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Annual Review of Clinical Psychology May 2019We live in an age of psychopharmacology. One in six persons currently takes a psychotropic drug. These drugs have profoundly shaped our scientific and cultural... (Review)
Review
We live in an age of psychopharmacology. One in six persons currently takes a psychotropic drug. These drugs have profoundly shaped our scientific and cultural understanding of psychiatric disease. By way of a historical review, we try to make sense of psychiatry's dependency on psychiatric drugs in the care of patients. Modern psychopharmacology began in 1950 with the synthesis of chlorpromazine. Over the course of the next 50 years, the psychiatric understanding and treatment of mental illness radically changed. Psychotropic drugs played a major part in these changes as state hospitals closed and psychotherapy gave way to drug prescriptions. Our review suggests that the success of psychopharmacology was not the consequence of increasingly more effective drugs for discrete psychiatric diseases. Instead, a complex mix of political economic realities, pharmaceutical marketing, basic science advances, and changes in the mental health-care system have led to our current infatuation with psychopharmacology.
Topics: History, 19th Century; History, 20th Century; History, 21st Century; Humans; Mental Health Services; Psychiatry; Psychopharmacology; Psychotropic Drugs
PubMed: 30786241
DOI: 10.1146/annurev-clinpsy-050718-095514 -
Psychotherapy and Psychosomatics 2020Studies on psychotropic medications decrease, discontinuation, or switch have uncovered withdrawal syndromes. The present overview aimed at analyzing the literature to... (Review)
Review
Studies on psychotropic medications decrease, discontinuation, or switch have uncovered withdrawal syndromes. The present overview aimed at analyzing the literature to illustrate withdrawal after decrease, discontinuation, or switch of psychotropic medications based on the drug class (i.e., benzodiazepines, nonbenzodiazepine benzodiazepine receptor agonists, antidepressants, ketamine, antipsychotics, lithium, mood stabilizers) according to the diagnostic criteria of Chouinard and Chouinard [Psychother Psychosom. 2015;84(2):63-71], which encompass new withdrawal symptoms, rebound symptoms, and persistent post-withdrawal disorders. All these drugs may induce withdrawal syndromes and rebound upon discontinuation, even with slow tapering. However, only selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors, and antipsychotics were consistently also associated with persistent post-withdrawal disorders and potential high severity of symptoms, including alterations of clinical course, whereas the distress associated with benzodiazepines discontinuation appears to be short-lived. As a result, the common belief that benzodiazepines should be substituted by medications that cause less dependence such as antidepressants and antipsychotics runs counter the available literature. Ketamine, and probably its derivatives, may be classified as at high risk for dependence and addiction. Because of the lag phase that has taken place between the introduction of a drug into the market and the description of withdrawal symptoms, caution is needed with the use of newer antidepressants and antipsychotics. Within medication classes, alprazolam, lorazepam, triazolam, paroxetine, venlafaxine, fluphenazine, perphenazine, clozapine, and quetiapine are more likely to induce withdrawal. The likelihood of withdrawal manifestations that may be severe and persistent should thus be taken into account in clinical practice and also in children and adolescents.
Topics: Humans; Mental Disorders; Psychotropic Drugs; Randomized Controlled Trials as Topic; Substance Withdrawal Syndrome
PubMed: 32259826
DOI: 10.1159/000506868 -
Actas Espanolas de Psiquiatria Sep 2019Schizoaffective disorder (SAD) is a psychotic disorder which has presented a certain nosological controversy. Apart from these difficulties, very few studies focused in... (Review)
Review
Schizoaffective disorder (SAD) is a psychotic disorder which has presented a certain nosological controversy. Apart from these difficulties, very few studies focused in SAD as a distinct condition from schizophrenia have been found. This lack of specifical studies on SAD results in a lack of specific evidence about treatment. Currently, its treatment is based mainly on the use of antipsychotics, although there are no specific treatment guidelines for SAD. The objective of this review is to establish which are the most recommended treatments according to evidence available, considering clinical variables such as efficacy, safety, adherence, and tolerance as well as the role of these factors in different subtypes of SAD. This exhaustive review examines experimental and observational studies involving patients with a diagnosis of SAD. It was concluded that more clinical trials performed exclusively on patients affected by SAD are needed. Paliperidone, the only drug with authorized use in SAD, is the one that has the highest quality of studies to support its use. Risperidone, olanzapine, aripiprazole and ziprasidone also have randomized clinical trials supporting their efficacy and safety. In treatment-refractory patients, there are observational studies indicating the usefulness of clozapine. Likewise, there is evidence from observational studies showing the usefulness of lithium and carbamazepine during the treatment maintenance phase. It is necessary to establish the role of combined treatment with mood stabilizers and/or antidepressants.
Topics: Humans; Psychopharmacology; Psychotic Disorders; Psychotropic Drugs
PubMed: 31648341
DOI: No ID Found -
The Journal of Nervous and Mental... Apr 2018
Topics: Adult; Bipolar Disorder; Drug Hypersensitivity; Female; Food Hypersensitivity; Humans; Male; Psychotropic Drugs
PubMed: 29595625
DOI: 10.1097/NMD.0000000000000787 -
Giornale Italiano Di Dermatologia E... Aug 2018Most dermatologists evaluate and treat patients with psychological or psychiatric issues related to their skin disease. These patients often require psychopharmacologic... (Review)
Review
Most dermatologists evaluate and treat patients with psychological or psychiatric issues related to their skin disease. These patients often require psychopharmacologic therapies. Therefore, it is important for dermatologists to be familiar with psychopharmacologic treatments for diseases that fit into the overlap between psychiatry and dermatology. This review aims to provide a concise overview of psychopharmacology as it applies to dermatology. Psychotropic medications commonly used in psychodermatology, including antidepressants, antipsychotics, and anxiolytics, are reviewed; safety profile and dosing recommendations are discussed.
Topics: Dermatology; Dose-Response Relationship, Drug; Humans; Mental Disorders; Psychopharmacology; Psychotropic Drugs; Skin Diseases
PubMed: 29667795
DOI: 10.23736/S0392-0488.18.05978-3 -
Advances in Clinical Chemistry 2021Synthetic drugs of abuse contain various psychoactive substances. These substances have recently emerged as novel drugs of abuse in public; thus, they are known as novel... (Review)
Review
Synthetic drugs of abuse contain various psychoactive substances. These substances have recently emerged as novel drugs of abuse in public; thus, they are known as novel psychoactive substances (NPS). As these compounds are artificially synthesized in a laboratory, they are also called designer drugs. Synthetic cannabinoids and synthetic cathinones are the two primary classes of NPS or designer drugs. Synthetic cannabinoids, also known as "K2" or "Spice," are potent agonists of the cannabinoid receptors. Synthetic cathinones, known as "Bath salts," are beta-keto amphetamine derivatives. These compounds can cause severe intoxication, including overdose deaths. NPS are accessible locally and online. NPS are scheduled in the US and other countries, but the underground chemists keep modifying the chemical structure of these compounds to avoid legal regulation; thus, these compounds have been evolving rapidly. These drugs are not detectable by traditional drug screening, and thus, these substances are mainly abused by young individuals and others who wish to avoid drug detection. These compounds are analyzed primarily by mass spectrometry.
Topics: Alkaloids; Cannabinoids; Humans; Illicit Drugs; Psychotropic Drugs; Substance-Related Disorders; Synthetic Drugs
PubMed: 34229850
DOI: 10.1016/bs.acc.2020.10.001 -
European Review For Medical and... Oct 2020Antiretroviral drugs are the mainstay of treatment for human immunodeficiency virus (HIV) infection. Lifelong highly active antiretroviral therapy (HAART) is indicated... (Review)
Review
OBJECTIVE
Antiretroviral drugs are the mainstay of treatment for human immunodeficiency virus (HIV) infection. Lifelong highly active antiretroviral therapy (HAART) is indicated to prevent disease progression to acquired immunodeficiency syndrome (AIDS). Efavirenz was a first-line component of HAART across the world for many years. The purpose of this article is to review the psychotropic properties of efavirenz, which are the most important adverse events associated with the drug and commonly result in treatment discontinuation.
MATERIALS AND METHODS
A PubMed search was conducted using efavirenz as a search term, which returned 4655 results. Titles and abstracts of articles were screened for relevance, and all relevant articles published in English were included in the narrative review.
RESULTS
Acute exposure to efavirenz may cause profound perceptual disturbances (delusions and hallucinations) whereas chronic exposure may be associated with abnormal dreams and other sleep disturbances, anxiety, depressed mood and suicidality. It may also be abused as a hallucinogen, especially in individuals with a history of poly-substance abuse. Recent research indicates that efavirenz directly affects monoaminergic neurotransmission and may partially substitute for psychedelic drugs, such as lysergic acid diethylamide (LSD). Efavirenz acts as a serotonin 5-HT2A receptor antagonist, a serotonin-dopamine reuptake inhibitor, an inhibitor of monoamine oxidase (MAO) and a vesicular monoamine transporter 2 (VMAT2) inhibitor, which are mechanisms common with many psychotropic drugs. Efavirenz interacts with many of the same molecular targets as the empathogen methylendioxymethamphetamine (MDMA), but the effects of the 2 drugs may differ.
CONCLUSIONS
The exact mechanism of action of efavirenz as a psychotropic drug remains unclear and future studies should focus on evaluating whether prolonged exposure could lead to irreversible side effects.
Topics: Alkynes; Benzoxazines; Cyclopropanes; Humans; Psychotic Disorders; Psychotropic Drugs
PubMed: 33155233
DOI: 10.26355/eurrev_202010_23433 -
Drugs & Aging Apr 2020The use of psychotropic drugs (antipsychotics, benzodiazepines and benzodiazepine-related drugs, and antidepressants) is common, with a prevalence estimates range of... (Review)
Review
The use of psychotropic drugs (antipsychotics, benzodiazepines and benzodiazepine-related drugs, and antidepressants) is common, with a prevalence estimates range of 19-29% among community dwelling older adults. These drugs are often prescribed for off-label use, including neuropsychiatric symptoms. The older adult population also has high rates of pneumonia and some of these cases may be associated with adverse drug events. In this narrative review, we summarize the findings from current observational studies on the association between psychotropic drug use and pneumonia in older adults. In addition to studies assessing the use of psychotropics, we included antiepileptic drugs, as they are also central nervous system-acting drugs, whose use is becoming more common in the aging population. The use of antipsychotics, benzodiazepine, and benzodiazepine-related drugs are associated with increased risk of pneumonia in older adults (≥ 65 years of age), and these findings are not limited to this age group. Minimal and conflicting evidence has been reported on the association between antidepressant drug use and pneumonia, but differences between study populations make it difficult to compare findings. Studies regarding antiepileptic drug use and risk of pneumonia in older persons are lacking, although an increased risk of pneumonia in antiepileptic drug users compared with non-users in persons with Alzheimer's disease has been reported. Tools such as the American Geriatric Society Beers Criteria and the STOPP/START criteria for potentially inappropriate medications aids prescribers to avoid these drugs in order to reduce the risk of adverse drug events. However, risk of pneumonia is not mentioned in the current criteria and more research on this topic is needed, especially in vulnerable populations, such as persons with dementia.
Topics: Aged; Alzheimer Disease; Antidepressive Agents; Antipsychotic Agents; Humans; Pneumonia; Psychotropic Drugs
PubMed: 32107741
DOI: 10.1007/s40266-020-00754-1 -
Journal of Psychoactive Drugs 2021Using psychiatric drugs to treat drug dependence and its comorbidities is very common. The objective of this study was to analyze the interactions between prescribed...
Using psychiatric drugs to treat drug dependence and its comorbidities is very common. The objective of this study was to analyze the interactions between prescribed drugs for patients treated at a specialized mental health-care center for persons who use drugs, located in the state of Santa Catarina, Brazil. A cross-sectional study was conducted on secondary data collected from 2010 to 2018. We reviewed the medical records of patients aged 18 years or older who took psychotropic drugs and had any type of substance dependence. The analysis of psychotropic drug interactions was conducted in three databases: , and . We included 1,022 of the 2,322 patients attending the care center during the study period. Psychotropic drug interactions were found in 779 (76.4%) study participants, and they presented 2,292 (100%) interactions, out of which 136 (6.0%) had minor clinical risk, 537 (23.4%) had moderate risk, and 1,619 (70.6%) had major risk for the patient, totaling 172 incompatible combinations between two psychotropic drugs. Of the total number of interactions, 128 were pharmacokinetic and 44 were pharmacodynamic. The high number of psychotropic drug interactions is a serious public health issue. Psychopharmacological treatment should be carefully addressed to be safe for the patient.
Topics: Cross-Sectional Studies; Drug Interactions; Humans; Pharmaceutical Preparations; Psychotropic Drugs; Substance-Related Disorders
PubMed: 33225871
DOI: 10.1080/02791072.2020.1849878 -
The American Journal of Nursing Jun 2017: Antipsychotic medications are primarily used to manage various symptoms of psychosis. In recent years, more adults-and teenagers-are taking at least one type of... (Review)
Review
: Antipsychotic medications are primarily used to manage various symptoms of psychosis. In recent years, more adults-and teenagers-are taking at least one type of psychotropic medication, the majority of which are prescribed by primary care and family physicians. Because nurses are now caring for people of varying ages, and with varying diagnoses, who are taking these types of medications, they need to develop a working knowledge of the agents available and know when it's appropriate to prescribe them for mental health disorders as well as for disorders unrelated to mental health. This article is the first in a series on commonly used psychotropic medications.
Topics: Antipsychotic Agents; Humans; Psychotic Disorders; Psychotropic Drugs; Schizophrenia
PubMed: 28504976
DOI: 10.1097/01.NAJ.0000520229.04987.46