Pharmacopsychiatry最新文献

{"title":"Association of Physical Activity and Bone Mineral Density in Adults with Depressive Symptoms.","authors":"Shakila Meshkat, Qiaowei Lin, Vanessa K Tassone, Reinhard Janssen-Aguilar, Wendy Lou, Venkat Bhat","doi":"10.1055/a-2645-4309","DOIUrl":"10.1055/a-2645-4309","url":null,"abstract":"<p><p>Depression affects a significant proportion of adults in the United States. Studies exploring the association between depression and bone mineral density (BMD) have shown mixed results. Moreover, the relationship between BMD and physical activity (PA) in individuals with depressive symptoms is unknown. In this paper, we evaluated the association of depressive symptoms and PA with BMD, as well as difference in BMD among females with depressive symptoms before and after menopause.Data from the 2011-2018 National Health and Nutrition Examination Survey were used. Multivariable linear regression was used to explore the relationship between BMD and exposure variables.The study included 9,238 participants, of whom 766 had depressive symptoms. The presence and severity of depressive symptoms were significantly associated with lower BMD (aCoef.=-0.0200 for depressive symptoms, -0.0017 for depressive symptom severity; <i>p</i><0.001). Vigorous PA intensity was positively correlated with BMD, with and without controlling for depressive symptoms (aCoef.=0.0006; CI=[0.0003, 0.0008]; <i>p</i><0.001). Additionally, high levels of vigorous PA showed a significant positive relationship with BMD (aCoef.=0.0141; CI=[0.0078, 0.0205]; <i>p</i><0.001). Postmenopausal status was significantly associated with lower BMD. No significant interaction effects were observed between depressive symptoms and PA or menopausal status on BMD.Our study demonstrated the an association between depressive symptoms and low BMD, as well as a positive association between high-intensity vigorous PA and BMD. Future studies should aim to replicate our findings and evaluate the underlying mechanisms.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"226-234"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Antidepressant and Antisuicidal Effects of Low-Dose Ketamine Infusion in Patients With Treatment-Resistant Depression With or Without Low-Grade Inflammation.","authors":"Mu-Hong Chen, Tung-Ping Su, Wei-Chen Lin, Cheng-Ta Li, Hui-Ju Wu, Shih-Jen Tsai, Ya-Mei Bai, Wei-Chung Mao, Pei-Chi Tu","doi":"10.1055/a-2499-7207","DOIUrl":"10.1055/a-2499-7207","url":null,"abstract":"<p><p>Low-grade inflammation (LGI) contributes to resistance against traditional antidepressants. However, whether the antidepressant and antisuicidal effects of ketamine on patients with treatment-resistant depression (TRD) differ between those with LGI and those without LGI remains unknown.This study included 167 patients with TRD, among whom 46 had LGI and 121 did not have LGI. The patients received a single infusion of either low-dose ketamine or a placebo. A C-reactive protein level of≥3 mg/L indicated LGI. Depressive symptoms were measured from baseline to day 3 by using the 17-item Hamilton Depression Rating Scale (HDRS) and the Montgomery-Asberg Depression Rating Scale (MADRS).Generalized estimating equation models revealed antidepressant effect of ketamine in patients with no LGI (HDRS scores: <i>p</i><0.001; MADRS scores: <i>p</i><0.001) but not in patients with LGI (all <i>p</i>>0.05). The antisuicidal effect of ketamine (indicated by the score on item 10 of the MADRS) was observed in both groups of patients with (<i>p</i>=0.046) and without LGI (<i>p</i><0.001). However, ketamine was effective for TRD regardless of whether inflammation levels were high or low, while the placebo response was notably greater only in patients with LGI.This study suggests that among patients with TRD, only those without LGI respond to low-dose ketamine infusion. Whether the negative findings of the antidepressant effect of ketamine among patients with LGI may be because of the effect of the placebo infusion needs further investigation. Further randomized, placebo-controlled studies are needed to validate these findings.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"235-241"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Glutamate Neurotransmission Genes on the Outcomes of Antipsychotic Treatments.","authors":"Marc Cendrós, Rosa Catalán, Mercè Torra, Rafael Penadés, Alexandre González-Rodríguez, Mercè Brunet, Josefina Perez-Blanco, Natalia Cullell, Alexandre Serra-Llovich, Marta H Hernandez, María J Arranz","doi":"10.1055/a-2603-0871","DOIUrl":"10.1055/a-2603-0871","url":null,"abstract":"<p><p>Traditionally, the aetiology of schizophrenia has been attributed to dopaminergic neurotransmission, but more recent information points to the role of glutamate pathways. Glutamatergic involvement in schizophrenia might be extensible to drug response. The aim of the study was to explore whether the variation in glutamate receptors, transporters and metabolism can influence the outcome of drug treatments.A total of 45 polymorphisms in the genes GRIN1, GRIN2A, GRIN2B, GRIN3A, GRIA1, GRIK2, GRM2, GRM3, GRM5, GRM8, SLC1A1, SLC1A3 and GAD1 were genotyped in 258 patients with schizophrenia. Efficacy and side effects were evaluated with the Positive and Negative Symptoms Scale and the UKU scale, respectively, at baseline and after 12 weeks.The analysis revealed associations between outcomes, including response and adverse effects and genetic variants in several genes (GAD1, GRIA1, GRIN2A, GRIN3A, GRIK2, GRM2, GRM5, GRM8 and SLC1A3). An association of rs1864205 in GRIA1 with autonomic side effects bordered statistical significance after correction for multiple comparisons.Our results suggest that genetic variation in glutamatergic pathways can influence the efficacy and safety of antipsychotic drugs.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"205-215"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to Psychotropic Drugs and Colorectal Cancer Risk in Patients with Affective Disorder: A Nested Case-Control Study.","authors":"Tien-Wei Hsu, Shih-Jen Tsai, Tzeng-Ji Chen, Mu-Hong Chen, Chih-Sung Liang","doi":"10.1055/a-2479-9430","DOIUrl":"10.1055/a-2479-9430","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the association between the risk of colorectal cancer (CRC) and exposure to mood stabilizers, antidepressants, and antipsychotics in patients with affective disorders.</p><p><strong>Methods: </strong>This nested case-control study used data from the National Health Insurance Database of Taiwan collected between 2001 and 2011. All participants in this study had affective disorders. Then, 1209 patients with CRC and 1:10 matched controls were identified based on their demographic and clinical characteristics. A logistic regression model adjusted for demographic and clinical characteristics was used to determine the risk of developing CRC after exposure to psychotropic drugs.</p><p><strong>Results: </strong>Among patients with affective disorders, exposure to mood stabilizers (reported as odds ratio; 95% confidence interval; 0.75; 0.57-0.98), antidepressants (0.83; 0.70-0.97), second-generation antipsychotics (0.67; 0.52-0.86), and first-generation antipsychotics (0.65; 0.52-0.81) were associated with a reduced risk of CRC compared to patients who were not exposed. When considering specific drugs, carbamazepine (0.34; 0.12-0.95), valproic acid (0.66; 0.46-0.95), gabapentin (0.44; 0.20-0.99), fluoxetine (0.82; 0.68-0.99), paroxetine (0.63; 0.45-0.87), and venlafaxine (0.72; 0.55-0.95) were associated with a lower risk of CRC.</p><p><strong>Conclusion: </strong>Exposure to psychotropic drugs in patients with affective disorders is associated with a lower risk of CRC compared to those who were not exposed. Although the causal relationship between psychotropic drug exposure and reduced risk of CRC could not be inferred directly, these findings may help clinicians and patients in clinical decision-making.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"216-225"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Intravenous Subnarcotic Ketamine Infusions as an Adjunct Treatment for Treatment-Resistant Depression Ready to be Recommended in European Guidelines?","authors":"Udo Bonnet, Norbert Scherbaum, Georg Juckel, Tom Bschor","doi":"10.1055/a-2646-7702","DOIUrl":"10.1055/a-2646-7702","url":null,"abstract":"","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"242-244"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Endocannabinoid System in PTSD: Molecular Targets for Modulating Fear and Anxiety.","authors":"Stanley Lyndon","doi":"10.1055/a-2647-8030","DOIUrl":"https://doi.org/10.1055/a-2647-8030","url":null,"abstract":"<p><p>Fear and anxiety perform essential protective roles, yet when they become dysregulated, they can trap trauma survivors in persistent hypervigilance and distress. Post-traumatic stress disorder (PTSD) manifests as intrusive memories, avoidance, and heightened arousal long after the precipitating event. Although current pharmacotherapies - including selective serotonin reuptake inhibitors, adrenergic blockers, benzodiazepines, and atypical antipsychotics - provide relief for some, many patients contend with residual symptoms or intolerable adverse effects. Recent discoveries position the endocannabinoid system as a pivotal regulator of fear acquisition, consolidation, and extinction. Clinical observations of altered anandamide levels and cannabinoid receptor CB₁ upregulation in individuals with severe PTSD underscore the therapeutic potential of restoring endocannabinoid tone. Preclinical studies demonstrate that direct CB₁ agonists, fatty acid amide hydrolase (FAAH) inhibitors, and phytocannabinoids such as tetrahydrocannabinol (THC) and cannabidiol (CBD) can facilitate extinction learning and attenuate anxiety-like behaviours. Preliminary human trials report that nabilone alleviates trauma-related nightmares and that acute cannabinoid administration modulates amygdala reactivity to a threat. Yet optimal dosing strategies, sex-specific responses, and ideal THC:CBD ratios remain to be defined. Self-medication with cannabis can offer transient relief but carries a risk of cannabis use disorder and potential worsening of PTSD symptoms. By elucidating molecular targets - including CB₁, CB₂, FAAH, and monoacylglycerol lipase - this review outlines a strategic framework for next-generation cannabinoid-based interventions. Harnessing the endocannabinoid system promises to expand the therapeutic arsenal for PTSD, offering hope for more effective and better-tolerated treatments.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Stress-Induced Cortisol Effects on Decision Making After Pharmacological Mineralocorticoid or Glucocorticoid Receptor Blockade.","authors":"Christian E Deuter, Theresa-Svea Weiß, Linn K Kuehl, Christian Otte, Katja Wingenfeld","doi":"10.1055/a-2646-7444","DOIUrl":"https://doi.org/10.1055/a-2646-7444","url":null,"abstract":"<p><p>Acute stress, potentially mediated by the stress-induced release of cortisol, affects decision-making processes. In the brain, cortisol activates two different types of receptors: the glucocorticoid receptor (GR) and the mineralocorticoid receptor (MR), each with different functional profiles. While previous studies suggest specific effects for MR and GR, the role of both receptor types in decision-making is insufficiently investigated.In this study, stress-induced effects of cortisol on decision-making processes were investigated after pharmacological receptor blockade of the MR (spironolactone, 300 mg) or the GR (mifepristone, 600 mg) in 318 healthy men (M=25.42, SD=5.01). After single-dose administration, participants were subjected to a social-evaluative stress task (Trier Social Stress Test, TSST), which reliably activates the HPA-axis, or a non-stressful control task (pTSST). Participants were randomly assigned to one study group: pTSST-placebo, TSST-placebo, TSST-spironolactone, or TSST-mifepristone. Subsequently, participants completed the Iowa Gambling Task (IGT) as an outcome measure. A mediation analysis was conducted to investigate direct effects of experimental manipulation in this study and indirect effects mediated by cortisol levels. The evidence for stress effects on decisions under ambiguity was positive.While stressed participants exhibited higher risk-taking, this was not the case in the TSST-spironolactone group, although this group had the most pronounced cortisol stress response. Thus, cortisol did not mediate this effect.The stress effect on decision-making was attenuated when MR was blocked. This corresponds to previous findings of increased risk-taking after MR activation and highlights a functional differentiation of both receptors for this domain.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Lumateperone Effective in Bipolar Depression? A Systematic Literature Review and Meta-Analysis on Placebo-Controlled Trials.","authors":"Maurizio Pompili, Mariarosaria Cifrodelli, Maria Anna Trocchia, Ludovica Longhini, Anna Comparelli, Roger S McIntyre, Isabella Berardelli","doi":"10.1055/a-2579-9406","DOIUrl":"https://doi.org/10.1055/a-2579-9406","url":null,"abstract":"<p><p>Bipolar depression is often difficult to treat and needs a specific therapeutic approach. This systematic review and meta-analysis aimed to evaluate the efficacy of lumateperone to be inclusive of more recently published studies with this agent in depressive episodes of bipolar disorder. Three meta-analyses were conducted to determine whether the mean Montgomery-Asberg Depression Rating Scale (MADRS) values in the placebo groups differ significantly from the mean MADRS scale values in the group receiving lumateperone 42 mg and whether the mean of Clinical Global Impression Bipolar Version - Severity Scale (CGI-BP-S) - (depression subscore and overall bipolar illness) values in the placebo groups differ significantly from the mean CGI-BP-S scale values in the group receiving lumateperone 42 mg. The meta-analysis showed a statistically significant difference between patients treated with lumateperone 42 mg and those treated with placebo for the MADRS and CGI subscores. The clinical profile of lumateperone indicates that it is a established and highly efficacious treatment option for major depressive episodes associated with bipolar disorder.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-Dependent Effects of Metformin and Olanzapine on the Metabolic System.","authors":"Gizem Kurt, Seyda T Durhan, Mehmet Ak, Tulin Yanik","doi":"10.1055/a-2634-7726","DOIUrl":"https://doi.org/10.1055/a-2634-7726","url":null,"abstract":"<p><p>Second-generation antipsychotic drugs, such as olanzapine, have been associated with metabolic side effects including significant weight gain. Recent evidence suggests that this adverse effect may be attenuated by metformin.Male Wistar rats were chronically treated with olanzapine, together with or without metformin, for 7 and 14 weeks. Feeding behavior, food intake, and weight gain were recorded, as well as plasma leptin and triglyceride levels were measured. The expression of hypothalamic candidate genes, <i>Pomc</i> and <i>Npy</i>, involved in appetite and energy balance expressions' was assessed by quantitative real-time polymerase chain reaction.Olanzapine alone caused significant body weight gain, and the co-administration of metformin for 14 weeks lowered body weight and food intake compared with both the 7-week and control groups. Plasma triglyceride levels did not differ among groups. Leptin levels were significantly higher in the olanzapine-only group and were lower in both metformin-olanzapine groups, more promising in the early co-treatment with metformin. Compared to the control group, the hypothalamus of the olanzapine treatment group exhibited downregulated <i>Pomc</i> expression and upregulated <i>Npy</i> expression.Early co-treatment with metformin significantly mitigated olanzapine-induced weight gain and food intake, demonstrating its potential in preventing metabolic side effects when initiated at the beginning of antipsychotic therapy.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2001-2021 Comparative Persistence of Oral Antipsychotics in Patients Initiating Treatment: Superiority of Clozapine in Time-to-Treatment Discontinuation.","authors":"Alberto Parabiaghi, Alessia A Galbussera, Barbara D'Avanzo, Mauro Tettamanti, Ida Fortino, Angelo Barbato","doi":"10.1055/a-2437-4366","DOIUrl":"10.1055/a-2437-4366","url":null,"abstract":"<p><strong>Background: </strong>Continuous antipsychotic (AP) therapy is crucial for managing psychotic disorders, and its early interruption reflects the drug's failure. Real-world epidemiological research is essential for confirming experimental data and generating new research hypotheses.</p><p><strong>Methods: </strong>The persistence of oral APs in a large population sample from 2000 to 2021 was analyzed by comparing AP prescriptions over this period across four Italian provinces, using dispensing data linked via a record-linkage procedure among regional healthcare utilization databases. We calculated personalized daily dosages and assessed time-to-treatment discontinuation over a 3-month period for patients initiating AP treatment. Treatment persistence was evaluated using Kaplan-Meier curves and Cox regression, with adjustments for age and sex.</p><p><strong>Results: </strong>Second-generation antipsychotics (SGAs) were favored over first-generation antipsychotics (FGAs), with olanzapine as the most prescribed. Within the study time frame, 42,434 individuals were prescribed a new continuous AP regimen. The analysis revealed 24 significant differences within 28 comparisons. As a class, SGAs demonstrated better treatment persistence than FGAs (HR: 0.76; 95%CI: 0.73, 0.79). Clozapine stood out for its superior persistence, surpassing all other SGAs, notably olanzapine (HR: 0.85; 95%CI: 0.79-0.91) and risperidone (HR: 0.80; 95%CI: 0.74-0.87). Olanzapine and aripiprazole showed better results than both risperidone and quetiapine. Quetiapine showed inferior 3-month persistence in all pairwise comparisons.</p><p><strong>Conclusion: </strong>The study results provide insight into the performance dynamics among SGAs: clozapine, despite being one of the less frequently dispensed APs in our sample, emerged as a significant prescription choice. The significance of pharmacoepidemiological studies in complementing experimental findings is also underscored.</p>","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"159-169"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}