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Goodarzi S, Teymouri Athar MM, Beiky M, Fathi H, Nakhaee Z, Omran SP, Shafiee A. Effect of physical activity for reducing anxiety symptoms in older adults: a meta-analysis of randomized controlled trials. BMC Sports Sci Med Rehabil 2024; 16:153. [PMID: 39014515 PMCID: PMC11251295 DOI: 10.1186/s13102-024-00947-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/09/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Anxiety symptoms in older adults can significantly impact their well-being. Physical activity is increasingly recognized as a potential intervention to alleviate anxiety in this population. We conducted a systematic review and meta-analysis to explore the impact of physical activity on anxiety symptoms in geriatric individuals. METHODS A systematic search was conducted in MEDLINE (via PubMed), Scopus, and Embase databases until November 29, 2023. Two independent reviewers screened articles based on predefined inclusion criteria. RESULTS Eleven randomized controlled trials were included. These trials, involving 770 geriatric participants, demonstrated a significant overall effect of physical activity on reducing anxiety symptoms (SMD =-0.60, 95% CI: -0.88 to -0.32). Subgroup analysis based on type of intervention and duration of follow-up was performed. The results showed all types of exercises reduced anxiety symptoms compared to the control group. Furthermore, those studies with shorter follow-up (less than 10 weeks) did not show a statistically significant reduction in anxiety symptoms. Moderate heterogeneity was observed (I2 = 67%). Sensitivity analyses confirmed the robustness of the overall effect size. Funnel plot inspection and Egger's test (p = 0.36) suggested no signs of publication bias or small study effects. CONCLUSION This meta-analysis provides strong evidence that physical activity significantly reduces anxiety symptoms in older adults. The study highlights the differential effects of cardio and strength exercises and underscores the high quality of evidence supporting the anxiolytic benefits of physical activity in geriatric populations.
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Affiliation(s)
- Saba Goodarzi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran
| | | | - Maryam Beiky
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran
| | - Hanieh Fathi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran
| | - Zahra Nakhaee
- School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | | | - Arman Shafiee
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran.
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Hassan Abad, Karaj, Alborz Province, Iran.
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Balietti M, Principi E, Giacomini L, Giorgetti B, Conti F. The effect of late-life environmental enrichment on stress and anxiety: The role of sex and age-related differences in coping with aversive stimuli. Heliyon 2024; 10:e32021. [PMID: 38867995 PMCID: PMC11168381 DOI: 10.1016/j.heliyon.2024.e32021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/08/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024] Open
Abstract
Anxiety significantly diminishes the quality of life in older adults, and the drugs used for its treatment often come with risky side effects. Non-pharmacological protocols could be valuable, but more research is needed in this area. Environmental enrichment induces positive effects on anxiety-like behavior in young and adult animals; whether the same happens in aged animals is still elusive. The aged brain undergoes changes that contribute to make it "fragile" and consequently even mild, potentially positive stimuli can trigger dyshomeostasis, worsening rather than ameliorating functioning. Here, by combining behavioral analysis and measurement of serum and brain corticosterone levels, we show that late-life environmental enrichment can induce eustress or distress, depending on sex and hypothalamic-pituitary-adrenal axis function. These findings pave the way for optimizing outcomes and minimizing undesired effects in the clinical setting, underscoring the need to overcome the limits of gender medicine and emphasizing the crucial role of individually tailored therapies.
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Affiliation(s)
- Marta Balietti
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
| | - Elisa Principi
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Luca Giacomini
- Center for Animal Welfare, Università Politecnica delle Marche, Ancona, Italy
| | | | - Fiorenzo Conti
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
- Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
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Antoniadou E, Giusti E, Capodaglio P, Han DS, Gimigliano F, Guzman JM, Oh-Park M, Frontera W. Frailty recommendations and guidelines: an evaluation of the implementability and a critical appraisal of clinical applicability by the ISPRM Frailty Focus Group. Eur J Phys Rehabil Med 2024; 60:530-539. [PMID: 38656081 PMCID: PMC11258911 DOI: 10.23736/s1973-9087.24.08486-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Aging is associated with an increased burden of multi-morbidity and disease related functional loss and disability, widely impacting patients and health care systems. Frailty is a major actor in age-related disability and is an important target for rehabilitation interventions, considering that is a reversible condition. EVIDENCE ACQUISITION A working group of members of the ISPRM, responding to WHO 2030 call for action to strengthen rehabilitation, was established to assess the quality and implementability of the existing guidelines for the rehabilitation of frailty. Guidelines were retrieved using a systematic search on Pubmed, Scopus and Web of Science and from the reference lists of screened articles. The included guidelines were evaluated using the AGREE II to assess their quality and using the AGREE-REX to assess their clinical credibility and implementability. Guidelines with a score >4 in the AGREE II item evaluating the overall quality of the guideline were considered for endorsement. Finally, nine external reviewers evaluated the applicability of each recommendation from the endorsed guidelines, providing comments about the barriers and facilitators for their implementation in their country. EVIDENCE SYNTHESIS Ten guidelines were retrieved and evaluated by the working group, of which four guidelines, i.e. the WHO Guidelines on Integrated Care for Older People, the FOCUS guidelines, the Asia-Pacific Clinical Practice Guidelines for the Management of Frailty and the ICFSR International Clinical Practice Guidelines for Identification and Management of Frailty, were considered for endorsement. All these guidelines were rated as of adequate quality and implementability. CONCLUSIONS The WHO Guidelines on Integrated Care for Older people (24) the ICFSR International Clinical Practice Guidelines for Identification and management of Frailty (15), the FOCUS guidelines (25) and the Asia Pacific Clinical Practice Guidelines (14) for the Management of Frailty have the best quality and applicability of the existing guidelines on the management of frailty, we suggest that should be employed to define the standards of care for patients with frailty. There are barriers for their implementation, as stated by our experts, to take into account, and some of them are country- or region-specific. Screening for frailty, exercise, nutrition, pharmacological management, social and psychological support, management of incontinence, and an overall comprehensive clinical management are the best tools to face upon frailty.
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Affiliation(s)
- Eleftheria Antoniadou
- Geriatric Rehabilitation Clinic Centre Hospitalier du Nord, Ettelbruck, Luxembourg -
| | - Emanuele Giusti
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Paolo Capodaglio
- Unit of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University of Turin, Turin, Italy
- Unit of Rehabilitation, Istituto Auxologico Italiano IRCCS, Piancavallo, Verbania, Italy
| | - Der-Sheng Han
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (R.O.C.)
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan (R.O.C.)
| | - Francesca Gimigliano
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva Università Vanvitelli Campania, Naples, Italy
| | | | - Mooyeon Oh-Park
- Burke Rehabilitation Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Montefiore Health System, New York, NY, USA
| | - Walter Frontera
- Department of Physical Medicine, Rehabilitation, and Sports Medicine, Department of Physiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
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Reza ASMA, Raihan R, Azam S, Shahanewz M, Nasrin MS, Siddique MAB, Uddin MN, Dey AK, Sadik MG, Alam AK. Experimental and pharmacoinformatic approaches unveil the neuropharmacological and analgesic potential of chloroform fraction of Roktoshirinchi (Achyranthes ferruginea Roxb.). JOURNAL OF ETHNOPHARMACOLOGY 2024; 324:117769. [PMID: 38219886 DOI: 10.1016/j.jep.2024.117769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/07/2024] [Accepted: 01/11/2024] [Indexed: 01/16/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Achyranthes ferruginea (A. ferruginea) Roxb. is a common plant used in traditional medicine in Asia and Africa. It has a variety of local names, including "Gulmanci" in Nigeria, "Dangar" in Pakistan, "Thola" in Ethiopia, and "Roktoshirinchi" in Bangladesh. It is edible and has several ethnomedical uses for a wide range of illnesses, including hysteria, dropsy, constipation, piles, boils, asthma, and shigellosis. However, the neuropharmacological and analgesic potential of A. ferruginea remains uninvestigated. AIM OF THE STUDY To assess the neuropharmacological and analgesic potential of A. ferruginea through a multifaceted approach encompassing both experimental and computational models. MATERIALS AND METHODS Methanol was used to extract the leaves of A. ferruginea. It was then fractionated with low to high polar solvents (n-hexane, chloroform, ethyl acetate, and water) to get different fractions, including chloroform fraction (CLF). The study selected CLF at different doses and conducted advanced chemical element and proximate analyses, as well as phytochemical profiling using GC-MS. Toxicological studies were done at 300 μg per rat per day for 14 days. Cholinesterase inhibitory potential was checked using an in-vitro colorimetric assay. Acetic acid-induced writhing (AAWT) and formalin-induced licking tests (FILT) were used to assess anti-nociceptive effects. The forced swim test (FST), tail suspension test (TST), elevated plus maze (EPM), hole board test (HBT), and light and dark box test (LDB) were among the behavioral tests used to assess depression and anxiolytic activity. Network pharmacology-based analysis was performed on selected compounds using the search tool for interacting chemicals-5 (STITCH 5), Swiss target prediction tool, and search tool for the retrieval of interacting genes and proteins (STRING) database to link their role with genes involved in neurological disorders through gene ontology and reactome analysis. RESULTS Qualitative chemical element analysis revealed the presence of 15 elements, including Na, K, Ca, Mg, P, and Zn. The moisture content, ash value, and organic matter were found to be 11.12, 11.03, and 88.97%, respectively. GC-MS data revealed that the CLF possesses 25 phytoconstituents. Toxicological studies suggested the CLF has no effects on normal growth, hematological and biochemical parameters, or cellular organs after 14 days at 300 μg per rat. The CLF markedly reduced the activity of both acetylcholinesterase and butyrylcholinesterase (IC50: 56.22 and 13.22 μg/mL, respectively). Promising dose-dependent analgesic activity (p < 0.05) was observed in chemically-induced pain models. The TST and FST showed a dose-dependent substantial reduction in immobility time due to the CLF. Treatment with CLF notably increased the number of open arm entries and time spent in the EPM test at doses of 200 and 400 mg/kg b.w. The CLF showed significant anxiolytic activity at 200 mg/kg b.w. in the HBT test, whereas a similar activity was observed at 400 mg/kg b.w. in the EPM test. A notable increase in the amount of time spent in the light compartment was observed in the LDB test by mice treated with CLF, suggesting an anxiolytic effect. A network pharmacology study demonstrated the relationship between the phytochemicals and a number of targets, such as PPARA, PPARG, CHRM1, and HTR2, which are connected to the shown bioactivities. CONCLUSIONS This study demonstrated the safety of A. ferruginea and its efficacy in attenuating cholinesterase inhibitory activity, central and peripheral pain, anxiety, and depression, warranting further exploration of its therapeutic potential.
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Affiliation(s)
- A S M Ali Reza
- Department of Pharmacy, International Islamic University Chittagong, Chittagong, 4318, Bangladesh.
| | - Riaj Raihan
- Department of Pharmacy, International Islamic University Chittagong, Chittagong, 4318, Bangladesh.
| | - Saidul Azam
- Department of Pharmacy, International Islamic University Chittagong, Chittagong, 4318, Bangladesh.
| | - Mohammed Shahanewz
- Department of Pharmacy, International Islamic University Chittagong, Chittagong, 4318, Bangladesh.
| | - Mst Samima Nasrin
- Department of Pharmacy, International Islamic University Chittagong, Chittagong, 4318, Bangladesh.
| | - Md Abu Bakar Siddique
- Institute of National Analytical Research and Service (INARS), Bangladesh Council of Scientific and Industrial Research (BCSIR), Dhanmondi, Dhaka, 1205, Bangladesh.
| | - Md Nazim Uddin
- Institute of Food Science and Technology (IFST), Bangladesh Council of Scientific and Industrial Research (BCSIR), Dhanmondi, Dhaka, 1205, Bangladesh.
| | - Anik Kumar Dey
- Department of Pharmacy, University of Rajshahi, Rajshahi, 6205, Bangladesh.
| | - Md Golam Sadik
- Department of Pharmacy, University of Rajshahi, Rajshahi, 6205, Bangladesh.
| | - Ahm Khurshid Alam
- Department of Pharmacy, University of Rajshahi, Rajshahi, 6205, Bangladesh.
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Skains RM, Koehl JL, Aldeen A, Carpenter CR, Gettel CJ, Goldberg EM, Hwang U, Kocher KE, Southerland LT, Goyal P, Berdahl CT, Venkatesh AK, Lin MP. Geriatric Emergency Medication Safety Recommendations (GEMS-Rx): Modified Delphi Development of a High-Risk Prescription List for Older Emergency Department Patients. Ann Emerg Med 2024:S0196-0644(24)00071-4. [PMID: 38483427 DOI: 10.1016/j.annemergmed.2024.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 04/14/2024]
Abstract
STUDY OBJECTIVE Half of emergency department (ED) patients aged 65 years and older are discharged with new prescriptions. Potentially inappropriate prescriptions contribute to adverse drug events. Our objective was to develop an evidence- and consensus-based list of high-risk prescriptions to avoid among older ED patients. METHODS We performed a modified, 3-round Delphi process that included 10 ED physician experts in geriatrics or quality measurement and 1 pharmacist. Consensus members reviewed all 35 medication categories from the 2019 American Geriatrics Society Beers Criteria and ranked each on a 5-point Likert scale (5=highest) for overall priority for avoidance (Round 1), risk of short-term adverse events and avoidability (Round 2), and reasonable medical indications for high-risk medication use (Round 3). RESULTS For each round, questionnaire response rates were 91%, 82%, and 64%, respectively. After Round 1, benzodiazepines (mean, 4.60 [SD, 0.70]), skeletal muscle relaxants (4.60 [0.70]), barbiturates (4.30 [1.06]), first-generation antipsychotics (4.20 [0.63]) and first-generation antihistamines (3.70 [1.49]) were prioritized for avoidance. In Rounds 2 and 3, hypnotic "Z" drugs (4.29 [1.11]), metoclopramide (3.89 [0.93]), and sulfonylureas (4.14 [1.07]) were prioritized for avoidability, despite lower concern for short-term adverse events. All 8 medication classes were included in the final list. Reasonable indications for prescribing high-risk medications included seizure disorders, benzodiazepine/ethanol withdrawal, end of life, severe generalized anxiety, allergic reactions, gastroparesis, and prescription refill. CONCLUSION We present the first expert consensus-based list of high-risk prescriptions for older ED patients (GEMS-Rx) to improve safety among older ED patients.
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Affiliation(s)
- Rachel M Skains
- Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL; Geriatric Research, Education and Clinical Center, Birmingham VAMC, Birmingham, AL
| | - Jennifer L Koehl
- Department of Pharmacy, Massachusetts General Hospital, Boston, MA
| | | | | | - Cameron J Gettel
- Department of Emergency Medicine, Yale University, New Haven, CT
| | | | - Ula Hwang
- Department of Emergency Medicine, Yale University, New Haven, CT; Geriatric Research, Education and Clinical Center, James J. Peters VAMC, Bronx, NY
| | - Keith E Kocher
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI
| | | | - Pawan Goyal
- Quality Division, American College of Emergency Physicians, Irving, TX
| | - Carl T Berdahl
- Department of Emergency Medicine, Cedars Sinai Medical Center, Los Angeles, CA
| | | | - Michelle P Lin
- Department of Emergency Medicine, Stanford University, Palo Alto, CA.
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Lanctôt KL, Rivet L, Tumati S, Perin J, Sankhe K, Vieira D, Mintzer J, Rosenberg PB, Shade D, Lerner AJ, Padala PR, Brawman-Mintzer O, van Dyck CH, Porsteinsson AP, Craft S, Levey AI, Padala KP, Herrmann N. Heterogeneity of Response to Methylphenidate in Apathetic Patients in the ADMET 2 Trial. Am J Geriatr Psychiatry 2023; 31:1077-1087. [PMID: 37385898 PMCID: PMC10765607 DOI: 10.1016/j.jagp.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE The Apathy in Dementia Methylphenidate Trial 2 (ADMET 2) found that methylphenidate was effective in treating apathy with a small-to-medium effect size but showed heterogeneity in response. We assessed clinical predictors of response to help determine individual likelihood of treatment benefit from methylphenidate. DESIGN Univariate and multivariate analyses of 22 clinical predictors of response chosen a priori. SETTING Data from the ADMET 2 randomized, placebo controlled multi-center clinical trial. PARTICIPANTS Alzheimer's disease patients with clinically significant apathy. MEASUREMENTS Apathy assessed with the Neuropsychiatric Inventory apathy domain (NPI-A). RESULTS In total, 177 participants (67% male, mean [SD] age 76.4 [7.9], mini-mental state examination 19.3 [4.8]) had 6-months follow up data. Six potential predictors met criteria for inclusion in multivariate modeling. Methylphenidate was more efficacious in participants without NPI anxiety (change in NPI-A -2.21, standard error [SE]:0.60) or agitation (-2.63, SE:0.68), prescribed cholinesterase inhibitors (ChEI) (-2.44, SE:0.62), between 52 and 72 years of age (-2.93, SE:1.05), had 73-80 mm Hg diastolic blood pressure (-2.43, SE: 1.03), and more functional impairment (-2.56, SE:1.16) as measured by the Alzheimer's Disease Cooperative Study Activities of Daily Living scale. CONCLUSION Individuals who were not anxious or agitated, younger, prescribed a ChEI, with optimal (73-80 mm Hg) diastolic blood pressure, or having more impaired function were more likely to benefit from methylphenidate compared to placebo. Clinicians may preferentially consider methylphenidate for apathetic AD participants already prescribed a ChEI and without baseline anxiety or agitation.
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Affiliation(s)
- Krista L Lanctôt
- Sunnybrook Research Institute (KLL, LR, ST, KS, DV, NH), University of Toronto, Toronto, Ontario, Canada.
| | - Luc Rivet
- Sunnybrook Research Institute (KLL, LR, ST, KS, DV, NH), University of Toronto, Toronto, Ontario, Canada
| | - Shankar Tumati
- Sunnybrook Research Institute (KLL, LR, ST, KS, DV, NH), University of Toronto, Toronto, Ontario, Canada
| | - Jamie Perin
- Bloomberg School of Public Health (JP, DS), Johns Hopkins University, Baltimore, MD
| | - Krushnaa Sankhe
- Sunnybrook Research Institute (KLL, LR, ST, KS, DV, NH), University of Toronto, Toronto, Ontario, Canada
| | - Danielle Vieira
- Sunnybrook Research Institute (KLL, LR, ST, KS, DV, NH), University of Toronto, Toronto, Ontario, Canada
| | - Jacobo Mintzer
- Ralph H. Johnson VA Medical Center (JM, OB-M), Medical University of South Carolina, Charleston, SC
| | - Paul B Rosenberg
- Department of Psychiatry and Behavioral Sciences (PBR), Johns Hopkins University, Baltimore, MD
| | - David Shade
- Bloomberg School of Public Health (JP, DS), Johns Hopkins University, Baltimore, MD
| | - Alan J Lerner
- University Hospitals Cleveland Medical Center (AJL), Case Western Reserve University School of Medicine, Cleveland, OH
| | - Prasad R Padala
- Central Arkansas Veterans Healthcare System (PRP, KPP), University of Arkansas for Medical Sciences, Little Rock, AR
| | - Olga Brawman-Mintzer
- Ralph H. Johnson VA Medical Center (JM, OB-M), Medical University of South Carolina, Charleston, SC
| | | | | | | | - Allan I Levey
- Emory Goizueta Alzheimer's Disease Research Center (AIL), Atlanta, GA
| | - Kalpana P Padala
- Central Arkansas Veterans Healthcare System (PRP, KPP), University of Arkansas for Medical Sciences, Little Rock, AR
| | - Nathan Herrmann
- Sunnybrook Research Institute (KLL, LR, ST, KS, DV, NH), University of Toronto, Toronto, Ontario, Canada
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Amitani H, Nishi R, Sagiyama K, Fukumoto T, Funakoshi K, Takayanagi N, Watanabe H, Hirose M, Tagawa K, Ota K, Ito YM, Asakawa A. The effect of lavender aroma for anxiety disorder: a study protocol for a multicenter, double-masked, randomized, placebo-controlled clinical trial. BMC Complement Med Ther 2023; 23:397. [PMID: 37932761 PMCID: PMC10626714 DOI: 10.1186/s12906-023-04231-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Anxiety disorder is the most prevalent psychiatric disorder. Benzodiazepines, which are often used for anxiety in patients with anxiety disorder, have various side effects. Lavender, one of the most commonly used essential oils in aromatherapy, has the potential to reduce benzodiazepine use for anxiety disorders. METHODS This study is a multicenter, double-masked, randomized, placebo-controlled clinical trial. The study will recruit patients aged 20-59 years old with generalized anxiety disorder and panic disorder among anxiety disorders. The bottle containing the test solution (lavender aroma essential oil or distilled water) will be given to the patients. Patients will carry the bottles with them in their daily life and use the drops on tissue paper when anxious. The primary endpoint is the number of times anxiolytics used in 28 days. DISCUSSION If the use of benzodiazepines could be reduced by sniffing lavender aroma, which is inexpensive and safe, it would contribute not only to the risks associated with benzodiazepine use but also to the health care economy and could even be added as a standard treatment. TRIAL REGISTRATION University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), ID: UMIN000034422 Registered 17 January 2019.
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Affiliation(s)
- Haruka Amitani
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ryusei Nishi
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kenichiro Sagiyama
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takamasa Fukumoto
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kouta Funakoshi
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Naomi Takayanagi
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroko Watanabe
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Masayuki Hirose
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Koshiro Tagawa
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Keiko Ota
- Center for Clinical Research and Innovation, Osaka City University Hospital, Osaka, Japan
| | - Yoichi M Ito
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan
| | - Akihiro Asakawa
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
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Tian J, Du E, Guo L. Mitochondrial Interaction with Serotonin in Neurobiology and Its Implication in Alzheimer's Disease. J Alzheimers Dis Rep 2023; 7:1165-1177. [PMID: 38025801 PMCID: PMC10657725 DOI: 10.3233/adr-230070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/16/2023] [Indexed: 12/01/2023] Open
Abstract
Alzheimer's disease (AD) is a lethal neurodegenerative disorder characterized by severe brain pathologies and progressive cognitive decline. While the exact cause of this disease remains unknown, emerging evidence suggests that dysregulation of neurotransmitters contributes to the development of AD pathology and symptoms. Serotonin, a critical neurotransmitter in the brain, plays a pivotal role in regulating various brain processes and is implicated in neurological and psychiatric disorders, including AD. Recent studies have shed light on the interplay between mitochondrial function and serotonin regulation in brain physiology. In AD, there is a deficiency of serotonin, along with impairments in mitochondrial function, particularly in serotoninergic neurons. Additionally, altered activity of mitochondrial enzymes, such as monoamine oxidase, may contribute to serotonin dysregulation in AD. Understanding the intricate relationship between mitochondria and serotonin provides valuable insights into the underlying mechanisms of AD and identifies potential therapeutic targets to restore serotonin homeostasis and alleviate AD symptoms. This review summarizes the recent advancements in unraveling the connection between brain mitochondria and serotonin, emphasizing their significance in AD pathogenesis and underscoring the importance of further research in this area. Elucidating the role of mitochondria in serotonin dysfunction will promote the development of therapeutic strategies for the treatment and prevention of this neurodegenerative disorder.
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Affiliation(s)
- Jing Tian
- Department of Pharmacology and Toxicology, University of Kansas, Lawrence, KS, USA
| | - Eric Du
- Department of Pharmacology and Toxicology, University of Kansas, Lawrence, KS, USA
- Blue Valley West High School, Overland Park, KS, USA
| | - Lan Guo
- Department of Pharmacology and Toxicology, University of Kansas, Lawrence, KS, USA
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9
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Iffland M, Livingstone N, Jorgensen M, Hazell P, Gillies D. Pharmacological intervention for irritability, aggression, and self-injury in autism spectrum disorder (ASD). Cochrane Database Syst Rev 2023; 10:CD011769. [PMID: 37811711 PMCID: PMC10561353 DOI: 10.1002/14651858.cd011769.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
BACKGROUND Pharmacological interventions are frequently used for people with autism spectrum disorder (ASD) to manage behaviours of concern, including irritability, aggression, and self-injury. Some pharmacological interventions might help treat some behaviours of concern, but can also have adverse effects (AEs). OBJECTIVES To assess the effectiveness and AEs of pharmacological interventions for managing the behaviours of irritability, aggression, and self-injury in ASD. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and two trials registers up to June 2022. We also searched reference lists of relevant studies, and contacted study authors, experts and pharmaceutical companies. SELECTION CRITERIA We included randomised controlled trials of participants of any age with a clinical diagnosis of ASD, that compared any pharmacological intervention to an alternative drug, standard care, placebo, or wait-list control. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Primary outcomes were behaviours of concern in ASD, (irritability, aggression and self-injury); and AEs. Secondary outcomes were quality of life, and tolerability and acceptability. Two review authors independently assessed each study for risk of bias, and used GRADE to judge the certainty of the evidence for each outcome. MAIN RESULTS We included 131 studies involving 7014 participants in this review. We identified 26 studies as awaiting classification and 25 as ongoing. Most studies involved children (53 studies involved only children under 13 years), children and adolescents (37 studies), adolescents only (2 studies) children and adults (16 studies), or adults only (23 studies). All included studies compared a pharmacological intervention to a placebo or to another pharmacological intervention. Atypical antipsychotics versus placebo At short-term follow-up (up to 6 months), atypical antipsychotics probably reduce irritability compared to placebo (standardised mean difference (SMD) -0.90, 95% confidence interval (CI) -1.25 to -0.55, 12 studies, 973 participants; moderate-certainty evidence), which may indicate a large effect. However, there was no clear evidence of a difference in aggression between groups (SMD -0.44, 95% CI -0.89 to 0.01; 1 study, 77 participants; very low-certainty evidence). Atypical antipsychotics may also reduce self-injury (SMD -1.43, 95% CI -2.24 to -0.61; 1 study, 30 participants; low-certainty evidence), possibly indicating a large effect. There may be higher rates of neurological AEs (dizziness, fatigue, sedation, somnolence, and tremor) in the intervention group (low-certainty evidence), but there was no clear evidence of an effect on other neurological AEs. Increased appetite may be higher in the intervention group (low-certainty evidence), but we found no clear evidence of an effect on other metabolic AEs. There was no clear evidence of differences between groups in musculoskeletal or psychological AEs. Neurohormones versus placebo At short-term follow-up, neurohormones may have minimal to no clear effect on irritability when compared to placebo (SMD -0.18, 95% CI -0.37 to -0.00; 8 studies; 466 participants; very low-certainty evidence), although the evidence is very uncertain. No data were reported for aggression or self -injury. Neurohormones may reduce the risk of headaches slightly in the intervention group, although the evidence is very uncertain. There was no clear evidence of an effect of neurohormones on any other neurological AEs, nor on any psychological, metabolic, or musculoskeletal AEs (low- and very low-certainty evidence). Attention-deficit hyperactivity disorder (ADHD)-related medications versus placebo At short-term follow-up, ADHD-related medications may reduce irritability slightly (SMD -0.20, 95% CI -0.40 to -0.01; 10 studies, 400 participants; low-certainty evidence), which may indicate a small effect. However, there was no clear evidence that ADHD-related medications have an effect on self-injury (SMD -0.62, 95% CI -1.63 to 0.39; 1 study, 16 participants; very low-certainty evidence). No data were reported for aggression. Rates of neurological AEs (drowsiness, emotional AEs, fatigue, headache, insomnia, and irritability), metabolic AEs (decreased appetite) and psychological AEs (depression) may be higher in the intervention group, although the evidence is very uncertain (very low-certainty evidence). There was no evidence of a difference between groups for any other metabolic, neurological, or psychological AEs (very low-certainty evidence). No data were reported for musculoskeletal AEs. Antidepressants versus placebo At short-term follow-up, there was no clear evidence that antidepressants have an effect on irritability (SMD -0.06, 95% CI -0.30 to 0.18; 3 studies, 267 participants; low-certainty evidence). No data for aggression or self-injury were reported or could be included in the analysis. Rates of metabolic AEs (decreased energy) may be higher in participants receiving antidepressants (very low-certainty evidence), although no other metabolic AEs showed clear evidence of a difference. Rates of neurological AEs (decreased attention) and psychological AEs (impulsive behaviour and stereotypy) may also be higher in the intervention group (very low-certainty evidence) although the evidence is very uncertain. There was no clear evidence of any difference in the other metabolic, neurological, or psychological AEs (very low-certainty evidence), nor between groups in musculoskeletal AEs (very low-certainty evidence). Risk of bias We rated most of the studies across the four comparisons at unclear overall risk of bias due to having multiple domains rated as unclear, very few rated as low across all domains, and most having at least one domain rated as high risk of bias. AUTHORS' CONCLUSIONS Evidence suggests that atypical antipsychotics probably reduce irritability, ADHD-related medications may reduce irritability slightly, and neurohormones may have little to no effect on irritability in the short term in people with ASD. There was some evidence that atypical antipsychotics may reduce self-injury in the short term, although the evidence is uncertain. There was no clear evidence that antidepressants had an effect on irritability. There was also little to no difference in aggression between atypical antipsychotics and placebo, or self-injury between ADHD-related medications and placebo. However, there was some evidence that atypical antipsychotics may result in a large reduction in self-injury, although the evidence is uncertain. No data were reported (or could be used) for self-injury or aggression for neurohormones versus placebo. Studies reported a wide range of potential AEs. Atypical antipsychotics and ADHD-related medications in particular were associated with an increased risk of metabolic and neurological AEs, although the evidence is uncertain for atypical antipsychotics and very uncertain for ADHD-related medications. The other drug classes had minimal or no associated AEs.
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Affiliation(s)
- Michelle Iffland
- Senior Practitioner Branch, NDIS Quality and Safeguards Commission, Penrith, Australia
| | - Nuala Livingstone
- Cochrane Evidence Production and Methods Directorate , Cochrane, London, UK
| | - Mikaela Jorgensen
- Senior Practitioner Branch, NDIS Quality and Safeguards Commission, Penrith, Australia
| | - Philip Hazell
- Speciality of Psychiatry, University of Sydney School of Medicine, Sydney, Australia
| | - Donna Gillies
- Senior Practitioner Branch, NDIS Quality and Safeguards Commission, Penrith, Australia
- Sydney, Australia
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Stanley M, Poupore N, Knisely K, Miller A, Imeh-Nathaniel A, Roley LT, Imeh-Nathaniel S, Goodwin R, Nathaniel TI. Differences in pharmacologic and demographic factors in male and female patients with vascular dementia, Alzheimer's disease, and mixed vascular dementia. FRONTIERS IN DEMENTIA 2023; 2:1137856. [PMID: 39081989 PMCID: PMC11285705 DOI: 10.3389/frdem.2023.1137856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/15/2023] [Indexed: 08/02/2024]
Abstract
Background Increasing evidence suggests that demographic and pharmacologic factors may play a significant role in the epidemiology of dementia. Sex differences in prevalence also depend on dementia subtypes, such as Alzheimer's dementia (AD), vascular dementia (VaD), and mixed vascular-Alzheimer's dementia (MVAD). Therefore, studies are needed to investigate sex-specific differences, and identify potential therapeutic targets for both sexes. Methods Data was collected from the Prisma Health-Upstate Alzheimer's registry from 2016 to 2021 for 6,039 VaD patients, 9,290 AD patients, and 412 MVAD patients. A logistic regression was used to determine demographic and pharmacological factors associated with gender differences in patients with VaD, AD, and MVAD. Results In patients with VaD, African Americans (OR = 1.454, 95% CI, 1.257-1.682, p < 0.001) with increasing age (OR = 1.023, 95% CI, 1.017-1.029, p < 0.001), treated with aripiprazole (OR = 4.395, 95% CI, 2.880-6.707, p < 0.001), were associated with females, whereas patients treated with galantamine (OR = 0.228, 95% CI, 0.116-0.449, p < 0.001), memantine (OR = 0.662, 95% CI, 0.590-0.744, p < 0.001), with a history of tobacco (OR = 0.312, 95% CI, 0.278-0.349, p < 0.001), and ETOH (OR = 0.520, 95% CI, 0.452-0.598, p < 0.001) were associated with males. Among AD patients, African Americans (OR = 1.747, 95% CI, 1.486-2.053, p < 0.001), and Hispanics (OR = 3.668, 95% CI, 1.198-11.231, P = 0.023) treated with buspirone (OR = 1.541, 95% CI, 1.265-1.878, p < 0.001), and citalopram (OR = 1.790, 95% CI, 1.527-2.099, p < 0.001), were associated with females, whereas patients treated with memantine (OR = 0.882, 95% CI, 0.799-0.974, p = 0.013), and with a history of tobacco (OR = 0.247, 95% CI, 0.224-0.273, p < 0.001), and ETOH (OR = 0.627, 95% CI, 0.547-0.718, p < 0.001) were associated with male AD patients. In patients with MVAD, rivastigmine (OR = 3.293, 95% CI, 1.131-9.585, p = 0.029), memantine (OR = 2.816, 95% CI, 1.534-5.168, p < 0.001), and risperidone (OR = 10.515, 95% CI, 3.409-32.437, p < 0.001), were associated with females while patients with an increased length of stay (OR = 0.910, 95% CI, 0.828-1.000, p = 0.049), with a history of tobacco (OR = 0.148, 95% CI, 0.086-0.254, p < 0.001) and ETOH use (OR = 0.229, 95% CI, 0.110-0.477, p < 0.001) were more likely to be associated with males. Conclusions Our study revealed gender differences and similarities in the demographic and pharmacological factors of VaD, AD, and MVAD. Prospective studies are needed to determine the role of demographic and pharmacological factors in reducing sex-based disparities among VaD, AD, and MVAD patients.
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Affiliation(s)
- Madison Stanley
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Nicolas Poupore
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Krista Knisely
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Alyssa Miller
- Department of Biology, North Greenville University, Tigerville, SC, United States
| | | | | | | | - Rich Goodwin
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Thomas I. Nathaniel
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
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11
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Nishtala PS, Chyou TY. An Updated Analysis of Psychotropic Medicine Utilisation in Older People in New Zealand from 2005 to 2019. Drugs Aging 2022; 39:657-669. [PMID: 35829958 DOI: 10.1007/s40266-022-00965-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Psychotropic medicine utilisation in older adults continues to be of interest because of overuse and concerns surrounding its safety and efficacy. OBJECTIVE This study aimed to characterise the utilisation of psychotropic medicines in older people in New Zealand. METHODS We conducted a repeated cross-sectional analysis of national dispensing data from 1 January, 2005 to 31 December, 2019. We defined utilisation using the Anatomical Therapeutic Chemical classification defined daily dose system. Utilisation was measured in terms of the defined daily dose (DDD) per 1000 older people per day (TOPD). RESULTS Overall, the utilisation of psychotropic medicines increased marginally by 0.42% between 2005 and 2019. The utilisation increased for antidepressants (72.42 to 75.21 DDD/TOPD) and antipsychotics (6.06-19.04 DDD/TOPD). In contrast, the utilisation of hypnotics and sedatives (53.74-38.90 DDD/TOPD) and anxiolytics decreased (10.20-9.87 DDD/TOPD). The utilisation of atypical antipsychotics increased (4.06-18.72 DDD/TOPD), with the highest percentage change in DDD/TOPD contributed by olanzapine (520.6 %). In comparison, utilisation of typical antipsychotics was relatively stable (2.00-2.06 DDD/TOPD). The utilisation of venlafaxine increased remarkably by 5.7 times between 2005 and 2019. The utilisation of zopiclone was far greater than that of other hypnotics in 2019. CONCLUSIONS There was only a marginal increase in psychotropic medicines utilisation from 2005 to 2019 in older adults in New Zealand. There was a five-fold increase in the utilisation of antipsychotic medicines. Continued monitoring of psychotropic medicine utilisation will be of interest to understand the utilisation of antidepressants and antipsychotic medicines during the coronavirus disease 2019 pandemic year.
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Affiliation(s)
- Prasad S Nishtala
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, BA2 7AY, UK. .,Centre for Therapeutic Innovation, University of Bath, Bath, UK.
| | - Te-Yuan Chyou
- Department of Biochemistry, University of Otago, Dunedin, Otago, New Zealand
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Górski M, Buczkowska M, Krzywkowska K, Całyniuk B, Górska K, Buczkowski K, Fojcik J, Grajek M, Polaniak R. Ambulophobia as a Specific Phobia—Defining the Problem Among Patients of Long-Term Care Facilities in Poland. Front Public Health 2022; 10:801109. [PMID: 35480582 PMCID: PMC9035898 DOI: 10.3389/fpubh.2022.801109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 03/10/2022] [Indexed: 12/04/2022] Open
Abstract
Background Ambulophobia is a type of specific phobia that involves a fear of walking. This phobia mainly affects older people, who prefer not to leave their bed or home to avoid walking on uneven surfaces and reduce the risk of falling. The problem seems to be very important in terms of public health and the organization of long-term care, as Poland has one of the highest rates of elderly population growth. Objectives The aim of the study was to determine the prevalence of ambulophobia among patients of long-term care facilities in Poland and to identify factors increasing the risk of this specific phobia in the study group. Material and Methods The study was conducted between January and July 2021. Data collected from 379 patients of 16 long-term care facilities located in Poland were analyzed. The study used the diagnostic criteria for specific phobias according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, and standardized questionnaires such as MMSE, GDS-16, DOS and ADL. The χ2 test was used to test the significance of differences (p = 0.05). Results The prevalence of ambulophobia in the study group was 30.1%. Ambulophobia significantly more often concerned the female sex (37.7%) and people over 70 years of age (42,1%). Factors such as depression, Parkinson's disease, orthostatic hypotonia, a history of falling or being a witness to another person falling, and disability of at least a moderate degree increased the likelihood of ambulophobia. Conclusions Based on the obtained results, it was found that the protective factors in the development of ambulophobia are male sex, younger age, high independence, fewer drugs used per day and no previous falls or seeing another person fall.
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Affiliation(s)
- Michał Górski
- Doctoral School of the Medical University of Silesia in Katowice, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
- *Correspondence: Michał Górski
| | - Marta Buczkowska
- Department of Toxicology and Health Protection in the Occupational Environment, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Karolina Krzywkowska
- Department of Psychiatric Rehabilitation in Katowice, Medical University of Silesia, Katowice, Poland
| | - Beata Całyniuk
- Department of Human Nutrition, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Karolina Górska
- Institute of Special Pedagogy, School and Teacher Education, Pedagogical University of Cracow, Cracow, Poland
| | - Krzysztof Buczkowski
- Department of General and Oncological Surgery, City Hospital of Siemianowice Śla̧skie, Siemianowice Slaskie, Poland
| | - Joanna Fojcik
- Department of Psychiatric Rehabilitation in Katowice, Medical University of Silesia, Katowice, Poland
| | - Mateusz Grajek
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Renata Polaniak
- Department of Human Nutrition, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
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Coker-Ayo OO, Nathaniel SI, Poupore N, Bailey-Taylor MJ, Roley LT, Goodwin RL, McPhail B, Russ-Sellers R, Nathaniel TI. Sex Differences in Demographic and Pharmacological Factors in Alzheimer Patients With Dementia and Cognitive Impairments. Front Behav Neurosci 2022; 16:828782. [PMID: 35431827 PMCID: PMC9012112 DOI: 10.3389/fnbeh.2022.828782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/16/2022] [Indexed: 12/26/2022] Open
Abstract
ObjectiveThe current study investigates sex differences associated with pharmacological and demographic characteristics in Alzheimer patients (AD) with dementia (ADD) or mild cognitive impairment (MCI).MethodA retrospective analytical approach was used to analyze data from 45,696 AD patients with MCI or ADD. The univariate analysis was used to determine differences in demographic, and pharmacological characteristics for male and female ADD and MCI-AD patients. Multivariate analysis was used to predict specific pharmacological and demographic factors that are associated with male and female MCI and ADD patients.ResultIn the adjusted analysis for male patients, Hispanics [0.166,0.020 – 1.355, P = 0.094] or African Americans [OR = 2.380, 95% CI,2.120 – 2.674, P < 0.001], were more likely to have MCI-AD and be treated with galantamine [OR = 0.559, 95% CI, 0.382 – 0.818, P = 0.003], donepezil [OR = 1.639, 95% CI,1.503 – 1.787, P < 0.001], rivastigmine [OR = 1.394, 95% CI,1.184 – 1.642, P < 0.001], olanzapine [OR = 2.727, 95% CI,2.315 – 3.212, P < 0.001], risperidone [OR = 2.973, 95% CI,2.506 – 3.526, P < 0.001], present with increasing age [1.075,1.071 – 1.079, P < 0.001], and are on tobacco use [OR = 1.150, 95% CI,1.054 – 1.254, P = 0.002]. For female patients, buspirone [OR = 0.767, 95% CI, 0.683 – 0.861, P < 0.001] and a history of alcohol (ETOH) use [OR = 0.484, 95% CI, 0.442 – 0.529, P < 0.001] were associated with MCI-AD. Increasing age [OR = 1.096, 95% CI, 1.093 – 1.100, P < 0.001], donepezil [OR = 2.185, 95% CI, 2.035 – 2.346, P < 0.001], memantine [OR = 2.283, 95% CI, 2.104 – 2.477, P < 0.001] aripiprazole [OR = 1.807, 95% CI, 1.544 – 2.113, P < 0.001] olanzapine [OR = 2.289, 95% CI, 1.986 – 2.640, P < 0.001] risperidone [OR = 2.548, 95% CI, 2.246 – 2.889, P < 0.001] buspirone [OR = 0.767, 95% CI, 0.683 – 0.861, P < 0.001] escitalopram [OR = 1.213, 95% CI,1.119 – 1.315, P < 0.001] African Americans [OR = 1.395, 95% CI, 1.268 – 1.535, P < 0.001] and tobacco use [OR = 1.150, 95% CI, 1.073 – 1.233, P < 0.001] were associated with ADD.ConclusionOur findings reveal that MCI-AD patients were more likely to be Hispanics or African American males treated with rivastigmine, olanzapine and citalopram. African American females were associated with ADD and more likely to be treated with buspirone and presented with a history of ETOH. This finding suggests the need for a pharmacological treatment approach encompassing sex-sensitive strategies for MCI-AD and ADD patients.
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Affiliation(s)
| | - Samuel I. Nathaniel
- Department of Biology, North Greenville University, Tigerville, SC, United States
| | - Nicolas Poupore
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | | | | | - Richard L. Goodwin
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Brooks McPhail
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Rebecca Russ-Sellers
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
| | - Thomas I. Nathaniel
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
- *Correspondence: Thomas I. Nathaniel,
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Pillerová M, Borbélyová V, Pastorek M, Riljak V, Hodosy J, Frick KM, Tóthová L. Molecular actions of sex hormones in the brain and their potential treatment use in anxiety disorders. Front Psychiatry 2022; 13:972158. [PMID: 36159923 PMCID: PMC9492942 DOI: 10.3389/fpsyt.2022.972158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Anxiety disorders are one of the most prevalent mood disorders that can lead to impaired quality of life. Current treatment of anxiety disorders has various adverse effects, safety concerns, or restricted efficacy; therefore, novel therapeutic targets need to be studied. Sex steroid hormones (SSHs) play a crucial role in the formation of brain structures, including regions of the limbic system and prefrontal cortex during perinatal development. In the brain, SSHs have activational and organizational effects mediated by either intracellular or transmembrane G-protein coupled receptors. During perinatal developmental periods, the physiological concentrations of SSHs lead to the normal development of the brain; however, the early hormonal dysregulation could result in various anxiety diorders later in life. Sex differences in the prevalence of anxiety disorders suggest that SSHs might be implicated in their development. In this review, we discuss preclinical and clinical studies regarding the role of dysregulated SSHs signaling during early brain development that modifies the risk for anxiety disorders in a sex-specific manner in adulthood. Moreover, our aim is to summarize potential molecular mechanisms by which the SSHs may affect anxiety disorders in preclinical research. Finally, the potential effects of SSHs in the treatment of anxiety disorders are discussed.
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Affiliation(s)
- Miriam Pillerová
- Faculty of Medicine, Institute of Molecular Biomedicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Veronika Borbélyová
- Faculty of Medicine, Institute of Molecular Biomedicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Michal Pastorek
- Faculty of Medicine, Institute of Molecular Biomedicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Vladimír Riljak
- First Faculty of Medicine, Institute of Physiology, Charles University, Prague, Czechia
| | - Július Hodosy
- Faculty of Medicine, Institute of Molecular Biomedicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Karyn M Frick
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - L'ubomíra Tóthová
- Faculty of Medicine, Institute of Molecular Biomedicine, Comenius University in Bratislava, Bratislava, Slovakia
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Transtornos de Ansiedade em Idosos. PAJAR - PAN AMERICAN JOURNAL OF AGING RESEARCH 2021. [DOI: 10.15448/2357-9641.2021.1.40528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objetivos: descrever a prevalência de transtornos de ansiedade e avaliar o perfil e os fatores associados em uma amostra de idosos atendidos no ambulatório de psiquiatria geriátrica de um hospital de Porto Alegre, Brasil.Métodos: trata-se de um estudo transversal que avaliou 69 idosos com diagnóstico de transtornos de ansiedade, atendidos no ambulatório de psiquiatria geriátrica, no período de 2014 a 2019.Resultados: a prevalência de transtornos de ansiedade foi de 21,9% e a média de idade 73,4±8,7 anos. Houve predomínio de indivíduos do sexo feminino (81,2%), com 5 a 8 anos de estudo (33,8%), casados (47,7%) e residentes de Porto Alegre (65,2%). Em relação a variáveis clínicas, a maior frequência dos idosos não apresentaram histórico familiar de doença ou de internação psiquiátrica. Do total, 92,6% relataram ter alguma comorbidade clínica, sendo a mais frequente as doenças cardiovasculares (69,8%). Os principais psicofármacos utilizados foram os antidepressivos (66,7%) e os benzodiazepínicos (44,9%).Conclusões: os transtornos de ansiedade são frequentes entre os idosos. Dessa forma, são necessários mais estudos na população geriátrica e padronizações das ferramentas de avaliação.
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An Overview of Anxiety, Trauma-Related and Obsessive-Compulsive Disorders. CURRENT GERIATRICS REPORTS 2021. [DOI: 10.1007/s13670-021-00361-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pham Nguyen TP, Abraham DS, Thibault D, Weintraub D, Willis AW. Low continuation of antipsychotic therapy in Parkinson disease - intolerance, ineffectiveness, or inertia? BMC Neurol 2021; 21:240. [PMID: 34167473 PMCID: PMC8223332 DOI: 10.1186/s12883-021-02265-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 05/31/2021] [Indexed: 12/25/2022] Open
Abstract
Background Antipsychotics are used in Parkinson disease (PD) to treat psychosis, mood, and behavioral disturbances. Commonly used antipsychotics differ substantially in their potential to worsen motor symptoms through dopaminergic receptor blockade. Recent real-world data on the use and continuation of antipsychotic therapy in PD are lacking. The objectives of this study are to (1) examine the continuation of overall and initial antipsychotic therapy in individuals with PD and (2) determine whether continuation varies by drug dopamine receptor blocking activity. Methods We conducted a retrospective cohort study using U.S. commercially insured individuals in Optum 2001–2019. Adults aged 40 years or older with PD initiating antipsychotic therapy, with continuous insurance coverage for at least 6 months following drug initiation, were included. Exposure to pimavanserin, quetiapine, clozapine, aripiprazole, risperidone, or olanzapine was identified based on pharmacy claims. Six-month continuation of overall and initial antipsychotic therapy was estimated by time to complete discontinuation or switching to a different antipsychotic. Cox proportional hazards models evaluated factors associated with discontinuation. Results Overall, 38.6% of 3566 PD patients in our sample discontinued antipsychotic therapy after the first prescription, 61.4% continued with overall treatment within 6 months of initiation. Clozapine use was too rare to include in statistical analyses. Overall therapy discontinuation was more likely for those who initiated medications with known dopamine-receptor blocking activity (adjusted hazard ratios 1.76 [95% confidence interval 1.40–2.20] for quetiapine, 2.15 [1.61–2.86] for aripiprazole, 2.12 [1.66–2.72] for risperidone, and 2.07 [1.60–2.67] for olanzapine), compared with serotonin receptor-specific pimavanserin. Initial antipsychotic therapy discontinuation also associated with greater dopamine-receptor blocking activity medication use – adjusted hazard ratios 1.57 (1.28–1.94), 1.88 (1.43–2.46), 2.00 (1.59–2.52) and 2.03 (1.60–2.58) for quetiapine, aripiprazole, risperidone, and olanzapine, respectively, compared with pimavanserin. Similar results were observed in sensitivity analyses. Conclusions Over one-third of individuals with PD discontinued antipsychotic therapy, especially if the initial drug has greater dopamine-receptor blocking activity. Understanding the drivers of antipsychotic discontinuation, including ineffectiveness, potentially inappropriate use, clinician inertia, patient adherence and adverse effects, is needed to inform clinical management of psychosis in PD and appropriate antipsychotic use in this population. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02265-x.
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Affiliation(s)
- Thanh Phuong Pham Nguyen
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive, Blockley Hall 829, Philadelphia, PA, 19104, USA. .,Department of Neurology Translational Center for Excellence for Neuroepidemiology and Neurological Outcomes Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. .,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. .,Center for Pharmacoepidemiology Research and Training, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Danielle S Abraham
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive, Blockley Hall 829, Philadelphia, PA, 19104, USA.,Department of Neurology Translational Center for Excellence for Neuroepidemiology and Neurological Outcomes Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Center for Pharmacoepidemiology Research and Training, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Dylan Thibault
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive, Blockley Hall 829, Philadelphia, PA, 19104, USA.,Department of Neurology Translational Center for Excellence for Neuroepidemiology and Neurological Outcomes Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Daniel Weintraub
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive, Blockley Hall 829, Philadelphia, PA, 19104, USA.,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Allison W Willis
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive, Blockley Hall 829, Philadelphia, PA, 19104, USA.,Department of Neurology Translational Center for Excellence for Neuroepidemiology and Neurological Outcomes Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Center for Pharmacoepidemiology Research and Training, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Choi NG, DiNitto DM, Phillips KT. Mental health treatment use among cannabis users aged 50+: Associations with cannabis use characteristics. Drug Alcohol Depend 2021; 223:108705. [PMID: 33862322 DOI: 10.1016/j.drugalcdep.2021.108705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/27/2021] [Accepted: 02/28/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study examined associations of mental health treatment use and perceived treatment need with cannabis use characteristics (medical vs. nonmedical use, initiation age, use frequency, and cannabis use disorder) among past-year cannabis users aged 50+. METHODS Data came from the 2015-2019 National Survey of Drug Use and Health (N = 44,007). After comparing past-year cannabis users with nonusers and nonmedical users with medical users on sociodemographic and health-related factors, the research questions were examined with logistic regression models. RESULTS In addition to mental disorders, medical use, compared to nonmedical use, was associated with higher odds of psychotherapeutic prescription medication use (AOR = 1.47, 95 % CI = 1.07-2.01) and any mental health treatment (prescription medication, outpatient care and/or inpatient care) (AOR = 1.51, 95 % CI = 1.13-2.03). Compared to 1-29 days of use, nonmedical users who used on 100-199 days (AOR = 0.60, 95 % CI = 0.40-0.89) and medical users who used on 200-365 days users (AOR = 0.48, 95 % CI = 0.26-0.87) had lower odds of treatment receipt. Factors associated with increased odds of receiving treatment included discussion with a healthcare professional about drug use, higher education, and having health insurance. Other illicit drug use, chronic illnesses, and female gender were associated with higher odds of perceived treatment need, while having health insurance was associated with lower odds. CONCLUSIONS Some older adults may use medical cannabis as an adjunct to professional mental health treatment while others may use it as a substitute. Affordability and accessibility gaps followed by cultural and personal sense of stigma and self-sufficiency beliefs appear to be barriers to receiving professional care.
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Affiliation(s)
- Namkee G Choi
- The University of Texas at Austin Steve Hicks School of Social Work, Austin, TX, 78702, United States.
| | - Diana M DiNitto
- The University of Texas at Austin Steve Hicks School of Social Work, Austin, TX, 78702, United States
| | - Kristina T Phillips
- Center for Integrated Health Care Research, Kaiser Permanente, Honolulu, HI, 96817, United States
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19
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Muhasaparur Ganesan R, Settu DK, Murkunde Y, Duraipandian C. Pharmacological and pharmacokinetic effect of a polyherbal combination with Withania somnifera (L.) Dunal for the management of anxiety. JOURNAL OF ETHNOPHARMACOLOGY 2021; 265:113337. [PMID: 32890709 DOI: 10.1016/j.jep.2020.113337] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/25/2020] [Accepted: 08/27/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE In the Indian system of medicine, Withania somnifera (L.) Dunal, Hemidesmus indicus (R.Br.), Aegle marmelos (L.) Correa, Emblica officinalis Gaertn, Ocimum sanctum (L.) has been mentioned as a remedy for the treatment of anxiety related disorders. Based on their folklore use, a polyherbal combination was derived for the management of anxiety. AIM OF THE STUDY The present study is aimed to find the best polyherbal combination (PHC), in terms of its pharmacological action, out of two PHC, namely PHC1 and PHC3, prepared based on the previous studies conducted and to carry out the pharmacokinetic (PK) study of the best combination (PHC3). MATERIALS AND METHODS Pharmacological activities include elevated plus maze model and hole-board test for anti-anxiety screening, gamma amino-butyric acid (GABAA) measurement in brain tissues and superoxide dismutase, lipid peroxidation and reduced glutathione measurement for anti-oxidant screening. RESULTS PHC3 (100 mg/kg) produced statistically significant (p < 0.05) effect on all the pharmacological outcome measures when compared to alprazolam standard. Therefore, it was chosen for PK study. PK study was carried out using Liquid Chromatography Mass Spectroscopy technique with respect to Withaferin-A. PK parameters such as maximum plasma concentration (Cmax), 16.78 ± 5.32 ng/mL; time of maximum concentration (Tmax), 18 ± 0.12min; half-life (T1/2) 61.20 ± 9.87min; mean residual time (MRT), 7.53 h s; area under the concentration versus time curve (AUC0-1), 1678 ± 34.13 ng/mL; area under the concentration versus time curve from zero to infinity (AUC0-∞), 1705 ± 28.87 ng/mL; total clearance (CL), 290.67 ± 15.89 mL/min and volume of distribution (Vd) 0.054 L were calculated. CONCLUSIONS The results of the studies revealed that PHC3 possessed significant anxiolytic, anti-oxidant activities and enhanced expression of GABAA mediated inhibition when compared to PHC1. Withaferin-A in PHC3 exhibited a rapid oral absorption in rat plasma. The findings of this study greatly help to provide useful evidence for the development of suitable formulation using PHC3.
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Affiliation(s)
- Rajanandh Muhasaparur Ganesan
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Porur, Chennai, 600 116, India.
| | - Dinesh Kumar Settu
- Department of Pharmacognosy, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Porur, Chennai, 600 116, India
| | - Yogeshkumar Murkunde
- Centre for Toxicology and Developmental Research, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Porur, Chennai, 600 116, India
| | - Chamundeeswari Duraipandian
- Department of Pharmacognosy, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), Porur, Chennai, 600 116, India.
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20
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Long-Term Treatment with Fluvoxamine Decreases Nonmotor Symptoms and Dopamine Depletion in a Postnatal Stress Rat Model of Parkinson's Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:1941480. [PMID: 32273939 PMCID: PMC7114775 DOI: 10.1155/2020/1941480] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/28/2020] [Accepted: 03/09/2020] [Indexed: 02/07/2023]
Abstract
Nonmotor symptoms (NMS) such as anxiety, depression, and cognitive deficits are frequently observed in Parkinson's disease (PD) and precede the onset of motor symptoms by years. We have recently explored the short-term effects of Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) on dopaminergic neurons in a parkinsonian rat model. Here, we report the long-term effects of Fluvoxamine, on early-life stress-induced changes in the brain and behavior. We specifically evaluated the effects of Fluvoxamine on brain mechanisms that contribute to NMS associated with PD in a unilateral 6-hydroxydopamine-lesioned rat model. A 14-day early postnatal maternal separation protocol was applied to model early-life stress followed by unilateral intracerebral infusion of 6-hydroxydopamine (6-OHDA) to model aspects of parkinsonism in rats. The anxiolytic, antidepressant, and cognitive effects of Fluvoxamine were confirmed using the elevated plus-maze (EPM) test, sucrose preference test (SPT), and Morris water maze (MWM) test. Further to that, our results showed that animals exposed to early-life stress displayed increased plasma corticosterone and malondialdehyde (MDA) levels which were attenuated by Fluvoxamine treatment. A 6-OHDA lesion effect was evidenced by impairment in the limb-use asymmetry test as well as decreased dopamine (DA) and serotonin levels in the striatum, prefrontal cortex, and hippocampus. These effects were surprisingly attenuated by Fluvoxamine treatment in all treated rats. This study is the first to suggest that early and long-term treatment of neuropsychological diseases with Fluvoxamine may decrease the vulnerability of dopaminergic neurons that degenerate in the course of PD.
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21
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Puspitasari IM, Sinuraya RK, Rahayu C, Witriani W, Zannah U, Hafifah A, Ningtyas AR, Vildayanti H. Medication Profile and Treatment Cost Estimation Among Outpatients with Schizophrenia, Bipolar Disorder, Depression, and Anxiety Disorders in Indonesia. Neuropsychiatr Dis Treat 2020; 16:815-828. [PMID: 32273708 PMCID: PMC7105358 DOI: 10.2147/ndt.s240058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/10/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The present retrospective study aimed to determine the medication profile and estimate the treatment costs from medical records of new outpatients with schizophrenia, bipolar disorder, depression, and anxiety disorders from a healthcare perspective at a national referral hospital in Indonesia from 2016 to 2018. METHODS Medical records (including medical and administrative data) of 357 new outpatients with schizophrenia, bipolar disorder, depression, or anxiety disorders were collected from the hospital information system. The records of new outpatients with schizophrenia, bipolar disorder, depression, or anxiety disorders aged >18 years and had only received drugs for treatment were included. The medication profile was descriptively assessed, and estimated costs were calculated based on direct costs from a healthcare perspective. RESULTS Overall, 173 medical records were further analyzed. The main drugs administered to the new outpatients were atypical and typical antipsychotics for schizophrenia, atypical antipsychotics and mood stabilizers for bipolar disorder, antidepressants and atypical antipsychotics for depression, and antidepressants and benzodiazepines for anxiety disorders. The average annual treatment costs per patient were IDR 3,307,931 (USD 236) for schizophrenia, IDR 17,978,865 (USD 1,284) for bipolar disorder, IDR 1,601,850 (USD 114) for depression, and IDR 1,190,563 (USD 85) for anxiety disorders. CONCLUSION The most commonly prescribed drugs for schizophrenia were haloperidol and risperidone; for bipolar disorders, sodium divalproex and risperidone; for depression, fluoxetine and sertraline; and for anxiety disorders, sertraline and lorazepam. Considering the high prevalence and estimated treatment costs for mental disorders, special attention is required to prevent an increase in their prevalence in Indonesia.
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Affiliation(s)
- Irma M Puspitasari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Rano K Sinuraya
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
| | | | - Witriani Witriani
- Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Uzlifatul Zannah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Auliani Hafifah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Ajeng R Ningtyas
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Hilda Vildayanti
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
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22
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Oizumi H, Kuriyama N, Imamura S, Tabuchi M, Omiya Y, Mizoguchi K, Kobayashi H. Influence of aging on the behavioral phenotypes of C57BL/6J mice after social defeat. PLoS One 2019; 14:e0222076. [PMID: 31479487 PMCID: PMC6719861 DOI: 10.1371/journal.pone.0222076] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 08/21/2019] [Indexed: 12/13/2022] Open
Abstract
Depression and anxiety are common psychiatric disorders that can occur throughout an individual’s lifetime. Numerous pathways underlying the onset of these diseases have been identified in rodents using a social defeat stress protocol, whereby socially defeated individuals exhibit depression- and/or anxiety-like phenotypes that typically manifest as social avoidance behavior. However, most studies in this field have been conducted using young adult mice; therefore, information about social defeat stress-related behavioral phenotypes in older mice is limited. In this study, we exposed groups of young adult (8–16 weeks old) and aged (24 months old) C57BL/6J mice to mild social defeat stress by challenging them with aggressive CD1 mice while restricting the intensity of aggression to protect the animals from severe injuries. We then identified stress-induced behavioral changes and compared their expression between the age groups and with a non-defeated (non-stressed) control group. We found that the stressed mice in both age groups exhibited similar reduced social interactions that were indicative of increased social avoidance behavior. Moreover, unlike the young stressed and control groups, only the aged stressed group showed a reduced preference for sucrose, which was correlated with social avoidance behavior. Also, the aged stressed mice exhibited an attenuated defeat-induced increase in water intake. These findings reveal that aging alters behavioral phenotypes after social defeat and that the hedonic behavior of aged mice is more vulnerable to social defeat compared with younger mice.
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Affiliation(s)
- Hiroaki Oizumi
- Tsumura Kampo Research Laboratories, Tsumura & Co., Ibaraki, Japan
- * E-mail:
| | - Nae Kuriyama
- Tsumura Kampo Research Laboratories, Tsumura & Co., Ibaraki, Japan
| | - Sachiko Imamura
- Tsumura Kampo Research Laboratories, Tsumura & Co., Ibaraki, Japan
| | - Masahiro Tabuchi
- Tsumura Kampo Research Laboratories, Tsumura & Co., Ibaraki, Japan
| | - Yuji Omiya
- Tsumura Kampo Research Laboratories, Tsumura & Co., Ibaraki, Japan
| | | | - Hiroyuki Kobayashi
- Center for Advanced Kampo Medicine and Clinical Research, Juntendo Graduate School of Medicine, Tokyo, Japan
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(Z)-7,4′-Dimethoxy-6-hydroxy-aurone-4-O-β-glucopyranoside exerts neuroprotective effects in vitro and anxiolytic activity in vivo. Neuroreport 2019; 30:280-287. [DOI: 10.1097/wnr.0000000000001198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Abstract
Summary
Introduction: Beta blockers are mainly used in treating cardiovascular diseases. However, it has been observed that these drugs have also an anxiolytic potential. Over the years, a number of clinical trials have been conducted aimed at determining the effectiveness of beta blockers in treating anxiety disorders.
The aim of the article: The main objective of the article is to present the significance and position of adrenolytic drugs in the pharmacotherapy of anxiety disorders on the basis of available literature. Moreover, the authors also decided to take into account the data from current research results, considering the problem of side effects of using adrenolytic drugs - especially the controversial reports on their effect on the development of affective disorders.
Method: An analysis was conducted of articles from Medline/PubMed database, selected on the basis of the following key words: anxiety disorders, beta blockers, adrenolytic drugs, as well as on the basis of their dates of publication: 1960-2017. In order to conduct a reliable and complete review of literature, the authors decided to include works from quite an extended period of time. The articles included in the review were published in Polish and English.
Results: The review of articles concerning the treatment of anxiety disorders clearly suggests that propranolol is effective in reducing the frequency of panic attacks and the tendency for avoidance behavior in patients with agoraphobia. Other studies report on potential benefits in terms of early interventional prevention and treating posttraumatic stress disorder with propranolol. However, there is lack of randomized clinical trials concerning the therapeutic effect of other adrenolytic drugs in treating anxiety disorders. Early research works reported that (mainly lipophilic) beta blockers may have a depressogenic effect; however, the latest studies have not confirmed it.
The contemporary research on the therapeutic potential of beta blockers in treating anxiety disorders is insufficient. What seems to be most promising, however, are reports concerning the desirable effects of using adrenolytic drugs in treating posttraumatic stress disorder, which implicates the necessity of conducting further research verifying the validity of their application.
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Rocha NP, Teixeira AL. Managing anxiety in Parkinson's disease: the role of nonpharmacological strategies. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:497-498. [PMID: 30231120 DOI: 10.1590/0004-282x20180081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 07/31/2018] [Indexed: 11/22/2022]
Affiliation(s)
- Natalia P Rocha
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brasil.,The University of Texas Health Science Center at Houston, McGovern Medical School, Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, Houston, Texas, USA
| | - Antonio L Teixeira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brasil.,The University of Texas Health Science Center at Houston, McGovern Medical School, Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, Houston, Texas, USA
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26
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The anxiolytic-like effects of ginsenoside Rg3 on chronic unpredictable stress in rats. Sci Rep 2018; 8:7741. [PMID: 29773855 PMCID: PMC5958129 DOI: 10.1038/s41598-018-26146-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 05/02/2018] [Indexed: 12/28/2022] Open
Abstract
The present study is to evaluate the anxiolytic-like activities underlying ginsenoside Rg3 (GRg3). The anxiolytic-like activities were induced by GRg3 (20 and 40 mg/kg, i.g), evidenced by blocking the decreased time and entries in the open arms in elevated plus maze test and by reversing the increased latency to feed in novelty-suppressed feeding test. In addition, the decreased levels on progesterone, allopregnanolone, serotonin (5-HT) in the prefrontal cortex and hippocampus of chronic unpredictable stress (CUS) were blocked by GRg3 (20 and 40 mg/kg, i.g). Furthermore, the increased corticotropin releasing hormone, corticosterone and adrenocorticotropic hormone were blocked by GRg3 (20 and 40 mg/kg, i.g). Collectively, the anxiolytic-like effects produced by GRg3 were associated with the normalization of neurosteroids biosynthesis, serotonergic system as well as HPA axis dysfunction.
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27
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Justice NJ. The relationship between stress and Alzheimer's disease. Neurobiol Stress 2018; 8:127-133. [PMID: 29888308 PMCID: PMC5991350 DOI: 10.1016/j.ynstr.2018.04.002] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/03/2018] [Accepted: 04/19/2018] [Indexed: 12/04/2022] Open
Abstract
Stress is critically involved in the development and progression of disease. From the stress of undergoing treatments to facing your own mortality, the physiological processes that stress drives have a serious detrimental effect on the ability to heal, cope and maintain a positive quality of life. This is becoming increasingly clear in the case of neurodegenerative diseases. Neurodegenerative diseases involve the devastating loss of cognitive and motor function which is stressful in itself, but can also disrupt neural circuits that mediate stress responses. Disrupting these circuits produces aberrant emotional and aggressive behavior that causes long-term care to be especially difficult. In addition, added stress drives progression of the disease and can exacerbate symptoms. In this review, I describe how neural and endocrine pathways activated by stress interact with ongoing neurodegenerative disease from both a clinical and experimental perspective.
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Affiliation(s)
- Nicholas J. Justice
- Institute of Molecular Medicine, University of Texas Health Sciences Center, Houston, TX, 77030, USA
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