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Molina-Oliva M, Martín-Sánchez R, Pastor-Benito E, Soto-Cámara R, Cárdaba-García RM, Thuissard IJ, Fernández-Domínguez JJ, Matellán-Hernández MP, Navalpotro-Pascual S, Morales-Sánchez A. Influence of Previous Mental State on Psychological Outcomes of Spanish Out-of-Hospital Professionals during the COVID-19 Pandemic. Int J Environ Res Public Health 2023; 20:3574. [PMID: 36834266 PMCID: PMC9962449 DOI: 10.3390/ijerph20043574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to describe factors relating to the psychological distress of healthcare workers (HCWs) in Spanish out-of-hospital emergency medical services (EMS), according to the previous or non-use of psychotropic drugs or psychotherapy. A multicentre, cross-sectional descriptive study was designed. The study population were all physicians, nurses, and emergency medical technicians (EMTs) working in any Spanish out-of-hospital EMS between February and April 2021. The main outcomes were the levels of stress, anxiety, depression, and self-efficacy, assessed by DASS-21 and G-SES. Differences in levels of stress, anxiety, depression, and self-efficacy, according to sex, age, previous use of psychotropic drug or psychotherapy, work experience, professional category, type of work, and modification of working conditions were measured using the Student's t-test for independent samples, one-way ANOVA, Pearson's correlation, or 2-factor analysis of covariance. A total of 1636 HCWs were included, of whom one in three had severe mental disorders because of the pandemic. The interaction of the previous or non-use of psychotropic drugs or psychotherapy with the rest of the factors considered did not modify the levels of stress, anxiety, depression, and self-efficacy. However, HCWs with a history of psychotropic drug or psychotherapy use had a more intense negative emotional response and lower self-efficacy, regardless of their sex, professional category, type of work, or change in the working conditions. These HCWs are considered particularly vulnerable to the development or recurrence of new disorders or other comorbidities; therefore, the implementation of monitoring and follow-up strategies should be a priority.
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Affiliation(s)
- María Molina-Oliva
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
| | - Rafael Martín-Sánchez
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Department of Nursing, Faculty of Nursing, University of Valladolid, 47005 Valladolid, Spain
| | - Elena Pastor-Benito
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Emergency Medical Service of Madrid–SUMMA 112, 28045 Madrid, Spain
| | - Raúl Soto-Cámara
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
| | - Rosa M. Cárdaba-García
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Department of Nursing, Faculty of Nursing, University of Valladolid, 47005 Valladolid, Spain
| | - Israel John Thuissard
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
| | - Juan José Fernández-Domínguez
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Emergency Medical Service of Madrid–SUMMA 112, 28045 Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
- Emergency Service, HLA Moncloa University Hospital, 28080 Madrid, Spain
| | - María Paz Matellán-Hernández
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
| | - Susana Navalpotro-Pascual
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Emergency Medical Service of Madrid–SUMMA 112, 28045 Madrid, Spain
- Department of Nursing, Faculty of Medicine, Autonomous University of Madrid, 2029 Madrid, Spain
| | - Almudena Morales-Sánchez
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
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Murakami T, Ishimaru R, Minami E, Iwamuro Y, Takamura N, Torai A, Watanabe T, Miki A, Katagi M, Kusano M, Tsuchihashi H, Zaitsu K, Chinaka S. Development of two fully automated quick, easy, cheap, effective, rugged, and safe pretreatment methods for the extraction of psychotropic drugs from whole blood samples. J Sep Sci 2023; 46:e2200681. [PMID: 36479834 DOI: 10.1002/jssc.202200681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/17/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
Quick, easy, cheap, effective, rugged, and safe extraction strategies are becoming increasingly adopted in various analytical fields to determine drugs in biological specimens. In the present study, we developed two fully automated quick, easy, cheap, effective, rugged, and safe extraction methods based on acetonitrile salting-out assisted liquid-liquid extraction (method 1) and acetonitrile salting-out assisted liquid-liquid extraction followed by dispersive solid-phase extraction (method 2) using a commercially available automated liquid-liquid extraction system. We applied these methods to the extraction of 14 psychotropic drugs (11 benzodiazepines and carbamazepine, quetiapine, and zolpidem) from whole blood samples. Both methods prior to liquid chromatography-tandem mass spectrometry analysis exhibited high linearity of calibration curves (correlation coefficients, > 0.9997), ppt level detection sensitivities, and satisfactory precisions (< 8.6% relative standard deviation), accuracies (within ± 16% relative error), and matrix effects (81-111%). Method 1 provided higher recovery rates (80-91%) than method 2 (72-86%), whereas method 2 provided higher detection sensitivities (limits of detection, 0.003-0.094 ng/mL) than method 1 (0.025-0.47 ng/mL) owing to the effectiveness of its dispersive solid-phase extraction cleanup step. These fully automated extraction methods realize reliable, labor-saving, user-friendly, and hygienic extraction of target analytes from whole blood samples.
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Affiliation(s)
- Takaya Murakami
- Forensic Science Laboratory, Ishikawa Prefectural Police Headquarters, Kanazawa, Japan.,Institute of Science and Engineering, Kanazawa University, Kanazawa, Japan
| | - Reiko Ishimaru
- Forensic Science Laboratory, Ishikawa Prefectural Police Headquarters, Kanazawa, Japan
| | - Eriko Minami
- Forensic Science Laboratory, Ishikawa Prefectural Police Headquarters, Kanazawa, Japan
| | - Yoshiaki Iwamuro
- Forensic Science Laboratory, Ishikawa Prefectural Police Headquarters, Kanazawa, Japan
| | | | - Aya Torai
- Shimadzu Trustech Corporation, Kyoto, Japan
| | | | - Akihiro Miki
- Forensic Science Laboratory, Osaka Prefectural Police Headquarters, Osaka, Japan
| | - Munehiro Katagi
- Department of Legal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Maiko Kusano
- Department of Legal Medicine, Showa University School of Medicine, Tokyo, Japan
| | | | - Kei Zaitsu
- Multimodal Informatics and Wide-data Analytics Laboratory, Department of Computational Systems Biology, Faculty of Biology-Oriented Science and Technology, Kindai University, Wakayama, Japan
| | - Satoshi Chinaka
- Forensic Science Laboratory, Ishikawa Prefectural Police Headquarters, Kanazawa, Japan.,Department of Forensic Medicine and Pathology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
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Cortese M. [An information booklet on psychotropic treatments for child psychiatry patients]. Soins Pediatr Pueric 2023; 44:34-7. [PMID: 36759067 DOI: 10.1016/j.spp.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In the child psychiatry hospital setting, educational approaches and the therapeutic alliance are fundamental principles on which professionals rely on a daily basis. Therapeutic acts, including the administration of psychotropic drugs, are carried out in a specific care area. What about the child's or adolescent's compliance with medication outside this setting? A booklet dedicated to psychotropic treatments, intended for patients and their relatives, has been designed with an informative objective.
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Abstract
The present study aimed to clarify the expressions and roles of clock genes involved in drug metabolism in patients taking benzodiazepines (BZDs), as well as the drug metabolism regulators controlled by clock genes for each BZD type. The relationships between the expressions of the clock genes BMAL1, PER2, and DBP and the drug-metabolizing enzymes CYP3A4 and CYP2C19 were investigated using livers from BZD-detected autopsy cases. In addition, the effect of BZD exposure on various genes was examined in HepG2 human hepatocellular carcinoma cells. The expressions of DBP, CYP3A4, and CYP2C19 in the liver were lower in the diazepam-detected group than in the non-detected group. Furthermore, BMAL1 expression correlated with CYP2C19 expression. Cell culture experiments showed that the expressions of DBP and CYP3A4 decreased, whereas those of BMAL1 and CYP2C19 increased after diazepam and midazolam exposure. The results of the analyses of autopsy samples and cultured cells suggested that DBP regulates CYP3A4 when exposed to BZD. Understanding the relationship between these clock genes and CYPs may help achieve individualized drug therapy.
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Affiliation(s)
- Naoto Tani
- Department of Legal Medicine, Graduate School of Medicine, Osaka Metropolitan University, Abeno, Osaka, Japan
- Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center, C/O Department of Legal Medicine, Graduate School of Medicine, Osaka Metropolitan University, Abeno, Osaka, Japan
| | - Tomoya Ikeda
- Department of Legal Medicine, Graduate School of Medicine, Osaka Metropolitan University, Abeno, Osaka, Japan
- Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center, C/O Department of Legal Medicine, Graduate School of Medicine, Osaka Metropolitan University, Abeno, Osaka, Japan
| | - Takaki Ishikawa
- Department of Legal Medicine, Graduate School of Medicine, Osaka Metropolitan University, Abeno, Osaka, Japan
- Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center, C/O Department of Legal Medicine, Graduate School of Medicine, Osaka Metropolitan University, Abeno, Osaka, Japan
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Akasaka K, Akasaka F, Akasaka T, Okada K, Sadahiro S. Relationship between mental disorders, psychotropic drugs, and constipation in psychiatric outpatients. Medicine (Baltimore) 2022; 101:e30369. [PMID: 36123894 PMCID: PMC9478243 DOI: 10.1097/md.0000000000030369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Constipation has been reported to be more common in patients with mental disorders than in the general population. However, its relationships with psychiatric diagnosis, medication, age, and sex have not been fully identified. A total of 875 patients from the outpatient department were included in the study. As a retrospective observational study, the psychiatric diagnoses and psychotropic medications were examined based on the medical charts. Fecal conditions, including problems with defecation, abdominal pain, sense of incomplete evacuation, use of laxatives, frequency of defecation, and stool characteristics according to the Bristol Scale, were investigated. The study included 368 males and 507 females, with median ages of 48 and 52 years, respectively. The most common psychiatric diagnoses were depressive disorders (33%), followed by anxiety disorders (19%). Females had significantly higher rates of problems with defecation and laxative use than males (P < .001, P < .0001, respectively). The frequency of laxative use increased significantly with age (P < .0001). The multivariate analyses revealed the close relationship between hypnotics and problems of defecation and that between hypnotics, antipsychotics, and laxative use. In psychiatric outpatients, females had significantly higher rates of problems with defecation and laxative use than males. The use of laxatives significantly increased with age. Problems with defecation were significantly more common in patients taking hypnotics and laxative use was significantly more common in patients taking hypnotics and antipsychotics.
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Affiliation(s)
- Kuni Akasaka
- Akebono Clinic, Ishinomaki, Japan
- *Correspondence: Kuni Akasaka, Akebono Clinic, 220 Shinsonedera, Hebita, Ishinomaki, Miyagi 986-0861, Japan (e-mail: )
| | | | | | | | - Sotaro Sadahiro
- Tokai University Hospital, Isehara, Japan
- Kameda Morinosato Hospital, Atsugi, Japan
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Hashimoto M, Maeda H, Oniki K, Yasui-Furukori N, Watanabe H, Saruwatari J, Kadowaki D. New Insight Concerning Therapeutic Drug Monitoring-The Importance of the Concept of Psychonephrology. Biol Pharm Bull 2022; 45:834-842. [PMID: 35786590 DOI: 10.1248/bpb.b22-00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Recently, the concept of psychonephrology was developed and has been recognized as a field of study that focuses on nephrology and mental health fields, such as psychiatry and psychosomatic medicine. Indeed, patients with chronic kidney disease frequently suffer from mental problems as the disease stage progresses. Most psychotropic drugs are hepatically metabolized, but some are unmetabolized and eliminated renally. However, renal disease may affect the pharmacokinetics of many psychotropic drugs, as the decreased renal function not only delays the urinary excretion of the drug and its metabolites but also alters various pharmacokinetic factors, such as protein-binding, enterohepatic circulation, and activity of drug-metabolizing enzymes. Therefore, when prescribing drug therapy for patients with both renal disease and mental issues, we should consider reducing the dosage of psychotropic drugs that are eliminated mainly via the kidney and also carefully monitor the blood drug concentrations of other drugs with a high extrarenal clearance, such as those that are largely metabolized in the liver. Furthermore, we should carefully consider the dialyzability of each psychotropic drug, as the dialyzability impacts the drug clearance in patients with end-stage renal failure undergoing dialysis. Therapeutic drug monitoring (TDM) may be a useful tool for adjusting the dosage of psychotropic drugs appropriately in patients with renal disease. We herein review the pharmacokinetic considerations for psychotropic drugs in patients with renal disease as well as those undergoing dialysis and offer new insight concerning TDM in the field of psychonephrology.
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Affiliation(s)
| | - Hitoshi Maeda
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
| | - Kentaro Oniki
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
| | | | - Hiroshi Watanabe
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
| | - Junji Saruwatari
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
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François B, Gindt M, Askenazy F, Fernandez A. [Child psychiatry in pediatric intensive care unit]. Soins Pediatr Pueric 2022; 43:33-35. [PMID: 35995536 DOI: 10.1016/j.spp.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A study was conducted in the pediatric intensive care and resuscitation unit of the Nice pediatric hospitals, University Hospital Center Lenval (06) from January to March 2015. Its objective was to describe the events and child psychiatric interventions experienced by young patients. Of the 181 individuals managed during the research, 63 met the inclusion criteria.
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Affiliation(s)
- Bérengère François
- Service universitaire de pédiatrie, Centre hospitalier universitaire-Lenval, 57 avenue de la Californie, 06200 Nice, France
| | - Morgane Gindt
- Service universitaire de psychiatrie de l'enfant et de l'adolescent, Hôpitaux pédiatriques de Nice, Centre hospitalier universitaire-Lenval, 57 avenue de la Californie, 06200 Nice, France; Université Côte d'Azur, CoBTek, FRIS, 06108 Nice, France
| | - Florence Askenazy
- Service universitaire de psychiatrie de l'enfant et de l'adolescent, Hôpitaux pédiatriques de Nice, Centre hospitalier universitaire-Lenval, 57 avenue de la Californie, 06200 Nice, France; Université Côte d'Azur, CoBTek, FRIS, 06108 Nice, France
| | - Arnaud Fernandez
- Service universitaire de psychiatrie de l'enfant et de l'adolescent, Hôpitaux pédiatriques de Nice, Centre hospitalier universitaire-Lenval, 57 avenue de la Californie, 06200 Nice, France; Université Côte d'Azur, CoBTek, FRIS, 06108 Nice, France.
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Deters M, Gollmann M, Rau F, Stürzebecher A, Prasa D. Exposures to psycholeptics, psychoanaleptics, and cardiovascular drugs reported to the PIC erfurt during heat waves from 2003 to 2018. J Environ Sci Health A Tox Hazard Subst Environ Eng 2022; 57:155-160. [PMID: 35574595 DOI: 10.1080/10934529.2022.2075214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 06/15/2023]
Abstract
Psycholeptics, psychoanaleptics, and cardiovascular drugs alter individual tolerance to extreme heat. To explore the influence of heat waves on their toxicity in acute overdose, we retrospectively analyzed all human exposures to psycholeptics and psychoanaleptics (PLAexp) as well as cardiovascular drugs (CVDexp) registered by the Poisons Information Center (PIC) Erfurt between June to September of the years 2003 to 2018 for frequency, age groups, sex, circumstances of exposure, and symptom severity. The results of the non-heat years (NHY) 2004-2005 and 2007-2014 (average air temperature June-September 16.2 °C) were compared to the results of the heat years (HY) 2003, 2006 and 2015-2018 (average air temperature June-September 17.5 °C). In total, 13,191 cases (HY 5,117; NHY 8,074) of PLAexp and 2,960 cases (HY 1,168; NHY 1,792) of CVDexp were registered. During HY, accidental PLAexp (11.2% versus 9.7%) and CVDexp (40.6% versus 36.8%) were more often seen. Severe symptoms were less frequent in PLAexp (4.4% versus 6.3%) and CVDexp (3.3% versus 4.9%). Although in HY, no higher rates of moderate or severe PLAexp and CVDexp were detected than in NHY, patients with these medications should be observed carefully during heat waves because of affected body's usual cooling mechanisms.
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Affiliation(s)
| | | | | | | | - Dagmar Prasa
- Poisons Information Center (PIC), Erfurt, Germany
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Benistand P, Vorilhon P, Laporte C, Bouillon-Minois JB, Brousse G, Bagheri R, Ugbolue UC, Baker JS, Flaudias V, Mulliez A, Dutheil F. Effect of the COVID-19 pandemic on the psychotropic drug consumption. Front Psychiatry 2022; 13:1020023. [PMID: 36590615 PMCID: PMC9797694 DOI: 10.3389/fpsyt.2022.1020023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Although the COVID-19 pandemic has had a negative impact on mental health, there is no comprehensive longitudinal study of the entire population of a country without selection bias. OBJECTIVE The objective of this study was to evaluate the prescription of psychotropic drugs during the COVID-19 pandemic, using data from the French national health data system (SNDS). DESIGN SETTINGS AND PARTICIPANTS Prescriptions for psychotropic drugs (antidepressants, anxiolytics, hypnotics, and antipsychotics) from 1 January 2015 to 30 September 2021 were collected from administrative data provided by the SNDS. This database includes more than 99% of the French population, i.e., 67 million people. The data were analyzed using an interrupted time series analysis (ITSA) model. MAIN OUTCOMES AND MEASURES Consumption of psychotropic drugs was aggregated in months and expressed in number of boxes per thousand inhabitants. RESULTS During the study period, more than 1.3 billion boxes of psychotropic medications were dispensed. Comparison of psychotropic drug dispensing before and after the pandemic showed a relative increase of 0.76 (95 CI 0.57 to 0.95, p<0.001) boxes per month per thousand inhabitants, all classes of psychotropic drugs combined. Three classes saw their consumption increase in an almost similar proportion, respectively, by 0.23 (0.15 to 0.32, p<0.001) boxes for antidepressants, 0.27 (0.20 to 0.34, p<0.001) boxes for anxiolytics and 0.23 (0.17 to 0.30, p<0.001) boxes for hypnotics. The change in antipsychotic consumption was very small, with an increase of 0.04 boxes (0.02 to 0.06, p = 0.001) per month per thousand population. CONCLUSION AND RELEVANCE The COVID-19 pandemic had led to an increase in the consumption of psychotropic drugs, confirming the significant impact of the pandemic on the mental health of the general population.
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Affiliation(s)
- Paul Benistand
- Département de Médecine Générale, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Philippe Vorilhon
- Research Unit AutomédiCation aCcompagnement Pluriprofessionnel PatienT (ACCePPT), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Catherine Laporte
- Clermont Auvergne INP, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, Centre National de Recherche Scientifique (CNRS), Institut Pascal, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jean-Baptiste Bouillon-Minois
- Centre National de Recherche Scientifique (CNRS), Laboratoire de Psychologie Sociale et Cognitive (LaPSCo), Physiological and Psychosocial Stress, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, WittyFit, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Georges Brousse
- Clermont Auvergne INP, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, Centre National de Recherche Scientifique (CNRS), Institut Pascal, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Ukadike Chris Ugbolue
- School of Health and Life Sciences, University of the West of Scotland, Glasgow, United Kingdom
| | - Julien S Baker
- Department of Physical Education and Health, Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Valentin Flaudias
- Laboratoire de Psychologie des Pays de la Loire, Université de Nantes, Nantes, France
| | - Aurélien Mulliez
- Direction de la Recherche Clinique et Innovations Biostatistics, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, Clermont-Ferrand, France
| | - Frédéric Dutheil
- Centre National de Recherche Scientifique (CNRS), Laboratoire de Psychologie Sociale et Cognitive (LaPSCo), Physiological and Psychosocial Stress, Centre Hospitalo-Universitaire (CHU) Clermont-Ferrand, WittyFit, Université Clermont Auvergne, Clermont-Ferrand, France
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Bildziukevich U, Kvasnicová M, Šaman D, Rárová L, Wimmer Z. Novel Oleanolic Acid-Tryptamine and -Fluorotryptamine Amides: From Adaptogens to Agents Targeting In Vitro Cell Apoptosis. Plants (Basel) 2021; 10:plants10102082. [PMID: 34685891 PMCID: PMC8540097 DOI: 10.3390/plants10102082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/23/2021] [Accepted: 09/28/2021] [Indexed: 12/29/2022]
Abstract
Background: Oleanolic acid is a natural plant adaptogen, and tryptamine is a natural psychoactive drug. To compare their effects of with the effect of their derivatives, tryptamine and fluorotryptamine amides of oleanolic acid were designed and synthesized. Methods: The target amides were investigated for their pharmacological effect, and basic supramolecular self-assembly characteristics. Four human cancer cell lines were involved in the screening tests performed by standard methods. Results: The ability to display cytotoxicity and to cause selective cell apoptosis in human cervical carcinoma and in human malignant melanoma was seen with the three most active compounds of the prepared series of compounds. Tryptamine amide of (3β)-3-(acetyloxy)olean-12-en-28-oic acid (3a) exhibited cytotoxicity in HeLa cancer cell lines (IC50 = 8.7 ± 0.4 µM) and in G-361 cancer cell lines (IC50 = 9.0 ± 0.4 µM). Fluorotryptamine amides of (3β)-3-(acetyloxy)olean-12-en-28-oic acid (compounds 3b and 3c) showed cytotoxicity in the HeLa cancer cell line (IC50 = 6.7 ± 0.4 µM and 12.2 ± 4.7 µM, respectively). The fluorotryptamine amide of oleanolic acid (compound 4c) displayed cytotoxicity in the MCF7 cancer cell line (IC50 = 13.5 ± 3.3 µM). Based on the preliminary UV spectra measured in methanol/water mixtures, the compounds 3a–3c were also found to self-assemble into supramolecular systems. Conclusions: An effect of the fluorine atom present in the molecules on self-assembly was observed with 3b. Enhanced cytotoxicity has been achieved in 3a–4c in comparison with the effect of the parent oleanolic acid (1) and tryptamine. The compounds 3a–3c showed a strong induction of apoptosis in HeLa and G-361 cells after 24 h.
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Affiliation(s)
- Uladzimir Bildziukevich
- Isotope Laboratory, Institute of Experimental Botany of the Czech Academy of Sciences, Vídeňská 1083, CZ-14220 Prague, Czech Republic;
- Department of Chemistry of Natural Compounds, University of Chemistry and Technology in Prague, Technická 5, CZ-16628 Prague, Czech Republic
| | - Marie Kvasnicová
- Department of Experimental Biology, Faculty of Science, Palacký University, Šlechtitelů 27, CZ-78371 Olomouc, Czech Republic;
- Laboratory of Growth Regulators, Institute of Experimental Botany of the Czech Academy of Sciences, Faculty of Science, Palacký University, Šlechtitelů 27, CZ-78371 Olomouc, Czech Republic
| | - David Šaman
- Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Flemingovo náměstí 2, CZ-16610 Prague, Czech Republic;
| | - Lucie Rárová
- Department of Experimental Biology, Faculty of Science, Palacký University, Šlechtitelů 27, CZ-78371 Olomouc, Czech Republic;
- Correspondence: (L.R.); or (Z.W.)
| | - Zdeněk Wimmer
- Isotope Laboratory, Institute of Experimental Botany of the Czech Academy of Sciences, Vídeňská 1083, CZ-14220 Prague, Czech Republic;
- Department of Chemistry of Natural Compounds, University of Chemistry and Technology in Prague, Technická 5, CZ-16628 Prague, Czech Republic
- Correspondence: (L.R.); or (Z.W.)
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Duchesne J, Laflamme L, Lu L, Lagarde E, Möller J. Post-injury benzodiazepine and opioid use among older adults involved in road traffic crashes: A Swedish register-based longitudinal study. Br J Clin Pharmacol 2021; 88:764-772. [PMID: 34331716 DOI: 10.1111/bcp.15019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 06/15/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022] Open
Abstract
AIM Psychotropic drugs like opioids and benzodiazepines are prescribed for traumas resulting from road traffic crashes and the risk of developing an addiction deserves consideration. This study aims to shed light on how the consumption of those drugs evolves over time among older road traffic injury (RTI) victims. METHODS We conducted a nationwide Swedish register-based longitudinal study to identify trajectories of post-RTI psychotropic drug use. All individuals aged 50 years and older who had a hospital visit for an RTI from 2007 to 2015 were followed up during a 2-year period; those who used the drugs prior to the RTI were excluded. Trajectories were identified by performing latent class trajectory analysis on drug dispensation data for opioids and benzodiazepines separately (66 034 and 66 859 adults, respectively, in total). RESULTS Three trajectories were identified for opioids and four for benzodiazepines. The largest group in both instances included people with no-use/minimal use throughout the follow-up (81.3% and 92.8%). "Sporadic users" were more frequent among users of opioids (16.7%) than benzodiazepines (4.3%), whereas "chronic users" were found in similar proportions (2.0% and 1.8%). "Delayed chronic use" characterized the fourth group of benzodiazepine users (1.0%). CONCLUSION Several trajectories of psychotropic drug use were identified after RTI, from limited to chronic. Although chronic use was uncommon, a better understanding of the factors likely to increase that risk is warranted given the seriousness of the problem.
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Affiliation(s)
- Jeanne Duchesne
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Institut de Santé Publique, d'Epidémiologie et de Développement, Université de Bordeaux, Bordeaux, France.,Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France
| | - Lucie Laflamme
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Li Lu
- Institut de Santé Publique, d'Epidémiologie et de Développement, Université de Bordeaux, Bordeaux, France.,Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France
| | - Emmanuel Lagarde
- Institut de Santé Publique, d'Epidémiologie et de Développement, Université de Bordeaux, Bordeaux, France.,Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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12
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Franck MC, Monteiro MG, Limberger RP. [Toxicology of suicide cases in the state of Rio Grande do Sul, Brazil, 2017 to 2019Perfil toxicológico de los casos de suicidio en Rio Grande do Sul (Brasil), 2017-2019]. Rev Panam Salud Publica 2021; 45:e28. [PMID: 33727909 PMCID: PMC7954196 DOI: 10.26633/rpsp.2021.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 12/07/2020] [Indexed: 01/08/2023] Open
Abstract
Objetivo. Descrever o perfil toxicológico de todas as vítimas de suicídio no Rio Grande do Sul, Brasil, de 2017 a 2019. Métodos. Neste estudo descritivo e transversal, foram consultados todos os laudos periciais e as ocorrências policiais relacionados aos óbitos por suicídio no estado. Foram realizadas análises de correspondência múltipla e construídos modelos independentes de regressão logística, tendo como variáveis dependentes o etanol, os ansiolíticos, os antidepressivos, as substâncias ilícitas e os agentes tóxicos não medicamentosos. Resultados. Foram realizados 2 978 exames de alcoolemia, com resultado positivo em 28,5%. A chance de resultados positivos para alcoolemia foi 0,5 (IC95%: 1,1 a 2,2) vez maior para suicídio durante a noite, 1,0 (IC95%: 1,4 a 2,9) vez maior para suicídio aos finais de semana e 0,9 (IC95%: 1,3 a 2,7) vez maior na presença de antecedentes criminais. A pesquisa de psicotrópicos (2 900 amostras) detectou algum medicamento em 30,4%. Os ansiolíticos foram a classe mais frequente, com chance 1,5 (IC95%: 1,6 a 4,1) vez maior em mulheres e 0,8 (IC95%: 1,2 a 2,7) vez maior para suicídios ocorridos no outono-inverno. As substâncias ilícitas (n = 338) tiveram chance 4,1 (IC95%: 1,9 a 14,4) vezes maior de detecção na macrorregião de Pelotas em relação à de Passo Fundo e 1,2 (IC95%: 1,3 a 3,6) vez maior em pessoas com resultados positivos para etanol. Não houve diferença significativa entre adolescentes e adultos. Conclusões. Embora sem evidência de causalidade, os resultados mostram um vínculo entre o suicídio e diversos psicoativos. Os médicos legistas devem ser orientados quanto à necessidade de realização de exames toxicológicos em todos os casos de suicídio.
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Affiliation(s)
- Maria Cristina Franck
- Instituto-Geral de Perícias do Rio Grande do Sul (IGP-RS), Departamento de Perícias Laboratoriais Porto Alegre (RS) Brasil Instituto-Geral de Perícias do Rio Grande do Sul (IGP-RS), Departamento de Perícias Laboratoriais, Porto Alegre (RS), Brasil
| | - Maristela Goldnadel Monteiro
- Pan American Health Organization (PAHO), Noncommunicable Diseases and Mental Health Washington, D.C. Estados Unidos Pan American Health Organization (PAHO), Noncommunicable Diseases and Mental Health, Washington, D.C., Estados Unidos
| | - Renata Pereira Limberger
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Farmacêuticas Porto Alegre (RS) Brasil Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Farmacêuticas, Porto Alegre (RS), Brasil
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13
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Varalda M, Antona A, Bettio V, Roy K, Vachamaram A, Yellenki V, Massarotti A, Baldanzi G, Capello D. Psychotropic Drugs Show Anticancer Activity by Disrupting Mitochondrial and Lysosomal Function. Front Oncol 2020; 10:562196. [PMID: 33194631 PMCID: PMC7604408 DOI: 10.3389/fonc.2020.562196] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/15/2020] [Indexed: 12/24/2022] Open
Abstract
Background and Purpose: Drug repositioning is a promising strategy for discovering new therapeutic strategies for cancer therapy. We investigated psychotropic drugs for their antitumor activity because of several epidemiological studies reporting lower cancer incidence in individuals receiving long term drug treatment. Experimental Approach: We investigated 27 psychotropic drugs for their cytotoxic activity in colorectal carcinoma, glioblastoma and breast cancer cell lines. Consistent with the cationic amphiphilic structure of the most cytotoxic compounds, we investigated their effect on mitochondrial and lysosomal compartments. Results: Penfluridol, ebastine, pimozide and fluoxetine, fluspirilene and nefazodone showed significant cytotoxicity, in the low micromolar range, in all cell lines tested. In MCF7 cells these drugs caused mitochondrial membrane depolarization, increased the acidic vesicular compartments and induced phospholipidosis. Both penfluridol and spiperone induced AMPK activation and autophagy. Neither caspase nor autophagy inhibitors rescued cells from death induced by ebastine, fluoxetine, fluspirilene and nefazodone. Treatment with 3-methyladenine partially rescued cell death induced by pimozide and spiperone, whereas enhanced the cytotoxic activity of penfluridol. Conversely, inhibition of lysosomal cathepsins significantly reduced cell death induced by ebastin, penfluridol, pimozide, spiperone and mildly in fluoxetine treated cells. Lastly, Spiperone cytotoxicity was restricted to colorectal cancer and breast cancer and caused apoptotic cell death in MCF7 cells. Conclusions: The cytotoxicity of psychotropic drugs with cationic amphiphilic structures relied on simultaneous mitochondrial and lysosomal disruption and induction of cell death that not necessarily requires apoptosis. Since dual targeting of lysosomes and mitochondria constitutes a new promising therapeutic approach for cancer, particularly those in which the apoptotic machinery is defective, these data further support their clinical development for cancer therapy.
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Affiliation(s)
- Marco Varalda
- Department of Translational Medicine, Centre of Excellence in Aging Sciences, University of Piemonte Orientale, Novara, Italy.,UPO Biobank, University of Piemonte Orientale, Novara, Italy
| | - Annamaria Antona
- Department of Translational Medicine, Centre of Excellence in Aging Sciences, University of Piemonte Orientale, Novara, Italy
| | - Valentina Bettio
- Department of Translational Medicine, Centre of Excellence in Aging Sciences, University of Piemonte Orientale, Novara, Italy.,UPO Biobank, University of Piemonte Orientale, Novara, Italy
| | - Konkonika Roy
- Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), University of Piemonte Orientale, Novara, Italy
| | - Ajay Vachamaram
- Department of Translational Medicine, Centre of Excellence in Aging Sciences, University of Piemonte Orientale, Novara, Italy.,Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), University of Piemonte Orientale, Novara, Italy
| | - Vaibhav Yellenki
- Department of Translational Medicine, Centre of Excellence in Aging Sciences, University of Piemonte Orientale, Novara, Italy
| | - Alberto Massarotti
- Department Pharmaceutical Sciences, University of Piemonte Orientale, Novara, Italy
| | - Gianluca Baldanzi
- Department of Translational Medicine, Centre of Excellence in Aging Sciences, University of Piemonte Orientale, Novara, Italy.,Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), University of Piemonte Orientale, Novara, Italy
| | - Daniela Capello
- Department of Translational Medicine, Centre of Excellence in Aging Sciences, University of Piemonte Orientale, Novara, Italy.,UPO Biobank, University of Piemonte Orientale, Novara, Italy
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14
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Hughes KL, Roberts G. Who is prescribing psychotropic medications in a public developmental-behavioural clinical service and how often? J Paediatr Child Health 2020; 56:532-536. [PMID: 31721351 DOI: 10.1111/jpc.14676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/15/2019] [Accepted: 10/14/2019] [Indexed: 11/29/2022]
Abstract
AIM Psychotropic prescribing by paediatricians is increasingly common, and there is considerable variation in care provided. The aims of this study were to examine current rates of psychotropic prescribing in the developmental-behavioural outpatient clinics at the Royal Children's Hospital's Centre for Community Child Health, and to compare rates between paediatric consultants and advanced trainees. METHODS Data were extracted for appointment encounters from electronic medical records across 12 months in 2017. Patient demographics, provider and medication order data were analysed using Excel and STATA to calculate logistic regression, standard deviation, percentages and means. RESULTS From 5069 encounters, there were 847 (16.7%) that included psychotropic prescribing. Advanced trainees prescribed psychotropic medications in only 4.4% of their encounters compared with consultants who prescribed these medications in 23% of encounters (P < 0.001). Stimulants were the most commonly prescribed psychotropic medication (62%), either alone (86.3%) or in combination (13.7%). CONCLUSIONS Psychotropic prescribing rates were lower than expected. Advanced trainees may need more experience in psychotropic prescribing.
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Affiliation(s)
- Katherine L Hughes
- Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Gehan Roberts
- Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.,Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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15
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Hata T, Kanenishi K, AboEllail MAM, Mori N, Koyano K, Kato I, Kusaka T. Effect of psychotropic drugs on fetal behavior in the third trimester of pregnancy. J Perinat Med 2019; 47:207-211. [PMID: 29894302 DOI: 10.1515/jpm-2018-0114] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 05/19/2018] [Indexed: 11/15/2022]
Abstract
AIM To assess the effect of psychotropic drugs on fetal behavior using four-dimensional (4D) ultrasound in the third trimester of pregnancy. METHODS Fetal behavior was assessed using Kurjak's antenatal neurodevelopmental test (KANET) using 4D ultrasound between 28 and 36 weeks of gestation. Thirty healthy (control group) and 10 psychotropic-drug-administered pregnant (case group) women were studied. The total value of the KANET score and values of each parameter (eight parameters) were compared between the two groups. RESULTS The total KANET score was normal (except for one fetus in the case group: total score of 9) in both groups, and there was no significant difference in the total KANET score. When individual KANET parameters were compared, no significant differences were noted in any of the eight parameters. CONCLUSION Our results showed that there is no difference in fetal behavior between fetuses of normal pregnant women and those of psychotropic-drug-administered pregnant women in the third trimester of pregnancy. These results suggest that psychotropic drugs may not affect fetal behavioral development in utero. However, the data and their interpretation in the present study should be taken with some degree of caution because of the small number of subjects studied. Further studies involving a larger sample size are needed to assess the effect of psychotropic drugs on fetal neurobehavior during pregnancy.
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Affiliation(s)
- Toshiyuki Hata
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan
| | - Kenji Kanenishi
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan
| | - Mohamed Ahmed Mostafa AboEllail
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan
| | - Nobuhiro Mori
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan
| | - Kosuke Koyano
- Department of Pediatrics, Kagawa University Graduate School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan
| | - Ikuko Kato
- Department of Pediatrics, Kagawa University Graduate School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan
| | - Takashi Kusaka
- Department of Pediatrics, Kagawa University Graduate School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan
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16
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Prajapati AR, Dima AL, Clark AB, Gant C, Gibbons C, Gorrod R, Mosa G, Scott S, Song F, Teague B, Twigg MJ, Wilson J, Bhattacharya D. Mapping of modifiable barriers and facilitators of medication adherence in bipolar disorder to the Theoretical Domains Framework: a systematic review protocol. BMJ Open 2019; 9:e026980. [PMID: 30760516 PMCID: PMC6377513 DOI: 10.1136/bmjopen-2018-026980] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION People with bipolar disorder require long-term treatment but it is estimated that 40% of these people do not adhere to prescribed medication regimens. Non-adherence increases the risk of relapse, hospitalisation and suicide. Some evidence syntheses report barriers to mental health treatment adherence but rarely delineate between modifiable and non-modifiable barriers. They also fail to distinguish between the patients' perspective and that of other stakeholders such as clinicians despite of their different understanding and priorities about adherence. Facilitators of adherence, which are also important for informing adherence intervention design, are also lacking from syntheses and few syntheses focus on medications for bipolar disorder.This systematic review aims to identify modifiable barriers and facilitators (determinants) of medication adherence in bipolar disorder. We also plan to report determinants of medication adherence from perspectives of patients, carers, healthcare professionals and other third parties. A unique feature of this systematic review in the context of mental health is the use of the Theoretical Domains Framework (TDF) to organise the literature identified determinants of medication adherence. METHODS AND ANALYSIS The protocol adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and ENhancing Transparency in REporting the synthesis of Qualitative research (ENTREQ) guidelines. This review will include both qualitative and quantitative primary studies exploring determinants of medication adherence in bipolar disorder. We will search the following databases using a preplanned strategy: CINAHL, Cochrane Library (CENTRAL), Embase, LiLACS, Medline, PsychINFO, PubMed without date restrictions. We will report the quality of included studies. We will use framework synthesis using the TDF as an a priori 'framework'. We will map the literature identified modifiable determinants to the domains of TDF. ETHICS AND DISSEMINATION Ethical approval is not required as primary data will not be collected. The results will be disseminated through a peer-reviewed publication. PROSPERO REGISTRATION NUMBER CRD42018096306.
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Affiliation(s)
- Asta Ratna Prajapati
- Pharmacy, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
- School of Pharmacy, University of East Anglia, Norwich, UK
| | | | | | - Claire Gant
- Patient and Carer Representatives, Norwich, UK
| | - Chris Gibbons
- Faculty of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | | | - George Mosa
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Sion Scott
- School of Pharmacy, University of East Anglia, Norwich, UK
| | | | - Bonnie Teague
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | | | - Jon Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
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17
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Iwata M, Iwamoto K, Kawano N, Kawaue T, Ozaki N. Evaluation method regarding the effect of psychotropic drugs on driving performance: A literature review. Psychiatry Clin Neurosci 2018; 72:747-773. [PMID: 29962103 DOI: 10.1111/pcn.12734] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2018] [Indexed: 12/31/2022]
Abstract
Although automobile driving is necessary for many people, including patients with mental disorders, the influence of psychotropic drugs on driving performance remains unclear and requires scientific verification. Therefore, the objective of this study was to conduct a review of the literature in order to aid the development of a valid evaluation method regarding the influence of medication on driving performance. We conducted a literature search using two sets of terms on PubMed. One set was related to psychotropic drugs, and the other to driving tests. We excluded reviews and case studies and added literature found on other sites. A total of 121 relevant reports were found. The experiments were roughly divided into on-the-road tests (ORT) and driving simulators (DS). Although highway driving tests in ORT are most often used to evaluate driving performance, DS are becoming increasingly common because of their safety and low cost. The validity of evaluation methods for alcohol should be verified; however, we found that there were few validated tests, especially for DS. The scenarios and measurement indices of each DS were different, which makes it difficult to compare the results of DS studies directly. No evaluation indices, except for SD of lateral position, were sufficiently validated. Although highway ORT are the gold standard, DS were shown to have an increasing role in evaluating driving performance. The reliability of DS needs to be established, as does their validation with alcohol in order to accumulate more high-quality evidence.
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Affiliation(s)
- Mari Iwata
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, Nagoya, Japan
| | - Kunihiro Iwamoto
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, Nagoya, Japan
| | - Naoko Kawano
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, Nagoya, Japan.,Institutes of Innovation for Future Society, Nagoya University, Nagoya, Japan
| | - Takumi Kawaue
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, Nagoya, Japan
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18
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Abstract
The use of pharmacogenetic tests was already being proposed in psychiatry in the early 2000s because genetic factors were known to influence drug pharmacokinetics and pharmacodynamics. However, sufficient levels of evidence to justify routine use have been achieved for only a few tests (eg, major histocompatibility complex, class I, B, allele 1502 [HLA-B*1502] for carbamazepine in epilepsy and bipolar disorders); many findings are too preliminary or, when replicated, of low clinical relevance because of a small effect size. Although drug selection and dose adaptation according to cytochrome P450 genotypes are sound, a large number of patients need to be genotyped in order to prevent one case of severe side effect and/or nonresponse. The decrease in cost for genetic analysis shifts the cost: benefit ratio toward increasing use of pharmacogenetic tests. However, they have to be combined with careful clinical evaluations and other tools (eg, therapeutic drug monitoring and phenotyping) to contribute to the general aim of providing the best care for psychiatric patients.
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Affiliation(s)
- Chin B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland; School of Pharmacy, Department of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
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19
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Ndukwe HC, Wang T, Tordoff JM, Croucher MJ, Nishtala PS. Geographic variation in psychotropic drug utilisation among older people in New Zealand. Australas J Ageing 2016; 35:242-248. [PMID: 26991493 DOI: 10.1111/ajag.12298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To examine psychotropic drug utilisation in older people in New Zealand by age, sex, health board domicile and deprivation status. METHODS A repeated cross-sectional analysis of population-based drug utilisation data stratified by age, sex, ethnicity, health board and deprivation status was conducted from 2005 to 2013. RESULTS Psychotropic utilisation increased between 2005 and 2013 (ranging from 7.0 to 74.0%) across all the health boards. In people aged 85 years and above, the hypnotic and sedative prevalence ratio compared to the 65- to 69-year age group was 1.45 (95% CI 1.44, 1.46). Between 2005 and 2013, the antidepressants prevalence ratio increased (1.27 (95% CI 1.22, 1.33)) relative to anxiolytics. CONCLUSIONS Overall psychotropic drug utilisation increased over time. Despite safety concerns, hypnotic and sedative utilisation increased in the oldest vulnerable group. Shifts from anxiolytics to antidepressants in some health boards were consistent with guidelines for extended indications of antidepressant drug use.
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Affiliation(s)
- Henry C Ndukwe
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Ting Wang
- Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand
| | - June M Tordoff
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Matthew J Croucher
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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20
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Carrasco-Garrido P, Hernández-Barrera V, Jiménez-Trujillo I, Esteban-Hernández J, Álvaro-Meca A, López-de Andrés A, DelBarrio-Fernández JL, Jiménez-García R. Time Trend in Psychotropic Medication Use in Spain: A Nationwide Population-Based Study. Int J Environ Res Public Health 2016; 13:ijerph13121177. [PMID: 27886138 PMCID: PMC5201318 DOI: 10.3390/ijerph13121177] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 11/10/2016] [Accepted: 11/22/2016] [Indexed: 11/24/2022]
Abstract
Background: We performed an epidemiologic study to analyze nationwide time trends in adult psychotropic drug use over a period from 2006 to 2012, and to identify those factors associated with the likelihood of consumption of these drugs during the study period; Methods: Cross-sectional study on psychotropic medication in the Spanish adult population. We used secondary individualized data drawn from the 2006 and 2012 Spanish National Health Surveys (SNHS). The dependent variable was the use of psychotropic drugs in the previous two weeks. Independent variables included socio-demographic characteristics, comorbidity, lifestyles and healthcare resource utilization. Using logistic multivariate regression models, we analyzed the temporal evolution of psychotropic medication consumption between 2006 and 2012 in both sexes; Results: The prevalence of psychotropic drug use was significantly greater in women (18.14% vs. 8.08% in 2012 (p < 0.05). In Spanish women, the variables associated with a greater probability of psychotropic use were, age, unemployment (adjusted odds ratio (AOR), 1.60; 95% CI, 1.24–2.07), negative perception of health or taking non-psychotropic drugs. Among men, psychotropic use is associated with presence of chronic disease, negative perception of health (AOR, 3.27; 95% CI, 2.62–4.07 in 2012) or inactive status; Conclusions: Between 2006 and 2012, the probability of having taken psychotropic drugs increased by 16% among women. Unemployed women aged ≥45 years with a negative perception of their health constitute a clear risk profile in terms of psychotropic drug use. Inactive men who have a negative perception of their health are the group most likely to consume psychotropic drugs.
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Affiliation(s)
- Pilar Carrasco-Garrido
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón 28922, Spain.
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón 28922, Spain.
| | - Isabel Jiménez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón 28922, Spain.
| | - Jesús Esteban-Hernández
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón 28922, Spain.
| | - Alejandro Álvaro-Meca
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón 28922, Spain.
| | - Ana López-de Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón 28922, Spain.
| | - José Luis DelBarrio-Fernández
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón 28922, Spain.
| | - Rodrigo Jiménez-García
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón 28922, Spain.
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Abstract
The authors used a population-based database to investigate antidepressant use among children and adolescents in Taiwan. The National Health Research Institutes provided a database of 1 000 000 random subjects for study. The authors adopted this sample of subjects who were younger than 18 years during 1997 to 2005. Subjects with at least 1 antidepressant prescription were identified. Trends, prevalence, associated factors, and disease patterns of antidepressant use were detected. The 1-year prevalence of pediatric antidepressant use increased from 0.27% in 1997 to 0.47% in 2005. The 1-year prevalence of tricyclic antidepressant, selective serotonin reuptake inhibitor, and other antidepressant use among pediatric population was 0.23%, 0.20%, and 0.08%, respectively, in 2005. The prevalence of pediatric antidepressant use increased from 1997 to 2005. Among pediatric subjects with antidepressant use, selective serotonin reuptake inhibitors, and other antidepressants were used the most for psychiatric disorders, whereas tricyclic antidepressant was used the most for nonpsychiatric disorders.
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Affiliation(s)
- I-Chia Chien
- Department of Health, Taoyuan Mental Hospital, 71 Longshow Street, Taoyuan, Taiwan.
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22
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Abstract
The response to a psychotropic medication reflects characteristics of both the medication and the substrate, ie, the individual receiving the medication. Sex is an individual characteristic that influences all elements of the pharmacokinetic process - absorption, distribution, metabolism, and elimination. The effects of sex on these components of the pharmacokinetic process often counterbalance one another to yield minimal or varying sexual differences in blood levels achieved. However, sex also appears to influence pharmacodynamics, the tissue response to a given level of medication. Consideration by the practitioner of sex as a possible contributing factor to treatment nonresponse will enhance the efficacy and precision of clinical interventions.
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Affiliation(s)
- David R Rubinow
- Behavioral Endocrinology Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Md, USA
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23
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Abstract
Conventional psychiatric diagnosis is founded on symptom description; this then governs the choice of psychotropic medication. This purely descriptive approach resembles a description of diphtheria from the premicrobiology era. Based on current advances in basic and clinical neuroscience, we propose inserting an intermediate level of analysis between psychiatric symptoms and pharmacologic modes of action. Paradigm 1 is to analyze psychiatric symptoms in terms of which higher brain function(s) is (are) abnormal, ie, symptoms should be analyzed as higher brain dysfunction: a case study in obsessive-compulsive disorder reveals pointers in four common symptoms to the higher functions of working memory, emotional overlay, absence of voluntary control, and the ability to evaluate personal mental phenomena. Paradigm 2 is to view psychotropic drugs as modifying normal higher brain functions, rather than merely treating symptoms, which they do only secondarily: thus depression may respond to agents that act on related aspects of mental life derived from higher brain functions, eg, the ability to enhance bonding. We advocate a strategy in which psychiatric illness is progressively reclassified through knowledge in clinical neuroscience and treatment targets are revised accordingly.
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Affiliation(s)
- P Schulz
- Clinical Psychopharmacology Unit, Department of Psychiatry, Geneva University Hospitals, Chêne-Bourg, Switzerland
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24
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Abstract
AIMS The purpose of this study was to examine the long-term effects of baclofen in a large cohort of alcohol-dependent patients compliant to baclofen treatment. METHODS A hundred patients with alcohol dependence, resistant to usual treatments, were treated with escalating doses of baclofen (no superior limit). Alcohol consumption (in grams) and craving for alcohol were assessed before treatment and at 3, 6, 12, and 24 months. Assessments were simply based on patients' statements. The outcome measure was the consumption of alcohol, rated according to the World Health Organization criteria for risk of chronic harm. RESULTS While all patients were rated "at high risk" at baseline, approximately half of them were rated "at low risk" at 3, 6, 12, and 24 months. The sum of patients who were at "low risk" and at "moderate risk" (improved patients) was 84% at 3 months, 70% at 6 months, 63% at 1 year, and 62% at 2 years. The constancy of improvement over the 2-years was remarkable. The average maximal dose of baclofen taken was 147 mg/day. Ninety-two percentage of patients reported that they experienced the craving-suppressing effect of baclofen. Significant relationships were found between the amount in grams of alcohol taken before treatment and the maximal dose of baclofen required, and between the existence of a mental disorder and a lesser effect of baclofen. CONCLUSION Baclofen produces an effortless decrease or suppression of alcohol craving when it is prescribed with no superior limit of dose. Potential limitations in the effectiveness of baclofen include the coexistence of a mental disorder, the concomitant use of other psychotropic drugs, a lack of real motivation in patients to stop drinking, and the impossibility to reach the optimal dose of baclofen because of unbearable side-effects (sometimes possibly related to too sharp a protocol of dose escalation).
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