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Nippert KE, Rowland CP, Vazey EM, Moorman DE. Alcohol, flexible behavior, and the prefrontal cortex: Functional changes underlying impaired cognitive flexibility. Neuropharmacology 2024; 260:110114. [PMID: 39134298 PMCID: PMC11694314 DOI: 10.1016/j.neuropharm.2024.110114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 08/22/2024]
Abstract
Cognitive flexibility enables individuals to alter their behavior in response to changing environmental demands, facilitating optimal behavior in a dynamic world. The inability to do this, called behavioral inflexibility, is a pervasive behavioral phenotype in alcohol use disorder (AUD), driven by disruptions in cognitive flexibility. Research has repeatedly shown that behavioral inflexibility not only results from alcohol exposure across species but can itself be predictive of future drinking. Like many high-level executive functions, flexible behavior requires healthy functioning of the prefrontal cortex (PFC). The scope of this review addresses two primary themes: first, we outline tasks that have been used to investigate flexibility in the context of AUD or AUD models. We characterize these based on the task features and underlying cognitive processes that differentiate them from one another. We highlight the neural basis of flexibility measures, focusing on the PFC, and how acute or chronic alcohol in humans and non-human animal models impacts flexibility. Second, we consolidate findings on the molecular, physiological and functional changes in the PFC elicited by alcohol, that may contribute to cognitive flexibility deficits seen in AUD. Collectively, this approach identifies several key avenues for future research that will facilitate effective treatments to promote flexible behavior in the context of AUD, to reduce the risk of alcohol related harm, and to improve outcomes following AUD. This article is part of the Special Issue on "PFC circuit function in psychiatric disease and relevant models".
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Affiliation(s)
- Kathryn E Nippert
- Neuroscience and Behavior Graduate Program, University of Massachusetts Amherst, Amherst, MA, 01003, USA
| | - Courtney P Rowland
- Department of Biology, University of Massachusetts Amherst, Amherst, MA, 01003, USA
| | - Elena M Vazey
- Neuroscience and Behavior Graduate Program, University of Massachusetts Amherst, Amherst, MA, 01003, USA; Department of Biology, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
| | - David E Moorman
- Neuroscience and Behavior Graduate Program, University of Massachusetts Amherst, Amherst, MA, 01003, USA; Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, 01003, USA.
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Bouteldja AA, Penichet D, Srivastava LK, Cermakian N. The circadian system: A neglected player in neurodevelopmental disorders. Eur J Neurosci 2024; 60:3858-3890. [PMID: 38816965 DOI: 10.1111/ejn.16423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/18/2024] [Accepted: 05/07/2024] [Indexed: 06/01/2024]
Abstract
Patients with neurodevelopmental disorders, such as autism spectrum disorder, often display abnormal circadian rhythms. The role of the circadian system in these disorders has gained considerable attention over the last decades. Yet, it remains largely unknown how these disruptions occur and to what extent they contribute to the disorders' development. In this review, we examine circadian system dysregulation as observed in patients and animal models of neurodevelopmental disorders. Second, we explore whether circadian rhythm disruptions constitute a risk factor for neurodevelopmental disorders from studies in humans and model organisms. Lastly, we focus on the impact of psychiatric medications on circadian rhythms and the potential benefits of chronotherapy. The literature reveals that patients with neurodevelopmental disorders display altered sleep-wake cycles and melatonin rhythms/levels in a heterogeneous manner, and model organisms used to study these disorders appear to support that circadian dysfunction may be an inherent characteristic of neurodevelopmental disorders. Furthermore, the pre-clinical and clinical evidence indicates that circadian disruption at the environmental and genetic levels may contribute to the behavioural changes observed in these disorders. Finally, studies suggest that psychiatric medications, particularly those prescribed for attention-deficit/hyperactivity disorder and schizophrenia, can have direct effects on the circadian system and that chronotherapy may be leveraged to offset some of these side effects. This review highlights that circadian system dysfunction is likely a core pathological feature of neurodevelopmental disorders and that further research is required to elucidate this relationship.
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Affiliation(s)
- Ahmed A Bouteldja
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Integrated Program in Neuroscience, McGill University, Montréal, Québec, Canada
| | - Danae Penichet
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Integrated Program in Neuroscience, McGill University, Montréal, Québec, Canada
| | - Lalit K Srivastava
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Nicolas Cermakian
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
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Daood M, Magal N, Peled-Avron L, Nevat M, Ben-Hayun R, Aharon-Peretz J, Tomer R, Admon R. Graph analysis uncovers an opposing impact of methylphenidate on connectivity patterns within default mode network sub-divisions. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2024; 20:15. [PMID: 38902791 PMCID: PMC11191242 DOI: 10.1186/s12993-024-00242-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 06/13/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The Default Mode Network (DMN) is a central neural network, with recent evidence indicating that it is composed of functionally distinct sub-networks. Methylphenidate (MPH) administration has been shown before to modulate impulsive behavior, though it is not yet clear whether these effects relate to MPH-induced changes in DMN connectivity. To address this gap, we assessed the impact of MPH administration on functional connectivity patterns within and between distinct DMN sub-networks and tested putative relations to variability in sub-scales of impulsivity. METHODS Fifty-five right-handed healthy adults underwent two resting-state functional MRI (rs-fMRI) scans, following acute administration of either MPH (20 mg) or placebo, via a randomized double-blind placebo-controlled design. Graph modularity analysis was implemented to fractionate the DMN into distinct sub-networks based on the impact of MPH (vs. placebo) on DMN connectivity patterns with other neural networks. RESULTS MPH administration led to an overall decreased DMN connectivity, particularly with the auditory, cinguloopercular, and somatomotor networks, and increased connectivity with the parietomedial network. Graph analysis revealed that the DMN could be fractionated into two distinct sub-networks, with one exhibiting MPH-induced increased connectivity and the other decreased connectivity. Decreased connectivity of the DMN sub-network with the cinguloopercular network following MPH administration was associated with elevated impulsivity and non-planning impulsiveness. CONCLUSION Current findings highlight the intricate effects of MPH administration on DMN rs-fMRI connectivity, uncovering its opposing impact on distinct DMN sub-divisions. MPH-induced dynamics in DMN connectivity patterns with other neural networks may account for some of the effects of MPH administration on impulsive behavior.
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Affiliation(s)
- Maryana Daood
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, 31905, Israel
- Sakhnin College of Education, Sakhnin, Israel
| | - Noa Magal
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, 31905, Israel
| | - Leehe Peled-Avron
- The Leslie and Susan Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Michael Nevat
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, 31905, Israel
| | - Rachel Ben-Hayun
- Stroke and Cognition Institute, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Judith Aharon-Peretz
- Stroke and Cognition Institute, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Rachel Tomer
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, 31905, Israel
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, 31905, Israel.
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel.
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Nardi J, Freddo N, Biazus IC, Oliveira AP, Soares SM, Fortuna M, Varela ACC, Siqueira L, Pompermaier A, Tamagno WA, do Prado L, Berton N, Barcellos LJG, Rossato-Grando LG. Methylphenidate exposure in juvenile period elicits locomotion changes and anxiolytic-like behavior in adulthood: Evidence using zebrafish as a translational model. Behav Brain Res 2024; 457:114709. [PMID: 37827251 DOI: 10.1016/j.bbr.2023.114709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/21/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023]
Abstract
Methylphenidate (MPH) is a central nervous system stimulant that is mainly used for Attention-Deficit/Hyperactivity Disorder (ADHD). It is well known that there is a high rate of ADHD misdiagnosis, leading to a great number of neurotypical children chronically exposed to MPH in early periods of life. This increase raises concern about possible long-lasting effects of this exposure. We aimed to evaluate whether exposure to MPH during childhood might impact adult behavioral pattern. For this purpose, we used zebrafish as a translational model considering its robustness as experimental model and fast life cycle. Fish were exposed during juvenile period (from 30 to 60 post-natal day) at MPH therapeutic concentration (2 mg L-1), and behavioral tests were performed at fish adulthood (120 post-natal day). MPH provoked slight anxiolytic-like effects and hyperlocomotion, and no differences on sociability and cortisol levels were observed. Moreover, sex did not affect any of the parameters evaluated. These results demonstrate that early chronic exposure to MPH leads to neurobehavioral adaptations that persist into adulthood in zebrafish regardless of sex, suggesting that the misuse of MPH during childhood and adolescence can alter neurobehavioral plasticity and these alterations might persist until adulthood.
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Affiliation(s)
- Jessica Nardi
- Programa de Pós-Graduação em Bioexperimentação, Universidade de Passo Fundo, BR 285, São José, Passo Fundo, Rio Grande do Sul, Brazil
| | - Natália Freddo
- Programa de Pós-Graduação em Bioexperimentação, Universidade de Passo Fundo, BR 285, São José, Passo Fundo, Rio Grande do Sul, Brazil
| | - Inara Carbonera Biazus
- Curso de Farmácia, Universidade de Passo Fundo, BR 285, São José, Passo Fundo, Rio Grande do Sul, Brazil
| | - Ana Paula Oliveira
- Curso de Farmácia, Universidade de Passo Fundo, BR 285, São José, Passo Fundo, Rio Grande do Sul, Brazil
| | - Suelen Mendonça Soares
- Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria, Avenida Roraima, Bairro Camobi, Santa Maria, Rio Grande do Sul, Brazil
| | - Milena Fortuna
- Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria, Avenida Roraima, Bairro Camobi, Santa Maria, Rio Grande do Sul, Brazil
| | - Amanda Carolina Cole Varela
- Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria, Avenida Roraima, Bairro Camobi, Santa Maria, Rio Grande do Sul, Brazil
| | - Lisiane Siqueira
- Programa de Pós-Graduação em Bioexperimentação, Universidade de Passo Fundo, BR 285, São José, Passo Fundo, Rio Grande do Sul, Brazil
| | - Aline Pompermaier
- Programa de Pós-Graduação em Bioexperimentação, Universidade de Passo Fundo, BR 285, São José, Passo Fundo, Rio Grande do Sul, Brazil
| | - Wagner Antonio Tamagno
- Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria, Avenida Roraima, Bairro Camobi, Santa Maria, Rio Grande do Sul, Brazil
| | - Luciane do Prado
- Programa de Pós-Graduação em Bioexperimentação, Universidade de Passo Fundo, BR 285, São José, Passo Fundo, Rio Grande do Sul, Brazil
| | - Nicole Berton
- Programa de Pós-Graduação em Bioexperimentação, Universidade de Passo Fundo, BR 285, São José, Passo Fundo, Rio Grande do Sul, Brazil
| | - Leonardo José Gil Barcellos
- Programa de Pós-Graduação em Bioexperimentação, Universidade de Passo Fundo, BR 285, São José, Passo Fundo, Rio Grande do Sul, Brazil; Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria, Avenida Roraima, Bairro Camobi, Santa Maria, Rio Grande do Sul, Brazil
| | - Luciana Grazziotin Rossato-Grando
- Programa de Pós-Graduação em Bioexperimentação, Universidade de Passo Fundo, BR 285, São José, Passo Fundo, Rio Grande do Sul, Brazil; Curso de Farmácia, Universidade de Passo Fundo, BR 285, São José, Passo Fundo, Rio Grande do Sul, Brazil.
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Time-dependent affective disturbances in abstinent patients with methylphenidate use disorder. BMC Psychiatry 2022; 22:564. [PMID: 35996130 PMCID: PMC9394023 DOI: 10.1186/s12888-022-04187-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 07/31/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Methylphenidate (MPH), also called Ritalin, is used to treat attention-deficit hyperactivity disorder (ADHD) patients. With occasional reports of subjects suffering from Methylphenidate use disorder (MPHUD), few studies analyzed the neuropsychological changes in this population. PURPOSE This study aims to evaluate the clinical outcomes of individuals with MPHUD. METHODS We retrospectively analyzed 61 MPH patients (aged 16-27 years) admitted to the Beijing Gaoxin Hospital drug rehabilitation program from Jan 2017 to Mar 2019. The drug use history and drug abuse motivation scale were collected at admission. Clinicians rated the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and DSM-5 Stimulant use disorder criteria each week during the 4 weeks rehabilitation program. Correlation analyses were conducted between drug use history and affective disturbances. RESULTS The results showed that the adolescent period is the peak for MPH exposure, and 1/3 of patients got their first exposure to MPH from their parents. MPH abstinence accompanies severe anxiety and depression symptoms, significantly alleviating after four weeks of treatment. CONCLUSIONS MPHUD is associated with substantial affective disturbances, which warrants a more considerable sample investigation.
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The Use of Methylphenidate for Cognitive Enhancement in Young Healthy Adults: The Clinical and Ethical Debates. J Clin Psychopharmacol 2021; 41:100-102. [PMID: 33666399 DOI: 10.1097/jcp.0000000000001336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Methylphenidate (MP), a drug of choice for attention-deficit/hyperactivity disorder (ADHD), is a federally restricted substance CII in the United States because of abuse and dependence, and similar restrictions are practiced in Canada and around the world. This designation is given to drugs with medical value that present a high potential for abuse. In view of these severe restrictions, it is concerning to find out that a large group of healthy young adults, at least as large as the ADHD group of patients, take MP for cognitive enhancement, in an attempt to improve their academic achievements during studies and examinations. These young adults buy MP illegally and consume it without any medical supervision. The objective of the present debate piece is to present the ethical and clinical issues that need to be addressed in an attempt to solve this dilemma. METHODS The issues presented here are systematically reviewed and discussed along the following lines: MP effectiveness in enhancing cognitive achievements in healthy people; "As these are normal healthy people, what is the duty of physicians to 'treat' them?"; potential benefits of cognitive enhancement to healthy people; the risks of MP; "How do these young people get their MP?"; and "What can be done?" RESULTS Methylphenidate is widely used for cognitive enhancement without medical supervision. The effectiveness of MP for cognitive enhancement is well documented along a dose-response curve. Congruent with the results of the randomized trials, repeated studies based on interviews suggest that numerous young people report that cognitive enhancement helps them in improving their academic achievements, and hence also improve their feeling of well-being. Presently, most regulatory and medical organizations limit the use of MP to ADHD and narcolepsy. Yet, the American Academy of Neurology ruled that there is a moral, ethical, and legal basis to prescribe the drug for cognitive enhancement. The drug has known dose-dependent adverse effects that can have serious ramifications and may often lead to poor adherence. The relative risk of MP causing sudden death/arrhythmia is 1.46 (95% confidence interval, 1.03-2.07), and there are estimated 20 million college and university students in the United States in 2020. The rate of sudden death/arrhythmias in this age group ranges between 1 and 10 per 100,000. This translates to an excess of 146 deaths caused by MP every year in the United States considering postsecondary students only. DISCUSSION We propose that an ethical-clinical debate should be followed by an action plan to ensure that the present reality of millions of young people taking unsupervised MP is not accepted as a force majeure that cannot be changed.
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Daubner J, Arshaad MI, Henseler C, Hescheler J, Ehninger D, Broich K, Rawashdeh O, Papazoglou A, Weiergräber M. Pharmacological Neuroenhancement: Current Aspects of Categorization, Epidemiology, Pharmacology, Drug Development, Ethics, and Future Perspectives. Neural Plast 2021; 2021:8823383. [PMID: 33519929 PMCID: PMC7817276 DOI: 10.1155/2021/8823383] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 12/15/2020] [Accepted: 12/30/2020] [Indexed: 11/17/2022] Open
Abstract
Recent pharmacoepidemiologic studies suggest that pharmacological neuroenhancement (pNE) and mood enhancement are globally expanding phenomena with distinctly different regional characteristics. Sociocultural and regulatory aspects, as well as health policies, play a central role in addition to medical care and prescription practices. The users mainly display self-involved motivations related to cognitive enhancement, emotional stability, and adaptivity. Natural stimulants, as well as drugs, represent substance abuse groups. The latter comprise purines, methylxanthines, phenylethylamines, modafinil, nootropics, antidepressants but also benzodiazepines, β-adrenoceptor antagonists, and cannabis. Predominant pharmacodynamic target structures of these substances are the noradrenergic/dopaminergic and cholinergic receptor/transporter systems. Further targets comprise adenosine, serotonin, and glutamate receptors. Meta-analyses of randomized-controlled studies in healthy individuals show no or very limited verifiability of positive effects of pNE on attention, vigilance, learning, and memory. Only some members of the substance abuse groups, i.e., phenylethylamines and modafinil, display positive effects on attention and vigilance that are comparable to caffeinated drinks. However, the development of new antidementia drugs will increase the availability and the potential abuse of pNE. Social education, restrictive regulatory measures, and consistent medical prescription practices are essential to restrict the phenomenon of neuroenhancement with its social, medical, and ethical implications. This review provides a comprehensive overview of the highly dynamic field of pharmacological neuroenhancement and elaborates the dramatic challenges for the medical, sociocultural, and ethical fundaments of society.
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Affiliation(s)
- Johanna Daubner
- Experimental Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Muhammad Imran Arshaad
- Experimental Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Christina Henseler
- Experimental Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Jürgen Hescheler
- Institute of Neurophysiology, University of Cologne, Faculty of Medicine, Robert-Koch-Str. 39, 50931 Cologne, Germany
| | - Dan Ehninger
- Molecular and Cellular Cognition, German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen, DZNE), Sigmund-Freud-Str. 27, 53127 Bonn, Germany
| | - Karl Broich
- Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Oliver Rawashdeh
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Anna Papazoglou
- Experimental Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Marco Weiergräber
- Experimental Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
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Sternfeld A, Bialer OY, Keidar D, Megiddo E, Budnik I, Stiebel-Kalish H, Livnat T. A Single Low-Dose of Methylphenidate Improves Abnormal Visual Field Testing. Curr Eye Res 2020; 46:1232-1239. [PMID: 33342320 DOI: 10.1080/02713683.2020.1858430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the effect of methylphenidate on visual field testing in healthy adults with abnormal visual field results. METHODS This prospective, randomized, controlled interventional clinical trial comprised all patients who had abnormal visual field test results and normal eye examination and ophthalmic history. Eligible patients were randomly assigned to either the study group or the control group. All patients repeated their visual field testing. Study group patients received a single dose of 10 mg methylphenidate prior to that. The main outcome measures were the percent difference in mean deviation and pattern standard deviation between the second and first visual fields. RESULTS The methylphenidate group had greater improvement in all parameters. Mean deviation improved by median 68% (IQR 19%-78%) in the methylphenidate group vs. 27% [-5% to 55%] in the controls. However, this was not statistically significant (p = .83). Pattern standard deviation improved by median 49% (22%-59%) vs. 7% [-9% to 45%], respectively (p = .012). The visual fields were also reviewed by 3 masked experienced ophthalmologists. They indicated that the second visual field improved in 76.2% of the methylphenidate group vs. 48.5% of the controls (p = .04). A normal repeat visual field occurred in 57.7% vs. 21.2%, respectively. A subgroup analysis of patients with prior experience in visual field testing yielded an even more striking improvement in the methylphenidate group vs. controls. CONCLUSIONS A single low dose of methylphenidate can improve visual field testing in subjects without ocular pathology, and even more in those with prior experience in perimetry.
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Affiliation(s)
- Amir Sternfeld
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Omer Y Bialer
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dotan Keidar
- Ramat-Hen Psychiatric Clinic, Clalit Health Services, Ramat Gan, Israel
| | - Elinor Megiddo
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - Ivan Budnik
- Department of Pathophysiology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Hadas Stiebel-Kalish
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Livnat
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Israeli National Hemophilia Center and the Amalia Biron Thrombosis Research Institute, Sheba Medical Center, Tel Hashomer, Israel.,Laboratory of Eye Research, Felsenstein Medical Research Center, Petach Tikva, Israel
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Napoletano F, Schifano F, Corkery JM, Guirguis A, Arillotta D, Zangani C, Vento A. The Psychonauts' World of Cognitive Enhancers. Front Psychiatry 2020; 11:546796. [PMID: 33024436 PMCID: PMC7516264 DOI: 10.3389/fpsyt.2020.546796] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 08/17/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is growing availability of novel psychoactive substances (NPS), including cognitive enhancers (CEs) which can be used in the treatment of certain mental health disorders. While treating cognitive deficit symptoms in neuropsychiatric or neurodegenerative disorders using CEs might have significant benefits for patients, the increasing recreational use of these substances by healthy individuals raises many clinical, medico-legal, and ethical issues. Moreover, it has become very challenging for clinicians to keep up-to-date with CEs currently available as comprehensive official lists do not exist. METHODS Using a web crawler (NPSfinder®), the present study aimed at assessing psychonaut fora/platforms to better understand the online situation regarding CEs. We compared NPSfinder® entries with those from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and from the United Nations Office on Drugs and Crime (UNODC) NPS databases up to spring 2019. Any substance that was identified by NPSfinder® was considered a CE if it was either described as having nootropic abilities by psychonauts or if it was listed among the known CEs by Froestl and colleagues. RESULTS A total of 142 unique CEs were identified by NPSfinder®. They were divided into 10 categories, including plants/herbs/products (29%), prescribed drugs (17%), image and performance enhancing drugs (IPEDs) (15%), psychostimulants (15%), miscellaneous (8%), Phenethylamines (6%), GABAergic drugs (5%), cannabimimetic (4%), tryptamines derivatives (0.5%), and piperazine derivatives (0.5%). A total of 105 chemically different substances were uniquely identified by NPSfinder®. Only one CE was uniquely identified by the EMCDDA; no CE was uniquely identified by the UNODC. CONCLUSIONS These results show that NPSfinder® is helpful as part of an Early Warning System, which could update clinicians with the growing numbers and types of nootropics in the increasingly difficult-to-follow internet world. Improving clinicians' knowledge of NPS could promote more effective prevention and harm reduction measures in clinical settings.
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Affiliation(s)
- Flavia Napoletano
- Department of Mental Health, Homerton University Hospital, East London Foundation Trust, London, United Kingdom
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Amira Guirguis
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Swansea, United Kingdom
| | - Davide Arillotta
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Caroline Zangani
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Alessandro Vento
- Department of Mental Health, Addictions’ Observatory (ODDPSS), Rome, Italy
- Department of Mental Health, Guglielmo Marconi” University, Rome, Italy
- Department of Mental Health, ASL Roma 2, Rome, Italy
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Raoofi A, Delbari A, Mahdian D, Mojadadi MS, Amini A, Javadinia SS, Dadashizadeh G, Ahrabi B, Ebrahimi V, Mousavi Khaneghah A. Toxicology of long-term and high-dose administration of methylphenidate on the kidney tissue - a histopathology and molecular study. Toxicol Mech Methods 2020; 30:611-619. [PMID: 32746681 DOI: 10.1080/15376516.2020.1805665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The present study aims to assess the influences of oral methylphenidate on kidney function and structure versus vehicle treatment in adult male rats. In this study, thirty adult male rats equally into two treatment groups divided randomly, and among them, MPH has been administered for 21 days, at doses of 20 mg/kg, and the control group has received salin. In renal, under the effect of MPH applying quantitative real-time PCR, we analyzed nephrotoxicity-related molecular pathways like autophagy, inflammation, and apoptosis. Moreover, the levels of GSH, CAT, and SOD were investigated as antioxidant enzymes. Afterward, stereological analysis in MPH-treated rats has been performed. Analysis of qPCR displayed inflammation, impaired autophagy, and enhanced apoptosis with histological changes in the kidney's tissue, also an important rise in the antioxidant enzymes' level. Besides, 20 mg/kg of MPH led to a decline in the mean of Bowman's space thickness and renal corpuscle's volume in comparison to the control rats. Collectively, our histological and molecular data implicit that in the kidney region, administrating of MPH evoked discriminative expression alterations in nephrotoxicity-associated signaling cascades, specifically autophagy, inflammation, and apoptosis paired with important damage to kidney tissue.
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Affiliation(s)
- Amir Raoofi
- Leishmaniasis Research Center, Department of Anatomy, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ali Delbari
- Leishmaniasis Research Center, Department of Anatomy, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Davood Mahdian
- Cellular and Molecular Research Center, Department of Pharmacology, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohammad-Shafi Mojadadi
- Leishmaniasis Research Center, Department of Immunology, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Abdollah Amini
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Sadat Javadinia
- Leishmaniasis Research Center, Department of Anatomy, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ghazaleh Dadashizadeh
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Behnaz Ahrabi
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Ebrahimi
- Faculty of Medicine, Department of Anatomy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Mousavi Khaneghah
- Faculty of Food Engineering, Department of Food Science, University of Campinas (UNICAMP), São Paulo, Brazil
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11
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Dutt M, Dharavath RN, Kaur T, Chopra K, Sharma S. Differential effects of alprazolam against methylphenidate-induced neurobehavioral alterations. Physiol Behav 2020; 222:112935. [DOI: 10.1016/j.physbeh.2020.112935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 01/03/2023]
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12
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Rinaldi R, Bersani G, Marinelli E, Zaami S. The rise of new psychoactive substances and psychiatric implications: A wide-ranging, multifaceted challenge that needs far-reaching common legislative strategies. Hum Psychopharmacol 2020; 35:e2727. [PMID: 32144953 DOI: 10.1002/hup.2727] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 12/21/2022]
Abstract
The ever-growing number of novel psychoactive substances (NPS) that have been surfacing globally, as well as related changes in drug abuse trends, undoubtedly constitute a difficult and multifaceted challenge for psychiatry. The intake and abuse of such substances has been linked to a risk of psychopathological disturbances, which stem from imbalances of a range of neurotransmitter pathways and receptors. Through an analysis of relevant research articles and reviews (particularly those outlining NPS neurological and cerebral mechanisms of action and psychopathological consequences arising from NPS abuse; research papers more closely focused on chemical/pharmacological aspects have been ruled out), through a systematic analysis of Pubmed, Medline, PsycLIT and EMBASE literature, as well as data released by health care institutions and drug enforcement agencies (among which the World Health Organization, the United Nations Office on Drugs and Crime, the European Monitoring Centre for Drugs and Drug Addiction, Eurojust, the Novel Psychoactive Treatment UK Network, the Court of Justice of the European Union), the authors aimed to elaborate on the most relevant data relative to NPS-related psychiatric effects, focusing on the conceptual and definition-related complexities inherent to NPS, clinical management and motivations for NPS use; moreover, an effort has been made to highlight the possible measures in order to tackle the unremitting rise of such elusive and potentially harmful substances.
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Affiliation(s)
- Raffaella Rinaldi
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Departmental Section of Legal Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Giuseppe Bersani
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Rome, Italy
| | - Enrico Marinelli
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Departmental Section of Legal Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Departmental Section of Legal Medicine, "Sapienza" University of Rome, Rome, Italy
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13
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Marinelli E, Beck R, Malvasi A, Faro AFL, Zaami S. Gamma-hydroxybutyrate abuse: pharmacology and poisoning and withdrawal management. Arh Hig Rada Toksikol 2020; 71:19-26. [PMID: 32597141 PMCID: PMC7837237 DOI: 10.2478/aiht-2020-71-3314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/01/2019] [Accepted: 03/01/2020] [Indexed: 12/19/2022] Open
Abstract
Gamma-hydroxybutyrate (GHB) is a central nervous system depressant primarily used as a recreational drug of abuse, but also for the treatment of narcolepsy with cataplexy in adult patients and as an adjuvant for control of alcohol withdrawal syndrome. The main aim of this review is to summarise updated knowledge about GHB pharmacokinetics and pharmacodynamics, acute poisoning, and clinical features of GHB withdrawal syndrome, its diagnosis and medical treatment. The most common clinical signs and symptoms of acute poisoning include sleepiness to deep coma, bradycardia, hypotension, and respiratory failure. Therapy is essentially supportive and based on continuous monitoring of vital signs. GHB withdrawal syndrome shares patterns with other withdrawal syndromes such as alcohol withdrawal and is sometimes difficult to distinguish, especially if toxicological tests are GHB-negative or cannot be performed. There are no official detoxification protocols for GHB withdrawal syndrome, but its therapy is based on benzodiazepine. When benzodiazepine alone is not effective, it can be combined with barbiturates or antipsychotics. Information about abuse and distribution of GHB and its precursors/analogues among the general population is still limited. Their prompt identification is therefore crucial in conventional and non-conventional biological matrices, the latter in particular, to clarify all the issues around this complex molecule.
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Affiliation(s)
- Enrico Marinelli
- Department of Anatomical, Histological, Forensic, and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Renata Beck
- Department of Anaesthesia, Santa Maria Hospital, GVM Care & Research, Bari, Italy
| | - Antonio Malvasi
- Department of Obstetrics and Gynaecology, Santa Maria Hospital, Bari, Italy
| | - Alfredo Fabrizio Lo Faro
- Section of Legal Medicine, Department of Excellence SBSP, University “Politecnica delle Marche” of Ancona, Ancona, Italy
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic, and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
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14
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The prefrontal cortex and the caudate nucleus respond conjointly to methylphenidate (Ritalin). Concomitant behavioral and neuronal recording study. Brain Res Bull 2020; 157:77-89. [PMID: 31987926 DOI: 10.1016/j.brainresbull.2019.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/15/2019] [Accepted: 10/23/2019] [Indexed: 01/07/2023]
Abstract
Methylphenidate (MPD) is commonly used to treat attention-deficit hyperactivity disorder (ADHD). Recently, it is being abused for cognitive enhancement and recreation leading to concerns regarding its addictive potential. The prefrontal cortex (PFC) and caudate nucleus (CN) are two of the brain structures involved in the motive/reward circuit most affected by MPD and are also thought to be responsible for ADHD phenomena. This study is unique in that it investigated acute and chronic, dose-response MPD exposure on animals' behavior activity concomitantly with PFC and CN neuronal circuitry in freely behaving adult animals without the interference of anesthesia. Further, it compared acute and chronic MPD action on over 1,000 subcortical and cortical neurons simultaneously, allowing for a more accurate interpretation of drug action on corticostriatal neuronal circuitry. For this experiment, four groups of animals were used: saline (control), 0.6, 2.5, and 10.0 mg/kg MPD following acute and repetitive exposure. The data shows that the same MPD dose elicits behavioral sensitization in some animals and tolerance in others and that the PFC and CN neuronal activity correlates with the animals' behavioral responses to MPD. The expression of sensitization and tolerance are experimental biomarkers indicating that a drug has addictive potential. In general, a greater percentage of CN units responded to both acute and chronic MPD exposure as compared to PFC units. Dose response differences between the PFC and the CN units were observed. The dichotomy that some PFC and CN units responded to the same MPD dose by excitation and other units by attenuation in neuronal firing rate is discussed. In conclusion, to understand the mechanism of action of the drug, it is essential to study, simultaneously, on more than one brain site, the electrophysiological and behavioral effects of acute and chronic drug exposure, as sensitization and tolerance are experimental biomarkers indicating that a drug has addictive potential. The behavioral and neuronal data obtained from this study indicates that chronic MPD exposure results in behavioral and biochemical changes consistent with a substance abuse disorder.
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15
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Pichini S, Di Trana A, Torrens M, Scherbaum N, Zaami S. Editorial: New Trends of Substance Abuse: Looking for New Psychotropic Effects of Chem Sex Drugs, Cognitive Enhancers, and New Psychoactive Substances. Front Psychiatry 2020; 11:612192. [PMID: 33329162 PMCID: PMC7719771 DOI: 10.3389/fpsyt.2020.612192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/13/2020] [Indexed: 12/13/2022] Open
Affiliation(s)
- Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Annagiulia Di Trana
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Marta Torrens
- Departament de Neuropsiquiatria, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Simona Zaami
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
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16
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Zaami S, Marinelli E, Varì MR. New Trends of Substance Abuse During COVID-19 Pandemic: An International Perspective. Front Psychiatry 2020; 11:700. [PMID: 32765328 PMCID: PMC7378810 DOI: 10.3389/fpsyt.2020.00700] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/03/2020] [Indexed: 12/20/2022] Open
Affiliation(s)
- Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrico Marinelli
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Rosaria Varì
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
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17
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Ricci G. Pharmacological Human Enhancement: An Overview of the Looming Bioethical and Regulatory Challenges. Front Psychiatry 2020; 11:53. [PMID: 32127792 PMCID: PMC7037021 DOI: 10.3389/fpsyt.2020.00053] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 01/21/2020] [Indexed: 12/12/2022] Open
Abstract
Cognitive enhancement, a rather broad-ranging principle, can be achieved in various ways: healthy eating and consistent physical exercise can lead to long-term improvements in many cognitive domains; commonplace stimulants such as caffeine, on the other hand, temporarily raise levels of alertness, attentiveness, and concentration; sedative substances are also used as an indirect form of enhancement to relax before an exam or an important meeting. Such approaches raise no ethical issue. Nonetheless, clinical research has led to the off-label use of drugs called nootropics or "smart drugs", which can, under certain conditions, elicit some degree of cognition-improving effects: methylphenidate and modafinil can enhance working memory and concentration in healthy individuals, although the significance and effectiveness of such applications are dubious. Such "cognitive enhancement" methods, however, do raise multiple ethical issues, and their contentious nature has caused bioethical authorities to lay out opinions and recommendations meant to regulate their use. Most notably, the Italian Committee on Bioethics has extensively dealt with the spread of nootropics, which resulted in the Italian Code of Medical Ethics including "cognitive enhancement" drugs and their prescription by doctors as critical points, along with cosmetic surgery (the latest version of the Code, updated in December 2017, deals with the two separately, in Article 76 and 76 BIS). The United States Presidential Commission for the Study of Bioethical Issues broadened the scope of cognitive enhancement techniques so as to include neural modifiers, i.e. mechanisms of brain and nervous system change: a much wider array of interventions, technologies, behaviors, and environmental conditions that may potentially affect several aspects of the human brain and nervous system. The potential of neuroscience to profoundly reshape society is nothing short of mind-blowing.
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Affiliation(s)
- Giovanna Ricci
- Section of Forensic Medicine, School of Law, University of Camerino, Camerino, Italy
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18
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Di Trana A, Carlier J, Berretta P, Zaami S, Ricci G. Consequences of COVID-19 Lockdown on the Misuse and Marketing of Addictive Substances and New Psychoactive Substances. Front Psychiatry 2020; 11:584462. [PMID: 33192730 PMCID: PMC7644618 DOI: 10.3389/fpsyt.2020.584462] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/28/2020] [Indexed: 12/20/2022] Open
Affiliation(s)
- Annagiulia Di Trana
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Jeremy Carlier
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy.,Unit of Forensic Toxicology, Section of Legal Medicine, Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Paolo Berretta
- National Centre on Addiction and Doping, National Institute of Health, Rome, Italy
| | - Simona Zaami
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Giovanna Ricci
- Medico Legal Section, School of Law, University of Camerino, Macerata, Italy
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19
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Schleim S. Neuroenhancement as Instrumental Drug Use: Putting the Debate in a Different Frame. Front Psychiatry 2020; 11:567497. [PMID: 33088276 PMCID: PMC7498688 DOI: 10.3389/fpsyt.2020.567497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/17/2020] [Indexed: 12/26/2022] Open
Abstract
The use of performance-enhancing drugs to study or work better is often called "cognitive enhancement" or "neuroenhancement" and sparked a debate between scholars from many disciplines. I argue that such behavior can better be subsumed under the more general category of "instrumental drug use". This broader perspective allows understanding neuroenhancement better from the perspective of addiction medicine and public health and supports a more consistent drug policy. I also summarize the most important systematic reviews and individual surveys of nonmedical substance use to study or work better. Different definitions and methodologies limit the comparability of these studies. The unified approach of drug instrumentalization would partially solve such problems. Finally, prevalence studies from the 1960s to 1980s as well as anecdotal evidence since the late 19th century show that instrumental drug use is and has been for a long time a common phenomenon. It should thus also be investigated and treated accordingly.
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Affiliation(s)
- Stephan Schleim
- Theory and History of Psychology, Heymans Institute for Psychological Research, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
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20
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Kexel AK, Vonmoos M, Preller KH, Hulka LM, Seifritz E, Quednow BB. Social and Non-Social Cognitive Enhancement in Cocaine Users-A Closer Look on Enhancement Motives for Cocaine Consumption. Front Psychiatry 2020; 11:618. [PMID: 32695032 PMCID: PMC7338788 DOI: 10.3389/fpsyt.2020.00618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cognitive disturbances of chronic cocaine users (CU) have been repeatedly investigated. However, it is yet unknown how CU using cocaine for cognitive or social enhancement differ from stimulant-naïve controls and CU that do not have these motives. More precisely, we assumed that CU with an enhancement motive self-medicate deficits in specific cognitive abilities, i.e., they use cocaine to enhance their performance in either social (social motive) or non-social cognitive situations (cognitive motive). METHODS Forty-two CU were categorized according to their motives for cocaine consumption into social and non-social motive groups as well as cognitive and non-cognitive motive groups, respectively. Subsequently, CU motive groups were compared to 48 stimulant-naïve controls in their social and non-social cognitive functioning applying a comprehensive neuropsychological test battery. RESULTS The social motive group showed deficits in cognitive empathy compared to controls (Cohen's d = 0.65) and the non-social motive group (d = 0.60). No mentionable effects were found for emotional empathy and Theory-of-Mind. Cognitive and non-cognitive motive groups both showed general cognitive deficits but with different patterns of impairments compared to controls: the cognitive motive group had deficits mainly in working memory (d = 0.84) and declarative memory (d = 0.60), whereas the non-cognitive motive group also had deficits in working memory (d = 0.61) but additionally in executive functions (d = 0.67). For the domains declarative memory and executive functions, the respective other CU group displayed intermediate performance. CONCLUSIONS This study demonstrates that cocaine is partially instrumentalized by CU with specific enhancement motives to counteract related cognitive impairments.
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Affiliation(s)
- Ann-Kathrin Kexel
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Matthias Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Lea M Hulka
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
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21
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Chien YJ, Chien YC, Liu CT, Wu HC, Chang CY, Wu MY. Effects of Methylphenidate on Cognitive Function in Adults with Traumatic Brain Injury: A Meta-Analysis. Brain Sci 2019; 9:brainsci9110291. [PMID: 31653039 PMCID: PMC6895997 DOI: 10.3390/brainsci9110291] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 10/18/2019] [Accepted: 10/22/2019] [Indexed: 12/29/2022] Open
Abstract
This meta-analysis evaluated the effects of methylphenidate (MPH) on cognitive outcome and adverse events in adults with traumatic brain injuries (TBI). We searched PubMed, EMBASE, and PsycINFO for randomized controlled trials (RCTs) published before July 2019. Studies that compared the effects of MPH and placebos in adults with TBI were included. The primary outcome was cognitive function, while the secondary outcome was adverse events. Meta-regression and sensitivity analysis were conducted to evaluate heterogeneity. Seventeen RCTs were included for qualitative analysis, and ten RCTs were included for quantitative analysis. MPH significantly improved processing speed, measured by Choice Reaction Time (standardized mean difference (SMD): -0.806; 95% confidence interval (CI): -429 to -0.182, p = 0.011) and Digit Symbol Coding Test (SMD: -0.653; 95% CI: -1.016 to -0.289, p < 0.001). Meta-regression showed that the reaction time was inversely associated with the duration of MPH. MPH administration significantly increased heart rate (SMD: 0.553; 95% CI: 0.337 to 0.769, p < 0.001), while systolic or diastolic blood pressure did not exhibit significant differences. Therefore, MPH elicited better processing speed in adults with TBI. However, MPH use could significantly increase heart rate. A larger study is required to evaluate the effect of dosage, age, or optimal timing on treatment of adults with TBI.
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Affiliation(s)
- Yung-Jiun Chien
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 231 New Taipei, Taiwan.
- School of Medicine, Tzu Chi University, 970 Hualien, Taiwan.
| | - Yung-Chen Chien
- Department of Medical Education, Taipei Medical University Hospital, 110 Taipei, Taiwan.
| | - Chien-Ting Liu
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 231 New Taipei, Taiwan.
- School of Medicine, Tzu Chi University, 970 Hualien, Taiwan.
| | - Hsin-Chi Wu
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 231 New Taipei, Taiwan.
- School of Medicine, Tzu Chi University, 970 Hualien, Taiwan.
| | - Chun-Yu Chang
- School of Medicine, Tzu Chi University, 970 Hualien, Taiwan.
| | - Meng-Yu Wu
- Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 231 New Taipei, Taiwan.
- Department of Emergency Medicine, School of Medicine, Tzu Chi University, 970 Hualien, Taiwan.
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22
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Herrera-Ferrá K, Saruwatari Zavala G, Nicolini Sánchez H, Pinedo Rivas H. Neuroética en México: Reflexiones médicas, legales y socioculturales. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.bioet.2019.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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23
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Farias TL, Marinho V, Carvalho V, Rocha K, da Silva PRA, Silva F, Teles AS, Gupta D, Ribeiro P, Velasques B, Cagy M, Bastos VH, Silva-Junior F, Teixeira S. Methylphenidate modifies activity in the prefrontal and parietal cortex accelerating the time judgment. Neurol Sci 2019; 40:829-837. [PMID: 30693423 DOI: 10.1007/s10072-018-3699-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 12/31/2018] [Indexed: 12/30/2022]
Abstract
Methylphenidate produces its effects via actions on cortical areas involved with attention and working memory, which have a direct role in time estimation judgment tasks. In particular, the prefrontal and parietal cortex has been the target of several studies to understand the effect of methylphenidate on executive functions and time interval perception. However, it has not yet been studied whether acute administration of methylphenidate influences performance in time estimation task and the changes in alpha band absolute power in the prefrontal and parietal cortex. The current study investigates the influence of the acute use of methylphenidate in both performance and judgment in the time estimation interpretation through the alpha band absolute power activity in the prefrontal and parietal cortex. This is a double-blind, crossover study with a sample of 32 subjects under control (placebo) and experimental (methylphenidate) conditions with absolute alpha band power analysis during a time estimation task. We observed that methylphenidate does not influence task performance (p > 0.05), but it increases the time interval underestimation by over 7 s (p < 0.001) with a concomitant decrease in absolute alpha band power in the ventrolateral prefrontal cortex and dorsolateral prefrontal cortex and parietal cortex (p < 0.001). Acute use of methylphenidate increases the time interval underestimation, consistent with reduced accuracy of the internal clock mechanisms. Furthermore, acute use of methylphenidate influences the absolute alpha band power over the dorsolateral prefrontal cortex, ventrolateral prefrontal cortex, and parietal cortex.
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Affiliation(s)
- Tiago Lopes Farias
- Neuro-innovation Technology and Brain Mapping Laboratory, Federal University of Piauí, Av. São Sebastião, 2819, Bairro São Benedito, Parnaíba, Piauí, CEP: 64202-020, Brazil.
| | - Victor Marinho
- Neuro-innovation Technology and Brain Mapping Laboratory, Federal University of Piauí, Av. São Sebastião, 2819, Bairro São Benedito, Parnaíba, Piauí, CEP: 64202-020, Brazil. .,The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil.
| | - Valécia Carvalho
- Neuro-innovation Technology and Brain Mapping Laboratory, Federal University of Piauí, Av. São Sebastião, 2819, Bairro São Benedito, Parnaíba, Piauí, CEP: 64202-020, Brazil.,The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Kaline Rocha
- Neuro-innovation Technology and Brain Mapping Laboratory, Federal University of Piauí, Av. São Sebastião, 2819, Bairro São Benedito, Parnaíba, Piauí, CEP: 64202-020, Brazil.,The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Paulo Ramiler Alves da Silva
- Neuro-innovation Technology and Brain Mapping Laboratory, Federal University of Piauí, Av. São Sebastião, 2819, Bairro São Benedito, Parnaíba, Piauí, CEP: 64202-020, Brazil.,Masters Programs in Biotechnology, Federal University of Piauí, Parnaíba, Brazil
| | - Francisca Silva
- Neuro-innovation Technology and Brain Mapping Laboratory, Federal University of Piauí, Av. São Sebastião, 2819, Bairro São Benedito, Parnaíba, Piauí, CEP: 64202-020, Brazil
| | - Ariel Soares Teles
- Neuro-innovation Technology and Brain Mapping Laboratory, Federal University of Piauí, Av. São Sebastião, 2819, Bairro São Benedito, Parnaíba, Piauí, CEP: 64202-020, Brazil
| | - Daya Gupta
- Department of Biology, Camden County College, Blackwood, NJ, USA
| | - Pedro Ribeiro
- Brain Mapping and Sensory Motor Integration Laboratory, Institute of Psychiatry of Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruna Velasques
- Brain Mapping and Sensory Motor Integration Laboratory, Institute of Psychiatry of Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mauricio Cagy
- Brain Mapping and Sensory Motor Integration Laboratory, Institute of Psychiatry of Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Victor Hugo Bastos
- Brain Mapping and Functionality Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Fernando Silva-Junior
- Neuro-innovation Technology and Brain Mapping Laboratory, Federal University of Piauí, Av. São Sebastião, 2819, Bairro São Benedito, Parnaíba, Piauí, CEP: 64202-020, Brazil
| | - Silmar Teixeira
- Neuro-innovation Technology and Brain Mapping Laboratory, Federal University of Piauí, Av. São Sebastião, 2819, Bairro São Benedito, Parnaíba, Piauí, CEP: 64202-020, Brazil.,The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil.,Masters Programs in Biotechnology, Federal University of Piauí, Parnaíba, Brazil
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24
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Marshall CA, Brodnik ZD, Mortensen OV, Reith MEA, Shumsky JS, Waterhouse BD, España RA, Kortagere S. Selective activation of Dopamine D3 receptors and norepinephrine transporter blockade enhances sustained attention. Neuropharmacology 2019; 148:178-188. [PMID: 30633928 DOI: 10.1016/j.neuropharm.2019.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 12/28/2018] [Accepted: 01/06/2019] [Indexed: 11/17/2022]
Abstract
Catecholamine transmitters dopamine (DA) and norepinephrine (NE) regulate prefrontal cortical (PFC) circuit activity and PFC-mediated executive functions. Accordingly, pharmacological agents that influence catecholamine neurotransmission exert prominent effects on cognition. Many such agents are used clinically to treat attention disorders. For example, methylphenidate blocks DA and NE reuptake and is the leading choice for attention deficit hyperactivity disorder (ADHD) treatment. Recently, we have designed SK609 - a selective small molecule agonist of the DA D3 receptor (D3R). In this study, we further characterized SK609's ability to selectively inhibit the reuptake of NE by NE transporters (NET). Our results indicate SK609 selectively inhibits NET with a Ki value of ∼500 nM and behaves as a NET substrate. Systemic dosing of SK609 (4 mg/kg; i.p.) in naïve rats produced a 300% and 160% increase in NE and DA, respectively, in the PFC as measured by microdialysis. Based on these neurochemical results, SK609 was tested in a PFC-dependent, visually-guided sustained attention task in rats. SK609 improved performance in a dose-dependent manner with a classical inverted-U dose response function with a peak effect at 4 mg/kg. SK609's peak effect was blocked by a pre-treatment with either the D2/D3R antagonist raclopride (0.05 mg/kg; i.p) or the alpha-1 adrenergic receptor antagonist prazosin (0.25 mg/kg; i.p), confirming a role for both DA and NE in promoting sustained attention. Additionally, SK609 improved sustained attention more prominently among low-performing animals. Doses of SK609 (2, 4, and 8 mg/kg) associated with cognitive enhancement did not produce an increase in spontaneous locomotor activity, suggesting a lack of side effects mediated by DA transporter (DAT) activity. These results demonstrate that the novel catecholaminergic modulator SK609 has the potential to treat sustained attention deficits without affecting DAT activity, distinguishing it from amphetamines and methylphenidate.
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Affiliation(s)
- Courtney A Marshall
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Zachary D Brodnik
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Ole V Mortensen
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Maarten E A Reith
- Department of Psychiatry and of Biochemistry and Molecular Pharmacology, New York University Langone Medical Center, New York City, NY, USA
| | - Jed S Shumsky
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Barry D Waterhouse
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, USA; Department of Cell Biology and Neurscience, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Rodrigo A España
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Sandhya Kortagere
- Department of Microbiology and Immunology, Institute for Molecular Medicine, Drexel University College of Medicine, Philadelphia, PA, USA; Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA, USA.
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25
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Zaami S, Tagliabracci A, Berretta P, Busardò FP, Marinelli E. Use of Methylphenidate Analogues as Cognitive Enhancers: The Prelude to Cosmetic Neurology and an Ethical Issue. Front Psychiatry 2019; 10:1006. [PMID: 32038333 PMCID: PMC6989549 DOI: 10.3389/fpsyt.2019.01006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 12/20/2019] [Indexed: 01/01/2023] Open
Affiliation(s)
- Simona Zaami
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University, Rome, Italy
| | - Adriano Tagliabracci
- Section of Legal Medicine, Department of Excellence-Biomedical Sciences and Public Health, Ancona, Italy
| | - Paolo Berretta
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Francesco Paolo Busardò
- Section of Legal Medicine, Department of Excellence-Biomedical Sciences and Public Health, Ancona, Italy
| | - Enrico Marinelli
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University, Rome, Italy
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26
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Schermann H, Gurel R, Ankory R, Kadar A, Yoffe V, Snir N, Sternheim A, Karakis I. Lower risk of fractures under methylphenidate treatment for ADHD: A dose-response effect. J Orthop Res 2018; 36:3328-3333. [PMID: 30129682 DOI: 10.1002/jor.24129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/03/2018] [Indexed: 02/04/2023]
Abstract
Methylphenidate (MP), a widely used and abused stimulant medication for ADHD, negatively affects bone mass. However, previous epidemiological studies demonstrated that MP is not associated with increased incidence of fractures in children, and may even have a protective effect due to behavior modification. This study aimed to investigate the association between MP and fracture risk in a retrospective cohort of healthy military recruits, aged 18-25, with at least 1 year of service between 2008 and 2017. Subjects were divided into five groups: subjects without ADHD; untreated subjects with ADHD; and subjects with ADHD and prescriptions of 1-90, 91-180, or 181+ tablets during the study period. The primary outcome was at least one fracture diagnosis during the study. Among 682,110 subjects (409,175 men [60%]), 50,999 (7.5%) had fractures. MP was used by 1,681 (0.4%) men and 2.828 (1%) women. The fracture rates in the no ADHD, untreated ADHD, ADHD 0-90, ADHD 91-180, and ADHD 181+ groups were 10.4%, 16.4%, 8.7%, 4.8% and 5.8% in men, and 3.6%, 7.1%, 4.6%, 4.4% and 3% in women, respectively. Multivariate regression analysis confirmed an inverse dose-response association between MP and fractures in men (p < 0.001). In women, untreated ADHD was associated with a significantly higher fracture risk, compared to healthy controls (OR = 1.82, p < 0.001). The study confirms previous literature and demonstrates an inverse dose-response association between MP and fracture risk in men. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:3328-3333, 2018.
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Affiliation(s)
- Haggai Schermann
- Divison of Orthopedics, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Weizmann 6, Tel Aviv, Israel
| | - Ron Gurel
- Divison of Orthopedics, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Weizmann 6, Tel Aviv, Israel
| | - Ran Ankory
- Divison of Orthopedics, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Weizmann 6, Tel Aviv, Israel
| | - Assaf Kadar
- Divison of Orthopedics, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Weizmann 6, Tel Aviv, Israel
| | - Victoria Yoffe
- Divison of Orthopedics, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Weizmann 6, Tel Aviv, Israel
| | - Nimrod Snir
- Divison of Orthopedics, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Weizmann 6, Tel Aviv, Israel
| | - Amir Sternheim
- National Unit of Orthopedic Oncology, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Tel Aviv, Israel
| | - Isabella Karakis
- Environmental Epidemiology Department, Public Health Services, Ministry of Health, Israel.,Ashkelon Academic College, Ashkelon, Israel
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27
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Carton L, Cabé N, Ménard O, Deheul S, Caous AS, Devos D, Cottencin O, Bordet R. Pharmaceutical cognitive doping in students: A chimeric way to get-a-head? Therapie 2018; 73:331-339. [PMID: 29625706 DOI: 10.1016/j.therap.2018.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 02/23/2018] [Indexed: 10/17/2022]
Abstract
For students, the pressing demands for memorization, top-level performance, and peer competition create an environment favorable for pharmaceutical cognitive doping behavior. We aimed to describe recent practices and the benefit/risk ratio of such behavior and to discuss the issues at stake. The prevalence of pharmaceutical cognitive doping among students has been reported from 1.3% to 33% across studies, with variations depending on country and definition of pharmaceutical cognitive doping. The therapeutic classes most frequently cited as being diverted for doping purposes are psychostimulants and nootropics (methylphenidate, modafinil, piracetam), corticosteroids, sedative drugs and beta-blockers. Some illegal substances such as cannabis, amphetamines and cocaine are also consumed in order to boost mental function. Finally, over-the-counter products, such as caffeine-based tablets or energy drinks, or alcohol, are also widely used by students whose motivations involve enhanced performance, concentration, memory, and staying awake during the revision and exam period. However, the expected (often fantasized) effectiveness of these products does not correspond to the reality of a modest controversial impact on cognitive performance. There appears to be an emerging profile of the student more inclined to doping behavior. Cognitive doping thus raises the question of its regulation, opening a debate opposing, on one hand, individual freedom and supposed collective benefits and, on the other hand, health consequences, educational (in)equality, and the risk of tarnished academic success. Strengthening school and university medicine, through prevention campaigns and the identification of subjects at risk, is essential to limit the extent, risk, and damages associated with such practices.
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Affiliation(s)
- Louise Carton
- Inserm, UMR S1171, service de pharmacologie médicale, CHU de Lille, université de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France; Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France.
| | - Nicolas Cabé
- Inserm, U1077, Unicaen, EPHE, neuropsychologie et imagerie de la mémoire humaine, PSL research university, CHU de Caen, Normandie université, 14000 Caen, France; Service universitaire d'addictologie, CHU de Caen, 14000 Caen, France
| | - Olivier Ménard
- Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France
| | - Sylvie Deheul
- Inserm, UMR S1171, service de pharmacologie médicale, CHU de Lille, université de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
| | - Anne-Sylvie Caous
- CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
| | - David Devos
- Inserm, UMR S1171, service de pharmacologie médicale, CHU de Lille, université de Lille, 59000 Lille, France; Licend Coen Center Lille, 59045 Lille, France
| | - Olivier Cottencin
- CNRS UMR 9193 SCALab PsyCHIC Team, université de Lille, 59045 Lille, France; Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France
| | - Régis Bordet
- Inserm, UMR S1171, service de pharmacologie médicale, CHU de Lille, université de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
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28
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Garrido Zinn C, Bühler L, Cavalcante LE, Schmidt SD, Fagundes Ferreira F, Zanini ML, Guerino Furini CR, de Carvalho Myskiw J, Izquierdo I. Methylphenidate induces state-dependency of social recognition learning: Central components. Neurobiol Learn Mem 2018; 149:77-83. [PMID: 29408055 DOI: 10.1016/j.nlm.2018.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/18/2018] [Accepted: 02/03/2018] [Indexed: 11/29/2022]
Abstract
Methylphenidate (MPH) is a widely prescribed drug for the treatment of attention-deficit hyperactivity disorder. Findings in the literature suggest that the effects of MPH on memory may result from increased extracellular levels of norepinephrine (NE) and dopamine (DA). Here, we report that the systemic administration of MPH before the acquisition phase in a social discrimination task impaired the retrieval of the social recognition memory (SRM), but made it state-dependent: another administration of MPH before the retention test recovered the SRM. We observed that the induction of state dependency by MPH relies on the ventromedial prefrontal cortex (vmPFC), but not on the CA1 region of the hippocampus (CA1). Also, the inhibitors of NE and DA, nisoxetine and GBR12909, respectively, restored the SRM when infused into the vmPFC. Only the GBR12909 was able to restore the SRM in the CA1, whereas nisoxetine could not restore and even caused an impairment on memory retrieval when infused alone before the retention test. The data suggest that the state-dependence of SRM induced by MPH depends on an influence of both catecholamines on the vmPFC, while NE inhibits the retrieval of SRM on the hippocampus.
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Affiliation(s)
- Carolina Garrido Zinn
- Memory Center, Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690-2nd Floor, 90610-000 Porto Alegre, RS, Brazil
| | - Leticia Bühler
- Memory Center, Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690-2nd Floor, 90610-000 Porto Alegre, RS, Brazil
| | - Lorena Evelyn Cavalcante
- Memory Center, Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690-2nd Floor, 90610-000 Porto Alegre, RS, Brazil
| | - Scheila Daiane Schmidt
- Memory Center, Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690-2nd Floor, 90610-000 Porto Alegre, RS, Brazil
| | - Flávia Fagundes Ferreira
- Memory Center, Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690-2nd Floor, 90610-000 Porto Alegre, RS, Brazil
| | - Mara Lise Zanini
- College of Chemistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, 90619-900 Porto Alegre, RS, Brazil
| | - Cristiane Regina Guerino Furini
- Memory Center, Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690-2nd Floor, 90610-000 Porto Alegre, RS, Brazil; National Institute for Translational Neuroscience (INNT), National Research Council of Brazil, Brazil
| | - Jociane de Carvalho Myskiw
- Memory Center, Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690-2nd Floor, 90610-000 Porto Alegre, RS, Brazil; National Institute for Translational Neuroscience (INNT), National Research Council of Brazil, Brazil
| | - Ivan Izquierdo
- Memory Center, Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690-2nd Floor, 90610-000 Porto Alegre, RS, Brazil; National Institute for Translational Neuroscience (INNT), National Research Council of Brazil, Brazil.
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29
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Schleim S, Quednow BB. How Realistic Are the Scientific Assumptions of the Neuroenhancement Debate? Assessing the Pharmacological Optimism and Neuroenhancement Prevalence Hypotheses. Front Pharmacol 2018; 9:3. [PMID: 29403383 PMCID: PMC5786508 DOI: 10.3389/fphar.2018.00003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/03/2018] [Indexed: 11/30/2022] Open
Abstract
Since two decades, neuroenhancement is a major topic in neuroethics and still receives much attention in the scholarly literature as well as in public media. In contrast to high hopes at the beginning of the “Decade of the Brain” in the United States and Europe that we subsume under the “pharmacological optimism hypothesis,” recent evidence from clinical neuroscience suggests that developing drugs that make healthy people smarter is even more difficult than finding new treatments for patients with mental disorders. However, cognitive enhancing drugs even for patients with impaired intellectual performance have not been successfully developed yet and new drugs that might have a disruptive impact on this field are unlikely to be developed in the near future. Additionally, we discuss theoretical, empirical, and historical evidence to assess whether cognitive enhancement of the healthy is common or even epidemic and if its application will further increase in the near future, as suggested by the “neuroenhancement prevalence hypothesis.” Reports, surveys, and reviews from the 1930s until today indicate that psychopharmacological neuroenhancement is a fact but less common than often stated, particularly in the public media. Non-medical use of psychostimulants for the purpose of cognitive enhancement exists since at least 80 years and it might actually have been more common in the past than today. Therefore, we conclude that the pharmacological optimism hypothesis and neuroenhancement prevalence hypotheses have to be rejected and argue that the neuroenhancement debate should take the available evidence more into account.
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Affiliation(s)
- Stephan Schleim
- Theory and History of Psychology, Faculty of Behavioral and Social Sciences, Heymans Institute for Psychological Research, University of Groningen, Groningen, Netherlands
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
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30
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Carton L, Cabé N, Ménard O, Deheul S, Caous AS, Devos D, Cottencin O, Bordet R. [Pharmaceutical cognitive doping in students: a chimeric way to get-a-head?]. Therapie 2017; 73:319-329. [PMID: 29224920 DOI: 10.1016/j.therap.2017.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/04/2017] [Accepted: 10/24/2017] [Indexed: 11/27/2022]
Abstract
For students, the pressing demands for memorization, top-level performance, and peer competition create an environment favorable for pharmaceutical cognitive doping behavior. We aimed to describe recent practices and the benefit / risk ratio of such behavior and to discuss the issues at stake. The prevalence of pharmaceutical cognitive doping among students has been reported from 1.3% to 33% across studies, with variations depending on country and definition of pharmaceutical cognitive doping. The therapeutic classes most frequently cited as being diverted for doping purposes are psychostimulants and nootropics (methylphenidate, modafinil, piracetam), corticosteroids, sedative drugs and beta-blockers. Some illegal substances such as cannabis, amphetamines and cocaine are also consumed in order to boost mental function. Finally, over-the-counter products, such as caffeine-based tablets or energy drinks, or alcohol, are also widely used by students whose motivations involve enhanced performance, concentration, memory, and staying awake during the revision and exam period. However, the expected (often fantasized) effectiveness of these products does not correspond to the reality of a modest controversial impact on cognitive performance. There appears to be an emerging profile of the student more inclined to doping behavior. Cognitive doping thus raises the question of its regulation, opening a debate opposing, on one hand, individual freedom and supposed collective benefits and, on the other hand, health consequences, educational (in)equality, and the risk of tarnished academic success. Strengthening school and university medicine, through prevention campaigns and the identification of subjects at risk, is essential to limit the extent, risk, and damages associated with such practices.
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Affiliation(s)
- Louise Carton
- Inserm, UMR S1171, service de pharmacologie médicale, université de Lille, CHU de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France; Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France.
| | - Nicolas Cabé
- Inserm, U1077, Unicaen, EPHE, neuropsychologie et imagerie de la mémoire humaine, PSL research university, Normandie université, CHU de Caen, 14000 Caen, France; Service universitaire d'addictologie, CHU de Caen, 14000 Caen, France
| | - Olivier Ménard
- Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France
| | - Sylvie Deheul
- Inserm, UMR S1171, service de pharmacologie médicale, université de Lille, CHU de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
| | - Anne-Sylvie Caous
- CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
| | - David Devos
- Inserm, UMR S1171, service de pharmacologie médicale, université de Lille, CHU de Lille, 59000 Lille, France; Licend Coen Center Lille, 59045 Lille, France
| | - Olivier Cottencin
- CNRS UMR 9193 SCALab PsyCHIC Team, université de Lille, 59045 Lille, France; Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France
| | - Régis Bordet
- Inserm, UMR S1171, service de pharmacologie médicale, université de Lille, CHU de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
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31
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[Doping for the brain]. Z Gerontol Geriatr 2017; 51:143-148. [PMID: 29209802 DOI: 10.1007/s00391-017-1351-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 11/02/2017] [Accepted: 11/17/2017] [Indexed: 12/14/2022]
Abstract
The enhancement of physical and cognitive abilities (i. e. concentration, vigilance, memory) has always been desirable for humans. The term pharmacological neuroenhancement refers to the use of legal or nonprescription psychoactive substances by healthy subjects with the intention of cognitive enhancement. To give the most prominent example, caffeine serves worldwide as a natural stimulant. Brain doping, however, specifies the use of illegal substances or prescription drugs beyond approval with the purpose of cognitive enhancement. Only amphetamines, methylphenidate and modafinil have significant effects on attentiveness, concentration and alertness, whereas other substances, such as anti-dementia drugs or anti-depressants failed to demonstrate cognitive enhancement in healthy subjects.
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32
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Sturman N, Deckx L, van Driel ML. Methylphenidate for children and adolescents with autism spectrum disorder. Cochrane Database Syst Rev 2017; 11:CD011144. [PMID: 29159857 PMCID: PMC6486133 DOI: 10.1002/14651858.cd011144.pub2] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Children with autistic spectrum disorder (ASD) frequently present with inattention, impulsivity and hyperactivity, which are the cardinal symptoms of attention deficit hyperactivity disorder (ADHD). The effectiveness of methylphenidate, a commonly used ADHD treatment, is therefore of interest in these children. OBJECTIVES To assess the effects of methylphenidate for symptoms of ADHD (inattention, impulsivity and hyperactivity) and ASD (impairments in social interaction and communication, and repetitive, restricted or stereotypical behaviours) in children and adolescents aged 6 to 18 years with ASD. SEARCH METHODS In November 2016, we searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, 11 other databases and two trials registers. We also checked reference lists and contacted study authors and pharmaceutical companies. SELECTION CRITERIA Randomised controlled trials (RCTs) that investigated the effect of methylphenidate versus placebo on the core symptoms of ASD or ADHD-like symptoms, or both, in children aged 6 to 18 years who were diagnosed with ASD or pervasive developmental disorder. The primary outcome was clinical efficacy, defined as an improvement in ADHD-like symptoms (inattention, impulsivity and hyperactivity) and in the core symptoms of ASD (impaired social interaction, impaired communication, and stereotypical behaviours), and overall ASD. Secondary outcomes examined were: rate of adverse events; caregiver well-being; need for institutionalisation, special schooling or therapy to achieve learning outcomes; and overall quality of life. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodological procedures. We combined outcome measures that used different psychometric scales, where clinically appropriate. We used a coefficient of 0.6 to calculate standard deviations and adjust for the studies' cross-over design. We considered a standardised mean difference (SMD) of 0.52 as the minimum clinically relevant inter-treatment difference. We applied the GRADE rating for strength of evidence for each outcome. MAIN RESULTS The studies: we included four cross-over studies, with a total of 113 children aged 5 to 13 years, most of whom (83%) were boys. We included two studies with five-year-old children since we were unable to obtain the disaggregated data for those aged six years and above, and all other participants were in our target age range. All participants resided in the USA. The duration of treatment in the cross-over phase was one week for each dose of methylphenidate. Studies used a range of outcome scales, rated by parents, teachers or both; clinicians; or programme staff. We report parent-rated outcomes separately. Risk of bias: we considered three trials to be at high risk of bias due to selective reporting and all trials to be at unclear risk of bias for blinding of participants and assessors, due to the potential for recognising the side effects of methylphenidate. We judged all trials to be at low or unclear risk of bias for other items. Primary outcomes: the meta-analysis suggested that high-dose methylphenidate (0.43 mg/kg/dose to 0.60 mg/kg/dose) had a significant and clinically relevant benefit on hyperactivity, as rated by teachers (SMD -0.78, 95% confidence interval (CI) -1.13 to -0.43; 4 studies, 73 participants; P < 0.001; low-quality evidence) and parents (mean difference (MD) -6.61 points, 95% CI -12.19 to -1.03, rated on the hyperactivity subscale of the Aberrant Behviour Checklist, range 0 to 48; 2 studies, 71 participants; P = 0.02; low-quality evidence). Meta-analysis also showed a significant but not clinically relevant benefit on teacher-rated inattention (MD -2.72 points, 95% CI -5.37 to -0.06, rated on the inattention subscale of the Swanson, Nolan and Pelham, Fourth Version questionnaire, range 0 to 27; 2 studies, 51 participants; P = 0.04; low-quality evidence). There were inadequate data to conduct a meta-analysis on the symptom of impulsivity. There was no evidence that methylphenidate worsens the core symptoms of ASD or benefits social interaction (SMD -0.51, 95% CI -1.07 to 0.05; 3 studies, 63 participants; P = 0.07; very low-quality evidence), stereotypical behaviours (SMD -0.34, 95% CI -0.84 to 0.17; 3 studies, 69 participants; P = 0.19; low-quality evidence), or overall ASD (SMD -0.53, 95% CI -1.26 to 0.19; 2 studies, 36 participants; P = 0.15; low-quality evidence), as rated by teachers. There were inadequate data to conduct a meta-analysis on the symptom of impaired communication. SECONDARY OUTCOMES no data were available for the secondary outcomes of caregiver well-being; need for institutionalisation, special schooling options or therapy to achieve learning outcomes; or overall quality of life. No trials reported serious adverse events. The only adverse effect that was significantly more likely with treatment was reduced appetite as rated by parents (risk ratio 8.28, 95% CI 2.57 to 26.73; 2 studies, 74 participants; P < 0.001; very low-quality evidence). Subgroup analysis by dose did not identify any significant differences in effect on our primary outcomes between low-, medium- or high-dose ranges. AUTHORS' CONCLUSIONS We found that short-term use of methylphenidate might improve symptoms of hyperactivity and possibly inattention in children with ASD who are tolerant of the medication, although the low quality of evidence means that we cannot be certain of the true magnitude of any effect. There was no evidence that methylphenidate has a negative impact on the core symptoms of ASD, or that it improves social interaction, stereotypical behaviours, or overall ASD. The evidence for adverse events is of very low quality because trials were short and excluded children intolerant of methylphenidate in the test-dose phase. Future RCTs should consider extending the duration of treatment and follow-up. The minimum clinically important difference also needs to be confirmed in children with ASD using outcome scales validated for this population.
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Affiliation(s)
- Nancy Sturman
- The University of QueenslandPrimary Care Clinical Unit, Faculty of MedicineHerstonBrisbaneQueenslandAustralia4029
| | - Laura Deckx
- The University of QueenslandPrimary Care Clinical Unit, Faculty of MedicineHerstonBrisbaneQueenslandAustralia4029
| | - Mieke L van Driel
- The University of QueenslandPrimary Care Clinical Unit, Faculty of MedicineHerstonBrisbaneQueenslandAustralia4029
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Urban KR, Gao WJ. Psychostimulants As Cognitive Enhancers in Adolescents: More Risk than Reward? Front Public Health 2017; 5:260. [PMID: 29034227 PMCID: PMC5626934 DOI: 10.3389/fpubh.2017.00260] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/12/2017] [Indexed: 12/25/2022] Open
Abstract
Methylphenidate and other psychostimulants, originally developed to treat attention deficit-hyperactivity disorder, are increasingly abused by healthy adolescents and adults seeking an advantage in scholastic performance and work productivity. However, how these drugs may affect cognitive performance, especially in the young brain, remains unclear. Here, we review recent literature and emphasize the risks of abuse of psychostimulants in healthy adolescents and young adults. We conclude that while the desire for cognitive enhancement, particularly with rising costs of education and increasingly competitive nature of scholarship programs, is unlikely to diminish in the near future, it is crucial for the scientific community to thoroughly examine the efficacy and safety of these stimulants in healthy populations across development. The current dearth of knowledge on the dose–response curve, metabolism, and cognitive outcomes in adolescents following methylphenidate or other psychostimulant exposure may be perpetuating a perception of these drugs as “safe” when that might not be true for developing brains.
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Affiliation(s)
- Kimberly R Urban
- Department of General Anesthesia, Division of Stress Neurobiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Wen-Jun Gao
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, United States
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Karim TJ, Reyes-Vazquez C, Dafny N. Comparison of the VTA and LC response to methylphenidate: a concomitant behavioral and neuronal study of adolescent male rats. J Neurophysiol 2017; 118:1501-1514. [PMID: 28615331 DOI: 10.1152/jn.00145.2017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/12/2017] [Accepted: 06/12/2017] [Indexed: 12/21/2022] Open
Abstract
Methylphenidate (MPD), also known as Ritalin, is a psychostimulant used to treat attention deficit hyperactivity disorder. However, it is increasingly being misused by normal adolescents for recreation and academic advantage. Therefore, it is important to elucidate the behavioral and neurophysiological effects of MPD in normal subjects. MPD inhibits the reuptake of catecholamines, mainly found in the ventral tegmental area (VTA) and locus coeruleus (LC). The VTA and LC normally mediate attention, motivation, and drug reward behaviors. Selective neuronal connections between the VTA and LC have been identified implicating regular interaction between the structures. The objective of this study was to compare the neuronal responses of the VTA and LC to MPD in normal adolescent rats. Animals were implanted with permanent electrodes in the VTA and LC, and neuronal units were recorded following acute and repetitive (chronic) saline or 0.6, 2.5, or 10.0 mg/kg MPD exposure. Animals displayed either behavioral sensitization or tolerance to all three doses of MPD. Acute MPD exposure elicited excitation in the majority of all VTA and LC units. Chronic MPD exposure elicited a further increase in VTA and LC neuronal activity in animals exhibiting behavioral sensitization and an attenuation in VTA and LC neuronal activity in animals exhibiting behavioral tolerance, demonstrating neurophysiological sensitization and tolerance, respectively. The similar pattern in VTA and LC unit activity suggests that the two structures are linked in their response to MPD. These results may help determine the exact mechanism of action of MPD, resulting in optimized treatment of patients.NEW & NOTEWORTHY The same dose of 0.6, 2.5, and 10 mg/kg methylphenidate (MPD) elicits either behavioral sensitization or tolerance in adolescent rats. There is a direct correlation between the ventral tegmental area (VTA) and locus coeruleus (LC) neuronal response to chronic MPD exposure. Both the VTA and LC are involved in the behavioral and neurophysiological effects of chronic MPD.
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Affiliation(s)
- Tahseen J Karim
- Department of Neurobiology and Anatomy, McGovern Medical School, Houston, Texas
| | - Cruz Reyes-Vazquez
- Department of Neurobiology and Anatomy, McGovern Medical School, Houston, Texas
| | - Nachum Dafny
- Department of Neurobiology and Anatomy, McGovern Medical School, Houston, Texas
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Abstract
Stimulants have been suggested as therapeutics in depression for 80 years now, but there is still no evidence from randomized controlled trials that stimulants, in general, possess specific antidepressant effects. Also, several recent large randomized controlled trials which tried to establish an indication for stimulants as add-on in depression failed, and the companies no longer proceed with regulatory filings. One reason why the common belief of an antidepressant effect has survived over decades is a lack of clarity in psychopathology. Tiredness in the sense of sleepiness (downregulation of arousal) and lack of drive are mixed up with tiredness in the sense of exhaustion with high inner tension (upregulation of arousal) and inhibition of drive. The latter is found in typical depression, and according to the recently introduced arousal regulation model of affective disorders, upregulation of arousal is considered to be an important pathogenetic factor. Psychostimulants are unlikely to have beneficial effects in those patients with upregulated arousal. However, there might be subgroups of depressed patients, such as atypical depression, which suffer from sleepiness and lack of drive and might respond to stimulants. Arousal, a dimension included in the Research Domain Criteria project of the National Institute of Mental Health, can be assessed with an electroencephalography-based algorithm (the Vigilance Algorithm Leipzig) and is a promising biomarker to identify subgroups of patients, which might respond to stimulants.
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Affiliation(s)
- Ulrich Hegerl
- 1 Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.,2 German Depression Foundation, Leipzig, Germany
| | - Tilman Hensch
- 1 Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
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Affiliation(s)
- Florence Levy
- School of Psychiatry, University of New South Wales, Prince of Wales Hospital, NSW 2031, Australia
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Murai T, Mutoh N. Sequential Addition Reaction of Sulfanylmethyllithiums and Grignard Reagents to Thioformamides Leading to the Formation of 2-Phenyl-2-sulfanylethyl Tertiary Amines. J Org Chem 2016; 81:8131-4. [PMID: 27565031 DOI: 10.1021/acs.joc.6b01857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The reaction of sulfanylmethyllithiums generated from benzylsulfanes and n-BuLi with N,N-dimethylthioformamide followed by the addition of Grignard reagents gave 2-phenyl-2-sulfanyl tertiary amines in moderate to good yields. A range of Grignard reagents involving primary alkyl, aryl, vinyl, and alkynyl Grignard reagents were used. Two carbon-carbon bond-forming reactions were achieved through a one-pot reaction. The reaction showed good to high diastereoselectivity, particularly with alkynyl Grignard reagents.
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Affiliation(s)
- Toshiaki Murai
- Department of Chemistry and Biomolecular Science, Faculty of Engineering, Gifu University , Yanagido, Gifu 501-1193, Japan
| | - Natsumi Mutoh
- Department of Chemistry and Biomolecular Science, Faculty of Engineering, Gifu University , Yanagido, Gifu 501-1193, Japan
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Khan MZ, Nawaz W. The emerging roles of human trace amines and human trace amine-associated receptors (hTAARs) in central nervous system. Biomed Pharmacother 2016; 83:439-449. [PMID: 27424325 DOI: 10.1016/j.biopha.2016.07.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/28/2016] [Accepted: 07/01/2016] [Indexed: 02/06/2023] Open
Abstract
Human trace amines (TAs) are endogenous compounds, previously almost ignored in human pathology for many reasons (difficulty of their measurement in biological fluids, unknown receptors for elusive amines), are now considered to play a significant role in synaptic transmission within the central nervous system (CNS) acting as neuromodulators. The recent discovery of a novel family of G-protein-coupled receptors (GPCRs) that includes individual members that are highly specific for TAs indicates a potential role for TAs as vertebrate neurotransmitters or neuromodulators, although the majority of these GPCRs so far have not been demonstrated to be activated by TAs. Human trace amine receptors (including TAAR1 TAAR2 TAAR5 TAAR6 TAAR8 TAAR9) are expressed in the brain and play significant physiological and neuropathological roles by activation of trace amines. We herein discuss the recent findings that provide insights into the functional roles of human trace amines (including P-Octopamine, β phenylethylamine, Tryptamine, Tyramine, Synephrine, 3-Iodothyronamine, 3-Methoxytyramine, N-Methyltyramine, N-Methylphenethylamine) in brain. Furthermore, we discuss the known functions of human trace amine receptors in brain.
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Affiliation(s)
- Muhammad Zahid Khan
- Department of Pharmacology, China Pharmaceutical University, Nanjing 210009, China.
| | - Waqas Nawaz
- School of basic medicine and clinical pharmacy, China Pharmaceutical University, Nanjing 210009, China
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