Psychotropic drug

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

Use of psychotropic drugs in mentally handicapped adults

Abstract: Type and frequency of psychotropic drug treatment have been analysed in the case of 1154 institutionalized and non-institutionalized mentally retarded adults. The psychotropic drug prevalence amounts to 21.7%, only about one half of corresponding rates in other studies; possible causes of this result are discussed. Neuroleptics are prescribed most frequently by far, succeeded by anxiolytics. The psychotropic drug prevalence is significantly related to age, sex, and setting. A comparison of the psychotropic drug treatment of 1980 with that of 1986 above all shows a distinctly rarer prescription of anxiolytics and hypnotics as well as a decrease of polypharmacy in 1986.

Event-related potentials and use of psychotropic medication in major psychiatric disorders

Abstract: Attention deficits measured using event-related potentials (ERPs) have been frequently reported in several major psychiatric disorders, e.g. mood disorder (MD), psychotic disorder (PD) and substance use disorder (SUD). However, comparisons between these specific categories are lacking. Here we investigated if electrophysiological parameters of basic information processing are associated with the above-mentioned categories of psychiatric disorders, or instead were associated with general psychopathology.579 subjects with MD, PD or SUD and healthy controls (HC) were included. Participants were tested in a passive auditory and an active visual oddball paradigm to assess mismatch negativity (MMN), P3A and P3B amplitudes. Additionally, we examined associations between these measures and psychoactive medication treatments.All patients had significantly lower P3B amplitudes compared to healthy controls, while only SUD patients had lower P3A amplitudes than MD, PD and HC. PD patients also produced significantly less MMN than both MD and SUD patients. Additionally, we found significantly higher P3B amplitude in HC compared to patients without psychopharmacological treatment and patients treated with two or more psychoactive compounds (polypharmacy), but no significant associations with medication on P3A and MMN amplitudes.Our results add to the theory that P3B deficits are associated with general psychopathology, whereas P3A and MMN deficits appear to be associated with substance abuse and psychotic disorders respectively.

Opinion: Secular Trends and Postgraduate Teaching Challenges in Psychopharmacology

Abstract: Much has changed in the past two decades in terms of the pharmacotherapy of psychiatric disorders across the lifespan. It was just over 20 years ago that fluoxetine was first marketed in the United States and shortly thereafter clozapine made its remarkable return to patient care. But at the time these medications received marketing approvals from the FDA, Health Canada, and other nations’ regulatory agencies, we were not to know the impact they would have—on clinical practice, the pharmaceutical industry, psychotropic drug research, drug nomenclature, psychiatric nosology, perceptions of psychiatric patients and care, as well as education in clinical psychopharmacology. Prozac® quickly became a household word, supplanting Valium® as the best known psychotropic (Kramer, 1993). It also emerged as a lightning rod in child and adolescent psychopharmacology (Healy, 2003; Teicher et al., 1990). Prozac® was the first of several very successfully marketed SSRIs, which were found to be particularly effective in pediatric anxiety disorders. However, this therapeutic advance was overshadowed by these SSRIs’ uncertain benefit in adolescent depression and the early indications that they could promote rather than thwart suicidality in young patients (Research Unit on Pediatric Psychopharmacology, 2001; Kutcher & Gardner, 2008). The “awakenings” of chronically psychotic patients treated with clozapine generated hope and renewed interest in psychiatric practice, not unlike the pride described by psychiatrists 30 to 40 years earlier when the benefits of lithium, chlorpromazine, iproniazid, and imipramine were serendipitously uncovered, and heralded the modern psychopharmacologic era (Duckworth et al., 1997; Lambert, 1998). It was much easier to teach (and to learn) about psychotropic drugs when our understanding of the pathophysiological processes of mental illness were simple and the proposed mechanisms of how these drugs worked were uncomplicated. It was also easier to teach about psychotropics when their numbers were limited to a few distinct families with simply described pharmacological actions—dopamine antagonism for schizophreina, dopamine agonistic effects for attention, GABAmimetics for anxiety, and enhancement of serotonin or norepinephrine for depression. For bipolar disorder, we seemed content to have found lithium and other so-called mood stabilizers, even if their mechanisms remained mysterious. Never mind that the above psychotropic drugs were incompletely effective for most patients and completely ineffective for some, the proposed pharmacologic mechanisms meshed well with the pathophysiological proposals (though in many cases this was no coincidence) and this suited us just fine (Teicher, 1988). The neuroscientific basis of psychiatric disorders and investigations into the pharmacological effects of their treatments have exploded in the past 20 years coincident with advances in molecular genetics, molecular and cell biology, molecular pharmacology, pharmacogenomics, and imaging technologies. New findings have revealed the initial biologic theories of psychiatric disorders to be overly simplistic, incomplete, or wrong. However, replacing these aging theories with newer, widely accepted ones has not occurred despite many dramatic advances (Conn & Roth, 2008). Exemplifying the growth in this area and its complexity are the contents of the American College of Neuropsychopharmacology’s exhaustive 2002 reference text Neuropsychopharmacology 5th Generation of Progress. This text has 2,010 pages, written by almost 300 expert contributors, covering 134 chapters (Davis et al., 2002). In contrast to these neuroscience advances, new drug discovery has been slow and disappointing. It is sobering to note that the most commonly prescribed psychotropics share the same mechanism of action discovered many decades earlier. For example, olanzapine, risperidone, and quetiapine are more potent antagonists at 5-HT2 compared to D2, an effect of clozapine which was developed in 1961; venlafaxine’s dual reuptake blockade of serotonin and noradrenaline is a characteristic of the tricyclic antidepressants, and the specificity for serotonin reuptake inhibition was first observed with zimelidine in 1977 but was hardly a new mechanism of antidepressant action even then (Conn & Roth, 2008). Paradoxically, as the research base has expanded there seems to be less emphasis on teaching the neuroscientific basis of psychiatric disorders and their treatments. That is, as the information has become increasingly complex the response has been to de-emphasize its importance.

Changed plasma prolactin levels after etoperidone and placebo.

Abstract: A neuroendocrinological study was carried out by evaluating plasma prolactin levels after etoperidone i.m. (100 mg) and placebo. Fourteen male inpatients (mean age: 35.36 +/- 11.7 years) with chronic schizophrenia were selected for the study, whose aim was to improve interpretation of the pharmacological activity of etoperidone. The results suggest that etoperidone plays the role of an atypical psychotropic drug since it does not affect prolactin levels. In addition, the drug is devoid of anticholinergic effects, which facilitates its prospective clinical use for medium-term and long-term therapy.