Psychotropic Research Articles

Recent trends in psychotropic medication use in children and adolescents in Ireland.

In response to concerns regarding overprescribing of psychotropic medication in children/adolescents, this study examined trends in psychotropic medication use in Ireland by age group and gender. A retrospective, repeated, cross-sectional study of the Irish pharmacy claims database was conducted. Yearly prevalence of children/adolescents receiving dispensed psychotropic medications was analysed from January 2017 to December 2021 and compared across years, age groups (5-15 years, and stratified as 5-11 and 12-15 years) and gender. Yearly prevalence was defined as the mean number of patients in receipt of medication per month per 1000 eligible population during a given calendar year. Negative binomial regression was used to examine the association of year, age group and gender on prevalence. Prevalence ratios (PRs) per year (average change in prevalence between each year) were presented with 95% confidence intervals (CIs). The prevalence of included psychotropic medications dispensed in the 5-15 years group increased from 6.41 (95% CI: 6.22, 6.59) in 2017 to 8.46 (95% CI: 8.26, 8.68) in 2021 per 1000 eligible population (32% increase). The PR per year (adjusting for age category and gender) was 1.07 (95% CI: 1.035, 1.107; p < 0.001). An increasing trend over time was also observed for all individual drug classes. These findings suggest increased use of psychotropic medication in children/adolescents from 2017 to 2021. However, despite increased prevalence over time, comparison with the literature shows that psychotropic medication use in Ireland remains lower than international comparators.

Psychotropic drug use among children and adolescents in the Nordic countries: a systematic review.

The Nordic countries have rather homogenous populations and similar health care systems, and one could therefore expect comparable levels of psychopathology and psychotropic drug use. However, recent studies show pronounced variations in psychotropic drug use among children and adolescents from different Nordic countries. Therefore, we aimed to conduct a systematic review of the literature examining the use of psychotropic drugs among children and adolescents in the Nordic countries. This review followed PRISMA guidelines. We searched PsycINFO, EMBASE and MEDLINE for population-based studies published 2010 or later that investigated prevalent or incident use of antidepressants, psychostimulants, antipsychotics, hypnotics, anxiolytics, and mood stabilizers among 0-19-year-olds in the Nordic countries. Two reviewers assessed all studies. Twenty-two out of 2142 eligible studies were included in the final review covering data collected from 1995 to 2018. The use of psychotropic drugs, except for anxiolytics, increased in most of the Nordic countries, but at different rates. Prevalent use of antidepressants was two to four times higher among Swedish children and adolescents compared to Danish and Norwegian peers. Prevalent use of psychostimulants, on the other hand, was two to sixfold higher in Iceland compared to the other Nordic countries. Finally, the prevalence of antipsychotic use was threefold higher in Finland compared to Sweden, Denmark, and Norway. This systematic review provides a thorough overview of psychotropic treatment of youths in the Nordic countries. We demonstrate a pronounced national variation in use of psychotropics that should be addressed further to facilitate rational pharmacotherapy in youths with psychiatric disorders.

О ПРЕСЕЧЕНИИ РАСПРОСТРАНЕНИЯ НАРКОТИЧЕСКИХ СРЕДСТВ И ПСИХОТРОПНЫХ ВЕЩЕСТВ НА ТЕРРИТОРИИ СОЮЗНОГО ГОСУДАРСТВА

The article shows the prerequisites for further improving the work of the internal affairs bodies of the Russian Federation and the Republic of Belarus to suppress the spread of narcotic drugs and psychotropic substances on the territory of the Union State. Based on the results of the generalization of materials, the legal basis for cooperation between the internal affairs bodies of the Russian Federation and the Republic of Belarus in the field of combating drug trafficking, information on the state of the drug situation in the territory of the Union State, measures to counter the spread of narcotic drugs and psychotropic substances in the territory of the Union State, some results of the implemented coordinated actions of internal affairs bodies, potential for further improvement of coopera-tion in the field of combating drug trafficking.

A facile one-pot iodine-mediated synthesis of cannabinol and derivatives, and their intestinal epithelial barrier protective effect

Cannabinol (CBN), an oxidation product of THC, is a minor cannabinoid that displays a wide range of medicinal properties with less psychoactive effects. Traditionally, CBN derivatives are synthesized from terpenoids and resorcinol derivatives using a complex multistep process, involving Friedel-Crafts alkylation, cyclization, and aromatization. In this study, we propose that iodine could serve as both a Lewis acid catalyst and an aromatization agent. As a result, a convenient one-pot iodine-mediated reaction between (1S,4R)-p-menthadienol and substituted resorcinol was developed. Various reaction parameters were explored, and the yields were assessed using quantitative 1H NMR. The optimized conditions gave a 71 % isolated yield of 3-(1′,1′-dimethylheptyl)cannabinol (DMH-CBN) as a model substrate. Further investigation of the substrate scope demonstrated that this one-pot iodine-mediated synthesis could provide alkyl-substituted CBN derivatives in isolated yields ranging from 28 % to 63 %, including the C3-unsubstituted CBN, which could undergo bromination to give novel 4-bromo and 2,4-dibromo derivatives in high yields. Citral was also successfully used in place of (1S,4R)-p-menthadienol as an inexpensive alternative starting material to give the natural CBN in 22 %. These newly synthesized CBN derivatives were studied for their protective effects on the intestinal epithelial barrier using the transepithelial electrical resistance (TER) assay, suggesting that the 2,4-diethyl, 4-bromo, and 2,4-dibromo derivatives of C3-unsubstituted CBN exhibited superior activity compared to natural CBN with low toxicity. This indicates their potential as novel candidates in the cannabinoid series, contributing to the anti-inflammatory activity.

Electroconvulsive Therapy for Psychogenic Polydipsia and Hyponatremia in Chronic Schizophrenia: A Case Report and Literature Review.

Compulsive drinking of excessive quantities of water, called psychogenic polydipsia (PP), is a challenging complication of chronic psychotic disorders, which can lead to hyponatremia and downstream morbidity or mortality. Treatments include behavioral modifications such as free water restriction, medications to modify free water excretion, and psychotropic medications to target psychotic symptoms. However, in many cases, these options remain ineffective and/or intolerable, necessitating chronic institutionalization with poor patient quality of life. Here we report the use of an acute course of 8 sessions of bilateral electroconvulsive therapy (ECT) in a 57-year-old man with chronic schizophrenia, PP, and moderate hyponatremia refractory to standard treatments in an inpatient psychiatric setting. Serum sodium normalized and remained stable during and immediately following his ECT course, despite chronic hyponatremia with high variability for months prior to ECT initiation. A literature review found remarkably few reported cases of ECT for PP in chronic schizophrenia, a surprising result given the use of this modality for patients with psychotic illness in many countries. Our findings support future investigation into the clinical utility and mechanism of ECT for PP in this patient population.

Antiseizure Medications and Sudden Unexpected Death in Epilepsy: An Updated Review.

Sudden unexpected death in epilepsy (SUDEP) is responsible for most epilepsy-related deaths. It is mainly related to unwitnessed nocturnal convulsions, either focal to bilateral or generalised tonic-clonic seizures (TCS). Targeted preventive strategies are currently lacking as underlying mechanisms are largely unknown. Antiseizure medications (ASMs) modulate SUDEP risk through seizure reduction, but it is yet undetermined whether individual ASMs or other medications could also influence the internal SUDEP cascade. Seizure detection devices (SDD) may offer an alternative strategy by preventing TCS from being unwitnessed. Here, we critically evaluated the current evidence on the influence of ASMs, non-epilepsy concomitant drugs and SDD on SUDEP occurrence. We found no robust evidence for the effect of starting ASMs on SUDEP beyond TCS control, but we found some indications of a protective effect for polytherapy. We found no signs that specific ASMs exert a risk for SUDEP. One study suggested a possible protective effect of levetiracetam requiring further investigation. Only a few small studies addressed the association between non-epilepsy concomitant drugs and SUDEP, with no consistent effect for psychotropic medications and one more extensive study suggesting a lower risk among statin users. We only found indirect evidence indicating a protective effect for enhancing nocturnal supervision without explicitly addressing the impact of SDD on SUDEP occurrence. Further work is needed to explore the potential of ASMs and other interventions to modulate SUDEP risk, and they should accurately account for TCS frequency, polypharmacy and markers of non-adherence.

Значение клинико-динамических параметров пациентов с сочетанной зависимостью от психоактивных веществ на этапе медицинской реабилитации

According to official statistics, the number of patients with combined addiction of psychoactive substances increases annually. At the same time, the effectiveness of therapy for such disorders remains at a low level. Aim. To study the clinical characteristics of patients with combined addiction of psychoactive substances in dynamics to improve the effectiveness of rehabilitation. Material and methods. 204 patients with combined addiction of psychoactive substances, men and women aged 18 to 50 years, who underwent inpatient treatment at the Moscow Scientific and Practical Center of Narcology, were examined. The patients were divided into 4 groups addiction on the combinations of psychoactive substances. Methods: clinical-psychopathological, anamnestic, psychometric (Visual-analog scale of pathological drug addiction, Montgomery–Asberg depression assessment scale, Beck depression severity self-assessment scale), statistical. The patients were examined on the 8–10th day and the 20–30th day of therapy. Further, the patients were followed by catamnestic observation for 12 months. Their mental status, quality and duration of remissions were assessed. Results. In patients with combined addiction of cannabinoids and psychostimulants and alcohol and psychostimulants, a lower percentage of hereditary burden, less pronounced antisocial personality traits, and a lower intensity of pathological attraction to psychoactive substance, especially behavioral and affective components, were revealed compared with patients with combined addiction of opioids and psychostimulants and addiction of several psychoactive substances. Patients with combined addiction of opioids and psychostimulants and several psychoactive substances at once had shorter remissions. Conclusion. Among patients with combined addiction of psychoactive substances, associations were found between the premorbid characteristics of patients, clinical features and quality, and duration of remissions. This will create a personalized approach to the rehabilitation of such patients and increase the effectiveness of therapy.

Structure-Activity Relationship of Synthetic Cathinones: An Updated Review.

The escalating prevalence of new psychoactive substances (NPSs) poses a significant public health challenge, evidenced by the vast chemical diversity, with over 500 substances reported annually to the United Nations Office on Drugs and Crime-Early Warning Advisory (UNODC-EWA) in the past five years. Among NPSs, synthetic cathinones are gaining a lot of popularity among users. Notably, synthetic cathinones accounted for approximately 50% of the total quantity of NPSs reported as seized by EU Member States in 2021. Preliminary data from UNODC indicates that a total of 209 synthetic cathinones have been reported to date. As their popularity grows, studying the structure-activity relationship (SAR) of synthetic cathinones is essential. SAR studies elucidate how structural features impact biological effects, aiding in toxicity prediction, regulatory compliance, and forensic identification. Additionally, SAR studies play a pivotal role in guiding drug policies, aiding authorities in categorizing and regulating newly emerging synthetic cathinones, mitigate public health risks and offer valuable insights into potential therapeutic applications. Thus, our Review consolidates recent findings on the effects of different substitutions in the chemical scaffold of synthetic cathinones on their mechanism of action as well as pharmacological and toxicological effects of synthetic cathinones, thus enhancing understanding of the SAR of synthetic cathinones' pharmacology and potential implications.

Exploration and Practice of Introducing the Pharmaceutical Care Network Europe Classification System to Psychiatric Drugs.

This research aims to summarize and discuss issues related to psychiatric drugs by using the classification system of the Pharmaceutical Care Network Europe (PCNE) and to provide a reference for the development and direction of clinical pharmacists' work in the future. Psychiatric patients who were hospitalized in our hospital from Janurary 2023 to December 2023 were enrolled. Drug-related problems (DRPs) were evaluated using the PCNE classification system (version 9.0). The types, causes, intervention plans, acceptance of intervention plans, and statuses of DRPs were analyzed. A total of 362 patients were included, covering 405 DRP cases, with an average DRP of 1.12 for each patient. All 405 DRP cases underwent interventions, with a success rate of 83.46%. The main categories of related drugs were psychotropic drugs (70.37%), anti-infective drugs (8.89%), and cardiovascular system drugs (5.19%). The main DRPs were possible adverse drug events (21.24%), poor treatment effects (69.14%), and unnecessary medication treatment (9.63%). The main causes of DRPs were inappropriate drug selection (18.52%), inappropriate combinations of drugs (16.05%), and excessive drug dosage (13.58%). The PCNE classification system helps clinical pharmacists improve their ability to identify and solve DRPs faced by psychiatric departments, improve pharmaceutical care efficiency, and ensure rational drug use.

Structural characteristics of areca nut seed neutral polysaccharide and its impact on gut microbiota from human feces

Areca nut (Areca catechuL.) is considered as the fourth most common psychoactive substance globally. Although areca nut seeds (ACS) are typically discarded as processing waste, some studies indicate that amounts of polysaccharides exist in the seeds. However, research on these polysaccharides remains limited. In this study, polysaccharide (ACSP) from areca catechu seeds was isolated into three fractions, among which neutral fraction had a highest yield up to 31.8%. Subsequently, the structural features of neutral fraction (ACSP-0) were analyzed, along with its impact on short-chain fatty acids and human gut microbiota through in vitro feces fermentation. It was found that the backbone chain of ACSP-0 was composed of →4)α-D-Glcp-(1→, α-D-Glcp-(1→, →3,4)α-D-Glcp-(1→ and →4)β-D-Glcp, and the side chain was consisted of α-D-Glcp-(1 → . In vitro digestion experiments demonstrated that ACSP-0 could pass through the upper digestive system without being broken down. Furthermore, in vitro fecal fermentation of ACSP-0 resulted in an increased concentration of short-chain fatty acids and promoted the growth of beneficial bacteria such as norank_f_norank_o_Clostridium UCG-014, which are known to produce generate antibacterial compounds and mitigate gut barrier damage. Additionally, by reducing the abundance ratio of Firmicutes to Bacteroidota, ACSP-0 may hold potential for obesity management. In conclusion, ACSP-0 shows potential as an innovative ingredient for enhancing gut health in humans. This study suggests a novel utilization strategy for areca nut seeds, which could be beneficial for the areca nut processing industry.

Хроническая боль, коморбидная психическим расстройствам: обзор литературы и клиническое наблюдение

Chronic pain is one of the main problems of modern clinical medicine. It is associated with its high prevalence, negative impact on the level of development and the life quality of patients, as well as difficulties in selecting effective drug therapy. According to various data, the population prevalence of chronic pain during life varies from 11% to 40%. Modern publications have proven the connection of various pain syndromes with unpredictable psychopathological conditions, including affective disorders, anxiety disorders, addiction to psychoactive substances, and personality disorders. Currently, a large number of methods that reduce the severity of chronic pain are available. Due to the emphasis of this article on the consequences associated with painful disorders, only methods used in psychiatric practice are discussed. This includes psychopharmacotherapy, psychotherapy and non-drug biological methods of therapy. In order to illustrate the main provisions presented in the review literature, the article offers a clinical observation.

Sales and regulatory status of fixed dose combination psychotropic drugs in India: a retrospective longitudinal study

Sales and regulatory status of fixed dose combination psychotropic drugs in India: a retrospective longitudinal study

Применение Мебикса в психиатрии и общей медицине: актуальность, перспективы, клинические примеры

Anxiety disorders, except the manifestations of anxiety itself, are characterized by a broad spectrum of cognitive and somatic symptoms significantly reducing the individual’s quality of life and increasing the risk of somatic disorders. The rate of cardiovascular, respiratory, gastrointestinal, and other disorders throughout life is significantly higher in people suffering from anxiety. Furthermore, many symptoms of anxiety and panic/fear mimic manifestations of somatic disorders. Optimal treatment of anxiety disorders includes both pharmacological and psychotherapeutic interventions. At the same time, psychotherapy is not always available for patients, and internists not always decide to prescribe psychotropic medication, for example antidepressants. In such situations, nonbenzodiazepine anxiolytics showing high efficacy and tolerability can be used. Mebix, having an adaptogenic effect on the central nervous system and a stabilizing effect on the autonomic nervous system, that affects almost all neurotransmitters can be considered one of such drugs. The paper reports clinical cases of patients with anxiety disorders, who were treated with Mebix as monotherapy or in combination with antidepressants.

Micro-solid phase extraction with in-lab-packed columns for cost-efficient drug extraction from urine samples

This study introduces a miniaturised solid-phase extraction (µ-SPE) method coupled with ultra-high performance liquid chromatography and tandem mass spectrometry (UHPLC-MS/MS) for the simultaneous quantification of 23 compounds, including psychoactive drugs, narcotics and their metabolites, in urine samples. The µ-SPE method, using standard laboratory equipment such as a centrifuge, was developed and validated, offering a practical and economical alternative to more traditional SPE methods. The key extraction parameters: elution solvent composition, sample and elution volumes, and sorbent mass were optimized to enhance performance. The method demonstrated high sensitivity, with detection limits between 0.06 and 0.41 ng cm−3 and quantification limits from 0.19 to 1.24 ng cm−3. The precision was confirmed with an intra-day precision ranging from 0.2% to 7.5% and an inter-day precision from 1.2% to 13.4%. Recovery rates ranged from 84.2% to 109.4%, with minimal matrix effects observed for most analytes (|ME|< 10%). The relative error remained below 5%, indicating good accuracy. The method was also evaluated in terms of greenness, practical, and analytical aspects using the WAC model. Based on the validation results, it was concluded that the developed method could be a good confirmatory method for results obtained by immunochemical tests and could also be used in both clinical analyses and forensic toxicology.Graphical abstract

Software-assisted automated detection and identification of "unknown" analogues of benzodiazepines in liquid chromatography mass spectrometry analysis.

Benzodiazepines (BZDs) construct a large group of psychoactive drugs acting as depressants of the central nervous system (CNS) and used in medicine as sedatives and anxiolytic and antiepileptic agents. The illicit use of these materials is a worldwide problem, and for many years, part of the benzodiazepines have been abused as rape drugs. For example, flunitrazepam (Rohypnol) is most commonly linked by media reports to drug-facilitated sexual assaults, more commonly referred to as "date rape." Furthermore, there are growing concerns for other misuses of these drugs. Over the last few years, there was an increase in the number, type, and availability of new psychoactive substances (NPS) belonging to the benzodiazepine group, challenging standard forensic labs to fully identify the chemical structure of new, unknown benzodiazepines. This work demonstrates a new application of the automated tool for the detection and identification of benzodiazepine analogues using high-resolution-accurate-mass LC-MS analysis, followed by "Compound Discoverer" (CD) software data processing, to automatically detect various benzodiazepine analogues by picking peaks and compare them to in silico calculated modifications made on a predefined basic backbone. Subsequently, a complete structural elucidation for the proposed molecular formula is obtained by MS/MS data analysis of the suspected component. This method was found to be useful for the automated detection and putative identification of a series of nine "unknown" benzodiazepine analogues, at concentrations in the low ng/mL range. We hereby present a general demonstration of this powerful tool for the forensic community in the detection and identification of hazardous unknown compounds.

Autolesiones en jóvenes universitarios sobrevivientes del suicidio

Self-injurious behaviors often arise as an attempt to regulate emotions and temporarily alleviate emotional and social pain, potentially leading to suicidal attempts over time—a complex phenomenon that demands a profound and diverse understanding of intense emotional distress and an urgent need for help and support. Thus, this article aimed to explore self-injurious experiences in survivors of suicide attempts during university years through a systematic review methodology using the PRISMA protocol, identifying and critically evaluating the quality of 24 studies spanning a period from 2003 to 2024, using keywords such as self-injury, non-suicidal self-injury, university students, adolescents, young adults, and others in databases like Web of Science, Redalyc, and Dialnet. It was found that self-injurious experiences in university students include cuts, burns, blows, pinches, falls, bites, scratches, and more, resulting from depression, anxiety, stress, impulsivity, emotional dysregulation, avoidant coping styles, psychoactive substance use, bullying, academic pressure, history of violence, existential void, fatalistic attitudes, low self-esteem, cognitive rumination, family dysfunction, negative sexual experiences, and more. The above reveals that these experiences require specialized management that includes institutional and family care and support protocols, encompassing emotional, social, and personal factors, which implies the creation of early intervention programs, continuous psychological support, and awareness campaigns to reduce the stigma associated with self-injury and suicide.

Combining machine learning, molecular dynamics, and free energy analysis for (5HT)-2A receptor modulator classification

The 5-Hydroxytryptamine (5HT)-2A receptor, a key target in psychoactive drug development, presents significant challenges in the design of selective compounds. Here, we describe the construction, evaluation and validation of two machine learning (ML) models for the classification of bioactivity mechanisms against the (5HT)-2A receptor. Employing neural networks and XGBoost models, we achieved an overall accuracy of around 87 %, which was further enhanced through molecular modelling (MM) (e.g. molecular dynamics simulations) and binding free energy analysis. This ML-MM integration provided insights into the mechanisms of direct modulators and prodrugs. A significant outcome of the current study is the development of a ‘binding free energy fingerprint’ specific to (5HT)-2A modulators, offering a novel metric for evaluating drug efficacy against this target. Our study demonstrates the prospective of employing a successful workflow combining AI with structural biology, offering a powerful tool for advancing psychoactive drug discovery.

The experience of adolescence process among French teenager pregnancies: a mixed-methods study

ABSTRACT Purpose Teenage pregnancy remains a significant global public health concern worldwide. However, it presents a complex phenomenon in developed countries, carrying potential short- and long-term consequences for both mothers and children. Methods This mixed method study used data from the French cross-sectional study “Portraits of adolescents”, which included 6000 girls aged between 13 and 17 years. The quantitative approach involved comparisons between a subgroup with an history of pregnancy and their peers, examining their lived-experience and mental health. The qualitative approach investigated the question “What does being a teenager mean for you?” specifically for the girls who reported an history of pregnancy. Results Teenage pregnancies presented elevated rates of mental health disorders, including dark thoughts, depression, self-harm, participating in dangerous games, attempting suicide and increased use of psychoactive substances. With limited support, in comparison to their peers. The qualitative approach revealed three major themes: “being in action”, “a way of feeling”, and “quality of relationship”. Conclusion This vulnerable subgroup of adolescents suggests the need for a coordinated multidisciplinary healthcare approach, given their limited parental and friend support, with a high risk of experiencing poor mental health. Additionally, these findings portray a “silent sufferer” population characterized by difficulties recognizing or managing emotions due to difficulties in expressing their emotional distress.

Potential Implications of Multi-Drug Exposure with Synthetic Cannabinoids: A Scoping Review of Human Case Studies

Synthetic cannabinoids are a rapidly evolving, diverse class of new psychoactive substances. Synthetic cannabinoid use results in a higher likelihood of adverse events and hospitalization when compared to cannabis use. The mechanisms behind synthetic cannabinoid toxicity remain elusive. Furthermore, poly-substance use may be a significant contributing factor in many cases. This scoping review aimed to identify the key characteristics of synthetic cannabinoid co-exposure cases and discuss the potential implications of poly-substance use in humans. There were 278 human cases involving 64 different synthetic cannabinoids extracted from the databases. Cases involved a total of 840 individual co-exposures, with an average of four substances involved in each case. The most common co-exposures were alcohol (11.4%), opioids (11.2%), and cannabis (11.1%). When analyzed by case outcome, co-exposure to either antipsychotics/antidepressants, alcohol, or tobacco were significantly associated with mortality as an outcome (p &lt; 0.05). Drug-use history (63.4%), mental illness (23.7%), and hypertensive and atherosclerotic cardiovascular disease (20.1%) were prevalent patient histories in the case cohort. There are several potential pharmacodynamic and pharmacokinetic interactions between co-exposure drugs and synthetic cannabinoids that could worsen clinical presentation and toxicity in synthetic cannabinoid users. Individuals with substance-use disorders or psychiatric illness would be especially vulnerable to these multi-drug interactions. Further research into these complex exposures is needed for the successful prevention and treatment of synthetic cannabinoid-related harms.

Exploring the Perceptions of Indian Mental Health Professionals Regarding Areca (Betel) Nut Products: A Cross-sectional Study

Background: Areca nut (AN) and AN products (ANPs) are commonly used as psychoactive substances with marked dependence potential. Scant information exists on the Indian mental health professionals’ (MHPs) knowledge of AN-ANPs, attitude toward AN-ANP use/users, and behavior regarding their clients’ AN-ANP use. To address this gap, a survey was undertaken to assess MHPs’ knowledge, attitudes, and behavioral responses toward AN-ANP use and addiction. Methods: We developed a pretested, customized questionnaire and conducted a cross-sectional online survey among a random sample of MHPs. Results: The 209 respondents included 91 psychiatrists, 105 clinical psychologists, and 13 other MHPs from diverse settings. Among them, 46.89% believed that AN-ANP use does not fit the definition of abuse/addiction as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition or International Classification of Diseases 10th Revision (ICD-10)/ICD-11. Among the psychiatrists, clinical psychologists, and other MHPs, 60.4%, 48.6%, and 61.5% were unaware of any AN-ANP cessation protocols. The addictive potential of AN-ANP with tobacco was rated as severe by 68.1% of psychiatrists and 51.4% of clinical psychologists; 46.2% of other MHPs rated it as moderate. The addictive potential of AN-ANP without tobacco was rated as moderate by 50.5% of clinical psychologists and mild by 46.2% of psychiatrists. Of the sample, 67.46% discussed the harmful effects of AN-ANPs with clients, while 74.6% said a few or none of their clients sought help for AN-ANP cessation. Conclusion: Major lacunae were detected in the understanding of Indian MHPs about the addictive potential of AN-ANPs, management aspects, etc. An urgent need has been revealed for sensitization programs on AN-ANPs and the development of evidence-based cessation protocols.