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British Journal of Pharmacology Dec 2018The fate and activity of drugs are frequently dictated not only by the host per se but also by the microorganisms present in the gastrointestinal tract. The gut... (Review)
Review
The fate and activity of drugs are frequently dictated not only by the host per se but also by the microorganisms present in the gastrointestinal tract. The gut microbiome is known to, both directly and indirectly, affect drug metabolism. More evidence now hints at the effects that drugs can have on the function and composition of the gut microbiome. Both microbiota-mediated alterations in drug metabolism and drug-mediated alterations in the gut microbiome can have beneficial or detrimental effects on the host. Greater insights into the mechanisms driving these reciprocal drug-gut microbiota interactions are needed to guide the development of microbiome-targeted dietary or pharmacological interventions, which may have the potential to enhance drug efficacy or reduce drug side effects. In this review, we explore the relationship between drugs and the gut microbiome, with a specific focus on potential mechanisms underpinning the drug-mediated alterations on the gut microbiome and the potential implications for psychoactive drugs. LINKED ARTICLES: This article is part of a themed section on When Pharmacology Meets the Microbiome: New Targets for Therapeutics? To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.24/issuetoc.
Topics: Animals; Gastrointestinal Microbiome; Humans; Neuropharmacology; Psychotropic Drugs
PubMed: 29782640
DOI: 10.1111/bph.14366 -
Current Topics in Behavioral... 2018Discriminative stimulus and other drug effects are determined by the concentration of drug at its target receptor and by the pharmacodynamic consequences of... (Review)
Review
Discriminative stimulus and other drug effects are determined by the concentration of drug at its target receptor and by the pharmacodynamic consequences of drug-receptor interaction. For in vivo procedures such as drug discrimination, drug concentration at receptors in a given anatomical location (e.g., the brain) is determined both by the dose of drug administered and by pharmacokinetic processes of absorption, distribution, metabolism, and excretion that deliver drug to and from that anatomical location. Drug discrimination data are often analyzed by strategies of dose-effect analysis to determine parameters such as potency and efficacy. Pharmacokinetic-Pharmacodynamic (PKPD) analysis is an alternative to conventional dose-effect analysis, and it relates drug effects to a measure of drug concentration in a body compartment (e.g., venous blood) rather than to drug dose. PKPD analysis can yield insights on pharmacokinetic and pharmacodynamic determinants of drug action. PKPD analysis can also facilitate translational research by identifying species differences in pharmacokinetics and providing a basis for integrating these differences into interpretation of drug effects. Examples are discussed here to illustrate the application of PKPD analysis to the evaluation of drug effects in rhesus monkeys trained to discriminate cocaine from saline.
Topics: Animals; Discrimination, Psychological; Drug Tolerance; Humans; Prodrugs; Psychotropic Drugs
PubMed: 27571746
DOI: 10.1007/7854_2016_36 -
Journal of the American Pharmacists... 2017With an increasing prevalence of psychotropic polypharmacy, clinicians depend on drug-drug interaction (DDI) references to ensure safe regimens, but the consistency of... (Review)
Review
BACKGROUND
With an increasing prevalence of psychotropic polypharmacy, clinicians depend on drug-drug interaction (DDI) references to ensure safe regimens, but the consistency of such information is frequently questioned.
OBJECTIVES
To evaluate the consistency of psychotropic DDIs documented in Clinical Pharmacology (CP), Micromedex (MM), and Lexicomp (LC) and summarize consistent psychotropic DDIs.
METHODS
In May 2016, we extracted severe or major psychotropic DDIs for 102 psychotropic drugs, including central nervous system (CNS) stimulants, antidepressants, an antimanic agent (lithium), antipsychotics, anticonvulsants, and anxiolytics-sedatives-hypnotics from CP, MM, and LC. We then summarized the psychotropic DDIs that were included in all 3 references and with evidence quality of "excellent" or "good" based on MM.
RESULTS
We identified 1496, 938, and 1006 unique severe or major psychotropic DDIs from CP, MM, and LC, respectively. Common adverse effects related to psychotropic DDIs include increased or decreased effectiveness, CNS depression, neurotoxicity, QT prolongation, serotonin syndrome, and multiple adverse effects. Among these interactions, only 371 psychotropic DDIs were documented in all 3 references, 59 of which had "excellent" or "good" quality of evidence based on MM.
CONCLUSION
The consistency of psychotropic DDI documentation across CP, MM, and LC is poor. DDI documentations need standards that would encourage consistency among drug information references. The list of the 59 DDIs may be useful in the assessment of psychotropic polypharmacy and highlighting DDI alerts in clinical practice.
Topics: Access to Information; Drug Information Services; Drug Interactions; Drug Therapy, Combination; Drug-Related Side Effects and Adverse Reactions; Humans; Polypharmacy; Psychotropic Drugs; Risk Assessment; Risk Factors
PubMed: 28844584
DOI: 10.1016/j.japh.2017.07.008 -
Deutsches Arzteblatt International Jan 2020
Topics: Aged; Drug Interactions; Humans; Polypharmacy; Psychotropic Drugs
PubMed: 32031513
DOI: 10.3238/arztebl.2020.0039a -
The Veterinary Clinics of North... Jan 2021Literature regarding the clinical use of psychotropic drugs in exotic animals remains scarce. Psychotropic drugs acting on serotonin, dopamine, norepinephrine, and... (Review)
Review
Literature regarding the clinical use of psychotropic drugs in exotic animals remains scarce. Psychotropic drugs acting on serotonin, dopamine, norepinephrine, and gamma-aminobutyric acid pathways work by decreasing fear and anxiety, reactivity, and hypervigilance, and by improving impulse control. They are indicated for some cases of aggression, self-mutilation, and compulsive and anxiety disorders, including feather-damaging behavior. Side effects are rarely seen when dosages are appropriately adjusted to the individual, starting with a low dose and slowly titrating to effect. Several drug interactions exist between psychotropic drugs and other classes. Psychotropic drugs cannot be used to replace appropriate environmental conditions in exotic animals. before "Side effects".
Topics: Animals; Animals, Exotic; Behavior, Animal; Drug Interactions; Humans; Psychotropic Drugs
PubMed: 33189249
DOI: 10.1016/j.cvex.2020.08.003 -
Psychopharmacology May 2019The human gut contains trillions of symbiotic bacteria that play a key role in programming different aspects of host physiology in health and disease. Psychotropic... (Review)
Review
The human gut contains trillions of symbiotic bacteria that play a key role in programming different aspects of host physiology in health and disease. Psychotropic medications act on the central nervous system (CNS) and are used in the treatment of various psychiatric disorders. There is increasing emphasis on the bidirectional interaction between drugs and the gut microbiome. An expanding body of evidence supports the notion that microbes can metabolise drugs and vice versa drugs can modify the gut microbiota composition. In this review, we will first give a comprehensive introduction about this bidirectional interaction, then we will take into consideration different classes of psychotropics including antipsychotics, antidepressants, antianxiety drugs, anticonvulsants/mood stabilisers, opioid analgesics, drugs of abuse, alcohol, nicotine and xanthines. The varying effects of these widely used medications on microorganisms are becoming apparent from in vivo and in vitro studies. This has important implications for the future of psychopharmacology pipelines that will routinely need to consider the host microbiome during drug discovery and development.
Topics: Antidepressive Agents; Antipsychotic Agents; Gastrointestinal Microbiome; Humans; Mental Disorders; Microbiota; Psychotropic Drugs
PubMed: 30806744
DOI: 10.1007/s00213-019-5185-8 -
The Primary Care Companion For CNS... Feb 2019To address a gap in the literature for concise recommendations on psychotropic medication monitoring geared to prescribers in primary care psychiatry. (Review)
Review
OBJECTIVE
To address a gap in the literature for concise recommendations on psychotropic medication monitoring geared to prescribers in primary care psychiatry.
DATA SOURCES
Large institutional guidelines from the United States, United Kingdom, Canada, and Australia/New Zealand combined with manual searches for psychiatric medication monitoring consensus and other recommendations up to January 31, 2018.
STUDY SELECTION
Any available guidelines and consensus statements making psychotropic medication monitoring recommendations for treatment of adults and published in English.
DATA EXTRACTION
Manual identification of all specific recommendations on psychotropic medication monitoring from the sources.
RESULTS
Psychotropic medication monitoring recommendations vary by source, but there is considerable agreement among English-language sources, which can be readily summarized for teaching and everyday use.
CONCLUSIONS
For prescribers working in many disciplines, medication monitoring may be improved by having more ready access to recommendations.
Topics: Drug Monitoring; Health Personnel; Humans; Practice Guidelines as Topic; Psychotropic Drugs
PubMed: 30806997
DOI: 10.4088/PCC.18r02324 -
Expert Opinion on Drug Safety Jan 2021: People with any psychiatric disorder tend to have difficulties in responding sexually. However,exual dysfunction (SD) is usually under-recognized, even the tightly... (Review)
Review
: People with any psychiatric disorder tend to have difficulties in responding sexually. However,exual dysfunction (SD) is usually under-recognized, even the tightly hormonal and neuronal common connexions through the brain-sex axis. Multiple sources of resistance to SD assessment and intervention persist. : The present review aims to underline the feasibility to introduce SD evaluation in patients with any psychiatric disorders, evaluating the potential mutual benefits of their management. : Women and men living with mental disorders frequently display sexual difficulties; however, some of them consider sexuality as a relevant parameter of their quality of life. In fact, SD as a side effect is a frequent reason for stopping the intake of medication. What is more, a holistic approach integrating sexual function could foster a better understanding of mental pathologies due to a common origin of pathogenesis. This could improve care quality, in keeping with the global tendency toward the development of personalized medicine. Consistently, the integration of SD assessment is highly recommended in mental health, all the more so when a psychotropic drug is prescribed. An expected consequence would be a reconstruction of the healthcare professional's consideration for the sexuality of people experiencing mental disorders.
Topics: Female; Humans; Male; Mental Disorders; Precision Medicine; Psychotropic Drugs; Quality of Life; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 33191796
DOI: 10.1080/14740338.2020.1849135 -
Journal of Psychiatric Practice Jan 2019Mental disorders affect a high percentage of the general population and are associated with a significant burden. One major component of treatment for mental illnesses... (Review)
Review
Mental disorders affect a high percentage of the general population and are associated with a significant burden. One major component of treatment for mental illnesses is pharmacotherapy. Various psychotropic medications are used in the treatment of psychiatric disorders and these are often associated with a plethora of side effects. The many side effects of psychotropic drugs can severely impair patients' quality of life and decrease their adherence to treatment. Among the relatively neglected and less-studied potential side effects of psychotropic drugs are impairment of sperm parameters and fertility problems among male patients. This article summarizes the data with regard to the effects of 6 widely used psychotropic drugs-lithium, valproate, haloperidol, olanzapine, imipramine, and fluoxetine-on sexual function and sperm parameters in male subjects. In general, the reviewed data suggest that these medications can be associated with sexual function problems and negative effects on sperm parameters among male subjects. It is important to note that most of the data are based on preclinical studies and nonrandomized clinical trials with relatively small sample sizes, so that it is not possible to draw unequivocal conclusions with regard to the clinical relevance of the findings. Prospective, randomized clinical trials are necessary to elucidate the effects of psychotropic drugs on men's sperm parameters and fertility indices per se.
Topics: Animals; Humans; Infertility, Male; Male; Mental Disorders; Psychotropic Drugs; Sexual Dysfunction, Physiological
PubMed: 30633729
DOI: 10.1097/PRA.0000000000000353 -
Cancer Letters Feb 2022Psychotropic drugs can penetrate the blood-brain barrier and regulate the levels of neurotransmitters and neuromodulators such as γ-aminobutyric acid, glutamate,... (Review)
Review
Psychotropic drugs can penetrate the blood-brain barrier and regulate the levels of neurotransmitters and neuromodulators such as γ-aminobutyric acid, glutamate, serotonin, dopamine, and norepinephrine in the brain, and thus influence neuronal activity. Neuronal activity in the tumor microenvironment can promote the growth and expansion of glioma. There is increasing evidence that in addition to their use in the treatment of mental disorders, antipsychotic, antidepressant, and mood-stabilizing drugs have clinical potential for cancer therapy. These drugs have been shown to inhibit the malignant progression of glioma by targeting signaling pathways related to cell proliferation, apoptosis, or invasion/migration or by increasing the sensitivity of glioma cells to conventional chemotherapy or radiotherapy. In this review, we summarize findings from preclinical and clinical studies investigating the use of antipsychotics, antidepressants, and mood stabilizers in the treatment of various types of cancer, with a focus on glioma; and discuss their presumed antitumor mechanisms. The existing evidence indicates that psychotropic drugs with established pharmacologic and safety profiles can be repurposed as anticancer agents, thus providing new options for the treatment of glioma.
Topics: Antipsychotic Agents; Drug Repositioning; Glioma; Humans; Psychotropic Drugs
PubMed: 34923043
DOI: 10.1016/j.canlet.2021.12.014