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Kovačić Petrović Z, Peraica T, Blažev M, Tomašić L, Kozarić-Kovačić D. Use of psychoactive substances and alcohol during the first three waves of the COVID-19 pandemic: Croatian experience. J Addict Dis 2024; 42:91-102. [PMID: 36444870 DOI: 10.1080/10550887.2022.2145076] [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] [Indexed: 11/30/2022]
Abstract
Increased prevalence and severity of both substance and behavioral addictions are among the most harmful consequences of the COVID-19 outbreak. To determine the sociodemographic characteristics, COVID-19-related stressors, and stress, anxiety, and depression symptoms that may predict the use and changes in the use of psychoactive substances (PS) during the first three COVID-19 waves in Croatia. The cross-sectional online survey included 1,118 adult participants (220 men and 898 women; mean age: 35.1 [SD = 12.3] years; age range: 18-78) from general adult population. Sociodemographic data were collected, and ad-hoc developed questionnaires on COVID-19-related stressors, PS use before and during the pandemic, CAGE Alcohol Questionnaire, Impact of Event Scale, and Hospital Anxiety Depression Scale were applied. The PS use increased in 31% of participants. The use of tobacco, caffeine, alcohol, cannabinoids, and anxiolytics showed the greatest increase in the last year (tobacco 7.1%; caffeine 5.8%; alcohol 6.4%; cannabinoids 2.5%; and anxiolytics 3.9%). Alcohol consumption during the pandemic increased in 16.8% of participants who consumed alcohol before the pandemic, with 4.5% of them reporting problematic alcohol use (PAU). The tested model demonstrated relatively good model-data fit and significantly predicted 11.8% increase in the use of PS and 9.8% of PAU. Being married or in a relationship and severe anxiety and depression symptoms predicted increased use of PS and PAU, while higher education level and ever being diagnosed with COVID-19 predicted only increased use of PS.
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Affiliation(s)
- Zrnka Kovačić Petrović
- Department of Psychiatry and Psychological Medicine, University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Addiction, University Psychiatric Hospital Vrapče, Zagreb, Croatia
| | - Tina Peraica
- Department of Psychiatry, Referral Center for Stress-related Disorders of the Ministry of Health, University Hospital Dubrava, Zagreb, Croatia
- Department of Forensic Sciences, University of Split, Split, Croatia
| | - Mirta Blažev
- Ivo Pilar Institute of Social Sciences, Zagreb, Croatia
| | - Lea Tomašić
- University Psychiatric Hospital Vrapče, Zagreb, Croatia
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Ramdin C, Makutonin M, Nelson LS, Meltzer AC, Mazer-Amirshahi M. Outcomes and resource utilisation of patients presented to the emergency department with opioid and benzodiazepine poisoning. Emerg Med J 2024; 41:114-115. [PMID: 37669833 DOI: 10.1136/emermed-2023-213180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/07/2023]
Affiliation(s)
- Christine Ramdin
- Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Michael Makutonin
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Lewis S Nelson
- Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Andrew C Meltzer
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Maryann Mazer-Amirshahi
- Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA
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Fogliano C, Carotenuto R, Agnisola C, Simoniello P, Karam M, Manfredonia C, Avallone B, Motta CM. Benzodiazepine Delorazepam Induces Locomotory Hyperactivity and Alterations in Pedal Mucus Texture in the Freshwater Gastropod Planorbarius corneus. Int J Mol Sci 2023; 24:17070. [PMID: 38069390 PMCID: PMC10706940 DOI: 10.3390/ijms242317070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/22/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Benzodiazepines, psychotropic drugs, are ubiquitous in the aquatic environment due to over-consumption and inefficient removal by sewage treatment plants. Bioaccumulation with consequent behavioral and physiological effects has been reported in many aquatic species. However, the responses are species-specific and still poorly understood. To improve the knowledge, we exposed the freshwater snail Planorbarius corneus to 1, 5, or 10 µg/L of delorazepam, the most widely consumed benzodiazepine in Italy. Conventional behavioral tests were used to assess the effects on locomotor and feeding behavior. Histological and biochemical analyses were also performed to detect possible changes in the structure and composition of the foot mucus and glands. The results show a paradoxical response with reduced feeding activity and locomotor hyperactivity. Pedal mucus was altered in texture but not in composition, becoming particularly rich in fibrous collagen-like material, and a significant change in the protein composition was highlighted in the foot. In conclusion, exposure to delorazepam induces disinhibited behavior in Planorbarius corneus, potentially increasing the risk of predation, and an increase in mucus protein production, which, together with reduced feeding activity, would severely compromise energy resources.
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Affiliation(s)
- Chiara Fogliano
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (C.F.); (R.C.); (C.A.); (M.K.); (C.M.); (C.M.M.)
| | - Rosa Carotenuto
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (C.F.); (R.C.); (C.A.); (M.K.); (C.M.); (C.M.M.)
| | - Claudio Agnisola
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (C.F.); (R.C.); (C.A.); (M.K.); (C.M.); (C.M.M.)
| | - Palma Simoniello
- Department of Science and Technology, University of Naples Parthenope, 80143 Naples, Italy;
| | - Myriam Karam
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (C.F.); (R.C.); (C.A.); (M.K.); (C.M.); (C.M.M.)
| | - Claudia Manfredonia
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (C.F.); (R.C.); (C.A.); (M.K.); (C.M.); (C.M.M.)
| | - Bice Avallone
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (C.F.); (R.C.); (C.A.); (M.K.); (C.M.); (C.M.M.)
| | - Chiara Maria Motta
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (C.F.); (R.C.); (C.A.); (M.K.); (C.M.); (C.M.M.)
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Moses J, Korona-Bailey J, Mukhopadhyay S. Exploring trends in benzodiazepine-positive fatal drug overdoses in Tennessee, 2019-2021. Ann Med 2023; 55:2287194. [PMID: 38039554 PMCID: PMC10836290 DOI: 10.1080/07853890.2023.2287194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Benzodiazepine-positive overdoses increased between 2019 and 2021 in Tennessee. We sought to determine the changes in the number and characteristics of prescription and illicit benzodiazepine-positive fatal drug overdoses during this period. MATERIALS AND METHODS A statewide study was conducted to determine changes in the number and characteristics of benzodiazepine-positive drug overdose decedents using 2019-2021 data from the Tennessee State Unintentional Drug Overdose Reporting System. The analyses were limited to Tennessee residents aged ≥ 18 years. A benzodiazepine-positive overdose was defined as any benzodiazepine on toxicology, regardless of the presence of other substances. Frequencies were generated to compare demographics, circumstances, prescription history, and toxicology between 2019 and 2021 for illicit and prescription benzodiazepine-positive fatal overdoses. RESULTS Between 2019 and 2021, 1666 benzodiazepine-positive unintentional or undetermined fatal drug overdoses out of 5916 total overdoses that occurred among adult Tennessee residents with available toxicological information. Prescription benzodiazepines were identified in 80.7% of deaths, whereas illicit benzodiazepines were identified in 12.0% of deaths. Many decedents had an anxiety disorder (45.5%), while over half of all decedents had a history of substance use disorder (52.3%). Most benzodiazepine-positive overdoses involved fentanyl (71.3%). CONCLUSIONS This analysis can inform local and regional public health workers to implement focused prevention and intervention efforts for people with co-occurring mental health conditions and substance use disorders to curb overdose epidemics among persons using benzodiazepines in Tennessee. Public health campaigns should focus on educating people on appropriate prescription medication use and the dangers of obtaining substances illicitly. Given the high proportion of opioids in this population, further education also is needed on the dangers of polysubstance drug use. The differences between prescription and illicit benzodiazepine-positive fatal overdoses indicate the need to develop substance-specific prevention and treatment strategies.
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Affiliation(s)
| | | | - Sutapa Mukhopadhyay
- TN Department of Health, Office of Informatics and Analytics, Nashville, TN, USA
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Myran D, Milani C, Pugliese M, Hensel JM, Sood M, Kendall CE, Kendzerska T, Tanuseputro P. Physician benzodiazepine self-use prior to and during the COVID-19 pandemic in Ontario, Canada: a population-level cohort study. BMJ Open 2023; 13:e062742. [PMID: 37085307 PMCID: PMC10123848 DOI: 10.1136/bmjopen-2022-062742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVES The aim of this study was to investigate physician benzodiazepine (BZD) self-use pre-COVID-19 pandemic and to examine changes in BZD self-use during the first year of the pandemic. DESIGN Population-based retrospective cohort study using linked routinely collected administrative health data comparing the first year of the pandemic to the period before the pandemic. SETTING Province of Ontario, Canada between March 2016 and March 2021. PARTICIPANTS INTERVENTION: Onset of the COVID-19 pandemic in March 2020. OUTCOMES MEASURES The primary outcome measure was the receipt of one or more prescriptions for BZD, which was captured via the Narcotics Monitoring System. RESULTS In a cohort of 30 798 physicians (mean age 42, 47.8% women), we found that during the year before the pandemic, 4.4% of physicians had 1 or more BZD prescriptions. Older physicians (6.8% aged 50+ years), female physicians (5.1%) and physicians with a prior mental health (MH) diagnosis (12.4%) were more likely than younger (3.7% aged <50 years), male physicians (3.8%) and physicians without a prior MH diagnosis (2.9%) to have received 1 or more BZD prescriptions. The first year of the COVID-19 pandemic was associated with a 10.5% decrease (adjusted OR (aOR) 0.85, 95% CI: 0.80 to 0.91) in the number of physicians with 1 or more BZD prescriptions compared with the year before the pandemic. Female physicians were less likely to reduce BZD self-use (aORfemale=0.90, 95% CI: 0.83 to 0.98) compared with male physicians (aORmale=0.79, 95% CI: 0.72 to 0.87, pinteraction=0.046 during the pandemic. Physicians presenting with an incident MH visit had higher odds of filling a BZD prescription during COVID-19 compared with the prior year. CONCLUSIONS Physicians' BZD prescriptions decreased during the first year of the COVID-19 pandemic in Ontario, Canada. These findings suggest that previously reported increases in mental distress and MH visits among physicians during the pandemic did not lead to greater self-use of BZDs.
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Affiliation(s)
- Daniel Myran
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Bruyere Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
| | - Christina Milani
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
| | - Michael Pugliese
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
| | | | - Manish Sood
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Claire E Kendall
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Tetyana Kendzerska
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
- Respirology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
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[Impact of COVID-19 lockdown on the prescription of benzodiazepines]. Aten Primaria 2023; 55:102552. [PMID: 36599201 PMCID: PMC9726689 DOI: 10.1016/j.aprim.2022.102552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To evaluate the effect of COVID-19 lockdown on the prescription of benzodiazepines by gender, age and district health departments. DESIGN Longitudinal observational study. LOCATION Primary care. Asturias (Spain) health district V. PARTICIPANTS People over 15 years of age with filled benzodiazepine prescriptions in between 2017 and 2020. MAIN MEASUREMENTS Benzodiazepine DHD (defined daily dose per 1000 habitants) mean difference between the period defined as pre-lockdown and lockdown. Additionally, the difference was adjusted for gender, sex and district health department and also with the interaction among them. RESULTS DHD mean pre-lockdown was 131.3 and 139.5 in the lockdown; this difference was significant in the global analysis (95% CI: 4.1-12.1). There was an increase in the DHD mean in the 60-74 age group (95% CI: 2.28-21.42), in the group over 90 years old (95% CI: 21.31-40.63) and in women (95% CI: 3.51-14.59). Finally, a decrease in the DHD mean of V11 (95% CI: -29 to -0.66) and V14 (95% CI: -54.28 to -25.04) district health departments was observed. CONCLUSIONS Certain subgroups show a change in the pattern of benzodiazepine prescription without being able to relate this to the lockdown. We believe that there could be some inertia in the prescription of psychiatric medication according to the biopsychosocial characteristics of the patients; it is important to detect this in order to avoid the medicalization of psychological disorders.
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Muacevic A, Adler JR, Nemrish K, Perna S, Al Khalifa D, Owen-Alkhaldi AM, Zameer S, Kamali M, Jassim G. Psychological Impact of COVID-19 on University Students in Bahrain. Cureus 2022; 14:e33079. [PMID: 36721623 PMCID: PMC9883807 DOI: 10.7759/cureus.33079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2022] [Indexed: 12/30/2022] Open
Abstract
Background COVID-19 is an ongoing event that has affected millions worldwide financially, socially, and psychologically; university students have also felt the devastating impact. Therefore, assessing how students have been affected psychologically is important, which is explored in this study. Methods This cross-sectional study took place in two institutions in Bahrain between October and December 2021. A survey assembled from pre-validated questionnaires was sent through Google Forms after receiving ethics approval. Data were analyzed using network plot analysis and linear regression analysis. Results Out of 292 responses, the most common demographic observed were vaccinated Bahraini females living with families at a mean age of 21.21 (SD±3.447). The mean scores for the Generalized Anxiety Disorder Scale (GAD-7), Centered for Epidemiological Studies-Depression scale (CES-D), and Stigma Scale were 10.55 (SD ± 6.144), 18.75 (SD ± 9.147), and 25.40 (SD ± 3.428), respectively. The significant associations on ANOVA observed were stigma score and living status (p-value = 0.002), stigma, and alcohol consumption (p-value = <0.001). Statistically significant predictors of the outcomes in this study included gender for depressive symptoms (p-value = 0.013) and alcohol consumption for stigma (p-value = 0.017). Discussion The stigmatization of the pandemic may additionally influence sub-threshold depressive and anxiety-related symptoms in university students. Concluding from the results of this study, the psychological impact of the pandemic is significant among university students and needs to be addressed in institutions in Bahrain.
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Sadrabadi EA, Khosravi F, Benvidi A, Shiralizadeh Dezfuli A, Khashayar P, Khashayar P, Azimzadeh M. Alprazolam Detection Using an Electrochemical Nanobiosensor Based on AuNUs/Fe-Ni@rGO Nanocomposite. BIOSENSORS 2022; 12:945. [PMID: 36354454 PMCID: PMC9687846 DOI: 10.3390/bios12110945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Despite all the psychological advantages of alprazolam, its long list of toxic properties and interactions has caused concern and highlighted the need for a reliable sensing method. In this study, we developed a simple, highly sensitive electrochemical nanobiosensor to determine the desirable dose of alprazolam, averting the undesirable consequences of overdose. Gold nanourchins (AuNUs) and iron-nickel reduced graphene oxide (Fe-Ni@rGO) were immobilized on a glassy carbon electrode, which was treated beforehand. The electrode surface was characterized using cyclic voltammetry, Fourier transform infrared spectroscopy, scanning electron microscopy/energy-dispersive X-ray spectroscopy, and differential pulse voltammetry. The fabricated sensor showed two linear ranges (4 to 500 µg L-1 and 1 to 50 mg L-1), low limit of detection (1 µg L-1), high sensitivity, good repeatability, and good recovery. Increased -OH and carboxyl (-COOH) groups on the electrode surface, resulting in improved the adsorption of alprazolam and thus lower limit of detection. This nanobiosensor could detect alprazolam powder dissolved in diluted blood serum; we also studied other benzodiazepine drugs (clonazepam, oxazepam, and diazepam) with this nanobiosensor, and results were sensible, with a significant difference.
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Affiliation(s)
| | - Fatemeh Khosravi
- Department of Medical Biotechnology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd 8915173143, Iran
| | - Ali Benvidi
- Department of Chemistry, Faculty of Science, Yazd University, Yazd 8915818411, Iran
| | - Amin Shiralizadeh Dezfuli
- Center of Excellence in Electrochemistry, Faculty of Chemistry, University of Tehran, Tehran 1439957131, Iran
- Ronash Technology Pars Company, Tehran 1439817435, Iran
| | - Pouria Khashayar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G3 8QP, UK
| | - Patricia Khashayar
- Center for Microsystem Technology, Imec and Ghent University, 9000 Gent, Belgium
| | - Mostafa Azimzadeh
- Department of Medical Biotechnology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd 8915173143, Iran
- Medical Nanotechnology & Tissue Engineering Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd 8916877391, Iran
- Stem Cell Biology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd 8916877391, Iran
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A Need for Benzodiazepine Deprescribing in the COVID-19 Pandemic: A Cohort Study. PHARMACY 2022; 10:pharmacy10050120. [PMID: 36287441 PMCID: PMC9611451 DOI: 10.3390/pharmacy10050120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/17/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has had a negative impact on patients’ mental health. The aim of this study was to explore whether the pandemic influenced the use and prescription of benzodiazepines and increased the need for community pharmacist involvement in counselling on deprescribing. Electronic prescription-related data from one pharmacy in Croatia were retrospectively collected for the COVID-19 period (April 2020 to March 2021) and compared with pre-COVID-19 (April 2019 to March 2020) data. Data were collected for patients diagnosed with anxiety disorders who filled out more than one prescription for benzodiazepines, and included age, sex, number of medicines, benzodiazepines, and comorbidities. A total of 1290 benzodiazepine users were identified; of these, 32.87% started using benzodiazepines during the COVID-19 period, while 35.2% continued with benzodiazepine use. More than half of all benzodiazepine users were identified as potential deprescribing candidates (dispensed more than three prescriptions). Women, older patients, multimorbid individuals, and patients with polypharmacy were more likely to use benzodiazepines for a prolonged period. The results show a negative trend of benzodiazepine usage among community-dwelling patients during the pandemic. Community pharmacists can identify potential candidates for deprescribing and initiate a process that ensures more rational use of benzodiazepines and increases the safety of treatment.
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Meda RT, Nuguru SP, Rachakonda S, Sripathi S, Khan MI, Patel N. Chronic Pain-Induced Depression: A Review of Prevalence and Management. Cureus 2022; 14:e28416. [PMID: 36171845 PMCID: PMC9509520 DOI: 10.7759/cureus.28416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 11/05/2022] Open
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Trigg S, Wells JM, McGann J, Bock S, Holman A, Harrison SM, Goh CY, Moggach SA, Brown DH. The alprazolam analogue 4'-chloro deschloroalprazolam identified in seized capsules. Drug Test Anal 2022; 14:1672-1680. [PMID: 35666014 DOI: 10.1002/dta.3325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 11/09/2022]
Abstract
New designer benzodiazepines continue to be identified in the illicit drug market. In December 2021, eight capsules were submitted to ChemCentre for analysis. The samples were analysed by a range of analytical techniques including gas chromatography-mass spectrometry (GC-MS), ultraviolet-visible spectrophotometry, liquid chromatography-mass spectrometry (LC-MS, low and high resolution), nuclear magnetic resonance (NMR) spectroscopy and X-ray crystallography, which identified the main component of the capsules to be 4'-chloro deschloroalprazolam, a new designer benzodiazepine. Alarmingly, the mass spectral data for this alprazolam analogue were very similar to that of alprazolam, such that misidentification could be possible. A minor component of the capsules was also partially characterised, it is believed to be the synthetic precursor 4'-chloro deschloronordiazepam. The information provided in this paper includes ways to discriminate these analogues from alprazolam and nordiazepam which will enable other laboratories to identify these new drugs.
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Affiliation(s)
- Sheena Trigg
- Forensic Science Laboratory, ChemCentre, Bentley, Western Australia, Australia
| | - Jason M Wells
- Forensic Science Laboratory, ChemCentre, Bentley, Western Australia, Australia
| | - Jasmine McGann
- Forensic Science Laboratory, ChemCentre, Bentley, Western Australia, Australia
| | - Soeren Bock
- Forensic Science Laboratory, ChemCentre, Bentley, Western Australia, Australia
| | - Adam Holman
- Forensic Science Laboratory, ChemCentre, Bentley, Western Australia, Australia
| | - Stephen M Harrison
- Forensic Science Laboratory, ChemCentre, Bentley, Western Australia, Australia
| | - Ching Yong Goh
- School of Molecular and Life Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Stephen A Moggach
- School of Molecular Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - David H Brown
- Forensic Science Laboratory, ChemCentre, Bentley, Western Australia, Australia.,School of Molecular and Life Sciences, Curtin University, Bentley, Western Australia, Australia
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Elsouri KN, Kalhori S, Colunge D, Grabarczyk G, Hanna G, Carrasco C, Aleman Espino A, Francisco A, Borosky B, Bekheit B, Ighanifard M, Astudillo AA, Demory Beckler M. Psychoactive Drugs in the Management of Post Traumatic Stress Disorder: A Promising New Horizon. Cureus 2022; 14:e25235. [PMID: 35747039 PMCID: PMC9214830 DOI: 10.7759/cureus.25235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/22/2022] [Indexed: 11/06/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is an anxiety disorder that often presents after exposure to a traumatic, life-threatening event. Experiencing a traumatic event is not rare, with inciting incidents ranging from being burglarized to politically motivated genocide. While traditional psychopharmacology and psychotherapy are the mainstays of the treatment of PTSD currently, psychoactive drugs (otherwise known as psychedelics) are being explored for their novel role in the treatment of PTSD patients. Psychoactive drugs such as MDMA, ketamine, and psilocybin have been shown to specifically target and decrease fear and anxiety pathways in the brain. These unique properties hold the potential to be utilized in addressing symptoms of trauma in those with refractory or treatment-resistant PTSD. Historically, federal and state laws have restricted research into how psychoactive drugs can be used to treat mental illness due to the widespread belief that these drugs present more harm than benefit. However, the current shift in public opinion on psychedelics has propelled research to look into the benefits of these drugs for patients with mental illness. This article aims to discuss the mechanisms of how MDMA, ketamine, and psilocybin work in the PTSD brain, as well as their beneficial role in treatment.
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Trajkovski T, Marić N. Use of anxiolytics and hypnotic drugs during COVID-19 pandemic: The literature review. MEDICINSKI PODMLADAK 2022. [DOI: 10.5937/mp73-35916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Anxiolytics and hypnotics are widely used drugs. First-line psychiatric indications for benzodiazepines (BZD) are alcohol/sedative-hypnotic withdrawal and catatonia, while panic disorder, general anxiety disorder, social anxiety disorder and insomnia are indications after failing of first/second-line treatments, and its use is recommended only for a short time. The spread of the SARS-CoV-2 virus influenced regular daily living, psychological, social, and economic stability. The COVID-19 pandemic has a multifactorial effect on people's mental health and has directly and indirectly influenced changing trends in the prescription, use and misuse of anxiolytics and hypnotics during the pandemic. This article will show use of anxiolytics and hypnotics in inpatients with SARS-CoV-2 infection with or without delirium, will present recommendation for BZD utilization in the infected individuals and will review interactions between BZD and antiviral drugs. Moreover, it will summarize available data on the frequency and reasons for use and abuse of BZD in the general population during the pandemic.
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