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Kazmierska-Grebowska P, Żakowski W, Myślińska D, Sahu R, Jankowski MM. Revisiting serotonin's role in spatial memory: A call for sensitive analytical approaches. Int J Biochem Cell Biol 2024; 176:106663. [PMID: 39321568 DOI: 10.1016/j.biocel.2024.106663] [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: 03/14/2024] [Revised: 09/17/2024] [Accepted: 09/17/2024] [Indexed: 09/27/2024]
Abstract
The serotonergic system is involved in various psychiatric and neurological conditions, with serotonergic drugs often used in treatment. These conditions frequently affect spatial memory, which can serve as a model of declarative memory due to well-known cellular components and advanced methods that track neural activity and behavior with high temporal resolution. However, most findings on serotonin's effects on spatial learning and memory come from studies lacking refined analytical techniques and modern approaches needed to uncover the underlying neuronal mechanisms. This In Focus review critically investigates available studies to identify areas for further exploration. It finds that well-established behavioral models could yield more insights with modern tracking and data analysis approaches, while the cellular aspects of spatial memory remain underexplored. The review highlights the complex role of serotonin in spatial memory, which holds the potential for better understanding and treating memory-related disorders.
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Affiliation(s)
| | - Witold Żakowski
- Department of Animal and Human Physiology, Faculty of Biology, University of Gdansk, Gdansk, Poland
| | - Dorota Myślińska
- Department of Animal and Human Physiology, Faculty of Biology, University of Gdansk, Gdansk, Poland
| | - Ravindra Sahu
- BioTechMed Center, Multimedia Systems Department, Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, Gdansk, Poland
| | - Maciej M Jankowski
- BioTechMed Center, Multimedia Systems Department, Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, Gdansk, Poland.
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2
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Carvalho-Silva L, Jiménez-Correa U, Santana-Miranda R, Heyerdahl-Viau I, Benitez-Morales J, García-Casas M, Martínez-Núñez JM. Irrational Use of Medications among Adults with Insomnia: An Observational Study at a Sleep Clinic in Mexico. PHARMACY 2024; 12:56. [PMID: 38668082 PMCID: PMC11054186 DOI: 10.3390/pharmacy12020056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/16/2024] [Accepted: 03/25/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND To determine the patterns of irrational use of medications among a sample of adult patients with insomnia. METHODS We included 89 adult patients diagnosed with chronic insomnia who had consumed medications for this disorder during the 12 months prior to admission to a specialized Sleep Disorders Clinic (SDC) in Mexico City. With a 13-item survey, information was gathered on patterns of medication use and irrational use, considering therapeutic indications, dose, route of administration, and duration of treatment. RESULTS The participants had taken hypnotics (65%), antidepressants (21%), anticonvulsants (8%), and antipsychotics (6%), and 92% had irrational use of their medication. Irrational use was greatest with benzodiazepines and antipsychotics. There were two main types of irrational use: (1) 47% of participants had consumed a drug unsuitable for their condition, although it was almost always prescribed by a doctor, and (2) 43% had consumed a drug for longer than the maximum time recommended. CONCLUSION It is worrisome to find that the irrational use of medications to treat insomnia, especially benzodiazepines and antipsychotics is widespread. Although most participants had acquired their medication by prescription, for many the drug was inappropriate to treat their condition. It should be mandatory that patients with insomnia receive specialized medical attention in primary clinical care.
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Affiliation(s)
- Lucelya Carvalho-Silva
- Department of Biological Systems, Universidad Autónoma Metropolitana, Campus Xochimilco, Mexico City 04960, Mexico; (L.C.-S.); (I.H.-V.)
| | - Ulises Jiménez-Correa
- Clinic of Sleep Disorders, School of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City 06720, Mexico (R.S.-M.)
| | - Rafael Santana-Miranda
- Clinic of Sleep Disorders, School of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City 06720, Mexico (R.S.-M.)
| | - Ivo Heyerdahl-Viau
- Department of Biological Systems, Universidad Autónoma Metropolitana, Campus Xochimilco, Mexico City 04960, Mexico; (L.C.-S.); (I.H.-V.)
| | - Jonatan Benitez-Morales
- Department of Hospital Pharmacy, Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City 14080, Mexico
| | - Mireya García-Casas
- Department of Clinical Pharmacy, Facultad de Estudios Superiores, Campus Zaragoza, Universidad Nacional Autónoma de México (UNAM), Mexico City 09230, Mexico
| | - Juan Manuel Martínez-Núñez
- Department of Biological Systems, Universidad Autónoma Metropolitana, Campus Xochimilco, Mexico City 04960, Mexico; (L.C.-S.); (I.H.-V.)
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3
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Zhou Q, Li X, Yang D, Xiong C, Xiong Z. A comprehensive review and meta-analysis of neurological side effects related to second-generation antidepressants in individuals with major depressive disorder. Behav Brain Res 2023; 447:114431. [PMID: 37044221 DOI: 10.1016/j.bbr.2023.114431] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 03/19/2023] [Accepted: 04/07/2023] [Indexed: 04/14/2023]
Abstract
Second-generation antidepressants (SGADs) often cause neurological side effects (SEs). This meta-analysis seeks to quantify the short-term rates of neurological SEs related to routinely used second-generation antidepressants used to treat major depressive disorder (MDD). A search of the PubMed, EMBASE,Cochrane Library databases and Web of Science was done to uncover double-blind, randomized, placebo-controlled studies evaluating the effectiveness of frequently used SGADs medicines in people with MDD. Qualifying studies were required to concentrate on the use of SGADs routinely used in MDD and to uncover data on treatment-emergent neurological SEs occurring within 12 weeks of therapy. Overall, 143 RCT studies containing 188 treatment arms were included in the meta-analyses. Most SGADs increased the risk of neurological SEs compared to placebo. The least tolerated antidepressants on the neurological tract were desvenlafaxine (OR=1.98; CI 0.85-4.65; p-value=0.12) and venlafaxine (OR=1.15; CI 0.96-1.38; p-value=0.13). Agomelatine, bupropion and vortioxetine exhibited reduced neurological SEs, showing diminished risk in insomnia (OR=0.56; CI 0.36-0.88; p-value=0.01), somnolence (OR=0.46; CI 0.27-0.79; p-value=0.01), vision blurred (OR=0.43; CI 0.19-0.96; p-value=0.04), respectively. Most SGADs did not or just marginally increased the risk of headache compared to placebo. In conclusion, frequently used SGADs demonstrated distinct patterns of neurological SEs, which physicians should consider when prescribing antidepressants to promote treatment adherence and favorable outcomes in patients with MDD.
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Affiliation(s)
- Qi Zhou
- Department of Neurology, The First People's Hospital of Fuzhou, Fuzhou, Jiangxi, China.
| | - Xinming Li
- Department of Neurology, The Third Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - Dejiang Yang
- Department of Neurology, The Third Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - Chongyu Xiong
- Public relations department, The First People's Hospital of Fuzhou, Fuzhou, Jiangxi, China.
| | - Zhenrong Xiong
- Public relations department, The First People's Hospital of Fuzhou, Fuzhou, Jiangxi, China.
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4
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Gugulothu K, Ramulu Meesa S, Kumar Utkoor U, Rajasekhara Reddy S, Shiva Kumar K. Pd/C and TFA‐promoted One‐pot, Two‐step Cascade Reaction: An Effective Synthesis of Oxepines. ASIAN J ORG CHEM 2021. [DOI: 10.1002/ajoc.202100449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Kishan Gugulothu
- Department of Chemistry Osmania University Hyderabad 500 007 India
| | | | | | - Sabbasani Rajasekhara Reddy
- Department of Chemistry School of Advanced Sciences Vellore Institute of Technology (VIT) Vellore 632014 India
| | - K. Shiva Kumar
- Department of Chemistry Osmania University Hyderabad 500 007 India
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5
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Abstract
Insomnia can have significant health and economic impacts. In contrast, sleep disturbance is common but does not usually affect daytime activity Short-term approaches for acute insomnia are often appropriate. These include dealing with precipitating factors such as stress Chronic insomnia has a high relapse and recurrence rate. It is best managed with cognitive behavioural therapy which includes sleep hygiene, stimulus control and sleep restriction In primary care, brief behavioural therapy for insomnia is an accessible and effective management strategy. If there is no response, referral should be considered Adjuvant use of drugs in insomnia may be appropriate in some cases. Prescription should be for a limited duration
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6
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Sweetman A, Lack L, Van Ryswyk E, Vakulin A, Reed RL, Battersby MW, Lovato N, Adams RJ. Co-occurring depression and insomnia in Australian primary care: recent scientific evidence. Med J Aust 2021; 215:230-236. [PMID: 34392547 DOI: 10.5694/mja2.51200] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 05/14/2021] [Accepted: 05/20/2021] [Indexed: 11/17/2022]
Abstract
Depression and insomnia commonly co-occur, resulting in greater morbidity for patients, and difficult diagnostic and treatment decisions for clinicians. When patients report symptoms of both depression and insomnia, it is common for medical practitioners to conceptualise the insomnia as a secondary symptom of depression. This implies that there is little purpose in treating insomnia directly, and that management of depression will improve both the depression and insomnia symptoms. In this review, we present an overview of research investigating the comorbidity and treatment approaches for patients presenting with depression and insomnia in primary care. Evidence shows that clinicians should avoid routinely conceptualising insomnia as a secondary symptom of depression. This is because insomnia symptoms: (i) often occur before mood decline and are independently associated with increased risk of future depression; (ii) commonly remain unchanged following depression treatment; and (iii) predict relapse of depression after treatment for depression only. Furthermore, compared with control, cognitive behaviour therapy for insomnia improves symptoms of both depression and insomnia. It is critical that primary care clinicians dedicate specific diagnostic and treatment attention to the management of both depression (eg, psychotherapy, antidepressants) and insomnia (eg, cognitive behaviour therapy for insomnia administered by trained therapists or psychologists through a mental health treatment plan referral, by online programs, or by a general practitioner or nurse) when they co-occur. These treatments may be offered concurrently or sequentially (eg, insomnia treatment followed by depression treatment, or vice versa), depending on presenting symptoms, history, lifestyle factors and other comorbidities.
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Affiliation(s)
- Alexander Sweetman
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA.,National Centre for Sleep Health Services Research, Flinders University, Adelaide, SA
| | - Leon Lack
- National Centre for Sleep Health Services Research, Flinders University, Adelaide, SA
| | - Emer Van Ryswyk
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA.,National Centre for Sleep Health Services Research, Flinders University, Adelaide, SA
| | - Andrew Vakulin
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA.,National Centre for Sleep Health Services Research, Flinders University, Adelaide, SA
| | - Richard L Reed
- National Centre for Sleep Health Services Research, Flinders University, Adelaide, SA.,College of Medicine and Public Health, Flinders University, Adelaide, SA
| | | | - Nicole Lovato
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA.,National Centre for Sleep Health Services Research, Flinders University, Adelaide, SA
| | - Robert J Adams
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA.,National Centre for Sleep Health Services Research, Flinders University, Adelaide, SA
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7
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Silver-assisted palladium-catalyzed one-pot synthesis of 3-(hetero)arylmethyl derivatives of imidazo[1,2-a]pyridines. Chem Heterocycl Compd (N Y) 2021. [DOI: 10.1007/s10593-021-02941-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Zhu S, Wang B, Li H, Xiao W, Teng F, Shen H, Gui Q, Li Z, Jiang H. Halogenation of Imidazo[1,2‐
α
]pyridines with DXDMH (X=Cl, Br and I) Using DMSO as a Solvent and an Oxidant. ChemistrySelect 2020. [DOI: 10.1002/slct.202003161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Sha Zhu
- School of Chemistry and Materials Science Hunan Agricultural University Changsha 410128 People's Republic of China
| | - Binbin Wang
- School of Chemistry and Materials Science Hunan Agricultural University Changsha 410128 People's Republic of China
| | - Huiqin Li
- School of Chemistry and Materials Science Hunan Agricultural University Changsha 410128 People's Republic of China
| | - Wending Xiao
- Hunan Jiudian Pharmaceutical Co. Changsha 410009 People's Republic of China
| | - Fan Teng
- School of Chemistry and Materials Science Hunan Agricultural University Changsha 410128 People's Republic of China
| | - Haicheng Shen
- School of Chemistry and Materials Science Hunan Agricultural University Changsha 410128 People's Republic of China
| | - Qing‐Wen Gui
- School of Chemistry and Materials Science Hunan Agricultural University Changsha 410128 People's Republic of China
| | - Zhouchao Li
- School of Chemistry and Materials Science Hunan Agricultural University Changsha 410128 People's Republic of China
| | - Hongmei Jiang
- School of Chemistry and Materials Science Hunan Agricultural University Changsha 410128 People's Republic of China
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9
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Samara MT, Huhn M, Chiocchia V, Schneider-Thoma J, Wiegand M, Salanti G, Leucht S. Efficacy, acceptability, and tolerability of all available treatments for insomnia in the elderly: a systematic review and network meta-analysis. Acta Psychiatr Scand 2020; 142:6-17. [PMID: 32521042 DOI: 10.1111/acps.13201] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Symptoms of insomnia are highly prevalent in the elderly. A significant number of pharmacological and non-pharmacological interventions exist, but, up-to-date, their comparative efficacy and safety has not been sufficiently assessed. METHODS We integrated the randomized evidence from every available treatment for insomnia in the elderly (>65 years) by performing a network meta-analysis. Several electronic databases were searched up to May 25, 2019. The two primary outcomes were total sleep time and sleep quality. Data for other 6 efficacy and 8 safety outcomes were also analyzed. RESULTS Fifty-three RCTs with 6832 participants (75 years old on average) were included, 43 of which examined the efficacy of one or more drugs. Ten RCTs examined the efficacy of non-pharmacological interventions and were evaluated only with pairwise meta-analyses because they were disconnected from the network. The overall confidence in the evidence was very low primarily due to the small amount of data per comparison and their sparse connectedness. Several benzodiazepines, antidepressants, and z-drugs performed better in both primary outcomes, but few comparisons had data from more than one trial. The limited evidence on non-pharmacological interventions suggested that acupressure, auricular acupuncture, mindfulness-based stress reduction program, and tart cherry juice were better than their control interventions. Regarding safety, no clear differences were detected among interventions due to large uncertainty. CONCLUSIONS Insufficient evidence exists on which intervention is more efficacious for elderly patients with insomnia. More RCTs, with longer duration, making more direct interventions among active treatments and presenting more outcomes are urgently needed.
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Affiliation(s)
- M T Samara
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Huhn
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social Foundation Bamberg, Teaching Hospital of the University of Erlangen, Erlangen, Germany
| | - V Chiocchia
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - J Schneider-Thoma
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - M Wiegand
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - G Salanti
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - S Leucht
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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10
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Roach M, Juday T, Tuly R, Chou JW, Jena AB, Doghramji PP. Challenges and opportunities in insomnia disorder. Int J Neurosci 2020; 131:1058-1065. [PMID: 32449423 DOI: 10.1080/00207454.2020.1773460] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
| | | | | | | | - Anupam B. Jena
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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11
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Temporal Trends in the Use of Anticholinergic Drugs Among Older People Living in Long-Term Care Facilities in Helsinki. Drugs Aging 2020; 37:27-34. [PMID: 31705445 PMCID: PMC6965041 DOI: 10.1007/s40266-019-00720-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background The use of drugs with anticholinergic properties (DAPs) is common among older adults despite their known adverse effects, such as cognitive decline. Professionals should pay attention to DAPs, since evidence on their adverse effects has been accumulating during the last decade. However, to our knowledge previous studies exploring temporal trends in the use of DAPs are scarce. Objective The aim of this study was to assess temporal trends in the use of DAPs from 2003 to 2017 in long-term care facilities in Helsinki. Methods Four cross-sectional studies were conducted in 2003, 2007, 2011, and 2017. Participants included older people (≥ 65 years) living in nursing homes (NHs) in 2003 (n = 1979), 2011 (n = 1568), and 2017 (n = 750), and in assisted living facilities (ALFs) in 2007 (n = 1336), 2011 (n = 1556), and 2017 (n = 1673) in Helsinki, Finland. Data on demographics, medication use, and diagnoses were collected by structured questionnaires. The assessments were conducted as a point prevalence over 1 day. The use of DAPs and the total anticholinergic burden were defined by the Anticholinergic Risk Scale (ARS). Results In ALFs, there has been an increasing trend in the use of DAPs over a 10-year period (41.2% in 2007 and 53.7% in 2017). In NHs, by contrast, the use of DAPs remained quite stable (52.3% in 2003 and 52.4% in 2017). The burden of DAPs measured by ARS score decreased in NHs and remained stable in ALFs. Marked changes occurred in the DAPs used; antidepressants, especially mirtazapine, increased in both settings, whereas the use of hydroxyzine and urinary antispasmodics nearly disappeared. The proportion of users of DAP antipsychotics increased in ALFs. Participants with dementia had a lower anticholinergic burden than those without dementia, in both settings. Conclusions Despite increased knowledge of the harms of DAPs, they remain widely used. Physicians seem to be aware of the harms of DAPs among people with dementia, and some other favorable trends in prescribing were also observed. Clinicians should especially consider the indications behind the use of DAP antidepressants and antipsychotics, and carefully weigh their potential benefits and harms.
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12
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Asghariganjeh MR, Mohammadi AA, Tahanpesar E, Rayatzadeh A, Makarem S. Electro-organic synthesis of tetrahydroimidazo[1,2-a]pyridin-5(1H)-one via a multicomponent reaction. Mol Divers 2020; 25:509-516. [PMID: 31919737 DOI: 10.1007/s11030-019-10029-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 12/23/2019] [Indexed: 11/24/2022]
Abstract
Electro-synthesis through a one-pot three-component condensation of corresponding aldehydes, Meldrum's acid, and 2-(nitromethylene)imidazolidine resulted in a series of novel tetrahydroimidazo[1,2-a]pyridine-5(1H)-one derivatives containing an electronegative pharmacophore (=CNO2). The process was carried out in propanol medium with sodium bromide presented as electrolyte, inside an undivided cell with good to excellent yields. As a powerful entry into fused polycyclic structures related to bioactive heterocycles, this green protocol shows great potential.
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Affiliation(s)
- Mohammad Reza Asghariganjeh
- Department of Chemistry, Khuzestan Science and Research Branch, Islamic Azad University, Ahvaz, Iran.,Department of Chemistry, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | - Ali Asghar Mohammadi
- Chemistry and Chemical Engineering Research Center of Iran (CCERCI), 14335-186, Tehran, Iran.
| | - Elham Tahanpesar
- Department of Chemistry, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | - Ayeh Rayatzadeh
- Department of Chemistry, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | - Somayeh Makarem
- Department of Chemistry, Karaj Branch, Islamic Azad University, Karaj, Iran
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13
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Vijay A, Becker JE, Ross JS. Patterns and predictors of off-label prescription of psychiatric drugs. PLoS One 2018; 13:e0198363. [PMID: 30024873 PMCID: PMC6053129 DOI: 10.1371/journal.pone.0198363] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 05/17/2018] [Indexed: 11/28/2022] Open
Abstract
Off-label prescribing of psychiatric drugs is common, despite lacking strong scientific evidence of efficacy and potentially increasing risk for adverse events. The goal of this study was to characterize prevalence of off-label prescriptions of psychiatric drugs and examine patient and clinician predictors of off-label use. This manuscript presents a retrospective, cross-sectional study using data from the 2012 and 2013 National Ambulatory Medical Care Surveys (NAMCS). The study examined all adult outpatient visits to psychiatric practices for chronic care management with a single listed visit diagnosis in which at least one psychiatric drug was prescribed. The main outcome measure was off-label prescribing of at least one psychiatric drug, defined as prescription for a condition for which it has not been approved for use by the FDA. Among our sample representative of 1.85 billion outpatient visits, 18.5 million (1.3%) visits were to psychiatrists for chronic care management in which at least one psychiatric drug was prescribed. Overall, the rate of off-label use was 12.9% (95% CI: 12.2-15.7). The most common off-label uses were for manic-depressive psychosis treated with citalopram and primary insomnia treated with trazodone. Several patient and clinician characteristics were positively associated with off-label prescribing, including seeing a psychiatrist (OR: 1.06, 95% CI, 1.01-1.12; p = 0.03) instead of another type of clinician, the office visit taking place in the Western region of the country (OR: 1.09, 95% CI, 1.01-1.17; p = 0.02), and the patient having 3 or more chronic conditions (OR: 1.12, 95% CI, 1.02-1.14; p = 0.003). In contrast, having Medicare coverage (OR: 0.93, 95% CI, 0.84-0.97; p = 0.04) and receiving payment assistance from a medical charity (OR: 0.91, 95% CI, 0.88-0.96; p = 0.03) instead of private insurance were negatively associated with off-label prescribing. These results suggest that certain classes of psychiatric medications are being commonly prescribed to treat conditions for which they have not been determined by the FDA to be clinically efficacious and/or safe.
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Affiliation(s)
- Aishwarya Vijay
- Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Jessica E. Becker
- MGH/McLean Psychiatry Residency Program, Massachusetts General Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
| | - Joseph S. Ross
- Section of General Internal Medicine and the National Clinician Scholars Program, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America
- The Center for Outcomes Research and Evaluation, Yale–New Haven Hospital, New Haven, Connecticut, United States of America
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14
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Park KM, Kim TH, Kim WJ, An SK, Namkoong K, Lee E. Cognitive Behavioral Therapy for Insomnia Reduces Hypnotic Prescriptions. Psychiatry Investig 2018; 15:499-504. [PMID: 29695151 PMCID: PMC5976005 DOI: 10.30773/pi.2017.11.20] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/20/2017] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE This study determined whether cognitive behavioral therapy for insomnia (CBT-i) decreased the need for sleep medications and produced better treatment outcomes than pharmacotherapy alone. METHODS We reviewed data from patients with insomnia in the outpatient clinic of a general hospital between 2009 and 2015. We compared 41 patients who received five sessions of CBT-i with 100 age- and sex-matched patients who received pharmacotherapy only. We evaluated the change in prescription for sleep (i.e., antidepressants, hypnotics, and others) between the first and last visits using repeated measures analysis of variance (ANOVA). Clinical global impressions and completion status at the last visit were assessed using the chisquare test. RESULTS We found a significant decrease in the prescription rate and the dosage of hypnotics among patients who received CBT-i when compared with control patients. There was no significant change in the dosage of antidepressants between the two groups. Achievement of case closure was better in the CBT-i group at the trend level. Clinical global impression at the last visit was not significantly different. CONCLUSION These results show that CBT-i reduces the need for hypnotics among insomnia patients. Our results indicate that CBT-i offers additional benefits beyond improving sleep characteristics and thus provides another reason for recommending CBT-i as a first-line treatment for insomnia.
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Affiliation(s)
- Kyung Mee Park
- Institute of Behavioral Science in Medicine and Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae Ho Kim
- Institute of Behavioral Science in Medicine and Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woo Jung Kim
- Department of Psychiatry, Seonam University College of Medicine, Myongji Hospital, Goyang, Republic of Korea
| | - Suk Kyoon An
- Institute of Behavioral Science in Medicine and Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kee Namkoong
- Institute of Behavioral Science in Medicine and Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Lee
- Institute of Behavioral Science in Medicine and Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
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15
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Dutta G, Jana AK, Natarajan S. Chemical Fixation of CO2
and Other Heterogeneous Catalytic Studies by Employing a Layered Cu-Porphyrin Prepared Through Single-Crystal to Single-Crystal Exchange of a Zn Analogue. Chem Asian J 2017; 13:66-72. [DOI: 10.1002/asia.201701384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 10/23/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Gargi Dutta
- Framework Solids Laboratory; Solid State and Structural Chemistry Unit; Indian Institute of Science; Bangalore 560012 India
| | - Ajay Kumar Jana
- Framework Solids Laboratory; Solid State and Structural Chemistry Unit; Indian Institute of Science; Bangalore 560012 India
| | - Srinivasan Natarajan
- Framework Solids Laboratory; Solid State and Structural Chemistry Unit; Indian Institute of Science; Bangalore 560012 India
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16
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Ghandi M, Moshtaghi P, Abbasi A. Catalyst-free synthesis of 3-hydroxyimidazo[1,2- a ]pyridine zwitterion derivatives via the three-component reaction of ethyl glyoxalate, 2‑aminopyridines and cyclic 1,3-dicarbonyls. Tetrahedron Lett 2017. [DOI: 10.1016/j.tetlet.2017.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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17
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Yu ZH, Xu XH, Wang SD, Song MF, Liu Y, Yin Y, Mao HJ, Tang GZ. Effect and safety of paroxetine combined with zolpidem in treatment of primary insomnia. Sleep Breath 2017; 21:191-195. [DOI: 10.1007/s11325-017-1462-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 12/18/2016] [Accepted: 01/11/2017] [Indexed: 10/20/2022]
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18
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Zhang Z, Ju T, Miao M, Han JL, Zhang YH, Zhu XY, Ye JH, Yu DG, Zhi YG. Transition-Metal-Free Lactonization of sp2 C–H Bonds with CO2. Org Lett 2017; 19:396-399. [DOI: 10.1021/acs.orglett.6b03601] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Zhen Zhang
- Chengdu
Institute of Organic Chemistry, Chinese Academy of Sciences, Chengdu 610041, China
- Key Laboratory of Green Chemistry & Technology of Ministry of Education, College of Chemistry, Sichuan University, Chengdu 610064, China
- University of the Chinese Academy of Sciences, Beijing 100049, China
| | - Tao Ju
- Key Laboratory of Green Chemistry & Technology of Ministry of Education, College of Chemistry, Sichuan University, Chengdu 610064, China
| | - Meng Miao
- Key Laboratory of Green Chemistry & Technology of Ministry of Education, College of Chemistry, Sichuan University, Chengdu 610064, China
| | - Jie-Lian Han
- Key Laboratory of Green Chemistry & Technology of Ministry of Education, College of Chemistry, Sichuan University, Chengdu 610064, China
| | - Yi-Han Zhang
- Key Laboratory of Green Chemistry & Technology of Ministry of Education, College of Chemistry, Sichuan University, Chengdu 610064, China
| | - Xing-Yong Zhu
- Key Laboratory of Green Chemistry & Technology of Ministry of Education, College of Chemistry, Sichuan University, Chengdu 610064, China
| | - Jian-Heng Ye
- Key Laboratory of Green Chemistry & Technology of Ministry of Education, College of Chemistry, Sichuan University, Chengdu 610064, China
| | - Da-Gang Yu
- Key Laboratory of Green Chemistry & Technology of Ministry of Education, College of Chemistry, Sichuan University, Chengdu 610064, China
| | - Yong-Gang Zhi
- Chengdu
Institute of Organic Chemistry, Chinese Academy of Sciences, Chengdu 610041, China
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19
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Nitrosylation of imidazo[1,2-a]pyridines in metal free system. JOURNAL OF SAUDI CHEMICAL SOCIETY 2017. [DOI: 10.1016/j.jscs.2016.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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20
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Abstract
PURPOSE OF REVIEW The aim of this review article was to summarize recent publications on effects of antidepressants on sleep and to show that these effects not only depend on the kind of antidepressant drugs but are also related to the dose, the time of drug administration, and the duration of the treatment. RECENT FINDINGS Complaints of disrupted sleep are very common in patients suffering from depression, and they are listed among diagnostic criteria for this disorder. Moreover, midnocturnal insomnia is the most frequent residual symptom of depression. Thus, all antidepressants should normalize sleep. However, at least in short-term treatment, many antidepressants with so-called activating effects (e.g. fluoxetine, venlafaxine) may disrupt sleep, while others with sedative properties (e.g., doxepin, mirtazapine, trazodone) rapidly improve sleep, but may cause problems in long-term treatment due to oversedation.For sleep-promoting action, the best effects can frequently be achieved with a very low dose, administered early enough before bedtime and importantly, always as a part of more complex interventions based on the cognitive-behavioral protocol to treat insomnia (CBT-I). For successful treatment of depression, it is necessary to understand the effects of antidepressants on sleep. Each physician should also be aware that some antidepressants may worsen or induce primary sleep disorders like restless legs syndrome, sleep bruxism, REM sleep behavior disorder, nightmares, and sleep apnea, which may result from an antidepressant-induced weight gain.
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21
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Copper-catalyzed four-component synthesis of imidazo[1,2-a]pyridines via sequential reductive amination, condensation, and cyclization. Tetrahedron Lett 2017. [DOI: 10.1016/j.tetlet.2016.11.081] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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22
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Characteristics and drug use patterns of older antidepressant initiators in Germany. Eur J Clin Pharmacol 2016; 73:105-113. [DOI: 10.1007/s00228-016-2145-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 10/06/2016] [Indexed: 10/20/2022]
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23
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Swami S, Devi N, Agarwala A, Singh V, Shrivastava R. ZnO nanoparticles as reusable heterogeneous catalyst for efficient one pot three component synthesis of imidazo-fused polyheterocycles. Tetrahedron Lett 2016. [DOI: 10.1016/j.tetlet.2016.02.045] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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24
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Kirsch I. Der Placeboeffekt in der antidepressiven Behandlung. VERHALTENSTHERAPIE 2016. [DOI: 10.1159/000443542] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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25
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Metal-free oxidative coupling of aminopyridines with nitroolefins to imidazo[1,2-a]pyridine in the presence of I2
–TBHP–pyridine. ZEITSCHRIFT FUR NATURFORSCHUNG SECTION B-A JOURNAL OF CHEMICAL SCIENCES 2016. [DOI: 10.1515/znb-2015-0171] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
A facile metal-free approach to the synthesis of imidazo[1,2-a]pyridine was developed through a tandem reaction of Michael addition and oxidative coupling. Iodine–t-butyl hydroperoxide–pyridine was found to be a green and efficient catalytic system for this approach.
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26
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Zhou X, Yan H, Ma C, He Y, Li Y, Cao J, Yan R, Huang G. Copper-Mediated Aerobic Oxidative Synthesis of 3-Bromo-imidazo[1,2-a]pyridines with Pyridines and Enamides. J Org Chem 2015; 81:25-31. [DOI: 10.1021/acs.joc.5b02384] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Xiaoqiang Zhou
- State
Key Laboratory of Applied Organic Chemistry, Key Laboratory of Nonferrous
Metal Chemistry and Resources Utilization of Gansu Province, Department
of Chemistry, Lanzhou University, Lanzhou, 730000, China
| | - Hao Yan
- State
Key Laboratory of Applied Organic Chemistry, Key Laboratory of Nonferrous
Metal Chemistry and Resources Utilization of Gansu Province, Department
of Chemistry, Lanzhou University, Lanzhou, 730000, China
- Shaanxi University of Chinese Medicine, Shiji Ave., Xi’an-Xianyang New Ecomic Zone, Shaanxi Province, Xianyang, 712046, China
| | - Chaowei Ma
- State
Key Laboratory of Applied Organic Chemistry, Key Laboratory of Nonferrous
Metal Chemistry and Resources Utilization of Gansu Province, Department
of Chemistry, Lanzhou University, Lanzhou, 730000, China
| | - Yongqin He
- State
Key Laboratory of Applied Organic Chemistry, Key Laboratory of Nonferrous
Metal Chemistry and Resources Utilization of Gansu Province, Department
of Chemistry, Lanzhou University, Lanzhou, 730000, China
| | - Yamin Li
- State
Key Laboratory of Applied Organic Chemistry, Key Laboratory of Nonferrous
Metal Chemistry and Resources Utilization of Gansu Province, Department
of Chemistry, Lanzhou University, Lanzhou, 730000, China
| | - Jinhui Cao
- State
Key Laboratory of Applied Organic Chemistry, Key Laboratory of Nonferrous
Metal Chemistry and Resources Utilization of Gansu Province, Department
of Chemistry, Lanzhou University, Lanzhou, 730000, China
| | - Rulong Yan
- State
Key Laboratory of Applied Organic Chemistry, Key Laboratory of Nonferrous
Metal Chemistry and Resources Utilization of Gansu Province, Department
of Chemistry, Lanzhou University, Lanzhou, 730000, China
| | - Guosheng Huang
- State
Key Laboratory of Applied Organic Chemistry, Key Laboratory of Nonferrous
Metal Chemistry and Resources Utilization of Gansu Province, Department
of Chemistry, Lanzhou University, Lanzhou, 730000, China
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27
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Abstract
Sleep disturbances are a common presenting symptom of older-age adults to their physicians. This article explores normal changes in sleep pattern with aging and primary sleep disorders in the elderly. Behavioral factors and primary psychiatric disorders affecting sleep in this population are reviewed. Further discussion examines sleep changes associated with 2 common forms of neurocognitive disorder: Alzheimer disease and Lewy Body Dementia. Common medical illnesses in the elderly are discussed in relation to sleep symptoms. Nonpharmacological and pharmacologic treatment strategies are summarized, with emphasis placed on risk of side effects in older adults. Future targets are considered.
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Affiliation(s)
- Kristina F Zdanys
- Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA.
| | - David C Steffens
- Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA
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28
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Bagdi PR, Basha RS, Khan AT. Synthesis of 2-triazolyl-imidazo[1,2-a]pyridine through a one-pot three-component reaction using a nano copper oxide assisted click-catalyst. RSC Adv 2015. [DOI: 10.1039/c5ra09671e] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The syntheses of 2-triazolyl imidazo[1,2-a]pyridine were accomplished through 5-exo dig cyclisation using 5 mol% nanocopper oxide together with 10 mol% sodium ascorbate as a click-catalyst in ethanol at 70 °C.
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Affiliation(s)
- Prasanta Ray Bagdi
- Department of Chemistry
- Indian Institute of Technology Guwahati
- Guwahati 781 039
- India
| | - R. Sidick Basha
- Department of Chemistry
- Indian Institute of Technology Guwahati
- Guwahati 781 039
- India
| | - Abu T. Khan
- Department of Chemistry
- Indian Institute of Technology Guwahati
- Guwahati 781 039
- India
- Vice-Chancellor
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29
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Kundu S, Basu B. Graphene oxide (GO)-catalyzed multi-component reactions: green synthesis of library of pharmacophore 3-sulfenylimidazo[1,2-a]pyridines. RSC Adv 2015. [DOI: 10.1039/c5ra04983k] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Graphene oxide (GO)-catalyzed multi-component reactions: green synthesis of library of pharmacophore 3-sulfenylimidazo[1,2-a]pyridines
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Affiliation(s)
- Samir Kundu
- Department of Chemistry
- North Bengal University
- Darjeeling 734013
- India
| | - Basudeb Basu
- Department of Chemistry
- North Bengal University
- Darjeeling 734013
- India
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30
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Kumar GS, Ragini SP, Kumar AS, Meshram HM. A copper-catalyzed multi-component reaction accessing fused imidazo-heterocycles via C–H functionalization. RSC Adv 2015. [DOI: 10.1039/c5ra09025c] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
An efficient synthesis of fused imidazo-heterocycles is described using Cu(OTf)2 in [bmim]BF4 by the multi-component reaction of pyridin-2(1H)-one or thiazol/benzo[d]thiazol-2(3H)-ones with O-tosylhydroxyl amine and acetophenones under microwave irradiation.
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Affiliation(s)
- G. Santosh Kumar
- Medicinal Chemistry and Pharmacology Division
- CSIR-Indian Institute of Chemical Technology
- Hyderabad – 500 007
- India
| | - S. Pushpa Ragini
- Medicinal Chemistry and Pharmacology Division
- CSIR-Indian Institute of Chemical Technology
- Hyderabad – 500 007
- India
| | - A. Sanjeeva Kumar
- Medicinal Chemistry and Pharmacology Division
- CSIR-Indian Institute of Chemical Technology
- Hyderabad – 500 007
- India
| | - H. M. Meshram
- Medicinal Chemistry and Pharmacology Division
- CSIR-Indian Institute of Chemical Technology
- Hyderabad – 500 007
- India
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31
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Zhai LH, Guo LH, Sun BW. Copper-catalyzed intramolecular dehydrogenative cyclization: direct access to sensitive formyl-substituted imidazo[1,2-a]pyridines. RSC Adv 2015. [DOI: 10.1039/c5ra19085a] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
A direct method for the synthesis of formyl-substituted imidazo[1,2-a]pyridines was achieved easily from cyclization of aminopyridines and cinnamaldehydes via copper catalysis.
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Affiliation(s)
- Li-Hai Zhai
- School of Chemistry and Chemical Engineering
- Southeast University
- Nanjing
- China
- Lunan Pharmaceutical Co. Ltd
| | | | - Bai-Wang Sun
- School of Chemistry and Chemical Engineering
- Southeast University
- Nanjing
- China
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32
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Chang WP, Lin CC. Use of opioid analgesics or sleeping medication and survival of cancer patients. Eur J Oncol Nurs 2014; 19:199-206. [PMID: 25553718 DOI: 10.1016/j.ejon.2014.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 11/07/2014] [Accepted: 11/13/2014] [Indexed: 01/15/2023]
Abstract
PURPOSE OF THE RESEARCH Pain and sleep disturbance have been shown to have a profound influence on the outcomes of cancer treatment. This study sought to determine whether administering opioid analgesics or sleeping medication to cancer patients during their first admission to a hospital is associated with poor prognoses. METHODS AND SAMPLE We conducted a population-based retrospective cohort study by analyzing data obtained from the National Health Insurance Research Database in Taiwan. The study population comprised cancer patients whose first admission to a hospital for initial cancer treatment was in 2004. KEY RESULTS We collected data on 2302 cancer patients. To analyze the effect of opioid analgesic and sleeping medication usage on cancer patient survival, we compared the 3-year survival rates among 4 groups of patients (no use, sleeping medications-only, opioid analgesics-only, both used). The 3-year Kaplan-Meier plots for these 4 groups show that the difference was statistically significant (log rank 48.244, p < 0.001). The longevity of cancer patients was the greatest among the no-use group, followed by the sleeping medications-only group, then the opioid analgesics-only group, and finally, the group in which both sleeping medications and opioid analgesics were used. CONCLUSIONS The use of opioid analgesics or sleeping medication was shown to be negatively correlated with the survival rate of cancer patients.
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Affiliation(s)
- Wen-Pei Chang
- Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, Taipei, Taiwan
| | - Chia-Chin Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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33
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Abstract
Major depressive disorder is frequently accompanied by sleep disturbances such as insomnia or hypersomnia and polysomnographic sleep findings of increased rapid-eye-movement sleep and decreased slow wave sleep. For many patients, insomnia persists even after mood symptoms have been adequately treated. These patients have poorer outcomes than patients without sleep problems. These outcomes suggest that overlapping neural mechanisms regulate sleep and mood. Treatment of these patients can incorporate sedating antidepressants, nonbenzodiazepine γ-aminobutyric acid agonists, and cognitive behavioral therapy. Sleep restriction has been found to improve mood in depressed patients; however, the benefits typically disappear after recovery sleep.
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Affiliation(s)
- Michael J Murphy
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA
| | - Michael J Peterson
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, 6001 Research Park Boulevard, Madison, WI 53719, USA; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, B6/593 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
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34
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Shinde AH, Srilaxmi M, Satpathi B, Sharada DS. A highly efficient synthesis of imidazo-fused polyheterocycles via Groebke–Blackburn–Bienaymè reaction catalyzed by LaCl3·7H2O. Tetrahedron Lett 2014. [DOI: 10.1016/j.tetlet.2014.08.126] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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35
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Lader M. Benzodiazepine harm: how can it be reduced? Br J Clin Pharmacol 2014; 77:295-301. [PMID: 22882333 DOI: 10.1111/j.1365-2125.2012.04418.x] [Citation(s) in RCA: 160] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 08/05/2012] [Indexed: 11/27/2022] Open
Abstract
The benzodiazepines (BZDs) are anxiolytics, hypnotics, anticonvulsants, muscle-relaxants and induce anaesthesia. Adverse effects comprise sedation subjectively and cognitive and psychomotor impairment objectively. Complex skills such as driving can be compromised. Paradoxical excitement can have forensic implications. Long term use beyond the licensed durations is common but both efficacy and adverse effects associated with this have been poorly documented. Withdrawal and dependence have excited particular concern, and even polemic. Perhaps a third of long term (beyond 6 months) users experience symptoms and signs on attempting to withdraw - anxiety, insomnia, muscle spasms and tension and perceptual hypersensitivity. Uncommonly, fits or a psychosis may supervene. The patterns following withdrawal vary widely. The usual method of withdrawal is slow tapering but it may not obviate the problems completely. BZDs are also drugs of abuse either on their own or in conjunction with opioids and stimulants. Claims have been made that the use of BZDs is associated with increased mortality. This is a concern in view of the widespread usage of these drugs, particularly in the elderly. All of these factors impinge on the risk : benefit ratio and the severity of the indications. Harm reduction should focus on choice of alternative treatments both psychological and pharmacological. Guidelines emphasise that BZDs are not drugs of first choice and should only be used short term. Schedules are available to educate about methods of withdrawal in current users, emphasising the slow rate of taper. General principles of harm minimization in the addiction field are appropriate to BZD abuse.
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36
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Santra S, Mitra S, Bagdi AK, Majee A, Hajra A. Iron(III)-catalyzed three-component domino strategy for the synthesis of imidazo[1,2-a]pyridines. Tetrahedron Lett 2014. [DOI: 10.1016/j.tetlet.2014.07.094] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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37
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Gooneratne NS, Vitiello MV. Sleep in older adults: normative changes, sleep disorders, and treatment options. Clin Geriatr Med 2014; 30:591-627. [PMID: 25037297 PMCID: PMC4656195 DOI: 10.1016/j.cger.2014.04.007] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Approximately 5% of older adults meet criteria for clinically significant insomnia disorders and 20% for sleep apnea syndromes. It is important to distinguish age-appropriate changes in sleep from clinically significant insomnia, with the latter having associated daytime impairments. Non-pharmacologic therapies, such as cognitive-behavioral therapy for insomnia, can be highly effective with sustained benefit. Pharmacologic therapies are also available, but may be associated with psychomotor effects. A high index of suspicion is crucial for effective diagnosis of sleep apnea because symptoms commonly noted in younger patients, such as obesity or loud snoring, may not be present in older patients.
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Affiliation(s)
- Nalaka S Gooneratne
- Division of Geriatric Medicine, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA; Division of Sleep Medicine, Center for Sleep and Circadian Neurobiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Michael V Vitiello
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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38
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Abstract
Physicians treating demented individuals are confronted with complex clinical presentations. This complexity results from the multi-factorial nature of clinical phenomena, the aetiologies of these phenomena, which differ from similar symptoms in younger populations, limited physiological reserves and the multiple co-morbidities and medications. This intricacy is well exemplified within the clinical presentation and management of psychological and behavioural symptoms of dementia. The latter are associated with a poor quality of life, increased burden for both patient and caregivers. A further challenge and source for frustration is the fact that many of the medications used to treat cognitive and behavioural symptoms of dementia are only marginally effective or not effective at all, on the one hand, and associated with increased risk for morbidity and mortality on the other hand. In the present review, we discuss these factors in the context of polypharmacy and suggest further clinical and research strategies that may enable more accurate and less harmful therapeutic strategies.
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39
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Koubachi J, El Kazzouli S, Bousmina M, Guillaumet G. Functionalization of Imidazo[1,2-a]pyridines by Means of Metal-Catalyzed Cross-Coupling Reactions. European J Org Chem 2014. [DOI: 10.1002/ejoc.201400065] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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40
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Yan H, Ma Y, Sun Y, Ma C, Wang Y, Ren X, Huang G. Catalyst-free synthesis of alkyl 4-oxo-4H-pyrido[1,2-a]pyrimidine-2-carboxylate derivatives on water. Tetrahedron 2014. [DOI: 10.1016/j.tet.2014.02.084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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One-Pot Synthesis ofN-(Imidazo[1,2-a]pyridin-3-yl)-Substituted Sulfonamides Using Catalytic Zinc Chloride. European J Org Chem 2014. [DOI: 10.1002/ejoc.201301612] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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42
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Abstract
Antidepressants are supposed to work by fixing a chemical imbalance,
specifically, a lack of serotonin in the brain. Indeed, their supposed
effectiveness is the primary evidence for the chemical imbalance theory. But
analyses of the published data and the unpublished data that were hidden by drug
companies reveals that most (if not all) of the benefits are due to the placebo
effect. Some antidepressants increase serotonin levels, some decrease it, and
some have no effect at all on serotonin. Nevertheless, they all show the same
therapeutic benefit. Even the small statistical difference between
antidepressants and placebos may be an enhanced placebo effect, due to the fact
that most patients and doctors in clinical trials successfully break blind. The
serotonin theory is as close as any theory in the history of science to having
been proved wrong. Instead of curing depression, popular antidepressants may
induce a biological vulnerability making people more likely to become depressed
in the future.
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Affiliation(s)
- Irving Kirsch
- Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
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43
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Kirsch I. The emperor's new drugs: medication and placebo in the treatment of depression. Handb Exp Pharmacol 2014; 225:291-303. [PMID: 25304538 DOI: 10.1007/978-3-662-44519-8_16] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin in the brain. Indeed their supposed effectiveness is the primary evidence for the chemical imbalance theory. But analyses of the published data and the unpublished data that were hidden by the drug companies reveal that most (if not all) of the benefits are due to the placebo effect. Some antidepressants increase serotonin levels, some decrease it, and some have no effect at all on serotonin. Nevertheless, they all show the same therapeutic benefit. Even the small statistical difference between antidepressants and placebos may be an enhanced placebo effect, due to the fact that most patients and doctors in clinical trials successfully break blind. The serotonin theory is as close to any theory in the history of science having been proved wrong. Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.
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Affiliation(s)
- Irving Kirsch
- Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA,
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44
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Cunnington D, Junge MF, Fernando AT. Insomnia: prevalence, consequences and effective treatment. Med J Aust 2013; 199:S36-40. [DOI: 10.5694/mja13.10718] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 09/02/2013] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Antonio T Fernando
- Department of Psychological Medicine, University of Auckland, Auckland, NZ
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45
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Bourgeois J, Elseviers MM, Van Bortel L, Petrovic M, Vander Stichele RH. The use of antidepressants in Belgian nursing homes: focus on indications and dosages in the PHEBE study. Drugs Aging 2013; 29:759-69. [PMID: 23018612 DOI: 10.1007/s40266-012-0003-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Since antidepressants are prescribed for multiple indications, the use of an antidepressant cannot be equated with a diagnosis of depression. OBJECTIVE The objective of this study was to examine the quality of antidepressant prescribing in Belgian nursing homes, with a critical evaluation of indications and dosages, to see whether depression was appropriately treated in terms of drug choice, the indications for which antidepressants were being prescribed and whether there was underdosing. METHODS This analysis was based on data obtained in the Prescribing in Homes for the Elderly in Belgium (PHEBE) study, a cross-sectional, descriptive study of a representative, stratified, random sample of 1,730 residents from 76 Belgian nursing homes. The PHEBE study investigated overall drug utilization in Belgian nursing homes in 2006. Clinical and medication data for the present study were obtained from this study. A 28-item checklist of clinical conditions was designed ad hoc for the PHEBE study and sent to the residents' general practitioners (GPs) to collect clinical information. We copied the residents' medication charts, classified the drugs using the Anatomical Therapeutic Chemical (ATC) classification system codes and transferred the drug names and dosages into a database. Information on indications was retrospectively obtained from the GPs, so that we could link the indication to each medication. Minimum effective doses (MEDs) of antidepressants to treat major depression were obtained from the literature to assess underdosing. RESULTS The overall use of antidepressants in nursing homes was 39.5 % (95 % CI 37.2, 41.8). The physicians classified 34.2 % (95 % CI 32.0, 36.4) of the residents as having depression, and 80.9 % of these patients were treated with an antidepressant. Indications among the single antidepressant users (n = 551) were depression (66.2 %), insomnia (13.4 %), anxiety (6.2 %) and neuropathic pain (1.6 %). In the indication of depression, 74.8 % used a selective serotonin reuptake inhibitor (SSRI), predominantly citalopram, sertraline and escitalopram. Venlafaxine was used by 10.7 % of the residents. Dosages for these antidepressants were equal to or higher than the MED. But when trazodone, amitriptyline or mirtazapine were used to treat depression, respectively, 92.3, 55.5 and 44.5 % of prescribed dosages were below the MED. In the indication of insomnia, most of the time, trazodone (90.5 %) or mirtazapine (5.4 %) were used, and in lower dosages than those required for depression treatment (<MED). Tricyclic antidepressants were predominantly used for the treatment of neuropathic pain and were also used at lower dosages. Of all the residents receiving a medication for anxiety, only 13.9 % received an antidepressant (mostly an SSRI), and the remaining received a benzodiazepine. CONCLUSIONS The number one indication for the use of an antidepressant was depression. Within this indication, mostly the recommended SSRIs were used, in dosages equal to or higher than the MED. Furthermore, we noticed that there was substantial use of sedative antidepressants for insomnia and that the physicians preferred to prescribe benzodiazepines over the recommended SSRIs to treat anxiety chronically.
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Ge W, Zhu X, Wei Y. Aerobic Multicomponent Tandem Synthesis of 3-Sulfenylimidazo[1,2-a]pyridines from Ketones, 2-Aminopyridines, and Disulfides. European J Org Chem 2013. [DOI: 10.1002/ejoc.201300905] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Gao Y, Yin M, Wu W, Huang H, Jiang H. Copper-Catalyzed Intermolecular Oxidative Cyclization of Halo- alkynes: Synthesis of 2-Halo-substituted Imidazo[1,2-a]pyridines, Imidazo[1,2-a]pyrazines and Imidazo[1,2-a]pyrimidines. Adv Synth Catal 2013. [DOI: 10.1002/adsc.201300157] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Santra S, Bagdi AK, Majee A, Hajra A. Iron(III)-Catalyzed Cascade Reaction between Nitroolefins and 2-Aminopyridines: Synthesis of Imidazo[1,2-a]pyridines and Easy Access towards Zolimidine. Adv Synth Catal 2013. [DOI: 10.1002/adsc.201201112] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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I2-promoted direct one-pot synthesis of 2-aryl-3-(pyridine-2-ylamino)imidazo[1,2-a]pyridines from aromatic ketones and 2-aminopyridines. Tetrahedron Lett 2013. [DOI: 10.1016/j.tetlet.2012.12.072] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Vande Griend JP, Anderson SL. Histamine-1 receptor antagonism for treatment of insomnia. J Am Pharm Assoc (2003) 2012; 52:e210-9. [DOI: 10.1331/japha.2012.12051] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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