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DNA and Cell Biology Nov 2022Psychotropic drugs have long been known to possess antimicrobial activity against several groups of microorganisms. Although this property has been extensively studied... (Review)
Review
Psychotropic drugs have long been known to possess antimicrobial activity against several groups of microorganisms. Although this property has been extensively studied both alone and when combined with antibiotics against antimicrobial-resistant bacterial and fungal species, relatively little attention has been given to their ability to contribute to the emergence of antimicrobial resistance (AMR). We have recently reported the acquisition of multidrug resistance in after exposure to gut-relevant concentrations of the antipsychotic quetiapine. Considering these observations, this review attempts to establish if a relationship between psychotropics and AMR in microorganisms has been defined in the scientific literature.
Topics: Drug Resistance, Bacterial; Escherichia coli; Anti-Bacterial Agents; Psychotropic Drugs
PubMed: 36251740
DOI: 10.1089/dna.2022.0471 -
Current Opinion in Psychiatry Jul 2020Drug checking services invite drug consumers to anonymously submit drug samples for chemical analysis and provide feedback of results. Drugs are tested for strength/dose... (Review)
Review
PURPOSE OF REVIEW
Drug checking services invite drug consumers to anonymously submit drug samples for chemical analysis and provide feedback of results. Drugs are tested for strength/dose and/or presence of adulterants. Drug checking appears to be more common in recent years in response to increases in fentanyl-related deaths and the proliferation of new psychoactive substances (NPS). We aim to provide information regarding the current state of drug checking in relation to analysis methods, adulteration rates, and behavioral responses to results.
RECENT FINDINGS
Various technologies are being used to detect the presence of fentanyl, its analogs, and other NPS in drug samples. Proxy drug checking, which we define as biospecimen testing for drug exposure postconsumption, is also becoming common. However, there appears to a dichotomy between research focusing on populations at high risk for fentanyl exposure and to exposure to NPS such as synthetic cathinones.
SUMMARY
Drug checking research and services largely focus on opioid consumers and nightclub and dance festival attendees, but more focus may be needed on the general population. Drug checking results can inform surveillance efforts, and more research is needed to overcome barriers to drug checking and to focus on whether test results indeed affect behavior change.
Topics: Fentanyl; Humans; Illicit Drugs; Psychotropic Drugs
PubMed: 32187173
DOI: 10.1097/YCO.0000000000000607 -
The International Journal of... Sep 2019Multiple initiatives at the national and international level support natural drug discovery. Psychiatrists and patients are not well informed about natural psychotropics... (Review)
Review
Multiple initiatives at the national and international level support natural drug discovery. Psychiatrists and patients are not well informed about natural psychotropics in general. Existing antidepressant and antipsychotic drugs were developed from atropine, a natural product. Subsequent drug developments were largely based on extension and modification of earlier molecular scaffolds. This limits their mechanisms of action to similar neuropathways. Natural psychotropic substances, particularly those with hallucinogenic and psychedelic properties and different chemical structures, may serve as new paths to novel psychotropic drug development.
Topics: Biological Products; Drug Design; Drug Development; Humans; Phytochemicals; Psychotropic Drugs
PubMed: 31353393
DOI: 10.1093/ijnp/pyz042 -
Expert Review of Clinical Pharmacology Feb 2020
Topics: Humans; Nocebo Effect; Placebo Effect; Psychotropic Drugs; Randomized Controlled Trials as Topic
PubMed: 31995411
DOI: 10.1080/17512433.2020.1722100 -
Psychological Medicine Jan 2021The present paper provides an updated review of both the large number of new/novel/emerging psychoactive substances (NPS) and their associated psychopathological... (Review)
Review
BACKGROUND
The present paper provides an updated review of both the large number of new/novel/emerging psychoactive substances (NPS) and their associated psychopathological consequences. Focus was here given on identification of those NPS being commented in specialised online sources and the related short-/long-term psychopathological and medical ill-health effects.
METHODS
NPS have been identified through an innovative crawling/navigating software, called the 'NPS.Finder®', created in order to facilitate the process of early recognition of NPS online. A range of information regarding NPS, including chemical and street names; chemical formula; three-dimensional image and anecdotally reported clinical/psychoactive effects, were here made available.
RESULTS
Using the 'NPS.Finder®' approach, a few thousand NPS were here preliminarily identified, a number which is about 4-fold higher than those figures suggested by European and international drug agencies. NPS most commonly associated with the onset of psychopathological consequences included here synthetic cannabinoids/cannabimimetics; new synthetic opioids; ketamine-like dissociatives; novel stimulants; novel psychedelics and several prescription and over-the-counter medicines.
CONCLUSIONS
The ever-increasing changes in terms of recreational psychotropics' availability represent a relatively new challenge for psychiatry, as the pharmacodynamics and pharmacokinetics of many NPS have not been thoroughly understood. Health/mental health professionals should be informed about the range of NPS; their intake modalities; their psychoactive sought-after effects; the idiosyncratic psychotropics' combinations and finally, their medical and psychopathological risks.
Topics: Humans; Illicit Drugs; Psychopathology; Psychotropic Drugs; Recreational Drug Use; Substance-Related Disorders
PubMed: 31327332
DOI: 10.1017/S0033291719001727 -
Nederlands Tijdschrift Voor Geneeskunde Jul 2021Assessment of the risk for arrhythmias requires knowledge of QTc interval prolonging drugs and baseline clinical risk factors for QTc prolongation. The combination of...
Assessment of the risk for arrhythmias requires knowledge of QTc interval prolonging drugs and baseline clinical risk factors for QTc prolongation. The combination of both determines whether ECG-monitoring is necessary at the start of a psychotropic drug. In this article, we summarize current literature regarding appropriate methods of calculating the QTc interval, risk factors for QTc prolongation and QTc-prolonging psychotropic drugs. The frequency of cardiac monitoring for patients receiving psychotropic drugs should be individually determined, based on the prescribed agent(s) and additional risk factors for TdP. In patients without baseline clinical risk factors for QTc prolongation or cardiac arrhythmias, starting a single psychotropic drug with a low risk profile, ECG-monitoring might not be necessary.
Topics: Antipsychotic Agents; Arrhythmias, Cardiac; Electrocardiography; Humans; Long QT Syndrome; Psychotropic Drugs; Risk Factors
PubMed: 34346615
DOI: No ID Found -
Aging & Mental Health Jan 2021The aim of this study was to describe the course of psychotropic drug use in people with young-onset dementia and to explore possible associations with age, sex,...
OBJECTIVES
The aim of this study was to describe the course of psychotropic drug use in people with young-onset dementia and to explore possible associations with age, sex, dementia severity, dementia subtype and neuropsychiatric symptoms.
METHODS
Psychotropic drug use was studied in 198 community-dwelling persons participating in the Needs in Young-onset Dementia study. Data about psychotropic drug use were retrieved at baseline, as well as at 6, 12, 18 and 24 months and was classified into five groups (antiepileptics, antipsychotics, anxiolytics, hypnotics/sedatives and antidepressants) and quantified as 'present' or 'absent'. Generalized Estimating Equation modeling and chi-square tests were used to study associations between the determinants and psychotropic drug use.
RESULTS
There was a statistically significant increase in the prevalence of psychotropic drug use from 52.3% to 62.6% during the course of the study. Almost three-quarters (72.4%) of the participants were treated with any psychotropic drug during the study, and more than one-third (37.4%) received psychotropic drugs continuously. Antipsychotics were used continuously in more than 10% of the participants and antidepressants in more than 25%. Increasing age was positively associated ( = .018) with psychotropic drug use at baseline, while apathy symptoms were negatively associated ( = .018).
CONCLUSIONS
Despite the recommendations of various guidelines, the prolonged use of psychotropic drugs in community-dwelling people with young-onset dementia is high. Therefore, more attention is needed to timely evaluate psychotropic drug use and the introduction of self-management programs for caregivers should be encouraged to support caregivers in dealing with the neuropsychiatric symptoms caused by the dementia.
Topics: Antidepressive Agents; Antipsychotic Agents; Dementia; Humans; Independent Living; Psychotropic Drugs
PubMed: 31746238
DOI: 10.1080/13607863.2019.1691145 -
Basic & Clinical Pharmacology &... Jun 2023This study explores the role of steroid administration in identifying distressed or even mentally disordered cancer patients (so-called case finding). Charts of 12 298...
This study explores the role of steroid administration in identifying distressed or even mentally disordered cancer patients (so-called case finding). Charts of 12 298 cancer patients (4499 treated with prednisone equivalents) were analysed descriptively. A subset of 10 945 was further explored via latent class analysis (LCA). LCA avoids confounding by indication because it subgroups patients without prior preconceptions based on homogeneous expression of traits (i.e. the variables examined). LCA identified four subgroups: two subgroups with high dosages of prednisone equivalent (≥80 mg/day on average over all treatment days) and two with low dosages. The two subgroups with high average dosages had an increased likelihood of psychotropic drug administration, but only one was more likely to require 1:1 observation. In one subgroup, low dosages of prednisone equivlents correlated with a slightly increased probability for a psychiatric assessment and psychotropic drug administration. The subgroup least likely to receive steroid treatment was also the least likely to receive a psychiatric assessment and psychotropic drug administration. Descriptive statistics on age, sex, cumulative inpatient treatment, type of cancer, stage of cancer at first diagnosis, mental disorders, severe mental disorders and psychotropic drug administration (antidepressants, antipsychotics, benzodiazepines, anticonvulsants/mood stabilizers, opioids) are provided for patients receiving no, less and more than 80 mg of prednisone equivalent.
Topics: Humans; Prednisone; Psychotropic Drugs; Antipsychotic Agents; Mental Disorders; Anticonvulsants; Neoplasms
PubMed: 36878670
DOI: 10.1111/bcpt.13853 -
Annals of Medicine Dec 2023Although the costs of bipolar disorder (BD) treatments are associated with local and universal factors, data from non-Western countries remain limited. The associations...
BACKGROUND
Although the costs of bipolar disorder (BD) treatments are associated with local and universal factors, data from non-Western countries remain limited. The associations between clinical features and costs of outpatient pharmacotherapy have not been well characterize. To estimate the costs of outpatient BD treatments and their associations with clinical features in a Japanese population, we investigated with special reference to the costs of medicines constituted the bulk of the total healthcare expense and were steadily increasing.
METHODS
The Multicenter Treatment Survey for Bipolar Disorder (MUSUBI) retrospectively evaluated 3130 patients with BD who visited 176 Japanese psychiatric outpatient clinics in 2016. Clinical features and drug prescriptions were recorded, and the total daily costs of psychotropic drug treatment were calculated. The annual medical costs related to outpatient BD treatments in Japan were estimated based on the corresponding demographics. The associations between daily medical costs and patients' clinical features were analyzed using multiple regression analysis.
RESULTS
The daily costs of psychotropic drugs ranged from zero to JPY3245 (mean, JPY349 equivalent to USD32.5) and were exponentially distributed. The annual costs for outpatients BD treatments were approximately 51.9 billion Japanese yens (519 million US dollars). Subsequent multiple regression analysis revealed that social adjustment, depressive symptoms, age, rapid cycling, psychotic symptoms, and comorbid mental disorders correlated strongly with the daily cost of psychotropic drugs.
CONCLUSION
The estimated annual costs for outpatient BD treatment in Japan were equivalent to those in OECD countries (except for the US) and higher than those in some Asian countries. The cost of psychotropic treatments was associated with individual characteristics and psychopathological conditions.Key MessagesPsychotropic treatment for an outpatient with bipolar disorder has a daily cost approximately JPY350.The annual outpatient treatment cost for bipolar disorder in Japan was estimated to 51.9 billion Japanese yen in 2016.Individual characteristics and psychopathological conditions affected the cost of drug treatment.
Topics: Humans; Bipolar Disorder; Outpatients; Retrospective Studies; Japan; Psychotropic Drugs
PubMed: 37322994
DOI: 10.1080/07853890.2023.2224047 -
Journal of Clinical Psychopharmacology
Topics: Female; Humans; Placenta; Pregnancy; Pregnancy Complications; Psychotropic Drugs
PubMed: 34369906
DOI: 10.1097/JCP.0000000000001451