Psychotropic drug

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

Neuroenhancement in Young People: Proposal for Research, Policy, and Clinical Management

Abstract: Psychotropic neuroenhancement by young people under 18 is growing, and is certain to increase further with the availability of effective drugs and increasing tolerance for neuroenhancement practices. Use of these agents by young people for purposes of enhancement has social and ethical implications that require scrutiny and analysis. It is particularly important that these analyses do not simply translate normative judgments on adult neuroenhancement practices or intentions to young people. In this article, we outline the key social and ethical concerns raised by the use of stimulant drugs for neuroenhancement in young people and make specific research, practice, and policy recommendations. We also suggest a rationale for clinical management of psychotropic drug neuroenhancers for young people, attending closely to the necessary boundaries on such practice asserted by organizational and clinical factors, as well as by potential ethical conflicts.

Molecular mechanisms of drug addiction: adaptations in signal transduction pathways.

Abstract: Despite staggering advances in the neurosciences over the past decade, detailed knowledge of the pathophysiology and pathogenesis of psychiatric disorders remains severely limited. Similarly, the mechanisms by which long-term exposure to psychotropic drugs leads to their clinically relevant actions are not yet known. This relative lack of progress in psychiatric research is due in part to the extraordinary complexity of the brain and the difficulties inherent in studying central nervous system pathology. However, the lack of progress is also due to the limited scope of psychiatric neuroscience, which remains focused to a great extent on traditional neurotransmitters and their receptors as the site of pathophysiological lesions in a disease state and as the ultimate targets for pharmacological treatments of these disorders. This limited focus persists despite our current knowledge that such neurotransmitters and receptors are truly the tip of the iceberg of the brain's complex inter- and intraneuronal regulatory machinery. The goal of this review is to illustrate how our rapidly evolving knowledge of neuronal regulatory mechanisms can be used as a template within which to delineate more complete models of the molecular mechanisms of psychotropic drug action, as well as the role of genetic and environmental factors in determining individual differences in drug responsiveness. The focus of the review is on drug addiction. Repeated exposure to drugs of abuse has been shown to elicit long-term adaptations in post-receptor second messenger and protein phosphorylation pathways in specific brain regions. There is increasing evidence that these adaptations are part of the molecular basis of an addictive state. Individual differences in some of these same signaling proteins also may contribute to individual differences in vulnerability for drug addiction. More recent research has demonstrated that drug-induced adaptations occur in other, non-second messenger-related, post-receptor signaling pathways, specifically, those influenced by neurotrophic factors. Together, these studies provide insight into the complex mechanisms that must be considered in understanding the brain's adaptations to chronic perturbations in general as well as the formation of a neuropsychiatric disorder and its treatment.

Prevalence and correlates of psychotropic drug use in Dutch nursing-home patients with dementia

Abstract: BACKGROUND: Neuropsychiatric symptoms in dementia patients are common and are often treated with psychotropic drugs. The aim of this study was to determine the prevalence and correlates of psychotropic drug use in Dutch nursing home patients with dementia. METHODS: Psychotropic drug use of 1322 patients on 59 dementia special care units (SCUs) in 25 nursing homes was registered. Drugs were categorized according to the Anatomical Therapeutical Chemical classification (ATC). The influence of age, gender, dementia stage measured by the Global Deterioration Scale (GDS), and type of neuropsychiatric symptoms on psychotropic drug use was analyzed using binomial logistic regression analysis. RESULTS: 63% of the patients used at least one psychotropic drug. Psychotropics in general and antipsychotics in particular were most frequently prescribed in GDS stage 6, and in patients aged between 65 and 75 years. Psychotropics in general were positively associated with depression, night-time behavior and agitation. Antipsychotic drug use was positively associated with psychosis, agitation and night-time behavior and was negatively associated with apathy. Anxiolytics were associated with age, psychosis, agitation and night-time behavior. Antidepressants were most frequently prescribed in GDS stage 6 and associated with female gender, agitation and depression. Sedatives were only associated with night-time behavior. CONCLUSION: Nursing home patients with dementia have a high prevalence of psychotropic drug use. In particular, the association with neuropsychiatric symptoms raises questions of efficacy of these drugs and the risk of chronic use.