Psychopharmacological Agents Research Articles

The future of psychopharmacology: challenges beyond efficacy and tolerability.

The future of psychopharmacology: challenges beyond efficacy and tolerability.

Investigation of crystal structures, spectral (FT-IR and NMR) analysis, DFT, and molecular docking studies of novel piperazine derivatives as antineurotic drugs

In this article, the psychopharmacological potential of piperazine derivatives as an antineurotic agent was presented. Crystal and molecular structure of newly synthesized hybrid piperazine derivatives; (C12H20N2)(ClO4).2H2O≡ (PIP1) and (C11H18N20)(ClO4)2.nH2O ≡ (PIP2) were characterized using FT-IR, X-ray crystallographic data and solid-state NMR spectroscopy. First principles computations were performed on the synthesized structures to comprehend their molecular electronic properties at the DFT/B3LYP/6–311++G(d,p) level of theory. Investigations of the Hirshfeld surfaces of (PIP1) and (PIP2) disclose that N-H···O and O-H···O hydrogen bonds between the organic and inorganic parts, constitute the principal contributors to the intermolecular stabilization within the crystal packing. The results from the computational investigation showed that the conformation of (PIP1) and (PIP2) are in correlation with the experimental results. Furthermore, molecular properties disclosed that (PIP1) is more stable compared to (PIP2) due to its high energy gap value. Also, the Fukui function, Mulliken charges, and electrostatic potential iso-surface maps, explicitly disclosed the various susceptible regions that could bind with the GIRK channel. Molecular docking result displayed that (PIP1) and (PIP2) significantly binds with the active sites of the neurotic enzymes and thus, can be considered potential psychopharmacological and antineurotic agents.

Orexin Receptor Antagonists as Adjunct Drugs for the Treatment of Depression: A Mini Meta-Analysis.

There is growing interest in the efficacy of orexin receptor antagonists (ORA), one of the new psychopharmacological agents used in the treatment of insomnia, in other psychiatric disorders such as depression. This meta-analysis was conducted in accordance with PRISMA requirements. Literature searches were conducted using PubMed, Scopus and EBSCO (Medline) databases. Search words were (depression OR mood disorder OR affective disorder) AND (orexin OR orx OR hypocretin OR orx1 OR orx2 OR orexin receptor antagonist OR almorexant OR suvorexant OR lemborexant OR daridorexant OR seltorexant OR vornorexant OR filorexant). No date restrictions were used. The random effects model was used for analyses with I2 values above 50% and fixed effects model was used for analyses with I2 values below 50%. In the acute phase, ORAs had no significant effect on core, sleep-adjusted and total symptoms of depression respectively; Standardized Mean Difference (SMD) for random effect -0.422, 95% CI [-0.90; 0.06], p=0.089, I2=62.4%; SMD for random effect -0.375, 95% CI [-1.24; 0.49], p=0.400; I2=66.6% and SMD for random effect -0.477, 95% CI [-0.97; 0.01], p=0.059; I2=83.1%). However, they had a significant effect on core and total symptoms of depression in the early period respectively; SMD for fixed effect=-0.228, 95% CI [-0.44; -0.01], p=0.036, I2=9.1%; and SMD for fixed effect=-0.186, 95% CI [-0.37; -0.001], p=0.048, I2=0.0%, respectively). The results of this meta-analysis suggest that ORAs may provide direct antidepressant efficacy when added to existing antidepressant treatment and may also have indirect antidepressant effects through improvement in sleep symptoms. Considering the physiological effects of orexin on behaviors, ORAs may be promising new treatment modalities in the treatment of many psychiatric disorders other than insomnia. However, these results are preliminary and further studies with different ORAs at different doses and with different samples are needed.

Psychotropic medications around perioperative period: How to go about?

Abstract Background: Medical comorbidities are frequent in patients suffering from psychiatric disorders. Many of these patients would need emergency or elective surgeries in their lifetime. The perioperative period is a unique and critical phase, and thoughtful, informed management can prevent various medical misadventures in this period, thus improving the postoperative outcomes. Aim: This article attempts to provide an overview of the use of psychopharmacological agents during the perioperative period, the current recommendations about continuing or discontinuing various psychotropics in the perioperative period, and how to restart medications in the postsurgical period. Material and Methods: For this narrative review, literature search was done on PubMed and Google Scholar and relevant articles were identified and included. Results: For elective surgery, the psychiatrist should review the available investigation, severity of the physical illness, physical health status of the patient as per the American Society of Anaesthesiology (ASA) category, severity and stability of psychiatric disorder, comorbid substance use, and the ongoing psychotropics and their interactions with ongoing medications. In patients with ASA categories I and II, psychotropic medications can be continued. For patients with ASA categories V and VI, preferably psychotropics should be stopped. For patients belonging to ASA categories III and IV, antipsychotics except for clozapine can be continued; however, if feasible antidepressants and lithium should be stopped. For elective surgery, clozapine needs to be stopped 12 h before surgery, lithium 48–72 h before surgery, antidepressants to be tapered about 7–10 days before surgery, and monoamine oxidase inhibitors to be tapered and stopped 14 days before surgery. Other antipsychotics, mood stabilizers, and benzodiazepines can be continued till the day of surgery. When there is lack of time due to emergency surgery then a proper discussion with the primary team and the anesthetist need to be done about the possible risks. Conclusion: The psychiatrists handling patients in the perioperative period should have an idea about how psychotropics interact with different anesthetic agents and ensure that the anesthesiologist and the surgeon are made aware of the possible complications that might occur during the surgical and anesthetic procedure due to the concurrent use of specific psychotropics.

Patients With Prenatal Alcohol Exposure Frequently Misdiagnosed, Face Multiple Challenges

Patients With Prenatal Alcohol Exposure Frequently Misdiagnosed, Face Multiple Challenges

Altered states, alkaloids, and catatonia: Monoaminoxidase inhibitors and their role in the history of psychopharmacology.

Monoamine oxidases are mitochondrial enzymes that catalyze the oxidative deamination of biogenic amines (adrenaline, noradrenaline, serotonin, and dopamine), causing their inactivation and subsequently playing a fundamental role in the homeostasis of various neurotransmitters. As the regulation of these effects was deemed important in clinical practice, numerous modulators of these enzymes were tested for various clinical effects. The purpose of this paper is to present a few historical landmarks regarding monoaminoxidase inhibitors and their usefulness as psychopharmacological agents. We will be focusing on banisterine, iproniazid, selegiline, rasagiline, tranylcypromine, moclobemide, and their role in the history of psychopharmacology. An almost unknown fact is that harmine, an MAO-A alkaloid, was used as early as the latter half of the 1920s in Bucharest, to reduce catatonic symptoms in schizophrenia, thus ushering the dawn of psychopharmacology era which started with chlorpromazine in the 1950s.

Comorbidity and quality of life in obesity-a comparative study with the general population in Gothenburg, Sweden.

ContextObesity is considered to have a detrimental impact on health-related quality of life (HRQoL).ObjectiveTo compare HRQoL in a well-defined group of people with obesity with a population-based control group from the general public.DesignObservational cross-sectional cohort study with a reference population.SettingThe Regional Obesity Center at the Department of Medicine at Sahlgrenska University Hospital, Gothenburg, Sweden.ParticipantsPeople with obesity (n = 1122) eligible for surgical and non-surgical obesity treatment in routine care were included consecutively between 2015 and 2017 into the BASUN study. Men and women from the WHO-MONICA-GOT project were used as a reference population (n = 414).Main outcome measuresHRQoL was measured with the RAND-36/Short Form-36 questionnaire (SF-36) and a Visual Analogue Scale (VAS) for self-related health (SRH). Prescription drugs for hypertension, diabetes mellitus, depression, and anxiety were taken as a proxy for these conditions.ResultsPeople with obesity rated their overall HRQoL lower than the reference population according to the SRH-VAS. Lower scores were reported on physical and social functioning, vitality, general and mental health after adjustment for age and use of prescription drugs (considered a proxy for burden of disease, or comorbidities) using the RAND-36/SF-36 questionnaire. Use of some psychopharmacological agents was more common in patients with obesity.ConclusionPeople with obesity seeking help with weight reduction are more likely to have lower physical and mental self-reported HRQoL than the general population.

Efficacy of Noninvasive Brain Stimulation on Borderline Personality Disorder Core Symptoms: A Systematic Review.

Although psychotherapy is the first-line treatment of borderline personality disorder (BPD), psychopharmacological agents have not been approved yet. Modulating brain functions with noninvasive brain stimulation (NIBS) interventions, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), may have a role in the treatment of BPD. In light of the limited knowledge available and the emerging interest in the possible role of NIBS as a therapeutic tool, the authors' main aim is to systematically review the literature on the effect of both rTMS and tDCS on BPD symptoms, specifically affective dysregulation, impulsive-behavioral dyscontrol, and cognitive-perceptual difficulties. The review process was conducted in accordance with PRISMA guidelines. The research methods were registered on PROSPERO (id code CRD42020209491). Eleven studies were included in the review. Despite the limited number of studies retrieved, preliminary data showed an improvement in all domains. Further studies are needed to understand potential long-term advantages of NIBS.

Efficacy of right sided low frequency repetitive transcranial magnetic stimulation in treatment resistant anxiety disorders

Introduction: The purpose of this study was to determine the efficacy of right sided low frequency rTMS in Treatment Resistant Anxiety Disorders including but not limited to, Generalized Anxiety Disorder, Social Anxiety & Panic Disorder and Post Traumatic Stress Disorder. Patient selection criteria included any patients between the ages of 18-60, with an Anxiety Disorder as a primary diagnosis and a Generalized Anxiety Disorder – 7 Score of 10 or more. All patients were screened for other differential diagnosis’, evidence based psychotherapy for more than a year, documented trials of 3 or more psychopharmacological agents & had no history of substance abuse which yielded 12 patients that were eligible for this study. All patients underwent 36 rTMS treatments over the course of 9 weeks, with an acute taper at starting week 7. All patients received the 1 Hz, Low frequency protocol, Right Dorsolateral Prefrontal Cortex, 2000 pulses with motor thresholds between 100%-120%. Patients completed GAD-7’s on a biweekly basis with reporting done during the middle of the week. Background: The objective of this study was to measure the outcomes of repetitive Transcranial Magnetic Stimulation (rTMS) for treatment of the Anxiety Based Disorders including GAD, Panic Disorder, & PTSD. Patient demographics both males & females, ages 18-60 years of age, with a mean score of 17.5 on their GAD-7. Methods: All 12 patients underwent 36 rTMS treatments with NeuroStar ™ TMS on the RDLPFC (80%-120% MT, 1 Hz in a sequence of 1 pulse per second for 33:20 minutes providing 2000 inhibitory pulses). Treatment occurred 5 times weekly for 6 weeks with a taper for 3 weeks. Patients would undergo bi-weekly clinical screening via GAD-7 and patient feedback. Results: 100% of participants completed the full course of 36 treatments with an appropriate taper. Patients who received the low frequency right sided TMS treatments had an average of a 14.0 points reduction on their GAD-7 measures, with a mean starting scale of 17.5 and a mean ending scale of 3.5. Conclusions: The results of low frequency right sided TMS for anxiety-based disorders are indicative of a significant clinical response. Low frequency protocols have been found to be mood stabilizing in theory. The GAD-7 scale is explanatory of the sensitivity of such a treatment protocol. Further investigation is warranted. Funding: None Conflicts of Interest: None

Characteristics of children with autism and unspecified intellectual developmental disorder (intellectual disability) presenting with severe self-injurious behaviours

Objective: This study aims to delineate the characteristics of severe self-injurious behaviors (SIB) in a cohort of children with autism and unspecified intellectual developmental disorder (UIDD) (intellectual disability) and examine potential risk factors for developing SIB. Methods: A retrospective chart review studied characteristics of severe SIB in 30 children with autism spectrum disorder (ASD) and UIDD referred to a tertiary care center. Characteristics examined include genetic syndromes, brain MRI abnormalities, verbal ability, adaptive functioning, SIB frequency and severity, age of onset, number of psychopharmacological agents, irritability, hyperactivity, stereotypy, psychiatric and physical comorbidities, among others. Descriptive and bivariate analysis were applied to explore potential relationships between factors. Results: Children with severe SIB exhibit this behaviour with high frequency, inflicting moderate to severe injury. Most children in the study sample are non-verbal and have ASD (93.3%; n = 28) with psychiatric (96.7%; n = 29) and physical (90%; n = 27) comorbidities. Overall SIB improvement using the Clinical Global Impression, Improvement Score (CGI-I) was 3.0 (minimally improved). A minority were much or very much improved following appropriate intervention. Conclusions: The severity of SIB is much higher in this sample than previously noted in the literature. Severe SIB is associated with ADHD, early onset mood disorders, tics, avoidant restrictive food intake disorder and Obsessive-Compulsive Disorder.

Diazepam diminishes temozolomide efficacy in the treatment of U87 glioblastoma cell line.

AimsMany patients with glioblastoma (GBM) suffer from comorbid neurological/psychiatric disorders and, therefore, are treated with psychopharmacological agents. Diazepam (DIA) is widely adopted to treat status epilepticus, alleviate anxiety, and inhibit chemotherapy‐associated delayed emesis in GBM patients. Even though temozolomide (TMZ) and DIA could be found as possible combination therapy in clinical practice, there are no reports of their combined effects in GBM. Hence, it may be of interest to investigate whether DIA enhances the antitumor efficacy of TMZ in GBM cells.MethodsU87 human GBM was used to examine the effects of combined TMZ and DIA on cell viability, and the oxygen consumption within the cells, in order to evaluate mitochondrial bioenergetic response upon the treatment.ResultsThe cooperative index showed the presence of antagonism between TMZ and DIA, which was confirmed on long‐term observation. Moreover, the level of apoptosis after the TMZ treatment was significantly decreased when administered with DIA (p < 0.001). Concomitant use of TMZ and DIA increased the basal cell respiration rate, the oxidative phosphorylation rate, and maximal capacity of mitochondrial electron transport chain, as well as the activities of complexes I and II, vs. TMZ alone (p < 0.001).ConclusionComparing our results with data reported that DIA elicits cell cycle arrest in the G0/G1 phase and favors senescence reveals that DIA diminishes TMZ efficacy in concomitant use in the treatment of GBM. However, due to its great potency to hinder GBM proliferation and metabolism, it could be considered using DIA as maintenance therapy after TMZ cycles.

The Effect of the Enteral Correction Program on Oxidative Stress Parameters in Patients with Poisoning with Psychopharmacological Agents or Corrosive Substances

RATIONALE Acute exogenous poisonings represent a serious medical problem due to the prevalence, severity of the course and high lethality. In their pathogenesis, an important place is given to oxidative stress (OS). Among modern methods of treatment of acute poisoning, the attention is drawn to approaches aimed at normalizing homeostatic indicators by cleansing the enteric environment, restoration of its barrier function.PURPOSE OF THE STUDY Assess the impact of the enteral correction program (ECP) on the parameters of lipid peroxidation (LPO) and antioxidant systems in acute exogenous poisoning.MATERIAL AND METHODS 119 patients who underwent treatment at the N.V. Sklifosovsky Research Institute for Emergency Medicine, of which 45 were with severe acute poisoning with psychopharmacological agents (PPPA) and 74 with poisoning with corrosive substances (PCS). The two study groups consisted of 40 patients with PCS and 23 patients with PPPA, whose standard therapy was supplemented with ECP. The ECP included making intestinal lavage on admission, the introduction of glucosed saline enteral solution in the following days; and for patients with PCS the treatment also included enteral nutrition and Pektovit.The comparison groups included 56 people (34 with PCS and 22 with PPPA) comparable to the patients of the study groups by sex, age, the type and severity of poisoning poisoning treated with standard therapy The severity of OS was assessed by the KMDA/TAA index which was calculated by means of measuring the concentration of malonic dialdehyde (as an LPO parameter) and total antioxidant activity in the blood plasma of the patients. Serum levels of nitric oxide stable metabolites were also measured.The analysis of the results was performed with the regard to patient’s age.RESULTS In patients of working age, regardless of the toxicant type, LPO activation occurred, which was expressed with an increased KMDA/TAA by 1.4–1.8 times compared to the norm. Using ECP at the study stages contributed to maintaining this balance level between pro- and antioxidants. In patients of comparison groups there was an increase in the LPO system imbalance, while KMDA/TAA exceeded the norm by 2.2–2.4 times that was statistically signifi cantly different from the parameters in the study groups.Older patients showed decreased levels of LPO products, the total antioxidant activity compared to the normal for the age, and, as a result, a decrease in KMDA/TAA by 1.3–1.5 times in PCS and by 2–2.4 times in PPPA. This is due to the low adaptive potential of this category of patients. In this age group, ECP contributed to a moderate activation of LPO, which provided the trend towards normalization of OS parameters.CONCLUSIONS The use of the enterable correction program has a positive impact on the dynamics of oxidative stress parameters, ensuring the maintenance of oxidative processes at the level required for an adequate protective reaction of the body to chemical injury.

The program of enteral correction of homeostasis disorders and its effect on intestinal permeability in acute poisoning

Background. The problem of pathologically increased permeability of the intestinal wall is actualized with the accumulation of information about the correlation of this phenomenon with complications of an inflammatory nature and multiple organ failure in critical conditions, including acute poisoning.Aim of study. To assess the effect of the program of enteral correction of homeostasis disorders on intestinal permeability in acute poisoning.Material and methods. 40 patients (67.5% of women and 32.5% of men) admitted at the Intensive Care Unit as part of the Scientific Department of Acute Poisonings and Somatopsychiatric Disorders of the N.V. Sklifosovsky Research Institute for Emergency Medicine were examined, 20 of them (group I) with severe acute oral poisoning with corrosive substances: acetic acid 35.6% and alkali (sodium hydroxide) 64.4 %, as well as 20 patients (group II) with severe acute oral poisoning with psychopharmacological agents. Both groups were divided into two subgroups: I-a and II-a – (10 patients in each), in whom an enteral correction program was used in addition to the standard treatment, and I-b and II-b comparison groups (10 patients in each each) who received only standard therapy.Results. It was found that in all observed patients with severe acute oral poisoning with corrosive substances, as well as psychopharmacological agents, the ratio of lactulose / mannitol concentration in urine as an indicator of intestinal permeability was increased before the start of treatment in relation to its reference value of 3.8-4.9 times.After 5 days, in patients who received the enteral correction program, the lactulose/mannitol ratio decreased by 15.4% in cases of poisoning with corrosive substances, and by 19.8% in cases of poisoning with psychopharmacological agents. At the same time, in patients with poisoning with corrosive substances, who received standard treatment, this parameter decreased by only 1%. Attention was drawn to the fact that in patients with psychopharmacological agents poisoning who received standard therapy, the intestinal permeability index after 5 days did not decrease, but continued to increase and exceeded the initial value by 11.4%.Conclusion. With the help of the enteral correction program, it is possible to reduce the permeability of the intestinal wall in acute poisoning with corrosive substances and psychopharmacological agents.

List of essential psychotherapeutic medicines 2019 of India: When science was left behind.

List of essential psychotherapeutic medicines 2019 of India: When science was left behind.

Management of Psychiatric Disorders in Patients with Stroke and Traumatic Brain Injury.

Management of Psychiatric Disorders in Patients with Stroke and Traumatic Brain Injury.

Psychopharmacology of patients with multiple sclerosis in Greece during the period 2017-2019.

Multiple Sclerosis (MS) is highly comorbid with mental disorders in any disease stage, while psychiatric manifestations may precede the onset of neurological symptoms as well as diagnosis. Neuropsychiatric comorbidities are associated with an elevated risk of MS disability progression, and therefore, people with multiple sclerosis (PwMS) with psychiatric comorbidities often experience a significantly lower functional status, perform worse in objective neuropsychological assessment, are less likely to adhere to pharmacological treatment, and exhibit higher levels of disruption of their supportive social environment as compared with "non-psychiatric" PwMS. The present study aims to estimate the nationwide use of psychopharmacological agents by PwMS in Greece. Prescription records of the nationwide digital prescription database were analyzed, in order to identify PwMS that have received prescriptions of an antipsychotic, an antidepressant, an anxiolytic or a psychostimulant during a 2-year study period. Pseudo-anonymized prescription records of PwMS (n=21218) were extracted from the Greek nationwide prescription database, dating from June 2017 to May 2019. According to this national level study, psychopharmacological agents are frequently prescribed in PwMS. Antidepressants were prescribed in 36.1% of the study sample, followed by anxiolytics (16.23%), psychostimulants (4.97%) and antipsychotics (3.76%). The proportion of patients under treatment with these agents was increasing with age. Selective serotonin reuptake inhibitors, second generation antipsychotics and benzodiazepines were the most often prescribed agents in each drug category and especially in younger age groups, possibly indicating a better efficacy/side-effect equilibrium, while modafinil was the only psychostimulant prescribed aiming to ameliorate levels of fatigue. A pharmacological preference for antidepressants and psychostimulants was observed in the 40-60 age group (p = 0.02), while antipsychotics and anxiolytics were more frequently prescribed in the >60 age group (p<0.001). Serotonin-norepinephrine reuptake inhibitors were mostly prescribed within the 40-60 age-group. Benzodiazepines were less favored among the >60 age-group. This study highlights the increased prevalence of mental disorders in this patient group. Adequate treatment and monitoring of psychiatric symptomatology, may improve long-term outcomes of the disease, however caution is needed regarding potential drug interactions and side effects.

The effects of duloxetine augmentation on clozapine in the treatment of negative symptoms in treatment resistant schizophrenia

The negative symptoms of schizophrenia have always been a challenge in treatment. The intensity and chronicity of these symptoms has direct impact on the life quality and treatment response. Current psychopharmacological agents have not offered a satisfactory result in addressing the negative symptoms of schizophrenia. The clinicians struggle with the approaches that can be utilized to target the negative symptoms of schizophrenia as no well-defined evidence exist. We present a case of treatment resistant schizophrenia with negative symptoms that responded well with augmentation of Duloxetine to Clozapine treatment.

Rehabilitation program for acute poisoning in a toxicological hospital

BACKGROUND: Diagnostics and treatment of acute poisoning, as well as the rehabilitation measures carried out in relation to them, including the stationary stage, are aimed at the most complete restoration of the lost capabilities of the body.&#x0D; AIMS: Increasing the efficiency of medical rehabilitation of acute poisoning (AP) in a toxicological hospital through a combination of drug therapy and non-drug treatment with preformed physical factors.&#x0D; MATERIAL AND METHODS: Of 1,207 patients with AP psychopharmacological agents (pPFA), neurotoxicants (pNT), cauterizing agents (pCA) and snake bites (SB), who were in the toxicology department of the N.V. Sklifosovsky, 421 patients with an unfavorable course of AP were subjected to an in-depth examination. Intravenous laser hemotherapy (LGT), hyperbaric oxygenation (HBO), mesodiencephalic modulation (MDM), wave biomechanotherapy (WBMT) and ethylmethylhydroxypyridine succinate (EP) were used in cases of 291 patients of the main groups.&#x0D; RESULTS: The unfavorable course of AP was accompanied by an increase in the duration of treatment by 2.26.8 times due to the addition of pneumonia (pPFA), toxicohypoxic encephalopathy (pNT), severe burns of the gastrointestinal tract (pCA) and local edematous-inflammatory changes (SB). There was a syndrome of high blood viscosity and moderate endotoxicosis. The best clinical and laboratory results were obtained with a combination of LHT (90 minutes) with EP (pPFA), HBO and EP (pCA), HBO, MDM, EP (heavy pNT), HBO, EP (moderate pNT) and WBMT (SB). The adaptive capabilities of the organism, the state of the autonomic nervous system (pNT), neuropsychological indicators and electrical activity of the brain (pNT) improved.&#x0D; CONCLUSION: Programmed rehabilitation made it possible to achieve a noticeable reduction in the incidence of symptoms of the studied poisoning (by 54.693.4%), the time to resolve their manifestations (by 9.175%), as well as inpatient treatment (by 16.159.3%), improving functional performance.

Identification of chlorpromazine hydrochloride role as a new systemic acquired resistance inducer against Magnaporthe oryzae in rice

Chlorpromazine HCL is considered an active ingredient for psychopharmacological agents for humans, the current study was undertaken to determine the ability of chlorpromazine HCL to induce systemic acquired resistance (SAR) in rice plants, to protect rice from blast disease caused by Magnaporthe oryzae. Chlorpromazine HCL was used at different concentrations; 10, 25, 50, 125, 250, 500, 1000 and 2000 mg/L under laboratory and greenhouse conditions. The results showed that chlorpromazine HCL was effective on fungus radial growth on high concentrations of more than 250 mg/L in vitro. Under greenhouse condition, resistance response was significantly improved with low and high concentrations. The potential inducer concentration was 250 mg/L which reached 18.4% of disease severity. The gene expression for chlorpromazine HCL treatment induces some of the indicators for salicylic acid (SA) pathway such as OsWRKY45 and OsNPR1 which recorded 15.14 and 17.79 fold changes, respectively after 24 h of inoculation, and jasmonic acid (JA) pathway such as AOS2, JAMYB and PBZ1 (OsPR10) which recorded 11.27, 10.57 and 13.51 fold changes, respectively, after 24 h of inoculation. The results suggest that chlorpromazine HCL induces SAR in rice against blast disease which could be related to SA and JA defense pathways.

Prevalence of dental disorders among people with mental illness: An umbrella review.

Psychiatric patients have increased rates of comorbid physical illness. There are less data on dental disease, especially decay, despite risk factors including lifestyle and psychotropic side effects such as xerostomia. We therefore undertook an umbrella review of all meta-analyses on the association between mental illness and oral health. We searched PubMed, MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, Embase and CINAHL. Articles were independently assessed. Outcomes were caries, periodontal disease, erosion, and partial or total tooth loss (edentulism), measured where possible with standardised measures such as the mean number of decayed, missing and filled teeth or surfaces. Quality was assessed in line with National Institutes of Health guidelines. We identified 11 meta-analyses. The most information and strongest association was between dental decay and severe mental illness or substance use, as well as erosion and eating disorders. Depressive, anxiety and eating disorders were also associated with caries, but the datasets were small. People with severe mental illness had nearly three times the odds of having lost all their teeth than the general community (odds ratio = 2.81, 95% confidence interval = [1.73, 4.57]) and those with depression between 1.17 and 1.32. Findings for periodontal disease were more equivocal, possibly because of study heterogeneity. Mental health clinicians should screen for oral diseases when treating those with mental illness and facilitate referral to affordable dental clinics when indicated. Prevention should be a priority, including the promotion of dental care, as well as the management of xerostomia when psychopharmacologic agents are prescribed.