Psychopharmacology bulletin最新文献

{"title":"Cannabidiol Induced Manic Episode: A Case Report.","authors":"Anas Ibn Auf, Razan A Almakki, Nora M Alhummayani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cannabidiol (CBD), a non-intoxicating compound derived from Cannabis sativa, has gained widespread popularity for its proposed therapeutic effects in conditions such as anxiety, insomnia, and chronic pain. Unlike tetrahydrocannabinol (THC), CBD is often perceived as safe, with minimal psychoactive properties. However, its psychiatric safety profile, particularly in relation to mood disorders, remains poorly understood.</p><p><strong>Case presentation: </strong>We report the case of a 31-year-old male with no prior psychiatric history who developed a manic episode characterized by irritability, decreased need for sleep, hyperactivity, and aggression. These symptoms emerged after three months of escalating daily CBD use via vaping, reaching high doses shortly before admission. Toxicology screening was negative for other substances, and the patient showed clinical improvement with mood stabilizers and antipsychotics following the discontinuation of CBD.</p><p><strong>Discussion: </strong>This case raises concerns about the potential of high-dose CBD to induce manic symptoms in certain individuals. While CBD has been proposed to have anxiolytic and antipsychotic effects, its influence on mood regulation may be complex and dose-dependent. The variability in commercial CBD product composition, including possible contamination or mislabeling, further complicates risk assessment. Current evidence from clinical trials on CBD's effects in mood disorders is limited and inconclusive.</p><p><strong>Conclusion: </strong>Clinicians should remain alert to the psychiatric effects of CBD, particularly in patients presenting with new-onset mood symptoms. This report underscores the need for controlled studies to assess the safety of CBD in psychiatric populations and calls for stricter regulation of cannabinoid products.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 4","pages":"116-122"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593362","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":"Methadone Prescribing Patterns at a Single Institution: A Retrospective Study and Clinical Implications.","authors":"Jamal Hasoon, Amad Qadeer, Grant H Chen, Omar Viswanath, Ivan Urits, Christopher L Robinson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Methadone is a long-acting opioid utilized in the management of chronic pain and opioid dependency. Given its unique pharmacokinetics and potential for both therapeutic benefit and risk, understanding prescribing patterns is essential. This study aimed to evaluate methadone utilization at a single academic university over a one-year period as well as discuss important considerations of methadone pharmacology.</p><p><strong>Methods: </strong>A retrospective review was conducted using electronic medical records to assess the number of methadone prescriptions issued across the institution between January 1, 2024, and December 31, 2024. The total number of prescriptions was analyzed and categorized into four quarters. In Q1 (January-March), 96 prescriptions were issued, followed by 109 in Q2 (April-June), 120 in Q3 (July-September), and 145 in Q4 (October-December).</p><p><strong>Results: </strong>A total of 470 methadone prescriptions were issued during the study period, demonstrating a steady increase over the year. The percentage increase in methadone prescriptions from Q1 to Q4 was approximately 51%. Notably, this analysis did not differentiate between prescriptions for chronic pain versus opioid dependency treatment. The rise likely reflects prescribing for pain management, as methadone for OUD is typically dispensed through regulated clinics not captured in this data. However, some prescriptions may reflect dual management by addiction medicine providers within our institution.</p><p><strong>Conclusions: </strong>This study highlights a consistent rise in methadone prescriptions at this particular institution, underscoring the need for further investigation into prescribing patterns, patient demographics, and clinical indications. Future research should stratify prescriptions by primary indication to better understand the drivers of methadone utilization and its impact on patient outcomes.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 4","pages":"43-54"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593300","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":"Prevalence of THC-Positive Urine Drug Screens in Patients Receiving Chronic Opioid Therapy: A Retrospective Review.","authors":"Jamal Hasoon, Omar Viswanath, Ivan Urits, Alaa Abd-Elsayed, Alan D Kaye","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose of study: </strong>This retrospective review aimed to evaluate the prevalence of tetrahydrocannabinol (THC)-positive urine drug screens (UDS) in patients undergoing chronic opioid therapy (COT) for chronic pain at a single academic institution. With a growing national trend toward cannabis legalization and increased public access to marijuana for medical and recreational purposes, understanding the intersection between THC use and opioid prescribing practices is essential. The presence of THC on UDS has clinical, legal, and ethical implications, especially in regions where cannabis remains illegal. This study sought to quantify the prevalence of THC positivity in patients receiving COT for chronic pain.</p><p><strong>Findings: </strong>A total of 244 UDS results were reviewed from January 1, 2024, to December 31, 2024. Among these, 24 patients (9.8%) tested positive for THC. Documentation and clinical responses to positive results varied, with some providers documenting patient counseling, while others did not acknowledge the result in the medical record. In a small subset of cases, positive THC findings contributed to changes in opioid therapy, including tapering or discontinuation.</p><p><strong>Conclusion: </strong>THC-positive UDS results are relatively common among patients receiving chronic opioid therapy, highlighting the increasing prevalence of cannabis use in this population. These findings align with prior literature and reinforce the need for individualized, non-punitive approaches to care. Routine screening, consistent documentation, and open communication about cannabis use are essential components of effective opioid risk stratification, safe prescribing practices, and informed treatment planning. These considerations are critical in regions where recreational marijuana remains illegal, which may further influence provider decision-making regarding ongoing opioid therapy.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 4","pages":"36-42"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593302","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":"Singing Without Speaking: A Unique Case of Psychogenic Speech and Voice Disorder in an Adolescent.","authors":"Courtney Barth, Brianna Chang, Anuradha Reddy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Psychogenic voice disorder, often a manifestation of conversion disorder, is characterized by a sudden impairment of voice following a stressful event or other psychological cause. This case report presents a patient with a psychogenic voice disorder featuring the atypical ability to sing despite losing conversational voice. Few case reports exist on psychogenic speech and voice disorders, and no cases in the current literature examine the loss of conversational voice with preservation of singing voice. In this case, the patient experienced sudden onset stuttering which progressed to complete loss of voice in all settings while retaining the ability to sing. Despite extensive medical, psychiatric, and speech-language evaluations, including psychotherapy and speech therapy, the symptoms persisted, highlighting the diagnostic and treatment challenges in psychogenic voice disorders. This case underscores the complex interplay between psychological stressors and physical symptoms in psychogenic voice disorders, and highlights the lack of effective, evidence-based therapies for psychogenic voice disorders.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 4","pages":"110-115"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593304","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":"Systematic Review of Second-Generation Antidepressant Monotherapy for Acute Bipolar-II Depression.","authors":"Ahmed Elmosalamy, Nicola Keeth, Jin Hong Park, Danielle J Gerberi, Susan L McElroy, Mark A Frye, Balwinder Singh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>Individuals with Bipolar II disorder (BD-II) face high rates of depression and have limited FDA-approved treatments, leading to treatment delays and poor functioning. Although not commonly recommended, monoaminergic antidepressants are prescribed to 50% of patients. This review updates the evidence for second-generation antidepressant (SGAD) monotherapy in treating acute BD-II depression.</p><p><strong>Methods: </strong>We searched Ovid MEDLINE, Embase, CENTRAL, PsycINFO, Scopus, and Web of Science from March 2021 to February 2025 and included five studies published before 2021. Randomized controlled trials (RCTs) evaluating SGAD monotherapy in adults with acute BD-II depression. Primary outcomes were response, remission, treatment-emergent affective switch (TEAS), dropouts owing to adverse events (AEs), and overall discontinuations.</p><p><strong>Results: </strong>Of 949 records identified, 12 studies were selected for full-text assessment, and six were included in our systematic review. The final dataset comprised four double-blind RCTs (n = 533), one open-label RCT (n = 83), and one triple-blind RCT (n = 40). Venlafaxine and sertraline produced short-term benefits, with response rates 60.4%-73.3% and remission rates 44.2%-58.5%. TEAS risk was ⩽ 19.9% and did not differ from lithium in head-to-head comparisons. AEs withdrawals were similar; SGADs often had comparable or better all-cause discontinuation than comparators.</p><p><strong>Conclusions: </strong>Limited short-term evidence indicates that SGAD monotherapy in acute BD-II depression is well-tolerated and has similar response rates to lithium, without increasing switch risk. Nevertheless, the evidence base is small and heterogeneous. Larger and longer RCTs are needed to confirm efficacy, characterize maintenance benefits, and inform personalized treatment decisions.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 4","pages":"79-103"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593305","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":"Effects of Valproate on Intracellular Calcium Ion Signaling: Implications for Mechanistic Research.","authors":"Steven L Dubovsky, Elsa Daurignac, Sevie Kandefer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>Hyperactive intracellular calcium ion concentration ([Ca²⁺]_i) in peripheral cells of patients with bipolar disorder has been reported repeatedly. Reduction of intracellular calcium ion concentration has been found with the established mood stabilizers lithium and carbamazepine, but less reliably with valproate. This study examined whether inconsistent findings with valproate could be a function of the subjects studied.</p><p><strong>Experimental design: </strong>Platelet [Ca²⁺]_i at baseline ([Ca²⁺]_B) and after stimulation with thrombin and platelet activating factor ([Ca²⁺]_S) was measured with and without incubation with therapeutic levels of valproate in mildly to moderately ill bipolar disorder patients (N = 14).</p><p><strong>Principal observations: </strong>Prior to incubation with valproate, platelet [Ca²⁺]_B and [Ca²⁺]_S were generally lower than has been reported in studies of intracellular calcium ion concentration in bipolar disorder, consistent with at most moderate symptom severity and impairment. Incubation with valproate raised [Ca²⁺]_B somewhat, primarily in patients with lower initial [Ca²⁺]_B. Valproate incubation blunted the increase in [Ca²⁺]_i with platelet stimulation, but valproate did not alter final [Ca²⁺]_S, reflecting a smaller increase with valproate but a higher starting point (i.e., [Ca²⁺]_B) in valproate incubated cells.</p><p><strong>Conclusions: </strong>Mixed results of studies of cellular actions of valproate on intracellular calcium signaling may be the results of use of subjects with milder illness and normal baseline signaling. Studies of animals and normal human subjects may be less informative about the potential mechanism of action of any psychotropic medication than studies of patients with sufficient severity of illness and abnormalities in the dimension of cellular function targeted by the medication.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 4","pages":"24-35"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593296","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":"Exploring the Potential Psychopharmacological Mechanisms Behind the Manicogenic Properties of Clozapine.","authors":"Samuel Cholette-Tétrault, Mehrshad Bakhshi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 4","pages":"130-132"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593297","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":"Comparison of Stress, Anxiety and Depression in Preclinical and Clinical Dental Students.","authors":"Yohana Yusra, Indrayadi Gunardi, Wiwiek Poedjiastoeti, Anggraeny Putri Sekar Palupi, Ade Prijanti Dwisaptarini, Jamison Wijaya, Julvyn, Andrijanto, Elizabeth Fitriana Sari","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To compare factors correlating with stress, anxiety, and depression between dental students (DS) in preclinical (PP) and clinical programs (CP).</p><p><strong>Method: </strong>This study involved 165 DS, utilizing the DASS-21, GAD-7, PSS-10, and PHQ-9 assessments. The data were analyzed using the Rasch model and Spearman test.</p><p><strong>Result: </strong>The study included 38.18% in PP and 61.81% in CP (M:F 1:3.7), and a mean age of 21.99 ± 2.36 years. Person map revealed perceptual differences in anxiety and depression between groups, but not in stress. In the PP group, family was the sole factor correlating with stress (p = 0.032). Stress was the primary mental health concern among dental students, particularly during both preclinical and clinical programs. Anxiety and depression, though less common in the preclinical stage, increased significantly in the clinical phase. In the CP group, both supervisor and family (p < 0.05) were correlated with anxiety, while age and self-health (p < 0.05) were linked to depression.</p><p><strong>Conclusion: </strong>Stress was the primary mental health concern among dental students, particularly during both preclinical and clinical programs. Anxiety and depression, though less common in the preclinical stage, increased significantly in the clinical phase. Identifying factors such as family, supervisors, age, self-health, and academic progression is essential for developing effective strategies to support dental students' mental health.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 4","pages":"55-67"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593363","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":"<i>OPRM1 rs1799971</i> Polymorphism Predicts Differential Response to Extended-Release Naltrexone in Alcohol Use Disorder: The Interplay of Genetics and Motivation.","authors":"Valentin Skryabin, Sergei Miroshkin, Anton Masyakin, Sergei Pozdniakov, Valentina Ivanchenko, Valery Shipitsin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Alcohol use disorder (AUD) remains a major contributor to the global burden of disease. Extended-release naltrexone (XR-NTX), a μ-opioid receptor antagonist, is a key pharmacological option for maintaining abstinence, though individual treatment response varies substantially. Genetic variability in the μ-opioid receptor gene (<i>OPRM1</i>), particularly <i>rs1799971</i>, may underpin this heterogeneity. Study objective was to evaluate the association between <i>OPRM1 rs1799971</i> polymorphism and clinical outcomes of XR-NTX therapy in patients with AUD while examining interactions with motivational profiles. In this prospective study, 100 patients with AUD in remission received six monthly intramuscular injections of XR-NTX (380 mg). Genotyping for <i>OPRM1 rs1799971</i> was performed using real-time allele-specific PCR. Primary outcomes included craving dynamics (PACS), relapse rates, abstinence duration, and treatment adherence over 180 days. Motivation was assessed through structured interviews. The A/A genotype was associated with longer abstinence (150.6 ± 36.2 days), lower relapse rates (29.2%), greater craving reduction, and higher treatment completion (86.2%) compared to A/G and G/G (A/A vs. A/G: p = 0.005; A/A vs. G/G: p = 0.021). The G allele significantly increased relapse risk (OR = 2.93; 95% CI: 1.48-5.79). Intrinsic motivation was associated with better outcomes. A significant genotype-motivation interaction was observed (p = 0.038). No genotype-related differences in adverse event frequency were observed. <i>OPRM1 rs1799971</i> polymorphism significantly influences the efficacy of XR-NTX in AUD. Carriers of the A/A genotype derive greater therapeutic benefit, while G allele carriers may require intensified clinical support. Pre-therapeutic <i>OPRM1</i> genotyping could optimize XR-NTX personalization, with G-allele carriers warranting intensified psychosocial support.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 4","pages":"68-78"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593361","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":"Pilot Trial of SDX/d-MPH Adult ADHD Examining Effects Throughout the Day.","authors":"Lenard A Adler, Dayeon Cho, Terry Leon, Mariane Guschwan, Caleb A Massimi, Deepti Anbarasan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To examine the effects of Serdexmethylphenidate/dexmethylphenidate (SDX/d-MPH) on ADHD symptoms throughout the day in adults with DSM-5 ADHD.</p><p><strong>Method: </strong>This was a 6-week pilot study that included 3 weeks of open label treatment with SDX/d-MPH (39.2/7.8 mg/day to 52.3/10.4 mg/day in clinical titration) after completion of a one-week screening period and a two-week observation period in seventeen adults with ADHD. Two subjects were discontinued from the trial, one for being placebo-responder and another for exhibiting blood pressure lability during the observation period. Of the remaining 15 subjects, one dropped out after one week on 39.2/7.8 mg/day, while all others completed the trial. All fifteen participants were included in the data analyses.</p><p><strong>Results: </strong>There were substantial effects of SDX/d-MPH on all clinical measures, including investigator symptom scores (AISRS); self-report (ASRS) scores, time-sensitive ADHD (TASS) scores throughout the day, impairment (CGI) and executive function scores (BRIEF-A) and measures of medication smoothness (AMSES). SDX/d-MPH was generally well tolerated.</p><p><strong>Conclusions: </strong>This pilot study is the first systematic treatment effect trial data for SDX/d-MPH in adults with DSM-5 ADHD. The data preliminarily supports the clinical efficacy of DSM/d-MPH in adult ADHD and its ability to ameliorate symptoms throughout the day.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 4","pages":"8-23"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593301","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}