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Psychoactive Drugs (psychoactive + drug)
Selected AbstractsA Primer of Drug Action: A Comprehensive Guide to the Actions, Uses, and Side Effects of Psychoactive DrugsDRUG AND ALCOHOL REVIEW, Issue 2 2009Femke T.A. Buisman-Pijlman [source] Antidepressant combinations: epidemiological considerationsACTA PSYCHIATRICA SCANDINAVICA, Issue 2005L. F. Agüera Objective:, To evaluate the treatment options in patients who do not respond appropriately to a single antidepressant alone. Method:, The medical literature was reviewed. Results:, A number of strategies are available if a patient fails to respond adequately to initial antidepressant treatment, including the combination with another psychoactive drug. Evidence published to date appears to suggest that benzodiazepines are the drugs most frequently combined with antidepressants. The combination of two antidepressants together is less common, occurring in approximately 5,15% of cases showing a poor initial response. The key figures involved in such co-prescription are psychiatrists. Conclusion:, There appears to be considerable variability in the data concerning combined prescription of antidepressants, with differences arising depending on the type of physician, the type of patient or illness and the geographical area. It is also unclear how closely research findings parallel with what doctors do in everyday practice. [source] Methadone and impairment in apprehended driversADDICTION, Issue 3 2009Jean-Paul Bernard ABSTRACT Aims According to Norwegian guidelines, patients who are in opioid-assisted rehabilitation programmes are permitted to drive a motor vehicle provided that certain requirements are met. The purpose of this study was to investigate apprehended drivers who had methadone in their blood at the time of apprehension and, further, the relationship between blood methadone concentration and impairment as measured by the clinical test of impairment (CTI). Methods The division of Forensic Toxicology and Drug Abuse (DFTDA) at the Norwegian Institute of Public Heath analyses blood samples from all drivers suspected of driving under the influence of drugs nation-wide. Cases with positive results for methadone in blood were collected over the period 2001,2006. Results A total of 635 drivers with methadone found in their blood samples were identified. The majority of drivers were men (>80%), aged between 30 and 40 years. Methadone was the only psychoactive drug detected in blood in only 10 cases. Benzodiazepines were a frequent finding (in approximately 90% of cases). A significant difference in blood methadone concentration was found between cases where only methadone was detected [median 0.46 mg/l (range 0.19,0.65)] and cases where methadone was detected in combination with other psychoactive drugs [median 0.28 mg/l (range 0.06,1.24)]. A CTI had been carried out, in conjunction with blood sampling, in 577 of the cases. A concentration,impairment relationship was not seen for methadone in these cases. Conclusions Cases of driving impairment involving methadone alone were very rare, with combination use most frequent. No correlation between methadone concentration and impairment as judged by the CTI was seen either for these cases or for the material as a whole. [source] A longitudinal evaluation of medical student knowledge, skills and attitudes to alcohol and drugsADDICTION, Issue 6 2006Gavin Cape ABSTRACT Aim To examine the knowledge, skills and attitudes of medical students to alcohol and drugs as training progresses. Design A longitudinal, prospective, cohort-based design. Setting The four schools of medicine in New Zealand. Participants All second-year medical students (first year of pre-clinical medical health sciences) in New Zealand were administered a questionnaire which was repeated in the fourth (first year of significant clinical exposure) and then sixth years (final year). A response rate of 98% in the second year, 75% in the fourth year and 34% in the sixth year, with a total of 637 respondents (47.8% male) and an overall response rate of 68%. Questionnaire The questionnaire consisted of 43 questions assessing knowledge and skills,a mixture of true/false and scenario stem-based multiple-choice questions and 25 attitudinal questions scored on a Likert scale. Demographic questions included first language, ethnicity and personal consumption of alcohol and tobacco. Findings The competence (knowledge plus skills) correct scores increased from 23.4% at the second year to 53.6% at the fourth year to 71.8% at the sixth year, being better in those students who drank alcohol and whose first language was English (P < 0.002). As training progressed the student's perceptions of their role adequacy regarding the effectiveness of the management of illicit drug users diminished. For example, at second year 21% and at sixth year 51% of students felt least effective in helping patients to reduce illicit drug use. At the sixth year, 15% of sixthyear students regarded the self-prescription of psychoactive drugs as responsible practice. Conclusion Education on alcohol and drugs for students remains a crucial but underprovided part of the undergraduate medical curriculum. This research demonstrated that while positive teaching outcomes were apparent, further changes to medical student curricula need to be considered to address specific knowledge deficits and to increase the therapeutic commitment and professional safety of medical students to alcohol and drugs. [source] REVIEW: Behavioural assessment of drug reinforcement and addictive features in rodents: an overviewADDICTION BIOLOGY, Issue 1 2006Carles Sanchis-Segura ABSTRACT Some psychoactive drugs are abused because of their ability to act as reinforcers. As a consequence behavioural patterns (such as drug-seeking/drug-taking behaviours) are promoted that ensure further drug consumption. After prolonged drug self-administration, some individuals lose control over their behaviour so that these drug-seeking/taking behaviours become compulsive, pervading almost all life activities and precipitating the loss of social compatibility. Thus, the syndrome of addictive behaviour is qualitatively different from controlled drug consumption. Drug-induced reinforcement can be assessed directly in laboratory animals by either operant or non-operant self-administration methods, by classical conditioning-based paradigms such as conditioned place preference or sign tracking, by facilitation of intracranial electric self-stimulation, or, alternatively by drug-induced memory enhancement. In contrast, addiction cannot be modelled in animals, at least as a whole, within the constraints of the laboratory. However, various procedures have been proposed as possible rodent analogues of addiction's major elements including compulsive drug seeking, relapse, loss of control/impulsivity, and continued drug consumption despite negative consequences. This review provides an extensive overview and a critical evaluation of the methods currently used for studying drug-induced reinforcement as well as specific features of addictive behaviour. In addition, comic strips that illustrate behavioural methods used in the drug abuse field are provided given for free download under http://www.zi-mannheim/psychopharmacology.de [source] Seasonal variations in [3H]citalopram platelet binding between healthy controls and violent offenders in FinlandHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2005James Callaway Abstract Monthly binding densities (Bmax) of [3H]citalopram to the platelet serotonin transporter (SERT) was measured longitudinally over 1 year in a control group of 18 healthy Finnish male volunteers. Single platelet samples were also analysed from 33 men who were incarcerated for violent crimes during the same calendar year. A statistically significant seasonal variation in SERT Bmax was observed in both data sets, and bi-monthly floating averages for SERT Bmax were calculated and then fit to an annual sinusoidal curve for both groups. The Bmax for platelet [3H]citalopram binding showed a statistically significant (p,=,0.001) seasonal variance between a winter (January,February) maximum of 1590 fmol/mg protein and a summer (July,August) minimum of 1216 fmol/mg protein for the control group, with an R2 of 70% for the annual sinusoidal curve fit. A statistically significant (p,=,0.007) seasonal variance was also observed between a winter (January,February) maximum of 1980 fmol/mg protein and an autumnal (August,September) minimum of 1234 fmol/mg protein for the violent offenders, again with an R2 of 70% for the annual sinusoidal curve fit. This observation lends additional support to the idea that violent human behavior and impulsivity may be directly linked to values of SERT Bmax, which can be affected by various psychoactive drugs and also varies with the natural change of seasons. Copyright © 2005 John Wiley & Sons, Ltd. [source] Psychotropics use in the Spanish elderly: predictors and evolution between years 1993 and 2003,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2007P. Carrasco-Garrido PhD Abstract Purpose This study mainly aimed at describing the prevalence of psychotropic medication consumption in the Spanish elderly population between the years 1993 and 2003. Methods Descriptive, cross-sectional study covering the Spanish population aged 65 years and over, using data drawn from the 1993 and 2003 Spanish National Health Surveys (ENSS). A total of 9570 interviews were analysed (3436 from 1993 and 6134 from 2003). The independent variables were sociodemographic and health-related, and the dependent variable was total consumption of psychotropic medication. Using logistic multivariate regression models, we have analysed the temporal evolution of psychotropic medication consumption between 1993 and 2003. Results The prevalence of consumption was significantly higher in women (6.7% from 1993 and 26.4 % from 2003) versus men (2.4% from 1993 and 10.6% from 2003) (p,<,0.001). Multivariate analysis, highlighted the association between increased psychoactive drug intake and sex, nervous, depressive, sleep disorders and negative perception of health, displayed a strong association with consumption of psychoactive drugs across the 2 years. Conclusions In Spain, the prevalence of psychoactive drug consumption is higher among elderly women than men, and increases with negative perception of health. The prevalence of consumption was significantly higher in the year 2003. Copyright © 2006 John Wiley & Sons, Ltd. [source] The Prescribing Pattern of a New Antipsychotic: A Descriptive Study of Aripiprazole for Psychiatric In-Patients,BASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 1 2008Stig Ejdrup Andersen The objective of this descriptive study is to examine the day-to-day prescriptions of aripiprazole to an unselected population of psychiatric in-patients. From 1 February to 1 May 2006, present and former in-patients treated with aripiprazole were identified. Prescriptions of aripiprazole and psychoactive comedication were collected retrospectively from the patient records. Seventy-one patients, mainly schizophrenic, received aripiprazole 2.5 to 55 mg/day for median 350 days. The median average exposure was 18.9 mg/day (range 2.5,45 mg/day) and exceeded 15 and 30 mg/day in 63% and 4.2% of the patients, respectively. Generally, aripiprazole was either added to the existing antipsychotic treatment or replaced other antipsychotics; only 17% of the patients were treatment-naïve. In 25% aripiprazole, monotherapy was commenced whereas aripiprazole-antipsychotic combinations were initially prescribed in 75%. Overall, 85% of the patients received periods of antipsychotic polypharmacy and aripiprazole was combined with 17 different antipsychotics. Each patient received median three (range 0,8) psychoactive drugs parallel with aripiprazole. This study demonstrates reality in psychopharmacology and quote aripiprazole as example. In day-to-day practice, aripiprazole is used as part of highly individualized regimens comprising polypharmacy and excessive dosing. Although theoretically appropriate for some patients, this approach also implies conducting unblinded and uncontrolled mini-experiments. Sparse evidence supports this practice and effectiveness studies of aripiprazole that takes into account the true complexity of clinical prescribing are urgently needed. [source] | |||||||||||||||||||