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Bipolar Disorders Nov 2019Substance use disorders (SUDs), including those for alcohol, stimulants, tobacco, opioids and cannabis, in patients with bipolar disorder are a major clinical and public...
OBJECTIVES
Substance use disorders (SUDs), including those for alcohol, stimulants, tobacco, opioids and cannabis, in patients with bipolar disorder are a major clinical and public health problem, and are present in the majority of these patients. Nonetheless, the development of effective pharmacological treatments for co-occurring SUDs in bipolar illness have not been well-developed and may be an important practical reason for the reduced effectiveness of these medications in community practice.
METHODS
We conducted a systematic review of the literature (PubMed, Medline, Google Scholar), and identified N = 29 clinical studies, which evaluated both mental health and SUD outcomes in patients with co-occurring bipolar disorders and SUDs.
RESULTS
Our findings suggest the potential of valproate sodium and lamotrigine as preferred pharmacological agents for the treatment of co-occurring psychiatric and substance use outcomes in these patients. However, many of the reviewed studies are of open-label designs and of modest sample sizes.
CONCLUSIONS
Thus, given the gaps in our knowledge, recommendations for treatment of this common and important co-morbidity are preliminary. Accordingly, the conduct of larger, randomized controlled trials for this co-morbidity is clearly needed.
Topics: Anticonvulsants; Antimanic Agents; Antipsychotic Agents; Bipolar Disorder; Comorbidity; Humans; Lamotrigine; Lithium Compounds; Quetiapine Fumarate; Substance-Related Disorders; Topiramate; Valproic Acid
PubMed: 31077521
DOI: 10.1111/bdi.12794 -
Frontiers in Endocrinology 2023Exposure to endocrine-disrupting chemicals (EDCs) during critical neurodevelopmental windows has been associated with the risk of autistic traits. This systematic review...
AIMS
Exposure to endocrine-disrupting chemicals (EDCs) during critical neurodevelopmental windows has been associated with the risk of autistic traits. This systematic review of epidemiological studies examined the association between maternal exposure to EDCs during pregnancy and the risk of autism spectrum disorder (ASD) in the offspring.
METHODS
We searched PubMed, Web of Science, Scopus, and Google Scholar from inception to November 17, 2022, for studies investigating the association between prenatal exposure to EDCs and outcomes related to ASD. Two independent reviewers screened studies for eligibility, extracted data, and assessed the risk of bias. The review was registered in PROSPERO (CRD42023389386).
RESULTS
We included 27 observational studies assessing prenatal exposure to phthalates (8 studies), polychlorinated biphenyls (8 studies), organophosphate pesticides (8 studies), phenols (7 studies), perfluoroalkyl substances (6 studies), organochlorine pesticides (5 studies), brominated flame retardants (3 studies), dioxins (1 study), and parabens (1 study). The number of examined children ranged from 77 to 1,556, the age at the assessment of autistic traits ranged from 3 to 14 years, and most studies assessed autistic traits using the Social Responsiveness Scale. All but one study was considered to have a low risk of bias. Overall, there was no association between maternal exposure to specific ECDs during pregnancy and the occurrence of autistic traits in offspring.
CONCLUSIONS
Findings from the epidemiological studies evaluated here do not support an association between prenatal exposure to ECDs and the likelihood of autistic traits in later in life. These findings should not be interpreted as definitive evidence of the absence of neurodevelopment effects of EDCs affecting ASD risk, given the limitations of current studies such as representative exposure assessment, small sample sizes, inadequacy to assess sexually dimorphic effects, or the effects of EDC mixtures. Future studies should carefully address these limitations.
Topics: Child; Pregnancy; Female; Humans; Adolescent; Child, Preschool; Endocrine Disruptors; Autism Spectrum Disorder; Prenatal Exposure Delayed Effects; Autistic Disorder; Pesticides; Epidemiologic Studies
PubMed: 37361542
DOI: 10.3389/fendo.2023.1184546 -
Journal of Child and Adolescent... May 2022Child- and adolescent-onset psychopathology is known to increase the risk for developing substance use and substance use disorders (SUDs). While pharmacotherapy is... (Review)
Review
Child- and adolescent-onset psychopathology is known to increase the risk for developing substance use and substance use disorders (SUDs). While pharmacotherapy is effective in treating pediatric psychiatric disorders, the impact of medication on the ultimate risk to develop SUDs in these youth remains unclear. We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic review of peer-reviewed literature published on PubMed through November 2021, examining pharmacological treatments of psychiatric disorders in adolescents and young adults and their effect on substance use, misuse, and use disorder development. Our search terms yielded 21 studies examining the impact of pharmacotherapy and later SUD in attention-deficit/hyperactivity disorder (ADHD), two studies on Major Depressive Disorder, and three studies on psychotic disorders. The majority of these studies reported reductions in SUD ( = 14 sides) followed by no effects ( = 10) and enhanced rates of SUD ( = 2). Studies in ADHD also reported that earlier-onset and longer-duration treatment was associated with the largest risk reduction for later SUD. Overall, pharmacological treatments for psychiatric disorders appear to mitigate the development of SUD, especially when treatment is initiated early and for longer durations. More studies on the development of SUD linked to the effects of psychotherapy alone and in combination with medication, medication initiation and duration, adequacy of treatment, non-ADHD disorders, and psychiatric comorbidity are necessary.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Comorbidity; Depressive Disorder, Major; Humans; Psychotherapy; Risk Factors; Substance-Related Disorders; Young Adult
PubMed: 35587209
DOI: 10.1089/cap.2022.0016 -
Experimental and Clinical... Dec 2021Behavioral processes underlying sexual behavior are important for understanding normal human functioning and risk behavior leading to sexually transmitted infections...
Behavioral processes underlying sexual behavior are important for understanding normal human functioning and risk behavior leading to sexually transmitted infections (STIs). This systematic review examines delay and probability discounting in human sexual behavior through synthesis of 50 peer-reviewed, original research articles. Sixteen studies focusing exclusively on monetary delay discounting found small effect size positive correlations with sexual risk behaviors. Eleven studies examined delay or probability discounting of sexual behavior itself using tasks that varied duration, frequency, or quality of sex to determine value. Results show delay and uncertainty of sex causes systematic decreases in value. These studies also show consistent medium effect size relationships between sexual discounting measures and sexual health and substance use, supporting utility above and beyond monetary discounting. Twenty-three studies have modeled clinically relevant decision-making, examining effects of delay until condom availability and STI contraction probability on condom use. Observational and experimental designs found condom-use discounting is elevated in high-risk substance use populations, is sensitive to context (e.g., partner desirability), and is more robustly related to sexual risk compared with monetary discounting or condom use decisions when no delay/uncertainty was involved. Administering cocaine, alcohol, and, for some participants, methamphetamine increased condom-use discounting with minimal effect on monetary discounting or condom use when no delay/uncertainty was involved. Reviewed studies robustly support that sexual behavior is highly dependent on delay and probability discounting, and that these processes strongly contribute to sexual risk. Future research should exploit these systematic relationships to design behavioral and pharmacological approaches to decrease sexual risk behavior. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Condoms; Delay Discounting; Humans; Safe Sex; Sexual Behavior; Sexually Transmitted Diseases
PubMed: 33001694
DOI: 10.1037/pha0000402 -
Odontology Apr 2022This study aimed to systematically review the literature about the virucidal efficacy of CHX in comparison to other substances used in the oral cavity. Electronic...
This study aimed to systematically review the literature about the virucidal efficacy of CHX in comparison to other substances used in the oral cavity. Electronic searches were performed in four databases (PubMed, Scopus, Embase, and Web of Science). Only studies that presented the following characteristics were included: (1) verified virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1), any Influenza, or any human coronavirus (HcoV); and (2) compared the virucidal efficacy of CHX with essential oils (Listerine), quaternary ammonium compounds, povidone-iodine, hydrogen peroxide, negative control substance, and absence of therapy. Two researchers independently selected the studies, extracted data and evaluated the risk of bias. A narrative data synthesis was used. Twenty-five studies were included, of which 21 were in vitro and four were randomized clinical trials (RCT). Studies assessed the virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1) (10 studies), Influenza A (InfluA) (4 studies), human coronavirus (HCoV) (4 studies) and Severe Acute Respiratory Syndrome-Related Coronavirus (SARS-CoV-2) (11 studies). Most studies demonstrated that CHX has a positive virucidal efficacy against HSV-1 and InfluA strains. However, lower efficacy was shown to InfluA strain in comparison to povidone-iodine. Lower to none virucidal efficacy of CHX is expected for HCoV and SARS-CoV-2 strains for in vitro studies. Three RCT demonstrated that CHX was able to significantly reduce the viral load of SARS-CoV-2 for a short period. CHX may present an interesting virucidal efficacy against HSV-1 and InfluA viruses. CHX also presents transient efficacy against SARS-CoV-2 when used as a mouthwash.
Topics: COVID-19; Chlorhexidine; Humans; Mouthwashes; Povidone-Iodine; SARS-CoV-2
PubMed: 34637092
DOI: 10.1007/s10266-021-00660-x -
The American Journal on Addictions Nov 2022Substance use disorders (SUDs) are chronic relapsing diseases characterized by significant morbidity and mortality. Phenomenologically, patients with SUDs present with a...
BACKGROUND AND OBJECTIVES
Substance use disorders (SUDs) are chronic relapsing diseases characterized by significant morbidity and mortality. Phenomenologically, patients with SUDs present with a repeating cycle of intoxication, withdrawal, and craving, significantly impacting their diagnosis and treatment. There is a need for better identification and monitoring of these disease states. Remote monitoring chronic illness with wearable devices offers a passive, unobtrusive, constant physiological data assessment. We evaluate the current evidence base for remote monitoring of nonalcohol, nonnicotine SUDs.
METHODS
We performed a systematic, comprehensive literature review and screened 1942 papers.
RESULTS
We found 15 studies that focused mainly on the intoxication stage of SUD. These studies used wearable sensors measuring several physiological parameters (ECG, HR, O , Accelerometer, EDA, temperature) and implemented study-specific algorithms to evaluate the data.
DISCUSSION AND CONCLUSIONS
Studies were extracted, organized, and analyzed based on the three SUD disease states. The sample sizes were relatively small, focused primarily on the intoxication stage, had low monitoring compliance, and required significant computational power preventing "real-time" results. Cardiovascular data was the most consistently valuable data in the predictive algorithms. This review demonstrates that there is currently insufficient evidence to support remote monitoring of SUDs through wearable devices.
SCIENTIFIC SIGNIFICANCE
This is the first systematic review to show the available data on wearable remote monitoring of SUD symptoms in each stage of the disease cycle. This clinically relevant approach demonstrates what we know and do not know about the remote monitoring of SUDs within disease states.
Topics: Humans; Craving; Delivery of Health Care; Substance-Related Disorders; Wearable Electronic Devices
PubMed: 36062888
DOI: 10.1111/ajad.13341 -
American Journal of Kidney Diseases :... Jan 2022Toxicity from gabapentin and pregabalin overdose is commonly encountered. Treatment is supportive, and the use of extracorporeal treatments (ECTRs) is controversial. The...
Toxicity from gabapentin and pregabalin overdose is commonly encountered. Treatment is supportive, and the use of extracorporeal treatments (ECTRs) is controversial. The EXTRIP workgroup conducted systematic reviews of the literature and summarized findings following published methods. Thirty-three articles (30 patient reports and 3 pharmacokinetic studies) met the inclusion criteria. High gabapentinoid extracorporeal clearance (>150mL/min) and short elimination half-life (<5 hours) were reported with hemodialysis. The workgroup assessed gabapentin and pregabalin as "dialyzable" for patients with decreased kidney function (quality of the evidence grade as A and B, respectively). Limited clinical data were available (24 patients with gabapentin toxicity and 7 with pregabalin toxicity received ECTR). Severe toxicity, mortality, and sequelae were rare in cases receiving ECTR and in historical controls receiving standard care alone. No clear clinical benefit from ECTR could be identified although major knowledge gaps were acknowledged, as well as costs and harms of ECTR. The EXTRIP workgroup suggests against performing ECTR in addition to standard care rather than standard care alone (weak recommendation, very low quality of evidence) for gabapentinoid poisoning in patients with normal kidney function. If decreased kidney function and coma requiring mechanical ventilation are present, the workgroup suggests performing ECTR in addition to standard care (weak recommendation, very low quality of evidence).
Topics: Drug Overdose; Frailty; Gabapentin; Humans; Poisoning; Pregabalin; Renal Dialysis
PubMed: 34799138
DOI: 10.1053/j.ajkd.2021.06.027 -
Journal of Ethnopharmacology Nov 2022Grayanoids are natural diterpenoids that are mostly found in the Ericaceae family, such as Rhododendron molle (Blume) G. Don (Relevant herb: nao yang hua), Rhododendron... (Review)
Review
ETHNOPHARMACOLOGICAL RELEVANCE
Grayanoids are natural diterpenoids that are mostly found in the Ericaceae family, such as Rhododendron molle (Blume) G. Don (Relevant herb: nao yang hua), Rhododendron micranthum Turcz (also known as: zhao shan bai), which have traditionally been used to treat abdominal pain, cephalgia, and rheumatoid arthritis.
AIMS OF THE REVIEW
The review investigated advancements in notable anti-nociception, toxicity, and probable mechanisms of grayanoids. Meanwhile some binding sites of these compounds on voltage-gated sodium channels (VSGCs) were also analyzed and evaluated.
MATERIALS AND METHODS
The substantial grayanoids literature published before 2022, in SCI Finder, PubMed, Science Direct, Springer, Scopus, Wiley Online Library, J-Stage, and other literature databases had been exhaustively consulted and thoroughly screened.
RESULTS
More than 50 compounds in grayanoids exhibited exceptionally significant anti-nociception (intraperitoneal injection, less than 1 mg/kg), and the alteration of several substituents that were closely associated to the change in activity were investigated. Multiple possible mechanisms of analgesic action and toxicity had been proposed, with VSGCs playing a key part in both. As a result, the binding locations of these compounds on VGSCs (mostly grayanotoxin I and III) had been summarized.
CONCLUSIONS
The considerable anti-nociception, toxicity, and probable mechanisms of grayanoids, as well as the investigation of the binding sites on VSGCs, were discussed in this review. Furthermore, the homology of toxicity and anti-nociception of these substances was considered, as well as the possibility of grayanoids being developed as analgesics.
Topics: Analgesics; Ericaceae; Plant Extracts; Rhododendron
PubMed: 35948141
DOI: 10.1016/j.jep.2022.115581 -
Nutrients Oct 2022Several studies have explored the effects of capsaicin and capsiate on endurance performance, with conflicting findings. This systematic review aimed to perform a... (Meta-Analysis)
Meta-Analysis Review
Several studies have explored the effects of capsaicin and capsiate on endurance performance, with conflicting findings. This systematic review aimed to perform a meta-analysis examining the effects of capsaicin and capsiate vs. placebo on endurance performance in humans. Seven databases were searched to find eligible studies. The effects of capsaicin and capsiate on aerobic endurance (e.g., time-trials or time-to-exhaustion tests), muscular endurance (e.g., repetitions performed to muscular failure), and rating of perceived exertion (RPE) were examined in a random-effects meta-analysis. Fourteen studies ( = 183) were included in the review. Most studies provided capsaicin or capsiate in the dose of 12 mg, 45 min before exercise. In the meta-analysis for aerobic endurance, there was no significant difference between the placebo and capsaicin/capsiate conditions (Cohen's : 0.04; 95% confidence interval: -0.16, 0.25; = 0.69). In subgroup meta-analyses, there were no significant differences between the placebo and capsaicin/capsiate conditions when analyzing only studies that used time-trials ( = 0.20) or time-to-exhaustion tests ( = 0.80). In the meta-analysis for muscular endurance, a significant ergogenic effect of capsaicin/capsiate was found (Cohen's : 0.27; 95% confidence interval: 0.10, 0.43; = 0.002). When analyzing set-specific effects, an ergogenic effect of capsaicin/capsiate was found in set 1, set 2, and set 3 (Cohen's : 0.21-29). Capsaicin/capsiate ingestion reduced RPE following muscular endurance ( = 0.03) but not aerobic endurance tests ( = 0.58). In summary, capsaicin/capsiate supplementation acutely enhances muscular endurance, while the effects on aerobic endurance are less clear.
Topics: Humans; Capsaicin; Performance-Enhancing Substances; Exercise; Physical Endurance
PubMed: 36364793
DOI: 10.3390/nu14214531 -
Revista de Neurologia Jun 2023Psychotic disorders are considered chronic mental health issues. Although it has been demonstrated that these disorders can present with a wide range of symptoms,... (Review)
Review
INTRODUCTION
Psychotic disorders are considered chronic mental health issues. Although it has been demonstrated that these disorders can present with a wide range of symptoms, pharmacological treatment is based on the use of typical and atypical antipsychotics, whose main mechanism of action is dopaminergic blockade, limiting their effect to the improvement of positive symptoms, without improving the rest of the symptoms and giving rise to a large number of serious adverse effects. For this reason, new therapeutic targets other than the dopaminergic system are being studied. The main objective of this review is to test whether these psychoactive substances used in clinical practice could provide additional benefits as an adjunctive treatment for people with psychotic disorders.
DEVELOPMENT
For this systematic review, a literature search was conducted in the databases PsycINFO, Medline, Psicodoc, PubMed and Google Scholar. Altogether 28 articles were included in the review. One of the main findings is that cannabidiol is more effective for improving positive symptoms and psychopathology; modafinil, for cognitive symptoms, motor and emotional functioning and quality of life; and ketamine, for negative symptoms. In addition, all the substances showed a good tolerability and safety profile, especially in comparison to antipsychotics.
CONCLUSION
The results obtained open up the possibility of having a guideline for clinicians/health professionals on the use of cannabidiol, modafinil and ketamine as adjunctive treatment for patients with psychotic conditions.
Topics: Humans; Antipsychotic Agents; Modafinil; Ketamine; Cannabidiol; Quality of Life; Psychotic Disorders
PubMed: 37231549
DOI: 10.33588/rn.7611.2023077