Nervenarzt最新文献_第9页

[Stimulants : Current insights into the principles, diagnostics and treatment]. [兴奋剂：原理、诊断和治疗的最新见解]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2024-09-01 Epub Date: 2024-06-12 DOI: 10.1007/s00115-024-01687-5

Patrick Bach, Manuel Stenger, Karen D Ersche

{"title":"[Stimulants : Current insights into the principles, diagnostics and treatment].","authors":"Patrick Bach, Manuel Stenger, Karen D Ersche","doi":"10.1007/s00115-024-01687-5","DOIUrl":"10.1007/s00115-024-01687-5","url":null,"abstract":"Background: Consumption of stimulant drugs, a heterogeneous group of addictive substances, has significantly increased in recent years with rising numbers of stimulant-associated intoxication and deaths.Objective: To provide an overview of recent scientific evidence of the diagnosis and treatment of stimulant use disorders.Material and methods: A literature review of the neuropathology, clinical presentation, diagnostic criteria and evidence-based treatment for stimulant use disorders.Results: The chronic use of stimulant drugs is associated with significant physical (e.g., hypertension, tachycardia and dyspnoea) and psychological harm (e.g., dependence, psychotic disorders and affective disorders). Despite major advances in the research of the neuropathology of stimulant use disorder and the refinement of diagnostic criteria, the disorder still presents a challenge, not least because of the lack of effective treatments. There are currently no approved pharmacotherapeutic interventions for stimulant use disorder and meta-analyses show that the efficacy of behavioural interventions is low to moderate, similar to cognitive behavioural treatment.Conclusion: Despite growing insights into the neuropathology associated with stimulant use disorder, treatment remains a challenge. The lack of effective interventions makes it difficult to give clear recommendations for the clinical practice. Further scientific research is thus warranted.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"797-802"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312065","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}

引用次数: 0

[Kratom-From natural remedy to addictive drug and back]. [Kratom--从天然药方到成瘾性药物，再到成瘾性药物]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2024-09-01 Epub Date: 2024-07-31 DOI: 10.1007/s00115-024-01721-6

Christian P Müller, Yuting Yang, Darshan Singh, Bernd Lenz, Elisabeth Müller

{"title":"[Kratom-From natural remedy to addictive drug and back].","authors":"Christian P Müller, Yuting Yang, Darshan Singh, Bernd Lenz, Elisabeth Müller","doi":"10.1007/s00115-024-01721-6","DOIUrl":"10.1007/s00115-024-01721-6","url":null,"abstract":"Background: Kratom/ketum is a psychoactive herbal preparation that has been used for a long time as a remedy and performance-enhancing substance in Southeast Asia. The advancement of globalization is making kratom increasingly more available in the western world, where it is becoming increasingly more used.Objective: The current research on kratom and its ingredients is presented.Material and methods: An overview of the use and effects of kratom is exemplary given on the basis of reports. The instrumentalization of the drug and its consequences up to the development of addiction are discussed.Results: Consumption is accompanied by several instrumentalizeable effects so that kratom is used as a therapeutic substance in the self-management of pain, anxiety and depression as well as other substance addictions. Another benefit comes from the performance-enhancing effects on physical work and in a social context. Consumption is usually well controlled, rarely escalates and has few and mostly mild aversive side effects. The danger arises from consumption particularly when there is an escalation of the dose and from mixed consumption with other psychoactive substances. The main alkaloid mitragynine and the more potent 7‑hydroxy-mitragynine are considered mainly responsible for the effect. Both have a complex pharmacology that involves partial µ‑opioid receptor agonism.Discussion: Epidemiological, clinical and neurochemical studies have shown that kratom only has a limited addictive drug profile, which might suggest a medical use as a remedy or substitute in addiction treatment.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"824-829"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861441","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}

引用次数: 0

[Challenges in the treatment of opioid dependence]. [阿片类药物依赖治疗的挑战]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2024-09-01 Epub Date: 2024-07-15 DOI: 10.1007/s00115-024-01691-9

Andreas Heinz, Stefan Gutwinski, Michael Krausz, Gernot Ernst, Marc Vogel, Norbert Scherbaum

{"title":"[Challenges in the treatment of opioid dependence].","authors":"Andreas Heinz, Stefan Gutwinski, Michael Krausz, Gernot Ernst, Marc Vogel, Norbert Scherbaum","doi":"10.1007/s00115-024-01691-9","DOIUrl":"10.1007/s00115-024-01691-9","url":null,"abstract":"Background: The number of persons using opioids has increased worldwide in the last decade, particularly the use of opioid analgesics in North America and Africa. In Germany, the prevalence of heroin addiction has remained relatively stable.Method: Narrative review of the literature.Results: Opioid-assisted maintenance treatment (OMT) with the established substances methadone, levomethadone, slow-release morphine and buprenorphine is recommended as the first-line treatment for heroin dependence. The OMT reduces the use of heroin, mortality and individual suffering and improves the quality of life and physical health. A diamorphine and heroine-assisted treatment is an option for people who do not benefit from conventional OMT. An alternative to the use of diamorphine could be treatment with hydromorphone hydrochloride. The regulations on carrying out maintenance treatment in the Controlled Substances Prescription Act and the guidelines of the Federal Medical Association in Germany have been loosened based on the experiences of the COVID-19 pandemic, for example with respect to take-home prescriptions. There is an ongoing intensive discussion on how to deal with the decreasing number of outpatient clinics offering OMT.Conclusion: The first-line treatment for opioid addiction is opioid-assisted substitution treatment, including diamorphine and heroin-assisted treatment. Long-acting depot medications and implants still play a subordinate role.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"811-817"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617498","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}

引用次数: 0

[Introduction to the topic: is work good for your health?] [主题介绍：工作有益健康吗？］

IF 0.9 4区医学

Nervenarzt Pub Date : 2024-09-01 Epub Date: 2024-09-04 DOI: 10.1007/s00115-024-01717-2

Steffi G Riedel-Heller

引用次数: 0

Mitteilungen der DGPPN 09/2024. DGPPN 09/2024 号来函。

IF 0.9 4区医学

Nervenarzt Pub Date : 2024-09-01 DOI: 10.1007/s00115-024-01741-2

引用次数: 0

[Advance directives and mental disorders: a practice recommendation of the Commission for Ethics and Law of the German Association for Psychiatry, Psychotherapy and Psychosomatics]. [预嘱与精神障碍：德国精神病学、心理治疗和心身医学协会伦理与法律委员会的实践建议]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2024-09-01 Epub Date: 2024-05-03 DOI: 10.1007/s00115-024-01662-0

Sabine Müller, Jakov Gather, Euphrosyne Gouzoulis-Mayfrank, Tanja Henking, Matthias Koller, Henning Saß, Tilman Steinert, Thomas Pollmächer

{"title":"[Advance directives and mental disorders: a practice recommendation of the Commission for Ethics and Law of the German Association for Psychiatry, Psychotherapy and Psychosomatics].","authors":"Sabine Müller, Jakov Gather, Euphrosyne Gouzoulis-Mayfrank, Tanja Henking, Matthias Koller, Henning Saß, Tilman Steinert, Thomas Pollmächer","doi":"10.1007/s00115-024-01662-0","DOIUrl":"10.1007/s00115-024-01662-0","url":null,"abstract":"Background: Since the creation of legal requirements for advance directives by the legislator in 2009, special aspects of their application in the treatment of people with mental illnesses have been discussed.Goal of the paper: Important questions on dealing with advance directives in everyday life will be answered in a practice-oriented manner.Results: Among other things, this document answers the question of the conditions under which a patient can refuse or consent to hospitalization and treatment in advance, and in particular how to deal with advance directives whose implementation would also affect the rights of third parties. The German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) has addressed these and other questions in the present document and added practical advice on how to formulate advance directives for people with mental illnesses and how to deal with psychiatric advance directives.Discussion: The DGPPN has developed an advance directive for the area of mental health and published it on its website together with detailed explanations. With the help of this advance directive, people can decide on their treatment in phases of incapacity to consent in the context of a mental crisis or illness.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"861-867"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870262","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}

引用次数: 0

[Cannabis use and cannabis use disorders]. [大麻使用和大麻使用障碍]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2024-09-01 Epub Date: 2024-08-12 DOI: 10.1007/s00115-024-01722-5

E Hoch, U W Preuss

引用次数: 0

[The challenges for psychiatric care posed by synthetic drugs]. [合成药物给精神病治疗带来的挑战]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2024-09-01 Epub Date: 2024-08-26 DOI: 10.1007/s00115-024-01705-6

Norbert Scherbaum, Udo Bonnet

{"title":"[The challenges for psychiatric care posed by synthetic drugs].","authors":"Norbert Scherbaum, Udo Bonnet","doi":"10.1007/s00115-024-01705-6","DOIUrl":"10.1007/s00115-024-01705-6","url":null,"abstract":"Background: In addition to the drugs that have been known for decades, several hundred mainly synthetic substances have been identified as drugs for the first time in the last 20 years.Aim of the work: Presentation of the various groups of substances and their psychotropic effects, the epidemiology of their use and the legal and social background of this development.Material: Narrative literature review.Results: The most important new psychoactive substances (NPS) are synthetic cannabinoids, synthetic stimulants (cathinones), halluginogens and new synthetic opioids (NSO), in particular fentanyl and related substances. The new substances do not have any qualitatively new psychotropic effects. They were brought onto the market in particular as substitutes for substances subject to the Narcotics Act but are often associated with dangerous side effects and even mortality. The increasing availability of these substances has gone hand in hand with the establishment of the Internet as a source of knowledge (e.g. for synthesis routes) and as a marketplace. Substance group-related regulations have also been established in Germany (New Psychoactive Substances Act). In Germany the prevalence of NPS use is significantly lower than that of cannabis; however, there are indications that the production and distribution of synthetic drugs is more profitable for drug dealers than with conventional plant-based drugs, such as heroin. In the USA, for example, NSOs are the primarily drugs used for opioid addiction.Discussion: It remains to be seen whether NPS and NSOs will replace conventional drugs. The availability of synthetic drugs is more difficult to reduce than that of plant-based drugs. Harm reduction measures should be expanded, e.g., early warning systems for new drugs, drug checking and naloxone programs.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"818-823"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057089","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}

引用次数: 0

[Psychedelic and dissociative agents in psychiatry: challenges in the treatment]. [精神病学中的迷幻剂和解离剂：治疗中的挑战]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2024-09-01 Epub Date: 2024-08-28 DOI: 10.1007/s00115-024-01727-0

Johannes Jungwirth, Francesco Bavato, Boris B Quednow

{"title":"[Psychedelic and dissociative agents in psychiatry: challenges in the treatment].","authors":"Johannes Jungwirth, Francesco Bavato, Boris B Quednow","doi":"10.1007/s00115-024-01727-0","DOIUrl":"10.1007/s00115-024-01727-0","url":null,"abstract":"With the discovery of the antidepressive effects of ketamine and the increasing withdrawal of the pharmaceutical industry from the development of new psychotropic drugs, the psychiatric research into the clinical application of hallucinogens in psychiatry has literally blossomed in the last two decades. Promising results for various treatment approaches with psychedelic agents, such lysergic acid diethylamide (LSD) and psilocybin, and dissociative agents, such as ketamine and esketamine, have raised great hopes among researchers, clinicians and patients in recent years, so that there was already talk of a new era in psychiatry. As one of the first of these substances, in December 2019 intranasal esketamine was approved in the USA and the EU for the treatment of treatment-resistant depression and Switzerland followed in 2020. Recently, psilocybin was approved in Australia, Canada and Switzerland for compassionate use in exceptional cases for the treatment of depression, while large approval studies with various psychedelic agents are currently ongoing worldwide. The medical application of psychedelic agents and ketamine/esketamine is considered to be safe; however, as with all new forms of treatment it is of crucial importance that, in addition to the hopes, the specific challenges of these new treatment approaches must also be carefully considered and assessed. Excessive expectations and an insufficient risk-benefit estimation are detrimental to the patients and the reputation of the treating physician. Although a possible paradigm shift in the care of mental health is already being discussed, this review article consciously concentrates on the possible risks of treatment and the methodological weaknesses of the studies carried out so far.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"803-810"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082425","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}

引用次数: 0

[Psychiatric symptoms of Huntington's disease]. [亨廷顿氏病的精神症状]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.1007/s00115-024-01728-z

Alzbeta Mühlbäck, Rainer Hoffmann, Nicolo Gabriele Pozzi, Martin Marziniak, Peter Brieger, Matthias Dose, Josef Priller

引用次数: 0