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Drug interactions in Psychiatry

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https://www.readbyqxmd.com/read/29493375/tdm-in-psychiatry-and-neurology-a-comprehensive-summary-of-the-consensus-guidelines-for-therapeutic-drug-monitoring-in-neuropsychopharmacology-update-2017-a-tool-for-clinicians
#1
Georgios Schoretsanitis, Michael Paulzen, Stefan Unterecker, Markus Schwarz, Andreas Conca, Gerald Zernig, Gerhard Gründer, Ekkerhard Haen, Pierre Baumann, Niels Bergemann, Hans Willi Clement, Katharina Domschke, Gabriel Eckermann, Karin Egberts, Manfred Gerlach, Christine Greiner, Ursula Havemann-Reinecke, Gudrun Hefner, Renate Helmer, Ger Janssen, Eveline Jaquenoud-Sirot, Gerd Laux, Thomas Messer, Rainald Mössner, Matthias J Müller, Bruno Pfuhlmann, Peter Riederer, Alois Saria, Bernd Schoppek, Margarete Silva Gracia, Benedikt Stegmann, Werner Steimer, Julia C Stingl, Manfred Uhr, Sven Ulrich, Roland Waschgler, Gabriela Zurek, Christoph Hiemke
OBJECTIVES: Therapeutic drug monitoring (TDM) combines the quantification of drug concentrations in blood, pharmacological interpretation and treatment guidance. TDM introduces a precision medicine tool in times of increasing awareness of the need for personalized treatment. In neurology and psychiatry, TDM can guide pharmacotherapy for patient subgroups such as children, adolescents, pregnant women, elderly patients, patients with intellectual disabilities, patients with substance use disorders, individuals with pharmacokinetic peculiarities and forensic patients...
April 2018: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/29476699/improving-medication-safety-in-psychiatry-a-controlled-intervention-study-of-nurse-involvement-in-avoidance-of-potentially-inappropriate-prescriptions
#2
Ann Lykkegaard Soerensen, Marianne Lisby, Lars Peter Nielsen, Birgitte Klindt Poulsen, Jan Mainz
The aim of this controlled, before-and-after study in the Department of Psychiatry in a university hospital in Denmark, was to examine the potential effects and characteristics of nurses reviewing psychiatric patients' medication records to identify potentially inappropriate prescriptions (PIPs). The control group and the intervention group each consisted of two bed units chosen based on patients' diagnoses and age categories. There were 396 patients (age≥18 years) included in the study. Senior clinical pharmacology physicians performed medication reviews for all patients in the study; these medication reviews were considered gold standard...
February 24, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29471411/mechanisms-underpinning-the-polypharmacy-effects-of-medications-in-psychiatry
#3
Chiara C Bortolasci, Briana Spolding, Edward Callaly, Sheree Martin, Bruna Panizzutti, Srisaiyini Kidnapillai, Timothy Connor, Kyoko Hasebe, Mohammadreza Mohebbi, Olivia M Dean, Sean L McGee, Seetal Dodd, Laura Gray, Michael Berk, Ken Walder
Background: Bipolar disorder (BD) is a mental health condition with progressive social and cognitive function disturbances. Most patients' treatments are based on polypharmacy, but with no biological basis and little is known of the drugs' interactions. The aim of this study was to analyse the effects of lithium, valproate, quetiapine and lamotrigine, and the interactions between them, on markers of inflammation, bioenergetics, mitochondrial function and oxidative stress in neuron-like cells (NT2) and microglial cells...
February 19, 2018: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29314463/prevalence-and-patterns-of-anti-epileptic-medication-prescribing-in-the-treatment-of-epilepsy-in-older-adults-with-intellectual-disabilities
#4
M O'Dwyer, J Peklar, N Mulryan, P McCallion, M McCarron, M C Henman
BACKGROUND: The prevalence of epilepsy is higher in people with intellectual disability (ID) and increases with the degree of ID. Although life expectancy for people with ID is increasing, people with ID coexisting with epilepsy have a higher mortality rate, particularly those who had recent seizures. There have been few observational studies of the prevalence and patterns of anti-epileptic prescribing among older people with ID and epilepsy. The aim of this study was to investigate prevalence and patterns of anti-epileptic prescribing in the treatment of epilepsy in a representative population of older people with ID and epilepsy...
March 2018: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/29053436/is-the-danish-version-of-mate-feasible-a-pilot-study-on-feasibility-and-adequacy
#5
Morten Ellegaard Hell, Kjeld Andersen, Anette Søgaard Nielsen
OBJECTIVE: Assessment is pivotal to the work of healthcare professionals and social workers as it provides fundamental, systematic information that is essential when planning interventions. Many patients have addiction problems as well as psychiatric illness and they very often interact. An assessment tool addressing both areas would be beneficial for this large group of patients. This pilot study explores feasibility and adequacy of the Danish translation of the Measurements in Addiction for Triage and Evaluation (MATE) assessment in the following sectors: drug- and alcohol treatment, psychiatry and social service...
October 20, 2017: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/28992526/improved-efficacy-with-targeted-pharmacogenetic-guided-treatment-of-patients-with-depression-and-anxiety-a-randomized-clinical-trial-demonstrating-clinical-utility
#6
Paul Bradley, Michael Shiekh, Vishaal Mehra, Keith Vrbicky, Stacey Layle, Marilyn C Olson, Alejandra Maciel, Ali Cullors, Jorge A Garces, Andrew A Lukowiak
The objective of this study was to evaluate the effect of pharmacogenetics-guided treatment on patients diagnosed with depression and/or anxiety, in a diverse set of clinical settings, as compared to the standard of care. The trial design followed a prospective, randomized, subject- and rater-blinded approach enrolling 685 patients from clinical providers specializing in Psychiatry, Internal Medicine, Obstetrics & Gynecology, and Family Medicine. The NeuroIDgenetix(®) test uses a genetic variant panel of ten genes, along with concomitant medications, to make medication management recommendations based on gene-drug and drug-drug interactions for over 40 medications used in the treatment of depression and anxiety...
September 23, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28936009/collaborative-care-in-ambulatory-psychiatry-content-analysis-of-consultations-to-a-psychiatric-pharmacist
#7
REVIEW
Dorothy Gotlib, Jolene R Bostwick, Seema Calip, Elizabeth Perelstein, Jacob E Kurlander, Thomas Fluent
OBJECTIVES: To determine the volume and nature (or topic) of consultations submitted to a psychiatric pharmacist embedded in an ambulatory psychiatry clinic, within a tertiary care academic medical center and to increase our understanding about the ways in which providers consult with an available psychiatric pharmacist. EXPERIMENTAL DESIGN: Authors analyze and describe the ambulatory psychiatric pharmacist consultation log at an academic ambulatory clinic. All consultation questions were submitted between July 2012 and October 2014...
September 15, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28910830/consensus-guidelines-for-therapeutic-drug-monitoring-in-neuropsychopharmacology-update-2017
#8
C Hiemke, N Bergemann, H W Clement, A Conca, J Deckert, K Domschke, G Eckermann, K Egberts, M Gerlach, C Greiner, G Gründer, E Haen, U Havemann-Reinecke, G Hefner, R Helmer, G Janssen, E Jaquenoud, G Laux, T Messer, R Mössner, M J Müller, M Paulzen, B Pfuhlmann, P Riederer, A Saria, B Schoppek, G Schoretsanitis, M Schwarz, M Silva Gracia, B Stegmann, W Steimer, J C Stingl, M Uhr, S Ulrich, S Unterecker, R Waschgler, G Zernig, G Zurek, P Baumann
Therapeutic drug monitoring (TDM) is the quantification and interpretation of drug concentrations in blood to optimize pharmacotherapy. It considers the interindividual variability of pharmacokinetics and thus enables personalized pharmacotherapy. In psychiatry and neurology, patient populations that may particularly benefit from TDM are children and adolescents, pregnant women, elderly patients, individuals with intellectual disabilities, patients with substance abuse disorders, forensic psychiatric patients or patients with known or suspected pharmacokinetic abnormalities...
September 14, 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28895028/prevalence-of-qt-interval-prolonging-drug-drug-interactions-qt-ddis-in-psychiatry-wards-of-tertiary-care-hospitals-in-pakistan-a-multicenter-cross-sectional-study
#9
Qasim Khan, Mohammad Ismail, Iqbal Haider, Fahadullah Khan
Background QT prolongation and associated arrhythmias, torsades de pointes (TdP), are considerable negative outcomes of many antipsychotic and antidepressant agents frequently used by psychiatric patients. Objective To identify the prevalence, levels, and predictors of QT prolonging drug-drug interactions (QT-DDIs), and AZCERT (Arizona Center for Education and Research on Therapeutics) classification of drugs involved in QT-DDIs. Setting Psychiatry wards of three major tertiary care hospitals of Khyber-Pakhtunkhwa, Pakistan...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28894302/g%C3%AE-%C3%AE-subunit-activation-promotes-dopamine-efflux-through-the-dopamine-transporter
#10
J Garcia-Olivares, T Baust, S Harris, P Hamilton, A Galli, S G Amara, G E Torres
The dopamine transporter (DAT) is an important regulator of brain dopamine (DA) homeostasis, controlling the intensity and duration of DA signaling. DAT is the target for psychostimulants-like cocaine and amphetamine-and plays an important role in neuropsychiatric disorders, including attention-deficit hyperactivity disorder and drug addiction. Thus, a thorough understanding of the mechanisms that regulate DAT function is necessary for the development of clinical interventions to treat DA-related brain disorders...
December 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28680170/pharmacokinetic-interactions-between-valproic-acid-and-lorazepam-pivotal-study-a-review-of-site-specific-practices
#11
Joane Y Tang, Tony K L Kiang, Mary H H Ensom
BACKGROUND: Coadministration of lorazepam and valproic acid is identified by tertiary references as causing a major drug interaction that requires therapy modification and dosage adjustments. The proposed mechanism involves inhibition of lorazepam glucuronidation via direct inhibition of uridine 5'-diphosphate-glucuronosyltransferase enzymes by valproic acid. However, the clinical significance of this interaction is unclear. OBJECTIVES: To identify site-specific practices and assess clinical responses to the interaction between valproic acid and lorazepam...
May 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28676017/antipsychotic-drugs-from-receptor-binding-profiles-to-metabolic-side-effects
#12
Spyridon Siafis, Dimitrios Tzachanis, Myrto Samara, Georgios Papazisis
Antipsychotic-induced metabolic side effects are major concerns in psychopharmacology and clinical psychiatry. Their pathogenetic mechanisms are still not elucidated. Antipsychotic drugs seem to interfere with feeding behaviors and energy balance processes that control metabolic regulation. Reward and energy balance centers in central nervous system constitute the central level of metabolic regulation. The peripheral level consists of skeletal muscles, the liver, the pancreas, the adipose tissue and neuroendocrine connections...
June 30, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28521005/using-directed-acyclic-graphs-in-epidemiological-research-in-psychosis-an-analysis-of-the-role-of-bullying-in-psychosis
#13
Giusi Moffa, Gennaro Catone, Jack Kuipers, Elizabeth Kuipers, Daniel Freeman, Steven Marwaha, Belinda R Lennox, Matthew R Broome, Paul Bebbington
Modern psychiatric epidemiology researches complex interactions between multiple variables in large datasets. This creates difficulties for causal inference. We argue for the use of probabilistic models represented by directed acyclic graphs (DAGs). These capture the dependence structure of multiple variables and, used appropriately, allow more robust conclusions about the direction of causation. We analyzed British national survey data to assess putative mediators of the association between bullying victimization and persecutory ideation...
October 21, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/28344933/precision-medicine-the-golden-gate-for-detection-treatment-and-prevention-of-alzheimer-s-disease
#14
H Hampel, S E O'Bryant, J I Castrillo, C Ritchie, K Rojkova, K Broich, N Benda, R Nisticò, R A Frank, B Dubois, V Escott-Price, S Lista
During this decade, breakthrough conceptual shifts have commenced to emerge in the field of Alzheimer's disease (AD) recognizing risk factors and the non-linear dynamic continuum of complex pathophysiologies amongst a wide dimensional spectrum of multi-factorial brain proteinopathies/neurodegenerative diseases. As is the case in most fields of medicine, substantial advancements in detecting, treating and preventing AD will likely evolve from the generation and implementation of a systematic precision medicine strategy...
December 2016: Journal of Prevention of Alzheimer's Disease
https://www.readbyqxmd.com/read/28242873/reduction-of-smoking-urges-with-intranasal-insulin-a-randomized-crossover-placebo-controlled-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
A Hamidovic, M Khafaja, V Brandon, J Anderson, G Ray, A M Allan, M R Burge
Many cigarette smokers express a desire to quit smoking, but ~85% of cessation attempts fail. In our attempt to delineate genetic modulators of smoking persistence, we have earlier shown that a locus within an ~250 kb haplotype block spanning the 5' untranslated region region of insulin-degrading enzyme is associated with serum cotinine levels; the study's measure of smoking quantity. Based on our findings, and coupled with recent preclinical studies showing the importance of multiple neuropeptides in reinstatement of drug use, we formulated intranasal insulin to evaluate its efficacy during acute abstinence from smoking...
October 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28236996/-modeling-for-clinical-trial-in-psychiatry-rationale-benefits-and-limitations
#16
N Simon, J-M Azorin, R Belzeaux, M Adida, A Kaladjian
Drug development of new compounds implies to define the dosage as well as the conditions of their use (indication, treatment duration, drug interactions, warnings …). This information requires the identification of the time course response. The decisions made during the clinical phases are now based on mathematical models. These models are continuously described and improved during all phases of the drug development using data collected in healthy volunteers and patients. Their objectives are to describe the most precisely, the link between the compound characteristics (pharmacology), the patient demographics and the effects...
December 2016: L'Encéphale
https://www.readbyqxmd.com/read/28115743/adnp-nap-dramatically-increase-microtubule-end-binding-protein-tau-interaction-a-novel-avenue-for-protection-against-tauopathy
#17
Y Ivashko-Pachima, C Laura Sayas, A Malishkevich, I Gozes
Activity-dependent neuroprotective protein (ADNP), vital for brain formation and cognitive function, is mutated in autism and linked to neurodegenerative/psychiatric diseases. An eight-amino-acid peptide snippet of ADNP, NAP (NAPVSIPQ), identified as a smallest active fragment, includes the SxIP microtubule (MT) end-binding protein (EB) association motif, and enhances ADNP-EB3 interaction. Depletion of EB1 or EB3 abolishes NAP protection against zinc intoxication. Furthermore, NAP enhances Tau-MT interaction, and Tau regulates the localization and function of EB1 and EB3 in developing neuronal cells...
September 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/27871720/-guidelines-for-the-prescription-of-mood-stabilizers-for-adolescents-a-literature-review
#18
G Munch, N Godart
INTRODUCTION: Adolescence is a unique phase of the human developmental process. In adolescents, psychotropic medications may have different efficacy and tolerance profiles compared to those at other stages of the lifespan. Mood stabilizers are a complex pharmacological category including lithium, some anticonvulsants, and some second generation antipsychotics. Focusing on this class of pharmacological agents, we aim to answer the following questions: in which indications and according to which modalities should mood stabilizers be prescribed during adolescence? METHODS: Information was sought from the websites of the French Haute Autorité de santé (HAS) and Agence nationale de sécurité du médicament et des produits de santé (ANSM), the American Food and Drug Administration (FDA) and the British National Institute for Health and Clinical Excellence (NICE)...
October 2017: L'Encéphale
https://www.readbyqxmd.com/read/27738373/a-prospective-surveillance-of-pharmacovigilance-of-psychotropic-medicines-in-a-developing-country
#19
Jisha Myalil Lucca, Madhan Ramesh, Gurumurthy Parthasarathi, Dushad Ram
AIMS/OBJECTIVES: Psychotropic drugs are associated with significant short-term and long-term safety issues which may affect patients' mental health, physical health and cost of care. EXPERIMENTAL DESIGNS: This was a prospective study conducted in psychiatry department of a tertiary care hospital. Study included patients of any age and either sex who presented with psychiatric illness as diagnosed by ICD-10 and were receiving at least one psychotropic agent. The study involved both intensive and spontaneous reporting methods to identify ADRs...
March 1, 2016: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/27662279/study-329-continuation-phase-safety-and-efficacy-of-paroxetine-and-imipramine-in-extended-treatment-of-adolescent-major-depression
#20
RANDOMIZED CONTROLLED TRIAL
Joanna Le Noury, John M Nardo, David Healy, Jon Jureidini, Melissa Raven, Catalin Tufanaru, Elia Abi-Jaoude
OBJECTIVE: This is an analysis of the unpublished continuation phase of Study 329, the primary objective of which was to compare the efficacy and safety of paroxetine and imipramine with placebo in the treatment of adolescents with unipolar major depression. The objectives of the continuation phase were to assess safety and relapse rates in the longer term. The objective of this publication, under the Restoring Invisible and Abandoned Trials (RIAT) initiative, was to see whether access to and analysis of the previously unpublished dataset from the continuation phase of this randomized controlled trial would have clinically relevant implications for evidence-based medicine...
September 17, 2016: International Journal of Risk & Safety in Medicine
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