Effects of Sympathetic Inhibition on Receptive, Proceptive, and Rejection Behaviors in the Female Rat
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Switching from Clonidine Immediate-Release to Guanfacine Extended-Release
/ DE L’ACADÉMIE CANADIENNE DE PSYCHIATRIE DE L’ENFANT ET DE L’ADOLESCENT PSYCHOPHARMACOLOGY Switching from Clonidine Immediate-Release to Guanfacine Extended-Release Dean Elbe PharmD, BCPP1,2,3 s a clinical pharmacy specialist in child and adolescent (Canada) Ltd, 2012b). Clonidine has been used off-label Amental health, I am frequently asked how to switch in children for many years for treatment of insomnia, patients from clonidine immediate-release (IR) to guanfa- ADHD, and disruptive behaviour disorders (Hunt, Capper cine extended-release (XR). This therapeutic switch may be & O’Connell, 1990; Rubinstein; Jaselskis, Cook, Fletcher required when poor adherence to a clonidine IR regimen & Leventhal, 1992; Silver & Licamele, 1994; Palumbo et (typically requiring 3–4 doses daily) is identified, when al., 2008; Efron, Lycett & Sciberras, 2014). A clonidine XR clonidine dose-optimization is limited by sedation, brady- formulation is not available in Canada, but is available in cardia or hypotension, or when coverage situations change. the United States for treatment of ADHD (Concordia Phar- The latter may occur if, for example, new eligibility for a maceuticals, Inc. 2015). government program or a third party-payer occurs. Weight-based dosing guidelines exist for clonidine IR Guanfacine XR, a selective alpha2A agonist, was first mar- (0.003–0.008 mg/kg/day) and guanfacine XR (0.05–0.08 keted in Canada in late 2013 for the treatment of attention mg/kg/day) (Shire Pharma Canada ULC, 2019; Elbe et deficit hyperactivity disorder (ADHD) in children and ado- al., 2018). Based on these guidelines and other literature, lescents (Shire Pharma Canada ULC, 2019). -
Memory Deficits Associated with Clonidine
Letter to the Editor Letters to the Editor are invited for comment on a topic of current interest or on Table material published in GENERAL HOSPITAL PSYCHIATRY. Letters should be typed doubled spaced and are subject to editing according to space limitations. - Memory Deficits Associated with Attent KnO Clonidine WA Verbal WA Drugs used in the treatment of essential hyperten- Initiation of clonidine therapy (0.1 mg b.i.d.) in WA sion are among the most commonly prescribed. April 1984 resulted in well-controlled hypertension Tactilc Some of these agents have primary effects on neu- without immediately apparent adverse effects. Fulc rotransmitter systems and are centrally active. However, the coincidence of the onset of memory Verba Thus, drugs such as a-methyldopa, propranalol, complaints and the beginning of clonidine treat- 3% ment suggested that clonidine might be respon- List Ll and reserpine have well-established neuropsychia- Fulc tric complications, ranging from depression to cog- sible. si nitive impairments and psychosis [l].Since the use After consultation with the patient's internist, a R of these drugs is widespread and unavoidable, we switch was made to captopril, an angiotensin-con- T must be alert to the possibility that these drugs verting enzyme inhibitor. Before the change we T administered tests of attention, concentration, and contribute to psychologic complaints and symp- -R toms of our patients. verbal skills as well as the Fuld Object-Memory Evaluation, which includes a measure of verbal 'Age-a Clonidine, a presynaptic adrenergic a2agonist, bNonc has become well established as a useful and rela- fluency as well as a selective reminding list learning tively safe therapeutic agent. -
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............................................................... -
Sleep & Dreams & Dsm-5
PAL Conference - Green River, WY - May 2015 SLEEP & DREAMS & DSM-5: ASSESSMENT AND TREATMENT OF PEDIATRIC INSOMNIA James Peacey, MD PAL Conference Green River, WY Disclosure Statement No relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider of commercial services discussed in this CME activity. I will reference off-label or investigational use of medications in this presentation. PAL Conference - Green River, WY - May 2015 Goals and Objectives Learn how to identify and categorize pediatric insomnia. Increase knowledge of common behavioral and pharmacologic sleep treatments. Increase understanding of sleep issues in particular patient populations (Autism, ADHD, depression and anxiety) and appropriate strategies to optimize treatment. PAL Conference - Green River, WY - May 2015 Sleep Stage Development PAL Conference - Green River, WY - May 2015 Homeostatic and Circadian Processes D. J. Dijk and D. M. Edgar, Regulation of Sleep and Wakefulness, 1999 PAL Conference - Green River, WY - May 2015 Homeostatic and Circadian Processes PAL Conference - Green River, WY - May 2015 Alerting Systems PAL Conference - Green River, WY - May 2015 Normal Sleep Requirements Babcock, Pediatr Clin N Am 58 (2011) 543–554PAL Conference - Green River, WY - May 2015 Percentiles for total sleep duration per 24 hours from infancy to adolescence. Iglowstein I et al. Pediatrics 2003;111:302-307 PAL Conference - Green River, WY - May 2015 ©2003 by American Academy of Pediatrics Insomnia “significant difficulty initiating -
Pharmacological Approach to Sleep Disturbances in Autism Spectrum Disorders with Psychiatric Comorbidities: a Literature Review
medical sciences Review Pharmacological Approach to Sleep Disturbances in Autism Spectrum Disorders with Psychiatric Comorbidities: A Literature Review Sachin Relia 1,* and Vijayabharathi Ekambaram 2,* 1 Department of Psychiatry, University of Tennessee Health Sciences Center, 920, Madison Avenue, Suite 200, Memphis, TN 38105, USA 2 Department of Psychiatry, University of Oklahoma Health Sciences Center, 920, Stanton L Young Blvd, Oklahoma City, OK 73104, USA * Correspondence: [email protected] (S.R.); [email protected] (V.E.); Tel.: +1-901-448-4266 (S.R.); +1-405-271-5251 (V.E.); Fax: +1-901-297-6337 (S.R.); +1-405-271-3808 (V.E.) Received: 15 August 2018; Accepted: 17 October 2018; Published: 25 October 2018 Abstract: Autism is a developmental disability that can cause significant emotional, social and behavioral dysfunction. Sleep disorders co-occur in approximately half of the patients with autism spectrum disorder (ASD). Sleep problems in individuals with ASD have also been associated with poor social interaction, increased stereotypy, problems in communication, and overall autistic behavior. Behavioral interventions are considered a primary modality of treatment. There is limited evidence for psychopharmacological treatments in autism; however, these are frequently prescribed. Melatonin, antipsychotics, antidepressants, and α agonists have generally been used with melatonin, having a relatively large body of evidence. Further research and information are needed to guide and individualize treatment for this population group. Keywords: autism spectrum disorder; sleep disorders in ASD; medications for sleep disorders in ASD; comorbidities in ASD 1. Introduction Autism is a developmental disability that can cause significant emotional, social, and behavioral dysfunction. According to the Diagnostic and Statistical Manual (DSM-V) classification [1], autism spectrum disorder (ASD) is characterized by persistent deficits in domains of social communication, social interaction, restricted and repetitive patterns of behavior, interests, or activities. -
Data Sheet SURMONTIL Trimipramine (As Maleate) 25 Mg Tablets and 50 Mg Capsules
Data Sheet SURMONTIL trimipramine (as maleate) 25 mg tablets and 50 mg capsules Presentation SURMONTIL tablets are compression coated, white or cream, circular, biconvex, containing the equivalent of 25mg trimipramine (as maleate) with a diameter of about 8.0mm. The face is indented with the name and strength, reverse plain. SURMONTIL capsules are opaque white with opaque green cap, printed SU50, each containing the equivalent of 50mg trimipramine (as maleate). Uses Actions SURMONTIL has a potent anti-depressant action similar to that of other tricyclic anti-depressants. The mechanism of action is not fully understood but it is thought to be via inhibition of neuronal re- uptake of noradrenalin, thereby increasing availability. SURMONTIL also possesses a pronounced sedative action. Pharmacokinetics SURMONTIL is readily absorbed after oral administration, reaching a mean peak plasma level after 3 hours. High first pass hepatic clearance results in a mean bioavailability of about 41% of the oral dose, and trimipramine is extensively protein bound in plasma. Elimination half-life is 24 hours. Metabolism is in the liver to its major metabolite, desmethyltrimipramine, which is excreted mainly in the urine. Indications SURMONTIL is indicated in the treatment of depressive illness, especially where sleep disturbance, anxiety or agitation is a presenting symptom. Sleep disturbance is controlled within 24 hours and true anti-depressant action follows within 7-10 days. Dosage and Administration Adults Mild/Moderate Depression in General Practice: The recommended dosage is 50-75 mg orally given two hours before bedtime, the larger dose (75 mg) being preferable for those patients with more marked sleep disturbance. -
(Mibg) Scintigraphy: Procedure Guidelines for Tumour Imaging
Eur J Nucl Med Mol Imaging (2010) 37:2436–2446 DOI 10.1007/s00259-010-1545-7 GUIDELINES 131I/123I-Metaiodobenzylguanidine (mIBG) scintigraphy: procedure guidelines for tumour imaging Emilio Bombardieri & Francesco Giammarile & Cumali Aktolun & Richard P. Baum & Angelika Bischof Delaloye & Lorenzo Maffioli & Roy Moncayo & Luc Mortelmans & Giovanna Pepe & Sven N. Reske & Maria R. Castellani & Arturo Chiti Published online: 20 July 2010 # EANM 2010 Abstract The aim of this document is to provide general existing procedures for neuroendocrine tumours. The information about mIBG scintigraphy in cancer patients. guidelines should therefore not be taken as exclusive of The guidelines describe the mIBG scintigraphy protocol other nuclear medicine modalities that can be used to obtain currently used in clinical routine, but do not include all comparable results. It is important to remember that the The European Association has written and approved guidelines to promote the use of nuclear medicine procedures with high quality. These general recommendations cannot be applied to all patients in all practice settings. The guidelines should not be deemed inclusive of all proper procedures and exclusive of other procedures reasonably directed to obtaining the same results. The spectrum of patients seen in a specialized practice setting may be different than the spectrum usually seen in a more general setting. The appropriateness of a procedure will depend in part on the prevalence of disease in the patient population. In addition, resources available for patient care may vary greatly from one European country or one medical facility to another. For these reasons, guidelines cannot be rigidly applied. These guidelines summarize the views of the Oncology Committee of the EANM and reflect recommendations for which the EANM cannot be held responsible. -
Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanismss
Supplemental Material can be found at: /content/suppl/2020/12/18/73.1.202.DC1.html 1521-0081/73/1/202–277$35.00 https://doi.org/10.1124/pharmrev.120.000056 PHARMACOLOGICAL REVIEWS Pharmacol Rev 73:202–277, January 2021 Copyright © 2020 by The Author(s) This is an open access article distributed under the CC BY-NC Attribution 4.0 International license. ASSOCIATE EDITOR: MICHAEL NADER Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanismss Antonio Inserra, Danilo De Gregorio, and Gabriella Gobbi Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Quebec, Canada Abstract ...................................................................................205 Significance Statement. ..................................................................205 I. Introduction . ..............................................................................205 A. Review Outline ........................................................................205 B. Psychiatric Disorders and the Need for Novel Pharmacotherapies .......................206 C. Psychedelic Compounds as Novel Therapeutics in Psychiatry: Overview and Comparison with Current Available Treatments . .....................................206 D. Classical or Serotonergic Psychedelics versus Nonclassical Psychedelics: Definition ......208 Downloaded from E. Dissociative Anesthetics................................................................209 F. Empathogens-Entactogens . ............................................................209 -
Do These Fearful and Aggressive Dogs Need Drugs? Gary Landsberg, DVM, Bsc, DACVB, DECVB-CA North Toronto Veterinary Behaviour Specialty Clinic Thornhill, Canada
Do these Fearful and Aggressive Dogs Need Drugs? Gary Landsberg, DVM, BSc, DACVB, DECVB-CA North Toronto Veterinary Behaviour Specialty Clinic Thornhill, Canada In this seminar Dr. Landsberg will collaborate with a colleague to discuss real cases of canine aggression cases and the selection and use of drugs and natural supplements for these cases. Therefore the summary below provides a brief overview of drug selection and use. Pharmacotherapy and canine aggression When a dog is excessively aroused, fearful, anxious, overly reactive lacking impulse control or “behaviorally abnormal”, psychotropic medications are indicated to improve the problem as well as address the dog’s well-being. However, drugs do not change the relationship with the stimulus; therefore, concurrent behavior modification is needed to desensitize, countercondition and train desirable. Selective serotonin reuptake inhibitors might be most effective for hyperactivity, aggression, social anxiety, generalized fear and anxiety and panic disorders. Four weeks or longer is generally required to achieve full therapeutic effects. Starting the medication at the time of the consultation allows time for the drug to reach optimal therapeutic effect when the exposure program begins. Medication might not be required for dogs that can be effectively kept away from fear- evoking situations, provided the dog is sufficiently settled and relaxed. Adjunctive medication to further reduce anxiety especially prior to stimulus exposure might include benzodiazepines, trazodone, clonidine or propranolol, alone or in combination. If effective these drugs might be used several times a day. Psychotropic drugs Selective serotonin reuptake inhibitors (SSRI) are most commonly used in dogs that are behaviorally abnormal, to control reactivity and impulsivity, reduce fear and anxiety and improve trainability as well as address the dog’s behavioral well-being. -
Drug and Medication Classification Schedule
KENTUCKY HORSE RACING COMMISSION UNIFORM DRUG, MEDICATION, AND SUBSTANCE CLASSIFICATION SCHEDULE KHRC 8-020-1 (11/2018) Class A drugs, medications, and substances are those (1) that have the highest potential to influence performance in the equine athlete, regardless of their approval by the United States Food and Drug Administration, or (2) that lack approval by the United States Food and Drug Administration but have pharmacologic effects similar to certain Class B drugs, medications, or substances that are approved by the United States Food and Drug Administration. Acecarbromal Bolasterone Cimaterol Divalproex Fluanisone Acetophenazine Boldione Citalopram Dixyrazine Fludiazepam Adinazolam Brimondine Cllibucaine Donepezil Flunitrazepam Alcuronium Bromazepam Clobazam Dopamine Fluopromazine Alfentanil Bromfenac Clocapramine Doxacurium Fluoresone Almotriptan Bromisovalum Clomethiazole Doxapram Fluoxetine Alphaprodine Bromocriptine Clomipramine Doxazosin Flupenthixol Alpidem Bromperidol Clonazepam Doxefazepam Flupirtine Alprazolam Brotizolam Clorazepate Doxepin Flurazepam Alprenolol Bufexamac Clormecaine Droperidol Fluspirilene Althesin Bupivacaine Clostebol Duloxetine Flutoprazepam Aminorex Buprenorphine Clothiapine Eletriptan Fluvoxamine Amisulpride Buspirone Clotiazepam Enalapril Formebolone Amitriptyline Bupropion Cloxazolam Enciprazine Fosinopril Amobarbital Butabartital Clozapine Endorphins Furzabol Amoxapine Butacaine Cobratoxin Enkephalins Galantamine Amperozide Butalbital Cocaine Ephedrine Gallamine Amphetamine Butanilicaine Codeine -
Clomipramine 25 Mg Capsules, Hard
Package leaflet: Information for the patient Other medicines and Clomipramine Tell your doctor if you are taking, have recently Clomipramine 10 mg Capsules, Hard taken or might take any other medicines. Clomipramine 25 mg Capsules, Hard Some medicines may increase the side effects of Clomipramine 50 mg Capsules, Hard Clomipramine and may sometimes cause very clomipramine hydrochloride serious reactions. Do not take any other medicines whilst taking Clomipramine without first talking to Read all of this leaflet carefully before you your doctor, especially: start taking this medicine because it contains - medicines for depression, particularly MAOIs (see important information for you. section “Do not take” above) e.g. tranylcypromine, - Keep this leaflet. You may need to read it again. phenelzine, moclobemide; SSRIs e.g. fluoxetine (or - If you have any further questions, ask your have taken within the last 3 weeks), fluvoxamine, doctor or pharmacist. paroxetine, sertraline; SNaRIs e.g. venlafaxine; - This medicine has been prescribed for you only. tricyclic and tetracyclic antidepressants e.g. Do not pass it on to others. It may harm them, amitriptyline, dothiepin, maprotiline even if their signs of illness are the same as yours. - diuretics, also known as ‘water tablets’, e.g. - If you get any side effects, talk to your doctor bendroflumethiazide, furosemide or pharmacist. This includes any possible side - anaesthetics, used for the temporary loss of effects not listed in this leaflet. See section 4. bodily sensation - antihistamines e.g. terfenadine What is in this leaflet - medicines for other mental health conditions 1. What Clomipramine is and what it is used for. such as schizophrenia or manic depression 2. -
Sustained Administration of Pramipexole Modifies the Spontaneous Firing of Dopamine, Norepinephrine, and Serotonin Neurons in the Rat Brain
Neuropsychopharmacology (2009) 34, 651–661 & 2009 Nature Publishing Group All rights reserved 0893-133X/09 $32.00 www.neuropsychopharmacology.org Sustained Administration of Pramipexole Modifies the Spontaneous Firing of Dopamine, Norepinephrine, and Serotonin Neurons in the Rat Brain ,1 1 1,2 O Chernoloz* , M El Mansari and P Blier 1 2 Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ontario, Canada Pramipexole (PPX) is a D2/D3 receptor agonist that has been shown to be effective in the treatment of depression. Serotonin (5-HT), norepinephrine (NE) and dopamine (DA) systems are known to be involved in the pathophysiology and treatment of depression. Due to reciprocal interactions between these neuronal systems, drugs selectively targeting one system-specific receptor can indirectly modify the firing activity of neurons that contribute to firing patterns in systems that operate via different neurotransmitters. It was thus hypothesized that PPX would alter the firing rate of DA, NE and 5-HT neurons. To test this hypothesis, electrophysiological experiments were carried out in anesthetized rats. Subcutaneously implanted osmotic minipumps delivered PPX at a dose of 1 mg/kg per day for 2 or 14 days. After a 2-day treatment with PPX the spontaneous neuronal firing of DA neurons was decreased by 40%, NE neuronal firing by 33% and the firing rate of 5-HT neurons remained unaltered. After 14 days of PPX treatment, the firing rate of DA had recovered as well as that of NE, whereas the firing rate of 5-HT neurons was increased by 38%.