Pharmacopsychiatry最新文献_第2页

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-07-01 Epub Date: 2025-02-25 DOI: 10.1055/a-2508-5757

Emytis Tavakoli, Angela Xiang, Mohamed I Husain, Daniel M Blumberger, Stefan Kloiber, Daniel J Mueller, Abigail Ortiz, Athina Perivolaris, Benoit H Mulsant

{"title":"Challenges Related to the Implementation of Measurement-Based Care for the Treatment of Major Depressive Disorder: A Feasibility Study.","authors":"Emytis Tavakoli, Angela Xiang, Mohamed I Husain, Daniel M Blumberger, Stefan Kloiber, Daniel J Mueller, Abigail Ortiz, Athina Perivolaris, Benoit H Mulsant","doi":"10.1055/a-2508-5757","DOIUrl":"10.1055/a-2508-5757","url":null,"abstract":"Measurement-based care (MBC) involves systematically assessing patients' symptoms and adverse events using standardized scales to guide treatment. While MBC has been shown to enhance the quality of care and outcomes in the pharmacotherapy of major depressive disorder (MDD), it is still rarely used in clinical practice. In this study, the feasibility of implementing MBC was assessed for patients with MDD seen in a large outpatient psychiatry clinic.Adults diagnosed with MDD were assessed at baseline and during a 12-week follow-up by phone or via emailed links with: the 9-item Patient Health Questionnaire (PHQ-9), an adverse effect rating scale, and a published suicide risk management protocol (SRMP). Antidepressants were recommended based on preferences expressed by the participant and treating psychiatrist; dosages were adjusted by the treating psychiatrist based on symptomatic improvement and adverse events.Over 2 years, 52 (21.2%) of 246 patients referred to the study were enrolled, 28 (53.8%) completed all assessments at all follow-up visits, 45 (87.0%) participants were prescribed one of the recommended antidepressants, and 22 (42.3%) remitted. Of the 27 participants presenting with suicidal ideation, 18 (66.6%) experienced a full resolution of these ideations.These findings highlight the challenges in implementing MBC for the pharmacotherapy of MDD and confirm some barriers to its broad adoption in clinical practice. The study also highlights its benefits in the selected group of patients who engage in MBC. Future studies need to continue to explore innovative ways to facilitate its broader implementation.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"170-177"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503135","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}

引用次数: 0

Regulatory Alignment of Psilocybin Clinical Trials in Major Depressive Disorder on ClinicalTrials.gov: A Cross-Sectional Analysis. 在ClinicalTrials.gov网站上，裸盖菇素治疗重度抑郁症临床试验的调控一致性：一项横断面分析。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-07-01 Epub Date: 2025-04-17 DOI: 10.1055/a-2529-7029

Damian Swieczkowski, Aleksander Kwaśny, Michal Pruc, Zuzanna Gaca, Lukasz Szarpak, Wiesław J Cubała

{"title":"Regulatory Alignment of Psilocybin Clinical Trials in Major Depressive Disorder on ClinicalTrials.gov: A Cross-Sectional Analysis.","authors":"Damian Swieczkowski, Aleksander Kwaśny, Michal Pruc, Zuzanna Gaca, Lukasz Szarpak, Wiesław J Cubała","doi":"10.1055/a-2529-7029","DOIUrl":"10.1055/a-2529-7029","url":null,"abstract":"Regulatory compliance is crucial in the clinical development of psychedelic substances, including psilocybin. This study aimed to examine the alignment of clinical trial protocols for psilocybin in the treatment of major depressive disorder (MDD) and treatment-resistant depression (TRD) with established regulatory requirements.A cross-sectional investigation was conducted on ClinicalTrials.gov using the keywords: \"Psilocybin\" and \"Psilocin\" to identify interventional studies with posted trial protocols. Only protocols for MDD and TRD were included. Data extraction focused on key regulatory aspects, including safety, functional unblinding, expectancy bias, and the distribution of investigational medical products.Eleven psilocybin trial protocols were identified, with four meeting the inclusion criteria. The most commonly studied psilocybin dose was 25 mg. Two trials were double-blind. Although the analyzed protocols superficially adhered to regulatory requirements, there were gaps in addressing potential drug interactions, the acute and chronic concurrent use of antidepressants, and prohibited medications. Certain aspects, such as functional unblinding or expectancy bias, did not share all pathways. Risk mitigation strategies were primarily based on external criteria. Patients with bipolar spectrum disorders or schizoaffective disorders were excluded.This study underscores the importance of conducting clinical trials on psychedelics in strict adherence to regulatory standards. Future research should focus on improving regulatory compliance and exploring the efficacy of psychedelics in broader patient populations.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"187-197"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005147","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}

引用次数: 0

Instruments Assessing Medication Literacy in Psychiatric Patients and the Caregivers: A Systematic Review. 评估精神科病人及照护者药物素养的仪器：一项系统回顾。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-07-01 Epub Date: 2025-06-04 DOI: 10.1055/a-2591-2089

Wan F H Wan Mohd Johari, Dayang F Abang Ma'mon, Izyan A Wahab, Nurul A Bahruddin, Noorasyikin Shamsuddin

引用次数: 0

Diversion and Abuse of Prescribed Methylphenidate - A Survey of an Outpatient Clinic for Adult Persons with ADHD. 处方哌醋甲酯的转移和滥用——对成年ADHD患者门诊的调查。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-07-01 Epub Date: 2025-03-27 DOI: 10.1055/a-2545-1286

Mona Abdel-Hamid, Naomi Lyons, Michael Specka, Claudia Bartels, Michael Belz, Philipp Hessmann, Henrike Schecke, Thomas Zwarg, Norbert Scherbaum

引用次数: 0

Cardiovascular Effects of Non-Selective Monoamine Oxidase Inhibitors and Intranasal Esketamine Combination in Depression - A Quasi-Experimental Design with Bayesian Analyses. 非选择性单胺氧化酶抑制剂和鼻内艾氯胺酮联合治疗抑郁症对心血管的影响——贝叶斯分析的准实验设计。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-06-02 DOI: 10.1055/a-2590-3469

Ludovic C Dormegny-Jeanjean, Suzie Lenoir, Ilia Humbert, Olivier A E Mainberger, Coraline Lozere, Camille Meyer, Bernard Geny, Bruno Michel, Jack R Foucher, Clément de Crespin de Billy

{"title":"Cardiovascular Effects of Non-Selective Monoamine Oxidase Inhibitors and Intranasal Esketamine Combination in Depression - A Quasi-Experimental Design with Bayesian Analyses.","authors":"Ludovic C Dormegny-Jeanjean, Suzie Lenoir, Ilia Humbert, Olivier A E Mainberger, Coraline Lozere, Camille Meyer, Bernard Geny, Bruno Michel, Jack R Foucher, Clément de Crespin de Billy","doi":"10.1055/a-2590-3469","DOIUrl":"https://doi.org/10.1055/a-2590-3469","url":null,"abstract":"Ketamine and esketamine (ESK) offer new treatment options for resistant depression. Unlike traditional antidepressants, they can be used in combination with non-selective monoamine oxidase inhibitors (NS-MAOI) without the risk of serotonergic syndrome. However, potential sympathomimetic synergy may lead to elevated blood pressure (BP). This series investigates whether cardiovascular parameters (heart rate, systolic [SP], and diastolic [DP] pressures) increase during ESK sessions and whether the ESK+NS-MAOI combination is associated with BP elevations.We collected cardiovascular parameters for ESK sessions conducted between 2018 and 2022. These parameters were measured at baseline and every 30 min for 2 h. Patients were categorized into two non-equivalent groups: those receiving ESK alone and those receiving ESK+NS-MAOI. A Bayesian random model was used to estimate the evolution of these parameters, while a Bayesian hierarchical model assessed factors contributing to BP elevation.ESK sessions (n=193), of which 116 involved NS-MAOI, were performed in 13 patients. SP, DP, and heart rate showed peak increases during sessions, but these changes were not clinically significant (SP+8.68 mmHg, DP+6.57 mmHg, and heart rate+3.5 bpm). No significant differences were found between the ESK-alone and ESK+NS-MAOI groups. The combination was not identified as a factor linked to BP elevations.These findings align with previous research on ketamine derivatives and suggest minimal peripheric sympathomimetic synergy with NS-MAOI. Bayesian models were used to account for biases intrinsically related to these ecological data and provide a foundation for future open adversarial collaborations. Registration NCT05530668.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209074","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}

引用次数: 0

Ensemble Machine Learning Model for Real-Time Valproic Acid Prediction in Epilepsy Treatment. 癫痫治疗中丙戊酸实时预测的集成机器学习模型。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-06-02 DOI: 10.1055/a-2593-3125

Jiangchuan Xie, Pan Ma, Xinmei Pan, Liya Cao, Ruixiang Liu, Lirong Xiong, Hongqian Wang, Xin Zhang, Linli Xie, Yongchuan Chen

{"title":"Ensemble Machine Learning Model for Real-Time Valproic Acid Prediction in Epilepsy Treatment.","authors":"Jiangchuan Xie, Pan Ma, Xinmei Pan, Liya Cao, Ruixiang Liu, Lirong Xiong, Hongqian Wang, Xin Zhang, Linli Xie, Yongchuan Chen","doi":"10.1055/a-2593-3125","DOIUrl":"https://doi.org/10.1055/a-2593-3125","url":null,"abstract":"To develop an optimal model to predict valproic acid (VPA) concentrations by machine learning, ensuring that the VPA plasma concentration is in the effective treatment range, and thus effectively control the patient's epilepsy.This single-center, retrospective study included patients diagnosed with epilepsy from January 2014 to January 2022. Patients receiving VPA and having undergone therapeutic drug monitoring were enrolled. Top three algorithms exhibiting superior model performance were selected to establish the ensemble prediction model, with Shapley Additive exPlanations (SHAP) employed for model interpretation. An independent dataset was collected as a clinical validation group to verify the prediction model performance.The algorithms chosen for the ensemble model-Light Gradient Boosting, Categorical Boosting, and Gradient Boosted Regression Trees-demonstrated high R 2 (0.549, 0.515, and 0.503, respectively). Post-feature selection, the final model incorporated 20 variables, proving superior in predictive performance compared to models considering all 24 variables. The R 2 , mean absolute error, mean square error, absolute accuracy (±20 mg/L), and relative accuracy (±20%) of external validation were 0.621, 10.67, 221.50, 78.98%, and 66.48%, respectively. The importance and direction of each variable were visually represented using SHAP values, with VPA administration and liver function emerging as the most significant factors.The innovative application harnesses advanced multi-algorithm mining methodologies to forecast VPA concentrations in adult epileptic patients. Furthermore, it employs SHAP to elucidate the nuanced influence of each feature within the integrated prediction model, thereby providing a robust and plausible explanation for the determinants affecting VPA concentration predictions.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209075","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}

引用次数: 0

Patient and Physician Exposure to Artificial Intelligence Hype. 病人和医生接触人工智能炒作。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-05-12 DOI: 10.1055/a-2577-7214

Scott Monteith, Tasha Glenn, John R Geddes, Peter C Whybrow, Eric D Achtyes, Rita Bauer, Michael Bauer

引用次数: 0

Therapeutic Drug Monitoring of Cariprazine - Updated Values for a Dose-Related Reference Range. 卡吡嗪的治疗药物监测-剂量相关参考范围的更新值。

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-05-01 Epub Date: 2025-01-29 DOI: 10.1055/a-2511-3744

Fabian Sattaf, Maike Scherf-Clavel, Stefan Unterecker, Andreas Eckert, Andreas Reif, Martina Hahn

{"title":"Therapeutic Drug Monitoring of Cariprazine - Updated Values for a Dose-Related Reference Range.","authors":"Fabian Sattaf, Maike Scherf-Clavel, Stefan Unterecker, Andreas Eckert, Andreas Reif, Martina Hahn","doi":"10.1055/a-2511-3744","DOIUrl":"10.1055/a-2511-3744","url":null,"abstract":"Dose-related reference ranges can be used in therapeutic drug monitoring to monitor pharmacotherapy. The deviation of a measured serum concentration from the expected serum concentration at the corresponding dose can thus be identified early and responded to appropriately. The serum concentrations of patients treated with cariprazine regularly deviated from this dose-related reference range. As this is a relatively new drug with only one recommendation on values for a dose-related reference range, the values were tested for validity using real-world data.Serum concentrations of 24 patients receiving cariprazine once daily were analyzed retrospectively. Only patients without pharmacokinetic abnormalities were included. The measured serum concentrations were compared with the values of the dose-related reference range in the guidelines of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie consensus guidelines of 2017 and checked whether a sufficient number of serum concentrations were within the dose-related reference range.Only 45.8% of the measured serum concentrations were within the dose-related reference range. The C/D ratio was 1.58±0.73. Accordingly, a lower value of 0.85 and an upper value of 2.31 were calculated for the updated dose-related reference range, which is below the currently recommended values.The results suggest that the current values for the dose-related reference range are too high and require adjustment. The updated dose-related reference range lies between 0.85 and 2.31, with a mean of 1.58±0.73.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"127-131"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067107","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}

引用次数: 0

Activation of Hippocampal Neuronal NADPH Oxidase NOX2 Promotes Depressive-Like Behaviour and Cognition Deficits in Chronic Restraint Stress Mouse Model. 激活海马神经元 NADPH 氧化酶 NOX2 可促进慢性束缚应激小鼠模型的抑郁样行为和认知缺陷

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-05-01 Epub Date: 2024-11-15 DOI: 10.1055/a-2429-4023

Zejie Zuo, Hongyang Zhang, Zhihui Li, Fangfang Qi, Haojie Hu, Junhua Yang, Zhibin Yao

{"title":"Activation of Hippocampal Neuronal NADPH Oxidase NOX2 Promotes Depressive-Like Behaviour and Cognition Deficits in Chronic Restraint Stress Mouse Model.","authors":"Zejie Zuo, Hongyang Zhang, Zhihui Li, Fangfang Qi, Haojie Hu, Junhua Yang, Zhibin Yao","doi":"10.1055/a-2429-4023","DOIUrl":"10.1055/a-2429-4023","url":null,"abstract":"Background: Nicotinamide adenosine dinucleotide phosphate oxidases (NOX) play important roles in mediating stress-induced depression. Three NOX isotypes are expressed mainly in the brain: NOX2, NOX3 and NOX4. In this study, the expression and cellular sources of these NOX isoforms was investigated in the context of stress-induced depression.Methods: Chronic restraint stress (CRS)-induced depressive-like behaviour and cognitive deficits were evaluated by tail suspension tests, forced swimming tests and the Morris water maze test. Hippocampal NOX expression was determined by immunofluorescence staining and western blotting. The hippocampal levels of the brain-derived neurotrophic factor (BDNF) mRNA were determined via quantitative real-time -polymerase chain reaction. Glucocorticoid levels in the hippocampus were measured using ELISA kits.Results: In the mouse CRS model, a significant increase in NOX2 expression was observed in the hippocampus, whereas no significant changes in NOX3 and NOX4 expression were detected. Next, NOX2 expression was primarily localised to neurons (NeuN+) but not microglia (Iba-1+) or astrocytes (GFAP+). Treatment with gp91ds-tat, a specific NOX2 inhibitor, effectively mitigated the behavioural deficits induced by CRS. The decreased expression of the BDNF mRNA in the hippocampus of CRS mice was restored upon gp91ds-tat treatment. A positive correlation was identified between neuronal NOX2 expression and serum glucocorticoid levels.Conclusions: Our study indicated that neuronal NOX2 may be a critical mediator of depression-like behaviours and spatial cognitive deficits in mice subjected to CRS. Blockade of NOX2 signalling may be a promising therapeutic strategy for depression.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"117-126"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638740","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}

引用次数: 0

Development of a Genetic Test Indicating Increased AVP/V1b Signalling in Patients with Acute Depression. 急性抑郁症患者AVP/V1b信号增加的基因检测的发展

IF 3.6 3区医学

Pharmacopsychiatry Pub Date : 2025-05-01 Epub Date: 2025-01-29 DOI: 10.1055/a-2508-5834

Marcus Ising, Florian Holsboer, Marius Myhsok, Bertram Müller-Myhsok

{"title":"Development of a Genetic Test Indicating Increased AVP/V1b Signalling in Patients with Acute Depression.","authors":"Marcus Ising, Florian Holsboer, Marius Myhsok, Bertram Müller-Myhsok","doi":"10.1055/a-2508-5834","DOIUrl":"10.1055/a-2508-5834","url":null,"abstract":"A subgroup of patients with acute depression show an impaired regulation of the hypothalamic-pituitary-adrenocortical axis, which can be sensitively diagnosed with the combined dexamethasone (dex)/corticotropin releasing hormone (CRH)-test. This neuropathological alteration is assumed to be a result of hyperactive AVP/V1b signalling. Given the complicated procedure of the dex/CRH-test, this study aimed to develop a genetic variants-based alternative approach to predict the outcome of the dex/CRH-test in acute depression.Using data of a representative cohort of 352 patients with severe depression participating in the dex/CRH-test, a genome-wide interaction analysis was performed starting with an anchor single nucleotide polymorphism located in the upstream transcriptional region of the human V1b-receptor gene to predict the adrenocorticotropic hormone (ACTH) response to this test. A probabilistic neural-network-algorithm was used to develop the optimal prediction model.Overall prediction accuracy for correctly identifying high ACTH responders in the dex/CRH-test was 93.5% (sensitivity 90%; specificity 95%). Analysis of pituitary RNAseq expression data confirmed that the identified genetic interactions of the gene test translate into an interactive network of corresponding transcripts in the pituitary gland, which is the biologically relevant target tissue, with the aggregated strength of the transcript interactions significantly stronger than expected from chance.The findings suggest the suitability of the presented gene test as a proxy for hyperactive AVP/V1b signalling during an acute depressive episode, highlighting its potential as companion test for identifying patients with acute depression whose pathology can be optimally treated by specific drugs targeting the AVP/V1b-signaling cascade.","PeriodicalId":19783,"journal":{"name":"Pharmacopsychiatry","volume":" ","pages":"132-138"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067104","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}

引用次数: 0