A rating scale for drug-induced akathisia has been derived that incorporates diagnostic criteria for pseudoakathisia, and mild, moderate, and severe akathisia. It comprises items for rating the observable, restless movements which characterise the condition, the subjective awareness of restlessness, and any distress associated with the akathisia. In addition, there is an item for rating global severity. A standard examination procedure is recommended. The inter-rater reliability for the scale items (Cohen's kappa) ranged from 0.738 to 0.955. Akathisia was found in eight of 42 schizophrenic in-patients, and nine had pseudoakathisia, where the typical sense of inner restlessness was not reported.

A rating scale for drug-induced akathisia

The study of pain in awake animals raises ethical, philosophical, and technical problems. We review the ethical standards for studying pain in animals and emphasize that there are scientific as well as moral reasons for keeping to them. Philosophically, there is the problem that pain cannot be monitored directly in animals but can only be estimated by examining their responses to nociceptive stimuli; however, such responses do not necessarily mean that there is a concomitant sensation. The types of nociceptive stimuli (electrical, thermal, mechanical, or chemical) that have been used in different pain models are reviewed with the conclusion that none is ideal, although chemical stimuli probably most closely mimic acute clinical pain. The monitored reactions are almost always motor responses ranging from spinal reflexes to complex behaviors. Most have the weakness that they may be associated with, or modulated by, other physiological functions. The main tests are critically reviewed in terms of their sensitivity, specificity, and predictiveness. Weaknesses are highlighted, including 1) that in most tests responses are monitored around a nociceptive threshold, whereas clinical pain is almost always more severe; 2) differences in the fashion whereby responses are evoked from healthy and inflamed tissues; and 3) problems in assessing threshold responses to stimuli, which continue to increase in intensity. It is concluded that although the neural basis of the most used tests is poorly understood, their use will be more profitable if pain is considered within, rather than apart from, the body's homeostatic mechanisms.

Animal Models of Nociception

Leptin enters the brain by a saturable system independent of insulin.

A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors

https://www.cell.com/cell/pdf/S0092-8674(01)00483-4.pdf

A Diverse Family of GPCRs Expressed in Specific Subsets of Nociceptive Sensory Neurons

What are the cognitive effects of stimulant medications? Emphasis on adults with attention-deficit/hyperactivity disorder (ADHD).

Objective: To examine the relationship between ADHD medications, study habits, and academic achievement of ADHD-diagnosed undergraduates. Method: A total of 92 students with a self-reported ADHD diagnosis and a current prescription for ADHD medication were compared with 143 control students in a survey of academic performance. Results: Most ADHD students took stimulant medication and said the drugs helped them, yet believed they were worse than other students at planning and completing assignments and avoiding distractions. Although most study habits of ADHD students did not differ from controls, their high school and college GPA (grade point average), and ACT scores were significantly lower, and they withdrew from significantly more classes than did control students. Interestingly, preliminary data suggested that good study habits alone, even without stimulants, could overcome the achievement disparity of ADHD students. Conclusion: As previously shown for children and adolescents, stimulant medications a...

College students with and without ADHD: comparison of self-report of medication usage, study habits, and academic achievement.

Objective: The authors studied the relationship between a diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD), grade point average (GPA), and licit and illicit drug use. Participants and Methods: They obtained survey data from a convenience sample of undergraduates in a large southern public university. Results: Among 1,550 respondents, 163 (10.5%) reported an ADHD diagnosis (ADHD Group). Of those without an ADHD diagnosis, 591 (43%) reported using prescription stimulants illicitly (No ADHD, Illicit Use group), and 794 (57%) reported not using prescription drugs illicitly (No ADHD, No Illicit Use group). The GPA of the ADHD group was significantly lower than the GPA of the other 2 groups. The ADHD group and the No ADHD, Illicit Use group reported significantly greater use of all other drugs than did the No ADHD, No Illicit Use group. Conclusions: Drug use was associated with a lower GPA in ADHD-diagnosed students than in students without ADHD.

Licit and Illicit Use of Medications for Attention-Deficit Hyperactivity Disorder in Undergraduate College Students

Objective/Method: The Conner’s Continuous Performance Test (CPT) was administered to four groups of adult college students who self-referred for comprehensive psychoeducational evaluation and received either no diagnosis (n = 30) or a diagnosis of ADHD (n = 26), a psychiatric disorder (n = 17), or various cognitive deficits (n = 22).Results: The groups did not differ with respect to age, sex, race, or IQ. Although the ADHD group made more CPT errors of omission, had longer response times, and showed greater variability in responding than the other three groups, these differences did not reach statistical significance when analyzed parametrically using standard scores. But when the pattern of scores across the groups was analyzed nonparametrically, significant and interpretable results emerged.Conclusion: The CPT reliably differentiated between individuals with ADHD and both normal college students and individuals with psychiatric diagnoses but not persons with learning/cognitive disorders.

Claire Advokat

Papers

What are the cognitive effects of stimulant medications? Emphasis on adults with attention-deficit/hyperactivity disorder (ADHD).

College students with and without ADHD: comparison of self-report of medication usage, study habits, and academic achievement.

Licit and Illicit Use of Medications for Attention-Deficit Hyperactivity Disorder in Undergraduate College Students

Continuous Performance Test (CPT) of college students with ADHD, psychiatric disorders, cognitive deficits, or no diagnosis.

Side effect profiles of atypical antipsychotics, typical antipsychotics, or no psychotropic medications in persons with mental retardation.