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Frontiers in Neuroscience 2019Drugs with anticholinergic action are widely prescribed in the elderly population due to their potential clinical benefits. However, these benefits are limited by... (Review)
Review
Drugs with anticholinergic action are widely prescribed in the elderly population due to their potential clinical benefits. However, these benefits are limited by adverse effects which may be serious in particular circumstances. This review presents different aspects of the use of anticholinergics in old age with a focus in psychogeriatric patients. We critically review published data on benefits and disadvantages of anticholinergics, which are often controversial. Prevalence, pathophysiology and measurement methods of the anticholinergic action of drugs are discussed. We also present the most important drawbacks resulting from its use, including effects on cognition in healthy and cognitively impaired people, in aged schizophrenia patients, emergence of delirium and psychiatric symptoms, influence in functionality, hospitalization, institutionalization and mortality, and the potential benefits and limitations of their discontinuation. Finally, we suggest practical recommendations for the safe use of anticholinergics in clinical conditions affecting elderly patients, such as dementia, schizophrenia and acute hallucinatory episodes, depression, anxiety, Parkinson's disease, cardiovascular conditions and urinary incontinence.
PubMed: 31866817
DOI: 10.3389/fnins.2019.01309 -
Frontiers in Psychiatry 2022
PubMed: 36704744
DOI: 10.3389/fpsyt.2022.1126021 -
Revue Medicale de Liege Sep 2022Major depressive disorder is an important cause of disability around the world, with a tremendous psychological burden and extensive socioeconomic consequences. Whilst... (Review)
Review
Major depressive disorder is an important cause of disability around the world, with a tremendous psychological burden and extensive socioeconomic consequences. Whilst both psychotherapy and psychopharmacology are effective in treating a depressive episode, often there is a delay of several weeks between the start of treatment and the first beneficial effects. More importantly, approximately 30 % of patients do not remit, even after several treatment attempts. As the oldest biological treatment in psychiatry that is still available, electroconvulsive therapy (ECT) remains the most potent of antidepressant interventions, today achieving a staggering 70-80 % response and a 50-60 % remission rate. In treatment-resistant patients, response rates are even as high as 50 %-70 %. Despite its effectiveness, the neurobiological mechanisms of ECT remain unclear. A large body of research suggests that ECT induces widespread changes in both brain structure and function. A key factor behind these powerful therapeutic properties appears to be the important neuroplastic effects of this treatment. This review of the literature will discuss the importance of neuroplasticity in the pathophysiology of depression and then bring up the neuroplastic effects of ECT.
Topics: Antidepressive Agents; Brain; Depressive Disorder, Major; Electroconvulsive Therapy; Humans; Neuronal Plasticity; Treatment Outcome
PubMed: 36082600
DOI: No ID Found -
Frontiers in Pharmacology 2021
PubMed: 34733162
DOI: 10.3389/fphar.2021.752292 -
Frontiers in Psychiatry 2019
PubMed: 32082197
DOI: 10.3389/fpsyt.2019.01013 -
Therapeutic Advances in... 2020Psychedelic drugs and virtual reality (VR) each have the capacity to disrupt the rigidity and limitations of typical conscious experience. This article delineates the... (Review)
Review
Psychedelic drugs and virtual reality (VR) each have the capacity to disrupt the rigidity and limitations of typical conscious experience. This article delineates the parallels among psychedelic and VR states as well as their potential synergistic applications in clinical and recreational settings. Findings indicate that, individually, psychedelics and VR are used in analogous ways to alter sensory experience and evoke awe. They are also both used in tandem with traditional therapies to treat a variety of mood disorders; their shared capacity to transiently alter perspective and disrupt rigid patterns of mental experience may underly their analogous and transdiagnostic therapeutic uses. In terms of their combined applications, a number of recreational users currently utilize psychedelics and VR together to enhance their experience. We propose that VR may be a useful tool for preparing hallucinogen-naïve participants in clinical trials for the sensory distortions experienced in psychedelic states. Given the critical role of "setting" in psychedelic treatment outcomes, we also detail how VR could be used to optimize the environment in psychedelic sessions. Finally, we provide considerations for future studies and detail how advancements in psychedelic and VR research can inform one another. Collectively, this article outlines a number of connections between psychedelics and VR, and, more broadly, is representative of growing scientific interest into the interactions among technology, psychopharmacology, and mental health.
PubMed: 32922734
DOI: 10.1177/2045125320948356 -
Psychopharmacology Bulletin Jun 2022Nearly forty percent of women with PMDD remain impaired and resistant to first-line agents. This reflects complexity and heterogeneity of etiopathogenesis at the core of... (Review)
Review
Nearly forty percent of women with PMDD remain impaired and resistant to first-line agents. This reflects complexity and heterogeneity of etiopathogenesis at the core of PMDD. Some agents, in the pipeline, sound promising that might usher in a new sparkle in the psychopharmacology of PMDD.
Topics: Female; Humans; Premenstrual Dysphoric Disorder
PubMed: 35815174
DOI: No ID Found -
Frontiers in Psychiatry 2024
PubMed: 38328762
DOI: 10.3389/fpsyt.2024.1364711 -
Psychopharmacology Aug 2019Psychopharmacology needs novel quantitative measures and theoretical approaches based on computational modelling that can be used to help translate behavioural findings... (Review)
Review
RATIONALE
Psychopharmacology needs novel quantitative measures and theoretical approaches based on computational modelling that can be used to help translate behavioural findings from experimental animals to humans, including patients with neuropsychiatric disorders.
OBJECTIVES
This brief review exemplifies this approach when applied to recent published studies of the effects of manipulating central dopaminergic and serotoninergic systems in rodents and marmoset monkeys, and possible comparisons with healthy human volunteers receiving systemic agents or patients with depression and schizophrenia.
METHODS
Behavioural effects of central depletions of dopamine or serotonin in monkeys in probabilistic learning paradigms are characterised further by computational modelling methods and related to rodent and human data.
RESULTS
Several examples are provided of the power of computational modelling to derive new measures and reappraise conventional explanations of regional neurotransmitter depletion and other drug effects, whilst enhancing construct validation in patient groups. Specifically, effects are shown on such parameters as 'stimulus stickiness' and 'side stickiness', which occur over and above effects on standard parameters of reinforcement learning, reminiscent of some early innovations in data analysis in psychopharmacology.
CONCLUSIONS
Computational modelling provides a useful methodology for further detailed analysis of behavioural mechanisms that are affected by pharmacological manipulations across species and will aid the translation of experimental findings to understand the therapeutic effects of medications in neuropsychiatric disorders, as well as facilitating future drug discovery.
Topics: Animals; Computational Biology; Depressive Disorder; Dopamine; Humans; Learning; Psychopharmacology; Reinforcement, Psychology; Schizophrenia; Serotonin; Translational Research, Biomedical
PubMed: 31273400
DOI: 10.1007/s00213-019-05302-3 -
Cureus Jan 2024Antipsychotics are considered a gold standard treatment for schizophrenia. However, there is considerable variation in antipsychotic medication choice. Factors...
Antipsychotics are considered a gold standard treatment for schizophrenia. However, there is considerable variation in antipsychotic medication choice. Factors considered involved include symptomatology, prior response, and adverse reactions. This case report presents a 38-year-old male patient with schizophrenia in acute psychosis refractory to several antipsychotics. Hypotheses for the mechanism of action of antipsychotics and psychopharmacology are discussed, and treatment resistance is defined. The patient's psychiatric, medical, and social history and past antipsychotic medications are reviewed. Afterward, the rationale for initiating perphenazine is discussed, and the patient's improvement with this medication is examined. Current literature on perphenazine's efficacy is also reviewed and discussed alongside its limitations.
PubMed: 38313962
DOI: 10.7759/cureus.51593