Psychotropic drug

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

Essential oil therapy for the short-term treatment of behavioral and psychological symptoms of dementia: a monocentric randomized pilot study

Abstract: The behavioral and psychological symptoms of dementia (BPSD) can be severely distressing for both patients and caregivers. This study assessed the efficacy of environmental diffusion essential oil therapy (EOT) combined with psychotropic drug therapy (group A) in BPSD management, compared with psychotropic drug therapy alone (group B). The stress responses of attending caregivers were also assessed. Thirty-two patients with dementia and BPSD were enrolled. The presence and severity of BPSD were assessed using the Italian version of the NPI-NH scale, which also measures the stress felt by professional caregivers. Global geriatric evaluations were performed to rule out acute diseases that could contribute to delirium and worsen patients’ mental status. Following treatment, the average NPI-NH value was significantly reduced in group A compared with group B (p < 0.001). Caregiver distress was also significantly reduced in group A (p < 0.01). This pilot study showed that BPSD were better treated using EOT combined with standard pharmacological treatment, compared with standard pharmacological treatment alone. No adverse effects of EOT were observed. Reductions in caregiver distress could be due either to reductions in BPSD severity and frequency resulting in decreased caregiver burden, and/or the emotional benefit for caregivers of exposure to essential oils. This study supports the combined use of EOT and psychotropic drugs in the treatment of BPSD. Essential oils may improve the wellbeing of both patients and caregivers, without adverse effects. Additionally, EOT is easy to administer by environmental diffusion.

Primary prevention for offspring of parents with mental illness.

Abstract: Byline: T. Sathyanarayana Rao, Chittaranjan. Andrade Much literature has addressed caregiver burden in relation to depression, [sup][1] anxiety disorders, [sup][2] bipolar disorder, [sup][3] schizophrenia, [sup][4] dementia, [sup][5] and other mental illnesses. [sup][6] How are families, specifically children, affected when the patients are themselves the caregivers? This question is important because the offspring of parents with mental illness are at increased risk of medical, psychological, and social adversity for psychosocial and biological reasons, such as inadequate parental care, socioeconomic difficulties, genetic disadvantage, and psychotropic drug exposure in utero and during the puerperium. Much literature is available on certain of these issues, such as the effects on children resulting from the use of psychotropic medications during pregnancy and lactation. However, there is only a modest body of research on the medical health of these children during their preschool years. Two very recent studies on the early survival of children of parents with mental illness are briefly reviewed. One study addresses the sudden infant death syndrome (SIDS) in infants of parents with a history of psychiatric admission, and the other addresses the natural and unnatural causes of death in preschool children of parents with mental illness. Both studies highlight new areas for primary prevention; areas that would otherwise be neglected in routine clinical practice. Sudden Infant Death Syndrome Sudden infant death syndrome (SIDS) refers to sudden, unexplained death occurring during the first year of life. The risk of SIDS is known to be higher in infants of persons with mental illness. [sup][7],[8] Webb et al , [sup][9] investigated the possible reasons for this finding. The study was based on data collected on nearly 2.5 million singleton live births in Sweden between 1978 and 2004. There were 1531 cases of SIDS in the whole cohort, and the crude rate of SIDS was 0.6 per 1000 live births. The study threw up several important findings. Relative to the infants of women who were never admitted for psychiatric treatment, the risk of SIDS was trebled in infants of mothers with a history of psychiatric admission (OR, 3.1; 95% CI, 2.6-3.8). The risk was particularly high in mothers admitted for alcohol or drug-related disorders (OR, 6.5; 95% CI, 4.9-8.7), and was also high in mothers admitted with other diagnoses (OR, 2.3; 95% CI, 1.8-2.9). Relative to the infants of control fathers, the risk of SIDS was more than doubled in infants of fathers with a history of psychiatric admission (OR, 2.5; 95% CI, 2.0-3.1). The risk was significantly elevated with alcohol and drug-related diagnoses (OR, 2.8; 95% CI, 2.1-3.8), as well as with other diagnoses (OR, 2.1; 95% CI, 1.5-3.0). The risk of SIDS was elevated nearly seven-fold when both parents had a history of admission for any mental illness (OR, 6.8; 95% CI, 4.7-10.0). Again, the risk was higher in association with alcohol and drug-related admissions (OR, 9.5; 95% CI, 5.5-16.4) than with admissions for other diagnoses (OR, 5.4; 95% CI, 3.2-9.2). Curiously, the risks were not significant for parental affective and non-affective psychoses, specifically, but this could have been because the analyses were underpowered. Strikingly, the risk remained elevated even if the last maternal admission was five or more years before the infant's birth. After a national campaign to reduce SIDS, the risk factor prevalence (especially maternal antenatal smoking) remained high in parents with a history of mental illness, and therefore, the relative risk of SIDS increased. During 1992-2004, smoking and individual social adversity measures together accounted for approximately half of the excess risk associated with maternal psychiatric admission, whereas the risk associated with obstetric factors remained minimal. Preschool Mortality Chen et al,[10] provided a good review of the previous research and presented the first Asian data on preschool mortality in children of parents with mental illness. …

Asterixis (Flapping Tremors) As an Outcome of Complex Psychotropic Drug Interaction

Abstract: To the Editor: Asterixis (flapping tremors) is an important clinical sign. It is not pathognomonic of any condition, but gives a clue to serious underlying disease processes. A few psychotropic drugs are also known to cause asterixis, especially when used in combination. Here, we report on a patient who developed asterixis on a combination of psychotropic agents: clozapine, sodium valproate, and risperidone. Asterixis (flapping tremors) is a motor disturbance marked by intermittent lapses of an assumed posture, as a result of intermittency of sustained contraction of groups of muscles. It was first described by Adams and Foley in 1949; it usually manifests as a bilateral flapping tremor at the wrist, metacarpo-phalangeal, and hip joints. It may also be seen in tongue, foot, and any skeletal muscle. Except for the facial muscles, the tremors occur in an asynchronous fashion on either side of the body. The exact mechanism by which asterixis occurs remains unknown. A leading theory suggests interruption of the posture pathway in the rostral reticular formation and abnormal joint proprioception. The lapse of posture has been termed “negative clonus” because, during tonic muscle contraction (i.e., posture), a short EMG silent period precedes the tremor. In essence, the patient struggles to maintain posture while posturecontrol repetitively vanishes. It is best demonstrated by extending the hand and dorsiflexing the hand. Common causes of asterixis are hepatic encephalopathy, renal failure, metabolic encephalopathy, CO2 toxicity, and Wilson’s disease. A few psychotropic drugs are also associated with asterixis, and, most of the time, it is the combination of psychotropic drugs that can lead to asterixis. Here, we report on a patient who developed asterixis on a combination of psychotropic agents: clozapine, sodium valproate, and risperidone.