MDMA): Relevance to Schizophrenia
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Dopamine D1 Rather Than D2 Receptor Agonists Disrupt Prepulse Inhibition of Startle in Mice
Neuropsychopharmacology (2003) 28, 108–118 & 2003 Nature Publishing Group All rights reserved 0893-133X/03 $25.00 www.neuropsychopharmacology.org Dopamine D1 Rather than D2 Receptor Agonists Disrupt Prepulse Inhibition of Startle in Mice 1 2 ,2 Rebecca J Ralph-Williams , Virginia Lehmann-Masten and Mark A Geyer* 1 2 Alcohol and Drug Abuse Research Center, Harvard Medical School and McLean Hospital, Belmont, MA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA Although substantial literature describes the modulation of prepulse inhibition (PPI) by dopamine (DA) in rats, few reports address the effects of dopaminergic manipulations on PPI in mice. We characterized the effects of subtype-specific DA agonists in the PPI paradigm to further delineate the specific influences of each DA receptor subtype on sensorimotor gating in mice. The mixed D1/D2 agonist apomorphine and the preferential D1-family agonists SKF82958 and dihydrexidine significantly disrupted PPI, with differing or no effects on startle. In contrast to findings in rats, the D2/D3 agonist quinpirole reduced startle but had no effect on PPI. Pergolide, which has affinity for D2/D3 and D1-like receptors, reduced both startle and PPI, but only at the higher, nonspecific doses. In addition, the D1-family receptor antagonist SCH23390 blocked the PPI-disruptive effects of apomorphine on PPI, but the D2-family receptor antagonist raclopride failed to alter the disruptive effect of apomorphine. These studies reveal potential species differences in the DA receptor modulation of PPI between rats and mice, where D1-family receptors may play a more prominent and independent role in the modulation of PPI in mice than in rats. -
Dopamine: a Role in the Pathogenesis and Treatment of Hypertension
Journal of Human Hypertension (2000) 14, Suppl 1, S47–S50 2000 Macmillan Publishers Ltd All rights reserved 0950-9240/00 $15.00 www.nature.com/jhh Dopamine: a role in the pathogenesis and treatment of hypertension MB Murphy Department of Pharmacology and Therapeutics, National University of Ireland, Cork, Ireland The catecholamine dopamine (DA), activates two dis- (largely nausea and orthostasis) have precluded wide tinct classes of DA-specific receptors in the cardio- use of D2 agonists. In contrast, the D1 selective agonist vascular system and kidney—each capable of influenc- fenoldopam has been licensed for the parenteral treat- ing systemic blood pressure. D1 receptors on vascular ment of severe hypertension. Apart from inducing sys- smooth muscle cells mediate vasodilation, while on temic vasodilation it induces a diuresis and natriuresis, renal tubular cells they modulate sodium excretion. D2 enhanced renal blood flow, and a small increment in receptors on pre-synaptic nerve terminals influence nor- glomerular filtration rate. Evidence is emerging that adrenaline release and, consequently, heart rate and abnormalities in DA production, or in signal transduc- vascular resistance. Activation of both, by low dose DA tion of the D1 receptor in renal proximal tubules, may lowers blood pressure. While DA also binds to alpha- result in salt retention and high blood pressure in some and beta-adrenoceptors, selective agonists at both DA humans and in several animal models of hypertension. receptor classes have been studied in the treatment of -
TECHNISCHE UNIVERSITÄT MÜNCHEN Large Scale
TECHNISCHE UNIVERSITÄT MÜNCHEN Lehrstuhl für Genomorientierte Bioinformatik Large Scale Knowledge Extraction from Biomedical Literature Based on Semantic Role Labeling Thorsten Barnickel Vollständiger Abdruck der von der Fakultät Wissenschaftszentrum Weihenstephan für Ernährung, Landnutzung und Umwelt der Technischen Universität München zur Erlangung des akademischen Grades eines Doktors der Naturwissenschaften genehmigten Dissertation. Vorsitzende: Univ.‐Prof. Dr. I. Antes Prüfer der Dissertation: 1. Univ.‐Prof. Dr. H.‐W. Mewes 2. Univ.‐Prof. Dr. R. Zimmer (Ludwig‐Maximilians‐Universität München) Die Dissertation wurde am 30. Juli bei der Technischen Universität München eingereicht und durch die Fakultät Wissenschaftszentrum Weihenstephan für Ernährung, Landnutzung und Umwelt am 25. November 2009 angenommen. ACKNOWLEDGEMENTS First and foremost, I would like to express my deep gratitude to my promoter Dr. Volker Stümpflen. Without his continuing, stimulating encouragement and his excellent background in Enterprise technologies still being predominantly used in the IT-industry rather than in academic research, I would not have been able to finish my doctorate in the presented form. Facing the tremendous amount of data that was generated by gathering the positional information of millions of biomedical terms, I was close to cutting the project down to a notably smaller version compared to the text mining system presented in this thesis. Volkers knowledge on database servers and performance tuning significantly contributed to the development of a database schema finally being able to cope with the immense amount of data. I would also like to cordially thank Prof. Dr. Hans-Werner Mewes, head of the Institute for Bioinformatics and Systems Biology (IBIS), for giving me the opportunity to do my doctorate at his institute and for his friendly support and encouragement all along my time at IBIS. -
Minimum Laboratory Monitoring for Psychotropic Medications
Minimum Laboratory Monitoring For Psychotropic Medications ANTIPSYCHOTIC MEDICATIONS GENERIC BRAND GENERIC BRAND Aripiprazole Abilify, Abilify Olanzapine Zyprexa, Zyprexa Zydis Maintena, Aristada Asenapine Saphris Paliperidone Invega, Invega Sustenna, Invega Trinza Brexpiprazole Rexulti Perphenazine Trilafon Cariprazine Vraylar Pimozide Orap Chlorpromazine Thorazine Quetiapine Seroquel, Seroquel XR Clozapine Clozaril, Fazaclo Risperidone Risperdal, Risperdal Consta, Risperdal M Tabs Fluphenazine, Fluphenazine D Prolixin, Prolixin D Thioridazine Mellaril Haloperidol, Haloperidol D Haldol, Haldol D Thiothixene Navane Iloperidone Fanapt Trifluoperazine Stelazine Loxapine Loxitane Ziprasidone Geodon Lurasidone Latuda MONITORING ANTIPSYCHOTIC FREQUENCY OF MONITORING AIMS (Abnormal Involuntary Movement Scale) On initiation of any antipsychotic medication and at least every six months thereafter, or more frequently as clinically indicated. ABDOMINAL GIRTH (>18 years old) For individuals at least 18 years old, on initiation of any medication and at least every six months thereafter, or more frequently as clinically indicated. WEIGHT & BODY MASS INDEX (BMI) On initiation of any medication and at least every six months thereafter, or more frequently as clinically indicated. HEART RATE & BLOOD PRESSSURE On initiation of any medication and at least every six months thereafter, or more frequently as clinically indicated. COMPREHENSIVE METABOLIC PANEL (CMP), On initiation of any medication affecting this parameter and at least annually LIPIDS, FASTING -
Drug Use Evaluation: Antipsychotic Utilization in Schizophrenia Patients
© Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 | Fax 503-947-1119 Drug Use Evaluation: Antipsychotic Utilization in Schizophrenia Patients Research Questions: 1. How many schizophrenia patients are prescribed recommended first-line second-generation treatments for schizophrenia? 2. How many schizophrenia patients switch to an injectable antipsychotic after stabilization on an oral antipsychotic? 3. How many schizophrenia patients are prescribed 2 or more concomitant antipsychotics? 4. Are claims for long-acting injectable antipsychotics primarily billed as pharmacy or physician administered claims? 5. Does adherence to antipsychotic therapy differ between patients with claims for different routes of administration (oral vs. long-acting injectable)? Conclusions: In total, 4663 schizophrenia patients met inclusion criteria, and approximately 14% of patients (n=685) were identified as treatment naïve without claims for antipsychotics in the year before their first antipsychotic prescription. Approximately 45% of patients identified as treatment naïve had a history of remote antipsychotic use, but it is unclear if antipsychotics were historically prescribed for schizophrenia. Oral second-generation antipsychotics which are recommended as first-line treatment in the MHCAG schizophrenia algorithm were prescribed as initial treatment in 37% of treatment naive patients and 28% of all schizophrenia patients. Recommended agents include risperidone, paliperidone, and aripiprazole. Utilization of parenteral antipsychotics was limited in patients with schizophrenia. Overall only 8% of patients switched from an oral to an injectable therapy within 6 months of their first claim. Approximately, 60% of all schizophrenia patients (n=2512) had claims for a single antipsychotic for at least 12 continuous weeks and may be eligible to transition to a long-acting injectable antipsychotic. -
Schizophrenia Care Guide
August 2015 CCHCS/DHCS Care Guide: Schizophrenia SUMMARY DECISION SUPPORT PATIENT EDUCATION/SELF MANAGEMENT GOALS ALERTS Minimize frequency and severity of psychotic episodes Suicidal ideation or gestures Encourage medication adherence Abnormal movements Manage medication side effects Delusions Monitor as clinically appropriate Neuroleptic Malignant Syndrome Danger to self or others DIAGNOSTIC CRITERIA/EVALUATION (PER DSM V) 1. Rule out delirium or other medical illnesses mimicking schizophrenia (see page 5), medications or drugs of abuse causing psychosis (see page 6), other mental illness causes of psychosis, e.g., Bipolar Mania or Depression, Major Depression, PTSD, borderline personality disorder (see page 4). Ideas in patients (even odd ideas) that we disagree with can be learned and are therefore not necessarily signs of schizophrenia. Schizophrenia is a world-wide phenomenon that can occur in cultures with widely differing ideas. 2. Diagnosis is made based on the following: (Criteria A and B must be met) A. Two of the following symptoms/signs must be present over much of at least one month (unless treated), with a significant impact on social or occupational functioning, over at least a 6-month period of time: Delusions, Hallucinations, Disorganized Speech, Negative symptoms (social withdrawal, poverty of thought, etc.), severely disorganized or catatonic behavior. B. At least one of the symptoms/signs should be Delusions, Hallucinations, or Disorganized Speech. TREATMENT OPTIONS MEDICATIONS Informed consent for psychotropic -
Current P SYCHIATRY
Current p SYCHIATRY N ew Investigators Tips to manage and prevent discontinuation syndromes Informed tapering can protect patients when you stop a medication Sriram Ramaswamy, MD Shruti Malik, MBBS, MHSA Vijay Dewan, MD Instructor, department of psychiatry Foreign medical graduate Assistant professor Creighton University Department of psychiatry Omaha, NE University of Nebraska Medical Center Omaha, NE bruptly stopping common psychotropics New insights on psychotropic A —particularly antidepressants, benzodi- drug safety and side effects azepines, or atypical antipsychotics—can trigger a discontinuation syndrome, with: This paper was among those entered in the 2005 • rebound or relapse of original symptoms Promising New Investigators competition sponsored • uncomfortable new physical and psycho- by the Neuroleptic Malignant Syndrome Information Service (NMSIS). The theme of this year’s competition logical symptoms was “New insights on psychotropic drug safety and • physiologic withdrawal at times. side effects.” To increase health professionals’ awareness of URRENT SYCHIATRY 1 C P is honored to publish this peer- the risk of these adverse effects, this article reviewed, evidence-based article on a clinically describes discontinuation syndromes associated important topic for practicing psychiatrists. with various psychotropics and offers strategies to NMSIS is dedicated to reducing morbidity and anticipate, recognize, and manage them. mortality of NMS by improving medical and psychiatric care of patients with heat-related disorders; providing -
Clinical Review, Adverse Events
Clinical Review, Adverse Events Drug: Carbamazepine NDA: 16-608, Tegretol 20-712, Carbatrol 21-710, Equetro Adverse Event: Stevens-Johnson Syndrome Reviewer: Ronald Farkas, MD, PhD Medical Reviewer, DNP, ODE I 1. Executive Summary 1.1 Background Carbamazepine (CBZ) is an anticonvulsant with FDA-approved indications in epilepsy, bipolar disorder and neuropathic pain. CBZ is associated with Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), closely related serious cutaneous adverse drug reactions that can be permanently disabling or fatal. Other anticonvulsants, including phenytoin, phenobarbital, and lamotrigine are also associated with SJS/TEN, as are members of a variety of other drug classes, including nonsteriodal anti-inflammatory drugs and sulfa drugs. The incidence of CBZ-associated SJS/TEN has been considered “extremely rare,” as noted in current U.S. drug labeling. However, recent publications and postmarketing data suggest that CBZ- associated SJS/TEN occurs at a much higher rate in some Asian populations, about 2.5 cases per 1,000 new exposures, and that most of this increased risk is in individuals carrying a specific human leukocyte antigen (HLA) allele, HLA-B*1502. This HLA-B allele is present in about 5- to 20% of many, but not all, Asian populations, and is also present in about 2- to 4% of South Asians/Indians. The allele is also present at a lower frequency, < 1%, in several other ethnic groups around the world (although likely due to distant Asian ancestry). About 10% of U.S. Asians carry HLA-B*1502. HLA-B*1502 is generally not present in the U.S. -
Management of Major Depressive Disorder Clinical Practice Guidelines May 2014
Federal Bureau of Prisons Management of Major Depressive Disorder Clinical Practice Guidelines May 2014 Table of Contents 1. Purpose ............................................................................................................................................. 1 2. Introduction ...................................................................................................................................... 1 Natural History ................................................................................................................................. 2 Special Considerations ...................................................................................................................... 2 3. Screening ........................................................................................................................................... 3 Screening Questions .......................................................................................................................... 3 Further Screening Methods................................................................................................................ 4 4. Diagnosis ........................................................................................................................................... 4 Depression: Three Levels of Severity ............................................................................................... 4 Clinical Interview and Documentation of Risk Assessment............................................................... -
Self-Reported Sensory Gating and Stress-Related Hypertension
Henry Ford Health System Henry Ford Health System Scholarly Commons Public Health Sciences Articles Public Health Sciences 9-1-2020 Self-Reported Sensory Gating and Stress-Related Hypertension Rosalind M. Peters Maher El-Masri Andrea E. Cassidy-Bushrow Follow this and additional works at: https://scholarlycommons.henryford.com/ publichealthsciences_articles Self-Reported Sensory Gating and Stress-Related Hypertension Rosalind M. Peters ▼ Maher El-Masri ▼ Andrea E. Cassidy-Bushrow Background: Increasing evidence views hypertension as a stress-induced disorder. Stressors must be “gated” by the brain before any inflammatory or immune processes that contribute to hypertension are initiated. No studies were found that examined sensory gating in relation to hypertension. Objectives: The aim of the study was to determine if disturbances in self-reported sensory gating could differentiate normotensive from hypertensive young adults. Methods: A nonmatched, case–control design was used. We administered an online survey to 163 young adult participants. Participants were predominantly female, in their mid-20s, well educated, and approximately evenly distributed by race and hypertension status. The Sensory Gating Inventory (SGI) measured gating disturbances. Results: The mean SGI scores were significantly higher among persons diagnosed with hypertension, reflecting a moderate effect size of sensory gating. After adjusting for confounders, however, the normotensive and hypertensive groups were not significantly different on their SGI scores. Discussion: With an observed moderate effect size of 0.35, but low power, more research is warranted regarding the role of gating disturbances in the development of stress-induced hypertension. Clinically, the SGI may be important for screening patients who would benefit from ambulatory blood pressure monitoring to identify persons with masked hypertension. -
Haloperidol Injection, USP and 3) Treatment of Any Concomitant Serious Medical Problems for Which Specific Treatments Are Available
drugs not essential to concurrent therapy, 2) intensive symptomatic treatment and medical monitoring, Haloperidol Injection, USP and 3) treatment of any concomitant serious medical problems for which specific treatments are available. (For Immediate Release) There is no general agreement about specific pharmacological treatment regimens for uncomplicated NMS. Rx only If a patient requires antipsychotic drug treatment after recovery from NMS, the potential reintroduction of drug therapy should be carefully considered. The patient should be carefully monitored, since recurrences WARNING of NMS have been reported. Increased Mortality in Elderly Patients with Dementia-Related Psychosis: Hyperpyrexia and heat stroke, not associated with the above symptom complex, have also been reported Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an in- with haloperidol. creased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), Usage in Pregnancy largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated pa- Rodents given 2 to 20 times the usual maximum human dose of haloperidol by oral or parenteral routes tients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of showed an increase in incidence of resorption, reduced fertility, delayed delivery and pup mortality. No a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, com- teratogenic effect has been reported in rats, rabbits or dogs at dosages within this range, but cleft palate pared to a rate of about 2.6% in the placebo group. -
Antagonism of Dopamine D2 Receptor/Я-Arrestin 2 Interaction Is a Common Property of Clinically Effective Antipsychotics
Antagonism of dopamine D2 receptor/-arrestin 2 interaction is a common property of clinically effective antipsychotics Bernard Masri, Ali Salahpour, Michael Didriksen*, Valentina Ghisi, Jean-Martin Beaulieu†, Raul R. Gainetdinov‡, and Marc G. Caron§ Departments of Cell Biology, Medicine and Neurobiology, Duke University Medical Center, Durham, NC 27710 Edited by Solomon H. Snyder, Johns Hopkins University School of Medicine, Baltimore, MD, and approved July 8, 2008 (received for review April 10, 2008) Since the unexpected discovery of the antipsychotic activity of beit with different potency, on the dopamine (DA) system. It has chlorpromazine, a variety of therapeutic agents have been devel- been demonstrated that clinical efficacy of essentially all anti- oped for the treatment of schizophrenia. Despite differences in psychotic drugs (including traditional and newer antipsychotics) their activities at various neurotransmitter systems, all clinically is directly correlated with dopamine D2 receptor (D2R) binding effective antipsychotics share the ability to interact with D2 class affinity and their capacity to antagonize this receptor (5, 6). It dopamine receptors (D2R). D2R mediate their physiological effects is commonly believed that the D2R, which belongs to the G via both G protein-dependent and independent (-arrestin 2- protein-coupled receptor (GPCR) family, mediates the major dependent) signaling, but the role of these D2R-mediated signaling part of its signaling and functions by coupling to Gi/o proteins to events in the actions of antipsychotics remains unclear. We dem- negatively regulate cAMP production. Thus, studies aimed at onstrate here that while different classes of antipsychotics have assessing the efficacy of antipsychotics on D2R signaling have complex pharmacological profiles at G protein-dependent D2R classically been mainly concerned with measuring Gi/o-mediated long isoform (D2LR) signaling, they share the common property of inhibition of cAMP.