1
|
Rodolico A, Cutrufelli P, Di Francesco A, Aguglia A, Catania G, Concerto C, Cuomo A, Fagiolini A, Lanza G, Mineo L, Natale A, Rapisarda L, Petralia A, Signorelli MS, Aguglia E. Efficacy and safety of ketamine and esketamine for unipolar and bipolar depression: an overview of systematic reviews with meta-analysis. Front Psychiatry 2024; 15:1325399. [PMID: 38362031 PMCID: PMC10867194 DOI: 10.3389/fpsyt.2024.1325399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/03/2024] [Indexed: 02/17/2024] Open
Abstract
Background Unipolar and bipolar depression present treatment challenges, with patients sometimes showing limited or no response to standard medications. Ketamine and its enantiomer, esketamine, offer promising alternative treatments that can quickly relieve suicidal thoughts. This Overview of Reviews (OoR) analyzed and synthesized systematic reviews (SRs) with meta-analysis on randomized clinical trials (RCTs) involving ketamine in various formulations (intravenous, intramuscular, intranasal, subcutaneous) for patients with unipolar or bipolar depression. We evaluated the efficacy and safety of ketamine and esketamine in treating major depressive episodes across various forms, including unipolar, bipolar, treatment-resistant, and non-resistant depression, in patient populations with and without suicidal ideation, aiming to comprehensively assess their therapeutic potential and safety profile. Methods Following PRIOR guidelines, this OoR's protocol was registered on Implasy (ID:202150049). Searches in PubMed, Scopus, Cochrane Library, and Epistemonikos focused on English-language meta-analyses of RCTs of ketamine or esketamine, as monotherapy or add-on, evaluating outcomes like suicide risk, depressive symptoms, relapse, response rates, and side effects. We included studies involving both suicidal and non-suicidal patients; all routes and formulations of administration (intravenous, intramuscular, intranasal) were considered, as well as all available comparisons with control interventions. We excluded meta-analysis in which the intervention was used as anesthesia for electroconvulsive therapy or with a randomized ascending dose design. The selection, data extraction, and quality assessment of studies were carried out by pairs of reviewers in a blinded manner. Data on efficacy, acceptability, and tolerability were extracted. Results Our analysis included 26 SRs and 44 RCTs, with 3,316 subjects. The intervention is effective and well-tolerated, although the quality of the included SRs and original studies is poor, resulting in low certainty of evidence. Limitations This study is limited by poor-quality SRs and original studies, resulting in low certainty of the evidence. Additionally, insufficient available data prevents differentiation between the effects of ketamine and esketamine in unipolar and bipolar depression. Conclusion While ketamine and esketamine show promising therapeutic potential, the current evidence suffers from low study quality. Enhanced methodological rigor in future research will allow for a more informed application of these interventions within the treatment guidelines for unipolar and bipolar depression. Systematic review registration [https://inplasy.com/inplasy-2021-5-0049/], identifier (INPLASY202150049).
Collapse
Affiliation(s)
- Alessandro Rodolico
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Pierfelice Cutrufelli
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Antonio Di Francesco
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gaetano Catania
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
- University of Catania, Catania, Italy
| | - Carmen Concerto
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy
| | - Ludovico Mineo
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Antimo Natale
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
- Department of Psychiatry, Adult Psychiatry Service (SPA), University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Laura Rapisarda
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
| | - Antonino Petralia
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| |
Collapse
|
2
|
Iqbal M. UHPLC-MS/MS assay using environment friendly organic solvents: A green approach for fast determination of quetiapine in rat plasma. ARAB J CHEM 2019. [DOI: 10.1016/j.arabjc.2014.11.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
3
|
Reich M, Bondenet X. Place des psychotropes en oncologie. PSYCHO-ONCOLOGIE 2018. [DOI: 10.3166/pson-2018-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
4
|
Should Benzodiazepines and Anticonvulsants Be Used During Electroconvulsive Therapy?: A Case Study and Literature Review. J ECT 2017; 33:237-242. [PMID: 28767528 DOI: 10.1097/yct.0000000000000441] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study aims to investigate the clinical effects of benzodiazepines or anticonvulsant use during a course of electroconvulsive therapy (ECT). METHOD A case report study of a patient who received ECT with and without concomitant flurazepam and pregabalin is presented. The literature on the use of benzodiazepines and anticonvulsants during ECT is reviewed. RESULTS A woman with treatment resistant depression received a course of ECT while taking flurazepam and pregabalin, but seizures were of short duration and symptomatic improvement was minimal. After discontinuation of flurazepam and pregabalin, a course of right unilateral ultrabrief ECT was associated with adequate seizures and remission of depression and suicidal ideation. Our literature review suggests that benzodiazepines decrease seizure duration, but most evidence shows no association with increased seizure threshold. One prospective RCT and 3 large retrospective studies found that benzodiazepines compromise the efficacy of unilateral but not bilateral ECT. Regarding anticonvulsants, several studies had varied and contradictory results on their effect on seizure duration and seizure threshold. Of the 2 large retrospective studies and 3 RCTs, only 1 retrospective study showed that anticonvulsants decrease the efficacy of ECT. CONCLUSIONS Judicious assessment of all medications used in combination with ECT is recommended. Overall, published studies suggest that benzodiazepines and anticonvulsants impact the clinical outcomes of ECT less than what would be expected given their pharmacologic effects. However, there are significant gaps in the literature, including a lack of study on suprathreshold stimulation of right unilateral ECT and the possibility of a greater effect with higher medication doses.
Collapse
|
5
|
Baloch S, Kazi TG, Afridi HI, Baig JA, Talpur FN, Arain MB. Correlation of lithium levels between drinking water obtained from different sources and scalp hair samples of adult male subjects. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2017; 39:1191-1199. [PMID: 27757573 DOI: 10.1007/s10653-016-9886-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 10/07/2016] [Indexed: 06/06/2023]
Abstract
There is some evidence that natural levels of lithium (Li) in drinking water may have a protective effect on neurological health. In present study, we evaluate the Li levels in drinking water of different origin and bottled mineral water. To evaluate the association between lithium levels in drinking water with human health, the scalp hair samples of male subjects (25-45 years) consumed drinking water obtained from ground water (GW), municipal treated water (MTW) and bottled mineral water (BMW) from rural and urban areas of Sindh, Pakistan were selected. The water samples were pre-concentrated five to tenfold at 60 °C using temperature-controlled electric hot plate. While scalp hair samples were oxidized by acid in a microwave oven, prior to determined by flame atomic absorption spectrometry. The Li content in different types of drinking water, GW, MTW and BMW was found in the range of 5.12-22.6, 4.2-16.7 and 0.0-16.3 µg/L, respectively. It was observed that Li concentration in the scalp hair samples of adult males consuming ground water was found to be higher, ranged as 292-393 μg/kg, than those who are drinking municipal treated and bottle mineral water (212-268 and 145-208 μg/kg), respectively.
Collapse
Affiliation(s)
- Shahnawaz Baloch
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan
| | - Tasneem Gul Kazi
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan
| | - Hassan Imran Afridi
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan.
| | - Jameel Ahmed Baig
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan
| | - Farah Naz Talpur
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan
| | | |
Collapse
|
6
|
[Impact of natural lithium ressources on suicide mortality in Chile 2000-2009: a geographical analysis]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT ÖSTERREICHISCHER NERVENÄRZTE UND PSYCHIATER 2017; 31:70-76. [PMID: 28357647 DOI: 10.1007/s40211-017-0222-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 02/28/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND There is increasing evidence for the hypothesis that lithium salts at naturally occurring levels in drinking water may have a moderating effect on suicide rates of the exposed population. The aim of this study was to examine whether the lithium rich Atacama region in Chile is associated with lower suicide mortality in comparison to other regions. METHODS Suicide data was acquired from the Chilean Ministry of Health. Socio-economic variables (rate of unemployment, urbanity, median household income, percentage of indeginous population) were obtained for all regions of Chile from the national statistical institute. We calculated annual suicide rates per 100,000 for each group for the years 2000-2009 and tested the hypothesis that suicide rates are lower in lithium rich regions in comparison to other regions of Chile. RESULTS The lithium rich Atacama Desert shows a significantly lower suicide rate (9.99 per 100,000) in comparison to other parts of Chile (12.50 per 100,000) (t = 4.75, df = 18, p < 0.001). CONCLUSIONS Chilean regions rich in naturally occurring lithium salts show lower suicide mortality rates in comparison to other regions. Although causality cannot be proven by this design, these findings add to previous findings and warrant further research on the effects of naturally occurring low-dose lithium on health.
Collapse
|
7
|
Effects of green tea extracts on the pharmacokinetics of quetiapine in rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:615285. [PMID: 25793001 PMCID: PMC4352449 DOI: 10.1155/2015/615285] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/29/2014] [Indexed: 01/16/2023]
Abstract
Quetiapine is an atypical antipsychotic, used clinically in the treatment of schizophrenia, acute mania in bipolar disorders, and bipolar depression in adults. In this study, the effect of green tea extracts (GTE) on the pharmacokinetics of quetiapine (substrate of CYP3A4) was investigated in rats. Male Wistar albino rats received GTE (175 mg/kg) or saline (control) by oral gavage for 7 days before a single intragastric administration of 25 mg/kg quetiapine. Plasma concentrations of quetiapine were measured up to 12 h after its administration by a validated ultraperformance liquid chromatography-tandem mass spectroscopy. Pretreatment with GTE produced significant reductions in the maximum plasma concentration and area under the curve of quetiapine by 45% and 35%, respectively, compared to quetiapine alone. However, GTE did not produce significant change in elimination half-life and oral clearance of quetiapine. This study concluded that GTE may decrease the bioavailability of quetiapine when coadministered.
Collapse
|
8
|
Abstract
Depression, anxiety, delirium, and other psychiatric symptoms are highly prevalent in the cancer setting, and pharmacological intervention is an important component in the overall psychosocial care of the patient. Psychopharmacology is also used as a primary or adjuvant treatment for the management of cancer-related symptoms stemming from the disease itself and/or its treatment, including sleep disturbance, loss of appetite, neuropathic pain, nausea, fatigue, and hot flashes. Psychiatrists, oncologists, and palliative care physicians working as members of a multidisciplinary team have the opportunity to target multiple symptoms that negatively affect a patient's quality of life with the strategic use of psychotropic medications when deemed appropriate. This article aims to review the indications for use of antidepressants, psychostimulants, anxiolytics, antipsychotics, and mood stabilizers in oncology. An updated review of the relevant literature is discussed and referenced in each section.
Collapse
Affiliation(s)
- Seema M Thekdi
- The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Unit 1454, Houston, TX, 77230-1402, USA,
| | | | | |
Collapse
|
9
|
Retrospective evaluation of therapeutic drug monitoring of clozapine and norclozapine in Belgium using a multidrug UHPLC–MS/MS method. Clin Biochem 2014; 47:336-9. [DOI: 10.1016/j.clinbiochem.2014.09.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 09/17/2014] [Accepted: 09/26/2014] [Indexed: 11/20/2022]
|
10
|
Turpin E, Muscat A, Vatier C, Chetrite G, Corruble E, Moldes M, Fève B. Carbamazepine directly inhibits adipocyte differentiation through activation of the ERK 1/2 pathway. Br J Pharmacol 2014; 168:139-50. [PMID: 22889231 DOI: 10.1111/j.1476-5381.2012.02140.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 06/03/2012] [Accepted: 06/27/2012] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND AND PURPOSE Carbamazepine (CBZ), known for its anti-epileptic, analgesic and mood-stabilizing properties, is also known to induce weight gain but the pathophysiology of this adverse effect is still largely unknown. We tested the hypothesis that CBZ could have a direct effect on adipocyte development and metabolism. EXPERIMENTAL RESEARCH: We studied the effects of CBZ on morphological biochemical and molecular markers of adipogenesis, using several pre-adipocyte murine cell lines (3T3-L1, 3T3-F442A and T37i cells) and primary cultures of human pre-adipocytes. To delineate the mechanisms underlying the effect of CBZ, clonal expansion of pre-adipocytes, pro-adipogenic transcription factors, glucose uptake and lipolysis were also examined. KEY RESULTS CBZ strongly inhibited pre-adipocyte differentiation and triglyceride accumulation in a time- and dose-dependent manner in all models. Pleiotropic mechanisms were at the basis of the inhibitory effects of CBZ on adipogenesis and cell lipid accumulation. They included suppression of both clonal expansion and major adipogenic transcription factors such as PPAR-γ and CCAAT/enhancer binding protein-α, activation of basal lipolysis and decrease in insulin-stimulated glucose transport. CONCLUSIONS AND IMPLICATIONS The effect of CBZ on adipogenesis involves activation of the ERK1/2 pathway. Our results show that CBZ acts directly on pre-adipocytes and adipocytes to alter adipose tissue development and metabolism.
Collapse
Affiliation(s)
- E Turpin
- INSERM, U, Le Kremlin-Bicêtre, France
| | | | | | | | | | | | | |
Collapse
|
11
|
Altamura AC, Dragogna F. Should the term 'antipsychotic' be changed to 'multidimensional stabiliser' in bipolar disorder? Towards a new denomination for 'atypical antipsychotics'. Aust N Z J Psychiatry 2013; 47:707-9. [PMID: 23728532 DOI: 10.1177/0004867413492572] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Alfredo Carlo Altamura
- Department of Psychiatry, Mood Disorder Treatment Unit, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | | |
Collapse
|
12
|
Imbrici P, Camerino DC, Tricarico D. Major channels involved in neuropsychiatric disorders and therapeutic perspectives. Front Genet 2013; 4:76. [PMID: 23675382 PMCID: PMC3646240 DOI: 10.3389/fgene.2013.00076] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 04/16/2013] [Indexed: 12/11/2022] Open
Abstract
Voltage-gated ion channels are important mediators of physiological functions in the central nervous system. The cyclic activation of these channels influences neurotransmitter release, neuron excitability, gene transcription, and plasticity, providing distinct brain areas with unique physiological and pharmacological response. A growing body of data has implicated ion channels in the susceptibility or pathogenesis of psychiatric diseases. Indeed, population studies support the association of polymorphisms in calcium and potassium channels with the genetic risk for bipolar disorders (BPDs) or schizophrenia. Moreover, point mutations in calcium, sodium, and potassium channel genes have been identified in some childhood developmental disorders. Finally, antibodies against potassium channel complexes occur in a series of autoimmune psychiatric diseases. Here we report recent studies assessing the role of calcium, sodium, and potassium channels in BPD, schizophrenia, and autism spectrum disorders, and briefly summarize promising pharmacological strategies targeted on ion channels for the therapy of mental illness and related genetic tests.
Collapse
Affiliation(s)
- Paola Imbrici
- Section of Pharmacology, Department of Pharmacy - Drug Science, University of Bari Bari, Italy
| | | | | |
Collapse
|
13
|
Lehmann SW, Lee J. Lithium-associated hypercalcemia and hyperparathyroidism in the elderly: what do we know? J Affect Disord 2013; 146:151-7. [PMID: 22985484 DOI: 10.1016/j.jad.2012.08.028] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 08/20/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Lithium has been reported to induce hypercalcemia and hyperparathyroidism, yet few studies have examined the impact on older patients. We therefore undertook this review and report our findings. METHOD We undertook a systematic review of articles on lithium-associated hypercalcemia and/or hyperparathyroidism that were identified via electronic English language database searches through PubMed. RESULTS Among reported cases and case series of lithium-associated hyperparathyroidism in which ages of specific subjects were provided, 40% of affected individuals were over age 60. Mean serum calcium levels are reported to be higher in lithium treated patients over age 60 compared with younger patients. While many patients who develop lithium-associated hypercalcemia and hyperparathyroidism are asymptomatic, symptomatic complications may be more of a concern in older patients, especially in those with co-morbid renal disease. LIMITATIONS To date, all cross-sectional studies of lithium-associated hypercalcemia and hyperparathyroidism are of mixed age group cohorts and more specific studies focused on older patients have yet to be performed. CONCLUSIONS Lithium-induced hypercalcemia and hyperparathyroidism are under-recognized potential complications of lithium therapy which may occur more frequently in older patients. Psychiatrists should be vigilant in screening for hypercalcemia and hyperparathyroidism in their older patients receiving lithium, both prior to starting treatment and at least annually thereafter.
Collapse
Affiliation(s)
- Susan W Lehmann
- The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 279, Baltimore, Maryland 21287-7279, United States.
| | | |
Collapse
|
14
|
Johnsen E, Kroken RA. Drug treatment developments in schizophrenia and bipolar mania: latest evidence and clinical usefulness. Ther Adv Chronic Dis 2013; 3:287-300. [PMID: 23342242 DOI: 10.1177/2040622312462275] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Schizophrenia and bipolar disorder are often highly debilitating with chronic courses, and psychotropic drugs represent cornerstones in the treatment. The primary aim of the review was to summarize the latest evidence with regards to the efficacy and effectiveness of drug treatment of schizophrenia and the manic phases of bipolar disorder. Schizophrenia systematic reviews conclude that antipsychotic drugs are effective in treating overall symptoms of psychosis and in preventing relapse. Some of the newer agents, the second-generation antipsychotics (SGAs), have demonstrated superiority compared with the older first-generation drugs and other SGAs but side-effect differences among the drugs are of a greater magnitude than effect differences. The pragmatic randomized trials of effectiveness have shown a longer time until treatment discontinuation for olanzapine compared with other antipsychotics. Cohort studies have found superiority for the long-acting injection formulations compared with the oral formulations of the drugs, and lower total mortality risk in users of antipsychotics compared with non-users. In bipolar mania SGAs have shown superior antimanic efficacy compared with other mood-stabilizing drugs. In conclusion antipsychotics, in particular some of the SGAs, seem to be drugs of first choice for both schizophrenia and bipolar mania. This perspective review focused on mean effects but the group means may not always be particularly useful as schizophrenia and bipolar mania are biologically heterogeneous disorders with large inter-individual variations in drug response and tolerance. In patients with a prior drug history the different pharmacological and clinical profiles may be exploited in subsequent choices of drugs.
Collapse
Affiliation(s)
- Erik Johnsen
- Division of Psychiatry, Haukeland University Hospital, and Section of Psychiatry, Department of Clinical Medicine, University of Bergen, Sandviksleitet 1, N-5035 Bergen, Norway
| | | |
Collapse
|
15
|
Luca M, Prossimo G, Messina V, Luca A, Romeo S, Calandra C. Epidemiology and treatment of mood disorders in a day hospital setting from 1996 to 2007: an Italian study. Neuropsychiatr Dis Treat 2013; 9:169-76. [PMID: 23412988 PMCID: PMC3572759 DOI: 10.2147/ndt.s39227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND THE PRESENT STUDY AIMED: to assess prescribing patterns in the treatment of major depression, bipolar disorder type I, cyclothymia, and dysthymia from 1996 to 2007 in a day hospital setting; to evaluate the prevalence of the above-mentioned mood disorders and gender distribution; and to relate familiality, comorbidity, and marital status to each diagnosis. METHODS Medical records for 777 day hospital patients with a diagnosis of major depression, bipolar disorder type I, cyclothymia, or dysthymia were grouped into two 6-year periods so as to compare the prescribing patterns of tricyclic antidepressants, selective serotonin reuptake inhibitors, noradrenergic reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, noradrenergic and specific serotonergic antidepressants, first-generation antipsychotics, second-generation antipsychotics, and mood stabilizers. Gender, prevalence, familiality, comorbidity, and marital status were related to each diagnosis. RESULTS The most common mood disorder, with a female preponderance, was major depression, regardless of marital status. High percentages of familiality and comorbidity were found for major depression, while a reduction was found in the utilization of tricyclic antidepressants. There was no statistically significant difference in rates of prescription of selective serotonin reuptake inhibitors and noradrenergic reuptake inhibitors, but some irregularities were found upon evaluating each diagnosis (eg, increased utilization of these agents in dysthymia and major depression, respectively). There was an increase in prescriptions for serotonin and norepinephrine reuptake inhibitors, but no marked differences in utilization of noradrenergic and specific serotonergic antidepressants, which remained basically low. There was no significant difference in prescribing of first-generation antipsychotic agents, although a reduction was found. There was a significant increase in utilization of second-generation antipsychotics and mood stabilizers. CONCLUSION Our epidemiological findings are consistent with data reported in the literature regarding the high prevalence of major depression among the mood disorders, as well as the impact of familiality and comorbidity. Analysis of prescribing patterns for antidepressants, antipsychotics, and mood stabilizers in the treatment of mood disorders shows a shift from older to newer drugs, and wider use of mood stabilizers.
Collapse
Affiliation(s)
- Maria Luca
- Department of Medical and Surgery Specialties, Psychiatry Unit, University Hospital Policlinico-Vittorio Emanuele, Catania, Sicily, Italy
| | | | | | | | | | | |
Collapse
|
16
|
|
17
|
Abstract
The aim of this review is to provide information for interpreting outcome results from monitoring of antipsychotics in biological samples. A brief overview of the working mechanisms, pharmacological effects, drug interactions, and analytical methods of classical and atypical antipsychotics is given. Nineteen antipsychotics were selected based on their importance in the worldwide market as follows: amisulpride, aripiprazole, asenapine, bromperidol, clozapine, flupenthixol, haloperidol, iloperidone, lurasidone, olanzapine, paliperidone, perphenazine, pimozide, pipamperone, quetiapine, risperidone, sertindole, sulpiride, and zuclopenthixol. A straightforward relationship between administered dose, plasma or serum concentration, clinical outcome, or adverse effects is often lacking. Nowadays, focus lies on therapeutic drug monitoring and individualized therapy to find adequate treatment, to explain treatment failure or nonresponse, and to check patient compliance. However, extensive research in this field is still mandatory.
Collapse
|
18
|
Helbich M, Leitner M, Kapusta ND. Geospatial examination of lithium in drinking water and suicide mortality. Int J Health Geogr 2012; 11:19. [PMID: 22695110 PMCID: PMC3441892 DOI: 10.1186/1476-072x-11-19] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 05/24/2012] [Indexed: 11/25/2022] Open
Abstract
Background Lithium as a substance occurring naturally in food and drinking water may exert positive effects on mental health. In therapeutic doses, which are more than 100 times higher than natural daily intakes, lithium has been proven to be a mood-stabilizer and suicide preventive. This study examined whether natural lithium content in drinking water is regionally associated with lower suicide rates. Methods Previous statistical approaches were challenged by global and local spatial regression models taking spatial autocorrelation as well as non-stationarity into account. A Geographically Weighted Regression model was applied with significant independent variables as indicated by a spatial autoregressive model. Results The association between lithium levels in drinking water and suicide mortality can be confirmed by the global spatial regression model. In addition, the local spatial regression model showed that the association was mainly driven by the eastern parts of Austria. Conclusions According to old anecdotic reports the results of this study support the hypothesis of positive effects of natural lithium intake on mental health. Both, the new methodological approach and the results relevant for health may open new avenues in the collaboration between Geographic Information Science, medicine, and even criminology, such as exploring the spatial association between violent or impulsive crime and lithium content in drinking water.
Collapse
Affiliation(s)
- Marco Helbich
- Institute of Geography, University of Heidelberg, Berliner Strasse 48, D-69120 Heidelberg, Germany
| | | | | |
Collapse
|
19
|
Kristensen LV, Sandager-Nielsen K, Hansen HH. Kv7 (KCNQ) channel openers normalize central 2-deoxyglucose uptake in a mouse model of mania and increase prefrontal cortical and hippocampal serine-9 phosphorylation levels of GSK3β. J Neurochem 2012; 121:373-82. [DOI: 10.1111/j.1471-4159.2012.07704.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
20
|
Vega P, Barbeito S, de Azúa SR, Martínez-Cengotitabengoa M, González–Ortega I, Saenz M, González-Pinto A. Bipolar Disorder Differences between Genders: Special Considerations for Women. WOMENS HEALTH 2011; 7:663-74; quiz 675-6. [DOI: 10.2217/whe.11.71] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The objective of this article is to review clinical differences between men and women with bipolar disorder. The secondary objective is to analyze the differences in adherence to medication between genders. Men usually present with manic episodes and have comorbid drug abuse, while women usually present with major depressive episode, the onset is often later, comorbidity of physical pathology is common and adherence to medication is greater than in men. In women who have an earlier onset of the illness and are single, the risk of nonadherence is higher than in other groups of women. There are two time periods that are very important in women: pregnancy and postpartum. Both are critical periods and a relapse or recurrence of symptoms at either stage can have serious consequences for the woman and/or her baby. In addition, the effect of medication on the fetus is unclear. In conclusion, there is a clear need for more studies on gender differences in bipolar disorder and how to improve adherence to treatment. Moreover, a better understanding of how to treat women with bipolar disorder during pregnancy and lactation will undoubtedly lead to improved outcomes for both the mother and her child.
Collapse
Affiliation(s)
- Patricia Vega
- Department of Psychiatry, Hospital Santiago Apóstol, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of the Basque Country Olaguibel 29, 01004 Vitoria, Spain
| | - Sara Barbeito
- Department of Psychiatry, Hospital Santiago Apóstol, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of the Basque Country Olaguibel 29, 01004 Vitoria, Spain
| | - Sonia Ruiz de Azúa
- Department of Psychiatry, Hospital Santiago Apóstol, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of the Basque Country Olaguibel 29, 01004 Vitoria, Spain
| | - Mónica Martínez-Cengotitabengoa
- Department of Psychiatry, Hospital Santiago Apóstol, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of the Basque Country Olaguibel 29, 01004 Vitoria, Spain
| | - Itxaso González–Ortega
- Department of Psychiatry, Hospital Santiago Apóstol, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of the Basque Country Olaguibel 29, 01004 Vitoria, Spain
| | - Margarita Saenz
- Department of Psychiatry, Hospital Santiago Apóstol, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of the Basque Country Olaguibel 29, 01004 Vitoria, Spain
| | - Ana González-Pinto
- Department of Psychiatry, Hospital Santiago Apóstol, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of the Basque Country Olaguibel 29, 01004 Vitoria, Spain
| |
Collapse
|
21
|
Oliveira RDL, Seibt KJ, Rico EP, Bogo MR, Bonan CD. Inhibitory effect of lithium on nucleotide hydrolysis and acetylcholinesterase activity in zebrafish (Danio rerio) brain. Neurotoxicol Teratol 2011; 33:651-7. [PMID: 21609761 DOI: 10.1016/j.ntt.2011.05.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Revised: 05/02/2011] [Accepted: 05/03/2011] [Indexed: 10/18/2022]
Abstract
Lithium has been used as an effective antimanic drug in humans and it is well known for its effects on neuropsychiatric disorders and neuronal communication. ATP and adenosine are important signaling molecules, and most nerves release ATP as a fast co-transmitter together with classical neurotransmitters such as acetylcholine. In this study, we evaluated the in vitro and in vivo effects of lithium on acetylcholinesterase and ectonucleotidase activities in zebrafish brain. There was a significant inhibition of ADP hydrolysis after in vivo exposure to lithium at 5 and 10 mg/l (27.6% and 29% inhibition, respectively), whereas an inhibitory effect was observed for AMP hydrolysis only at 10 mg/l (30%). Lithium treatment in vivo also significantly decreased the acetylcholinesterase activity at 10 mg/l (21.9%). The mRNA transcript levels of the genes encoding for these enzymes were unchanged after exposure to 5 and 10 mg/l lithium chloride. In order to directly evaluate the action of lithium on enzyme activities, we tested the in vitro effect of lithium at concentrations ranging from 1 to 1000 μM. There were no significant changes in zebrafish brain ectonucleotidase and acetylcholinesterase activities at all concentrations tested in vitro. Our findings show that lithium treatment can alter ectonucleotidase and acetylcholinesterase activities, which may regulate extracellular nucleotide, nucleoside, and acetylcholine levels. These data suggest that cholinergic and purinergic signaling may be targets of the pharmacological effects induced by this compound.
Collapse
Affiliation(s)
- Renata da Luz Oliveira
- Programa de Pós-Graduação em Biologia Celular e Molecular, Laboratório de Neuroquímica e Psicofarmacologia, Departamento de Biologia Celular e Molecular, Faculdade de Biociências, Pontifícia Universidade Católica do Rio Grande do Sul, Avenida Ipiranga 6681, Porto Alegre, RS, Brazil
| | | | | | | | | |
Collapse
|
22
|
Kapusta ND, Mossaheb N, Etzersdorfer E, Hlavin G, Thau K, Willeit M, Praschak-Rieder N, Sonneck G, Leithner-Dziubas K. Lithium in drinking water and suicide mortality. Br J Psychiatry 2011; 198:346-50. [PMID: 21525518 DOI: 10.1192/bjp.bp.110.091041] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND There is some evidence that natural levels of lithium in drinking water may have a protective effect on suicide mortality. AIMS To evaluate the association between local lithium levels in drinking water and suicide mortality at district level in Austria. METHOD A nationwide sample of 6460 lithium measurements was examined for association with suicide rates per 100,000 population and suicide standardised mortality ratios across all 99 Austrian districts. Multivariate regression models were adjusted for well-known socioeconomic factors known to influence suicide mortality in Austria (population density, per capita income, proportion of Roman Catholics, as well as the availability of mental health service providers). Sensitivity analyses and weighted least squares regression were used to challenge the robustness of the results. RESULTS The overall suicide rate (R(2) = 0.15, β = -0.39, t = -4.14, P = 0.000073) as well as the suicide mortality ratio (R(2) = 0.17, β = -0.41, t = -4.38, P = 0.000030) were inversely associated with lithium levels in drinking water and remained significant after sensitivity analyses and adjustment for socioeconomic factors. CONCLUSIONS In replicating and extending previous results, this study provides strong evidence that geographic regions with higher natural lithium concentrations in drinking water are associated with lower suicide mortality rates.
Collapse
Affiliation(s)
- Nestor D Kapusta
- Medical University of Vienna, Department for Psychoanalysis and Psychotherapy, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Woo YS, Bahk WM. Recent advances in the pharmacotherapy of psychiatric disorders. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2011. [DOI: 10.5124/jkma.2011.54.10.1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|