scispace - formally typeset
Search or ask a question
Topic

Psychotropic drug

About: Psychotropic drug is a research topic. Over the lifetime, 2309 publications have been published within this topic receiving 54070 citations.


Papers
More filters
Journal ArticleDOI
18 Jun 2014-BMJ
TL;DR: Safety warnings about antidepressants and widespread media coverage decreased antidepressant use, and there were simultaneous increases in suicide attempts among young people.
Abstract: Objective To investigate if the widely publicized warnings in 2003 from the US Food and Drug Administration about a possible increased risk of suicidality with antidepressant use in young people were associated with changes in antidepressant use, suicide attempts, and completed suicides among young people. changes in antidepressant use were −31.0% (95% confidence interval −33.0% to −29.0%) among adolescents, −24.3% (−25.4% to −23.2%) among young adults, and −14.5% (−16.0% to −12.9%) among adults. These reflected absolute reductions of 696, 1216, and 1621 dispensings per 100 000 people among adolescents, young adults, and adults, respectively. Simultaneously, there were significant, relative increases in psychotropic drug poisonings in adolescents (21.7%, 95% confidence interval 4.9% to 38.5%) and young adults (33.7%, 26.9% to 40.4%) but not among adults (5.2%, −6.5% to 16.9%). These reflected absolute increases of 2 and 4 poisonings per 100 000 people among adolescents and young adults, respectively (approximately 77 additional poisonings in our cohort of 2.5 million young people). Completed suicides did not change for any age group.

170 citations

Journal ArticleDOI
TL;DR: Knowing the substrates, inhibitors, and inducers of CYP3A3/ and other cytochrome P450 isoforms may help clinicians to anticipate and avoid pharmacokinetic drug interactions and improve rational prescribing practices.
Abstract: Recent advances in molecular pharmacology have allowed the characterization of the specific isoforms that mediate the metabolism of various medications. This information can be integrated with older clinical observations to begin to develop specific mechanistic and predictive models of psychotropic drug interactions. The polymorphic cytochrome P450 2D6 has gained much attention, because competition for this isoform is responsible for serotonin reuptake inhibitor-induced increases in tricyclic antidepressant concentrations in plasma. However, the cytochrome P450 3A subfamily and the 3A3 and 3A4 isoforms (CYP3A3/4) in particular are becoming increasingly important in psychopharmacology as a result of their central involvement in the metabolism of a wide range of steroids and medications, including antidepressants, benzodiazepines, calcium channel blockers, and carbamazepine. The inhibition of CYP3A3/4 by medications such as certain newer antidepressants, calcium channel blockers, and antibiotics can increase the concentrations of CYP3A3/4 substrates, yielding toxicity. The induction of CYP3A3/4 by medications such as carbamazepine can decrease the concentrations of CYP3A3/4 substrates, yielding inefficiency. Thus, knowledge of the substrates, inhibitors, and inducers of CYP3A3/ and other cytochrome P450 isoforms may help clinicians to anticipate and avoid pharmacokinetic drug interactions and improve rational prescribing practices.

169 citations

Journal ArticleDOI
TL;DR: The impaired HPA response following 5-HT1A receptor challenge in unipolar depression could have resulted from glucocorticoid-dependent subsensitivity of the (post-synaptic) 5- HT1A receptors itself and/or from a defective postreceptor signaling pathway [inhibitory guanine nucleotide-binding protein (Gi)-adenylate cyclase complex function], thus supporting the hypothesis that a disintegrated 5/HPA system interaction may be present in depression.

163 citations

Journal Article
TL;DR: The prevalence of questionable high-risk prescribing, especially of psychotropic drugs, is substantial among elderly people and may be a potentially important and avoidable risk factor for drug-related illness in elderly people.
Abstract: OBJECTIVE: To estimate the prevalence of questionable and rational high-risk prescribing among elderly people of the three drug groups most commonly implicated in drug-related illness: cardiovascular drugs, psychotropic drugs and nonsteroidal anti-inflammatory drugs (NSAIDs). DESIGN: Retrospective prevalence study; all prescription and billing records for the period Jan. 1 to Dec. 31, 1990, for the study sample were retrieved from the relevant provincial databases of the Regie de l9assurance-maladie du Quebec. SETTING: Quebec. PARTICIPANTS: Regionally stratified random sample of 63,268 elderly medicare registrants who made at least one visit to physician in 1990 and were not living in a health care institution for the entire year. MAIN OUTCOME MEASURE: Prescription information was examined for three types of high-risk prescribing: rational and questionable drug combinations, excessive treatment duration and drugs relatively contraindicated for use in elderly people. RESULTS: Overall, 52.6% of the patients experienced one or more events of high-risk prescribing, and 45.6% experienced at least one that was questionable. High-risk prescribing was most prevalent for psychotropic drugs, and questionable prescribing was more frequent than rational prescribing in this drug group. An estimated 30.8% of the total elderly population in Quebec received benzodiazepines for more than 30 consecutive days, 12.9% received a long-acting benzodiazepine, and 13.0% received a questionable high-risk psychotropic drug combination. The prevalence of high-risk prescribing was higher among the women than among the men and increased with age until 75 to 84 years. There were significant unexplained differences between regions in the regional prevalence of high-risk prescribing, particularly of psychotropic drugs. CONCLUSION: The prevalence of questionable high-risk prescribing, especially of psychotropic drugs, is substantial among elderly people. This may be a potentially important and avoidable risk factor for drug-related illness in elderly people.

163 citations

Journal ArticleDOI
TL;DR: A ranking approach was used to elucidate preferences of the lay public regarding sources of help and treatment options in case of mental disorder, aiming to reflect the real life decision-making process.
Abstract: Research on lay public’s attitudes toward the treatment of mental disorders is receiving increasing scientific attention. Most of the surveys on lay public attitudes have used rating approaches. However, in daily life, people are forced to make decisions. Therefore, we used a ranking approach to elucidate preferences of the lay public, aiming to reflect the real life decision-making process. We investigated preferences of the lay public regarding sources of help and treatment options in case of mental disorder. In the spring of 2001, a representative survey was carried out in Germany (n=5015). A personal fully structured interview was conducted which started with the presentation of a vignette depicting someone with either schizophrenia or major depression. Respondents were asked to make first and second choices regarding the recommendation of source of help and treatment. Furthermore, socio-demographic characteristics and illness behaviour as possible determinants were assessed and analysed using logistic regression. Even though most of the people advise professional help, especially from mental health professionals, a large gap remains between evidence-based treatment strategies and public opinion. Psychotherapy is by far the most favoured treatment. In contrast, psychotropic drug treatment was only suggested by the minority for first-choice treatment. Certain beliefs concerning illness and socio-demographic characteristics are associated with specific recommendations regarding source of help and treatment. The consequences are twofold. First, as mental health professionals are dealing with non-compliance especially to psychotropic drugs, they have to realise that basic beliefs and expectations may play a more prominent role than has been previously assumed. Consequently, they have to put far more effort into what is called psychoeducation. Secondly, public knowledge about mental disorders and their treatment strategies has to be enhanced by working with the mass media and looking for other tailored interventions.

159 citations


Network Information
Related Topics (5)
Schizophrenia
38.2K papers, 1.6M citations
86% related
Anxiety disorder
17.6K papers, 1.3M citations
86% related
Comorbidity
26.8K papers, 1.4M citations
82% related
Anxiety
141.1K papers, 4.7M citations
81% related
Mental health
183.7K papers, 4.3M citations
81% related
Performance
Metrics
No. of papers in the topic in previous years
YearPapers
202332
202268
202175
202058
201960
201876