Psychotropic drug

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

Caracterización de muestras de cocaína inorgánica en una provincia ecuatoriana

Abstract: Consumption of cocaine represents an emerging health problem because it is an illicit psychotropic drug consumed among patients treated in emergency rooms, and it also generates other risks related to the components that may be present in it. The study was carried out with a quantitative, descriptive approach. The research aimed to characterize the inorganic samples of cocaine in the Forensic Chemistry Laboratory of a province in the Ecuadorian context during the period July-December 2016. The whole population of 90 samples was taken into account. The quantification of the chemical elements presented in the specimens was carried out through gas chromatography using a mass detector coupled to the equipment. It was determined that half of the samples contained impurities sucah as cinnamoylcocaine, methylecgonine and tropococaine, benzoylecgonine and only 11.1% of the samples did not have alkaloidal impurities as results of the research. Regarding the presence of adulterants in the material analyzed, starch was the most used by cocaine drug dealers in the studied environment; the use of phenacetin, levamisole and aminopyrine could also be observed.

Psychotropic drug use following venous thromboembolism versus diabetes mellitus in adolescence or young adulthood: a Danish nationwide cohort study

Abstract: Objectives Critical and chronic illness in youth such as diabetes can lead to impaired mental health. Despite the potentially traumatic and life-threatening nature of venous thromboembolism (VTE), the long-term mental health of adolescents and young adults with VTE is unclear. We compared the long-term mental health of adolescents and young adults with VTE versus adolescents and young adults with insulin-dependent diabetes mellitus (IDDM) using psychotropic drug purchase as proxy for mental health. Design Nationwide registry-based cohort study. Setting Denmark 1997–2015. Participants All patients aged 13–33 years with an incident diagnosis of VTE (n=5065) or IDDM (n=6609). Exposure First time primary hospital diagnosis of VTE or IDDM. Primary and secondary outcome measures Adjusted absolute risk and risk difference at 1 and 5 years follow-up for first psychotropic drug purchase comparing patients with VTE and patients with IDDM. Results The absolute 1 year risk of psychotropic drug use was 6.2% among VTE patients versus 3.6% among patients with IDDM, at 5 years this was 19.3%–14.7%, respectively. After adjusting for the effect of sex, age and risk factors for VTE this corresponded to a 1 year risk differences of 1.9% (95 % CI 0.1% to 3.3%). At 5 years follow-up the risk difference was 1.9% (95% CI 0.5% to 3.3%). Conclusion One-fifth of adolescents and young adults with incident VTE had claimed a prescription for a psychotropic drug within 5 years, a risk comparable to that of young patients with IDDM.

Psychotropic Drug Intolerance.

Abstract: I ntolerance to psychotropic drugs can reflect an underlying food intolerance syndrome. Such a diagnosis is rarelymade as a consequence of a lack of awareness of the syndrome, the generally nebulous pattern of symptoms, and the likelihood of viewing such a phenomenon as simply reflecting that all psychotropic drugs have side effects. Two case vignettes are presented to provide representative clinical profiles. The second vignette details how intervention involving an elimination diet and progressive exposure to at-risk foods and psychotropic medications can effect improvement or resolution of the syndrome. Although psychotropic drug side effects are common and intolerance to them canmanifest in differing ways and reflect differing underlyingmechanisms, their intolerance as a consequence of the individual having a food intolerance syndrome is rare and often undetected by managing clinicians. In this article I seek to advance recognition of the phenomenon and how it may be addressed by providing 2 clinical vignettes. Patient A: A 25-year-old woman who developed her first melancholic depressive episode after the birth of her only child and was initially treated with sertraline and later with venlafaxine and reboxetine, all for brief periods as they provided minimal benefit and were described by her as causing significant side effects. Over the next 3 months, she experienced mild hypomanic episodes for the first time in her life, and it was unclear whether thesewere induced by the antidepressant medication (i.e., a bipolar III scenario) or she had developed an intrinsic bipolar II condition. Her only nominated allergic condition was eczema. Over the next few years, she was trialed on a number of antidepressant medications (including mirtazapine, moclobemide, tranylcypromine, methylphenidate, and several selective serotonin reuptake inhibitors), mood stabilizers (i.e., lithium, valproate, and lamotrigine), and augmenting antipsychotic drugs (e.g., olanzapine) when the existence of a true bipolar II syndrome was more evident. In addition to a number of side effects common to differing psychotropic medications, she reported less common ones. Low-dose sertraline was associated with her developing panic attacks, venlafaxine at a dose of 37.5 mg caused hyperacusis, mirtazapine at a daily dose of 15 mg was associated with agitation, and tranylcypromine inducedmarked anergia and impaired concentration. Some of the antidepressants were initially beneficial before side effects commenced. When ceased, her mood would improve for short periods only. While taking lithium, she reported a poor memory (but with a brain magnetic resonance imaging being reported as normal) and hair loss. While taking concurrent lamotrigine, lithium, and tranylcypromine, she developed right-sided ear pain and vertigo. An ear, nose, and throat specialist recorded that he could not provide a diagnosis in light of the unusual history and symptom pattern, but in light of the sinusitis and eustachian tube dysfunction, a grommet was inserted. While taking lithium and low-dose lamotrigine, she developed tics. Valproate also caused hair loss. In light of her tics, she was referred to a neurologist. He obtained a history of her having “a slight tendency to twitch or mannerisms” in childhood. She detailed how shewould experience jaw tightening, tilting of the head, a rising of the pharynx, and tightening of the abdominal muscles, all often associated with jaw clenching. The neurologist also noted that she “has no true drug allergies but has had very unpleasant reactions to codeine.” Her creatinine levels increased over 3 years while prescribed lithium (which she judged as of some benefit) to a level indicative of compromised renal clearance. She was referred to a renal physician who also obtained a history of recent disproportionate fatigue and breathlessness on mild exertion andmade a diagnosis of mild lithium-associated nephrogenic diabetes insipidus but judged that lithium could be continued. Over the next year (while in receipt of 625 mg of lithium/day only), her fatigue worsened and she had repeat sinus infections. In light of an extended pattern of protean side effects associated with low doses of medications, the multiple physical problems, and a vague history of intolerance to alcohol, sugar, and fatty foods, she was referred to an allergy unit, where she underwent an elimination diet and challenge program to identify any food chemical intolerances. Such testing identified that she had reactions to milk, wheat, gluten, soy, amines, salicylates, and added antioxidants. She was encouraged to follow a prescribed diet low in those chemicals and that her diet would then be later liberalized as she was able to tolerate such food chemicals.

Multiple indicators of ill health are evident in people with psychosis.

Abstract: Commentary on: Stubbs B, Koyanagi A, Veronese N, et al . Physical multimorbidity and psychosis: comprehensive cross sectional analysis including 242,952 people across 48 low- and middle-income countries. BMC Med 2016 Nov 22;14:189. There is a very strong association between mental and physical illness that challenges the typical focus of healthcare systems on either mental or physical disorders.1 The relationship between psychosis and physical illness, including multiple physical illnesses (multimorbidity), is of considerable interest because people with psychosis have a greatly reduced life expectancy2 and in high-income countries most of those excess early deaths are due to natural causes. The most common of these causes may be inter-related and may therefore form a distinctive pattern of ‘multimorbidity’ associated with psychosis.3 Unravelling that pattern by age and gender, and by exposure to salient risk factors, may provide timely targets for clinical trials and early intervention initiatives to improve health and extend life expectancy. The observed level or pattern of multimorbidity may vary across high-income, middle-income and low-income countries because of variation in exposure to salient risk factors including local psychotropic drug prescribing patterns and tobacco use; both have been implicated in the poor physical health of people with psychosis in high-income countries where cardiovascular disease is the primary cause of excess early deaths. The aim of the study by Stubbs …