range of concentrations from 1.25 μg/ml to 40 μg/ml, including therapeutic one of 5-10 μg/ml, LE activity was significantly lower compared to control (p Different concentrations (0.00375 mg/ml - 3.75 mg/ml) of choline alfoscerate had no influence on LE activity (p = 0.33). Cerebrolysin at concentrations from 0.043 mg/ml to 2.15 mg/ml also had no influence on LE activity, however, at concentration 4.3 mg/ml, which corresponds to a double maximum dose, cerebrolysin had a potentiating effect on LE, whose activity significantly increased by 17.5% compared to control (p Conclusion Thus, it has been shown that psychotropic drugs such as chlorpromazine and imipramine have an inhibitory effect on LE activity in an in vitro experiment, while nootropic cerebrolysin can activate LE. The obtained data indicate that these drugs, used in the treatment of mental illness, can influence inflammatory response, which is important in the pathogenesis of mental disorders.

Board Certified Behavior Analysts and Psychotropic Medications: Slipshod Training, Inconsistent Involvement, and Reason for Hope.

People with autism spectrum disorder often receive psychotropic medications and two drugs, risperidone and aripiprazole, are approved for treating "irritability" in this population. A number of authors have suggested that behavior analysts can contribute to the prudent use of such drugs, but little is known regarding Board Certified Behavior Analysts' involvement in practices relevant to the use of psychotropic drugs. We e-mailed Board Certified Behavior Analysts an anonymous web-based survey regarding such practices. A majority of respondents work with individuals with autism spectrum disorder who take at least one psychotropic medication but respondents' training relevant to psychotropic medications is inconsistent. Many report that their training is inadequate, they do not regularly work as part of interdisciplinary teams concerned with medication, and behavior-analytic interventions are not typically evaluated before drugs are prescribed. Nonetheless, the majority of respondents reported that medications sometimes produce beneficial effects. Those involved in training behavior analysts should consider the competencies needed for graduates to work effectively as members of teams concerned with the optimal use of medications and how to foster and assess those competencies. Behavior analysts should also work to develop and implement strategies that foster collaboration with psychiatrists and other physicians. • Psychotropic drugs are often prescribed for people with autism, and both risperidone and aripiprazole are approved for reducing "irritability," which comprises self-injury, aggression, tantrums, and other challenging responses. • Respondents are not consistently involved in monitoring the effects of psychotropic drugs, which are often administered prior to evaluating an alternative, less restrictive, intervention. • Respondents are not trained consistently with respect to matters relevant to psychotropic drugs, and many apparently are not trained adequately. • People involved in training behavior analysts should consider the competencies needed for graduates to work effectively as members of teams concerned with the optimal use of medications and how to foster and assess those competencies. • Behavior analysts should also work to develop and implement strategies that foster collaboration with psychiatrists and other physicians.

Pediatric NMDAR encephalitis: A single center observation study with a closer look at movement disorders.

Anti-N-Methyl-d-aspartate-receptor (NMDAR) encephalitis is the most frequent autoimmune encephalitis in pediatric age. This retrospective observational study was aimed at describing the clinical characteristics of the disease in a cohort of children and teenagers. Eighteen patients (10 females and 8 males), with a median age of 12.4years at symptom onset were enrolled. The clinical presentation of the disease was marked by neurological manifestations in 13 patients and by severe psychiatric and behavioral symptoms in 5. The symptoms at onset varied according to the age: all the children presented with prominent neurological symptoms, whereas psychiatric symptoms were prominent in teenagers. Regardless the age, movement disorders (MDs) were distinctive symptoms during the acute stage of the disease. Several MDs might coexist in a given patient, and persist during sleep. The complexity, and the oddness of MDs often challenged their definition and the differential diagnosis with psychiatric manifestations and epileptic seizures. Stereotyped motor phenomena were the most typical MDs, and were recorded in all patients. Among them, perseveration, reproduction of acquired complex motor activities, and orofacial dyskinesia were the most distinctive features. In children, hyperkinetic MDs dominate; in teenagers, by contrast, a constellation of symptoms consistent with catatonia was the most frequent syndrome observed. The management of the several symptoms requires their accurate recognition, definition and assessment, and the knowledge of the potential side effects of antiepileptic and psychotropic drugs which could either mimic or worsen symptoms of encephalitis.

Oral Health Is a Challenging Problem for Patients with Schizophrenia: A Narrative Review

Context: Poor oral health is part of co-morbidities and exposes patients suffering from schizophrenia to excess mortality. The purpose of this review is to make an up-to-date assessment on the oral health of these patients and make suggestions for improvement. Evidence Acquisition: Based on a bibliographic search of Pub Med, we identified, using keywords, all the clinical studies up to 2015 conducted on the oral health of patients with schizophrenia. Results: From 81 articles chosen, we retained 23 clinical studies that met our inclusion criteria. These studies find higher dentaland periodontal indexes in patients with schizophrenia than in the general population. Access to healthcare is a problem for thesepatients. The level of research is insufficiently considered compared to other chronic pathologies. Many factors contribute to poor oral health in these patients such as their mental illness, side effects of psychotropic drugs, and any psychosocial factors they might encounter. Conclusions: For these fragile patients with specific needs, simple measures can be implemented to improve their oral health. Better taken into account, the oral health of these patients should contribute to the overall improvement of quality of life and to the general health of these subjects.

Let The Drugs Lead The Way! On the Unfolding of a Research Program in Psychiatry

After reports in the late 1950s of a correlation between the effects of psychotropic drugs on mono-amine metabolism and on affective states, it became generally accepted that brain monoaminergic systems contributed to the pathophysiology of depression. After this, psychiatric researchers continued to pursue the neurochemical effects of antidepressants, hoping to gain novel insights into the biology of depression, what researchers themselves have referred to as the "pharmacological bridge." In this way, researchers repeatedly adapted their field's theoretical framework to fit conflicting evidence without challenging underlying and highly questionable assumptions concerning the specificity of psychotropic drug treatments. The result is a series of depression theories in which neuroplasticity theories are the most recent addition. The author uses Imre Lakatos's concept of "research program" to investigate this chronological sequence of theories. It is proposed that for over thirty years the pharmacological bridge provided direction to a psychiatric research program; more recently, however, the pharmacological bridge has come under siege as new laboratory technologies, such as neuroimaging, have increasingly replaced drugs as standard tools to investigate neuropathophysiology. Thus, this work illustrates how the epistemological and technological aspects of research intertwine in the history of psychiatry in general and the field of depression in particular.

Modern aspects of antiepileptic therapy during pregnancy

This review of literature is devoted to contemporary issues of antiepileptic therapy in pregnancy, with identifying the most effective drug according to publications from 2006 to 2016 (PUBMED, MEDline, The Cochrane Lb.). The review presents the current published data on the incidence of seizures in pregnant women, specificity of therapy with antiepileptic drugs (AEDs), frequency of fetal malformations in pregnant women taking AEDs regularly and their dependence on the frequency, dosage and nature of therapy. The authors studied and analyzed the literature on antiepileptic therapy with AED for the last ten years and selected AED with the least teratogenic effect and less side-effects. Lamotrigine, phenytoin, carbamazepine, valproic acid, phenobarbital were studied. In addition to classic AEDs, new AEDs (vigabatrin, gabapentin, topiramate, tiagabine, oxcarbazepine, levetiracetam, pregabalin) were investigated. Over the past decade, the use of new-generation AEDs has increased. It has been found that the risk of birth defects in children is associated with high doses of drugs and polytherapy compared to monotherapy. New data of recent studies showed the effect of psychotropic drugs on the fetus allowing to assess the 'risk/benefit' ratio and develop recommendations on rational pharmacotherapy of epilepsy in pregnancy.

Operant self-administration of pregabalin in a mouse model of neuropathic pain.

Pregabalin is a first-line agent for neuropathic pain treatment whose abuse liability remains controversial. Surprisingly, studies exploring the reinforcing properties of pregabalin in operant mouse models are missing. We evaluated the acquisition of operant pregabalin self-administration in mice exposed to a partial sciatic nerve ligation (PSNL) or a sham operation. After surgery, mice were trained in operant boxes to intravenously self-administer pregabalin at 1.5 or 3mg/kg/inf or saline during 10days. Thermal and mechanical sensitivity were assessed before and after self-medication, and depressive-like behaviour was evaluated after discontinuation of the treatment. Partial sciatic nerve ligation and sham-operated mice exposed to pregabalin at 3mg/kg/inf showed higher active responding compared to mice exposed to saline. The differences in active responding were more robust in nerve-injured than in sham-operated mice. Self-medication at either dose of pregabalin partially inhibited thermal hypersensitivity, whereas only self-medication at 3mg/kg/inf reduced mechanical sensitivity. Finally, a depressive-like behaviour was revealed after saline treatment in nerve-injured mice, and this emotional manifestation was abolished after pregabalin treatment at the high dose. Pregabalin showed reinforcing effects both in PSNL and sham-operated mice and attenuated the nociceptive and emotional manifestations of neuropathic pain in mice self-administering this drug. Therefore, pregabalin self-administration was related to neuropathic pain relief, but also to reinforcing properties related to psychotropic drug effects. This study reveals the improvement in nociceptive and emotional manifestations of neuropathic pain after operant pregabalin self-medication in mice and suggests the reinforcing effects of this drug in an operant paradigm. This study shows that mice with a nerve injury self-administer pregabalin at doses effective reducing nociceptive hypersensitivity and depressive-like behaviour associated with the neuropathic pain model. Interestingly, mice without neuropathy also develop operant self-administration behaviour, suggesting potential abuse liability of this first-line drug for neuropathic pain treatment.

МОЖЕТ ЛИ МЕЛАТОНИН ЭФФЕКТИВНО ИСПОЛЬЗОВАТЬСЯ ДЛЯ КОРРЕКЦИИ ПОБОЧНЫХ ЭФФЕКТОВ РАЗЛИЧНЫХ ПСИХОТРОПНЫХ ЛЕКАРСТВ И ЭЛЕКТРОСУДОРОЖНОЙ ТЕРАПИИ?

Цель исследования. Изучить и обобщить имеющуюся доказательную базу для применения мелатонина в качестве корректора побочных эффектов психотропных лекарств и электросудорожной терапии, и представить читателю соответствующие выводы.Методология проведения работы. Авторами был проведён поиск литературы о применении мелатонина в качестве корректора побочных эффектов психотропных лекарств и электросудорожной терапии в PubMed и Google Scholar. Найденные в результате этого поиска литературные данные представлены в настоящей статье.Результаты. Полученные нами в результате данного обзора литературы данные свидетельствуют о том, что мелатонин может быть эффективно использован как в монотерапии, так и в комбинации с другими корректорами с целью уменьшения ряда побочных эффектов психотропных лекарств и электросудорожной терапии, и заслуживает дальнейшего изучения в этом качестве. Доказательная база по его применению различна для различных побочных эффектов. Наибольшая доказательная база имеется об эффективности применения мелатонина в предотвращении и лечении диссомнических нарушений, нарушений памяти и когнитивных функций, акатизии, поздних дискинезий, а также метаболического синдрома.Область применения результатов. Полученные нами результаты могут применяться в психиатрии, неврологии и наркологии, а также во всех тех областях общесоматической медицины, в которых находят своё применение психотропные препараты.

Oral health impacts of medications used to treat mental illness

BackgroundMany psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. MethodsThe Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. ResultsFifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. ConclusionsWhile xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives.

Alopecia associated with agomelatine use: a case report

ABSTRACTDrug-induced alopecia, characterized by non-scarring hair loss of scalp and body, is a rare side effect of psychotropic drugs. It has previously been reported with the different antidepressant medications, but has not been described with agomelatine. Agomelatine is an antidepressant with a novel mechanism of action and fewer side effects. Here, we report a 31-year-old male patient with diffuse hair loss induced by agomelatine use and improved by discontinuation the drug. Because antidepressant-induced hair loss is relatively rare, many clinicians may not pay attention for this side effect. As far as we know, this is the first published case report of alopecia associated with agomelatine.