Neuropsychopharmacology Reports最新文献

Contradictory results for the association between metformin intake and changes in cognitive function have been reported. We attempted to overview systematic reviews and meta-analyses showing the role of metformin, as mono or combination therapy, in cognitive performance alterations among patients with type 2 diabetes mellitus (T2DM) and to determine the quality of the evidence as well. To find the English-written reviews, a literature search was conducted on PubMed, Web of Science, Scopus, Cochrane Library, Trip, and Google Scholar by May 1, 2023. The literature search unearthed 2672 records, 10 of which were included in the study. Metformin may provide cognitive benefits for patients with type 2 diabetes, as evidence suggests potential improvements in memory and a reduced risk of neurodegenerative diseases. Even though the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) score alterations correspond to raising concerns about cognitive decline, Mini-Mental State Examination (MMSE) and selective reminding test (SRT) score improvements support metformin's role in improving specific cognitive domains. As such, metformin may exert differential impacts on various aspects of cognitive performance in these patients. However, the inconsistency and low quality of current evidence point toward the need for accurate research to elucidate whether metformin's cognitive effects are protective, neutral, or context-dependent based on patient profiles.

"Death Coffee" is an incredibly potent brew with caffeine content three times higher than conventional coffees, making it the strongest coffee in the world. Caffeine, a relatively safe psychostimulant substance consumed as dietary products or daily drinks, enhances physical and mental performance. According to long-lasting safe experiences of daily coffee consumption, caffeine intoxication with a cup of coffee is hardly believable in Iran. This paper reports five cases of coffee toxicity with a single cup of coffee within the last weeks. Presentation of toxicity varied among patients and ranged from lethargy to hallucination, tremors, agitation, shortness of breath, and decreased level of consciousness. Surprisingly, all five patients consumed an unknown caffeinated beverage called Death Coffee within 12 weeks, demonstrating that a new and unknown beverage prevails in our region.

Background: There is a complex relationship between tobacco use and pain. Nicotine provides temporary pain relief but increases the risk of chronic pain. This study aimed to investigate use of tobacco for pain relief and its association with demographic and medical characteristics in Japan.

Methods: We used a web-based survey to recruit 2000 individuals aged 20-69 who had experienced pain in the previous month. They answered questions on demographics, smoking status, lifestyle, socioeconomic status, and medical information. Smokers were asked if they smoked tobacco to relieve pain. Those who responded "strongly agree" or "agree" were labeled as using tobacco for pain relief. We used analysis of covariance to test the associations among smokers' background characteristics by whether they used tobacco for pain relief.

Results: Overall, 6.6% of smokers with pain (3.5% with acute or subacute pain and 8.8% with chronic pain) used tobacco for pain relief. These individuals were generally younger, more likely to be treated for schizophrenia and use analgesics, with higher pain severity, more catastrophic thinking about pain, and a centralized symptom. However, they were less likely to engage in regular exercise.

Conclusions: Overall, 6.6% of smokers (3.5% with acute or subacute pain and 8.8% with chronic pain) used tobacco to relieve their pain, even though most of them also received medical treatment and used pain medication. Healthcare providers and policy makers should account for this population of smokers in their planning.

Aim: Individuals with insomnia frequently have comorbid depression or anxiety. This study sought to provide a preliminary indication of the effects of lemborexant (LEM) in subjects treated for mild depression/anxiety symptoms.

Methods: E2006-G000-303 (NCT02952820; EudraCT 2015-001463-39; SUNRISE-2) was a 12-month, phase 3, randomized, placebo-controlled, double-blind study where subjects with insomnia disorder were randomized (1:1:1) to placebo, LEM 5 mg (LEM5), or LEM 10 mg (LEM10) for 6 months. During the second 6 months (not reported), placebo-treated subjects were re-randomized to LEM5 or LEM10. In this post hoc analysis, changes from baseline (CFB) in subject-reported (subjective) sleep onset latency (sSOL), sleep efficiency (sSE), wake after sleep onset (sWASO), total sleep time (sTST), Fatigue Severity Scale, and Insomnia Severity Index were evaluated in subjects treated with medications for symptoms of depression/anxiety (subpopulation).

Results: Of 949 randomized subjects, 61 treated with medications for symptoms of depression/anxiety were included. In the subpopulation, CFB comparing LEM with placebo were generally smaller than the overall population due to a larger placebo response in the subpopulation. However, the magnitudes of CFB within the active treatment groups for sSOL, sWASO, sTST, and sSE were similar between the subpopulation and the overall population. No new safety signals were observed in the subpopulation.

Conclusion: LEM treatment benefited subjects with insomnia treated with medications for depression/anxiety symptoms, with no new safety signals. A greater placebo response in the subpopulation than in the overall population decreased the drug versus placebo effect size for LEM, as has been reported for other insomnia medications.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with both genetic and environmental risk factors. Imbalanced dietary Intake has recently been proposed as a possible environmental risk factor for ASD. The purpose of this study was to investigate the possible connection between ASD and intake of various carbohydrate types.

Methods: 110 patients with autism from 5 to 15 years of age have been included as the case group and 110 neurotypical children who are part of a similar age category have been chosen as controls for this case-control study. To estimate the dietary intake of carbohydrates, a validated food frequency questionnaire (FFQ) was used.

Results: Positive connections were found between ASD and the intake of sugar (OR = 1.03, CI 95%: 1.02-1.06, p = 0.001), and maltose (OR = 2.09, CI 95%: 1.37-3.20, p = 0.001). A reverse correlation was found between ASD and dietary intake of carbohydrates (OR = 0.97, CI 95%: 0.96-0.98, p = 0.001), fructose (OR = 0.85, CI 95%: 0.77-0.94, p = 0.002), and lactose (OR = 0.89, CI 95%: 0.83-0.96, p = 0.002).

Conclusion: This study showed a direct link between autism and the intake of sugar and maltose and an inverse connection between autism and the dietary intake of total carbohydrate, fructose, and lactose. There is a need to carry out additional long-term studies.

Background: Maternal psychiatric condition during the perinatal period is relevant to children's cognitive development and mental health. Psychotropic medications are necessary to maintain the mental health of pregnant women with psychiatric disorders, but they are often avoided due to concerns about adverse effects, such as congenital malformations and abnormal neurodevelopment. A retrospective study of pregnant women with psychiatric disorders using psychotropic medications was performed to clarify maternal and child demographic data and to investigate whether psychotropic medications affected the Apgar score and the decision to breastfeed.

Methods: Data of pregnant women with psychiatric disorders who were referred from the Department of Obstetrics and Gynecology to the Department of Neuropsychiatry at Ehime University Hospital from January 2014 to December 2022 were collected retrospectively. Pearson's chi-squared test and multiple regression analysis were used for statistical analyses.

Results: A total of 226 women were included; 194 gave birth at our hospital, of whom 79 (40.7%) were taking psychotropic drugs at the time of delivery. None of the children had malformations. There was no relationship between the use of psychotropic medications and the choice to breastfeed. Multiple regression analysis showed that only the gestational weeks at birth were significantly associated with birth weight (p < 0.001) and Apgar score (1 min: p = 0.030; 5 min: p = 0.044).

Conclusions: The use of psychotropic medications during the perinatal period appears safe and beneficial for both pregnant women with psychiatric disorders and their children, and breastfeeding should be considered even if the mother continues to take the medication. To clarify these points, prospective studies using large samples from several countries are needed.

Introduction: Clozapine is an atypical antipsychotic drug approved for treatment-resistant schizophrenia (TRS). Despite its high efficacy for TRS, clozapine is associated with several serious adverse effects, such as neutropenia and diabetes, so it requires vigilant monitoring. Severe anemia has also been documented as a rare but serious complication with an unclear mechanism. We present a case report of severe anemia potentially associated with zinc deficiency during clozapine therapy.

Case report: A 51-year-old woman was diagnosed with TRS without physical complications. Zinc deficiency was identified as a potential contributing factor. Zinc supplementation improved her hemoglobin levels, enabling the patient to continue clozapine at a therapeutic dose. The patient has remained stable, with no recurrence of anemia.

Discussion: Clozapine is a highly effective antipsychotic, despite side effects including blood dyscrasias. While zinc deficiency is most likely to be implicated in clozapine-induced anemia, the exact mechanism remains unclear. Further research is required to explore this relationship between clozapine and zinc decrement.

3,4-methylenedioxymethamphetamine (MDMA), a commonly abused recreational drug, induces prosocial effects such as increased sociability and empathy. The nucleus accumbens (NAc) has been suggested to play a crucial role in these MDMA-mediated prosocial effects. However, the relationship between social behavior and NAc neural activity, and the effects of MDMA on this relationship, remain unknown. In this study, we measured NAc neural activity using fiber photometry and classified the behaviors of mice at times of transient increases in NAc neural activity during the social approach test (SAT). We found that NAc neural activity transiently increased at the onset of turning toward and sniffing novel mice during the SAT, although the frequency of turning was relatively low. We then examined the effects of MDMA on behavior and NAc neural activity and found that MDMA decreased the duration of sniffing per bout but did not alter NAc neural activity at the onset of turning toward or sniffing novel mice. These results suggest that MDMA does not affect the transient increase in NAc neural activity at the onset of social behaviors.

Background: Mild depression lacks a consistent definition across diagnostic criteria and rating scales, posing challenges to standardizing treatment strategies. International guidelines predominantly recommend psychotherapy as the first-line treatment for mild depression, while the use of antidepressants remains contentious. Supplements such as omega-3 fatty acids, St. John's Wort, and magnesium have garnered attention as alternative therapeutic options for depression. This systematic review aims to assess the efficacy of pharmacological interventions, including supplements, in the treatment of mild depression.

Methods: Comprehensive searches were performed in PubMed and Embase through November 2024 to identify randomized controlled trials (RCTs) investigating pharmacotherapy or supplements for mild depression diagnosed using standardized criteria. Eligible studies underwent screening and risk of bias assessment utilizing the ROB2 tool. Data on remission rates, symptom improvement, dropout rates, and adverse events were extracted, with meta-analyses conducted where applicable.

Results: Eight RCTs comprising 1049 participants met inclusion criteria. Among the agents studied, St. John's Wort was analyzed in two trials, both comparing it to fluoxetine. A meta-analysis found no significant difference in response rates between the two treatments (risk ratio [RR] = 0.96, 95% CI: 0.78-1.18) or dropout rates (RR = 1.08, 95% CI: 0.62-1.88). For other agents, single studies evaluated their effects. Eicosapentaenoic acid and Rhodiola rosea demonstrated significant improvements in depressive symptoms compared to placebo. In non-blinded trials, magnesium chloride showed efficacy in alleviating depressive symptoms. Other interventions, such as lavender, lemon balm, and transcranial electroacupuncture stimulation, were as effective as antidepressants. Conversely, S-adenosylmethionine did not produce significant improvements relative to placebo.

Conclusion: This review demonstrates that certain supplements, such as eicosapentaenoic acids and Rhodiola rosea, are therapeutic options for mild depression. However, no RCTs compared antidepressants directly to placebo for mild depression. The paucity of high-quality RCTs exclusively targeting mild depression limits definitive conclusions, warranting further rigorous research.