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Ketamine As a Rapid Antidepressant
BJPsych Advances (2016), vol. 22, 222–233 doi: 10.1192/apt.bp.114.014274 ARTICLE Ketamine as a rapid anti depressant: the debate and implications Roger C. M. Ho & Melvyn W. Zhang Roger Ho is an Associate Professor response rates to SSRIs and NaSSAs are around SUMMARY and consultant psychiatrist in 62% and 67% respectively (Papakostas 2008). the Department of Psychological Ketamine, a synthetic derivative of phencyclidine, Environmental factors such as relationship Medicine, Yong Loo Lin School of is a commonly misused party drug that is Medicine, National University of problems, financial difficulties and comorbid restricted in high-income countries because of Singapore. He has a special interest substance misuse often lead to poor treatment its addictive potential. Ketamine is also used as in psychoneuroimmunology and response, and antidepressants combined with the interface between medicine an anaesthetic in human and veterinary medicine. and psychiatry. Melvyn Zhang In the 1990s, research using ketamine to study the CBT have shown promising results in prevention is a senior resident with the pathophysiology of schizophrenia was terminated of mood disorders (Brenner 2010). Although 70– National Addiction Management owing to ethical concerns. Recently, controversy 90% of patients with depression achieve remission, Service, Institute of Mental Health, surrounding the drug has returned, as researchers around 10–30% are refractory to initial treatment Singapore. Correspondence Dr Roger C. M. have demonstrated that intravenous ketamine but respond to switching or combination of Ho, National University of Singapore, infusion has a rapid antidepressant effect and antidepressants, electroconvulsive therapy (ECT) Department of Psychological have therefore proposed ketamine as a novel or psychotherapy. -
Precursors and Chemicals Frequently Used in the Illicit Manufacture of Narcotic Drugs and Psychotropic Substances 2017
INTERNATIONAL NARCOTICS CONTROL BOARD Precursors and chemicals frequently used in the illicit manufacture of narcotic drugs and psychotropic substances 2017 EMBARGO Observe release date: Not to be published or broadcast before Thursday, 1 March 2018, at 1100 hours (CET) UNITED NATIONS CAUTION Reports published by the International Narcotics Control Board in 2017 The Report of the International Narcotics Control Board for 2017 (E/INCB/2017/1) is supplemented by the following reports: Narcotic Drugs: Estimated World Requirements for 2018—Statistics for 2016 (E/INCB/2017/2) Psychotropic Substances: Statistics for 2016—Assessments of Annual Medical and Scientific Requirements for Substances in Schedules II, III and IV of the Convention on Psychotropic Substances of 1971 (E/INCB/2017/3) Precursors and Chemicals Frequently Used in the Illicit Manufacture of Narcotic Drugs and Psychotropic Substances: Report of the International Narcotics Control Board for 2017 on the Implementation of Article 12 of the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988 (E/INCB/2017/4) The updated lists of substances under international control, comprising narcotic drugs, psychotropic substances and substances frequently used in the illicit manufacture of narcotic drugs and psychotropic substances, are contained in the latest editions of the annexes to the statistical forms (“Yellow List”, “Green List” and “Red List”), which are also issued by the Board. Contacting the International Narcotics Control Board The secretariat of the Board may be reached at the following address: Vienna International Centre Room E-1339 P.O. Box 500 1400 Vienna Austria In addition, the following may be used to contact the secretariat: Telephone: (+43-1) 26060 Fax: (+43-1) 26060-5867 or 26060-5868 Email: [email protected] The text of the present report is also available on the website of the Board (www.incb.org). -
Case Discussions in Palliative Medicine Levorphanol For
JOURNAL OF PALLIATIVE MEDICINE Volume 21, Number 3, 2018 Case Discussions in Palliative Medicine ª Mary Ann Liebert, Inc. DOI: 10.1089/jpm.2017.0475 Feature Editor: Craig D. Blinderman Levorphanol for Treatment of Intractable Neuropathic Pain in Cancer Patients Akhila Reddy, MD,1,* Amy Ng, MD,1,* Tarun Mallipeddi,2 and Eduardo Bruera, MD1 Abstract Neuropathic pain in cancer patients is often difficult to treat, requiring a combination of several different pharmacological therapies. We describe two patients with complex neuropathic pain syndromes in the form of phantom limb pain and Brown-Sequard syndrome who did not respond to conventional treatments but re- sponded dramatically to the addition of levorphanol. Levorphanol is a synthetic strong opioid that is a potent N- methyl-d-aspartate receptor antagonist, mu, kappa, and delta opioid receptor agonist, and reuptake inhibitor of serotonin and norepinephrine. It bypasses hepatic first-pass metabolism and thereby not subjected to numerous drug interactions. Levorphanol’s unique profile makes it a potentially attractive opioid in cancer pain man- agement. Keywords: Brown-Sequard syndrome; cancer; cancer pain; levorphanol; neuropathic pain; phantom limb pain Introduction changes, structural reorganization of spinal cord and primary somatosensory cortex, and increased sensitization of spinal ne-third of cancer patients who experience pain cord may be the neurological basis for PLP.8,9 Because the Oalso experience neuropathic pain1 and about half the pathophysiology of PLP is not clearly understood, the treat- patients with cancer who suffer from neuropathic pain also ment options are mainly based on clinical experience.9 There have nociceptive pain.2 Most neuropathic pain exists as are case series showing that tramadol and methadone may be mixed pain in combination with nociceptive pain. -
Hallucinogens and Dissociative Drugs
Long-Term Effects of Hallucinogens See page 5. from the director: Research Report Series Hallucinogens and dissociative drugs — which have street names like acid, angel dust, and vitamin K — distort the way a user perceives time, motion, colors, sounds, and self. These drugs can disrupt a person’s ability to think and communicate rationally, or even to recognize reality, sometimes resulting in bizarre or dangerous behavior. Hallucinogens such as LSD, psilocybin, peyote, DMT, and ayahuasca cause HALLUCINOGENS AND emotions to swing wildly and real-world sensations to appear unreal, sometimes frightening. Dissociative drugs like PCP, DISSOCIATIVE DRUGS ketamine, dextromethorphan, and Salvia divinorum may make a user feel out of Including LSD, Psilocybin, Peyote, DMT, Ayahuasca, control and disconnected from their body PCP, Ketamine, Dextromethorphan, and Salvia and environment. In addition to their short-term effects What Are on perception and mood, hallucinogenic Hallucinogens and drugs are associated with psychotic- like episodes that can occur long after Dissociative Drugs? a person has taken the drug, and dissociative drugs can cause respiratory allucinogens are a class of drugs that cause hallucinations—profound distortions depression, heart rate abnormalities, and in a person’s perceptions of reality. Hallucinogens can be found in some plants and a withdrawal syndrome. The good news is mushrooms (or their extracts) or can be man-made, and they are commonly divided that use of hallucinogenic and dissociative Hinto two broad categories: classic hallucinogens (such as LSD) and dissociative drugs (such drugs among U.S. high school students, as PCP). When under the influence of either type of drug, people often report rapid, intense in general, has remained relatively low in emotional swings and seeing images, hearing sounds, and feeling sensations that seem real recent years. -
Hallucinogens
Hallucinogens What Are Hallucinogens? Hallucinogens are a diverse group of drugs that alter a person’s awareness of their surroundings as well as their thoughts and feelings. They are commonly split into two categories: classic hallucinogens (such as LSD) and dissociative drugs (such as PCP). Both types of hallucinogens can cause hallucinations, or sensations and images that seem real though they are not. Additionally, dissociative drugs can cause users to feel out of control or disconnected from their body and environment. Some hallucinogens are extracted from plants or mushrooms, and others are synthetic (human-made). Historically, people have used hallucinogens for religious or healing rituals. More recently, people report using these drugs for social or recreational purposes. Hallucinogens are a Types of Hallucinogens diverse group of drugs Classic Hallucinogens that alter perception, LSD (D-lysergic acid diethylamide) is one of the most powerful mind- thoughts, and feelings. altering chemicals. It is a clear or white odorless material made from lysergic acid, which is found in a fungus that grows on rye and other Hallucinogens are split grains. into two categories: Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine) comes from certain classic hallucinogens and types of mushrooms found in tropical and subtropical regions of South dissociative drugs. America, Mexico, and the United States. Peyote (mescaline) is a small, spineless cactus with mescaline as its main People use hallucinogens ingredient. Peyote can also be synthetic. in a wide variety of ways DMT (N,N-dimethyltryptamine) is a powerful chemical found naturally in some Amazonian plants. People can also make DMT in a lab. -
Pharmacy and Poisons (Third and Fourth Schedule Amendment) Order 2017
Q UO N T FA R U T A F E BERMUDA PHARMACY AND POISONS (THIRD AND FOURTH SCHEDULE AMENDMENT) ORDER 2017 BR 111 / 2017 The Minister responsible for health, in exercise of the power conferred by section 48A(1) of the Pharmacy and Poisons Act 1979, makes the following Order: Citation 1 This Order may be cited as the Pharmacy and Poisons (Third and Fourth Schedule Amendment) Order 2017. Repeals and replaces the Third and Fourth Schedule of the Pharmacy and Poisons Act 1979 2 The Third and Fourth Schedules to the Pharmacy and Poisons Act 1979 are repealed and replaced with— “THIRD SCHEDULE (Sections 25(6); 27(1))) DRUGS OBTAINABLE ONLY ON PRESCRIPTION EXCEPT WHERE SPECIFIED IN THE FOURTH SCHEDULE (PART I AND PART II) Note: The following annotations used in this Schedule have the following meanings: md (maximum dose) i.e. the maximum quantity of the substance contained in the amount of a medicinal product which is recommended to be taken or administered at any one time. 1 PHARMACY AND POISONS (THIRD AND FOURTH SCHEDULE AMENDMENT) ORDER 2017 mdd (maximum daily dose) i.e. the maximum quantity of the substance that is contained in the amount of a medicinal product which is recommended to be taken or administered in any period of 24 hours. mg milligram ms (maximum strength) i.e. either or, if so specified, both of the following: (a) the maximum quantity of the substance by weight or volume that is contained in the dosage unit of a medicinal product; or (b) the maximum percentage of the substance contained in a medicinal product calculated in terms of w/w, w/v, v/w, or v/v, as appropriate. -
The Effects of the Morphine Analogue Levorphanol on Leukocytes: Metabolic Effects at Rest and During Phagocytosis
The effects of the morphine analogue levorphanol on leukocytes: Metabolic effects at rest and during phagocytosis Nancy Wurster, … , Penelope Pettis, Sharon Lebow J Clin Invest. 1971;50(5):1091-1099. https://doi.org/10.1172/JCI106580. Studies on bacteria have suggested that morphine-like drugs have effects on the cell membrane. To determine the effect of this class of drugs on a mammalian cell, we selected the rabbit peritoneal exudate granulocyte, which undergoes striking membrane changes during phagocytosis. We examined the effect in vitro of the morphine analogue, levorphanol on phagocytosis and metabolism by granulocytes incubated with and without polystyrene particles or live Escherichia coli. Levorphanol (1 or 2 mmoles/liter) decreased: (a) acylation of lysolecithin or lysophosphatidylethanolamine in the medium (which is stimulated about two-fold during phagocytosis) both at rest (40%) and during phagocytosis (60%); (b) uptake of latex particles and Escherichia coli, as judged by electron microscopy; (c) killing of live Escherichia coli (10-fold); (d) 14 14 + CO2 production from glucose-1- C during phagocytosis by at least 80%; (e) K content of granulocytes (35%); (f) oxidation of linoleate-1-14C by 50%, and its incorporation into triglyceride by more than 80%. However, levorphanol stimulated 2 to 3-fold the incorporation of linoleate-1-14C or palmitate-1-14C into several phospholipids. Glucose uptake, lactate production, and adenosine triphosphate (ATP) content are not affected by the drug. Thus, levorphanol does not appear to exert its effects through generalized metabolic suppression. Removal of levorphanol by twice resuspending the granulocytes completely reverses all inhibition. In line with observations on bacteria, it appears that the complex effects of levorphanol on […] Find the latest version: https://jci.me/106580/pdf The Effects of the Morphine Analogue Levorphanol on Leukocytes METABOLIC EFFECTS AT REST AND DURING PHAGOCYTOSIS NANcY WuRsTE, PETER ELSBACH, ERIc J. -
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 -
Drugs of Abuseon September Archived 13-10048 No
U.S. DEPARTMENT OF JUSTICE DRUG ENFORCEMENT ADMINISTRATION WWW.DEA.GOV 9, 2014 on September archived 13-10048 No. v. Stewart, in U.S. cited Drugs of2011 Abuse EDITION A DEA RESOURCE GUIDE V. Narcotics WHAT ARE NARCOTICS? Also known as “opioids,” the term "narcotic" comes from the Greek word for “stupor” and originally referred to a variety of substances that dulled the senses and relieved pain. Though some people still refer to all drugs as “narcot- ics,” today “narcotic” refers to opium, opium derivatives, and their semi-synthetic substitutes. A more current term for these drugs, with less uncertainty regarding its meaning, is “opioid.” Examples include the illicit drug heroin and pharmaceutical drugs like OxyContin®, Vicodin®, codeine, morphine, methadone and fentanyl. WHAT IS THEIR ORIGIN? The poppy papaver somniferum is the source for all natural opioids, whereas synthetic opioids are made entirely in a lab and include meperidine, fentanyl, and methadone. Semi-synthetic opioids are synthesized from naturally occurring opium products, such as morphine and codeine, and include heroin, oxycodone, hydrocodone, and hydromorphone. Teens can obtain narcotics from friends, family members, medicine cabinets, pharmacies, nursing 2014 homes, hospitals, hospices, doctors, and the Internet. 9, on September archived 13-10048 No. v. Stewart, in U.S. cited What are common street names? Street names for various narcotics/opioids include: ➔ Hillbilly Heroin, Lean or Purple Drank, OC, Ox, Oxy, Oxycotton, Sippin Syrup What are their forms? Narcotics/opioids come in various forms including: ➔ T ablets, capsules, skin patches, powder, chunks in varying colors (from white to shades of brown and black), liquid form for oral use and injection, syrups, suppositories, lollipops How are they abused? ➔ Narcotics/opioids can be swallowed, smoked, sniffed, or injected. -
The Interaction of Selective A1 and A2A Adenosine Receptor Antagonists with Magnesium and Zinc Ions in Mice: Behavioural, Biochemical and Molecular Studies
International Journal of Molecular Sciences Article The Interaction of Selective A1 and A2A Adenosine Receptor Antagonists with Magnesium and Zinc Ions in Mice: Behavioural, Biochemical and Molecular Studies Aleksandra Szopa 1,* , Karolina Bogatko 1, Mariola Herbet 2 , Anna Serefko 1 , Marta Ostrowska 2 , Sylwia Wo´sko 1, Katarzyna Swi´ ˛ader 3, Bernadeta Szewczyk 4, Aleksandra Wla´z 5, Piotr Skałecki 6, Andrzej Wróbel 7 , Sławomir Mandziuk 8, Aleksandra Pochodyła 3, Anna Kudela 2, Jarosław Dudka 2, Maria Radziwo ´n-Zaleska 9, Piotr Wla´z 10 and Ewa Poleszak 1,* 1 Chair and Department of Applied and Social Pharmacy, Laboratory of Preclinical Testing, Medical University of Lublin, 1 Chod´zkiStreet, PL 20–093 Lublin, Poland; [email protected] (K.B.); [email protected] (A.S.); [email protected] (S.W.) 2 Chair and Department of Toxicology, Medical University of Lublin, 8 Chod´zkiStreet, PL 20–093 Lublin, Poland; [email protected] (M.H.); [email protected] (M.O.); [email protected] (A.K.) [email protected] (J.D.) 3 Chair and Department of Applied and Social Pharmacy, Medical University of Lublin, 1 Chod´zkiStreet, PL 20–093 Lublin, Poland; [email protected] (K.S.);´ [email protected] (A.P.) 4 Department of Neurobiology, Polish Academy of Sciences, Maj Institute of Pharmacology, 12 Sm˛etnaStreet, PL 31–343 Kraków, Poland; [email protected] 5 Department of Pathophysiology, Medical University of Lublin, 8 Jaczewskiego Street, PL 20–090 Lublin, Poland; [email protected] Citation: Szopa, A.; Bogatko, K.; 6 Department of Commodity Science and Processing of Raw Animal Materials, University of Life Sciences, Herbet, M.; Serefko, A.; Ostrowska, 13 Akademicka Street, PL 20–950 Lublin, Poland; [email protected] M.; Wo´sko,S.; Swi´ ˛ader, K.; Szewczyk, 7 Second Department of Gynecology, 8 Jaczewskiego Street, PL 20–090 Lublin, Poland; B.; Wla´z,A.; Skałecki, P.; et al. -
DXM Fast Facts
What is DXM? doses—usually at least half an 8-ounce ketamine. While under the influence of bottle—by drinking the liquid very the drug, which can last for as long as DXM (dextromethorphan) is a quickly. (Consumption of large quanti- 6 hours, DXM abusers risk injuring cough suppressant available in a ties of cough syrup induces vomiting. themselves and others because of the variety of over-the-counter cough and Thus, to achieve the desired effects, drug’s effects on visual perception and cold medications. DXM is abused abusers must drink the product quickly cognitive processes. because, when taken in doses that enough to allow the body to absorb the In addition, individuals who ingest dramatically exceed those recom- DXM before vomiting occurs.) mended by physicians and pharma- high doses of DXM risk hyperthermia cists, it produces hallucinations and The availability of powdered extrac- (exceptionally high fever), particularly if a sense of dissociation. tions of DXM has resulted in abusers they use the drug in a hot environment either inhaling the powder (snorting) or or while physically exerting themselves— What does DXM look like? repackaging it in capsules, which are such as at a rave or dance club. Other then swallowed. risks associated with DXM abuse As an over-the-counter medication, include nausea, abdominal pain, vomit- DXM is available in various forms Who abuses DXM? ing, irregular heartbeat, high blood including liquids, lozenges, tablets, pressure, headache, numbness of capsules, and gel caps. In addition, DXM It is difficult to gauge the extent of fingers and toes, loss of consciousness, powder—prepared by extracting the drug DXM abuse in the United States seizures, brain damage, and death. -
University of Groningen Stereoselectivity in the Hepatic Metabolism and Transport of Quaternary Drugs of the Morphinan Type Lant
University of Groningen Stereoselectivity in the hepatic metabolism and transport of quaternary drugs of the morphinan type Lanting, Aleida Bartha Louisa IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2000 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Lanting, A. B. L. (2000). Stereoselectivity in the hepatic metabolism and transport of quaternary drugs of the morphinan type. s.n. Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 24-09-2021 In this thesisthe potential of some quaternaryamine derivativesof the morphinan analoguesdextrorphan, levorphanol, dextromethorphan and levomethorphanas model compoundswas investigatedto study stereoselectivityin hepatic metabolismand transport of cationic drugs.These model compoundspossess a rigid stereochemicalstructure, resulting in major differencesin receptor affinity. We assumedthat the major influenceof the stereochemicalstructure on the receptor level might also causedifferences in carrier-mediatedtransport and biotransformation processes.