Psychotropic drug

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

Development of a classification rule for four clinical therapeutic psychotropic drug classes with EEG power-spectrum variables of human volunteers

Abstract: An objective rule for the classification of psychotropic substances has been developed. Classification is based on data from five basic studies simultaneously designed and performed and involving 75 healthy volunteers who ingested 20 different psychotropic drugs and 5 placebos in single oral dosages. Each volunteer took one psychostimulant, one antidepressant, one neuroleptic, one minor tranquilizer and one placebo in a double-blind Latin square cross-over design. The variables were 6 frequency bands, based on power spectrum estimates and determined by factor analysis, plus total power in the 1.5-30.0 Hz range. An objective classification rule was established by multi-group (5 groups) linear discriminant analysis. Reclassification of the substances by the new rule yielded correct results for 17 out of 20 psychotropic drugs and 4 out of 5 placebos. Of placebos from various studies not used for the establishment of the classification rule, 7/9 were classified correctly. The validity of the rule for other classes of substances will have to be verified in independent studies.

Polypharmacy in psychiatry: a multi-state comparison of psychotropic drug combinations.

Abstract: Surveys of prescription practices have indicated that what was initially a novel treatment choice begins to be employed with greater frequency in psychiatric samples. While data from geriatric samples show an apparent restraint on the part of psychiatrists in use of potent neuroleptic combinations, it is clear, drug combinations are still employed in older patients. Combinations of specific psychotropic agents are related to sex and age of the patient with the most frequent combination of drug type being of neuroleptic and antidepressant. This study presents data derived from an incidental sample of psychiatrists from four states having large patient and psychiatrist populations. A single case questionnaire survey was devoted to identifying the types of drugs used in combination. It was clear that this sample of psychiatrists, from diverse backgrounds who are responding to the same set of symptoms, used a broad array of drug combinations. Chlorpromazine-trifluoperazine was the combination showing most frequent use. As the patients' symptoms persisted, combinations of drugs used in treatment became more unique and diverse. After one year of ineffective chemotherapy combinations of three and up to six potent neuroleptics were prescribed. It would seem that once drugs were prescribed in combination then it becomes easier to add another and another to a failing chemotherapeutic regimen. New York respondents combined two drugs most frequently. Some go to combinations of three, four, and as many as six drugs at one time. Pennsylvania psychiatrists were next most frequent in multiple drug use. California and Texas respondents used combinations least frequently. Nonetheless, concern regarding polypharmacy practices may need to give way to "maxipharmacy" which in the extreme was represented by a regimen of six neuroleptic agents which included: fluphenazine-haloperidol-promazine-thioridazine-thiothixene-trifluoperazine. The proliferation of potent but partially effective psychotropic drugs has advanced the development of unnecessary treatment procedures. Polypharmacy in psychiatry represents an example of a "legitimate" but unnecessary use of psychotropic agents. The use of combinations of psychoactive medications developed and continues largely out of arbitrary clinical experience instead of evolving from medical data. Use of polypharmacy in treatment is similar in kind to developing a new generation of treatment forms, essentially investigational with insufficient evidence available regarding compatibility, dose response factors, side effects and relative efficacy.

Psychotropic medication use in patients with epilepsy: effect on seizure frequency.

Abstract: Physicians are often reluctant to use psychotropic medications in epilepsy patients with psychiatric disorders because of concern over the potential risk for lowering seizure threshold. This study assesses retrospectively the impact of psychotropic medications on seizure frequency in 57 patients seen consecutively at an epilepsy center. During psychotropic drug therapy, seizure frequency decreased in 33% of patients, was unchanged in 44%, and increased in 23%. Mean seizure frequency was not statistically different between pre-treatment and treatment periods (t = 0.23, df = 56). Simultaneous adjustments in antiepileptic drug regimen could not account for the findings. Results support the position that psychotropic medications, introduced slowly in low to moderate doses, can be safely used in epilepsy patients with comorbid psychiatric pathology during the regular course of clinical care.

Psychotropic medication in children and adolescents in the United States in the year 2004 vs 2014

Abstract: There is a global perception that psychotropic utilization in children and adolescents is increasing in the US. We present prevalent estimates for all psychotropics prescribed in the US (using commercial claims from Medicare and Medicaid) to children and adolescents in 2004 (total population N = 6,808,453) and in 2014 (total population N = 11,082.260). Further we evaluated if there has been a statistically significant change in prevalence during this time period. Analyses were stratified for the 6 major drug classes, all individuals’ psychotropics (87 drugs), age and sex. The prevalence of psychotropic drug prescription was 8.55% in 2004 and 9.00% in 2014 (age stratified in 2004 and 2014 toddlers: 3.08 and 2.63%, children: 8.74 and 8.73%, adolescents: 10.89% and 12.11). The prevalence for each drug class in 2004 and 2014 was: stimulants/other ADHD drugs 5.0 and 5.8%; antidepressants 2.8 and 2.7%; anxiolytic-hypnotic-sedative 2.2 and 2.3%; mood stabilizers 0.1 and 0.1%; antipsychotics 1.3 and 1.1%; and for drugs treating drug dependence 0.02 and 0.02%. The perception that psychotropic utilization in children and adolescents is increasing in the US, derived from the 2 to 3 fold increase seen from the mid 80’s to the mid 90’s is not valid anymore. There has been a slowdown in the increase of prescribing psychotropics. In the last 10 years, in toddlers there was a decrease in the prescription; in children there was no change; and in adolescents there was a slight increase. The prescription of antidepressants, antipsychotics and mood stabilizers has decreased overall.

Opioids, antiepileptic and anticholinergic drugs and the risk of fractures in patients 65 years of age and older: a prospective population-based study

Abstract: Background in men, the concomitant use of two or more benzodiazepines or two or more antipsychotics is associated with an increased risk of fracture(s). Potential associations between the concomitant use of drugs with central nervous system effects and fracture risk have not been studied. Objective the purpose was to describe the gender-specific risk of fractures in a population aged 65 years or over associated with the use of an opioid, antiepileptic or anticholinergic drug individually; or, their concomitant use with each other; or the concomitant use of one of these with a psychotropic drug. Methods this study was part of a prospective, population-based study performed in Lieto, Finland. Information about fractures in 1,177 subjects (482 men and 695 women) was confirmed with radiology reports. Results at 3 years of follow-up, the concomitant use of an opioid with an antipsychotic was associated with an increased risk of fractures in men. During the 6-year follow-up, the concomitant use of an opioid with a benzodiazepine was also related to the risk of fractures for males. No significant associations were found for females. Conclusion the concomitant use of an opioid with an antipsychotic, or with a benzodiazepine may increase the risk of fractures in men aged 65 years and older.