Psychotropic Research Articles

Ecotoxicological risk assessment of the novel psychoactive substance Esketamine: Emphasis on fish skeletal, behavioral, and vascular development

Novel psychoactive substances (NPS), such as Esketamine (Esket), often contaminate the aquatic ecosystems following human consumption, raising concerns about the residues and potential ecological hazards to non-target organisms. The study used zebrafish as a model organism to investigate the developmental toxicity and ecotoxicological effects of acute Esket exposure. Our findings demonstrate that exposure to Esket significantly affected the early development and angiogenesis of zebrafish embryos/larvae. The mandible length was significantly decreased, and the angles between the pharyngeal arch cartilages were narrowed compared to the control group (all P < 0.05). Additionally, Esket resulted in a decrease of 47.6–89.8 % in the number of neural crest cells (NCC). Transcriptome analysis indicated altered expression of genes associated with cartilage and osteoblast growth. Moreover, Esket significantly inhibited swimming ability in zebrafish larvae and was accompanied by behavioral abnormalities and molecular alterations in the brain. Potential mechanisms underlying Esket-induced behavioral disorders involve neurotransmitter system impairment, abnormal cartilage development and function, aberrant vascular development, as well as perturbations in oxidative stress and apoptosis signaling pathways. Notably, the dysregulation of skeleton development through the bone morphogenetic protein (BMP) signaling pathway is identified as the primary mechanistic behind Esket-induced behavioral disorder. This study enhances our understanding of Esket's ecotoxicology profile and provides a comprehensive assessment of the environmental risks associated with NPS.

Pharmacovigilance of drug-drug interactions: A pharmacokinetic study on the combined oral administration of lurasidone and clozapine in rats by using LC-MS/MS

In recent years, the expanding array of psychotropic medications has led to an increase in drug-drug interactions, particularly with combinations of different antipsychotics or psychotropic medications in clinical practice. However, the potential pharmacokinetic interactions between Lurasidone and Clozapine have not been extensively studied. Thus, this study aims to investigate these potential interactions by analyzing their pharmacokinetics in rat plasma after single oral administrations using developed LC-MS/MS methods. The study revealed notable changes in Lurasidone's pharmacokinetic parameters between single and combination administrations. Specifically, there were significant reductions in t1/2 and Vd by 3.3 and 1.5-fold (p < 0.05) respectively, while Cmax and AUC0-t proved a significant increase by 1.8 and 1.6-fold (p < 0.05) respectively following the combination administration. Furthermore, separate co-administration markedly decreased Clozapine's Cmax and AUC 0-t by 1.6 and 1.3-fold (p < 0.05) respectively, after the combination administration. Moreover, the AUC ratio for Lurasidone was 0.2, indicating a diminished therapeutic effect, whereas the AUC ratio for Clozapine suggested an elevated risk of adverse effects. These findings confirm the presence of drug-drug interactions between Lurasidone and Clozapine, suggesting potential implications for treatment efficacy. Recommendations for future clinical research include conducting pharmacodynamic studies to evaluate the impact of Lurasidone and Clozapine combination therapy. This underscores the importance of thoroughly assessing these interactions for clinical relevance and provides a scientific foundation for future evaluations of this drug combination.

Between faces: childhood adversity is associated with reduced threat-safety discrimination during facial expression processing in adolescence

BackgroundChildhood adversity has been associated with alterations in threat-related information processing, including heightened perceptual sensitivity and attention bias towards threatening facial expressions, as well as hostile attributions of neutral faces, although there is a large degree of variability and inconsistency in reported findings.MethodsHere, we aimed to implicitly measure neural facial expression processing in 120 adolescents between 12 and 16 years old with and without exposure to childhood adversity. Participants were excluded if they had any major medical or neurological disorder or intellectual disability, were pregnant, used psychotropic medication or reported acute suicidality or an ongoing abusive situation. We combined fast periodic visual stimulation with electroencephalography in two separate paradigms to assess the neural sensitivity and responsivity towards neutral and expressive, i.e. happy and angry, faces. Linear mixed effects models were used to assess the impact of childhood adversity on facial expression processing.ResultsSixty-six girls, 53 boys and one adolescent who identified as ‘other’, between 12 and 16 years old (M = 13.93), participated in the current study. Of those, 64 participants were exposed to childhood adversity. In contrast to our hypotheses, adolescents exposed to adversity show lower expression-discrimination responses for angry faces presented in between neutral faces and higher expression-discrimination responses for happy faces presented in between neutral faces than unexposed controls. Moreover, adolescents exposed to adversity, but not unexposed controls, showed lower neural responsivity to both angry and neutral faces that were simultaneously presented.ConclusionsWe therefore conclude that childhood adversity is associated with a hostile attribution of neutral faces, thereby reducing the dissimilarity between neutral and angry faces. This reduced threat-safety discrimination may increase risk for psychopathology in individuals exposed to childhood adversity.

Machiavellianism as a crucial Dark Tetrad trait for the prediction of life-course criminal behavior

The Dark Tetrad (Machiavellianism, psychopathy, narcissism, and sadism) is a taxonomy of personality dispositions toward immoral, antisocial, and antagonistic behavior; still, its predictive power in the domain of criminal behavior is rarely tested. In the present research, we analyzed the associations between the Dark Tetrad and several indicators of criminal behavior (onset of criminal behavior, juvenile correctional measures, problematic use of psychoactive substances [PUPS], penal recidivism, number of convictions, violent offences, and the risk of future recidivism) in a sample of Serbian prisoners (N = 471). While all dark traits were positively associated with criminal behavior indicators on a zero-order level (except violent offences), regression analyses identified Machiavellianism as the most prominent predictor. Psychopathy positively predicted PUPS, while narcissism had a negative contribution to PUPS and penal recidivism. Interactions with the participants’ sex showed that sadism represents a risk factor for females regarding early offences and PUPS, while Machiavellianism elevates the chance of repeated prison sentences for men. Finally, the structural model showed that juvenile offending mediates the association between Machiavellianism and general criminal recidivism. Findings showed the fruitfulness of assessing the Dark Tetrad traits in order to predict various aspects of criminal behavior.

Association Between Neighborhood Context and Psychotropic Polypharmacy Use Among High-Need Children.

The authors explored whether neighborhood context is associated with psychotropic polypharmacy and psychotherapy among a cohort of children with high needs for psychiatric and general medical care. Electronic health record data from a large health care system were used in a cross-sectional design to examine psychotropic polypharmacy and psychotherapy in 2015-2019 among children ages 2-17 years (N=4,017) with geocoded addresses. Inclusion criteria were a diagnosis of a mental health condition, an intellectual and developmental disability, or a complex medical condition and one or more clinical encounters annually over the study period. Polypharmacy was defined as two or more psychotropic drug class prescriptions concurrently for ≥60 days. Psychotherapy was defined as receipt of any psychotherapy or adaptive behavior treatment. Neighborhood context (health, environment, education, and wealth) was measured with the Child Opportunity Index. Multilevel generalized linear mixed models with random intercept for census tracts were used to assess the associations between individual and neighborhood characteristics and psychotropic polypharmacy and psychotherapy. Moderate (vs. low) child opportunity was associated with higher odds of polypharmacy (adjusted OR [AOR]=1.79, 95% CI=1.19-2.67). High (vs. low) child opportunity was associated with higher odds of psychotherapy (AOR=2.15, 95% CI=1.43-3.21). Black (vs. White) race (AOR=0.51, 95% CI=0.37-0.71) and Hispanic ethnicity (AOR=0.44, 95% CI=0.26-0.73) were associated with lower odds of polypharmacy. Among high-need children, neighborhood Child Opportunity Index, race, and ethnicity were significantly associated with treatment outcomes in analyses adjusted for clinical factors. The findings underscore concerns about structural disparities and systemic racism and raise questions about access.

Long-read sequencing of CYP2D6 may improve psychotropic prescribing and treatment outcomes: A systematic review and meta-analysis.

The enzyme expression (i.e. phenotype) of the Cytochrome P450 2D6 (CYP2D6) gene is highly relevant to the metabolism of psychotropic medications, and therefore to precision medicine (i.e. personalised prescribing). This review aims to assess the improvement in CYP2D6 phenotyping sensitivity (IPS) and accuracy (IPA) offered by long-read sequencing (LRS), a new genetic testing technology. Human DNA samples that underwent LRS genotyping of CYP2D6 in published, peer-reviewed clinical research were eligible for inclusion. A systematic literature search was conducted until 30 September 2023. CYP2D6 genotypes were translated into phenotypes using the international consensus method. IPS was the percentage of non-normal LRS CYP2D6 phenotypes undetectable with FDA-approved testing (AmpliChip). IPA was the percentage of LRS CYP2D6 phenotypes mischaracterised by non-LRS genetic tests (for samples with LRS and non-LRS data). Six studies and 1411 samples were included. In a meta-analysis of four studies, IPS was 10% overall (95% CI = (2, 18); n = 1385), 20% amongst Oceanians (95% CI = (17, 23); n = 582) and 2% amongst Europeans (95% CI = (1, 4); n = 803). IPA was 4% in a large European cohort (95% CI = (2, 7); n = 567). When LRS was used selectively (e.g. for novel or complex CYP2D6 genotypes), very high figures were observed for IPS (e.g. 88%; 95% CI = (72, 100); n = 17; country = Japan) and IPA (e.g. 76%; 95% CI = (55, 98); n = 17; country = Japan). LRS improves CYP2D6 phenotyping compared to established genetic tests, particularly amongst Oceanian and Japanese individuals, and those with novel or complex genotypes. LRS may therefore assist in optimising personalised prescribing of psychotropic medications. Further research is needed to determine associated clinical benefits, such as increased medication safety and efficacy.

Concurrent Opioid and Psychotropic Drug Use During Pregnancy: Descriptive Study from Two Canadian Provinces

ObjectivesThis study aims to describe the patterns of concurrent opioid and psychotropic drug use (CU) during pregnancy and the characteristics of the mothers dispensed these drugs. MethodsPregnancies between 2000-2020 were identified using administrative data from Manitoba and British Columbia, Canada. Prenatal opioid and psychotropic drug dispensations were assessed, and exposure groups created based on the number of dispensations within each drug category. Descriptive statistics are reported. ResultsApproximately 1.4% of 1,040,021 pregnancies involved CU. Odds of CU were greater for 2+ opioid pregnancies compared to pregnancies with only 1 opioid (OR=4.05). Among CU pregnancies, it was more likely for 2+ types of psychotropics to be dispensed for those involving 2+ opioids compared to 1 (OR=2.23). Percent of CU pregnancies did not change over time, while opioid pregnancies decreased, and psychotropic pregnancies increased. Average morphine equivalent dose of opioids/pregnancy was higher in CU than opioid only pregnancies. Compared to mothers without exposure, CU exposed mothers were of similar age, more likely to live rurally, in lower income areas, and have lower care continuity. ConclusionCU pregnancies remained stable over time. It was more likely for mothers dispensed 2+ opioids to be CU than mothers dispensed only 1 opioid, and more likely for CU mothers dispensed 2+ opioids to be dispensed 2+ psychotropic types. Overall strength of opioids was higher for CU mothers compared to opioid only exposed mothers. ImplicationsStudies measuring the impact of CU on maternal and child outcomes should be conducted to inform safe prescribing practices.

Does change in area-level deprivation, change health outcomes? A latent class growth analysis of population data.

BackgroundWhile the link between deprivation and health is established, little is known about the association of persistent deprivation or deprivation trajectories over time with adverse health outcomes. AimTo examine latent class trajectories of area level-deprivation from 2010-2016 and their association with social distress indicators from 2017-2021. MethodAnalysis was based on linked administrative data (N=1,569,110) from NI GP Registrations Index, emergency department records (2017-21), enhanced prescribing data (2017-21) and biennial area-level deprivation (2010-2016). Latent class growth analysis (LCGA) identified deprivation trajectories between 2010 and 2016; and regression-based models, adjusted for age, sex and urbanicity, examined their association with indicators of individual level distress: occurrence of death, any accident and emergency (A&amp;E) visit, and any psychotropic medication between 2017 and 2021. ResultsBased on comparison of models and fit statistics, a non-linear LGCA model identified six trajectories: consistently deprived (21.2%); slight improvement (7.1%); substantial improvement (1.2%); consistently average deprivation (31.7%); slight worsening (18.5%); and consistently non-deprived (20.4%). Consistently living in a deprived area was associated with higher likelihood of death, A&amp;E visits and receipt of hypnotics, anxiolytics, and anti-depressants. Compared to consistent deprivation, slight improvement was associated with lower likelihood of death (OR=0.94, CI: 0.91-0.97) and all psychotropic medication in the follow-up period. ImplicationsFindings indicate that even a slight improvement in deprivation status can have a positive influence on health outcomes. Further population-wide analysis of deprivation trajectories, their determinants and associated health impact will inform targeted interventions that promote social mobility and improved health.

Development and method validation of a sampling technique for a reproducible detection of synthetic cannabinoids in exhaled breath using an in vitro pig lung model.

Alternative matrices, especially exhaled breath (EB), have gained increasing attention for a few years. To interpret toxicological findings, knowledge on the toxicokinetic (TK) properties of a substance in EB is indispensable. Whilst such data are already accessible for various drugs (e.g. Δ9-tetrahydrocannabinol), they are still not available for new psychoactive substances, particularly synthetic cannabinoids (SCs). As SCs raise a high public health concern, the aim of this study was to assess these data in future TK studies in pigs. For this purpose, an in vitro sampling technique of EB was initially developed, being prospectively applied to anesthetized and ventilated pigs for the detection of SCs in a controlled and reproducible manner as exemplified by cumyl-5F-P7AICA. Furthermore, a method for the qualitative and quantitative detection of cumyl-5F-P7AICA in EB using glass fiber filters (GFF) was established und fully validated. Therefore, cumyl-5F-P7AICA (0.5 mg/mL in ethanol abs.) was initially nebulized using a ventilation machine and a breathing tube, as they are also used in surgeries. The aerosol was delivered into a simulated pig lung. To collect EB, a pump was connected to that part of the breathing tube, that contains EB (expiratory limb), and sampling was performed repeatedly (n=6) for 15 min (2 L EB/min) each using GFF. For extraction of the substance, the GFF were macerated with acetone and the remaining experimental components were rinsed with ethanol. After sample preparation, the extracts were analyzed by LC-MS/MS. In the complete experimental setup, about 40% of the initially nebulized cumyl-5F-P7AICA dose was found with 3.6 ± 1.3% being detected in the GFF. Regarding the comparably high loss of substance, the open ventilation system and a conceivable adsorption of the SC in the ventilator have to be considered. However, the herein introduced approach is promising to determine the TK properties of cumyl-5F-P7AICA in EB.

Mental health conditions of Colombian adolescent population: An approach to risk.

To determine the mental health conditions of adolescents in the city of Manizales, Colombia, and explore risk regarding gender-based differences. Quantitative, nonexperimental, descriptive research with associative scope. A total of 316 adolescents were assessed using five scales to evaluate mental health conditions: the Perceived Stress Scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale, Penn Alcohol Craving Scale and The Substance Dependence Severity Scale. Univariate and bivariate analysis was performed, Chi square and Odds Ratio were tested. The findings indicated that being female is a risk factor for high levels of perceived stress, depressive episodes and anxiety. Additionally, adolescents who are not attending school are at higher risk for dependence and abuse of psychoactive substances. Conversely, being female acts as a protective factor against dependence on psychoactive substances. The findings suggest a higher tendency among the participants towards experiencing depressive episodes. Regarding perceived stress, 71.5% of the participants fell into the low category, while 70.6% experienced a current episode of generalized anxiety.

Mental disorders in adults from Ribeirão Preto, Brazil: a cross-sectional analysis of two birth cohorts

BackgroundIn Brazil, the prevalence of mental disorders is heterogeneous, with most studies conducted in large cities with high population density. This study aimed to assess the prevalence of mental disorders and psychiatric comorbidities among young adults (22–23 years old) and adults (37–38 years old) from Ribeirão Preto, a city located in the Northeast of the São Paulo state, with approximately 700,000 inhabitants, and to explore associations with sociodemographic variables, suicide risk, and health service usage. Second, we aimed to evaluate the performance of the Self-Report Questionnaire (SRQ-20) as a screening tool for mental disorders to be applied to the local population.MethodsParticipants from the 1978/1979 and 1994 Ribeirão Preto birth cohorts were evaluated using the Mini International Neuropsychiatric Interview (MINI) and the SRQ-20 at mean ages of 22–23, and 37–38 years, respectively.ResultsOur sample comprised 1,769 individuals from the 1978/1979 cohort and 1,037 from the 1994 cohort. The prevalence of mental disorders ranged from 28.6% (1978/79) to 31% (1994), with frequent comorbid diagnoses (42.7% and 43.3%, respectively). Men and women had a similar prevalence of mental disorders in the younger cohort, while women had a higher prevalence in the older cohort. Low educational attainment was associated with higher rates of diagnosis. In both cohorts, alcohol and other psychoactive substance use was higher among those with a psychiatric diagnosis. Although those with a psychiatric diagnosis were less satisfied with their own health, only one-fifth had seen a mental health professional in the previous year. A psychiatric diagnosis increased the suicide risk by 5.6 to 9.1 times. Regarding the SRQ-20, the best cutoff points were 5/6 for men and 7/8 for women, with satisfactory performance.ConclusionsThe prevalence and comorbidity of mental disorders were high in both cohorts and comparable to those in larger Brazilian cities. However, few individuals with a diagnosis had sought specialized care. These data suggest that the mental health gap is still significant in Brazil.

Exploiting the triple quadrupole mass analyzer for the open detection and tentative identification of synthetic cannabinoid receptor agonists based on common fragmentation pathways

BackgroundThe use of new psychoactive substances (NPS) has emerged as a significant public health concern globally, due to their unknown and unpredictable effects on both physical and mental health. Among them, synthetic cannabinoids receptor agonists (SCRAs) currently stand as the most widely consumed NPS family in Europe. Since the detection of JWH-018 in 2008, the structures of these compounds have evolved to circumvent legislation and/or enhance their effects, consequently increasing the number of reported SCRAs to be monitored. Therefore, new strategies are needed to identify these compounds, whether in seized products or in biological samples. ResultsThis study presents the development of an open method for detecting SCRAs employing a “pseudo-target” screening approach, a strategy previously developed and used in our laboratory for synthetic cathinones identification. The methodology involves monitoring the main product ions and neutral losses derived from 179 SCRAs of the third and fourth generations, based on their fragmentation pathways. This approach allows for the tentative identification of the SCRAs, supported also by the created database. The versatility of the developed methodology is highlighted, extending its utility beyond seizure products or ‘legal highs’, to biological samples. In this sense, it has been successfully applied not only to the detection of SCRAs in research chemicals but also in authentic urine from an anonymous SCRAs consumer, through the identification of a metabolite. SignificanceThis strategy will be particularly useful for the rapid detection of SCRAs in forensic and toxicological laboratories equipped with low-resolution MS/MS instrumentation. This is a valuable tool for the identification and monitoring of SCRAs across various contexts, significantly contributing to public health and forensic security efforts. It is especially beneficial for healthcare providers, enabling them to make informed treatment decisions.

Development and internal validation of a predictive model for prolonged intensive care unit stays in patients with psychotropic drug poisoning

BackgroundSome patients with psychotropic drug poisoning need intensive care unit (ICU) admission, but risk prediction models for prolonged ICU stays are lacking. ObjectivesDevelop and evaluate a prediction model for prolonged ICU stays in patients with psychotropic drug poisoning. MethodsThe clinical data of patients with psychotropic drug poisoning were collected from the Medical Information Mart for Intensive Care (MIMIC)-Ⅳ 2.2 database. Patients were grouped by their ICU length of stay: non-prolonged (<2 days) and prolonged (≥2 days).Variable selection methods included LASSO and logistic regression. The selected variables were used to construct the model, which was subsequently evaluated for discrimination, calibration, and clinical utility. ResultsThe cohort included 413 patients with psychotropic drug poisoning, 49.4 % male, with a median age of 41 years. The variables stepwise selected for model construction through LASSO and logistic regression include sepsis, SAPS Ⅱ, heart rate, respiratory rate, and mechanical ventilation. The model showed good discrimination with an area under the receiver operating characteristic curve (AUC) of 0.785 (95 % CI: 0.736–0.833) and was validated well with bootstrap internal validation (AUC: 0.792, 95 % CI: 0.745–0.839). Calibration curves indicated good fit (χ2 = 4.148, P = 0.844), aligning observed and predicted rates of prolonged ICU stays. Decision curve analysis (DCA) showed positive net benefits across a threshold probability range of 0.07–0.85. ConclusionsThe model developed in this study may help predict the risk of prolonged ICU stays for patients with psychotropic drug poisoning.

Psychotropic medication profiles and future treatment risk among Northern Irish adults: a Latent Transition Analysis

ObjectiveTo identify within the Northern Irish adult population distinct psychotropic prescription profiles at initiation/discontinuation of a ‘treatment episode’ and associated risk of future psychotropic treatment. ApproachData linkage analysis of psychotropic prescriptions and household information. The ‘treatment episode’ was defined as the first identified period (&gt;6 months) of psychotropic prescriptions preceded and followed by ≥ 12 months without psychotropics. Latent Transition Analysis was used to identify classes of psychotropic usage at initiation/discontinuation of treatment, with Cox regression used to estimate the likelihood of recommencing psychotropics. ResultsWe identified 157,836 patients, median age forty-five years (IQR 32,62) , 58.7% female, median exposure 1.5 years (IQR 1,2.5). Five latent classes of patients were identified in relation to received prescriptions: hypnotics, anxiolytics, antipsychotics, antidepressants and multiple psychotropics. The percentage of patients in the antidepressant class increased between initiation and discontinuation (from 64.2% to 67.1%) while that in the multiple psychotropics class fell (from 7.2% to 5.4%). 43% of patients who started treatment with multiple psychotropics had switched to antidepressants at discontinuation. These patients were significantly less likely to restart treatment than those who continued to receive multiple psychotropics (Hazard Ratio 0.83, 95%CI 0.76, 0.89) after adjusting for age at discontinuation, year of entry, deprivation, sex and duration of previous treatment. ConclusionsContinued receipt of multiple psychotropics is associated with an increased risk of future/ongoing treatment. This may reflect diagnostic uncertainly, complex disorder and discontinuation-associated side-effects. ImplicationsResearchers and practitioners alike should consider the diagnostic, health and treatment implications of these findings.

Classics in Chemical Neuroscience: Muscimol.

Muscimol (3) is a psychoactive isoxazole present in various Amanita mushrooms, along with ibotenic acid and muscarine. It is structurally related to GABA and acts as a GABAA agonist with great affinity. Muscimol use dates back to Siberian shamanic cultures as an entheogen, where it was ingested orally to exert psychoactive effects. Although not approved for clinical use, its potential and use as a research tool in neuroscience is of immense value, with 3H-muscimol being used as a radioligand in GABA receptor research. Since its discovery in the early 60s, many research groups have worked on the synthesis of the compound. Recent research suggests the potential use of muscimol in neuropathic pain relief and other potential uses are also being studied. In this review, we will cover the history, chemistry, pharmacology and overall importance of the compound.

Influence of Road Infrastructure Design over the Traffic Accidents: A Simulated Case Study

The influence of road infrastructure over the severity of road accidents, in particular some specific features of it, represents the subject of this study. Generally, when an accident occurs, its causes are represented by a number of factors such as driver experience, fatigue, driving under the influence of alcohol and other psychoactive substances, road configuration, weather conditions, speeding, distracted driving, and unsafe road infrastructure. Road design is a key factor regarding the safety of all traffic participants. In this paper, the influence of unsafe roadside element designs on the incidence of traffic accidents, the degree of vehicle passenger injury, and the level of car damage were investigated. The present study was inspired by the high number of accidents produced on European route E68 (DN1) in Romania, a significant part of which was generated and accentuated by the effects of improper roadside design.

Medical and Social Characteristics of Toxicological Patients

Background: Acute poisoning of chemical etiology is currently a significant socio-economic and medical problem. It is a leading cause of high morbidity and premature mortality among the economically active population. Objectives: This study aimed to analyze the medical and social characteristics of toxicological patients. Methods: The study was conducted on 100 patients with acute chemical poisoning treated at the Specialized Toxicology Centre in Saint Petersburg. Data were collected by copying material from medical records and conducting a survey among patients. The data were then assessed using statistical methods. Results: In the studied group of toxicological patients, the majority (62.0%) were men. Age distribution showed that most patients (62.0%) were between 20 - 40 years old. More than half (55.0%) were unemployed, and only 25.0% were married. Analysis of the patient distribution by diagnosis showed that a large proportion (44.0%) had been poisoned with drugs, 26.0% with medications, 17.0% with ethanol, 11.0% with psychotropic drugs, and 2.0% with other substances. The main causes of poisoning were drug overdose (44.0%), self-medication (26.0%), and intoxication (21.0%). One-third of the patients (33.0%) had a concomitant viral infection. Additionally, 37.0% of patients consumed alcohol more than once a week, and half of the patients (50.0%) associated drinking alcohol with relaxation and pleasure. The largest proportion of patients (56.0%) did not engage in sports or other forms of physical activity at home. Conclusions: Analysis of the medical and social characteristics of toxicological patients indicates a need for public hygiene education measures to promote social competence and cultivate a negative attitude towards harmful factors affecting health.

Pregnant Women Presenting to Psychiatric Emergency Services: A Retrospective Chart Review from India

Background: Managing psychiatric emergencies during pregnancy is often challenging, as the safety of both the mother and the unborn fetus needs to be considered. This study aimed to examine the nature of psychiatric emergencies in pregnancy, their management, and clinical outcomes in women presenting to a psychiatry emergency room (ER). Methods: Charts of perinatal women consulting psychiatry ER between January 2016 and June 2021 were reviewed for the nature of the psychiatric emergency, pregnancy details, psychiatric symptoms, sociodemographic information, medical comorbidities, clinical diagnosis, and care plan. Results: Among 286 perinatal women who attended psychiatry ER, 57 (19.9%) patients were pregnant. Over half ( n = 30, 52.6%) women were multiparous and in their second trimester ( n = 29, 50.9%). Bipolar disorder ( n = 22, 38.6%) was the most common diagnosis. Agitation/aggression ( n = 34, 59.6%) was the most common reason for visiting ER, with risk of self-harm ( n = 14, 24.6%) and risk of harm to the fetus ( n = 7, 12.3%) being other reasons. Emergency psychotropic medications were used in 32 (56.1%) women, with the use of haloperidol in combination with promethazine ( n = 12, 37.5%) or lorazepam ( n = 8, 25%) being the most common. Conclusion: One-fifth of women in the perinatal period presenting to the ER were pregnant. Agitation and aggression were the most common reasons. Parenteral medications were commonly used, and more than a fifth required inpatient care, emphasizing the seriousness of risk.

Mathematical Modeling of the Dynamics of Psychoactive Drug Abuse with Intervention of Control Agencies

Drug abuse continues to pose a significant threat to both developed and developing countries. This paper examines the dynamics of psychoactive drug abuse with intervention of control agencies. The study established that the drug abuse model remains positively invariant over time, as indicated by the positivity of the solutions to the model equations. The study identified both drug abuse endemic and drug abuse free equilibrium states. Basic reproduction number was obtained using the method of next generation matrix. The local stability of the drug abuse free equilibrium state was analyzed using Jacobian method and the analysis showed that the drug abuse free equilibrium state is locally asymptotically stable since all the Eigen values are negative. Similarly, the global stability analysis of the drug abuse free equilibrium state confirmed that the system is globally asymptotically stable. The sensitivity index was computed. The results indicate that parameters with positive sensitivity indices increase the prevalence, while those with negative sensitivity indices decrease it. This suggests that these parameters have the ability to either increase or decrease the persistence of drug abuse in the population. The numerical simulation of the model was performed using MATLAB R2015a software and results show that enlightenment and law enforcement agencies play a vital role in reducing the spread of drug abuse. This research recommends intensification of early enlightenment to curtail the spread of drug abuse. Also making more policies, enactment and enforcement of more laws that will check the use of hard drugs

Lower Plasma Levels of Selective VGF (Non-Acronymic) Peptides in Bipolar Disorder: Comparative Analysis Reveals Distinct Patterns across Mood Disorders and Healthy Controls

Introduction: Discriminating bipolar disorder (BD) from major depressive disorder (MDD) remains a challenging clinical task. Identifying specific peripheral biosignatures that can differentiate between BD and MDD would significantly increase diagnostic accuracy. Dysregulated neuroplasticity is implicated in BD and MDD, and psychotropic medications restore specific disrupted processes by increasing neurotrophic signalling. The nerve growth factor inducible vgf gene (non-acronymic) encodes a precursor protein named proVGF, which undergoes proteolytic processing to produce several VGF peptides, some of which were suggested to be implicated in mood disorders and have antidepressant effects. Since the presence of VGF peptides in humans has been exclusively investigated in brain and cerebrospinal fluid, we aimed to identify which VGF peptides are present in the plasma and to investigate whether their levels could differentiate BD from MDD as well as responders from non-responders to pharmacological interventions. Methods: VGF peptides were investigated in plasma from patients diagnosed with MDD (n = 37) or BD (n = 40 under lithium plus n = 29 never exposed to lithium), as well as healthy controls (HC; n = 36). Results: Three VGF peptides (TLQP-11, AQEE-14, and NAPP-19) were identified using spectrometry analysis of plasma from HC. These peptides were then measured in the entire sample using ELISA, which showed significantly lower levels of AQEE and NAPP in BD than in HC and MDD (p = 5.0 × 10−5, p = 0.001, respectively). Conclusion: Our findings suggest that lower plasma levels of NAPP and AQEE are specifically associated with BD, thus possibly representing a diagnostic biomarker in mood disorders.