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Bade R, van Herwerden D, Rousis N, Adhikari S, Allen D, Baduel C, Bijlsma L, Boogaerts T, Burgard D, Chappell A, Driver EM, Sodre FF, Fatta-Kassinos D, Gracia-Lor E, Gracia-Marín E, Halden RU, Heath E, Jaunay E, Krotulski A, Lai FY, Löve ASC, O'Brien JW, Oh JE, Pasin D, Castro MP, Psichoudaki M, Salgueiro-Gonzalez N, Gomes CS, Subedi B, Thomas KV, Thomaidis N, Wang D, Yargeau V, Samanipour S, Mueller J. Workflow to facilitate the detection of new psychoactive substances and drugs of abuse in influent urban wastewater. J Hazard Mater 2024; 469:133955. [PMID: 38457976 DOI: 10.1016/j.jhazmat.2024.133955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/22/2024] [Accepted: 03/03/2024] [Indexed: 03/10/2024]
Abstract
The complexity around the dynamic markets for new psychoactive substances (NPS) forces researchers to develop and apply innovative analytical strategies to detect and identify them in influent urban wastewater. In this work a comprehensive suspect screening workflow following liquid chromatography - high resolution mass spectrometry analysis was established utilising the open-source InSpectra data processing platform and the HighResNPS library. In total, 278 urban influent wastewater samples from 47 sites in 16 countries were collected to investigate the presence of NPS and other drugs of abuse. A total of 50 compounds were detected in samples from at least one site. Most compounds found were prescription drugs such as gabapentin (detection frequency 79%), codeine (40%) and pregabalin (15%). However, cocaine was the most found illicit drug (83%), in all countries where samples were collected apart from the Republic of Korea and China. Eight NPS were also identified with this protocol: 3-methylmethcathinone 11%), eutylone (6%), etizolam (2%), 3-chloromethcathinone (4%), mitragynine (6%), phenibut (2%), 25I-NBOH (2%) and trimethoxyamphetamine (2%). The latter three have not previously been reported in municipal wastewater samples. The workflow employed allowed the prioritisation of features to be further investigated, reducing processing time and gaining in confidence in their identification.
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Affiliation(s)
- Richard Bade
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia.
| | - Denice van Herwerden
- Van't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, the Netherlands
| | - Nikolaos Rousis
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Sangeet Adhikari
- School of Sustainable Engineering and Built Environment, Arizona State University, Tempe, AZ 85281, United States; Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, 1001 S. McAllister Ave., Tempe, AZ 85281, United States
| | - Darren Allen
- Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia
| | - Christine Baduel
- Université Grenoble Alpes, CNRS, IRD, Grenoble INP, Institute of Environmental Geosciences (IGE), Grenoble, France
| | - Lubertus Bijlsma
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda, Sos Baynat s/n, E-12071 Castellón, Spain
| | - Tim Boogaerts
- Toxicological Centre, Department of Pharmaceutical Sciences, University of Antwerp, 2610 Wilrijk, Belgium
| | - Dan Burgard
- Department of Chemistry and Biochemistry, University of Puget Sound, Tacoma, WA 98416, United States
| | - Andrew Chappell
- Institute of Environmental Science and Research Limited (ESR), Christchurch Science Centre, 27 Creyke Road, Ilam, Christchurch 8041, New Zealand
| | - Erin M Driver
- Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, 1001 S. McAllister Ave., Tempe, AZ 85281, United States
| | | | - Despo Fatta-Kassinos
- Nireas-International Water Research Centre and Department of Civil and Environmental Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - Emma Gracia-Lor
- Department of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, Avenida Complutense s/n, 28040 Madrid, Spain
| | - Elisa Gracia-Marín
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda, Sos Baynat s/n, E-12071 Castellón, Spain
| | - Rolf U Halden
- School of Sustainable Engineering and Built Environment, Arizona State University, Tempe, AZ 85281, United States; Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, 1001 S. McAllister Ave., Tempe, AZ 85281, United States; OneWaterOneHealth, Arizona State University Foundation, 1001 S. McAllister Avenue, Tempe, AZ 85287-8101, United States
| | - Ester Heath
- Jožef Stefan Institute and International Postgraduate School Jožef Stefan, Jamova 39, 1000 Ljubljana, Slovenia
| | - Emma Jaunay
- Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5001, South Australia, Australia
| | - Alex Krotulski
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, Willow Grove, PA 19090, United States
| | - Foon Yin Lai
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences (SLU), SE-75007 Uppsala, Sweden
| | - Arndís Sue Ching Löve
- University of Iceland, Department of Pharmacology and Toxicology, Hofsvallagata 53, 107 Reykjavik, Iceland; University of Iceland, Faculty of Pharmaceutical Sciences, Hofsvallagata 53, 107 Reykjavik, Iceland
| | - Jake W O'Brien
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia; Van't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, the Netherlands
| | - Jeong-Eun Oh
- Department of Civil and Environmental Engineering, Pusan National University, Jangjeon-dong, Geumjeong-gu, Busan 46241, Republic of Korea
| | - Daniel Pasin
- Forensic Laboratory Division, San Francisco Office of the Chief Medical Examiner, 1 Newhall St, San Francisco, CA 94124, United States
| | | | - Magda Psichoudaki
- Nireas-International Water Research Centre and Department of Civil and Environmental Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - Noelia Salgueiro-Gonzalez
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Health Sciences, Via Mario Negri 2, 20156 Milan, Italy
| | | | - Bikram Subedi
- Department of Chemistry, Murray State University, Murray, KY 42071-3300, United States
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Nikolaos Thomaidis
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece
| | - Degao Wang
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, PR China
| | - Viviane Yargeau
- Department of Chemical Engineering, McGill University, Montreal, QC, Canada
| | - Saer Samanipour
- Van't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, the Netherlands; UvA Data Science Center, University of Amsterdam, the Netherlands
| | - Jochen Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
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Oliveira Gracini CLD, Nascimento GG, Vidigal MTC, Oliveira MND, Herval ÁM, Blumenberg C, Vieira WA, Lima RR, Paranhos LR. Suicide ideation and psychotropic recreational drug use by adolescents: a systematic review and meta-analysis. SAO PAULO MED J 2024; 142:e2022641. [PMID: 38655989 DOI: 10.1590/1516-3180.2022.0641.r2.23012024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/23/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Adolescence is characterized by complex and dynamic changes, often involving experimentation, including the use of psychotropic substances. Although it is well-established that recreational psychotropic drugs are associated with suicide ideation in adults, evidence of this association in adolescents remains limited. OBJECTIVE To investigate the relationship between suicide ideation and psychotropic recreational drug use among adolescents. DESIGN AND SETTING Systematic review with meta-analysis developed at Universidade Federal de Uberlândia (UFU) and Universidade Estadual de Campinas (UNICAMP), Brazil. METHODS A search across eight electronic databases for observational studies, without language or publication year restrictions, was conducted. The Joanna Briggs Institute tool was used to assess the risk of bias. Random-effects meta-analyses and odds ratios were used to measure the effects. RESULTS The search yielded 19,732 studies, of which 78 were included in the qualitative synthesis and 32 in the meta-analysis. The findings indicated that suicidal ideation was 1.96 times more likely (95% confidence interval, CI = 1.47; 2.61) for adolescents who used some drug recurrently and 3.32 times more likely (95%CI = 1.86; 5.93) among those who abused drugs. Additionally, adolescents who used cannabis were 1.57 times more likely (95%CI = 1.34; 1.84) to experience suicide ideation compared with non-users, while cocaine users had 2.57 times higher odds (95%CI = 1.47; 4.50). CONCLUSIONS Psychotropic recreational drug use is associated with suicidal ideation among adolescents regardless of current or previous use, abuse, or type of substance used. SYSTEMATIC REVIEW REGISTRATION Registered in the PROSPERO database under the identification number CRD42021232360. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232360.
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Affiliation(s)
- Cássia Lima de Oliveira Gracini
- MSc. Nurse, Master's student, Postgraduate Program in Management and Public Health, Universidade Estadual de Campinas (UNICAMP), Piracicaba (SP), Brazil
| | - Gustavo Giacomelli Nascimento
- PhD. Dentist, Principal Investigator, National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore; Professor, Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Maria Tereza Campos Vidigal
- MSc. Dentist, Master's student, Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Murilo Navarro de Oliveira
- MSc. Dentist, Doctoral student, Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Álex Moreira Herval
- PhD. Dentist, Professor, Division of Preventive and Community Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Cauane Blumenberg
- PhD. Computer Scientist, Collaborative Researcher, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Walbert A Vieira
- MSc. Dentist, Doctoral student, Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba (SP), Brazil
| | - Rafael Rodrigues Lima
- PhD. Dentist, Professor, Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém (PA), Brazil
| | - Luiz Renato Paranhos
- PhD. Dentist, Professor, Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
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Boehnke T, Franke C, Bauerfeind A, Heinemann K, Kolberg-Liedtke C, Koelkebeck K. Systematic analysis of combined oral contraceptive prescription patterns in psychotropic drug users across twelve European countries. Contraception 2024; 132:110375. [PMID: 38253249 DOI: 10.1016/j.contraception.2024.110375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 11/24/2023] [Accepted: 01/16/2024] [Indexed: 01/24/2024]
Abstract
OBJECTIVE To investigate prescription patterns of combined oral contraceptives (COC) among psychotropic drug users compared to non-psychotropic drug users in routine clinical practice in Europe. STUDY DESIGN A pooled analysis of three large, prospective, multinational cohort studies including women with a new prescription of COC from 12 European countries. We calculated standardized mean differences (SMD) to investigate whether the status of psychotropic drug use (use/no use) or the psychotropic drug class (psycholeptics/psychoanaleptics) is associated with the healthcare professional's choice of a specific type of COC progestin. RESULTS Our analysis comprised 143,069 non-psychotropic drug users and 2174 psychotropic drug users. Progestins with the highest frequency in the cohorts were levonorgestrel (non-psychotropic drug users: 33.8%; psychotropic drug users: 32.4%), nomegestrol/nomegestrol acetate (non-psychotropic drug users: 19.1%; psychotropic drug users: 26.4%), and drospirenone (non-psychotropic drug users: 15.9%; psychotropic drug users: 14.8%). SMD analysis indicated no substantial differences in COC prescription patterns between the two cohorts. However, we observed association signals for users of the herbal antidepressant St. John's wort in that those individuals more often received a prescription for drospirenone and less frequently for nomegestrol/nomegestrol acetate compared to non-psychotropic drug users. CONCLUSIONS Psychotropic drug user status does not seem to affect healthcare professionals' decisions when prescribing COC. However, limited evidence suggests that the risk for drug interactions might differ by progestin type, and some COC might be more suitable for psychotropic drug users than others. Specific guidelines should be conveyed to healthcare professionals to assist them in contraceptive counseling. IMPLICATIONS With exception of St. John's wort, our analysis showed no differential prescription behavior of combined oral contraceptives in psychotropic drug users and non-users. However, healthcare professionals should carefully consider psychotropic drug use in contraceptive counseling as it is still unclear whether drug interactions exist when co-administered with certain oral contraceptives.
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Affiliation(s)
- Tanja Boehnke
- ZEG Berlin - Center for Epidemiology and Health Research, Berlin, Germany.
| | - Christian Franke
- ZEG Berlin - Center for Epidemiology and Health Research, Berlin, Germany
| | - Anja Bauerfeind
- ZEG Berlin - Center for Epidemiology and Health Research, Berlin, Germany
| | - Klaas Heinemann
- ZEG Berlin - Center for Epidemiology and Health Research, Berlin, Germany
| | - Cornelia Kolberg-Liedtke
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, North Rhine-Westphalia, Germany
| | - Katja Koelkebeck
- LVR-University Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, Essen, North Rhine-Westphalia, Germany; Center for Translational Neuro, and Behavioral Sciences, University of Duisburg-Essen, Essen, North Rhine-Westphalia, Germany
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Abdoli F, Davoudi M, Momeni F, Djafari F, Dolatshahi B, Hosseinzadeh S, Aliyaki H, Khalili Z. Estimate the prevalence of daily caffeine consumption, caffeine use disorder, caffeine withdrawal and perceived harm in Iran: a cross-sectional study. Sci Rep 2024; 14:7644. [PMID: 38561480 PMCID: PMC10984976 DOI: 10.1038/s41598-024-58496-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/29/2024] [Indexed: 04/04/2024] Open
Abstract
One of the informal diagnoses in DSM-5 is Caffeine Use Disorder (CUD). CUD and high levels of caffeine consumption could impact mental health conditions. This study aimed to estimate the prevalence of CUD, caffeine consumption, caffeine-related harms, and related psychiatric symptoms in Iran. A cross-sectional survey with a convenience sample of 1228 adults were conducted in Iran. Caffeine consumption was assessed across 20 products in Iran. Caffeine Use Disorder Questionnaire (CUDQ), Caffeine Withdrawal Symptoms Questionnaire (CWSQ), 14-item Caffeine-related Harm Screening (CHS), and Symptom Checklist-25 (SCL-25) were used in the present study. We used SPSS (desktop version 26.0) to analyze the data using descriptive statistics, chi-square, and the least significant difference (LSD) post hoc test. The daily average caffeine consumption was 146.67 mg. The prevalence of CUD and caffeine withdrawal (C.W.) were estimated at 19.5% and 46.62%, respectively. Also, 12.9% of responders received CUD and C.W.s simultaneously. The prevalence of CUD was higher in men than females (25.08% vs. 13.93%). 95% of participants (n = 1166) reported using at least one caffeine product yesterday. Moreover, the most reported caffeine-related harms were the desire for sugar (42.9%), insomnia (39.3%), and caffeine dependence (38.3%). Age significantly correlates with CUD (- 0.07) and daily caffeine intake (0.08). Moreover, all SCL-90 subscales had a significant correlation with daily caffeine intake. Finally, responders at younger ages reported higher levels of CUD and caffeine consumption than older adults(P < 0.05). High rates of C.W. and CUD in the Iranian population suggest that it is necessary to develop evidence-based treatments.
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Affiliation(s)
- Fatemeh Abdoli
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammadreza Davoudi
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
- Department of Clinical Psychology, School of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Fereshte Momeni
- Department of Clinical Psychology, School of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farhang Djafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Behrooz Dolatshahi
- Department of Clinical Psychology, School of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Samaneh Hosseinzadeh
- Biostatistics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hajar Aliyaki
- Department of Clinical Psychology, School of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Zahra Khalili
- Department of Clinical Psychology, School of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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5
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Senior M, Pierce M, Taxiarchi VP, Garg S, Edge D, Newlove-Delgado T, Neufeld SAS, Abel KM. 5-year mental health outcomes for children and adolescents presenting with psychiatric symptoms to general practitioners in England: a retrospective cohort study. Lancet Psychiatry 2024; 11:274-284. [PMID: 38490760 DOI: 10.1016/s2215-0366(24)00038-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Little information is available on the clinical trajectories of children and adolescents who attend general practice (GP) with psychiatric symptoms. We aimed to examine 5-year service use in English primary care for children and adolescents with neurodevelopmental or mental health symptoms or diagnoses. METHODS In this retrospective cohort study, we used anonymised primary care health records from the Clinical Practice Research Datalink Aurum database (CPRD-Aurum). We identified children and adolescents (aged 3-18 years) presenting to primary care in England between Jan 1, 2000, and May 9, 2016, with a symptom or diagnosis of a mental health, behavioural, or neurodevelopmental condition. Participants were excluded if they had less than 1 year of follow-up. We followed up participants from their index date until either death, transfer out of the practice, or the end of data collection on May 5, 2021, and for trajectory analysis we limited follow-up to 5 years. We used group-based multi-trajectory models to identify clusters with similar trajectories over 5 years of follow-up for three primary outcomes: mental health-related GP contacts, psychotropic medication prescriptions, and specialist mental health-care contact. We did survival analysis to examine the associations between trajectory-group membership and hospital admission for self-harm or death by suicide, as indicators of severe psychiatric distress. FINDINGS We included 369 340 children and adolescents, of whom 180 863 (49·0%) were girls, 188 438 (51·0%) were boys, 39 (<0·1%) were of indeterminate gender, 290 125 (78·6%) were White, 9161 (2·5%) were South Asian, 10 418 (2·8%) were Black, 8115 (2·2%) were of mixed ethnicity, and 8587 (2·3%) were other ethnicities, and the median age at index presentation was 13·6 years (IQR 8·4-16·7). In the best-fitting, seven-group, group-based multi-trajectory model, over a 5-year period, the largest group (low contact; 207 985 [51·2%]) had low rates of additional service contact or psychotropic prescriptions. The other trajectory groups were moderate, non-pharmacological contact (43 836 [13·0%]); declining contact (25 469 [8·7%]); year-4 escalating contact (18 277 [6·9%]); year-5 escalating contact (18 139; 5·2%); prolonged GP contact (32 147 [8·6%]); and prolonged specialist contact (23 487 [6·5%]). Non-White ethnicity and presentation in earlier study years (eg, 2000-2004) were associated with low-contact group membership. The prolonged specialist-contact group had the highest risk of hospital admission for self-harm (hazard ratio vs low-contact group 2·19 [95% CI 2·03-2·36]) and suicide (2·67 [1·72-4·14]). INTERPRETATION Most children and adolescents presenting to primary care with psychiatric symptoms or diagnoses have low or declining rates of ongoing contact. If these trajectories reflect symptomatic improvement, these findings provide reassurance for children and adolescents and their caregivers. However, these trajectories might reflect an unmet need for some children and adolescents. FUNDING National Institute for Health and Care Research and the Wellcome Trust.
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Affiliation(s)
- Morwenna Senior
- Centre for Women's Mental Health, University of Manchester, Manchester, UK; Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, UK.
| | - Matthias Pierce
- Centre for Women's Mental Health, University of Manchester, Manchester, UK; Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, UK
| | - Vicky P Taxiarchi
- Centre for Women's Mental Health, University of Manchester, Manchester, UK; Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, UK
| | - Shruti Garg
- Division of Neuroscience, School of Biological Sciences, University of Manchester, Manchester, UK
| | - Dawn Edge
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK; Equality, Diversity & Inclusion Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester, UK; NIHR Greater Manchester Patient Safety Research Collaboration, Manchester, UK
| | | | | | - Kathryn M Abel
- Centre for Women's Mental Health, University of Manchester, Manchester, UK; Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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La Maida N, Di Giorgi A, Pichini S, Pellegrini M, Di Trana A, Elmo MG, Polselli GM, Casella P, Di Stefano A, Ducci G. Comprehensive Monitoring of Psychoactive Substances in Psychiatric Patients Using Liquid Chromatography-High-Resolution Mass Spectrometry: A Key Tool for Treatment Planning and Understanding Consumption Patterns in Rome, Italy. Ther Drug Monit 2024; 46:203-209. [PMID: 38018870 DOI: 10.1097/ftd.0000000000001163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/05/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND The comprehensive monitoring of licit and illicit drug consumption plays a crucial role in understanding the complexities of patient conditions and designing effective treatment strategies. In this study, the prevalence of psychoactive prescription drugs, classical illicit drugs, and new psychoactive substances (NPS) were objectively assessed in individuals diagnosed with drug-related psychiatric disorders or episodes. METHODS Blood, urine, and hair samples were collected from psychiatric patients admitted to the Mental Health Department and Drug Addiction Service of the North Rome Local Health Authority with declared or suspected psychoactive drug use. Comprehensive drug screening was conducted for all samples using ultra-high-performance liquid chromatography-high-resolution mass spectrometry. RESULTS A total of 71 blood and urine and 50 hair samples were analyzed to confirm the suitability of the ultra-high-performance liquid chromatography-high-resolution mass spectrometry method for the study purposes. The main substances found in blood and urine were antipsychotics (71.8% and 66.2%) and benzodiazepines (62.0% and 59.2%), respectively, whereas cocaine (84.0%) and antipsychotics (74.0%) was more evident in hair. Z-drugs were detected in blood (7.0%), urine (5.6%), and hair (24%) samples; amphetamines were mainly detected in hair samples (14.0%). Synthetic cathinones were the most frequently detected NPS in hair specimens (8.0%), whereas synthetic cannabinoids were mainly found in blood samples (11.3%). These analyses showed that patients were polydrug users (77.5% detected in blood and urine, and 94.0% in hair). CONCLUSIONS Comprehensive screening enabled the assessment of past, recent, and actual consumption of psychoactive substances, including licit and illicit drugs and NPS, by psychiatric patients. A thorough understanding of substance consumption patterns can enhance therapeutic interventions and management of psychiatric disorders associated with psychoactive substance use.
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Affiliation(s)
- Nunzia La Maida
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Alessandro Di Giorgi
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche" of Ancona, Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Manuela Pellegrini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Annagiulia Di Trana
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Giuseppa Elmo
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), San Filippo Neri Hospital, Rome, Italy
| | - Gian Marco Polselli
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), San Filippo Neri Hospital, Rome, Italy
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), S. Spirito Hospital, Rome, Italy
| | - Pietro Casella
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Drug Dipendence and Addiction Unit, Rome, Italy; and
| | - Adele Di Stefano
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Mental Health and Drug Dipendence Unit in prison, Rome, Italy
| | - Giuseppe Ducci
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), San Filippo Neri Hospital, Rome, Italy
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Le Marois M, Doudka N, Tzavara E, Delaunay L, Quaranta S, Blin O, Belzeaux R, Guilhaumou R. Simultaneous Quantification of Psychotropic Drugs in Human Plasma and Breast Milk and Its Application in Therapeutic Drug Monitoring and Peripartum Treatment Optimization. Ther Drug Monit 2024; 46:227-236. [PMID: 37684719 DOI: 10.1097/ftd.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/07/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Therapeutic drug monitoring is recommended for several psychotropic drugs, particularly in sensitive situations such as the peripartum period. This study aimed to develop an ultra-high-performance liquid chromatography-tandem spectrometry method for the simultaneous quantification of 14 psychotropic drugs in human plasma and 4 in breast milk. METHODS The samples were precipitated with methanol containing the stable isotope-labeled analogs. Chromatographic separation was performed using a Phenomenex Luna Omega Polar C18 column. Detection was performed using a triple-quadrupole mass spectrometer equipped with an electrospray ionization interface. The method was fully validated in plasma according to the European Guidelines on Bioanalytical Method Validation and partially validated in breast milk by determining the intraday precision and accuracy, linearity, lower limit of quantification, and matrix effect. RESULTS The correlation coefficients of the calibration curves were greater than 0.99. Coefficients of variation ranged from 3.05% to 14.66% and 0.62%-14.90% for internal standard-normalized matrix effect, 1.4%-14.1% and 2.1%-10.4% for intraday precision, and 3.2%-13.9% and 4.1%-9.6% for interday precision, in plasma and milk, respectively. The relative error in accuracy did not exceed ±15% for any analyte. The method was successfully applied clinically to measure the concentrations of psychotropic drugs in 952 plasma samples, among which 43% of the concentrations were out of the therapeutic range, and 13 breast milk samples, with calculated relative infant doses ranging from 0.32% to 8.18%. CONCLUSIONS To the best of the authors' knowledge, this is the first routine technique validated for the quantification of psychotropic drugs in both plasma and breast milk, allowing for treatment optimization and prevention of adherence issues, including those in breastfeeding patients.
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Affiliation(s)
- Marguerite Le Marois
- Service de Pharmacologie Clinique et Pharmacovigilance, Hôpital de la Timone, Marseille Cedex 5 13385, France
- Aix Marseille Université, Institut de Neurosciences des Systèmes, Inserm UMR 1106, Marseille 13385, France
- Aix Marseille Univ, CNRS, Inst Neurosci Timone, Marseille, France
| | - Natalia Doudka
- Service de Pharmacologie Clinique et Pharmacovigilance, Hôpital de la Timone, Marseille Cedex 5 13385, France
| | - Eleni Tzavara
- Pôle de Psychiatrie, Hôpital Sainte-Marguerite, AP-HM, Marseille, France
- Université Paris Cité, CNRS, Integrative Neuroscience and Cognition Center, Paris 75006, France
- Fondation FondaMental, Créteil, France
| | - Laurence Delaunay
- Service de Pharmacologie Clinique et Pharmacovigilance, Hôpital de la Timone, Marseille Cedex 5 13385, France
| | - Sylvie Quaranta
- Laboratoire de Pharmacocinétique et Toxicologie, Hôpital de la Timone, Marseille Cedex 5 13385, France; and
| | - Olivier Blin
- Service de Pharmacologie Clinique et Pharmacovigilance, Hôpital de la Timone, Marseille Cedex 5 13385, France
- Aix Marseille Université, Institut de Neurosciences des Systèmes, Inserm UMR 1106, Marseille 13385, France
| | - Raoul Belzeaux
- Aix Marseille Univ, CNRS, Inst Neurosci Timone, Marseille, France
- Fondation FondaMental, Créteil, France
- Pôle Universitaire de Psychiatrie, CHU de Montpellier, Montpellier, France
| | - Romain Guilhaumou
- Service de Pharmacologie Clinique et Pharmacovigilance, Hôpital de la Timone, Marseille Cedex 5 13385, France
- Aix Marseille Université, Institut de Neurosciences des Systèmes, Inserm UMR 1106, Marseille 13385, France
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8
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Frost J, Mikkelsen T, Andersen MN, Bjerke HA, Gundersen POM, Aamo TO. Avrusning etter bruk av nye rusmidler fra internett. Tidsskr Nor Laegeforen 2024; 144:23-0668. [PMID: 38506014 DOI: 10.4045/tidsskr.23.0668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Background The knowledge base on new psychoactive substances (NPS) is generally limited. This introduces new challenges and increased unpredictability in substance abuse treatment. Case presentation A man in his thirties was submitted to detoxification after reportedly using flubromazolam, a high potency designer benzodiazepine, which he had purchased on the dark web. Extensive drug testing of serum, urine and hair, and the remains in a dropper bottle delivered by the patient, did not reveal flubromazolam or possible metabolites, but did reveal several common drugs of abuse, and 8-aminoclonazolam, a metabolite of clonazolam, another designer benzodiazepine sold on the dark web. The detoxification was uncomplicated. An excessive treatment protocol based on the patient's information, involving high preparedness and increased resources, both clinically and analytically, turned out to be unnecessary. Interpretation The drug use and clinical course in this case proved to be more common than the unit prepared for. The case history illustrates both the challenges with users of NPS and the general unpredictability in substance abuse treatment.
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Affiliation(s)
- Joachim Frost
- Avdeling for klinisk farmakologi, St. Olavs hospital, og, Avdeling for laboratoriemedisin, Vestre Viken, og, Institutt for klinisk og molekylær medisin, NTNU
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9
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Whitehill JM, Dunn KE, Johnson RM. The Public Health Challenge of Δ8-THC and Derived Psychoactive Cannabis Products. JAMA 2024; 331:834-836. [PMID: 38470394 DOI: 10.1001/jama.2024.0801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Affiliation(s)
- Jennifer M Whitehill
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst
| | - Kelly E Dunn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Renee M Johnson
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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10
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Lin W, Qin Y, Ren Y. Flunitrazepam and its metabolites induced brain toxicity: Insights from molecular dynamics simulation and transcriptomic analysis. J Hazard Mater 2024; 465:133113. [PMID: 38043427 DOI: 10.1016/j.jhazmat.2023.133113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/25/2023] [Accepted: 11/26/2023] [Indexed: 12/05/2023]
Abstract
Psychoactive drugs frequently contaminate aquatic environments after human consumption, raising concerns about their residues and ecological harm. This study investigates the effects of flunitrazepam (FLZ) and its metabolite 7-aminoflunitrazepam (7-FLZ), benzodiazepine-class psychoactive drugs, on brain accumulation, blood-brain barrier (BBB), and neuroinflammation of the model organism zebrafish. Molecular dynamics simulation and transcriptome sequencing were used to uncover their toxic mechanisms. Results demonstrate that both FLZ and 7-FLZ can accumulate in the brain, increasing Evans blue levels by 3.4 and 0.8 times, respectively. This increase results from abnormal expression of tight junction proteins, particularly ZO-1 and Occludin, leading to elevated BBB permeability. Furthermore, FLZ and 7-FLZ can also induce neuroinflammation, upregulating TNFα by 91% and 39%, respectively, leading to pathological changes and disrupted intracellular ion balance. Molecular dynamics simulation reveals conformational changes in ZO-1 and Occludin proteins, with FLZ exhibiting stronger binding forces and greater toxicity. Weighted gene co-expression network analysis identifies four modules correlated with BBB permeability and neuroinflammation. KEGG enrichment analysis of genes within these modules reveals pathways like protein processing in the endoplasmic reticulum, NOD-like receptor signaling pathway, and arginine and proline metabolism. This study enhances understanding of FLZ and 7-FLZ neurotoxicity and assesses environmental risks of psychoactive substances. ENVIRONMENTAL IMPLICATION: With the increasing prevalence of mental disorders and the discharge of psychoactive drugs into water, even low drug concentrations (ng/L-μg/L) can pose neurological risks. This study, utilizing molecular dynamic (MD) simulations and transcriptome sequencing, investigate the neurotoxicity and mechanisms of flunitrazepam and 7-aminoflunitrazepam. It reveals that they disrupt the blood-brain barrier in zebrafish and induce neuroinflammation primarily by inducing conformational changes in tight junction proteins. MD simulations are valuable for understanding pollutant-protein interactions. This research offers invaluable insights for the environmental risk assessment of psychoactive drugs and informs the development of strategies aimed at prevention and mitigation.
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Affiliation(s)
- Wenting Lin
- School of Environment and Energy, South China University of Technology, Guangzhou 510006, PR China
| | - Yingjun Qin
- School of Environment and Energy, South China University of Technology, Guangzhou 510006, PR China
| | - Yuan Ren
- School of Environment and Energy, South China University of Technology, Guangzhou 510006, PR China; The Key Lab of Pollution Control and Ecosystem Restoration in Industry Clusters, Ministry of Education, Guangzhou 510006, PR China; The Key Laboratory of Environmental Protection and Eco-Remediation of Guangdong Regular Higher Education Institutions, Guangzhou 510006, PR China.
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11
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Uematsu T, Tomita T, Obara R, Gonai T, Hattori K, Aonuma T, Usui K, Tanifuji H, Ishizawa F, Ishii H, Suzuki E. Reducing the use of psychotropics in a convalescent rehabilitation ward. Neuropsychopharmacol Rep 2024; 44:227-233. [PMID: 37882457 PMCID: PMC10932766 DOI: 10.1002/npr2.12388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/28/2023] [Accepted: 10/04/2023] [Indexed: 10/27/2023] Open
Abstract
AIMS Many patients who are transferred to the convalescent rehabilitation ward of Kawasaki Kokoro Hospital (hereinafter, our hospital) are on psychotropics prescribed for delirium by their physicians at acute care hospitals. In this study, psychiatrists and pharmacists collaborated with rehabilitation physicians to reduce the use of psychotropics. METHODS The basic information and psychotropics prescription statuses of 88 patients discharged from the convalescent rehabilitation ward of our hospital between April 1, 2021 and March 31, 2022 were derived from their medical records. RESULTS At admission, psychotropics were prescribed to 55 patients and the number of prescribed drugs was 2 (median). At discharge, psychotropics were prescribed to 41 patients and the number of prescribed drugs was 1 (median), showing a significant decrease (p < 0.05). Compared with those at admission, prescribed psychotropic doses at discharge were significantly higher for lemborexant but significantly lower for antipsychotics, benzodiazepine/nonbenzodiazepine hypnotics, antidepressants, suvorexant, ramelteon, and sodium valproate (p < 0.05). CONCLUSIONS These results suggest that it may be possible to reduce the types and doses of psychotropics prescribed at acute care hospitals in convalescent rehabilitation wards. However, further investigation is needed because the number of patients in this study was limited, and selection bias due to different patient characteristics cannot be ruled out.
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Affiliation(s)
- Takuya Uematsu
- Department of PharmacyKawasaki Kokoro HospitalKawasakiJapan
| | - Takashi Tomita
- Department of Pharmaceutical Sciences, School of PharmacyInternational University of Health and WelfareOtawaraJapan
- Department of PharmacyInternational University of Health and Welfare Mita HospitalMinato‐kuJapan
| | - Ryo Obara
- Department of PharmacyKawasaki Kokoro HospitalKawasakiJapan
| | - Takuya Gonai
- Department of PharmacyKawasaki Kokoro HospitalKawasakiJapan
| | - Koshi Hattori
- Department of RehabilitationTohoku University HospitalSendaiJapan
- Department of RehabilitationOsaki Citizen HospitalOsakiJapan
| | - Takanori Aonuma
- Department of RehabilitationKawasaki Kokoro HospitalKawasakiJapan
| | - Kensuke Usui
- Division of Clinical Pharmaceutics and Pharmacy PracticeTohoku Medical and Pharmaceutical UniversitySendaiJapan
| | | | | | - Hiroshi Ishii
- Geriatric PsychiatryKawasaki Kokoro HospitalKawasakiJapan
| | - Eiji Suzuki
- Division of PsychiatryTohoku Medical and Pharmaceutical UniversitySendaiJapan
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12
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Yu T, Cui J, Chen S. Electrochemical detection of the neurotransmitter glutamate and the effect of the psychotropic drug riluzole on its oxidation response. Anal Bioanal Chem 2024; 416:1707-1716. [PMID: 38363306 DOI: 10.1007/s00216-024-05175-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/17/2024]
Abstract
Glutamate is the main excitatory neurotransmitter in the brain and plays a leading role in degenerative diseases, such as motor neuron diseases. Riluzole is a glutamate regulator and a therapeutic drug for motor neuron diseases. In this work, the interaction between glutamate and riluzole was studied using cyclic voltammetry and square-wave voltammetry at a glassy carbon electrode (GCE). It was shown that glutamate underwent a two-electron transfer reaction on the GCE surface, and the electrochemical detection limits of glutamate and riluzole were 483 μmol/L and 11.47 μmol/L, respectively. The results confirm that riluzole can promote the redox reaction of glutamate. This work highlights the significance of electrochemical technology in the sensing detection of the interaction between glutamate and related psychotropic drugs.
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Affiliation(s)
- Tao Yu
- School of Automation, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Jingjie Cui
- School of Automation, Hangzhou Dianzi University, Hangzhou, 310018, China.
| | - Shaowei Chen
- Department of Chemistry and Biochemistry, University of California, 1156 High Street, Santa Cruz, CA, 95064, USA
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13
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Mansuri Z, Shah B, Yadav G, Kainth T, Kochhar H, Srinivas S, Kamil SH, Bachu A, Reddy A. Drug Interactions Between Psychotropic Medications and Treatment of Mpox (tecovirimat and cidofovir). Prim Care Companion CNS Disord 2024; 26:23lr03608. [PMID: 38382079 DOI: 10.4088/pcc.23lr03608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Affiliation(s)
- Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
- Corresponding Author: Zeeshan Mansuri, MD, MPH, Boston Children's Hospital/Harvard Medical School, 300 Longwood Ave, Boston, MA 02115
| | - Bhumika Shah
- Department of Psychiatry and Behavioral Science, University of Louisville, Kentucky
| | - Garima Yadav
- Department of Psychiatry, Texas Tech University Health Science Center at Permian Basin, Midland, Texas
| | - Tejasvi Kainth
- Department of Psychiatry, Bronx Care Health System at Icahn School of Medicine at Mount Sinai, New York
| | - Hansini Kochhar
- Department of Psychiatry, Maimonides Medical Center, Brooklyn, New York
| | - Sushma Srinivas
- Department of Psychiatry, Baptist Health-UAMS Psychiatry Residency Education Program, North Little Rock, Arkansas
| | - Sahar Hooda Kamil
- Department of Pediatrics, Dell Children's Medical Center, Austin, Texas
| | - Anil Bachu
- Department of Psychiatry, Baptist Health-UAMS Psychiatry Residency Education Program, North Little Rock, Arkansas
| | - Abhishek Reddy
- Department of Psychiatry, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
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14
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Ripoll J, Chela-Alvarez X, Briones-Vozmediano E, Fiol de-Roque MA, Zamanillo-Campos R, Ricci-Cabello I, Llobera J, Calafat-Villalonga C, Serrano-Ripoll MJ. Impact of COVID-19 on mental health of health care workers in Spain: a mix-methods study. BMC Public Health 2024; 24:463. [PMID: 38355471 PMCID: PMC10865523 DOI: 10.1186/s12889-024-17979-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/04/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Spain's lockdown measures couldn't prevent the severe impact of the COVID-19 first wave, leading to high infections, deaths, and strain on healthcare workers (HCWs). This study aimed to explore the mental health impact on HCWs in the Balearic Islands during the initial months of the pandemic, the influencing factors, and the experiences of those in a COVID-19 environment. METHODS Using a mixed-methods approach, the study encompassed quantitative and qualitative elements. Cross-sectional survey data from April to June 2020 comprised HCWs who were emailed invitations. The survey covered demographics, work, clinical and COVID-19 variables, along with psychological distress and PTSD symptoms, using validated measures. Additionally, semi-structured interviews with HCWs offered qualitative insights. RESULTS Three hundred thirty-six HCWs averaging 46.8 years, mainly women (79.2%), primarily nurses in primary care with over 10 years of experience. Anxiety symptoms were reported by 28.8%, 65.1% noted worsened sleep quality, and 27.7% increased psychoactive drug usage. Psychological distress affected 55.2%, while 27.9% exhibited PTSD symptoms. Gender, age, experience, COVID-19 patient contact, and workload correlated with distress, PTSD symptoms, sleep quality, and psychoactive drug usage. Interviews uncovered discomfort sources, such as fear of infection and lack of control, leading to coping strategies like information avoidance and seeking support. LIMITATIONS Static cross-sectional design, non-probabilistic sample, and telephone interviews affecting non-verbal cues, with interviews conducted during early pandemic lockdown. CONCLUSIONS HCWs faced significant psychological distress during the pandemic's first wave, underscoring the necessity for robust support and resources to counteract its impact on mental health.
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Affiliation(s)
- J Ripoll
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - X Chela-Alvarez
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain.
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain.
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain.
| | - E Briones-Vozmediano
- Departamento de Enfermería y Fisioterapia Grupo de estudios en sociedad, salud, educación y cultura (GESEC), Universidad de Lleida.Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB) de Lleida, Lleida, 25001, Spain
| | - M A Fiol de-Roque
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - R Zamanillo-Campos
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
| | - I Ricci-Cabello
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - J Llobera
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - C Calafat-Villalonga
- Department of Psychology, University of the Balearic Islands, Palma, 07122, Spain
| | - M J Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
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Stelmaszczyk P, Iwan M, Pawcenis D, Wietecha-Posłuszny R. Comparison of ZrO 2 Particles and Polyaniline as Additives in Polystyrene-Based Sorbents for the Micro-Solid Phase Extraction of Psychoactive Drugs from Biofluids. Molecules 2024; 29:761. [PMID: 38398513 PMCID: PMC10893364 DOI: 10.3390/molecules29040761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
The intensive development of extraction methods based on μ-SPE extraction contributes to the increased interest in the synthesis of new sorption materials. This work presents the characterization of polystyrene fibers and polystyrene fibers blended with ZrO2 particles or polyaniline obtained by electrospinning and their use in the extraction of selected psychoactive drugs from biological samples. The characteristic of produced fibers is made by performing SEM images, measuring average fiber diameter, and examining their sorption abilities. Among the fibers based on pure polystyrene, tested in the first stage, the best sorption properties are demonstrated for the fibers obtained from a polystyrene solution in DMF with a concentration of 17.5 wt%. In the next stage, this material was modified with synthesized ZrO2 particles and polyaniline. Among the tested materials, the sorbent based on polystyrene with polyaniline shows the best sorption properties of the tested substances. The use of this material in the μ-SPE in a needle enables the extraction of selected compounds from aqueous and biological samples such as urine and human plasma.
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Affiliation(s)
- Paweł Stelmaszczyk
- Laboratory for Forensic Chemistry, Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University in Kraków, Gronostajowa St. 2, 30-387 Kraków, Poland; (P.S.); (M.I.)
- Doctoral School of Exact and Natural Sciences, Faculty of Chemistry, Jagiellonian University in Kraków, Gronostajowa St. 2, 30-387 Kraków, Poland
| | - Mateusz Iwan
- Laboratory for Forensic Chemistry, Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University in Kraków, Gronostajowa St. 2, 30-387 Kraków, Poland; (P.S.); (M.I.)
| | - Dominika Pawcenis
- Faculty of Chemistry, Jagiellonian University in Kraków, Gronostajowa St. 2, 30-387 Kraków, Poland;
| | - Renata Wietecha-Posłuszny
- Laboratory for Forensic Chemistry, Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University in Kraków, Gronostajowa St. 2, 30-387 Kraków, Poland; (P.S.); (M.I.)
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Annuar NAK, Azlan UK, Mediani A, Tong X, Han R, Al-Olayan E, Baharum SN, Bunawan H, Sarian MN, Hamezah HS, Jantan I. An insight review on the neuropharmacological effects, mechanisms of action, pharmacokinetics and toxicity of mitragynine. Biomed Pharmacother 2024; 171:116134. [PMID: 38219389 DOI: 10.1016/j.biopha.2024.116134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024] Open
Abstract
Mitragynine is one of the main psychoactive alkaloids in Mitragyna speciosa Korth. (kratom). It has opium-like effects by acting on μ-, δ-, and κ-opioid receptors in the brain. The compound also interacts with other receptors, such as adrenergic and serotonergic receptors and neuronal Ca2+ channels in the central nervous system to have its neuropharmacological effects. Mitragynine has the potential to treat diseases related to neurodegeneration such as Alzheimer's disease and Parkinson's disease, as its modulation on the opioid receptors has been reported extensively. This review aimed to provide an up-to-date and critical overview on the neuropharmacological effects, mechanisms of action, pharmacokinetics and safety of mitragynine as a prospective psychotropic agent. Its multiple neuropharmacological effects on the brain include antinociceptive, anti-inflammatory, antidepressant, sedative, stimulant, cognitive, and anxiolytic activities. The potential of mitragynine to manage opioid withdrawal symptoms related to opioid dependence, its pharmacokinetics and toxic effects were also discussed. The interaction of mitragynine with various receptors in the brain produce diverse neuropharmacological effects, which have beneficial properties in neurological disorders. However, further studies need to be carried out on mitragynine to uncover its complex mechanisms of action, pharmacokinetics, pharmacodynamic profiles, addictive potential, and safe dosage to prevent harmful side effects.
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Affiliation(s)
- Nur Aisyah Khairul Annuar
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Ummi Kalthum Azlan
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Ahmed Mediani
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Xiaohui Tong
- School of Life Sciences, Anhui University of Chinese Medicine, Hefei, China
| | - Rongchun Han
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, China
| | - Ebtesam Al-Olayan
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Syarul Nataqain Baharum
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Hamidun Bunawan
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Murni Nazira Sarian
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Hamizah Shahirah Hamezah
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia.
| | - Ibrahim Jantan
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
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Sujak M, Neuhauser J, Matz K. [Sweet cannabis intoxication at the airport]. Nervenarzt 2024; 95:159-161. [PMID: 38172264 DOI: 10.1007/s00115-023-01591-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Marian Sujak
- Landesklinikum Mödling, Schwester-Maria-Restitutagasse 12, 2340, Mödling, Österreich.
| | - Julia Neuhauser
- Landesklinikum Mödling, Schwester-Maria-Restitutagasse 12, 2340, Mödling, Österreich
| | - Karl Matz
- Landesklinikum Mödling, Schwester-Maria-Restitutagasse 12, 2340, Mödling, Österreich
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Almeida OP, Page A, Sanfilippo FM, Preen DB, Etherton-Beer C. Research Letter: Effect of antivirals for COVID-19 on the mortality of older adults dispensed treatment with lithium, antipsychotics, antidepressants, anxiolytics and hypnotics. Aust N Z J Psychiatry 2024; 58:183-186. [PMID: 38084609 PMCID: PMC10838474 DOI: 10.1177/00048674231217700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Affiliation(s)
- Osvaldo P Almeida
- Medical School, WA Centre for Health & Ageing (M577), University of Western Australia, Perth, WA, Australia
| | - Amy Page
- School of Allied Health, University of Western Australia, Perth, WA, Australia
| | - Frank M Sanfilippo
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - David B Preen
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Christopher Etherton-Beer
- Medical School, WA Centre for Health & Ageing (M577), University of Western Australia, Perth, WA, Australia
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Chiauzzi E, Williams A, Mariano TY, Pajarito S, Robinson A, Kirvin-Quamme A, Forman-Hoffman V. Demographic and clinical characteristics associated with anxiety and depressive symptom outcomes in users of a digital mental health intervention incorporating a relational agent. BMC Psychiatry 2024; 24:79. [PMID: 38291369 PMCID: PMC10826101 DOI: 10.1186/s12888-024-05532-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/17/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Digital mental health interventions (DMHIs) may reduce treatment access issues for those experiencing depressive and/or anxiety symptoms. DMHIs that incorporate relational agents may offer unique ways to engage and respond to users and to potentially help reduce provider burden. This study tested Woebot for Mood & Anxiety (W-MA-02), a DMHI that employs Woebot, a relational agent that incorporates elements of several evidence-based psychotherapies, among those with baseline clinical levels of depressive or anxiety symptoms. Changes in self-reported depressive and anxiety symptoms over 8 weeks were measured, along with the association between each of these outcomes and demographic and clinical characteristics. METHODS This exploratory, single-arm, 8-week study of 256 adults yielded non-mutually exclusive subsamples with either clinical levels of depressive or anxiety symptoms at baseline. Week 8 Patient Health Questionnaire-8 (PHQ-8) changes were measured in the depressive subsample (PHQ-8 ≥ 10). Week 8 Generalized Anxiety Disorder-7 (GAD-7) changes were measured in the anxiety subsample (GAD-7 ≥ 10). Demographic and clinical characteristics were examined in association with symptom changes via bivariate and multiple regression models adjusted for W-MA-02 utilization. Characteristics included age, sex at birth, race/ethnicity, marital status, education, sexual orientation, employment status, health insurance, baseline levels of depressive and anxiety symptoms, and concurrent psychotherapeutic or psychotropic medication treatments during the study. RESULTS Both the depressive and anxiety subsamples were predominantly female, educated, non-Hispanic white, and averaged 38 and 37 years of age, respectively. The depressive subsample had significant reductions in depressive symptoms at Week 8 (mean change =-7.28, SD = 5.91, Cohen's d = -1.23, p < 0.01); the anxiety subsample had significant reductions in anxiety symptoms at Week 8 (mean change = -7.45, SD = 5.99, Cohen's d = -1.24, p < 0.01). No significant associations were found between sex at birth, age, employment status, educational background and Week 8 symptom changes. Significant associations between depressive and anxiety symptom outcomes and sexual orientation, marital status, concurrent mental health treatment, and baseline symptom severity were found. CONCLUSIONS The present study suggests early promise for W-MA-02 as an intervention for depression and/or anxiety symptoms. Although exploratory in nature, this study revealed potential user characteristics associated with outcomes that can be investigated in future studies. TRIAL REGISTRATION This study was retrospectively registered on ClinicalTrials.gov (#NCT05672745) on January 5th, 2023.
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Affiliation(s)
- Emil Chiauzzi
- Woebot Health, 535 Mission Street, 14th Floor, San Francisco, CA, 94105, USA
| | - Andre Williams
- Woebot Health, 535 Mission Street, 14th Floor, San Francisco, CA, 94105, USA
| | - Timothy Y Mariano
- Woebot Health, 535 Mission Street, 14th Floor, San Francisco, CA, 94105, USA
- RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Sarah Pajarito
- Woebot Health, 535 Mission Street, 14th Floor, San Francisco, CA, 94105, USA
| | - Athena Robinson
- Woebot Health, 535 Mission Street, 14th Floor, San Francisco, CA, 94105, USA
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20
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SUN H, ZHANG B, CUI D, DONG B, WANG H, HU G. [Determination of 145 pharmaceuticals and personal care products in eleven categories in water by ultra-high performance liquid chromatography-triple quadrupole mass spectrometry]. Se Pu 2024; 42:24-37. [PMID: 38197204 PMCID: PMC10782274 DOI: 10.3724/sp.j.1123.2023.04004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Indexed: 01/11/2024] Open
Abstract
Pharmaceuticals and personal care products (PPCPs) are emerging contaminants frequently detected in aquatic environments at trace levels. These chemicals have diverse structures and physicochemical properties and includes pharmaceuticals like antibiotics, antihypertensive drugs, antiviral drugs, and psychotropic drugs that are widely used in large quantities worldwide. Considering the large number of pharmaceuticals currently in usage, it is crucial to establish a priority list of PPCPs that should be monitored and/or treated first. An accurate understanding of the occurrence and levels of PPCPs in aquatic environments is essential for providing objective materials for monitoring these emerging contaminants. Therefore, accurate, efficient, sensitive, and high-throughput screening techniques need to be established for determining and quantifying PPCPs. This study developed a method for the determination of 145 PPCPs (grouped into eleven categories: antibiotics, antihypertensive drugs, antidiabetic drugs, antiviral drugs, β-receptor agonists, nitroimidazoles, H2 receptor antagonists, psychotropic drugs, hypolipidemic drugs, non-steroidal anti-inflammatory drugs, and others) in water. The method was based on large volume direct injection without sample enrichment and cleanup and used ultra-high performance liquid chromatography-triple quadrupole mass spectrometry (UHPLC-MS/MS). Water samples were collected and filtered through a 0.22-μm regenerated cellulose (RC) filter membrane. Subsequently, Na2EDTA was added to the samples to adjust their pH to 6.0-8.0. Internal standards were mixed with the solutions, and because of the addition of Na2EDTA, the interference of metal ions could be eliminated in the determination of compounds, especially for tetracycline and quinolone antibiotics. Among the six filter membranes tested in this study (PES, PFTE-Q, PFTE, MCE, GHP, and RC), RC filter membranes were screened for water sample filtration. The UHPLC-MS/MS parameters were optimized by comparing the results of various mobile phases, as well as by establishing the best instrumental conditions. The 145 PPCPs were separated using an Phenomenex Kinetex C18 column (50 mm×3 mm, 2.6 μm) via gradient elution. The mobile phases were 0.1% (v/v) formic acid aqueous solution containing 5 mmol/L ammonium formate and acetonitrile for positive ion modes, 5 mmol/L aqueous solutions of ammonium formate and acetonitrile for negative ion modes. The samples were quantified using the scheduled multiple reaction monitoring (scheduled-MRM) mode with electrospray ionization in positive and negative ion modes. A standard internal calibration procedure was used to calculate contents of sample. The established method was systematically verified, and it demonstrated a good linear relationship. The average recoveries of the 145 PPCPs at the three spiked levels were in the range of 80.4%-128% with relative standard deviations (RSDs, n=6) of 0.6%-15.6%. The method detection limits (MDLs) ranged from 0.015 to 5.515 ng/L. Finally, the optimization method was applied to analyze the 145 PPCPs in 11 surface water samples and 6 drinking water samples. Overall, 93 (64%) out of the 145 analytes were detected. The total contents of the PPCPs in surface water samples ranged from 276.9 to 2705.7 ng/L. The detection frequencies of antidiabetic, antiviral, and psychotropic drugs were 100%. The total contents of the PPCPs in drinking water samples ranged from 140.5 to 211.5 ng/L, and antibiotics, antidiabetic drugs, and antiviral drugs comprised the largest proportion of analytes (by mass concentration) in drinking water samples. Our method exhibited high analytical speed and high sensitivity. It is thus suitable for the trace analysis and determination of the 145 PPCPs in environmental water and showed improved detection efficiency for PPCPs in water, indicating that it has a high potential for practical applications. This study can extend technical support for further pollution-level analysis of PPCPs in water and provide an objective basis for environmental management.
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Levenson SA. Antipsychotics in Perspective: Past, Present, and Future. Sr Care Pharm 2024; 39:5-13. [PMID: 38160240 DOI: 10.4140/tcp.n.2024.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
For more than half a century, there has been controversy and conflict over using psychotropic medications ("psychotropics") as strategies to modulate behavior, enhance mood, and address cognitive issues for nursing home residents. The current situation reflects a long history of investigation, reports, discussions, government and professional activity, and other attempted improvement. Although attention has focused primarily on the use of antipsychotics, particularly to manage symptoms associated with dementia, there are much broader issues. The use of all psychotropics has arguably been challenging and inconsistent. Although antipsychotic use in nursing homes has been reduced substantially, many controversies and concerns remain, such as the continuing significant use of other psychotropics. It is tempting to conclude that efforts to reduce the use of these medications might have been deliberately stymied, and that more drastic-if not coercive-measures are needed to correct these issues. However, many other compelling considerations must be defined accurately and addressed. Further improvement in the current situation requires reconsidering some current beliefs and approaches. A pause and reopening of meaningful discussion is needed. This 3-part series (in this and the next 2 issues of The Senior Care Pharmacist) will examine the history of the issues (this month), various perspectives on the issues (part 2), and lessons and recommended approaches for the future (part 3).
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Affiliation(s)
- Steven A Levenson
- Retired physician and medical director and former advisor to the Centers for Medicare and Medicaid Services
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22
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Affiliation(s)
- Kevin M Simon
- Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
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23
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Yang X, Mo PKH, Ip MTK, Wang Z. Prevalence and Predictors of Psychoactive Drug Use among Chinese Men Who Have Sex with Men: A Longitudinal and Mediation Study. J Psychoactive Drugs 2024; 56:117-126. [PMID: 36355403 DOI: 10.1080/02791072.2022.2144556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 08/07/2022] [Accepted: 09/23/2022] [Indexed: 11/12/2022]
Abstract
Few longitudinal studies have examined the prevalence of psychoactive drug use and its related predictors among Chinese men who have sex with men (MSM) in Hong Kong. This longitudinal study aimed to investigate the prevalence of psychoactive drug use in this population and the relationships of background characteristics, health status, MSM-related self-stigma, and perceived stress with psychoactive drug use. Furthermore, the study tested the mediation effect of perceived stress in the relationship between MSM-related self-stigma and psychoactive drug use based on the minority stress model and the general strain model. A total of 600 MSM were recruited through multiple sources and completed a telephone interview at baseline, and 407 completed the 6-month follow-up survey. Prevalence of using any type of psychoactive drugs in the past 12 months at baseline and in the past six months at follow-up was 16.8% and 9.1% respectively. History of sexually transmitted infection (STI), self-stigma and perceived stress significantly predicted psychoactive drug use at 6-month follow-up. Bootstrapping analysis showed that self-stigma could, directly and indirectly, predict psychoactive drug use at 6-month follow-up through perceived stress. The results highlighted the need for interventions to reduce psychoactive drug use among local MSM and its potential modifiable factors.
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Affiliation(s)
- Xue Yang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, GD, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, GD, China
| | - Mary T K Ip
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, GD, China
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24
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Konecki C, Hadjoudj J, Tralongo F, Haudecoeur C, Gozalo C, Fouley A, Marty H, Feliu C, Djerada Z. Simultaneous quantification of 55 psychotropic drugs and metabolites in human plasma with a fast UPLC-MS/MS method. Biomed Pharmacother 2023; 169:115918. [PMID: 38007935 DOI: 10.1016/j.biopha.2023.115918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023] Open
Abstract
OBJECTIVES Therapeutic drug monitoring is strongly recommended for psychotropic drugs, which present a strong inter- and intra-individual variability due to multiple factors like inflammatory state, smoking, diet, drug interactions due to polypharmacy, and genetic profile. The aim of this study was to develop and validate a fast, simple, and sensitive method allowing the simultaneous quantification of a large number of psychotropic drugs. METHODS After a simple sample preparation with a one-step protein precipitation, a total of 55 compounds, including 22 antidepressants, 18 antipsychotics, 2 other psychotropic drugs (bupropion and nefopam), and their metabolites, was separated on a Waters Acquity HSS T3 ultra-performance liquid chromatography column, and subsequently detected and quantified by a triple quadrupole Quantis mass spectrometer with electrospray ionization operated in positive mode. RESULTS Total run time was only 5.7 min. Limits of detection ranged from 0.01 to 0.18 µg/L depending on compound. Measuring ranges were from 0.195 to 1000 µg/L depending on compound, and were defined according to therapeutic ranges. Inter- and intra-assay precisions values were less than 15 %. After validation, this method was successfully applied in daily practice for therapeutic drug monitoring of polymedicated psychiatric patients. CONCLUSION We developed and validated one of the most sensitive and complete UPLC-MS/MS methods in psychopharmacology, allowing the simultaneous determination of 55 psychotropic drugs in only 5.7 min after a simple sample preparation. This method has been successfully used in daily practice for therapeutic drug monitoring of psychiatric patients and is especially useful in polymedicated patients.
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Affiliation(s)
- Celine Konecki
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims Champagne-Ardenne University, 51 Rue Cognacq-Jay, 51095 Reims, France; Laboratory of Pharmacology and Toxicology, Reims University Hospital Centre, Rue du General Koenig, 51100 Reims, France
| | - Jed Hadjoudj
- Laboratory of Pharmacology and Toxicology, Reims University Hospital Centre, Rue du General Koenig, 51100 Reims, France
| | - Federica Tralongo
- Laboratory of Pharmacology and Toxicology, Reims University Hospital Centre, Rue du General Koenig, 51100 Reims, France
| | - Cyril Haudecoeur
- Laboratory of Pharmacology and Toxicology, Reims University Hospital Centre, Rue du General Koenig, 51100 Reims, France
| | - Claire Gozalo
- Laboratory of Pharmacology and Toxicology, Reims University Hospital Centre, Rue du General Koenig, 51100 Reims, France
| | - Aurelie Fouley
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims Champagne-Ardenne University, 51 Rue Cognacq-Jay, 51095 Reims, France; Laboratory of Pharmacology and Toxicology, Reims University Hospital Centre, Rue du General Koenig, 51100 Reims, France
| | - Helene Marty
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims Champagne-Ardenne University, 51 Rue Cognacq-Jay, 51095 Reims, France; Laboratory of Pharmacology and Toxicology, Reims University Hospital Centre, Rue du General Koenig, 51100 Reims, France
| | - Catherine Feliu
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims Champagne-Ardenne University, 51 Rue Cognacq-Jay, 51095 Reims, France; Laboratory of Pharmacology and Toxicology, Reims University Hospital Centre, Rue du General Koenig, 51100 Reims, France
| | - Zoubir Djerada
- Department of Pharmacology, EA 3801, SFR CAP-Santé, Reims Champagne-Ardenne University, 51 Rue Cognacq-Jay, 51095 Reims, France; Laboratory of Pharmacology and Toxicology, Reims University Hospital Centre, Rue du General Koenig, 51100 Reims, France.
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Martini M, Arenhardt FK, Caldieraro MA, Fleck MP, Feiten JG, Marschner RA, Wajner SM. Chronic pain predicts a worse response to depression treatment, regardless of thyroid function or psychotropics prescribed. J Affect Disord 2023; 343:1-7. [PMID: 37734625 DOI: 10.1016/j.jad.2023.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/28/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Chronic pain (CP) and thyroid hormones' (TH) abnormalities are associated with depression, but the impact of pain and TH fluctuation on the response to depression treatment is uncertain. METHODS Eighty-eight patients with major depression were evaluated before and after 6 months of specific treatment, through scales of symptoms' severity (HAM-D-17), psychomotor disturbance (CORE), and quality of life (WHOQOL-Bref). We reviewed psychiatric medications and measured TSH, T3 and T4. We used Generalized Estimating Equations to assess the interaction effect between CP and treatment time on depression severity and TH levels, and Bonferroni to compare means. RESULTS 47.7 % of the patients had CP. Patients with and without CP did not differ at baseline. At follow-up, those with CP experienced a more modest decrease in symptoms' severity and no improvement in any domain of psychomotor disturbance, contrasting with a decrease of over 40 % from the baseline values of CORE in patients without CP (non-CP). Initial and final scores were respectively: HAM-D CP 24.06 and 19.3, Δ = -4.75; HAM-D non-CP 22.92 and 14.7, Δ = -8.21; CORE CP 5.36 and 5.24, Δ = -0.12; CORE non-CP 5.8 and 3.22, Δ = -2.57. There was no interaction with TH or life quality. Model adjustments for psychotropic drugs received and sensitivity analysis excluding somatic symptoms from severity scales did not impact the results. LIMITATIONS Findings may not replicate in mildly depressed patients from primary care. Pain scales were not applied. CONCLUSIONS Individuals with chronic pain showed a suboptimal response to depression treatment, regardless of the medications used or TH levels.
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Affiliation(s)
- Murilo Martini
- Postgraduate Program in Medical Sciences: Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 Porto Alegre, RS, Brazil; Endocrine Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil; Department of Internal Medicine, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil; Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil.
| | - Fernanda Klagenberg Arenhardt
- Postgraduate Program in Medical Sciences: Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 Porto Alegre, RS, Brazil; Endocrine Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil; Department of Internal Medicine, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil
| | - Marco Antonio Caldieraro
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil; Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 Porto Alegre, RS, Brazil
| | - Marcelo P Fleck
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil; Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 Porto Alegre, RS, Brazil
| | - Jacson Gabriel Feiten
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil; Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 Porto Alegre, RS, Brazil
| | - Rafael Aguiar Marschner
- Postgraduate Program in Medical Sciences: Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 Porto Alegre, RS, Brazil; Endocrine Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil; Department of Internal Medicine, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil
| | - Simone Magagnin Wajner
- Postgraduate Program in Medical Sciences: Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 Porto Alegre, RS, Brazil; Endocrine Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil; Department of Internal Medicine, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil
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26
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Selalmazidou AM, Bschor T. [Depression: Low-threshold Cardinal Measures as a Complement or Alternative to Pharmacological or Psychotherapeutic Interventions]. Fortschr Neurol Psychiatr 2023; 91:523-534. [PMID: 38081166 DOI: 10.1055/a-2169-2120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The third edition of the German National Clinical Practice Guideline for Depression emphasizes the significance of cardinal measures much more strongly than before. Low-threshold cardinal measures are an indispensable component of every depression treatment, regardless of severity and setting. They are suitable as a standalone treatment for mild and moderate depression. If inadequate improvement is observed, additional therapies should be supplemented. They should be implemented immediately after diagnosis to enhance the success rate.Regarding cardinal measures, among other things, comprehensive patient education in understandable language is essential. Patients with depressive disorders require guidance on structuring their day and building healthy activities. Patients with depression-related sleep disturbances benefit from sleep hygiene rules. Wake therapy constitutes an excellent and low-risk treatment method with immediate effect, which is a standard component of adequate depression treatment. Patients with a seasonal pattern of depression should be advised on light therapy. All patients should be encouraged to engage in regular physical activity with moderate intensity.
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Brushett S, Gacesa R, Vich Vila A, Brandao Gois M, Andreu-Sánchez S, Swarte J, Klaassen M, Collij V, Sinha T, Bolte L, Wu J, Swertz M, de Kroon M, Reijneveld S, Wijmenga C, Weersma R, Fu J, van Loo H, Kurilshikov A, Zhernakova A. Gut feelings: the relations between depression, anxiety, psychotropic drugs and the gut microbiome. Gut Microbes 2023; 15:2281360. [PMID: 38017662 PMCID: PMC10730195 DOI: 10.1080/19490976.2023.2281360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/06/2023] [Indexed: 11/30/2023] Open
Abstract
The gut microbiome is involved in the bi-directional relationship of the gut - brain axis. As most studies of this relationship are small and do not account for use of psychotropic drugs (PTDs), we explored the relations of the gut microbiome with several internalizing disorders, while adjusting for PTDs and other relevant medications, in 7,656 Lifelines participants from the Northern Netherlands (5,522 controls and 491 participants with at least one internalizing disorder). Disorders included dysthymia, major depressive disorder (MDD), any depressive disorder (AnyDep: dysthymia or MDD), generalized anxiety disorder (GAD) and any anxiety disorder (AnyAnx: GAD, social phobia and panic disorder). Compared to controls, 17 species were associated with depressive disorders and 3 were associated with anxiety disorders. Around 90% of these associations remained significant (FDR <0.05) after adjustment for PTD use, suggesting that the disorders, not PTD use, drove these associations. Negative associations were observed for the butyrate-producing bacteria Ruminococcus bromii in participants with AnyDep and for Bifidobacterium bifidum in AnyAnx participants, along with many others. Tryptophan and glutamate synthesis modules and the 3,4-Dihydroxyphenylacetic acid synthesis module (related to dopamine metabolism) were negatively associated with MDD and/or dysthymia. After additional adjustment for functional gastrointestinal disorders and irritable bowel syndrome, these relations remained either statistically (FDR <0.05) or nominally (P < 0.05) significant. Overall, multiple bacterial species and functional modules were associated with internalizing disorders, including gut - brain relevant components, while associations to PTD use were moderate. These findings suggest that internalizing disorders rather than PTDs are associated with gut microbiome differences relative to controls.
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Affiliation(s)
- S. Brushett
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
- Department of Health Sciences, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - R. Gacesa
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
- Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - A. Vich Vila
- Department of Microbiology and Immunology, Rega Institute for Medical Research, Leuven, Belgium
- VIB-KU Leuven Center for Microbiology, Leuven, Belgium
| | - M.F. Brandao Gois
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - S. Andreu-Sánchez
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
- Department of Pediatrics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - J.C. Swarte
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
- Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - M.A.Y. Klaassen
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
- Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - V. Collij
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
- Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - T. Sinha
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - L.A. Bolte
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
- Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - J. Wu
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - M. Swertz
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
- Genomics Coordination Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M.L.A. de Kroon
- Department of Health Sciences, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - S.A. Reijneveld
- Department of Health Sciences, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - C. Wijmenga
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - R.K. Weersma
- Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - J. Fu
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
- Department of Pediatrics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - H.M. van Loo
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A. Kurilshikov
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - A. Zhernakova
- Department of Genetics, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
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Cooney C, Kennedy N, Doherty A, Shipsey M, Lindow SW, Hinds C. Evaluation of a new Perinatal Mental Health Service in a University Maternity Hospital. Ir J Psychol Med 2023; 40:588-591. [PMID: 37231740 DOI: 10.1017/ipm.2023.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES Specialist Perinatal Mental Health Services (SPMHS) are a new development in Ireland. This service evaluation examined the impact of the introduction of a SPMHS multidisciplinary team (MDT) on prescribing practices and treatment pathways in an Irish maternity hospital. METHODS Clinical charts were reviewed to collect data on all referrals, diagnoses, pharmacological and non-pharmacological interventions delivered in a SPMHS over a 3-week period in 2019. The findings were compared to the same 3-week period in 2020 following the expansion of the SPMHS MDT. RESULTS In 2019 (n = 32) and 2020 (n = 47), most (75 and 79%, respectively) assessments were antenatal. The proportion of patients prescribed psychotropic medication within the SPMHS was not significantly different from 2019 (31%) to 2020 (23%), though more patients were already prescribed psychotropic medications at the time of referral (22% in 2019 v. 36% in 2020). There was an increase in MDT interventions in 2020 with more input from psychology, clinical nurse specialist (CNS), and social work intervention. Adherence to prescribing standards improved from 2019 to 2020. CONCLUSION Prescribing patterns remained unchanged between 2019 and 2020. Improvement was observed in adherence to prescribing standards and there was increased provision of MDT interventions in 2020. Broader diagnostic categories were also used in 2020, possibly suggesting that the service is now providing more individualized care.
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Affiliation(s)
- C Cooney
- Coombe Women and Infants University Hospital, Specialist Perinatal Mental Health Service, Cork St, Dolphin's Barn, Dublin 8, Ireland
| | - N Kennedy
- St. Patrick's University Hospital, St James' St, Dublin 8, Ireland
| | - A Doherty
- Coombe Women and Infant's University Hospital, Dublin 8, Ireland
| | - M Shipsey
- Coombe Women and Infant's University Hospital, Dublin 8, Ireland
| | - S W Lindow
- Coombe Women and Infant's University Hospital, Dublin 8, Ireland
| | - C Hinds
- Coombe Women and Infants University Hospital, Specialist Perinatal Mental Health Service, Cork St, Dolphin's Barn, Dublin 8, Ireland
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Thaler H, Falter-Wagner C. [Autism spectrum disorder in adulthood]. Fortschr Neurol Psychiatr 2023; 91:466-478. [PMID: 37944552 DOI: 10.1055/a-1898-5347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Autism is a neurodevelopmental disorder that starts in early childhood and persists over the lifespan. A combination of genetic factors and environmental factors around birth contribute to its etiology. Autistic individuals show differences and difficulties in social interaction and communication as well as repetitive, stereotypical behavior and interests. The diagnostic procedure is complex and should be carried out in a specialized assessment unit. Diagnostic assessment is based on behavioral observation and a careful evaluation of developmental history. A wide range of potential differential diagnoses should be considered. Autistic adults have a higher risk of developing psychiatric disorders such as anxiety and depression. Psychotherapeutic treatment that is adapted to autism-related difficulties can be helpful. Co-occurring conditions should be treated in accordance with disorder-specific guidelines. Psychopharmacological treatment of co-occurring conditions is, in most cases, only recommended as an addition to behavioral interventions. Autistic people often experience difficulties in social participation, which can be targeted with sociotherapeutic interventions.
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Amrein MA, Hengartner MP, Näpflin M, Farcher R, Huber CA. Prevalence, trends, and individual patterns of long-term antidepressant medication use in the adult Swiss general population. Eur J Clin Pharmacol 2023; 79:1505-1513. [PMID: 37668659 PMCID: PMC10618304 DOI: 10.1007/s00228-023-03559-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/24/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE Antidepressant use has increased in many European countries, mostly driven by longer treatment duration. The aim of this study was to provide prevalence rates of long-term users of antidepressants for the Swiss population over the last decade and to investigate associated factors for longer use. METHODS We examined the prevalence rates of individuals with at least one prescription for antidepressants using longitudinal health claims data for 2013 to 2021. We defined short- (< one year), medium- (one-two years), and long-term users (> two years) for 2015 to 2019. We applied a binary logistic regression model to investigate the effects of population (gender, age, area of living, language, health insurance plan, and nursing home) and treatment characteristics (psychiatric or psychotherapeutic care) on long-term compared to short- and medium-term users in 2019. RESULTS In 2021, 9% of the Swiss population (n = 770,698) received at least one antidepressant prescription, which remained stable since 2013. In 2019, the proportion of long-term users was 57.4%, with steady increase since 2015. The proportion of medium- and short-term users has decreased. Older age, being a woman, living in an urban area, living in a nursing home, being enrolled in a standard care plan, and receiving psychiatric or psychotherapeutic care were factors positively associated with being a long-term user. CONCLUSION The proportion of long-term users in Switzerland is high and steadily increasing. Given the ongoing debate about the confounding effects of relapse and withdrawal, more research is needed to investigate longer use of antidepressants that could indicate overprescribing.
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Affiliation(s)
- Melanie A Amrein
- Department of Health Sciences, Helsana Group, Zurich, Switzerland.
| | - Michael P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Markus Näpflin
- Department of Health Sciences, Helsana Group, Zurich, Switzerland
| | - Renato Farcher
- Department of Health Sciences, Helsana Group, Zurich, Switzerland
| | - Carola A Huber
- Department of Health Sciences, Helsana Group, Zurich, Switzerland
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
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Mazaira S, Giménez M. Simultaneous use of contraceptives and hormone replacement therapy in women receiving psychoactive drugs. From theory to integral health practice. Vertex 2023; 34:45-60. [PMID: 37819064 DOI: 10.53680/vertex.v34i161.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Indexed: 10/13/2023]
Abstract
Sexuality in people with mental disorders is a topic usually tinged with prejudice and stigma. Women with severe mental disorders are more exposed to suffer sexually transmitted diseases, becoming victims of gender violence and being involved with unintended pregnancies. In adults and adolescents, sexual intercourse under the influence of alcohol or other drugs, or during worsening or exacerbation of baseline symptoms or condition, are often unplanned, unprotected, with casual partners from high risk groups, without contraceptive methods and with less capacity to agree or deny safe sexual practices. Sexual and reproductive rights as well as gender perspective need to be considered an integral part of women with mental disorders health being and treatment. For this reason, discussing with patients about their desire or not to have children, their sexual life and provide them the most adequate options of contraceptive methods taking into consideration their needs so that and informed decision should be part of the psychiatric consultation. Hormonal contraceptives are widely used globally, being one of the most prescribed groups of drugs. It is estimated that more than 100 million women take oral contraceptives to prevent pregnancy, to treat menstrual pain and/or menstrual heavy bleeding or to control acne. Oral contraceptives result from the combination of estrogen and progestin derivatives, or progestins alone. This review will focus on the description of each hormonal contraceptive methods and hormone replacement therapy and the special features of their concomitant use with psychotropic drugs during treatment of women with psychiatric disorders.
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Affiliation(s)
- Silvina Mazaira
- Médica especialista en psiquiatría. Hospital de Emergencias Psiquiátricas "T. de Alvear", Buenos Aires, Argentina. Docente del Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, UBA. Presidenta del Capítulo de Salud Mental y Psiquiatría Perinatal de APSA. Presidenta honoraria del Capítulo de Salud Mental de las Mujeres de APSA..
| | - Mariana Giménez
- Médica especialista en psiquiatría. Hospital General de Agudos "Parmenio Piñero", Buenos Aires, Argentina. Docente del Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires (UBA).
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Ananchenkova PI, Vrubel ME, Shegai MN, Tonkonog VV. [LEGAL BASIS FOR THE MOVEMENT OF MEDICINES ACROSS THE CUSTOMS BORDER OF THE EURASIAN ECONOMIC UNION BY LEGAL ENTITIES]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2023; 31:1248-1256. [PMID: 38069894 DOI: 10.32687/0869-866x-2023-31-s2-1248-1256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/05/2023] [Indexed: 12/18/2023]
Abstract
The issues of the movement of medicines across the customs border of the Eurasian Economic Union are timely and relevant, due to the increase in the turnover of medicines in the Russian Federation. The article deals with the issues of import and export through the customs border of the Eurasian Economic Union of both registered and unregistered medicines in the Russian Federation by legal entities. In addition, the authors investigated the regulatory and legal procedure for the movement of medicines across the customs border of the Eurasian Economic Union containing narcotic and psychotropic substances. Topical issues of falsification of medicines and criminal norms of the law on combating it are touched upon. The analysis carried out in the work allowed the authors to identify the existing problems of regulatory regulation of the issue under study and propose a solution.
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Affiliation(s)
- P I Ananchenkova
- Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, 115088, Moscow, Russia
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia
| | - M E Vrubel
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia
| | - M N Shegai
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia
| | - V V Tonkonog
- Admiral Ushakov State Maritime University, 353924, Novorossiysk, Russia,
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Aoki Y, Takaesu Y, Matsui K, Tokumasu T, Tani H, Takekita Y, Kanazawa T, Kishimoto T, Tarutani S, Hashimoto N, Takeuchi H, Mishima K, Inada K. Development and acceptability testing of a decision aid for considering whether to reduce antipsychotics in individuals with stable schizophrenia. Neuropsychopharmacol Rep 2023; 43:391-402. [PMID: 37452456 PMCID: PMC10496039 DOI: 10.1002/npr2.12366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/12/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023] Open
Abstract
AIM Continued antipsychotic treatment is the key to preventing relapse. Maintenance antipsychotic monotherapy and optimal dose use are recommended for individuals with stable schizophrenia because of their undesirable effects. Decision aids (DAs) are clinical conversation tools that facilitate shared decision-making (SDM) between patients and health-care providers. This study aimed to describe the development process and results of acceptability testing of a DA for individuals with stable schizophrenia, considering (i) whether to continue high-dose antipsychotics or reduce to the standard dose and (ii) whether to continue two antipsychotics or shift to monotherapy. METHODS A DA was developed according to the guidelines for the appropriate use of psychotropic medications and International Patient Decision Aid Standards (IPDAS). First, a DA prototype was developed based on a previous systematic review and meta-analysis conducted for identifying the effects of continuing or reducing antipsychotic treatment. Second, mixed-method survey was performed among individuals with schizophrenia and health-care providers to modify and finalize the DA. RESULTS The DA consisted of an explanation of schizophrenia, options to continue high-dose antipsychotics or reduce to the standard dose, options to continue two antipsychotics or shift to monotherapy, pros and cons of each option, and a value-clarification worksheet for each option. The patients (n = 20) reported acceptable language use (75%), adequate information (75%), and well-balanced presentation (79%). Health-care providers (n = 20) also provided favorable overall feedback. The final DA covered six IPDAS qualifying criteria. CONCLUSION A DA was successfully developed for schizophrenia, considering whether to reduce antipsychotics, which can be used in the SDM process.
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Affiliation(s)
- Yumi Aoki
- Department Psychiatric and Mental Health Nursing, Graduate School of NursingSt. Luke's International UniversityTokyoJapan
- Department of NeuropsychiatryKyorin University School of MedicineTokyoJapan
| | - Yoshikazu Takaesu
- Department of NeuropsychiatryKyorin University School of MedicineTokyoJapan
- Department of Neuropsychiatry, Graduate School of MedicineUniversity of the RyukyusOkinawaJapan
| | - Kentaro Matsui
- Department of Clinical LaboratoryNational Center Hospital, National Center of Neurology and PsychiatryTokyoJapan
| | - Takahiro Tokumasu
- Department of PsychiatryShowa University Northern Yokohama HospitalKanagawaJapan
| | - Hideaki Tani
- Department of NeuropsychiatryKeio University School of MedicineTokyoJapan
| | - Yoshiteru Takekita
- Department of Neuropsychiatry, Faculty of MedicineKansai Medical UniversityOsakaJapan
| | - Tetsufumi Kanazawa
- Department of Neuropsychiatry, Faculty of MedicineOsaka Medical and Pharmaceutical UniversityOsakaJapan
| | - Taishiro Kishimoto
- Department of NeuropsychiatryKeio University School of MedicineTokyoJapan
- Hills Joint Research Laboratory for Future Preventive Medicine and WellnessKeio University School of MedicineTokyoJapan
| | - Seiichiro Tarutani
- Department of PsychiatryShin‐Abuyama Hospital, Osaka Institute of Clinical PsychiatryOsakaJapan
| | - Naoki Hashimoto
- Department of PsychiatryHokkaido University Graduate School of MedicineHokkaidoJapan
| | - Hiroyoshi Takeuchi
- Department of NeuropsychiatryKeio University School of MedicineTokyoJapan
| | - Kazuo Mishima
- Department of NeuropsychiatryAkita University Graduate School of MedicineAkitaJapan
| | - Ken Inada
- Department of Psychiatry, School of MedicineKitasato UniversityKanagawaJapan
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Rousis N, Bade R, Romero-Sánchez I, Mueller JF, Thomaidis NS, Thomas KV, Gracia-Lor E. Festivals following the easing of COVID-19 restrictions: Prevalence of new psychoactive substances and illicit drugs. Environ Int 2023; 178:108075. [PMID: 37399770 DOI: 10.1016/j.envint.2023.108075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/15/2023] [Accepted: 06/29/2023] [Indexed: 07/05/2023]
Abstract
The market for illicit drugs and new psychoactive substances (NPS) has grown significantly and people attending festivals have been identified as being at high risk (high extent and frequency of substance use). Traditional public health surveillance data sources have limitations (high costs, long implementation times, and ethical issues) and wastewater-based epidemiology (WBE) can cost-effectively support surveillance efforts. Influent wastewater samples were analyzed for NPS and illicit drug consumption collected during New Year period (from 29-Dec-2021 to 4-Jan-2022) and a summer Festival (from 29-June-2022 to 12-July-2022) in a large city in Spain. Samples were analyzed for phenethylamines, cathinones, opioids, benzodiazepines, plant-based NPS, dissociatives, and the illicit drugs methamphetamine, MDA, MDMA, ketamine, heroin, cocaine, and pseudoephedrine by liquid chromatography mass spectrometry. High consumption rates of specific NPS and established illicit drugs were identified at the peak of each event. Furthermore, a dynamic change in NPS use (presence and absence of substances) was detected over a period of six months. Eleven NPS, including synthetic cathinones, benzodiazepines, plant-based NPS and dissociatives, and seven illicit drugs were found across both the New Year and summer Festival. Statistically significant differences (p < 0.05) were seen for 3-MMC (New Year vs summer Festival), eutylone (New Year vs summer Festival), cocaine (summer Festival vs normal week and summer Festival vs New Year), MDMA (New Year vs normal week and summer Festival vs normal week), heroin (summer Festival vs New Year) and pseudoephedrine (summer Festival vs New Year). This WBE study assessed the prevalence of NPS and illicit drugs at festivals following the reduction of the COVID-19 pandemic restrictions highlighting the high use of specific substances at the peak of each event. This approach identified in a cost-effective and timely manner without any ethical issues the most used drugs and changes in use patterns and, thus, can complement public health information.
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Affiliation(s)
- Nikolaos Rousis
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia; Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece.
| | - Richard Bade
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia.
| | - Iván Romero-Sánchez
- Department of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, Avenida Complutense s/n, 28040 Madrid, Spain
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Nikolaos S Thomaidis
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Emma Gracia-Lor
- Department of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, Avenida Complutense s/n, 28040 Madrid, Spain.
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Du Y, Hua Z, Liu C, Lv R, Jia W, Su M. ATR-FTIR combined with machine learning for the fast non-targeted screening of new psychoactive substances. Forensic Sci Int 2023; 349:111761. [PMID: 37327724 DOI: 10.1016/j.forsciint.2023.111761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/15/2023] [Accepted: 06/06/2023] [Indexed: 06/18/2023]
Abstract
Due to the diversity and fast evolution of new psychoactive substances (NPS), both public health and safety are threatened around the world. Attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR), which serves as a simple and rapid technique for targeted NPS screening, is challenging with the rapid structural modifications of NPS. To achieve the fast non-targeted screening of NPS, six machine learning (ML) models were constructed to classify eight categories of NPS, including synthetic cannabinoids, synthetic cathinones, phenethylamines, fentanyl analogues, tryptamines, phencyclidine types, benzodiazepines, and "other substances" based on the 1099 IR spectra data items of 362 types of NPS collected by one desktop ATR-FTIR and two portable FTIR spectrometers. All these six ML classification models, including k-nearest neighbor (KNN), support vector machine (SVM), random forest (RF), extra trees (ET), voting, and artificial neural networks (ANNs) were trained through cross validation, and f1-scores of 0.87-1.00 were achieved. In addition, hierarchical cluster analysis (HCA) was performed on 100 synthetic cannabinoids with the most complex structural variation to investigate the structure-spectral property relationship, which leads to a summary of eight synthetic cannabinoid sub-categories with different "linked groups". ML models were also constructed to classify eight synthetic cannabinoid sub-categories. For the first time, this study developed six ML models, which were suitable for both desktop and portable spectrometers, to classify eight categories of NPS and eight synthetic cannabinoids sub-categories. These models can be applied for the fast, accurate, cost-effective, and on-site non-targeted screening of newly emerging NPS with no reference data available.
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Affiliation(s)
- Yu Du
- China Pharmaceutical University, Nanjing 210009, Jiangsu, PR China
| | - Zhendong Hua
- Key Laboratory of Drug Monitoring and Control, Drug Intelligence and Forensic Center, Ministry of Public Security, PR China; National Anti-Drug Laboratory of China, Beijing 100193, PR China
| | - Cuimei Liu
- Key Laboratory of Drug Monitoring and Control, Drug Intelligence and Forensic Center, Ministry of Public Security, PR China; National Anti-Drug Laboratory of China, Beijing 100193, PR China.
| | - Rulin Lv
- College of Forensic Science, People's Public Security University of China, Beijing, PR China
| | - Wei Jia
- Key Laboratory of Drug Monitoring and Control, Drug Intelligence and Forensic Center, Ministry of Public Security, PR China; National Anti-Drug Laboratory of China, Beijing 100193, PR China
| | - Mengxiang Su
- China Pharmaceutical University, Nanjing 210009, Jiangsu, PR China.
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Cohen N, Mathew M, Brent J, Wax P, Davis AL, Obilom C, Burns MM, Canning J, Baumgartner K, Koons AL, Wiegand TJ, Judge B, Hoyte C, Chenoweth JA, Froberg B, Farrar H, Carey JL, Hendrickson RG, Hodgman M, Caravati EM, Christian MR, Wolk BJ, Seifert SA, Bentur Y, Levine M, Farrugia LA, Vearrier D, Minns AB, Kennedy JM, Kirschner RI, Aldy K, Schuh S, Campleman S, Li S, Myran DT, Feng L, Freedman SB, Finkelstein Y. Severe outcomes following pediatric cannabis intoxication: a prospective cohort study of an international toxicology surveillance registry. Clin Toxicol (Phila) 2023; 61:591-598. [PMID: 37603042 DOI: 10.1080/15563650.2023.2238121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 07/09/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION An increasing number of jurisdictions have legalized recreational cannabis for adult use. The subsequent availability and marketing of recreational cannabis has led to a parallel increase in rates and severity of pediatric cannabis intoxications. We explored predictors of severe outcomes in pediatric patients who presented to the emergency department with cannabis intoxication. METHODS In this prospective cohort study, we collected data on all pediatric patients (<18 years) who presented with cannabis intoxication from August 2017 through June 2020 to participating sites in the Toxicology Investigators Consortium. In cases that involved polysubstance exposure, patients were included if cannabis was a significant contributing agent. The primary outcome was a composite severe outcome endpoint, defined as an intensive care unit admission or in-hospital death. Covariates included relevant sociodemographic and exposure characteristics. RESULTS One hundred and thirty-eight pediatric patients (54% males, median age 14.0 years, interquartile range 3.7-16.0) presented to a participating emergency department with cannabis intoxication. Fifty-two patients (38%) were admitted to an intensive care unit, including one patient who died. In the multivariable logistic regression analysis, polysubstance ingestion (adjusted odds ratio = 16.3; 95% confidence interval: 4.6-58.3; P < 0.001)) and cannabis edibles ingestion (adjusted odds ratio = 5.5; 95% confidence interval: 1.9-15.9; P = 0.001) were strong independent predictors of severe outcome. In an age-stratified regression analysis, in children older than >10 years, only polysubstance abuse remained an independent predictor for the severe outcome (adjusted odds ratio 37.1; 95% confidence interval: 6.2-221.2; P < 0.001). As all children 10 years and younger ingested edibles, a dedicated multivariable analysis could not be performed (unadjusted odds ratio 3.3; 95% confidence interval: 1.6-6.7). CONCLUSIONS Severe outcomes occurred for different reasons and were largely associated with the patient's age. Young children, all of whom were exposed to edibles, were at higher risk of severe outcomes. Teenagers with severe outcomes were frequently involved in polysubstance exposure, while psychosocial factors may have played a role.
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Affiliation(s)
- Neta Cohen
- Division of Emergency Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Mathew Mathew
- Division of Emergency Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Jeffrey Brent
- Departments of Medicine and Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Toxicology Associates, Littleton, USA
| | - Paul Wax
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- American College of Medical Toxicology, Phoenix, AZ, USA
| | - Adrienne L Davis
- Division of Emergency Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Cherie Obilom
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Joshua Canning
- Department of Medical Toxicology, Banner - University Medical Center, Phoenix, AZ, USA
| | - Kevin Baumgartner
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrew L Koons
- Department of Emergency Medicine, Lehigh Valley Health Network, USF Morsani College of Medicine, Allentown, PA, USA
| | - Timothy J Wiegand
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Bryan Judge
- Department of Emergency Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Christopher Hoyte
- Rocky Mountain Poison and Drug Center, Denver Health, Denver, CO, USA
| | - James A Chenoweth
- Department of Emergency Medicine, University of California at Davis, Sacramento, CA, USA
| | - Blake Froberg
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Henry Farrar
- Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | | | - Michael Hodgman
- Department of Emergency Medicine, Upstate Medical University, Syracuse, NY, USA
| | - E Martin Caravati
- Department of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Brian J Wolk
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Steven A Seifert
- Department of Emergency Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Yedidia Bentur
- Rambam Health Care Campus, Technion-Israel Institute of Technology, Haifa, Israel
| | - Michael Levine
- Department of Emergency Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Lynn A Farrugia
- UF Health Shands Hospital, University of Florida College of Medicine, Gainesville, FL, USA
| | - David Vearrier
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Alicia B Minns
- Department of Emergency Medicine, University of California San Diego, San Diego, CA, USA
| | - Joseph M Kennedy
- Department of Emergency Medicine, University of Vermont Medical Center, Burlington, VT, USA
| | | | - Kim Aldy
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- American College of Medical Toxicology, Phoenix, AZ, USA
| | - Suzanne Schuh
- Division of Emergency Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, University of Toronto, Toronto, Canada
| | | | - Shao Li
- American College of Medical Toxicology, Phoenix, AZ, USA
| | | | - Lisa Feng
- Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Stephen B Freedman
- Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Yaron Finkelstein
- Division of Emergency Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, University of Toronto, Toronto, Canada
- Division of Clinical Pharmacology and Toxicology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada
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Ellilä V, Levola J, Denissoff A, Partanen M, Niemelä S. Psychotic-Like Experiences and Concurrent Substance Use Among People Who Use New Psychoactive Substances. Subst Use Misuse 2023; 58:1606-1614. [PMID: 37482647 DOI: 10.1080/10826084.2023.2236212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
New psychoactive substances (NPS) are a group of substances that mimic established drugs, e.g., cannabinoids, stimulants, and opioids. NPS use has been associated with psychotic-like experiences, but current research is limited. This study focused on NPS use and psychotic-like experiences in persons attending substance use services in South-West Finland. The primary aim was to evaluate if NPS use associates with psychotic-like experiences, and if the association is independent of comorbid psychotic illness. As a secondary aim, this study evaluated concurrent substance use among people who use NPS. The study was based on a voluntary and anonymous survey administered on-site for people attending substance use services. The survey was conducted in 17 substance use service centers in South-West Finland in 2019, totaling 219 respondents. Information on substance use, service use due to psychotic episodes, and comorbid psychotic illness was collected. A validated PROD questionnaire was used for information on psychotic-like experiences. In all, 17% of 219 participants (n = 38) reported NPS use. After adjustments with comorbid psychotic illness, age, and gender, NPS use associated with PROD-screen positivity, i.e., reporting at least three psychotic-like symptoms. NPS use also associated with service use due to substance-induced psychotic episodes, and extensive use of several substances. In this study, NPS use associated with psychotic-like experiences independently of comorbid psychotic illness. However, as NPS use is also associated with heavy use of several substances, this study implicates concurrent substance use as a confounding factor when studying NPS use, which should be considered in future research.
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Affiliation(s)
- Venla Ellilä
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland
| | - Jonna Levola
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
- HUS Brain Centre, Psychiatry, Hospital District of Helsinki and Uusimaa and Helsinki University Hospital, Helsinki, Finland
| | - Alexander Denissoff
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland
- Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
| | | | - Solja Niemelä
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland
- Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
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Lima VMD, Marinho MGSMDC. Reports by explorers and travelers and the first scientific studies on ayahuasca (dating from 1850 to 1950) within the current debate on the "psychedelic renaissance". Hist Cienc Saude Manguinhos 2023; 30:e2023023. [PMID: 37436297 PMCID: PMC10395591 DOI: 10.1590/s0104-59702023000100023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/08/2022] [Indexed: 07/13/2023]
Abstract
This article describes the associations and controversies between indigenous and western uses of ayahuasca between 1850 and 1950 in relation to the "psychedelic renaissance." This movement has gained scientific attention since 2000, but hearkens back to the 1960s and 1970s, when anti-drug policy halted research on the "therapeutic potential" of psychoactive substances. Pioneering studies on ayahuasca date back to the early twentieth century and mention reports of expeditions to Amazonia from 1850 onward. Here, these articles and reports are analyzed according to the historical aspect of actor-network theory and recent studies. We infer that history casts light on the current political debate about indigenous uses, classifications, and meanings, pharmaceutical interest in ayahuasca, and the debate on "drugs."
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Affiliation(s)
- Vinícius Maurício de Lima
- Doutorando, Programa de Pós-graduação em Ciências Humanas e Sociais/Universidade Federal do ABC. São Bernardo do Campo - SP - Brasil
| | - Maria Gabriela Silva Martins da Cunha Marinho
- Professora e pesquisadora, Programa de Pós-graduação em Ciências Humanas e Sociais/Universidade Federal do ABC; pesquisadora associada, Museu Histórico/Faculdade de Medicina/Universidade de São Paulo. São Bernardo do Campo - SP - Brasil
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Kirby T. Ian Wong: a career focused on paediatric psychoactive drugs. Lancet Psychiatry 2023; 10:487. [PMID: 37353261 DOI: 10.1016/s2215-0366(23)00195-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
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Schepker R, Keller F, Fegert JM. [Trends in Adolescents' Satisfaction with Their Inpatient Psychiatric Treatment: A Panel Analysis over 7 Years]. Z Kinder Jugendpsychiatr Psychother 2023; 51:283-293. [PMID: 36524383 DOI: 10.1024/1422-4917/a000911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Trends in Adolescents' Satisfaction with Their Inpatient Psychiatric Treatment: A Panel Analysis over 7 Years Abstract. Because the German legislature is increasingly enabling adolescents' participation in their psychiatric treatment, we traced changes in satisfaction of 6,893 patients at the end of their stay in 10 hospitals using BEST-J. The treatments resulted in a fair overall satisfaction without any improvement over the 7 years studied. In seven hospitals, we calculated deviation from the overall satisfaction based on annual surveys. Satisfaction with the psychotherapeutic relationship was good from the beginning, whereas the relationship with caregivers improved during the sample period. When new legal standards were introduced, we measured an improvement in some items concerning patient participation (coercive measures information, goals of treatment discussed). Patients were less satisfied with the information about their illness than with medication information. Initially poor satisfaction with leave regulations significantly improved over time. Respect for privacy also improved. Satisfaction with the environment and service organization scored substantially worse than the other items. Peer relations within the ward were rated close to overall satisfaction. The results point to benefits from training in psychotherapy and a growing awareness of closeness-distance issues and patients' rights. Nevertheless, psychoeducation and leave regulations require improvement. Furthermore, patients stated unmet needs for refurbishing and renovating buildings.
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Affiliation(s)
- Renate Schepker
- Klinik für Kinder- und Jugendpsychiatrie/ Psychotherapie, Universitätsklinikum Ulm, Deutschland
| | - Ferdinand Keller
- Klinik für Kinder- und Jugendpsychiatrie/ Psychotherapie, Universitätsklinikum Ulm, Deutschland
| | - Jörg Michael Fegert
- Klinik für Kinder- und Jugendpsychiatrie/ Psychotherapie, Universitätsklinikum Ulm, Deutschland
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Valdivieso-Jiménez G. Efficacy of cognitive behavioural therapy for bipolar disorder: A systematic review. Rev Colomb Psiquiatr (Engl Ed) 2023; 52:213-224. [PMID: 37867032 DOI: 10.1016/j.rcpeng.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/19/2021] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Bipolar disorder (BD) is a serious mental illness with a chronic course and significant morbidity and mortality. BD has a lifetime prevalence rate of 1%-1.5% and is characterised by recurrent episodes of mania and depression, or a mixture of both phases. Although it has harmacological and psychotherapeutic treatment, cognitive behavioural therapy (CBT) has shown beneficial effects, but there is not enough clinical information in the current literature. METHODS The main aim was to determine the efficacy of CBT alone or as an adjunct to pharmacological treatment for BD. A systematic review of 17 articles was carried out. The inclusion criteria were: quantitative or qualitative research aimed at examining the efficacy of CBT in BD patients with/without medication; publications in English language; and) being 18-65 years of age. The exclusion criteria were: review and meta-analysis articles; articles that included patients with other diagnoses in addition to BD and that did not separate the results based on such diagnoses; and studies with patients who did not meet the DSM or ICD criteria for BD. The PubMed, PsycINFO and Web of Science databases were searched up to 5 January 2020. The search strategy was: "Bipolar Disorder" AND "Cognitive Behavioral Therapy". RESULTS A total of 1531 patients both sexes were included. The weighted mean age was 40.703 years. The number of sessions ranged from 8 to 30, with a total duration of 45-120 min. All the studies show variable results in improving the level of depression and the severity of mania, improving functionality, reducing relapses and recurrences, and reducing anxiety levels and the severity of insomnia. CONCLUSIONS The use of CBT alone or adjunctive therapy in BD patients is considered to show promising results after treatment and during follow-up. Benefits include reduced levels of depression and mania, fewer relapses and recurrences, and higher levels of psychosocial functioning. More studies are needed.
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Affiliation(s)
- Glauco Valdivieso-Jiménez
- Instituto Peruano para el Estudio y Abordaje Integral de la Personalidad, Lima, Peru; Servicio de Psiquiatría, Hospital de Emergencias Villa El Salvador, Lima, Peru.
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Jaworska N, Soo A, Stelfox HT, Burry LD, Fiest KM. Impacts of antipsychotic medication prescribing practices in critically ill adult patients on health resource utilization and new psychoactive medication prescriptions. PLoS One 2023; 18:e0287929. [PMID: 37384760 PMCID: PMC10310007 DOI: 10.1371/journal.pone.0287929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/15/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Antipsychotic medications are commonly prescribed to critically ill adult patients and initiation of new antipsychotic prescriptions in the intensive care unit (ICU) increases the proportion of patients discharged home on antipsychotics. Critically ill adult patients are also frequently exposed to multiple psychoactive medications during ICU admission and hospitalization including benzodiazepines and opioid medications which may increase the risk of psychoactive polypharmacy following hospital discharge. The associated impact on health resource utilization and risk of new benzodiazepine and opioid prescriptions is unknown. RESEARCH QUESTION What is the burden of health resource utilization and odds of new prescriptions of benzodiazepines and opioids up to 1-year post-hospital discharge in critically ill patients with new antipsychotic prescriptions at hospital discharge? STUDY DESIGN & METHODS We completed a multi-center, propensity-score matched retrospective cohort study of critically ill adult patients. The primary exposure was administration of ≥1 dose of an antipsychotic while the patient was admitted in the ICU and ward with continuation at hospital discharge and a filled outpatient prescription within 1-year following hospital discharge. The control group was defined as no doses of antipsychotics administered in the ICU and hospital ward and no filled outpatient prescriptions for antipsychotics within 1-year following hospital discharge. The primary outcome was health resource utilization (72-hour ICU readmission, 30-day hospital readmission, 30-day emergency room visitation, 30-day mortality). Secondary outcomes were administration of benzodiazepines and/or opioids in-hospital and following hospital discharge in patients receiving antipsychotics. RESULTS 1,388 propensity-score matched patients were included who did and did not receive antipsychotics in ICU and survived to hospital discharge. New antipsychotic prescriptions were not associated with increased health resource utilization or 30-day mortality following hospital discharge. There was increased odds of new prescriptions of benzodiazepines (adjusted odds ratio [aOR] 1.61 [95%CI 1.19-2.19]) and opioids (aOR 1.82 [95%CI 1.38-2.40]) up to 1-year following hospital discharge in patients continuing antipsychotics at hospital discharge. INTERPRETATION New antipsychotic prescriptions at hospital discharge are significantly associated with additional prescriptions of benzodiazepines and opioids in-hospital and up to 1-year following hospital discharge.
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Affiliation(s)
- Natalia Jaworska
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
| | - Andrea Soo
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Henry T. Stelfox
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Leslie Dan Faculty of Pharmacy, O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lisa D. Burry
- Departments of Pharmacy and Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Kirsten M. Fiest
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Leslie Dan Faculty of Pharmacy, O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Pérez Arqueros V, Ibáñez-Beroiz B, Goñi-Sarriés A, Galbete Jiménez A. Efficacy of psychotherapeutic interventions for non-suicidal self-injury in adolescent population: Systematic review and meta-analysis. Spanish Journal of Psychiatry and Mental Health 2023; 16:119-126. [PMID: 37689523 DOI: 10.1016/j.rpsm.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/30/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
Non-suicidal self-injury (NSSI) is the deliberate and self-inflicted damage to body tissue in the absence of fatal intent, and has become a serious health problem among adolescents. The aim of this study was to evaluate the efficacy of treatment for NSSI in this population through a systematic revision and meta-analysis (PROSPERO ID: 252355). Studies with therapies that reduced NSSI were included. The search was performed in the Medline, APA PsycINFO and PubPsych databases. The synthesis of measures for the main outcome (NSSI reduction) and for secondary outcomes (global functioning change and depressive symptomatology reduction) was performed using a random effects model. The search identified a total of 1881 studies. The systematic review included five studies and the meta-analysis four studies. The summary effect estimate for the standardized mean difference in NSSI was -0.53 (95% CI: -0.82, -0.25), in global functioning it was 0.62 (95% CI: 0.34, 0.91), and in depressive symptomatology it was -0.59 (95% CI: -0.82, -0.36). The certainty of the evidence using the GRADE method is low. We conclude that therapies specifically aimed at reducing NSSI are effective in reducing both NSSI and depressive symptoms while increasing global functioning.
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Affiliation(s)
| | - Berta Ibáñez-Beroiz
- Departamento de Salud, Universidad Pública de Navarra (UPNA), Pamplona, Spain; Navarrabiomed-HUN-UPNA, Pamplona, Spain; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Pamplona, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdISNA), Pamplona, Spain.
| | | | - Arkaitz Galbete Jiménez
- Navarrabiomed-HUN-UPNA, Pamplona, Spain; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Pamplona, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdISNA), Pamplona, Spain; Departamento de Estadística, Matemáticas e Informática. Universidad Pública de Navarra (UPNA), Pamplona, Spain
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Jonson M, Sigström R, Hedna K, Rydberg Sterner T, Falk Erhag H, Wetterberg H, Fässberg MM, Waern M, Skoog I. Time trends in depression prevalence among Swedish 85-year-olds: repeated cross-sectional population-based studies in 1986, 2008, and 2015. Psychol Med 2023; 53:2456-2465. [PMID: 35238290 PMCID: PMC10123839 DOI: 10.1017/s0033291721004335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/29/2021] [Accepted: 10/04/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Octogenarians of today are better educated, and physically and cognitively healthier, than earlier born cohorts. Less is known about time trends in mental health in this age group. We aimed to study time trends in the prevalence of depression and psychotropic drug use among Swedish 85-year-olds. METHODS We derived data from interviews with 85-year-olds in 1986-1987 (N = 348), 2008-2010 (N = 433) and 2015-17 (N = 321). Depression diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders. Symptom burden was assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS). Information on psychotropic drug use, sociodemographic, and health-related factors were collected during the interviews. RESULTS The prevalence of major depression was lower in 2015-2017 (4.7%, p < 0.001) and 2008-2010 (6.9%, p = 0.010) compared to 1986-1987 (12.4%). The prevalence of minor depression was lower in 2015-2017 (8.1%) compared to 2008-2010 (16.2%, p = 0.001) and 1986-1987 (17.8%, p < 0.001). Mean MADRS score decreased from 8.0 in 1986-1987 to 6.5 in 2008-2010, and 5.1 in 2015-2017 (p < 0.001). The reduced prevalence of depression was not explained by changes in sociodemographic and health-related risk factors for depression. While psychoactive drug use was observed in a third of the participants in each cohort, drug type changed over time (increased use of antidepressants and decreased use of anxiolytics and antipsychotics). CONCLUSIONS The prevalence of depression in octogenarians has declined during the past decades. The decline was not explained by changes in known risk factors for depression. The present study cannot answer whether changed prescription patterns of psychoactive drugs have contributed to the decline.
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Affiliation(s)
- Mattias Jonson
- Department of Psychiatry and Neurochemistry, Center for Ageing and Health (Age Cap), Gothenburg University, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Affective Clinic, Gothenburg, Sweden
| | - Robert Sigström
- Department of Psychiatry and Neurochemistry, Center for Ageing and Health (Age Cap), Gothenburg University, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Clinic of Cognition and Old Age Psychiatry, Gothenburg, Sweden
| | - Khedidja Hedna
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Statistikkonsulterna Jostat & Mr Sample AB, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, Center for Ageing and Health (Age Cap), Gothenburg University, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hanna Falk Erhag
- Department of Psychiatry and Neurochemistry, Center for Ageing and Health (Age Cap), Gothenburg University, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hanna Wetterberg
- Department of Psychiatry and Neurochemistry, Center for Ageing and Health (Age Cap), Gothenburg University, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Madeleine Mellqvist Fässberg
- Department of Psychiatry and Neurochemistry, Center for Ageing and Health (Age Cap), Gothenburg University, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margda Waern
- Department of Psychiatry and Neurochemistry, Center for Ageing and Health (Age Cap), Gothenburg University, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychosis Clinic, Gothenburg, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Center for Ageing and Health (Age Cap), Gothenburg University, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Clinic of Cognition and Old Age Psychiatry, Gothenburg, Sweden
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Balcaen M, Ventura M, Gil C, Luf A, Martins D, Cunha M, Tögel-Lins K, Wolf D, Blanckaert P, Deconinck E. Challenges in Drug Surveillance: Strengthening the Analysis of New Psychoactive Substances by Harmonizing Drug Checking Services in Proficiency Testing. Int J Environ Res Public Health 2023; 20:4628. [PMID: 36901637 PMCID: PMC10002093 DOI: 10.3390/ijerph20054628] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/22/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Drug checking is a proven harm reduction strategy and provides real-time information on the market of new psychoactive substances (NPS). It combines chemical analysis of samples with direct engagement with people who use drugs (PWUD), giving the ability to increase preparedness and responsiveness towards NPS. Next to that, it supports rapid identification of potential unwitting consumption. However, NPS cause a toxicological battle for the researchers, as factors such as the unpredictability and quick shift of the market complicate the detection. METHODS To evaluate challenges posed towards drug checking services, proficiency testing was set up to evaluate existing analytical techniques and investigate the capability to correctly identify circulating NPS. Twenty blind substances, covering the most common categories of substances, were analyzed according to the existing protocols of the existing drug checking services, including several analytical methods such as gas chromatography-mass spectrometry (GC-MS) and liquid chromatography with diode array detector (LC-DAD). RESULTS The proficiency test scores range from 80 to 97.5% accuracy. The most common issues and errors are mainly unidentified compounds, presumably due to no up-to-date libraries, and/ or confusion between structural isomers, such as 3- and 4-chloroethcathinone, or structural analogs, such as MIPLA (N-methyl-N-isopropyl lysergamide) and LSD (D-lysergic acid diethylamide). CONCLUSIONS The participating drug checking services have access to adequate analytical tools to provide feedback to drug users and provide up-to-date information on NPS.
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Affiliation(s)
- Margot Balcaen
- Unit Illicit Drugs, Lifestyle and Chronic Diseases, Scientific Direction Epidemiology, Sciensano, 1050 Brussels, Belgium
| | - Mireia Ventura
- Energy Control, Associació Benestar i Desenvolupament, 08041 Barcelona, Spain
| | - Cristina Gil
- Energy Control, Associació Benestar i Desenvolupament, 08041 Barcelona, Spain
| | - Anton Luf
- Clinical Department of Laboratory Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | | | - Mar Cunha
- Kosmicare, 1170-283 Lisbon, Portugal
| | | | - Danny Wolf
- Legal-high-Inhaltsstoffe, 60439 Frankfurt, Germany
| | - Peter Blanckaert
- Unit Illicit Drugs, Lifestyle and Chronic Diseases, Scientific Direction Epidemiology, Sciensano, 1050 Brussels, Belgium
| | - Eric Deconinck
- Service Medicines and Health Products, Scientific Direction Physical and Chemical Health Risks, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium
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Abstract
PURPOSE OF REVIEW Down syndrome regression disorder (DSRD) is a symptom cluster consisting of neuropsychiatric regression without cause. Although knowledge of this condition has accelerated over the last decade, prior studies have been limited by heterogenous nomenclature, diagnostic approaches and therapeutic interventions. This review highlights recent advances in the diagnosis and clinical approach to DSRD and reviews the most up-to-date literature on therapeutic interventions for this condition. RECENT FINDINGS Several multicentre studies have reported exciting findings on the presence of neurodiagnostic study abnormalities and responses to a variety of therapeutics, including psychotropics (including benzodiazepines), electroconvulsive therapy and immunotherapy. Differential response rates have been observed in the presence and absence of a variety of clinical and diagnostic factors. SUMMARY Individuals with DSRD are responsive to a variety of psychiatric pharmacotherapy and immunotherapy underscoring this phenotype may have multiple causes. Multidisciplinary care is helpful in the evaluation and management of individuals with this condition.
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Affiliation(s)
- Jonathan D Santoro
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, California
| | - Robyn A Filipink
- Department of Pediatrics, University of Pittsburgh School of Medicine
- Division of Child Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Nicole T Baumer
- Department of Neurology
- Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts
| | | | - Benjamin L Handen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Djerroud L, Leclair G, Sullivan T, Dagenais-Beaulé V. Visual compatibility and particle counter evaluations of syringes of intramuscular psychotropic coadministered solutions. Eur J Hosp Pharm 2023; 30:e97-e100. [PMID: 36002244 PMCID: PMC10086701 DOI: 10.1136/ejhpharm-2022-003378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/02/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Patients in the acute phase of agitation can require the administration of multiple drugs by intramuscular injection in order to temporarily stabilise their condition. Administration of multiple psychotropic medications in a single syringe can be beneficial to both the patient and healthcare professionals. However, there are very little data in the literature regarding psychotropic drug compatibility in syringes for acute agitation. OBJECTIVE The aim of this study was to assess the visual compatibility of various combinations of 12 intramuscular psychotropic medications in syringes, and to validate compatibility with the use of a particle counter. The medications evaluated were benztropine mesylate, diazepam, dimenhydrinate, diphenhydramine hydrochloride, haloperidol lactate, hydroxyzine, lorazepam, loxapine, methotrimeprazine, midazolam, olanzapine and zuclopenthixol acetate. METHODS Compounded solutions of medication combinations underwent visual inspection initially and after 0.25, 0.5, 1, 2 and 4 hours using a white background and a black background. In order to validate the compatibility results, the presence of particulate matter was determined by light obscuration. RESULTS This study identified 35 combinations that were visually compatible and 35 that were visually incompatible. We chose eight highly clinically relevant combinations to test using the requirements of the United States Pharmacopoeia (USP) chapter 788 (Particulate Matter in Injections). Of those eight, six were physically compatible, including the triple combinations of lorazepam and haloperidol with either benztropine or diphenhydramine. CONCLUSION These physical compatibility results will give healthcare professionals an idea of the possible compatible combinations of psychotropic drugs in syringes, and thus complete some of the missing data in the literature.
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Affiliation(s)
- Lydia Djerroud
- Faculté de Pharmacie, Université de Montréal, Montreal, Québec, Canada
- Pharmacy, Jewish General Hospital, Montreal, Québec, Canada
| | - Gregoire Leclair
- Faculté de Pharmacie, Université de Montréal, Montreal, Québec, Canada
- Groupe de Recherche Universitaire sur le Médicament, Université de Montréal, Montreal, Québec, Canada
| | | | - Vincent Dagenais-Beaulé
- Faculté de Pharmacie, Université de Montréal, Montreal, Québec, Canada
- Pharmacy, Jewish General Hospital, Montreal, Québec, Canada
- Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
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Hartmann S, Parrino L, Ensrud K, Stone KL, Redline S, Clark SR, Baumert M. Association between psychotropic medication and sleep microstructure: evidence from large population studies. J Clin Sleep Med 2023; 19:581-589. [PMID: 36546402 PMCID: PMC9978436 DOI: 10.5664/jcsm.10394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 12/24/2022]
Abstract
STUDY OBJECTIVES To assess the association between psychotropic medications and sleep microstructure in large community-based cohorts of older people. METHODS We analyzed overnight polysomnograms of 381 women from the Study of Osteoporotic Fractures (SOF) and 2,657 men from the Osteoporotic Fractures in Men Sleep Study (MrOS), who either used no psychotropic medication (n = 2,819), only benzodiazepines (n = 112), or only selective serotonin reuptake inhibitors (SSRI) (n = 107). Sleep microstructure (cyclic alternating pattern, CAP) was compared between the no medication group and psychotropic medication groups using the Mann-Whitney U test. Significant differences were investigated using multivariable linear regression adjusted for confounders. RESULTS CAP rate, arousal index, apnea-hypopnea index, and the frequency of slow, low-amplitude electroencephalography activation phases were significantly lower in MrOS participants using benzodiazepines than participants not taking psychotropic medication. SSRI users in MrOS experienced no altered sleep microstructure compared to those with no psychotropic use. SOF participants using benzodiazepines did not show similar associations with sleep microstructure. However, SSRI users from SOF had a significantly higher frequency of rapid, high-amplitude electroencephalography activation phases (A2 + 3) and periodic limb-movement index than participants not taking psychotropic medication. Multivariable linear regression adjusted for demographic, lifestyle, mood disorders, and health variables indicated additional significant associations between benzodiazepine usage and CAP rate and A2 + 3 index, respectively, in older men, and between CAP rate and SSRI usage in older women. CONCLUSIONS We identified significant associations between sleep microstructure and psychotropic drugs in MrOS and SOF, highlighting the importance of comprehensive sleep analysis, including CAP. Our results may improve understanding of the differences in sleep-wake mechanisms based on psychotropic usage. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Title: Outcomes of Sleep Disorders in Older Men; Identifier: NCT00070681; URL: https://clinicaltrials.gov/ct2/show/record/NCT00070681. CITATION Hartmann S, Parrino L, Ensrud K, et al. Association between psychotropic medication and sleep microstructure: evidence from large population studies. J Clin Sleep Med. 2023;19(3):581-589.
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Affiliation(s)
- Simon Hartmann
- The University of Adelaide, School of Electrical and Electronic Engineering, Adelaide, South Australia, Australia
- The University of Adelaide, Discipline of Psychiatry, Adelaide Medical School, Adelaide, South Australia, Australia
| | - Liborio Parrino
- Sleep Disorders Center, Department of Neurology, University of Parma, Parma, Emilia-Romagna, Italy
| | - Kristine Ensrud
- Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota
- Department of Medicine and Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota
| | - Katie L. Stone
- California Pacific Medical Center Research Institute, San Francisco, California
| | - Susan Redline
- Departments of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Scott R. Clark
- The University of Adelaide, Discipline of Psychiatry, Adelaide Medical School, Adelaide, South Australia, Australia
| | - Mathias Baumert
- The University of Adelaide, School of Electrical and Electronic Engineering, Adelaide, South Australia, Australia
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Gjerde H, Frost J. Prevalence of alcohol and drugs among drivers killed in road traffic crashes in Norway during 2011-2020. Traffic Inj Prev 2023; 24:256-261. [PMID: 36763459 DOI: 10.1080/15389588.2023.2174801] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/26/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Driving under the influence of alcohol or drugs is one of the main contributing causes of serious road traffic crashes (RTCs). This study aimed to investigate the involvement of alcohol and drugs in driver fatalities in Norway during 2011-2020 and compare the findings with data from the previous decade. METHODS We linked the results of forensic toxicology testing for alcohol and the 17 most commonly used drugs assigned with legal limits with data on fatal road traffic crashes obtained from Statistics Norway and the Norwegian Public Roads Administration. RESULTS The number of fatalities had decreased significantly since the previous decade, while the proportion of drivers and riders tested for alcohol and drug use increased. Blood alcohol concentrations at the legal limit or higher were found in 14.4% and psychoactive drugs were detected in 15.8% of the cases; 10.7% tested positive for illicit drugs, and 10.1% for medicinal drugs. The most prevalent illicit drugs were tetrahydrocannabinol (7.9%) and amphetamine/methamphetamine (4.7%), whereas the most prevalent medicinal drugs were clonazepam (3.7%) and diazepam (2.2%). CONCLUSIONS There was a marked reduction in the number of motor vehicle drivers killed in RTCs compared with the previous decade, and also a reduction in the prevalence of alcohol. For other substances, there were no marked changes in the prevalence.
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Affiliation(s)
- Hallvard Gjerde
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Joachim Frost
- Department of Clinical Pharmacology, St. Olav's University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Lei L, Samus QM, Thomas KS, Maust DT. Medication Costs and Use of Older Americans in Assisted Living Settings: a Nationally Representative Cross-Sectional Study. J Gen Intern Med 2023; 38:294-301. [PMID: 35132546 PMCID: PMC9905365 DOI: 10.1007/s11606-022-07434-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/21/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Assisted-living (AL) settings are an important residential care option for old and disabled Americans, but there are no national data characterizing medication use in AL. OBJECTIVE To investigate medication costs and use of older adults living in the AL settings compared to those in the community, independent living, and nursing home settings. DESIGN 2015 National Health and Aging Trends Study; nationally representative cross-sectional study. PATICIPANTS Respondents ≥ 65 years with Medicare Part D prescription drug coverage (n = 5980, representing 32.34 million older adults). MEASURES Total Part D medication costs; number of 30-day prescription fills; binary indicators for overall polypharmacy (≥ 5 and ≥ 10 concurrent medications), prescription fills of opioid and psychotropic medications including antipsychotics, benzodiazepines, gabapentinoids, antidepressants, and central nervous system-active (CNS-active) polypharmacy. RESULTS Adjusting for demographics, the annual medication costs among AL residents, at $3890, were twice as high as those of their community-dwelling counterparts ($1932; p < .01). All medication outcomes except opioids were higher for older adults in AL compared to community settings. While the adjusted number of 30-day prescription fills among AL residents was slightly lower than that of nursing home residents (89.5 vs. 106.2; p < .05), AL residents experienced equivalent rates of overall polypharmacy ≥ 10 medications (30.2% vs. 23.5%), antipsychotics (30.8% vs. 27.8%), benzodiazepines (30.7% vs. 32.6%), gabapentinoids (21.2% vs. 16.1%), and CNS-active polypharmacy (26.0% vs. 36.9%; p > .05 for all). Patterns of use across settings were consistent when limited to older adults with dementia. CONCLUSIONS Older Americans in AL experience a prescription medication burden similar to those in nursing homes. AL settings have an important opportunity to ensure their medication-related clinical services and supports match the needs of their residents.
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Affiliation(s)
- Lianlian Lei
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
| | - Quincy M Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kali S Thomas
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA
- Center of Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, RI, USA
| | - Donovan T Maust
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
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