Human Psychopharmacology: Clinical and Experimental最新文献

{"title":"Role of serotonin transporter and receptor gene polymorphisms in treatment response to selective serotonin reuptake inhibitors in major depressive disorder","authors":"Varsha Ramesh,&nbsp;Vettriselvi Venkatesan,&nbsp;Balakrishnan Ramasamy","doi":"10.1002/hup.2830","DOIUrl":"10.1002/hup.2830","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Significant challenges in the management of major depressive disorder include the lag period from treatment initiation to an evident response, low response rates and unpredictable disparities in outcome between patients. As a large part of these has been linked to genetic mechanisms, we tried to establish a relationship between genes associated with serotonin neurotransmission and outcome to selective serotonin reuptake inhibitor (SSRI) treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred and twenty-five patients with moderate to severe depression [at least 15 on the Hamilton Depression (HAM-D) Rating Scale] being started on SSRI were recruited. Those with a reduction of at least 50% from baseline or an absolute score of 7 or less after 8 weeks of treatment were considered as responders. The serotonin transporter linked polymorphic region 5HTTLPR, serotonin transporter intron 2 (STin2) polymorphism and the 5-HT receptor 1A rs6295 polymorphisms were studied in association with outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The l/l genotype of the 5HTTLPR was associated with greater likelihood of response (OR: 4.65, CI: 1.74–12.38, <i>p</i> = 0.003). Patients with the 12/12 repeat variant of the STin2 VNTR polymorphism showed a greater reduction in HAM-D score, compared to patients with the 10/10 genotype (OR: 0.12, CI: 0.03–0.44, <i>p</i> = 0.001). We found no association of the 5HTR1Ars6295 polymorphism with response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The 5HTTLPR polymorphism and the SLC6A4 intron 2 polymorphism were associated with treatment response, with the l/l genotype and 12-copy allele showing a tendency towards better outcomes, respectively.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychopharmacoepidemiology of antidepressant medications among homeless and unstably housed service users in the Veterans Affairs healthcare system","authors":"Jack Tsai,&nbsp;Dorota Szymkowiak,&nbsp;Theddeus Iheanacho","doi":"10.1002/hup.2829","DOIUrl":"10.1002/hup.2829","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study conducted a pharmacoepidemiologic examination of antidepressant prescription patterns in homeless and unstably housed (HUH) populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were analyzed on over 2.6 million veterans from the U.S. Department of Veterans Affairs (VA), the largest provider of healthcare for HUH veterans and a system that does not require healthcare insurance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multivariable analyses revealed that HUH veterans with depression and PTSD were less likely to receive an antidepressant Rx compared to their stably housed (SH) counterparts with these conditions (OR = 0.77, 99% CI = 0.74–0.79; and OR = 0.87, 99% CI = 0.84–0.90, respectively). Antidepressants were mostly prescribed in specialty mental health care settings, but HUH veterans were less likely to be prescribed antidepressants in primary care settings than SH veterans. In the total sample, the 40–49 age group, female sex, VA service-connected disability, outpatient mental health visits, and emergency department visits were positively associated with any antidepressant Rx. Nearly all psychiatric diagnoses were more associated with prescription of selective serotonin reuptake inhibitors/serotonin and norepinephrine reuptake inhibitors (SSRIs/SNRIs) than tricyclic antidepressants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings highlight socioeconomic disparities in antidepressant Rx in a healthcare system that does not rely on insurance and suggest clinical challenges with antidepressant prescriptions in HUH populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39893623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress, caffeine and psychosis-like experiences—A double-blind, placebo-controlled experiment","authors":"Csilla Ágoston,&nbsp;László Bernáth,&nbsp;Peter J. Rogers,&nbsp;Zsolt Demetrovics","doi":"10.1002/hup.2828","DOIUrl":"10.1002/hup.2828","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Psychosis-like perceptual distortions can occur in the general population, and both stress and caffeine can enhance the proneness to psychosis-like experiences, such as hallucinations. The current study aims to explore the effects of acute caffeine intake and acute stress on perceptual distortions in a double-blind, placebo-controlled experiment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Regular caffeine consumers (<i>n</i> = 92) and non/low consumers (<i>n</i> = 89) were assigned to 100 mg caffeine/placebo and stress/no stress conditions. The White Christmas Paradigm (WCP) was used to measure hallucination-like symptoms, and bias towards threat-related words was used as an indicator of persecutory ideation. Participants reported their daily caffeine intake, and completed the State-Trait Anxiety Inventory, the Launay-Slade Hallucination Scale, the Persecutory Ideation Questionnaire and the Marlow-Crowne Social Desirability Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Acute stress slightly increased hallucination-like experiences, but not recall bias, while the small amount of caffeine had a time-dependent effect on recall bias. Proneness to persecutory ideation was positively and social desirability was negatively correlated with recall bias towards threat-related words, while proneness to hallucinations positively correlated with hallucination-like experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results indicate that psychosocial stress—in line with the diathesis–stress model—can lead to the enhancement of hallucination-like experiences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39635295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective analysis of serum prolactin levels, clinical symptomatology and sexual functions in patients with schizophrenia switched to paliperidone palmitate 3-monthly from paliperidone palmitate 1-monthly: Preliminary findings of the first 3 months","authors":"Ersin Hatice Karslioğlu,&nbsp;Zeynep Kolcu,&nbsp;Nisa İrem Karslioğlu,&nbsp;Ali Çayköylü","doi":"10.1002/hup.2827","DOIUrl":"10.1002/hup.2827","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Long-acting injectable (LAI) antipsychotics were developed to improve adherence to schizophrenia treatment. Paliperidone palmitate (PP) has two LAI forms: Monthly (PP1M) and three-monthly (PP3M). PP3M shows less difference in Peak-to-Trough drug concentration levels. This could be related to a lower incidence of hyperprolactinemia, which may negatively affect adherence. We aimed to compare prolactin levels and investigate relationships between prolactin levels, symptomatology and sexual function in patients with schizophrenia after switching from PP1M to PP3M.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-five patients were enrolled. The sociodemographic data form, the Positive and Negative Syndromes Scale (PANSS) and the Arizona Sexual Experience Scale (ASEX) were used. Morning blood samples were drawn to determine prolactin levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prolactin level (<i>p</i> &lt; 0.001), the total score and arousal sub-score of ASEX (respectively; <i>p</i> = 0.015, <i>p</i> = 0.020) and the total score and positive scale of PANSS (respectively; <i>p</i> = 0.017, <i>p</i> = 0.021) were decreased on the 90th day (±15 days).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>After switching to PP3M, the decreases in prolactin levels and potentially related sexual side effects was statistically significant. There may be a difference between two formulations of the same drug in terms of side effects, and there is a need for prospective follow-up studies with larger samples.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39632010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of eight ABCB1 polymorphisms on antidepressant response in a prospective cohort of treatment-free Russian patients with moderate or severe depression: An explorative psychopharmacological study with naturalistic design","authors":"Lisanne M. Geers,&nbsp;Taichi Ochi,&nbsp;Natalya M. Vyalova,&nbsp;Innokentiy S. Losenkov,&nbsp;Diana Z. Paderina,&nbsp;Ivan V. Pozhidaev,&nbsp;German G. Simutkin,&nbsp;Nikolay A. Bokhan,&nbsp;Bob Wilffert,&nbsp;Daniël J. Touw,&nbsp;Anton J.M. Loonen,&nbsp;Svetlana A. Ivanova","doi":"10.1002/hup.2826","DOIUrl":"10.1002/hup.2826","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many antidepressants are substrates of P-glycoprotein, an efflux transporter in the blood-brain-barrier encoded by the <i>ABCB1</i> gene. Genetic variations might influence the transport rate of antidepressants and hence their pharmacological effects. This study investigates the influence of eight polymorphisms in the <i>ABCB1</i> gene on antidepressant treatment response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>152 patients were included from psychiatric departments of the Mental Health Research Institute in Tomsk. The difference in Hamilton-Depression-Rating-Scale (HAMD-17)-scores between baseline and week two, week two and four, and baseline and week four was used to estimate timing of improvement of depression. Associations between the <i>ABCB1</i> gene-polymorphisms and reduction in HAMD-17 score were assessed using independent <i>t</i>-test and multiple linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tricyclic antidepressants were associated with a higher reduction of HAMD-17 score when compared to SSRIs. The SNP rs2235040 A-allele had a significant positive influence on the ΔHAMD-17_(0→2W) score but a significant negative influence on the ΔHAMD-17_(2→4W) score. The rs4148739 G-allele had a significant negative influence on the ΔHAMD-17_(0→2W) score but a significant positive influence on the ΔHAMD-17_(2→4W) score. The SNP rs2235015 T-allele is significant negatively related to the ΔHAMD-17_(2→4W) score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ABCB1 Genetic variations appear to affect speed but not magnitude of antidepressant drug response.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/a4/HUP-37-0.PMC9285790.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39741346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential role of lysergic acid diethylamide for psychological assisted therapy: A meta-analysis of randomised controlled trials in healthy volunteers","authors":"Hang Li,&nbsp;Yi Zhong,&nbsp;Siyuan Yang,&nbsp;Jiahe Wang,&nbsp;Xiang Li,&nbsp;Jianguo Xu,&nbsp;Heng Gao,&nbsp;Gang Chen","doi":"10.1002/hup.2825","DOIUrl":"10.1002/hup.2825","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In recent years, interest in using lysergic acid diethylamide (LSD) in psychiatric research and corresponding therapy has increased rapidly. In this meta-analysis, we explored the effects of LSD on healthy subjects with respect to subjective drug effects, blood pressure, heart rate, body temperature and side effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>PubMed, Embase, and the Cochrane Library were searched from January 2010 to December 2020 for randomized controlled trials (RCTs) on the effects of LSD in healthy people. Subsequently, 5 RCTs with 132 healthy people which focused on the effects of LSD were enrolled in our study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>We found that taking 50, 100 and 200 mcg LSD doses were associated with a significant increase in the maximal difference from the baseline compared to the placebo group among the outcomes of AMRS (Adjective Mood Rating Scale) score. Significant differences existed between the LSD and placebo groups when taking 100 and 200 mcg LSD in acute adverse effects (100 mcg: SMD = .97, 95% confidence interval [CI], .50, 1.44, <i>Z</i> = 4.04, <i>p</i> &lt; .001; 200 mcg: SMD = 1.18, 95% CI, 0.65, 1.72, <i>Z</i> = 4.32, <i>p</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Meta-analysis of the subjective effects of LSD in healthy people revealed moderate significant effect sizes in favor of LSD with no significant adverse effects. A 100 mcg dose of LSD has potential for use in psychological-assisted therapy and may improve the mental fitness of patients with disease-related psychiatric distress. Additional clinical trials are necessary to explore the efficacy and safety of LSD as a psychological-assisted therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2021-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39681951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential processes of change in MDMA-Assisted therapy for social anxiety disorder: Enhanced memory reconsolidation, self-transcendence, and therapeutic relationships","authors":"Jason B. Luoma,&nbsp;Ben Shahar,&nbsp;M. Kati Lear,&nbsp;Brian Pilecki,&nbsp;Anne Wagner","doi":"10.1002/hup.2824","DOIUrl":"10.1002/hup.2824","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Researchers have suggested that psychotherapy may be enhanced by the addition of 3,4-methylenedioxymethamphetamine (MDMA), particularly in the treatment of disorders wherein interpersonal dysfunction is central, such as social anxiety disorder. We review literature pertaining to three potential processes of change that may be instigated during sessions involving MDMA administration in the treatment of social anxiety disorder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This is a narrative review that integrates research on the etiology and maintenance of social anxiety disorder and mechanisms of action of MDMA to examine how MDMA may enhance psychotherapy outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We first outline how MDMA may enhance memory reconsolidation in social anxiety disorder. We then discuss how MDMA may induce experiences of self-transcendence and self-transcendent emotions such as compassion, love, and awe; and how these experiences may be therapeutic in the context of social anxiety disorder. We subsequently discuss the possibility that MDMA may enhance the strength and effectiveness of the therapeutic relationship which is a robust predictor of outcomes across many disorders as well as a potential key ingredient in treating disorders where shame and social disconnection are central factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We discuss how processes of change may extend beyond the MDMA dosing sessions themselves.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2021-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/b6/HUP-37-0.PMC9285360.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39593532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first patient to receive olanzapine: A recollection","authors":"David S. Baldwin","doi":"10.1002/hup.2823","DOIUrl":"10.1002/hup.2823","url":null,"abstract":"Olanzapine was approved for general use in patients with schizophrenia 25 years ago, in September 1996: however, the first patient to receive it did so in December 1988, by participating in a safety and dose‐finding study of an experimental compound, then designated LY170053, developed by the Eli Lilly pharmaceutical company at its neuroscience research centre in Erl Wood, Surrey. Awareness of the superior efficacy of clozapine when compared to other antipsychotic drugs had encouraged the search for related compounds which might preserve its efficacy and the reduced burden of extrapyramidal adverse effects, whilst avoiding tolerability problems such as weight gain and the risks of neutropenia and agranulocytosis. LY170053 had a marked molecular resemblance to clozapine, possessed somewhat similar pharmacological properties (Bymaster et al., 1996), and its administration produced effects in experimental animals like those seen with antipsychotic drugs (Moore et al., 1992), indicating that an initial investigation in patients was warranted. But pre‐clinical studies had suggested potential hepatoxicity, and the dosage for exerting possible antipsychotic effects in patients remained uncertain: such an investigation would necessarily involve exclusion of patients with any evidence of hepatic disease or dysfunction, and careful monitoring of liver function tests at baseline and during dosage escalation, whilst assessing any treatment effects on positive and negative features of schizophrenia. Dominic was in his early twenties when he arrived in London to labour on a building site. He soon missed his distant family, found it hard to banter with his robust workmates, became troubled by persecutory delusions and auditory hallucinations, and neglected his basic needs. He may have experienced something similar a few years before coming to England but was not able to recall having ever undergone psychotropic drug treatment. He knew he was unwell and readily consented to participate in the study. As baseline blood tests proved unremarkable, he started medication at the initial dosage of 10 mg/day, expecting twice‐weekly increases according to a pre‐ determined protocol, to a maximum of 120 mg/day over four weeks, with a potential two‐week extension. All went well, at first, although the ward pharmacist and nursing staff found it hard to dispense and offer a tablet called ‘LY170053’, referring to it informally as ‘lillazapine’. Delusions lessened in intensity in the second week of treatment, hallucinations become less frequent, and his appetite increased: but on Day 19, when the study medication dosage was 30 mg/day, he said he felt weak and sluggish: “I just don't feel right, doc”. Levels of ALT and AST enzymes were both greater than 2.5 times the upper limit of normal, and an ESR was raised. Treatment was stopped and hepatic enzymes returned to within normal limits within a week. He was switched to what was then conventional antipsychotic treatment (chlorpro","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"36 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2021-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39558954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How prevalent and severe is addiction on GABAmimetic drugs in an elderly German general hospital population? Focus on gabapentinoids, benzodiazepines, and z-hypnotic drugs","authors":"Udo Bonnet,&nbsp;Heath B. McAnally","doi":"10.1002/hup.2822","DOIUrl":"10.1002/hup.2822","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Gabapentinoids (GPT) are reported to be increasingly misused by opioid- and polydrug-users, but the addictive potential of GPT outside of these populations remains understudied. Investigations comparing GPT abuse and dependence liability to that of other commonly prescribed Central Nervous System-acting medications are therefore warranted. We provide a comparison of GPT-abuse/dependence to that of other GABAmimetics within an elderly population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>DSM-IV-TR-based data (previously prospectively collected by SKID-I-interview) from a random sample of elderly patients admitted to a metropolitan German general hospital were reviewed. The prevalence and severity of GPT, benzodiazepine (BDZ), and z-hypnotic drug (ZD)-abuse and -dependence were compared, stratified also by mono-substance (no concurrent current or previous substance use) and de novo-substance (first)-abuse and -dependence states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 400 patients (75 ± 6.4 years old; 63% females), neither current nor past abuse of BDZ, ZD or GPT, nor other illicit substances was observed. Dependence upon BDZ, ZD or GPT was observed among 55 (13.75%) individuals. The related lifetime/12-month prevalence-rates were: dependence condition (BDZ: 7%/2.45%; ZD: 4.25%/4.25%; GPT: 2.75/2.5%); mono-dependence condition (BDZ: 2.25%/0.75%; ZD: 1%/1%, GPT: 0%/0%); de novo-dependence condition (BDZ: 2.75%/1.75%; ZD: 1%/1%, GPT: 0.5%/0.5%). Opioid analgesic-dependence (<i>N</i> = 43/400) was significantly more frequently linked with BDZ than with GPT (<i>p</i> &lt; 0.01) [Correction added on 29 December 2021, after first online publication: In the sentence ‘Opioid analgesic-dependence…’, the term ‘and ZD’ has been deleted]. For all three GABAmimetic classes, most mono- and de novo-dependence states were mild-to-moderate and lasted 2–6 years (median).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>GABAmimetic-dependence was usually mixed with other substance-dependences. Every third to fourth instance of BDZ- or ZD-dependence was a mono-dependence condition, while a pure GPT-dependence was absent in this elderly (and illicit substance-naïve) population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2021-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hup.2822","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39552565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melatonin and melatonin-agonists for metabolic syndrome components in patients treated with antipsychotics: A systematic review and meta-analysis","authors":"Alessandro Miola,&nbsp;Michele Fornaro,&nbsp;Fabio Sambataro,&nbsp;Marco Solmi","doi":"10.1002/hup.2821","DOIUrl":"10.1002/hup.2821","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Metabolic side effects are a limiting factor in the use of antipsychotics, which remain the cornerstone of long-term management of patients with severe mental illness. There is contrasting evidence on a possible role of melatonin and melatonin-agonists in attenuating antipsychotic-induced metabolic abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>We conducted a systematic review (PubMed, PsycInfo, Cochrane databases, up to August 2020) and a random-effect meta-analysis of double-blind, randomized placebo-controlled trials (RCTs) involving melatonin and melatonin-agonists in the treatment of antipsychotic-induced metabolic changes. The primary outcome was the standardized mean difference (SMD) of composite metabolic outcomes built with metabolic syndrome components. Secondary outcomes were individual metabolic syndrome components, and other anthropometric, glucose metabolism, lipid profile, and psychopathology measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of the initial 41 studies, six documented five separate RCTs randomizing 248 patients (126 to melatonin/ramelteon, 122 to placebo) affected by schizophrenia-spectrum disorders and bipolar disorder. Melatonin/ramelteon outperformed placebo on the primary outcome (SMD −0.28, 95% CI = −0.39 ÷ −0.168), as well as on all individual components of metabolic syndrome (systolic blood pressure MD −3.266, 95% CI = −6.020 ÷ −0.511; fasting glucose MD −3.766, 95% CI = −5.938 ÷ −1.593; triglycerides MD −9.800, 95% CI = −19.431 ÷ −0.169; HDL MD 2.995, 95% CI = 0.567 ÷ 5.423), except waist circumference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Melatonin/ramelteon augmentation may be beneficial for non-anthropometric metabolic syndrome components in patients treated with antipsychotics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2021-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39549109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}