Journal of Psychopharmacology (Oxford, England)最新文献

{"title":"Equasy revisited.","authors":"Allan H Young","doi":"10.1177/02698811211012604","DOIUrl":"https://doi.org/10.1177/02698811211012604","url":null,"abstract":"3,4-Methylenedioxymethamphetamine (MDMA), commonly known as ecstasy, was developed by Merck over a century ago and was used by clinicians in the 1970s to augment psychotherapy. MDMA was also widely used recreationally and this led to legal prohibitions in many countries. In the United Kingdom, MDMA was made illegal in 1977 by a modification order to the existing Misuse of Drugs Act (1971). In the USA the decision to make MDMA as a Schedule 1 drug was controversial, and some argued that the therapeutic uses of MDMA had not been sufficiently considered. As we have seen in the COVID-19 pandemic, politics can trump science and perhaps one of the more egregious examples of this was the reaction to an editorial in this Journal by Professor Nutt (2009) in which he tried to set the potential harms of MDMA in context and was then subsequently dismissed by the UK Home Secretary from his position as the chairman of the Advisory Council on the Misuse of Drugs. Following this, recognition of potential therapeutic benefits led eventually to the Food and Drug Administration granting breakthrough therapy designation for MDMA use with psychotherapy for post-traumatic stress disorder (PTSD) in 2017, thus providing some retrospective vindication for Nutt. The story of ecstasy has clearly been agonising at times over recent decades and often coloured by politics, but the question remains, what does the science show and has the balance of benefits and risks changed? We have five papers in this edition of the Journal which add to this literature. Firstly, the systematic review by Illingworth et al. (2021) reports therapeutic benefit with minimal physical and neurocognitive from the use of MDMA-assisted psychotherapy in treatment with resistant PTSD. Although bigger trials are called for, one can only speculate as to the number of persons in treatment with resistant PTSD who might have been helped if such research on MDMA’s putative benefits had been permitted sooner. Oeri (2021) reviews the existing literature of benefits and harms for several entactogenic drugs, with a few compounds from these classes identified as potential alternatives to MDMA. Van Amsterdam et al. report the results of a multi-decision, multicriterion decision analysis and how this might contribute to MDMA policy. They conclude that their results provide a feasible and realistic set of policy instrument options to revise the legislation towards a rational MDMA policy, that is likely to reduce both adverse (public) health risks and MDMA-related criminal burden (van Amsterdam et al., 2021). Borissova et al. (2021) conducted a double-blind, placebocontrolled experiment examining the effects of MDMA on trust, co-operative behaviour and empathy and interestingly report no increase in prosocial behaviour in a laboratory setting. The last MDMA paper in this edition of the Journal is by Studerus et al. (2021) who examined the prediction of MDMA response in healthy humans in a pooled analysis of placebo-co","PeriodicalId":156490,"journal":{"name":"Journal of Psychopharmacology (Oxford, England)","volume":" ","pages":"499-500"},"PeriodicalIF":4.1,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/02698811211012604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38942089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cocaine-specific speed-accuracy trade-off during anti-saccade testing differentiates patients with cocaine use disorder who achieve initial abstinence during treatment.","authors":"Constanza de Dios,&nbsp;Robert Suchting,&nbsp;Heather E Webber,&nbsp;Jin H Yoon,&nbsp;Luba Yammine,&nbsp;Jessica Vincent,&nbsp;Michael F Weaver,&nbsp;Angela L Stotts,&nbsp;Joy M Schmitz,&nbsp;Scott D Lane","doi":"10.1177/0269881121991566","DOIUrl":"https://doi.org/10.1177/0269881121991566","url":null,"abstract":"<p><strong>Background: </strong>The response time speed-accuracy trade-off (SATO) is an established index of information processing ability, but rarely examined as a variable in association with treatment of substance use disorder (SUD).</p><p><strong>Aim: </strong>The purpose of this study was to test baseline information-processing ability differences between individuals who respond to treatment for cocaine use disorder v. those who do not.</p><p><strong>Methods: </strong>Eighty patients enrolled in a clinical trial for cocaine use disorder completed a baseline drug-specific eye-tracking (anti-saccade) assessment prior to treatment, which included trials with both cocaine-related and neutral stimuli. SATO functions were computed for treatment responders v. non-responders.</p><p><strong>Results: </strong>Unexpectedly, responders demonstrated statistically different SATO functions, showing poorer accuracy when executing faster response times. This difference was present on trials that presented cocaine stimuli only.</p><p><strong>Conclusions: </strong>SATO during performance of an eye-movement task may be useful for predicting differential response to substance use disorder treatment. However, in the present study, results were specific to cocaine cues rather than an overall SATO performance decrement.</p>","PeriodicalId":156490,"journal":{"name":"Journal of Psychopharmacology (Oxford, England)","volume":" ","pages":"611-614"},"PeriodicalIF":4.1,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0269881121991566","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25370143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute effects of MDMA on trust, cooperative behaviour and empathy: A double-blind, placebo-controlled experiment.","authors":"Anna Borissova,&nbsp;Bart Ferguson,&nbsp;Matthew B Wall,&nbsp;Celia Ja Morgan,&nbsp;Robin L Carhart-Harris,&nbsp;Mark Bolstridge,&nbsp;Michael Ap Bloomfield,&nbsp;Tim M Williams,&nbsp;Amanda Feilding,&nbsp;Kevin Murphy,&nbsp;Robin J Tyacke,&nbsp;David Erritzoe,&nbsp;Lorna Stewart,&nbsp;Kim Wolff,&nbsp;David Nutt,&nbsp;H Valerie Curran,&nbsp;Will Lawn","doi":"10.1177/0269881120926673","DOIUrl":"https://doi.org/10.1177/0269881120926673","url":null,"abstract":"Background: 3,4-Methylenedioxymethamphetamine (MDMA) is being actively researched as an adjunct to psychotherapy. It may be beneficial to trust, empathy and cooperative behaviour due to its acute prosocial effects. Aim: To test (a) the acute effects of MDMA on measures of empathy, trust and cooperative behaviour, and (b) subacute changes in mood three days after MDMA administration. Methods: Twenty-five participants (n=7 female), participated in this double-blind, repeated-measures, placebo-controlled experiment. Participants attended two acute sessions, one week apart. Each acute session was followed by a subacute session three days later. Participants received placebo (100 mg ascorbic acid) during one acute session, and MDMA (100 mg MDMA-HCl) at the other, with order counterbalanced. Participants completed the following tasks assessing prosocial behaviour: a trust investment task, a trustworthy face rating task, an empathic stories task, a public project game, a dictator game and an ultimatum game. Participants reported subjective effects. Blood was taken pre-drug, 2 and 4 hours post-drug, and tested for plasma MDMA levels. Results: MDMA acutely increased self-reported ‘closeness to others’ and ‘euphoria’ and increased plasma concentrations of MDMA. MDMA did not significantly change task-based empathy, trust or cooperative behaviour. Using Bayesian analyses, we found evidence that MDMA and placebo did not differ in their effects on empathy and cooperative behaviour. MDMA did not significantly change subacute mood and this was supported by our Bayesian analyses. Conclusion: Despite augmentation in plasma MDMA levels and subjective drug effects, we found no increase in prosocial behaviour in a laboratory setting.","PeriodicalId":156490,"journal":{"name":"Journal of Psychopharmacology (Oxford, England)","volume":" ","pages":"547-555"},"PeriodicalIF":4.1,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0269881120926673","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38048302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond ecstasy: Alternative entactogens to 3,4-methylenedioxymethamphetamine with potential applications in psychotherapy.","authors":"Hans Emanuel Oeri","doi":"10.1177/0269881120920420","DOIUrl":"https://doi.org/10.1177/0269881120920420","url":null,"abstract":"<p><p>The last two decades have seen a revival of interest in the entactogen 3,4-methylenedioxy-N-methylamphetamine (MDMA) as an adjunct to psychotherapy, particularly for the treatment of post-traumatic stress disorder. While clinical results are highly promising, and MDMA is expected to be approved as a treatment in the near future, it is currently the only compound in its class of action that is being actively investigated as a medicine. This lack of alternatives to MDMA may prove detrimental to patients who do not respond well to the particular mechanism of action of MDMA or whose treatment calls for a modification of MDMA's effects. For instance, patients with existing cardiovascular conditions or with a prolonged history of stimulant drug use may not fit into the current model of MDMA-assisted psychotherapy, and could benefit from alternative drugs. This review examines the existing literature on a host of entactogenic drugs, which may prove to be useful alternatives in the future, paying particularly close attention to any neurotoxic risks, neuropharmacological mechanism of action and entactogenic commonalities with MDMA. The substances examined derive from the 1,3-benzodioxole, cathinone, benzofuran, aminoindane, indole and amphetamine classes. Several compounds from these classes are identified as potential alternatives to MDMA.</p>","PeriodicalId":156490,"journal":{"name":"Journal of Psychopharmacology (Oxford, England)","volume":" ","pages":"512-536"},"PeriodicalIF":4.1,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0269881120920420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38459843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic mechanisms of psilocybin: Changes in amygdala and prefrontal functional connectivity during emotional processing after psilocybin for treatment-resistant depression.","authors":"Lea J Mertens,&nbsp;Matthew B Wall,&nbsp;Leor Roseman,&nbsp;Lysia Demetriou,&nbsp;David J Nutt,&nbsp;Robin L Carhart-Harris","doi":"10.1177/0269881119895520","DOIUrl":"https://doi.org/10.1177/0269881119895520","url":null,"abstract":"<p><strong>Background: </strong>Psilocybin has shown promise as a treatment for depression but its therapeutic mechanisms are not properly understood. In contrast to the presumed actions of antidepressants, we recently found increased amygdala responsiveness to fearful faces one day after open-label treatment with psilocybin (25 mg) in 19 patients with treatment-resistant depression, which correlated with treatment efficacy.</p><p><strong>Aims: </strong>Aiming to further unravel the therapeutic mechanisms of psilocybin, the present study extends this basic activation analysis. We hypothesised changed amygdala functional connectivity, more precisely decreased amygdala-ventromedial prefrontal cortex functional connectivity, during face processing after treatment with psilocybin.</p><p><strong>Methods: </strong>Psychophysiological interaction analyses were conducted on functional magnetic resonance imaging data from a classic face/emotion perception task, with the bilateral amygdala and ventromedial prefrontal cortex time-series as physiological regressors. Average parameter estimates (beta weights) of significant clusters were correlated with clinical outcomes at one week.</p><p><strong>Results: </strong>Results showed decreased ventromedial prefrontal cortex-right amygdala functional connectivity during face processing post- (versus pre-) treatment; this decrease was associated with levels of rumination at one week. This effect was driven by connectivity changes in response to fearful and neutral (but not happy) faces. Independent whole-brain analyses also revealed a post-treatment increase in functional connectivity between the amygdala and ventromedial prefrontal cortex to occipital-parietal cortices during face processing.</p><p><strong>Conclusion: </strong>These results are consistent with the idea that psilocybin therapy revives emotional responsiveness on a neural and psychological level, which may be a key treatment mechanism for psychedelic therapy. Future larger placebo-controlled studies are needed to examine the replicability of the current findings.</p>","PeriodicalId":156490,"journal":{"name":"Journal of Psychopharmacology (Oxford, England)","volume":" ","pages":"167-180"},"PeriodicalIF":4.1,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0269881119895520","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37547231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of acute cannabidiol administration on anxiety and tremors induced by a Simulated Public Speaking Test in patients with Parkinson's disease.","authors":"Stephanie Martins de Faria,&nbsp;Daiene de Morais Fabrício,&nbsp;Vitor Tumas,&nbsp;Paula Costa Castro,&nbsp;Moacir Antonelli Ponti,&nbsp;Jaime Ec Hallak,&nbsp;Antonio W Zuardi,&nbsp;José Alexandre S Crippa,&nbsp;Marcos Hortes Nisihara Chagas","doi":"10.1177/0269881119895536","DOIUrl":"https://doi.org/10.1177/0269881119895536","url":null,"abstract":"<p><strong>Background: </strong>Cannabidiol (CBD) is one of the main components of <i>Cannabis sativa</i> and has anxiolytic properties, but no study has been conducted to evaluate the effects of CBD on anxiety signs and symptoms in patients with Parkinson's disease (PD). This study aimed to evaluate the impacts of acute CBD administration at a dose of 300 mg on anxiety measures and tremors induced by a Simulated Public Speaking Test (SPST) in individuals with PD.</p><p><strong>Methods: </strong>A randomised, double-blinded, placebo-controlled, crossover clinical trial was conducted. A total of 24 individuals with PD were included and underwent two experimental sessions within a 15-day interval. After taking CBD or a placebo, participants underwent the SPST. During the test, the following data were collected: heart rate, systemic blood pressure and tremor frequency and amplitude. In addition, the Visual Analog Mood Scales (VAMS) and Self-Statements during Public Speaking Scale were applied. Statistical analysis was performed by repeated-measures analysis of variance (ANOVA) while considering the drug, SPST phase and interactions between these variables.</p><p><strong>Results: </strong>There were statistically significant differences in the VAMS anxiety factor for the drug; CBD attenuated the anxiety experimentally induced by the SPST. Repeated-measures ANOVA showed significant differences in the drug for the variable related to tremor amplitude as recorded by the accelerometer.</p><p><strong>Conclusion: </strong>Acute CBD administration at a dose of 300 mg decreased anxiety in patients with PD, and there was also decreased tremor amplitude in an anxiogenic situation.</p>","PeriodicalId":156490,"journal":{"name":"Journal of Psychopharmacology (Oxford, England)","volume":" ","pages":"189-196"},"PeriodicalIF":4.1,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0269881119895536","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37519191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of energy drink consumption with substance-use initiation among adolescents: A 12-month longitudinal study.","authors":"Artur Galimov,&nbsp;Reiner Hanewinkel,&nbsp;Julia Hansen,&nbsp;Jennifer B Unger,&nbsp;Steve Sussman,&nbsp;Matthis Morgenstern","doi":"10.1177/0269881119895545","DOIUrl":"https://doi.org/10.1177/0269881119895545","url":null,"abstract":"<p><strong>Background: </strong>Aggressive marketing has resulted in exponential growth of energy drink sales in recent years. Despite growing concerns about the negative health effects of energy drinks, they are increasingly popular among young people. Little is known about temporal associations between energy drink consumption and other drug use, though some researchers have suggested that energy drink consumption reflects an entry into a drug-using lifestyle.</p><p><strong>Aims: </strong>The purpose of this study was to evaluate whether energy drink use among adolescents who have never tried substances is associated with a risk of initiating tobacco (i.e. cigarettes, e-cigarettes, and hookah) and alcohol use.</p><p><strong>Methods: </strong>A school-based longitudinal study of 3071 adolescents ages 9-17 years was conducted in six federal states of Germany. Data analyses involved two assessment waves that took place approximately 12 months apart: baseline (fall-winter of school year 2016-2017), and 12-month follow-up (fall-winter of school year 2017-2018).</p><p><strong>Results: </strong>Multilevel models revealed that energy drink use at baseline was associated with cigarette (odds ratio for energy drink ever use, 3.15 (95% confidence interval, 2.07-4.78 )), e-cigarette (odds ratio, 4.32 (95% confidence interval, 2.87-6.51)), hookah smoking (odds ratio, 3.15 (95% confidence interval, 2.06-4.82)), and alcohol use (odds ratio, 2.26 (95% confidence interval, 1.75-2.93)) initiation within 12 months.</p><p><strong>Conclusions: </strong>These results raise the possibility that energy drinks may potentially act as a gateway drug to other substances. However, inferences regarding whether this association is or is not causal cannot yet be made.</p>","PeriodicalId":156490,"journal":{"name":"Journal of Psychopharmacology (Oxford, England)","volume":" ","pages":"221-228"},"PeriodicalIF":4.1,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0269881119895545","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37522738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of long-term antipsychotics treatment on body weight: A population-based cohort study","authors":"J. C. Bazo-Alvarez, T. Morris, J. Carpenter, J. Hayes, I. Petersen","doi":"10.1177/0269881119885918","DOIUrl":"https://doi.org/10.1177/0269881119885918","url":null,"abstract":"Background: Antipsychotics are often prescribed for long-term periods, however, most evidence of their impact on body weight comes from short-term clinical trials. Particularly, impact associated with dosage has been barely studied. Aims: The aim of this study was to describe the short- and long-term change in body weight of people initiated on high or low doses of the three most commonly prescribed second-generation antipsychotics. Methods: Retrospective cohorts of individuals with a diagnosed psychotic disorder observed from 2005 to 2015 in the UK primary care. The exposure was the first prescription of olanzapine, quetiapine or risperidone. The main outcome was change in body weight four years before and four years after initiation of antipsychotic treatment, stratified on sex and ‘low’ or ‘high’ dose. Results: In total, 22,306 women and 16,559 men were observed. Olanzapine treatment was associated with the highest change in weight, with higher doses resulting in more weight gain. After 4 years, given a high dose of olanzapine (> 5 mg), women gained on average +6.1 kg; whereas given a low dose (⩽ 5 mg), they gained +4.4 kg. During the first six weeks of olanzapine treatment, they gained on average +3.2 kg on high dose and +1.9 kg on low dose. The trends were similar for men. Individuals prescribed risperidone and quetiapine experienced less weight gain in both the short- and long-term. Conclusions: Olanzapine treatment was associated with the highest increase in weight. Higher doses were associated with more weight gain. Doctors should prescribe the lowest effective dose to balance mental-health benefits, weight gain and other adverse effects.","PeriodicalId":156490,"journal":{"name":"Journal of Psychopharmacology (Oxford, England)","volume":"240 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115786789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pro-cognitive effect of upregulating cyclic guanosine monophosphate signalling during memory acquisition or early consolidation is mediated by increased AMPA receptor trafficking","authors":"Elentina K. Argyrousi, P. Heckman, B. T. V. van Hagen, Hannah Muysers, Nick P. van Goethem, J. Prickaerts","doi":"10.1177/0269881119885262","DOIUrl":"https://doi.org/10.1177/0269881119885262","url":null,"abstract":"Background: Episodic memory consists of different mnemonic phases, including acquisition and early and late consolidation. Each of these phases is characterised by distinct molecular processes. Although both cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) are implicated in the acquisition phase, early consolidation only depends on cGMP, whereas late consolidation is mediated by cAMP. Accordingly, the cGMP-selective phosphodiesterase 5 (PDE5) inhibitor vardenafil or the cAMP-selective PDE4 inhibitor rolipram can improve memory acquisition or consolidation when applied during their respective time windows. Aims: Considering the important role of glutamatergic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPAR) during normal memory function, we aimed to investigate whether the differential actions of these PDE inhibitors are mediated through AMPAR dynamics. Methods: For biochemical analysis, mice were treated with either vardenafil or rolipram and sacrificed shortly after injection. For the behavioural studies, mice received either of the inhibitors during the different mnemonic phases, while their spatial memory was tested using the object location task, and they were sacrificed 24 hours later. Results: Administration of either vardenafil or rolipram causes rapid changes in AMPARs. Moreover, treatment with vardenafil during the acquisition or early consolidation of spatial memory resulted in increased surface levels of AMPARs which were still augmented 24 hours after learning. Membrane levels of AMPARs were not affected anymore 24 hours after learning when rolipram was administrated at either the acquisition or late consolidation phase. Conclusions: These results suggest that dissociative molecular mechanisms could mediate the pro-cognitive function of different classes of PDE inhibitors, and in the case of vardenafil, this phenomenon could be explained by changes in AMPAR dynamics.","PeriodicalId":156490,"journal":{"name":"Journal of Psychopharmacology (Oxford, England)","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125887552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective serotonin reuptake inhibitors and benzodiazepines in panic disorder: A meta-analysis of common side effects in acute treatment.","authors":"Laiana A Quagliato,&nbsp;Fiammetta Cosci,&nbsp;Richard I Shader,&nbsp;Edward K Silberman,&nbsp;Vladan Starcevic,&nbsp;Richard Balon,&nbsp;Steven L Dubovsky,&nbsp;Carl Salzman,&nbsp;John H Krystal,&nbsp;Steve J Weintraub,&nbsp;Rafael C Freire,&nbsp;Antonio E Nardi","doi":"10.1177/0269881119859372","DOIUrl":"https://doi.org/10.1177/0269881119859372","url":null,"abstract":"<p><strong>Background: </strong>Benzodiazepines (BZs) and selective serotonin reuptake inhibitors (SSRIs) are effective in the pharmacologic treatment of panic disorder (PD). However, treatment guidelines favor SSRIs over BZs based on the belief that BZs are associated with more adverse effects than SSRIs. This belief, however, is currently supported only by opinion and anecdotes.</p><p><strong>Aim: </strong>The aim of this review and meta-analysis was to determine if there truly is evidence that BZs cause more adverse effects than SSRIs in acute PD treatment.</p><p><strong>Methods: </strong>We systematically searched Web of Science, PubMed, Cochrane Central Register of Controlled Trials, and clinical trials register databases. Short randomized clinical trials of a minimum of four weeks and a maximum of 12 weeks that studied SSRIs or BZs compared to placebo in acute PD treatment were included in a meta-analysis. The primary outcome was all-cause adverse event rate in participants who received SSRIs, BZs, or placebo.</p><p><strong>Results: </strong>Overall, the meta-analysis showed that SSRIs cause more adverse events than BZs in short-term PD treatment. Specifically, SSRI treatment was a risk factor for diaphoresis, fatigue, nausea, diarrhea, and insomnia, whereas BZ treatment was a risk factor for memory problems, constipation, and dry mouth. Both classes of drugs were associated with somnolence. SSRIs were associated with abnormal ejaculation, while BZs were associated with libido reduction. BZs were protective against tachycardia, diaphoresis, fatigue, and insomnia.</p><p><strong>Conclusion: </strong>Randomized, blinded studies comparing SSRIs and BZs for the short-term treatment of PD should be performed. Clinical guidelines based on incontrovertible evidence are needed.</p>","PeriodicalId":156490,"journal":{"name":"Journal of Psychopharmacology (Oxford, England)","volume":" ","pages":"1340-1351"},"PeriodicalIF":4.1,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0269881119859372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37416197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}