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A Randomized Placebo-Controlled Clinical Trial Exploring the Short-Term Cognitive and Cerebrovascular Effects of Consuming Peppermint Tea: A Mediation Study 一项随机安慰剂对照临床试验,探讨薄荷茶对短期认知和脑血管的影响:一项中介研究
IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-04-06 DOI: 10.1002/hup.70005
Luka Netzler, Brian Lovell

The cognitive-enhancing effects of peppermint have been widely reported. Vasodilation, causing an increase in cerebral blood flow (CBF) in the prefrontal cortex, has been implicated as a possible mediator. We tested this here. A total of N = 25 individuals, all aged over 18 years, were recruited via convenience sampling. A randomized, single blind placebo-controlled, independent groups design was used to assess whether groups (peppermint vs. placebo control) could be differentiated with respect to change in cognition, assessed via a computerized battery, and change in cerebral blood flow, assessed with Near-Infrared-Spectroscopy (NIRS), from pre-post intervention. Groups disparities in both cognitive and cerebrovascular change scores (from pre-post intervention) emerged. Improvements in cognitive performance were better in the peppermint group. Increases in hemodynamic activity, indexed by Oxygenated (Oxy-Hb) and Total hemoglobin (Total-Hb), were also greater in the peppermint group. Cerebrovascular changes from pre-to post-intervention were unrelated to cognitive changes over the same period, ruling out mediation effects. In conclusion, 200 mL of peppermint, consumed as tea, effectively boosted cognition and cerebral blood flow in otherwise healthy adults. Increased cerebral blood flow, however, did not mediate the cognitive-enhancing effects of peppermint. Future research incorporating larger samples and exploring other neurophysiological mediators is encouraged.

薄荷的认知增强作用已被广泛报道。血管舒张,引起前额叶皮层脑血流(CBF)的增加,被认为是一个可能的中介。我们在这里进行了测试。采用方便抽样法,共招募了25名年龄在18岁以上的个体。采用随机、单盲安慰剂对照、独立组设计来评估各组(薄荷组与安慰剂组)在认知变化(通过计算机化电池评估)和脑血流变化(通过近红外光谱(NIRS)评估)方面是否可以从干预前后区分开来。认知和脑血管变化评分(从干预前到干预后)出现组间差异。薄荷组在认知能力方面的改善更好。以氧合血红蛋白(Oxy-Hb)和总血红蛋白(Total- hb)为指标的血流动力学活性增加,薄荷组也更大。干预前后的脑血管变化与同期的认知变化无关,排除了中介作用。综上所述,200毫升的薄荷茶可以有效地促进健康成年人的认知和脑血流量。然而,脑血流量的增加并没有调节薄荷的认知增强作用。鼓励未来的研究纳入更大的样本和探索其他神经生理介质。
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引用次数: 0
Alcohol Consumption During the COVID-19 Pandemic: A Critical Review COVID-19大流行期间的酒精消费:一项重要审查
IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-03-25 DOI: 10.1002/hup.70004
A. Merlo, P.A. Hendriksen, N.R. Severeijns, J. Garssen, G. Bruce, J.C. Verster

Objective

The purpose of this systematic review was to summarize the impact of the 2019 coronavirus disease (COVID-19) pandemic on individuals' alcohol consumption.

Methods

PubMed was searched to identify relevant studies. Articles were included if they provided information on overall (changes in) alcohol consumption, and factors that may influence alcohol consumption including demographics, socioeconomic status, educational background, living situation, and health status. Following screening, 100 articles were identified and included in this review.

Results

Overall findings show no change (51%) or a reduction (23%) in alcohol consumption during the COVID-19 pandemic. However, across countries, on average 1 in 4 individuals reported an increase in alcohol consumption (26%), in particular during the COVID-19 lockdown periods. Most common correlates of increased alcohol consumption were being female, having a child at home, higher educational level, and poorer mental health (including higher scores for stress, anxiety and depression).

Conclusion

Although overall alcohol consumption was reduced during the COVID-19 pandemic, a considerable subpopulation of drinkers increased their alcohol consumption.

目的总结2019冠状病毒病(COVID-19)大流行对个体饮酒量的影响。方法检索PubMed检索相关文献。如果文章提供了总体(变化)酒精消费的信息,以及可能影响酒精消费的因素,包括人口统计、社会经济地位、教育背景、生活状况和健康状况,则纳入。经过筛选,确定了100篇文章并纳入本综述。总体结果显示,在COVID-19大流行期间,饮酒量没有变化(51%)或减少(23%)。然而,在各国,平均每4个人中就有1人报告酒精消费量增加(26%),特别是在COVID-19封锁期间。饮酒增加最常见的相关因素是女性、家里有孩子、受教育程度较高和心理健康状况较差(包括压力、焦虑和抑郁得分较高)。结论:尽管在COVID-19大流行期间,总体饮酒量有所减少,但相当一部分饮酒者的饮酒量增加了。
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引用次数: 0
Baseline Exposure to Antipsychotic Medication in Young People at Clinical High Risk for Psychosis: A 2-Year Italian Follow-Up Study 临床精神病高危年轻人基线抗精神病药物暴露:一项为期2年的意大利随访研究
IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-02-17 DOI: 10.1002/hup.70003
Lorenzo Pelizza, Alessandro Di Lisi, Emanuela Leuci, Emanuela Quattrone, Derna Palmisano, Simona Pupo, Pietro Pellegrini, Marco Menchetti

Objective

Despite various models examining baseline factors, predicting outcomes in individuals at clinical high risk for psychosis (CHR-P) remains challenging. Specifically, neglecting factors like ongoing antipsychotic (AP) medications introduce bias and reduce method precision. The main aim of this research was to determine if the presence of AP prescription at baseline identifies a CHR-P subgroup with worse prognostic outcomes over a 2-year period.

Methods

A group of 180 FEP individuals (92 CHR-P/AP+, 88 CHR-P/AP−) were evaluated at baseline and after 24 months using the PANSS and GAF scales. Individuals with baseline AP prescription were included in the CHR-P/AP+ subgroup; those not taking APs were grouped as CHR-P/AP−. Univariate Cox regression analysis and mixed-design ANOVA were performed.

Results

After 2 years, CHR-P/AP+ had a higher rate of new hospitalization but lower rate of service disengagement. No significant inter-group difference in psychosis transition rate was found. A “time-×-group” interaction effect on longitudinal improvement in PANSS total score was observed in CHR-P/AP+ subjects.

Conclusions

It is advisable to conduct a more extensive outcome evaluation beyond the psychometric criteria for CHR-P and the mere consideration of psychosis transition. Such an approach would facilitate the identification of specific CHR-P subgroups with divergent prognoses and different AP response.

目的尽管有各种各样的模型检查基线因素,但预测临床精神病高危个体(chrp)的预后仍然具有挑战性。具体来说,忽略诸如持续的抗精神病药物(AP)等因素会引入偏差并降低方法的准确性。本研究的主要目的是确定基线时AP处方的存在是否可以确定2年内预后较差的chrp亚组。方法采用PANSS和GAF量表在基线和24个月后对180例FEP患者(其中chrp - p /AP+ 92例,chrp - p /AP−88例)进行评估。具有基线AP处方的个体被纳入chrp /AP+亚组;未服用AP组分为chrp - p /AP -。进行单因素Cox回归分析和混合设计方差分析。结果2年后,chrp /AP+组的新住院率较高,但离职率较低。两组间精神病转化率无显著差异。chrp /AP+组PANSS总分纵向改善存在“时间-×-group”交互作用。结论除了chrp的心理测量标准和单纯考虑精神病转变外,还应进行更广泛的结局评估。这种方法将有助于识别具有不同预后和不同AP反应的特定chrp亚组。
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引用次数: 0
Acute Administration of 10 mg Methylphenidate on Cognitive Performance and Visual Scanning in Healthy Adults: Randomised, Double-Blind, Placebo-Controlled Study 急性给予10mg哌醋甲酯对健康成人认知表现和视觉扫描的影响:随机、双盲、安慰剂对照研究
IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-02-10 DOI: 10.1002/hup.70002
Blair Aitken, Luke A. Downey, Serah Rose, Brooke Manning, Thomas R. Arkell, Brook Shiferaw, Amie C. Hayley

Objective

To examine the effect of a low dose (10 mg) of methylphenidate on cognitive performance, visuospatial working memory (VSWM) and gaze behaviour capabilities in healthy adults.

Methods

This randomised, double-blind, placebo-controlled and crossover study examined the effects of 10 mg methylphenidate on cognitive performance, VSWM and gaze behaviour. Fixation duration and rate, gaze transition entropy, and stationary gaze entropy were used to quantify visual scanning efficiency in 25 healthy adults (36% female, mean ± SD age = 33.5 ± 7.8 years, BMI = 24.1 ± 2.9 kg/m2). Attention, memory, and reaction time were assessed using the E-CogPro test battery.

Results

Methylphenidate significantly enhanced performance in numeric working memory tasks, reflected by reduced errors and increased accuracy relative to placebo. No significant changes were observed in other cognitive or visual scanning metrics.

Conclusions

A low dose of methylphenidate improves limited domains of psychomotor speed and accuracy but does not affect visual scanning efficiency. This suggests limited usefulness as a general pro-cognitive aid and raises the possibility of a lower threshold of effect for measurable psychostimulant-induced changes to visual scanning behaviour. Further research is needed to explore these potential dose-response relationships and effects across diverse populations.

Trial Registration

ACTRN12620000499987

目的探讨低剂量(10 mg)哌醋甲酯对健康成人认知能力、视觉空间工作记忆(VSWM)和凝视行为能力的影响。方法本研究采用随机、双盲、安慰剂对照和交叉试验,研究了10mg哌醋甲酯对认知能力、VSWM和凝视行为的影响。采用注视时间和注视率、注视转换熵和静止注视熵来量化25名健康成人(36%为女性,平均±SD年龄= 33.5±7.8岁,BMI = 24.1±2.9 kg/m2)的视觉扫描效率。使用E-CogPro测试电池评估注意力、记忆力和反应时间。结果与安慰剂相比,哌醋甲酯显著提高了数字工作记忆任务的表现,减少了错误,提高了准确性。在其他认知或视觉扫描指标中未观察到显著变化。结论低剂量哌醋甲酯可改善有限领域的精神运动速度和准确性,但不影响视觉扫描效率。这表明,作为一种普遍的认知辅助手段,它的实用性有限,并提出了一种可能性,即对于可测量的精神兴奋剂引起的视觉扫描行为变化,其效果阈值较低。需要进一步的研究来探索这些潜在的剂量-反应关系和在不同人群中的影响。试验注册ACTRN12620000499987
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引用次数: 0
Effects of COVID-19 Lockdowns on Alcohol Consumption, Hangovers and Smoking Among Young Adults (n = 140) in Germany: An On-Line Study 新冠肺炎封锁对德国年轻人(n = 140)饮酒、宿醉和吸烟的影响:一项在线研究。
IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2025-01-30 DOI: 10.1002/hup.70000
Agnese Merlo, Anna H. Koyun, Pauline A. Hendriksen, Johan Garssen, Gillian Bruce, Ann-Kathrin Stock, Joris C. Verster

Objective

This study investigated the impact of 2019 coronavirus disease (COVID-19) lockdowns on alcohol consumption and smoking behavior among young adults from Germany.

Methods

An online survey was completed by N = 317 young adults living in Germany. Of these, 140 (44.2%) consumed alcohol and were included in the analysis. They reported on alcohol consumption, hangover frequency and severity, and smoking behavior across four time periods: (1) “BP” (the period before the COVID-19 pandemic), (2) “L1” (the first lockdown; March–May, 2020), (3), NL1 (the no lock-down period; summer 2020), and (4) L2 (the second lockdown, November 2020 to May 2021).

Results

During L1, a significant decrease was observed in weekly alcohol intake, the number of drinking days, and the number of days where more than eight alcoholic drinks were consumed. Whereas hangover frequency was significantly increased during L1, hangover severity was significantly reduced. During NL1, drinking behaviors returned to BP levels. During L2, the decrease in alcohol consumption was much smaller, and not significantly different from BP. However, compared to BP, during L2 hangover frequency was significantly increased and hangover severity was significantly reduced. With regards to smoking, no significant differences compared to BP were found.

Conclusions

During the COVID-19 lockdown periods in Germany, a significant decrease in alcohol consumption was observed among this group of young adults. Whereas hangover frequency was significantly increased during the lockdown periods, hangover severity was significantly reduced.

目的:本研究调查了2019冠状病毒病(COVID-19)封锁对德国年轻人饮酒和吸烟行为的影响。方法:对居住在德国的317名年轻人进行在线调查。其中,140人(44.2%)饮酒,并被纳入分析。他们报告了四个时间段的饮酒、宿醉频率和严重程度以及吸烟行为:(1)“BP”(COVID-19大流行前的时期),(2)“L1”(第一次封锁;2020年3月- 5月),(3),NL1(无锁定期;(4) L2(第二次封锁,2020年11月至2021年5月)。结果:在L1期间,每周酒精摄入量、饮酒天数和饮酒超过8天的天数显著减少。而宿醉频率在L1期间显著增加,宿醉严重程度显著降低。在NL1期间,饮酒行为恢复到血压水平。在L2阶段,酒精消耗量的下降幅度要小得多,与BP没有显著差异。然而,与BP相比,L2阶段的宿醉频率显著增加,宿醉严重程度显著降低。在吸烟方面,与BP相比没有发现显著差异。结论:在德国COVID-19封锁期间,这组年轻人的饮酒量显着下降。在封锁期间,宿醉频率显著增加,宿醉严重程度显著降低。
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引用次数: 0
A Naturalistic Examination of the Acute Effects of High-Potency Cannabis on Emotion Regulation Among Young Adults: A Pilot Study 高效大麻对年轻人情绪调节的急性效应的自然检验:一项试点研究。
IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-28 DOI: 10.1002/hup.2915
Jessica M. Cavalli, Carrie Cuttler, Anita Cservenka

Objective

Despite the popular public perception that cannabis use may be beneficial for relieving mental health symptoms, the empirical evidence remains equivocal. Various legal hurdles limit the ability to research whether acute high-potency cannabis use affects mental health-related processes. Therefore, the current study used a novel methodology to examine the acute effects of high-potency cannabis flower on emotion regulation.

Methods

Using a remote, within-subjects study design, 12 young adult (ages 21–30) cannabis users (who used cannabis at least 1 day/week on average across the past year) completed measures of emotion regulation while sober and acutely intoxicated in a counterbalanced manner. Participants completed the Emotional Go/No-Go Task to measure implicit emotion regulation and a cognitive reappraisal task to assess explicit emotion regulation. For the intoxication condition, participants were observed smoking cannabis flower in their homes via videoconferencing.

Results

Participants reported a more positive mood and decreases in anxiety while intoxicated. There was no evidence that acute high-potency cannabis affected participants' implicit or explicit emotion regulation task performance.

Conclusions

Future research with larger samples might consider adopting this novel remote study design to assess the acute effects of high-potency cannabis use on different measures of emotion regulation and other health outcomes.

目的:尽管公众普遍认为使用大麻可能有利于缓解精神健康症状,但经验证据仍然模棱两可。各种法律障碍限制了研究急性高效大麻使用是否影响心理健康过程的能力。因此,本研究采用了一种新颖的方法来研究高效大麻花对情绪调节的急性效应。方法:采用远程,受试者内研究设计,12名年轻成人(21-30岁)大麻使用者(在过去一年中平均每周至少使用1天大麻)在清醒和急性醉酒时以平衡的方式完成情绪调节测量。参与者完成了内隐情绪调节的“情绪去/不去”任务和外显情绪调节的“认知再评价”任务。对于中毒情况,研究人员通过视频会议观察参与者在家中吸食大麻。结果:参与者报告醉酒时情绪更加积极,焦虑减少。没有证据表明急性强效大麻会影响参与者内隐或外显情绪调节任务的表现。结论:未来更大样本的研究可能会考虑采用这种新颖的远程研究设计,以评估高效大麻使用对不同情绪调节措施和其他健康结果的急性影响。
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引用次数: 0
Nick Drake: A Troubled Mind, a Troublesome ‘Cure’ 尼克·德雷克:一个烦恼的心灵,一个麻烦的“治疗”。
IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-26 DOI: 10.1002/hup.2916
David S. Baldwin
<p>The British Association for Psychopharmacology (BAP) concluded its Fiftieth Anniversary Summer Meeting in July 2024 with a plenary symposium in which BAP stalwarts glanced back and looked forward, to identify achievements in psychopharmacology since 1999 and consider likely developments in neuroscience before 2049. There was much to ponder, whilst travelling home from the University of Birmingham: and my dream-like musings continued that same evening, when the BBC Radio 3 Promenade (‘Prom’) concert broadcast was devoted solely to ‘An Orchestral Celebration’ of the music of Nick Drake, who died when aged only twenty-six, almost fifty years before, in November 1974.</p><p>Born in Rangoon, Burma (now Yangon, Myanmar), to expatriate Britons—his father worked as a Civil Engineer, his mother came from a senior Indian Civil Service family—Nicholas Rodney Drake moved with his family to the UK as a toddler, went to a preparatory boarding school, then boarded at Marlborough College, before somewhat unexpectedly scraping into Fitzwilliam College Cambridge in 1967, to read English Literature. But he left Cambridge two years later, nine months before graduation, against the advice of his tutors and family, to further his musical career: his first album, the wistful and pastoral <i>Five Leaves Left</i> had been released a few months earlier. A strike-delayed second album, <i>Bryter Later</i>, sometimes considered to be ensemble-heavy, appeared in March 1971. Both were critically acclaimed by music journalists and other musicians, but neither gained much traction with the buying public. His third album, the desolate and intermittently agitated <i>Pink Moon</i>, was released in February 1972, but probably sold less than its predecessors.</p><p>Characteristically reticent and often seeming aloof, he became steadily more isolated and withdrawn, possibly linked to or worsened by regular smoking of cannabis, which he started before University. He declared himself increasingly reluctant to play the live concerts which could probably have led to wider recognition and greater sales. Although he was an astonishingly adept, technically innovative guitarist and widely respected lyricist, it was more challenging for him to synchronise playing with singing. He sought company but was uncommunicative whilst in it. He neglected himself, seemed erratic and unpredictable, and sometimes had observable difficulty in sequencing tasks, such as making tea. Increasing parental concern prompted admission to the local inpatient psychiatric unit, where after a few weeks the thoughtful, compassionate consultant psychiatrist suggested their 23-year old son might suffer from simple-type schizophrenia.</p><p>Psychiatric diagnoses can be unreliable, and treatment plans are often contested. Drake himself stated that taking medication was ‘against my principles’. The well-meaning social worker attached to the local unit indicated that psychotropic medication was not as beneficial as psychoth
英国精神药理学协会(BAP)于2024年7月在一次全体研讨会上结束了五十周年夏季会议,BAP的坚定成员回顾了过去,展望了未来,确定了自1999年以来精神药理学的成就,并考虑了2049年之前神经科学可能的发展。在从伯明翰大学回家的路上,我有很多事情要思考:就在那天晚上,当英国广播公司第三频道的逍遥音乐会(“舞会”)的广播专门播放尼克·德雷克音乐的《管弦乐庆典》时,我的梦幻般的沉思还在继续。尼克·德雷克于1974年11月去世,享年26岁,大约50年前。尼古拉斯·罗德尼·德雷克出生于缅甸仰光(现缅甸仰光),父亲是一名土木工程师,母亲来自印度一个高级公务员家庭。尼古拉斯·罗德尼·德雷克在蹒跚学步的时候随家人移居英国,先是上了一所寄宿预科学校,然后在马尔伯勒学院寄宿,1967年意外地进入剑桥大学菲茨威廉学院学习英国文学。但两年后,也就是毕业前9个月,他不顾导师和家人的建议,离开了剑桥,去发展他的音乐事业:他的第一张专辑《剩下的五张叶子》(Five Leaves left)在几个月前发行了。他的第二张专辑《Bryter Later》于1971年3月发行,这张专辑因罢工而推迟,有时被认为是合奏曲目较多的专辑。两者都得到了音乐记者和其他音乐家的好评,但都没有得到购买大众的太多关注。他的第三张专辑《粉红月亮》(Pink Moon)于1972年2月发行,但销量可能不如前几张专辑。他性格沉默寡言,常常显得冷漠,变得越来越孤立和孤僻,这可能与他在上大学前就开始经常吸食大麻有关,或者因吸食大麻而恶化。他声称自己越来越不愿意参加现场音乐会,因为这可能会带来更广泛的认可和更高的销量。尽管他是一位技艺精湛、技术创新的吉他手和广受尊敬的词作者,但对他来说,将演奏与唱歌同步起来更具挑战性。他寻求同伴,但在同伴中却沉默寡言。他忽视了自己,似乎不稳定、不可预测,有时在安排任务时明显有困难,比如泡茶。越来越多的父母的担忧促使他们把儿子送进了当地的精神病住院病房,几周后,一位体贴、富有同情心的精神病顾问建议他们23岁的儿子可能患有单纯型精神分裂症。精神科的诊断可能不可靠,治疗方案也常常存在争议。德雷克自己说服药“违背了我的原则”。附属于当地单位的善意的社会工作者指出,精神药物治疗不如心理治疗有益,并建议转介给兰根心理治疗师。相比之下,一位地区专家咨询精神科医生推荐电休克疗法(ECT)。随后,一位著名的伦敦教学医院顾问私下给德雷克看病,更倾向于诊断为抑郁症,并建议用阿米替林、三氟拉嗪、奥非那定和地西泮联合治疗。德雷克没有参加莱恩创立的费城协会的约见。ECT只进行了一次。坚持服药的时间伴随着一些有益的影响,包括写新材料的愿望,但治疗和改善并没有持续下去。他变得越来越沮丧,于1973年2月故意过量服用地西泮(36片),并于次年秋天在大量过量服用阿米替林(大约60片)后死亡:验尸官的调查记录了“患抑郁症时”自杀的判决。总的来说,在这本法医详尽的传记(《杰克2023》)中,对朋友和同龄人的多次深刻观察与一些重要特征(包括阴性症状和紊乱)一致,表明可能患有精神分裂症。他的父亲相信这是事实,并加入了国家精神分裂症协会寻求支持和建议:这个一直支持他、充满爱的家庭被一种困惑无助的感觉所困扰。他们不知道阿米替林即使是少量过量服用也会致命。他大学时代的一位好友后来成为了一名精神病学家,他认为,不管诊断结果如何,单靠精神药物是不足以改善病情的。但不管诊断结果如何,德雷克接受的住院和门诊治疗都无法阻止他不可阻挡的衰退。 目前的精神健康服务——比如精神病小组的早期干预——将努力提供一种个案管理的、以社区为基础的、多学科的方法,包括果断的外展、建议不要再吸大麻、精神药物优化(可能包括长效注射抗精神病药物)、心理治疗、康复活动以及家庭参与和支持。如果当时有这样的规定,这个麻烦缠身的年轻人的结局很可能会有所不同。考虑到尼克·德雷克(Nick Drake)的产量减少,意识到他与个人心理健康问题的斗争似乎很重要,但对艺术遗产的认可取决于他精湛的音乐技艺,同龄人对他作品的高度尊重,以及忠诚的、不断增加的听众的欣赏。到他去世时,这三张专辑加起来可能只卖了不到四千张。但即使在朋克时代,当大多数民谣摇滚歌手兼词曲作者被怀疑的时候,他自学成才、毫不妥协的才能也得到了认可和理解。他的名声稳步上升,唱片销量在过去的五十年里每十年都在增长:BBC3舞会的宣传正确地指出,他已经获得了“新的、跨代的听众,他们中的许多人被他的脆弱和宿命论所迷惑,他的音乐融合了外在的简单和内在的复杂”。作者声明无利益冲突。
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引用次数: 0
Agomelatine as Antidepressant Treatment in Elderly Patients With Previous Hyponatremia Due To SSRI Use: Case Series 阿戈美拉汀作为抗抑郁药治疗老年患者既往低钠血症由于使用SSRI:病例系列。
IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-12 DOI: 10.1002/hup.2914
José Alfonso. Ontiveros-Sánchez de la Barquera, Luis Alberto De la Garza García, Guillermo Sánchez-Torres, Andoni Gogeascoechea-Hernández, Sofia Jezzini Martinez, Guillermo A. Porras-Garza, Pablo Patricio Zarate Garza

Objective

To evaluate agomelatine treatment in elderly patients with major depressive disorder (MDD) who developed hyponatremia while using selective serotonin receptor inhibitors (SSRIs).

Methods

Patients (60 years or older) with hyponatremia after SSRI treatment for MDD were changed to agomelatine 50 mg/day during one month to observe sodium levels during the treatment and change in depressive symptoms. Montgomery-Asberg Depression Rating Scale (MADRS) and the Clinical Global Impression Scale (CGI) of severity were used before and after treatment with agomelatine.

Results

The mean age of our sample (five patients) was 75.3 (SD ± 7.8) years. Sodium levels while using SSRIs were reported with a mean of 122.54 (SD ± 10.8) mEq/L. Mean MADRS and CGI scores on SSRIs before treatment with agomelatine were 27.8 (SD ± 3.90) and 5 (SD ± 0.71) respectively. After 4 weeks of treatment with agomelatine 50 mg/day, mean scores of sodium were reported at 135.48 (SD ± 1.6) mEq/L, and mean MADRS and CGI scores were 13.6 (SD ± 8.35) and 2.4 (SD ± 1.5). The difference in means of the MADRS scale before and after treatment with agomelatine was found to be statistically significant (27.8 [3.89] versus 13.6 [8.35], p = < 0.01).

Conclusion

Our open observational study suggests that agomelatine represents a safe and effective treatment option for elderly patients with major depressive disorder and previous SSRIs-induced hyponatremia.

目的:评价阿戈美拉汀治疗老年重度抑郁症(MDD)伴低钠血症患者同时使用选择性5 -羟色胺受体抑制剂(SSRIs)的疗效。方法:在SSRI治疗MDD后出现低钠血症的患者(60岁及以上),在一个月内改为阿戈美拉汀50 mg/天,观察治疗期间钠水平和抑郁症状的变化。应用阿戈美拉汀治疗前后分别采用Montgomery-Asberg抑郁评定量表(MADRS)和临床总体印象量表(CGI)评定抑郁严重程度。结果:5例患者的平均年龄为75.3 (SD±7.8)岁。使用SSRIs时的钠水平平均为122.54 (SD±10.8)mEq/L。阿戈美拉汀治疗前ssri类药物的平均MADRS和CGI评分分别为27.8 (SD±3.90)和5 (SD±0.71)。阿戈美拉汀50 mg/天治疗4周后,钠的平均评分为135.48 (SD±1.6)mEq/L,平均MADRS和CGI评分分别为13.6 (SD±8.35)和2.4 (SD±1.5)。阿戈美拉汀治疗前后MADRS量表均值差异有统计学意义(27.8[3.89]对13.6 [8.35],p =结论:我们的开放式观察性研究表明,阿戈美拉汀是老年重度抑郁症患者既往ssris所致低钠血症患者安全有效的治疗选择。
{"title":"Agomelatine as Antidepressant Treatment in Elderly Patients With Previous Hyponatremia Due To SSRI Use: Case Series","authors":"José Alfonso. Ontiveros-Sánchez de la Barquera,&nbsp;Luis Alberto De la Garza García,&nbsp;Guillermo Sánchez-Torres,&nbsp;Andoni Gogeascoechea-Hernández,&nbsp;Sofia Jezzini Martinez,&nbsp;Guillermo A. Porras-Garza,&nbsp;Pablo Patricio Zarate Garza","doi":"10.1002/hup.2914","DOIUrl":"10.1002/hup.2914","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate agomelatine treatment in elderly patients with major depressive disorder (MDD) who developed hyponatremia while using selective serotonin receptor inhibitors (SSRIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients (60 years or older) with hyponatremia after SSRI treatment for MDD were changed to agomelatine 50 mg/day during one month to observe sodium levels during the treatment and change in depressive symptoms. Montgomery-Asberg Depression Rating Scale (MADRS) and the Clinical Global Impression Scale (CGI) of severity were used before and after treatment with agomelatine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of our sample (five patients) was 75.3 (SD ± 7.8) years. Sodium levels while using SSRIs were reported with a mean of 122.54 (SD ± 10.8) mEq/L. Mean MADRS and CGI scores on SSRIs before treatment with agomelatine were 27.8 (SD ± 3.90) and 5 (SD ± 0.71) respectively. After 4 weeks of treatment with agomelatine 50 mg/day, mean scores of sodium were reported at 135.48 (SD ± 1.6) mEq/L, and mean MADRS and CGI scores were 13.6 (SD ± 8.35) and 2.4 (SD ± 1.5). The difference in means of the MADRS scale before and after treatment with agomelatine was found to be statistically significant (27.8 [3.89] versus 13.6 [8.35], <i>p</i> = &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our open observational study suggests that agomelatine represents a safe and effective treatment option for elderly patients with major depressive disorder and previous SSRIs-induced hyponatremia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"40 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient outcome following selective serotonin reuptake inhibitor prescribing in primary care in Wales (UK) 英国威尔士基层医疗机构在开具选择性 5-羟色胺再摄取抑制剂处方后的患者疗效。
IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-07 DOI: 10.1002/hup.2912
Shaila Ahmed, Katherine Chaplin, Richard S. Young, Paul N. Deslandes

Objective

This study investigated prescribing patterns of two cohorts of patients treated with selective serotonin reuptake inhibitors (SSRI) in primary care in Wales (UK), to better understand drivers for increased usage.

Methods

This e-cohort study included patients receiving a first READ-coded SSRI prescription in SAIL in either 2005 or 2015. Patients were followed up for 3 years from date of SSRI prescription. Influence of age and other demographic data on prescribing patterns, and details of mental health or medication reviews that took place were identified.

Results

In total 67,006 patients were included across the two cohorts; 29,534 in 2005, and 37,472 in 2015. Citalopram was the most commonly prescribed SSRI in both cohorts. A READ-coded diagnosis relating to SSRI treatment could not be identified in 24,797 patients. The percentage of patients continuing treatment for 3 years was 6.9% and 11.3% in 2005 and 2015, respectively. In total, 21,150 (72%) patients in the 2005 cohort and 23,947 (64%) in the 2015 cohort received at least one medication review during follow-up.

Conclusions

The proportion of patients continuing longer term treatment was small, whilst the number of recorded mental health and medication reviews offers some reassurance that prescribing remained appropriate.

研究目的本研究调查了威尔士(英国)初级医疗中使用选择性血清素再摄取抑制剂(SSRI)治疗的两组患者的处方模式,以更好地了解使用量增加的驱动因素:这项电子队列研究包括 2005 年或 2015 年首次在 SAIL 收到 READ 编码 SSRI 处方的患者。自开具SSRI处方之日起,对患者进行为期3年的随访。研究确定了年龄和其他人口统计学数据对处方模式的影响,以及精神健康或用药审查的详细情况:两个队列共纳入了 67,006 名患者;2005 年为 29,534 人,2015 年为 37,472 人。在两个队列中,西酞普兰是最常用的处方 SSRI。24797名患者无法确定与SSRI治疗相关的READ编码诊断。2005年和2015年,持续治疗3年的患者比例分别为6.9%和11.3%。在随访期间,2005年队列中的21150名患者(72%)和2015年队列中的23947名患者(64%)至少接受了一次药物复查:继续接受长期治疗的患者比例较小,而记录在案的精神健康和用药复查次数则在一定程度上保证了处方的合理性。
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引用次数: 0
Antipsychotic-Treated Schizophrenia Patients Develop Inflammatory and Oxidative Responses Independently From Obesity: However, Metabolic Disturbances Arise From Schizophrenia-Related Obesity 经抗精神病药物治疗的精神分裂症患者产生炎症和氧化反应与肥胖无关:然而,与精神分裂症有关的肥胖会导致代谢紊乱。
IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-11-07 DOI: 10.1002/hup.2913
Sarandol Emre, Sarandol Asli, Mercan Sener, Salih Saygin Eker, Surmen-Gur Esma

Objective

To define the impact of obesity on inflammatory and oxidative disturbances in antipsychotic-treated schizophrenia patients.

Methods

Several cytokines, inflammatory, metabolic, and oxidative status markers were evaluated in obese (n = 40) and non-obese (n = 40) antipsychotic-treated patients and compared with age-and BMI-matched controls (n = 80).

Results

Schizophrenia patients had higher leptin, TNF-α, adiponectin, visfatin, resistin, P-selectin, NPY, BDNF, CD40-L, MCP-1, and malondialdehyde, and lower IL-6, ghrelin, neopterin, and vitamin E levels compared to their respective controls (p < 0.001). Total oxidant status was higher in non-obese patients compared to controls (p < 0.001), total antioxidant capacity was higher in obese compared to non-obese patients (p < 0.01), but vitamin A and paraoxonase levels were not different. High sensitive-CRP levels were higher in obsese controls relative to non-obese controls (p < 0.05) and in obese patients relative to non-obese patients (p < 0.001). Fasting glucose, insulin, HbA1c, HOMA-IR, uric acid, total cholesterol, and triglyceride concentrations were higher in obese patients compared to non-obese patients. Insulin concentrations and HOMA-IR were also higher in obese controls than in non-obese controls.

Conclusions

Our results suggest that inflammatory responses and oxidative stress develop independently from obesity in antipsychotic-treated schizophrenia patients. However, schizophrenia-induced obesity causes metabolic disturbances; thereby, obese schizophrenia patients are more liable to cardiovascular events and progress of metabolic syndrome than non-obese patients.

目的:确定肥胖对接受抗精神病药物治疗的精神分裂症患者的炎症和氧化紊乱的影响:明确肥胖对抗精神病药物治疗的精神分裂症患者炎症和氧化紊乱的影响:方法:评估肥胖(n = 40)和非肥胖(n = 40)抗精神病药物治疗患者的多种细胞因子、炎症、代谢和氧化状态标记物,并与年龄和体重指数匹配的对照组(n = 80)进行比较:结果:与各自的对照组相比,精神分裂症患者的瘦素、TNF-α、脂肪连通素、粘蛋白、抵抗素、P-选择素、NPY、BDNF、CD40-L、MCP-1和丙二醛水平较高,而IL-6、胃泌素、新蝶呤和维生素E水平较低(p 结论:我们的研究结果表明,肥胖患者和非肥胖患者的炎症反应和炎症反应程度与对照组不同:我们的研究结果表明,抗精神病药物治疗的精神分裂症患者的炎症反应和氧化应激与肥胖无关。然而,精神分裂症引起的肥胖会导致代谢紊乱;因此,与非肥胖患者相比,肥胖精神分裂症患者更容易发生心血管事件和代谢综合征。
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引用次数: 0
期刊
Human Psychopharmacology: Clinical and Experimental
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