Psychopharmacology bulletin最新文献

{"title":"Trends in Outpatient Buprenorphine Prescribing for Chronic Pain: A Retrospective Analysis Over 18 Months.","authors":"Jamal Hasoon, Ahish Chitneni, Omar Viswanath, Ivan Urits, Farnad Imani, Giustino Varrassi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Buprenorphine, a partial opioid agonist, has gained attention for its use in chronic pain management due to its lower risk of abuse and respiratory depression compared to traditional opioids. The utilization of buprenorphine for chronic pain has increased in recent years. This study aimed to analyze trends in buprenorphine prescribing for chronic pain in an outpatient setting over an 18-month period, excluding buprenorphine-naloxone combinations used for opioid use disorder and opioid dependence.</p><p><strong>Methods: </strong>A retrospective chart review was conducted, examining outpatient buprenorphine and long-acting opioid prescriptions issued by three pain management physicians between January 1, 2023, and June 30, 2024. Prescription data were collected from electronic medical records (EMRs) and analyzed across three six-month intervals: January 1, 2023, to June 30, 2023; July 1, 2023, to December 31, 2023; and January 1, 2024, to June 30, 2024. Only unique buprenorphine prescriptions for chronic pain management were included, while buprenorphine-naloxone prescriptions for opioid use disorder were excluded. Long-acting opioids analyzed included extended release (ER) formulations including tramadol ER, morphine ER, hydrocodone ER, oxycodone ER, fentanyl, and methadone.</p><p><strong>Results: </strong>Over the 18-month study period, a total of 61 unique buprenorphine prescriptions for chronic pain were issued by the three physicians. The number of prescriptions increased across each six-month period: 18 prescriptions were issued between January 1, 2023, and June 30, 2023; 20 prescriptions from July 1, 2023, to December 31, 2023; and 23 prescriptions from January 1, 2024, to June 30, 2024. This represents a 27.8% increase over the entire 18-month period. During the same timeframe, 117 long-acting opioid prescriptions (excluding buprenorphine) were issued in the first six-month period, 121 prescriptions in the second period, and 108 prescriptions in the third period. Buprenorphine prescriptions accounted for 13.3% of all long-acting opioid prescriptions in the first period (18 out of 135 total prescriptions), 14.2% in the second period (20 out of 141 total prescriptions), and 17.6% in the third period (23 out of 131 total prescriptions). Notably, while the absolute number of buprenorphine prescriptions increased steadily, its proportion relative to total long-acting opioid prescriptions also grew over time.</p><p><strong>Conclusions: </strong>The findings demonstrate a steady increase in buprenorphine prescribing for chronic pain in the outpatient setting, while long-acting opioid prescriptions exhibited a slight decline in the later periods. The proportion of buprenorphine prescriptions relative to long-acting opioids increased over time, suggesting growing acceptance of buprenorphine as a safer alternative for chronic pain management. Further research is needed to explore the factors driving these prescribing p","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 3","pages":"8-19"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053911","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":"Challenges in Transitioning from Methadone to Buprenorphine-Naloxone for Chronic Pain Management: Two Cases.","authors":"Jamal Hasoon, Anvinh Nguyen, Omar Viswanath, Alaa Abd-Elsayed","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Methadone is frequently used for chronic pain management due to its long half-life and NMDA receptor activity, making it an effective option for opioid-tolerant patients. Buprenorphine-naloxone is increasingly explored as an alternative for chronic pain and opioid use disorder, offering partial opioid agonism with a ceiling effect on respiratory depression. The transition from methadone to buprenorphine-naloxone remains clinically challenging, requiring careful management to prevent withdrawal and ensure adequate pain control.</p><p><strong>Case descriptions: </strong>Two patients with chronic pain were transitioned from methadone to buprenorphine-naloxone. The first patient, a mid-40s female, was abruptly switched from methadone 10 mg twice daily dosing to buprenorphine-naloxone 4 mg-1 mg twice daily dosing without a taper, resulting in severe withdrawal requiring hospitalization. The second patient, a late-50s male, underwent a two-month methadone taper before initiating buprenorphine-naloxone 4 mg-1 mg twice daily dosing, but reported persistent uncontrolled pain despite dose escalation to 4 mg-1 mg three times a day. Both patients reported significant dissatisfaction with buprenorphine-naloxone therapy, citing inadequate pain relief. Both patients eventually left the practice and were lost to follow up.</p><p><strong>Conclusion: </strong>These cases underscore the challenges of transitioning chronic pain patients from methadone to buprenorphine-naloxone formulations. Transitioning patients between these medications may lead to issues regarding withdrawal symptoms, inadequate pain control, and patient attrition.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 3","pages":"60-65"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060076","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":"Kuwait-Mental Illness Disability Scale (K-MIDS): <i>A Proposal</i>.","authors":"Bibi Alamiri, Hend Fm Fr Alenezi, Ahmed Naguy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>It is widely agreed that the mentally ill constitute a sizeable chunk of the disabled population not only for those afflicted but also for their caregivers alike.</p><p><strong>Objective: </strong>To assess the degree of disability with subsequent medico-legal ramifications, clinicians largely rely on generic clinical impressions and short brief interviews that are by no means bias-free lacking in standardization and objectivity.</p><p><strong>Methods: </strong>To this end, authors, herein, draft, the K-MIDS or the Kuwait-Mental Illness Disability Scale.</p><p><strong>Results: </strong>Baseline Requirements and Scoring System of K-MIDS are devised largely drawing on authors' vast clinical expertise in this area.</p><p><strong>Conclusions: </strong>The assessment of functional disability related to serious mental illness remains an unmet need in the Gulf region where disability allowance is currently based on generic clinical impressions, brief interviews and collateral input. K-MIDS is intended to be a step moving forward. Psychometric properties are due second.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 3","pages":"20-25"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049287","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":"Assessment of the Correlation Between Unipolar and Bipolar Depression, Calcium Levels, Thyroid Function, and Inflammatory Markers: A Pilot Cross-Sectional Study.","authors":"Marta Ielmini, Daniela Gallo, Maria Laura Tanda, Eliana Piantanida, Camilla Callegari, Ivano Caselli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recent mental health research has highlighted the critical role of inflammation in conditions like depression and bipolar disorder, examining correlations with markers such as calcium levels, thyroid function, and inflammatory markers. The study aims to compare unipolar and bipolar depression samples in terms of socio-demographic and clinical features. Patients were prospectively enrolled during their hospitalization at the University of Insubria Psychiatric Unit. Patients were administered psychometric questionnaires (Beck Depression Inventory-II, Mental Pain Questionnaire, Beck Anxiety Inventory, Clinical Global Impressions Severity scale, and Brief Reasons for Living Inventory). Thirty-six patients (17 males, 19 females) were enrolled. A statistically significant association emerged between calcium levels and bipolar depression (Pearson Chi square = 0.050) and between CRP and bipolar depression (Pearson Chi-square = 0.017). Additionally, a statistically significant association was observed between the unipolar and bipolar depression subgroups and current substance abuse (p = 0.0275) A statistically significant difference between the BRLF scores and UD (unipolar depression) subgroup emerged (p = 0.0126). The results of the pilot study revealed significant associations between calcium/CRP levels with depressive symptoms, particularly in bipolar depression. Further research on inflammatory markers is needed to refine diagnostic subtypes and therapeutic strategies.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 2","pages":"8-23"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401131","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":"Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) for Treatment of Fibromyalgia: A Comprehensive Clinical Review.","authors":"Aila Malik, Zoe Brown, Alexa Ryder, Vanshika Balayan, Lauren Jameson, Peter Vu, Rana Al-Jumah, Jamal Hasoon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fibromyalgia is a complex clinical entity characterized by a broad range of symptoms including chronic widespread musculoskeletal pain, profound fatigue, impaired cognition, and mood disturbances. Current understanding of disease pathogenesis assumes neurotransmitter dysregulation and central pain sensitization play a key role resulting in heightened pain sensitivity. Genetic predisposition as well as alterations in endocrine and immune function have been implicated. Accurate diagnosis requires a comprehensive evaluation, and a personalized treatment approach is needed to address the biopsychosocial components of the disease process. Among pharmacologic treatment options, serotonin norepinephrine reuptake inhibitors (SNRIs) have demonstrated analgesic effects in addition to mood stabilizing properties. Currently, duloxetine and milnacipran are approved by the Food and Drug Administration although other agents in this drug class including venlafaxine and desvenlafaxine have been studied in the management of fibromyalgia. In addition, selective norepinephrine reuptake inhibitors, esreboxetine and reboxetine, as well as tramadol, a weak opioid mu-receptor agonist with SNRI activity have shown potential utility. Although some studies have demonstrated SNRIs to be effective and well tolerated in patients with fibromyalgia, individual response may vary. There remains a continued need for large scale clinical trials to establish the safety and clinical effectiveness of these agents in this patient population. Further information is needed to optimize patient selection and dosing regimens as well as elucidate the clinical factors associated with poor response. Moreover, pharmacologic agents may be combined with lifestyle changes and non-drug-based treatments to address the complex interactions of biological and psychosocial factors that facilitate disease development and persistence of symptoms.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 2","pages":"24-40"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401089","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":"Before Attributing Catatonia to Autism with Anxiety, All Other Causes should be Carefully Excluded, Especially in a Patient with Meningioma.","authors":"João Gama Marques, Josef Finsterer","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 2","pages":"110-111"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401072","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":"Borderline Personality Disorder and Self-Injurious Behaviours-<i>Attention-Seeking or Attachment-Seeking?</i> Psychopharmacological Considerations.","authors":"Ahmed Naguy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>High rates of both suicidality and NSSI in individuals with BPD indicate the severity of the distress experienced by many of those diagnosed. It behoves clinicians to delve into the many disparate determinants these behaviours might subserve, in order to inform tailored and effective treatment decisions.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 2","pages":"75-79"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401076","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":"Hallucinogen-Persisting Perception Disorder in a 16-Year-Old Adolescent.","authors":"Anna Mori-Kreiner, Arpit Aggarwal, Meelie Bordoloi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Hallucinogen-persisting Perception Disorder (HPPD) is a rare condition characterized by the re-experiencing of one or more perceptual symptoms that an individual experienced while intoxicated with a hallucinogenic substance when the individual is sober. While there are several case reports of HPPD in adult patients, there is a scarcity of documented cases in children and adolescents. The purpose of this article is to highlight the presentation, diagnosis, and treatment of HPPD in a 16-year-old male patient.</p><p><strong>Methods: </strong>In this case report, the patient is a 16-year-old male with a history of major depressive disorder (MDD) and polysubstance use using Lysergic acid diethylamide (LSD), 3,4-Methylenedioxymethamphetamine (MDMA), psilocybin, cannabis, and benzodiazepines. He endorsed having auditory hallucinations and a heightened sense of hearing in between usage of MDMA for the past eight months and described auditory and visual hallucinations during his 5-day admission at the inpatient child psychiatric unit. Aripiprazole 5 mg was used as treatment for HPPD.</p><p><strong>Results: </strong>On review of literature, the first-line treatment for HPPD with clonidine and benzodiazepine has been documented by few case reports. Second generation antipsychotics are documented to be less effective with the exception of aripiprazole. The authors witnessed gradual improvement in the patient's symptoms with the use of aripiprazole, although it was not completely resolved during his hospital course.</p><p><strong>Conclusions: </strong>This case demonstrates the presentation of HPPD and efficacy of aripiprazole in an adolescent patient. The diagnosis was further complicated by the patient's history of polysubstance use, and determining a distinction from non-substance-induced psychotic disorders was paramount.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 2","pages":"94-99"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401081","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 Interplay of Sleep and Nicotine Vaping in Adolescents: An Evidence-Based Narrative Review.","authors":"Sriram Birur, Bradley G Burk, Rachel E Fargason, Ahmed Alhassan, Abhishek Reddy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Although adolescent use of combustible cigarettes (CC) has decreased, the rise of nicotine electronic vaping products (EVPs) presents new public health concerns. Nicotine vaping devices, with appealing packaging and flavors, are now the most commonly used nicotine delivery method among adolescents. While the long-term effects remain unclear, short-term effects include tachycardia, coughing, and wheezing. This review explores the relationship between nicotine vaping and sleep disturbances in adolescents.</p><p><strong>Methods: </strong>A PubMed search (2006-2024) using keywords \"nicotine sleep adolescents,\" \"vaping sleep adolescents,\" and \"e-cigarette sleep adolescents\" identified 159 articles. Filters for \"Humans,\" \"English,\" and \"Age-Birth-18 years\" narrowed the list to 124. Abstracts were independently screened for cross-sectional studies describing sleep disturbances, yielding nine articles. Outcome measures included insufficient sleep (< 7-8 hours/night) and sleep latency, assessed through self-reported hours and the Pittsburgh Sleep Quality Index (PSQI).</p><p><strong>Results: </strong>Data from 106,628 adolescents (12-18 years; males = females) revealed e-cigarette (most common vaping device used) and dual users (e-cigs + CC) reported significantly more insufficient sleep on school nights than non-users. Dual users exhibited increased sleep latency, particularly in males. Two studies suggested chronic insufficient sleep might lead to initiation or increased use of vaping devices, highlighting a bidirectional relationship.</p><p><strong>Conclusions: </strong>Many survey studies indicate vaping nicotine is associated with sleep disturbances in adolescents. Other studies determined sleep disturbances were associated with an initiation or increase in vaping nicotine indicating a cause-and-effect conundrum. Further investigation through longitudinal studies are needed to determine factors such as the causal relationship, dose-response and product-specific effects.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 2","pages":"60-74"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401078","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":"Psychopharmacology: The 'Combo Pills'-Did it find its way into Practice?","authors":"Ahmed Naguy, Dalaal S Alablani, Bibi Alamiri","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fixed-dose combinations were, and still, quite in vogue in medical practice but for better or worse, did not gain a foothold in psychiatric prescriptions. Whilst briefing the merits and demerits of these formulations, authors herein provide a list of common psychotropic drug combinations on market, explaining the underneath psychopharmacological rationale.</p>","PeriodicalId":94351,"journal":{"name":"Psychopharmacology bulletin","volume":"55 2","pages":"80-84"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401138","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}