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https://www.readbyqxmd.com/read/28764992/impact-on-gaba-systems-in-monogenetic-developmental-cns-disorders-clues-to-symptomatic-treatment
#1
REVIEW
Dietmar Benke, Hanns Möhler
Animal studies of several single-gene disorders demonstrate that reversing the molecular signaling deficits can result in substantial symptomatic improvements in function. Focusing on the ratio of excitation to inhibition as a potential pathophysiological hallmark, seven single-gene developmental CNS disorders are reviewed which are characterized by a striking dysregulation of neuronal inhibition. Deficits in inhibition and excessive inhibition are found. The examples of developmental disorders encompass Neurofibromatosis type 1, Fragile X syndrome, Rett syndrome, Dravet syndrome including autism-like behavior, NONO-mutation-induced intellectual disability, Succinic semialdehyde dehydrogenase deficiency and Congenital nystagmus due to FRMD7 mutations...
July 29, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28728114/variation-in-receipt-of-pharmacotherapy-for-alcohol-use-disorders-across-racial-ethnic-groups-a-national-study-in-the-u-s-veterans-health-administration
#2
Emily C Williams, Shalini Gupta, Anna D Rubinsky, Joseph E Glass, Rhonda Jones-Webb, Kara M Bensley, Alex H S Harris
OBJECTIVE: Pharmacologic treatment is recommended for alcohol use disorders (AUD), but most patients do not receive it. Although racial/ethnic minorities have greater AUD consequences than whites, whether AUD medication receipt varies across race/ethnicity is unknown. We evaluate this in a national sample. METHODS: Electronic health records data were extracted for all black, Hispanic, and/or white patients who received care at the U.S. Veterans Health Administration (VA) during Fiscal Year 2012 and had a documented AUD diagnosis...
July 11, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28669022/pharmacological-treatment-of-bipolar-disorder-with-comorbid-alcohol-use-disorder
#3
Andrew Naglich, Bryon Adinoff, E Sherwood Brown
Bipolar disorder (BD) spectrum and alcohol use disorders (AUDs) commonly occur together. Comorbidity between the two conditions predisposes patients to elevated risks of adverse outcomes, including hospitalization and suicide, compared with either condition alone. Despite the consistent relationship observed between BD and AUD, the underlying cause remains incompletely characterized. Few trials conducted have been able to identify promising interventions for patients with these disease states. The antipsychotic quetiapine has been evaluated most commonly as a therapeutic agent for patients with BD and AUD followed by naltrexone and acamprosate...
August 2017: CNS Drugs
https://www.readbyqxmd.com/read/28658981/pharmacotherapy-of-alcoholism-an-update-on-approved-and-off-label-medications
#4
Michael Soyka, Christian A Müller
Only a few medications are available for the treatment of alcohol use disorders (AUDs). Areas covered: This paper discusses approved AUD medications, including the opioid antagonists naltrexone and nalmefene (the latter is licensed for reduction of alcohol consumption only), the putative glutamate receptor antagonist acamprosate and the aldehyde dehydrogenase inhibitor disulfiram. It also covers off-label medications of interest, including topiramate, gabapentin, ondansetron, varenicline, baclofen, sodium oxybate and antidepressants...
July 24, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28616095/acamprosate-in-a-mouse-model-of-fragile-x-syndrome-modulation-of-spontaneous-cortical-activity-erk1-2-activation-locomotor-behavior-and-anxiety
#5
Tori L Schaefer, Matthew H Davenport, Lindsay M Grainger, Chandler K Robinson, Anthony T Earnheart, Melinda S Stegman, Anna L Lang, Amy A Ashworth, Gemma Molinaro, Kimberly M Huber, Craig A Erickson
BACKGROUND: Fragile X Syndrome (FXS) occurs as a result of a silenced fragile X mental retardation 1 gene (FMR1) and subsequent loss of fragile X mental retardation protein (FMRP) expression. Loss of FMRP alters excitatory/inhibitory signaling balance, leading to increased neuronal hyperexcitability and altered behavior. Acamprosate (the calcium salt of N-acetylhomotaurinate), a drug FDA-approved for relapse prevention in the treatment of alcohol dependence in adults, is a novel agent with multiple mechanisms that may be beneficial for people with FXS...
2017: Journal of Neurodevelopmental Disorders
https://www.readbyqxmd.com/read/28566752/metabolomics-biomarkers-to-predict-acamprosate-treatment-response-in-alcohol-dependent-subjects
#6
David J Hinton, Marely Santiago Vázquez, Jennifer R Geske, Mario J Hitschfeld, Ada M C Ho, Victor M Karpyak, Joanna M Biernacka, Doo-Sup Choi
Precision medicine for alcohol use disorder (AUD) allows optimal treatment of the right patient with the right drug at the right time. Here, we generated multivariable models incorporating clinical information and serum metabolite levels to predict acamprosate treatment response. The sample of 120 patients was randomly split into a training set (n = 80) and test set (n = 40) five independent times. Treatment response was defined as complete abstinence (no alcohol consumption during 3 months of acamprosate treatment) while nonresponse was defined as any alcohol consumption during this period...
May 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28500210/first-line-medications-for-alcohol-use-disorders-among-public-drug-plan-beneficiaries-in-ontario
#7
Sheryl Spithoff, Suzanne Turner, Tara Gomes, Diana Martins, Samantha Singh
OBJECTIVE: To examine use of first-line alcohol use disorder (AUD) medications (naltrexone and acamprosate) among public drug plan beneficiaries in the year following an AUD diagnosis. DESIGN: Retrospective population-based cohort study. SETTING: Ontario. PARTICIPANTS: Individuals eligible for public drug plan benefits who had an AUD diagnosis at a hospital visit between April 1, 2011, and March 31, 2012. MAIN OUTCOME MEASURES: Number of AUD medications dispensed to public drug plan beneficiaries who had a recent hospital visit with an AUD diagnosis, and number of prescriptions dispensed per person...
May 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28476269/barriers-to-and-facilitators-of-pharmacotherapy-for-alcohol-use-disorder-in-va-residential-treatment-programs
#8
Andrea K Finlay, Laura S Ellerbe, Jessie J Wong, Christine Timko, Anna D Rubinsky, Shalini Gupta, Thomas R Bowe, Jennifer L Burden, Alex H S Harris
Among US military veterans, alcohol use disorder (AUD) is prevalent and in severe cases patients need intensive AUD treatment beyond outpatient care. The Department of Veterans Affairs (VA) delivers intensive, highly structured addiction and psychosocial treatment through residential programs. Despite the evidence supporting pharmacotherapy among the effective treatments for AUD, receipt of these medications (e.g., naltrexone, acamprosate) among patients in residential treatment programs varies widely. In order to better understand this variation, the current study examined barriers and facilitators to use of pharmacotherapy for AUD among patients in VA residential treatment programs...
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28413623/glutamate-plasticity-woven-through-the-progression-to-alcohol-use-disorder-a-multi-circuit-perspective
#9
REVIEW
Lara Hwa, Joyce Besheer, Thomas Kash
Glutamate signaling in the brain is one of the most studied targets in the alcohol research field. Here, we report the current understanding of how the excitatory neurotransmitter glutamate, its receptors, and its transporters are involved in low, episodic, and heavy alcohol use. Specific animal behavior protocols can be used to assess these different drinking levels, including two-bottle choice, operant self-administration, drinking in the dark, the alcohol deprivation effect, intermittent access to alcohol, and chronic intermittent ethanol vapor inhalation...
2017: F1000Research
https://www.readbyqxmd.com/read/28406579/disparities-in-pharmacotherapy-for-alcohol-use-disorder-in-the-context-of-universal-health-care-a-swedish-register-study
#10
Katherine J Karriker-Jaffe, Jianguang Ji, Jan Sundquist, Kenneth S Kendler, Kristina Sundquist
BACKGROUND AND AIMS: Pharmacotherapy can be an important part of the continuum of care for alcohol use disorder (AUD). The Swedish universal health-care system emphasizes provision of care to marginalized groups. The primary aim was to test associations of neighborhood deprivation and disadvantaged social status with receipt of AUD pharmacotherapy in this context. DESIGN: Data from linked population registers were used to follow an open cohort over 7 years. SETTING: Sweden...
August 2017: Addiction
https://www.readbyqxmd.com/read/28319159/drug-therapy-for-alcohol-dependence-in-primary-care-in-the-uk-a-clinical-practice-research-datalink-study
#11
Andrew Thompson, Darren M Ashcroft, Lynn Owens, Tjeerd P van Staa, Munir Pirmohamed
AIM: To evaluate drug therapy for alcohol dependence in the 12 months after first diagnosis in UK primary care. DESIGN: Open cohort study. SETTING: General practices contributing data to the UK Clinical Practice Research Database. PARTICIPANTS: 39,980 people with an incident diagnosis of alcohol dependence aged 16 years or older between 1 January 1990 and 31 December 2013. MAIN OUTCOME MEASURE: Use of pharmacotherapy (acamprosate, disulfiram, naltrexone, baclofen and topiramate) to promote abstinence from alcohol or reduce drinking to safe levels in the first 12 months after a recorded diagnosis of alcohol dependence...
2017: PloS One
https://www.readbyqxmd.com/read/28301219/management-of-comorbid-bipolar-disorder-and-substance-use-disorders
#12
Ihsan M Salloum, Edson Sherwood Brown
BACKGROUND: The comorbidity of substance use disorders (SUDs) in bipolar disorder is among the highest in psychiatric disorders. Evidence-based controlled psychosocial or pharmacological interventions trials, which may guide treatment decisions, have not been systematically reviewed. OBJECTIVE: To present a narrative review of the public health and clinical significance of this condition, including diagnostic and treatment implications, and to evaluate controlled trials conducted to date...
July 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28240173/personalized-medicine-of-alcohol-addiction-pharmacogenomics-and-beyond
#13
Vangelis George Manolopoulos, Georgia Ragia
Alcohol addiction or alcoholism is the most severe form of problem drinking. A variety of treatment methods for alcoholism are currently available that combine medications, behavioral treatment and peer support. The drugs that are currently approved by the U.S. Food and Drug Administration (FDA) for treatment of alcohol dependence are disulfiram, naltrexone and acamprosate. For many patients, however, these treatments are not effective. Evidence from a number of different studies suggests that different factors, both psychosocial and economic, as well as genetic variation, are significant contributors to interindividual variation both of clinical presentation of alcohol problems and response to a given treatment...
February 23, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28220511/review-article-pharmacotherapy-for-alcohol-dependence-the-why-the-what-and-the-wherefore
#14
REVIEW
E T Goh, M Y Morgan
BACKGROUND: The development of alcohol dependence is associated with significant morbidity and mortality. For the majority of affected people the most appropriate goal, in terms of drinking behaviour, is abstinence from alcohol. Psychosocial intervention is the mainstay of the treatment but adjuvant pharmacotherapy is also available and its use recommended. AIM: To provide an updated analysis of current and potential pharmacotherapeutic options for the management of alcohol dependence...
February 20, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28132696/socioeconomic-and-geographic-disparities-in-access-to-pharmacotherapy-for-alcohol-dependence
#15
Kirsten C Morley, Warren Logge, Sallie-Anne Pearson, Andrew Baillie, Paul S Haber
A higher rate of alcohol-attributable morbidity and mortality exists in remote and socioeconomically disadvantaged regions of Australia. This study aimed to explore the dispensing pattern of pharmacotherapy for alcohol dependence across these groups. A retrospective cohort study of patients (aged 15-84) dispensed acamprosate or naltrexone (July 2009-June 2013) was conducted. Observed dispensing rates were obtained for 541 local government areas (LGA) of Australia. Expected dispensing was based on national rates and age standardized to each LGA...
March 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28093021/altering-ethanol-pharmacokinetics-to-treat-alcohol-use-disorder-can-you-teach-an-old-dog-new-tricks
#16
Carolina L Haass-Koffler, Fatemeh Akhlaghi, Robert M Swift, Lorenzo Leggio
Disulfiram was the first pharmacotherapy approved to treat alcohol use disorder in the 1950s. Disulfiram alters ethanol pharmacokinetics and causes uncomfortable reactions (e.g. headache, tachycardia, nausea, flushing and hypotension) when alcohol is consumed. Subsequently, a better understanding of the neurobiological pathways involved in alcohol use disorder led to the development of other medications (e.g. naltrexone and acamprosate). These neurobiological-based medications act on alcohol use disorder-related phenotypes including craving, stress, and/or withdrawal...
January 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28064151/supervised-disulfiram-s-superior-effectiveness-in-alcoholism-treatment-ethical-methodological-and-psychological-aspects
#17
REVIEW
Colin Brewer, Emmanuel Streel, Marilyn Skinner
Disulfiram (DSF) causes the ALDH-mediated deterrence of alcohol consumption. We review recent meta-analyses showing the superior effectiveness of supervised disulfiram (SD) in alcoholism treatment compared with oral naltrexone or acamprosate (ACP). The success of SD is also consistent with the almost complete absence of alcoholism in Japanese homozygotes for 'inefficient' ALDH. However, SD is an underused treatment and some clinicians have ethical objections to DSF. We examine these objections and argue that they are based on a misunderstanding of how DSF works...
March 9, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/27984008/treatment-of-alcohol-use-disorder-in-patients-with-alcoholic-liver-disease
#18
REVIEW
Lorenzo Leggio, Mary R Lee
Alcohol is a leading cause of liver disease worldwide. Although alcohol abstinence is the crucial therapeutic goal for patients with alcoholic liver disease, these patients have less access to psychosocial, behavioral, and/or pharmacologic treatments for alcohol use disorder. Psychosocial and behavioral therapies include 12-step facilitation, brief interventions, cognitive behavioral therapy, and motivational enhancement therapy. In addition to medications approved by the US Food and Drug Administration for alcohol use disorder (disulfiram, naltrexone, and acamprosate), recent efforts to identify potential new treatments have yielded promising candidate pharmacotherapies...
February 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/27895598/pharmacotherapy-for-alcohol-use-disorders-physicians-perceptions-and-practices
#19
Caridad Ponce Martinez, Priyanka Vakkalanka, Nassima Ait-Daoud
BACKGROUND AND OBJECTIVES: Alcohol use disorders (AUDs) are an important cause of morbidity and mortality. Despite the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommendations that medications be considered for patients with alcohol dependence, the mainstay of treatment has been counseling. We designed a survey to assess the treatment practices of psychiatrists and family medicine (FM) physicians in an effort to identify barriers to the use of pharmacotherapy and develop strategies to increase physician knowledge and utilization of these medications...
2016: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/27890540/association-of-plasma-calcium-concentrations-with-alcohol-craving-new-data-on-potential-pathways
#20
Rilana Schuster, Anne Koopmann, Martin Grosshans, Iris Reinhard, Rainer Spanagel, Falk Kiefer
Recently, calcium was suggested to be the active moiety of acamprosate. We examined plasma calcium concentrations in association with severity of alcohol dependence and its interaction with regulating pathways and alcohol craving in alcohol-dependent patients. 47 inpatient alcohol-dependent patients undergoing detoxification treatment underwent laboratory testing, including calcium, sodium, liver enzymes as well as serum concentrations of calcitonin, parathyroid hormone and vitamin D. The psychometric dimension of craving was analyzed with the Obsessive Compulsive Drinking Scale (OCDS)...
November 24, 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
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