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Psychotropic Drugs (psychotropic + drug)
Selected AbstractsCurrent awareness in human psychopharmacologyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 5 2010Article first published online: 29 JUN 2010 In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of human psychopharmacology. Each bibliography is divided into 18 sections: 1 Reviews; 2 General; 3 Psychotropic Drugs - General; Antidepressive Agents: 4 Tricyclics; 5 Monoamine Oxidase Inhibitors; 6 Serotonergics; Euthymic Agents: 7 Lithium; Tranquillizing Agents: 8 Major; 9 Minor & Hypnotics; 10 Analeptic Agents; 11 Anticonvulsant Agents; 12 Drugs of Abuse; 13 Transmitters, Receptors, Metabolites & Modulating Agents; 14 Neuropeptides; 15 Psychoneuroendocrinology; 16 Psychoneuroimmunology; 17 Behavioural Genetics; 18 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source] Current awareness in human psychopharmacologyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 1 2010Article first published online: 29 DEC 200 In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of human psychopharmacology. Each bibliography is divided into 18 sections: 1 Reviews; 2 General; 3 Psychotropic Drugs - General; Antidepressive Agents: 4 Tricyclics; 5 Monoamine Oxidase Inhibitors; 6 Serotonergics; Euthymic Agents: 7 Lithium; Tranquillizing Agents: 8 Major; 9 Minor & Hypnotics; 10 Analeptic Agents; 11 Anticonvulsant Agents; 12 Drugs of Abuse; 13 Transmitters, Receptors, Metabolites & Modulating Agents; 14 Neuropeptides; 15 Psychoneuroendocrinology; 16 Psychoneuroimmunology; 17 Behavioural Genetics; 18 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source] Current awareness in human psychopharmacologyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 4 2008Article first published online: 22 MAY 200 In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of human psychopharmacology. Each bibliography is divided into 18 sections: 1 Reviews; 2 General; 3 Psychotropic Drugs - General; Antidepressive Agents: 4 Tricyclics; 5 Monoamine Oxidase Inhibitors; 6 Serotonergics; Euthymic Agents: 7 Lithium; Tranquillizing Agents: 8 Major; 9 Minor & Hypnotics; 10 Analeptic Agents; 11 Anticonvulsant Agents; 12 Drugs of Abuse; 13 Transmitters, Receptors, Metabolites & Modulating Agents; 14 Neuropeptides; 15 Psychoneuroendocrinology; 16 Psychoneuroimmunology; 17 Behavioural Genetics; 18 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source] Current awareness in human psychopharmacologyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 3 2008Article first published online: 31 MAR 200 In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of human psychopharmacology. Each bibliography is divided into 18 sections: 1 Reviews; 2 General; 3 Psychotropic Drugs - General; Antidepressive Agents: 4 Tricyclics; 5 Monoamine Oxidase Inhibitors; 6 Serotonergics; Euthymic Agents: 7 Lithium; Tranquillizing Agents: 8 Major; 9 Minor & Hypnotics; 10 Analeptic Agents; 11 Anticonvulsant Agents; 12 Drugs of Abuse; 13 Transmitters, Receptors, Metabolites & Modulating Agents; 14 Neuropeptides; 15 Psychoneuroendocrinology; 16 Psychoneuroimmunology; 17 Behavioural Genetics; 18 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source] Current awareness in human psychopharmacologyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 6 2007Article first published online: 2 AUG 200 In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of human psychopharmacology. Each bibliography is divided into 18 sections: 1 Reviews; 2 General; 3 Psychotropic Drugs - General; Antidepressive Agents: 4 Tricyclics; 5 Monoamine Oxidase Inhibitors; 6 Serotonergics; Euthymic Agents: 7 Lithium; Tranquillizing Agents: 8 Major; 9 Minor & Hypnotics; 10 Analeptic Agents; 11 Anticonvulsant Agents; 12 Drugs of Abuse; 13 Transmitters, Receptors, Metabolites & Modulating Agents; 14 Neuropeptides; 15 Psychoneuroendocrinology; 16 Psychoneuroimmunology; 17 Behavioural Genetics; 18 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source] Current awareness in human psychopharmacologyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2006Article first published online: 29 NOV 200 In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of human psychopharmacology. Each bibliography is divided into 18 sections: 1 Books, Reviews & Symposia; 2 General; 3 Psychotropic Drugs - General; Antidepressive Agents: 4 Tricyclics; 5 Monoamine Oxidase Inhibitors; 6 Serotonergics; Euthymic Agents: 7 Lithium; Tranquillizing Agents: 8 Major; 9 Minor & Hypnotics; 10 Analeptic Agents; 11 Anticonvulsant Agents; 12 Drugs of Abuse; 13 Transmitters, Receptors, Metabolites & Modulating Agents; 14 Neuropeptides; 15 Psychoneuroendocrinology; 16 Psychoneuroimmunology; 17 Behavioural Genetics; 18 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source] Current awareness in human psychopharmacologyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2006Article first published online: 9 OCT 200 In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of human psychopharmacology. Each bibliography is divided into 18 sections: 1 Books, Reviews & Symposia; 2 General; 3 Psychotropic Drugs - General; Antidepressive Agents: 4 Tricyclics; 5 Monoamine Oxidase Inhibitors; 6 Serotonergics; Euthymic Agents: 7 Lithium; Tranquillizing Agents: 8 Major; 9 Minor & Hypnotics; 10 Analeptic Agents; 11 Anticonvulsant Agents; 12 Drugs of Abuse; 13 Transmitters, Receptors, Metabolites & Modulating Agents; 14 Neuropeptides; 15 Psychoneuroendocrinology; 16 Psychoneuroimmunology; 17 Behavioural Genetics; 18 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source] Current awareness in human psychopharmacologyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 3 2005Article first published online: 30 MAR 200 In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of human psychopharmacology. Each bibliography is divided into 18 sections: 1 Books, Reviews & Symposia; 2 General; 3 Psychotropic Drugs - General; Antidepressive Agents: 4 Tricyclics; 5 Monoamine Oxidase Inhibitors; 6 Serotonergics; Euthymic Agents: 7 Lithium; Tranquillizing Agents: 8 Major; 9 Minor & Hypnotics; 10 Analeptic Agents; 11 Anticonvulsant Agents; 12 Drugs of Abuse; 13 Transmitters, Receptors, Metabolites & Modulating Agents; 14 Neuropeptides; 15 Psychoneuroendocrinology; 16 Psychoneuroimmunology; 17 Behavioural Genetics; 18 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source] Current Awareness in Human PsychopharmacologyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 4 2003Article first published online: 19 MAY 200 In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of human psychopharmacology. Each bibliography is divided into 18 sections: 1 Books, Reviews & Symposia; 2 General; 3 Psychotropic Drugs - General; Antidepressive Agents: 4 Tricyclics; 5 Monoamine Oxidase Inhibitors; 6 Serotonergics; Euthymic Agents: 7 Lithium; Tranquillizing Agents: 8 Major; 9 Minor & Hypnotics; 10 Analeptic Agents; 11 Anticonvulsant Agents; 12 Drugs of Abuse; 13 Transmitters, Receptors, Metabolites & Modulating Agents; 14 Neuropeptides; 15 Psychoneuroendocrinology; 16 Psychoneuroimmunology; 17 Behavioural Genetics; 18 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source] Current Awareness in Human PsychopharmacologyHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2002Article first published online: 24 SEP 200 In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of human psychopharmacology. Each bibliography is divided into 18 sections: 1 Books, Reviews & Symposia; 2 General; 3 Psychotropic Drugs - General; Antidepressive Agents: 4 Tricyclics; 5 Monoamine Oxidase Inhibitors; 6 Serotonergics; Euthymic Agents: 7 Lithium; Tranquillizing Agents: 8 Major; 9 Minor & Hypnotics; 10 Analeptic Agents; 11 Anticonvulsant Agents; 12 Drugs of Abuse; 13 Transmitters, Receptors, Metabolites & Modulating Agents; 14 Neuropeptides; 15 Psychoneuroendocrinology; 16 Psychoneuroimmunology; 17 Behavioural Genetics; 18 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. [source] Transient ST Segment Elevation in Right Precordial Leads Induced by Psychotropic Drugs: Relationship to the Brugada SyndromeJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 1 2001FREDERIC ROULEAU M.D. Psychotropic Drugs and ST Segment Elevation. Transient ST segment elevation in right precordial leads with use of psychotropic drugs is reported in two cases of overdose and one case of therapeutic administration. Flecainide did not reproduce ST segment elevation. The relationship of these abnormalities to the Brugada syndrome and the electrophysiologic hypothesis are discussed. [source] Improving geriatric mental health nursing care: Making a case for going beyond psychotropic medicationsINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2003Philippe Voyer ABSTRACT Providing high-quality mental health nursing care should be an important and continuous preoccupation in the gerontological nursing field. As the proportion of elderly people in our society is growing, the emphasis on high-quality care will receive increasing attention from administrators, politicians, organized groups, researchers and clinical nurses. Recent findings illustrate unequivocally the important contribution of nurses to achieving the goal of high-quality geriatric care. However, the quality of care for the elderly with psychological difficulties has not been addressed. The objective of this article is to illustrate that while nurses can accomplish much to improve the well-being and mental health of the elderly, their skills are often underutilized. Psychotropic drugs are often the first-line interventions used by health-care professionals to treat mental health concerns of elderly persons. Alternative therapies that could be implemented and evaluated, such as psychological counselling, supportive counselling, education and life review, are infrequently used. Nevertheless, current scientific data suggest that it would be very advantageous if nurses were to play a dominant role in the care of elderly people who are depressed or experiencing sleep pattern disturbances. The same can be said about elderly chronic users of benzodiazepines, as well as those with cognitive impairment. Evidence for the use of psychotropic medications as a viable treatment option for the elderly both in the community and in the long-term care setting who are experiencing mental health challenges is examined. Alternative non-pharmacological approaches that nurses can use to augment care are also briefly discussed. [source] The new Swedish Prescribed Drug Register,Opportunities for pharmacoepidemiological research and experience from the first six months,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 7 2007Björn Wettermark M.Sc.Pharm Abstract Purpose To describe the content and potentials of the new Swedish national register on prescribed and dispensed medicines. Methods The Swedish Prescribed Drug Register contains information about age, sex and unique identifier of the patient as well as the prescriber's profession and practice. Information regarding drug utilization and expenditures for prescribed drugs in the entire Swedish population was extracted from the first six months July,December 2005 and compared with total drug sales in the country including OTC and hospital use. Results The total quantity of drugs sold in Sweden was 2666 million DDDs, corresponding to 1608 DDD/1000 inhabitants daily. The total expenditures were 1.6 billion Euro. The prescribed drugs, included in the register, accounted for 84% of the total utilization and 77% of the total expenditures. About half of all men and two-thirds of all women in the country purchased drugs. The proportion increased by age. The most common drugs for chronic treatment were diuretics among women (8.8% of the population) and antithrombotic agents among men (7.6%). Psychotropic drugs, corticosteroids and analgesics were more common among women, while men used antithrombotic agents, antidiabetic drugs, lipid lowering agents and ACE inhibitors to a greater extent. Conclusions The new register provides valuable data on exposure to drugs and is useful to study patterns of drug utilization. The possibilities for record linkage to other health registers gives from an international perspective good opportunities to explore drug and disease associations and the risks, benefits, effectiveness and health economical effects of drug use. Copyright © 2006 John Wiley & Sons, Ltd. [source] Psychotropic drugs and fatal pulmonary embolismPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 8 2003Lianne Parkin MB Abstract Purpose To examine the association between the use of psychotropic drugs and fatal pulmonary embolism. Methods We conducted a national case-control study of fatal pulmonary embolism. Cases were 75 New Zealand men and women aged 15,59 years who died between 1 January 1990 and 31 December 1998, where the underlying cause of death was certified as codes 415.1, 451 or 453 of the International Classification of Diseases (9th Revision). Four controls, matched for sex and age, were selected from the general practice to which each case had belonged. Information was abstracted from the records of general practitioners, family planning clinics and psychiatric services. Odds ratios and 95% confidence intervals (95%,CI) were estimated using conditional logistic regression. The key analyses were restricted to cases (n,=,62) and controls (n,=,243) without major risk factors for venous thromboembolism. Results Compared to non-use, the adjusted odds ratio for current use of antipsychotic drugs was 13.3 (95%,CI: 2.3,76.3). Low potency antipsychotics appeared to carry the highest risk (odds ratio: 20.8 [95%,CI: 1.7,259.0]). The main drug involved was thioridazine. The odds ratio for current use of antidepressants was also increased, at 4.9 (95%,CI: 1.1,22.5). Conclusions Our results for conventional antipsychotics are consistent with previous studies of non-fatal venous thromboembolism. The finding for antidepressants needs to be replicated in other studies. Copyright © 2003 John Wiley & Sons, Ltd. [source] Five-year follow-up during antipsychotic treatment: efficacy, safety, functional and social outcomeACTA PSYCHIATRICA SCANDINAVICA, Issue 2007E. Lindström Objective:, Explore the long-term course of schizophrenia and related disorders. Method:, Naturalistic study of 225 patients initially treated with risperidone (monotherapy or in combination with other psychotropic drugs) over 5 years. Results:, Stable symptomatology and side effects were observed. Clinician GAF scores were 55,61, but patients' self-ratings were higher. Clinician and patient CGI scores were at the same level. Annual in-patient days decreased but days in sheltered accommodations increased still more. Only 12% of the patients studied or worked full-time. One in four had no social contacts except with staff. Eight patients died during the 5 years. Conclusion:, The findings underline the chronicity and seriousness of psychotic disorders in terms of social outcome and, indirectly, the low quality of life of this group of persons. Patients were generally well aware of their illness and able to sort out symptoms from drug side effects. This opens for more active involvement of patients in monitoring their own treatment. [source] Torsade de pointes in a patient with complex medical and psychiatric conditions receiving low-dose quetiapineACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2005W. V. R. Vieweg Objective:, Describe potential cardiac complications of low-dose quetiapine and other atypical antipsychotic drugs. Method:, We present a case report of a 45-year-old Black woman with multiple medical and psychiatric problems taking low-dose quetiapine. Results:, Coincident with a generalized seizure, the patient developed ,ventricular fibrillation'. She was countershocked with restoration of normal sinus rhythm. The initial electrocardiogram showed QT interval prolongation. Shortly thereafter, classical torsade de pointes appeared, lasted 10 min, and resolved spontaneously. Hypomagnesemia was present. A cardiac electrophysiologist was concerned that the very slow shortening of the prolonged QTc interval after magnesium replacement implicated quetiapine as a risk factor for QTc interval prolongation and torsade de pointes. A psychosomatic medicine consultant asserted that the fragmented medical and psychiatric care almost certainly contributed to the patient's medical problems. We discuss other cases of QT interval prolongation by newer antipsychotic drugs and previous reports by our group concerning the association of psychotropic drugs, QT interval prolongation, and torsade de pointes. Conclusion:, Atypical antipsychotic drug administration, when accompanied by risk factors, may contribute to cardiac arrhythmias including torsade de pointes. [source] Drug/substance reversal effects of a novel tri-substituted benzoflavone moiety (BZF) isolated from Passiflora incarnata Linn.,a brief perspectiveADDICTION BIOLOGY, Issue 4 2003Kamaldeep Dhawan The present work is a mini-review of the author's original work on the plant Passiflora incarnata Linn., which is used in several parts of the world as a traditional medicine for the management of anxiety, insomnia, epilepsy and morphine addiction. A tri-substituted benzoflavone moiety (BZF) has been isolated from the bioactive methanol extract of this plant, which has been proposed in the author's earlier work to be responsible for the biological activities of this plant. The BZF moiety has exhibited significantly encouraging results in the reversal of tolerance and dependence of several addiction-prone psychotropic drugs, including morphine, nicotine, ethanol, diazepam and delta-9-tetrahydrocannabinol, during earlier pharmacological studies conducted by the author. In addition to this, the BZF moiety has exhibited aphrodisiac, libido-enhancing and virility-enhancing properties in 2-year-old male rats. When administered concomitantly with nicotine, ethanol and delta-9-tetrahydrocannabinol for 30 days in male rats, the BZF also prevented the drug-induced decline in sexuality in male rats. Because the BZF moiety isolated from P. incarnata is a tri-substituted derivative of alpha-naphthoflavone (7,8-benzoflavone), a well-known aromatase-enzyme inhibitor, the mode of action of BZF has been postulated to be a neurosteroidal mechanism vide in which the BZF moiety prevents the metabolic degradation of testosterone and upregulates blood-testosterone levels in the body. As several flavonoids (e.g. chrysin, apigenin) and other phytoconstituents also possess aromatase-inhibiting properties, and the IC 50 value of such phytomoieties is the main factor determining their biochemical efficacy, by altering their chemical structures to attain a desirable IC 50 value new insights in medical therapeutics can be attained, keeping in view the menace of drug abuse worldwide. [source] Metabolic drug interactions with new psychotropic agentsFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 5 2003Edoardo Spina Abstract New psychotropic drugs introduced in clinical practice in recent years include new antidepressants, such as selective serotonin reuptake inhibitors (SSRI) and ,third generation' antidepressants, and atypical antipsychotics, i.e. clozapine, risperidone, olanzapine, quetiapine, ziprasidone and amisulpride. These agents are extensively metabolized in the liver by cytochrome P450 (CYP) enzymes and are therefore susceptible to metabolically based drug interactions with other psychotropic medications or with compounds used for the treatment of concomitant somatic illnesses. New antidepressants differ in their potential for metabolic drug interactions. Fluoxetine and paroxetine are potent inhibitors of CYP2D6, fluvoxamine markedly inhibits CYP1A2 and CYP2C19, while nefazodone is a potent inhibitor of CYP3A4. These antidepressants may be involved in clinically significant interactions when coadministered with substrates of these isoforms, especially those with a narrow therapeutic index. Other new antidepressants including sertraline, citalopram, venlafaxine, mirtazapine and reboxetine are weak in vitro inhibitors of the different CYP isoforms and appear to have less propensity for important metabolic interactions. The new atypical antipsychotics do not affect significantly the activity of CYP isoenzymes and are not expected to impair the elimination of other medications. Conversely, coadministration of inhibitors or inducers of the CYP isoenzymes involved in metabolism of the various antipsychotic compounds may alter their plasma concentrations, possibly leading to clinically significant effects. The potential for metabolically based drug interactions of any new psychotropic agent may be anticipated on the basis of knowledge about the CYP enzymes responsible for its metabolism and about its effect on the activity of these enzymes. This information is essential for rational prescribing and may guide selection of an appropriate compound which is less likely to interact with already taken medication(s). [source] ,Mother's Little Helper': The Crisis of Psychoanalysis and the Miltown ResolutionGENDER & HISTORY, Issue 2 2003Jonathan M. Metzl This paper examines the discourse surrounding the release in 1955 of Miltown, America's first psychotropic wonder drug. According to many histories of psychiatry, Miltown heralded the arrival of a new paradigm in treating psychiatric patients , as a drug that operated on a neurochemical level, it was argued to replace a psychoanalytic approach with its focus on the mother-child relation. Between 1955 and 1960, articles about pharmaceutical miracle cures for mental illnesses filled mass-circulation news magazines and top fashion magazines. Through analysis of these representations, this article shows how the newly discovered pills came to be associated with existing concerns about conditions problematically referred to as ,maternal conditions,' ranging from a woman's frigidity, to a bride's uncertainty, to a wife's infidelity. Using these representations, the paper demonstrates how in American popular culture, psychoanalytic notions of motherhood prevalent in the 1950s shaped early understandings and uses of psychotropic drugs. [source] Cardiac side effects of psychiatric drugs,HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue S1 2008Paul Mackin Abstract This review describes the common effects of psychotropic drugs on the cardiovascular system and offers guidance for practical management. Selected reports from the literature describing common side effects associated with psychotropic drugs are reviewed, and suggestions for further reading are given throughout the text. Orthostatic hypotension is the most common adverse autonomic side effect of antipsychotic drugs. Among the atypical antipsychotics the risk of orthostatic hypotension is highest with clozapine and among the conventional drugs the risk is highest with low potency agents. Rarely, orthostatic hypotension may result in neurocardiogenic syncope. QTc prolongation can occur with all antipsychotics but an increased risk is seen with pimozide, thioridazine, sertindole and zotepine. QTc prolongation is a marker of arrhythmic risk. Torsade de pointe, a specific arrhythmia, may lead to syncope, dizziness or ventricular fibrillation and sudden death. Heart muscle disease presents most commonly in the elderly as chronic heart failure, but myocarditis and cardiomyopathy, although relatively rare, are devastating, but potentially reversible complications of psychotropic drug therapy have been particularly linked to clozapine treatment. Patients with severe mental illness (SMI) are a ,high risk' population with regard to cardiovascular morbidity and mortality. It is probable that many patients accumulate an excess of ,traditional' risk factors for the development of cardiovascular disease, but other mechanisms including psychotropic drugs may also be influential in increasing risk in this vulnerable group. These risks need to be seen in the context of the undoubted therapeutic efficacy of the psychotropic armamentarium and the relief that these drugs bring to those suffering from mental disorder. Copyright © 2007 John Wiley & Sons, Ltd. [source] Glucuronidation of olanzapine by cDNA-expressed human UDP-glucuronosyltransferases and human liver microsomesHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 5 2002Kristian Linnet Abstract Olanzapine is a widely used, newer antipsychotic agent, which is metabolized by various pathways: hydroxylation and N -demethylation by cytochrome P450, N -oxidation by flavin monooxygenase and direct glucuronidation. In vivo studies have pointed towards the latter pathway as being of major importance. Accordingly, the glucuronidation reaction was studied in vitro using cDNA-expressed human UDP-glucuronosyltransferase (UGT) enzymes and a pooled human liver microsomal preparation (HLM). Glucuronidated olanzapine was determined by HPLC after acid or enzymatic hydrolysis. The following UGT-isoenzymes were screened for their ability to glucuronidate olanzapine: 1A1, 1A3, 1A4, 1A6, 1A9, 2B7 and 2B15. Only UGT1A4 was able to glucuronidate olanzapine obeying saturation kinetics. The Km value was 227,,mol/l (SE 43), i.e. of the same order of magnitude as for other psychotropic drugs, and the Vmax value was 2370,pmol/(min,mg) (SE 170). Glucuronidation was also mediated by the HLM preparation, but a saturation level was not reached. The olanzapine glucuronidation reaction was inhibited by several drugs known as substrates for UGT1A4, e.g. amitriptyline, trifluoperazine and lamotrigine. Thus, competition for glucuronidation by UGT1A4 represents a possibility for drug,drug interactions in subjects receiving several of these psychotropic drugs at the same time. Whether such possible interactions are of any clinical importance may await further studies in patients. Copyright © 2002 John Wiley & Sons, Ltd. [source] The prevalence of psychiatric symptoms and behavioural disturbances and the use of psychotropic drugs in Norwegian nursing homes,INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2007Geir Selbæk Abstract Background Psychiatric and behavioural symptoms in dementia are associated with a range of negative outcomes, including institutional placement and the widespread use of psychotropic drugs in spite of limited evidence for their efficacy. Aims To determine the prevalence of psychiatric and behavioural symptoms and the pattern of psychotropic drug prescription in patients with various degrees of dementia. Methods A sample of 1,163 non-selected nursing home patients were assessed by means of the Neuropsychiatric Inventory, the Clinical Dementia Rating scale and Lawton's activities of daily living scale. In addition, information was collected from the patients' records. Results Dementia was found in 81% of the patients and 72% of them had clinically significant psychiatric and behavioural symptoms. The frequencies of symptoms increased with the severity of the dementia. Psychotropic medication was being prescribed to 75% of patients with dementia. There was a significant relationship between the type of drug and the symptom for which it had been dispensed. Conclusion Psychiatric and behavioural symptoms are frequent in nursing homes and the rate increases with the progression of the dementia. Systematic programmes are needed for disseminating skills and providing guidance regarding the evaluation and treatment of these symptoms in nursing homes. Copyright © 2006 John Wiley & Sons, Ltd. [source] Prevalence of psychotropic drug use in nursing homes for the aged in Quebec and in the French-speaking area of SwitzerlandINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2005Micheline Gobert Abstract Background The use of psychotropic drugs is high in institutionalised elderly, which raises the question of its appropriateness. This study aimed to: (1) estimate the use of psychotropics, for each family, in terms of the prevalence and dosage among the elderly in nursing homes in French-speaking Switzerland and Quebec; and (2) assess, for each family of psychotropic drugs and for each care facility, the prevalence of use and departure from average prescription (ratio of observed-to-expected prevalence). Method An administrative database was used for this cross-sectional analysis. The sample included 8183 Quebec and 7592 Swiss long-term care residents. Three classes of psychotropics (antipsychotics, antidepressants, hypnotics-anxiolytics) were defined as dichotomous variables. Logistic regressions were conducted to identify residents characteristics associated with the use of each psychotropic type and to compute expected prevalence. Results Swiss residents were slightly older and less dependent than Quebec residents. Use of psychotropic drugs was higher in Swiss than in Quebec residents, on the whole as well as for each family of drug. A total of 78.1% of Swiss residents used at least one drug as compared to 66.9% in Quebec. Ninety percent of residents were given less than 7 defined daily doses per week, irrespective of the drug family. According to Beer's criteria, only 4.9% of prescriptions were inadequate. In Quebec and in Switzerland, the prevalence of antidepressant use was associated with the prevalence of hypnotic-anxiolytic use. No ratios of observed-to-expected reached statistical significance. Interpretation There was a considerable use of psychotropics in Quebec and Switzerland with, seemingly, no dramatic departure from the average practice. Our data cannot tell if there is a global overuse of psychotropics, but indicated that dosage and medication selection seem adequate. Physicians should critically reassess the necessity of prescribed medications for their patients. Copyright © 2005 John Wiley & Sons, Ltd. [source] Development of a registry for monitoring psychotropic drug prescriptions: aims, methods and implications for ordinary practice and researchINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2005Dr Corrado Barbui Abstract In psychiatry, individual-based registries have provided key information on risks and benefits associated with the use of psychotropic drugs but they have rarely been employed for monitoring and evaluating the everyday prescribing of psychopharmacological treatments. This article describes the cultural background that gave impetus to the idea of registering all prescriptions of psychotropic drugs dispensed by physicians working in the South Verona community mental health service, and presents the methodology employed to develop such a registry in a community psychiatric service where a psychiatric case register (PCR) has been operating since 1978. We developed a registry including every patient receiving psychotropic medications in ordinary practice. This registry is linked to the PCR in order to obtain data on social and demographic characteristics, clinical symptoms, diagnosis, use of services, and outcomes. No exclusion criteria are allowed , anyone receiving treatment is automatically included. This system, which can link drug and service-use data with hard outcome indicators, can generate information on the proportion of subjects discontinuing treatment, switching medication because of side-effects, recovery or inefficacy, as well as on the proportion of subjects failing to return to the physician, and the proportion of patients who improve. The innovative aspect of this approach is that this registry is developed, organized and used by physicians interested in monitoring their clinical practice and in providing patients, relatives and the public with accurate information on drug use in their specific context of care. Copyright © 2005 John Wiley & Sons, Ltd. [source] The Appropriateness of Drug Use in an Older Nondemented and Demented PopulationJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2001Maria Stella T. Giron MD OBJECTIVE: To assess the extent of inappropriateness of drug use in an older nondemented and demented population. DESIGN: Descriptive analysis based on data from a sample of older subjects age 81 years and older. Data were collected from the second follow-up conducted in 1994,1996. SETTING: A population-based study of the Kungsholmen project in Stockholm, Sweden. PARTICIPANTS: Drug information was obtained from 681 subjects with a mean age of 86.9 years. The subjects were predominantly women (78%). Thirteen percent resided in institutions and 27.6% were diagnosed with dementia. MEASUREMENTS: Dementia diagnosis based on DSM III-R. Criteria for inappropriateness of drug use: use of drugs with potent anticholinergic properties, drug duplication, potential drug-drug and drug-disease interactions, and inappropriate drug dosage. RESULTS: The mean number of drugs used was 4.6: 4.5 drugs for nondemented and 4.8 for demented subjects. Nondemented subjects more commonly used cardiovascular-system drugs and demented subjects used nervous-system drugs. Demented subjects were more commonly exposed to drug duplication and to drugs with potent anticholinergic properties, both involving the use of psychotropic drugs. Nondemented subjects were more commonly exposed to potential drug-disease interactions, mostly with the use of cardiovascular drugs. The most common drug combination leading to a potential interaction was the use of digoxin with furosemide, occurring more frequently among nondemented subjects. The most common drug-disease interaction was the use of beta-blockers and calcium antagonists in subjects with congestive heart failure. The doses of drugs taken by both nondemented and demented subjects were mostly lower than the defined daily dose. CONCLUSION: There was substantial exposure to presumptive inappropriateness of drug use in this very old nondemented and demented population. The exposure of demented subjects to psychotropic drugs and nondemented subjects to cardiovascular drugs reflect the high frequency of prescribing these drugs in this population. [source] Propranolol Intoxication Revealing a Brugada SyndromeJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 3 2005PHILIP AOUATE M.D. This is the first report of Brugada syndrome revealed by beta-blocker intoxication. A 24-year-old healthy man ingested propranolol (2.28 g) to commit suicide. After early gastric lavage, electrolytes, cardiac enzymes, chest X-ray, and echocardiography were normal. Dosages of psychotropic drugs were negative. ECG showed a typical coved-type pattern of Brugada syndrome. Follow-up showed partial ECG normalization of the discrete saddleback-type pattern. The ajmaline- test confirmed Brugada syndrome. These ECG modifications may be explained by the stabilizing membrane effect of high concentration of propranolol and/or inhibition of ICaL. This case illustrates the possible deleterious effects of beta-blockers in patients with Brugada syndrome. [source] Transient ST Segment Elevation in Right Precordial Leads Induced by Psychotropic Drugs: Relationship to the Brugada SyndromeJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 1 2001FREDERIC ROULEAU M.D. Psychotropic Drugs and ST Segment Elevation. Transient ST segment elevation in right precordial leads with use of psychotropic drugs is reported in two cases of overdose and one case of therapeutic administration. Flecainide did not reproduce ST segment elevation. The relationship of these abnormalities to the Brugada syndrome and the electrophysiologic hypothesis are discussed. [source] Quality of life and attitudes towards psychotropics and dependency: consumers vs. non-consumers aged 50 and overJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 5 2004M. Baumann SocD PhD Summary Aim:, To assess the relationships between socio-demographic factors, quality of life and attitudes towards psychotropic drugs and dependency and to compare those relationships in continuous consumers (CC), occasional consumers (OC) and non-consumers (NC) of those drugs. Methods:, Quality of life (SF36) and attitudes (14 statements) were measured in 601 subjects (45,60 years old) from the SUVIMAX cohort (SUpplémentation en VItamines et en sels Minéraux AntioXydants). Data were obtained on 334 NC, 142 CC, 125 OC from the inclusion questionnaire and the monthly consumption report notebooks kept by subjects between 1994 and 1998. Dichotomous and polychotomous logistic regressions were used for the analysis. Results:, The lower the quality of life score the more frequent was consumption. NC tended to be men, with high quality of life scores. They entertained negative attitudes towards psychotropics and dependency. OC tended to be women reporting a chronic pathology, with fairly high social status. They had intermediate quality of life and denied dependency. CC tended to be men with no professional activity and low quality of life scores in particular for mental health and perceived health. They had positive attitudes towards psychotropics and accept dependency. Discussion:, Assessment of patients' quality of life and understanding of their attitudes towards psychotropics can provide essential information for those in charge of health promotion programmes and may help in identifying new intervention strategies. Preventive education and follow-up of therapy may be better suited to the needs of patients. [source] Synthesis of new hetero[1,2,4]thiadiazin-3-one S,S-dioxides and oxazolo[3,2- b]hetero[1,2,4]thiadiazine S,S-dioxides as potential psychotropic drugs ,JOURNAL OF HETEROCYCLIC CHEMISTRY, Issue 5 2005Salvador Vega A series of 2-substituted 2H -thieno[3,4- e][1,2,4]thiadiazin-3(4H)-one 1,1-dioxides (2), 2-substituted 2H -thieno[2,3- e][1,2,4]thiadiazin-3(4H)-one 1,1-dioxides (3), 2-substituted 4,6-dihydropyrazolo[4,3- e]-[1,2,4]thiadiazin-3(2H)-one 1,1-dioxides (4), 2-substituted 2,3-dihydrooxazolo[3,2- b]thieno[3,4- e]-[1,2,4]thiadiazine 5,5-dioxides, (5), 6-substituted 6,7-dihydro-2H -oxazolo[3,2- b]pyrazolo[4,3- e][1,2,4]thia-diazine 9,9-dioxides (6) and 7-substituted 6,7-dihydro-2H -oxazolo[3,2- b]pyrazolo[4,3- e][1,2,4]thiadiazine 9,9-dioxides (7) were synthesized as potential psychotropic agents. [source] The biopharmaceutical aspects of nasal mucoadhesive drug deliveryJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 1 2001Michael Ikechukwu Ugwoke Nasal drug administration has frequently been proposed as the most feasible alternative to parenteral injections. This is due to the high permeability of the nasal epithelium, allowing a higher molecular mass cut-off at approximately 1000 Da, and the rapid drug absorption rate with plasma drug profiles sometimes almost identical to those from intravenous injections. Despite the potential of nasal drug delivery, it has a number of limitations. In this review, the anatomy and physiology of the nasal cavity, as well as ciliary beating and mucociliary clearance as they relate to nasal drug absorption, are introduced. The rationale for nasal drug delivery and its limitations, some factors that influence nasal drug absorption, and the experimental models used in nasal drug delivery research are also reviewed. Nasal mucoadhesion as a promising method of nasal absorption enhancement is discussed, and factors that influence mucoadhesion, as well as safety of nasal mucoadhesive drug delivery systems are reviewed in detail. Nasal drug administration is presently mostly used for local therapies within the nasal cavity. Anti-allergic drugs and nasal decongestants are the most common examples. However, nasal drug administration for systemic effects has been practised since ancient times. Nasally-administered psychotropic drugs by native Americans, the use of tobacco snuffs, and nasal administration of illicit drugs such as cocaine are all well known (Illum & Davis 1992). Nowadays, the nasal cavity is being actively explored for systemic administration of other therapeutic agents, particularly peptides and proteins (Illum 1992; Edman & Bjork 1992), as well as for immunization purposes (Lemoine et al 1998). To better understand the basis for nasal drug absorption and factors that can influence it, a brief review of the anatomy and physiology of the nose is appropriate. [source] | |||||||||||||||||||||||||||||||