Psychotropic drug

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

Clinical Evaluation of Psychotropic Drugs: Principles and Guidelines

Abstract: Part 1 Historical perspectives: history and role of guidelines and guidance of drug evaluation, Jerome Levine decision processes in establishing the efficacy and safety of psychotropic drugs, Louis Lasagna. Part 2 General principles in the evaluation of psychotropic drugs: design issues for the clinical evaluation of psychotropic drugs, Eugene M. Laska et al classification issues in patient selection and description, Jean Endicott et al assessment and measurement of clinical change, A. John Rush et al pharmacologic considerations, David J. Grenblatt et al statistical issues for the clinical evaluation of psychotropic drugs, Philip W. Lavori et al clinical trial implementation, Ronald Kartzinel et a premarketing safety evaluation of psychotropic drugs, Thomas P. Laughren et al post-marketing surveillance of drugs, Leo E. Hollister et al documenting and reporting the study results of a randomized clinical trial (spicy meatballs, not pabulum), David J. Kupfer et al ethical and legal considerations in drug trials, Don Gallant and Susan Krinsky. Part 3 Specific patient groups - application of general methodologic principles: evaluating drug treatments of depressive disorders, Gerals L. Klerman et al evaluating pharmacologic treatments for bipolar disorder, Alan J. Gelenberg et al methods for clinical evaluation of pharmacologic treatments of schizophrenia, John M. Kane et al evaluating drug treatments of generalized anxiety disorder and adjustment disorders with anxious mood, Karl Rickels et al evaluation of psychotropic drug treatment of panic-related disorders and social phobia, Donald F. Klein et al obsessive-compulsive disorder, Wayne K. Goodman et al methods for the evaluation of pharmacologic agents in the treatment of cognitive and other deficits in dementia, Samuel Gershon et al clinical trials in children and adolescents, Rachel G. Klein et al evaluation of pharmacolocig treatments in eating disorders, Katherine A. Hamli et al evaluation of hypnotic medications, Thomas Roth et al establishing the efficacy and safety of medications for the treatment of drug dependence and abuse - methodologic issues, Jack D. Blaine et al evaluation of pharmacological treatments for alcohol abuse, dependence and their complications, Markku Linnoila et al evaluation of pharmacologic treatments in personality disorders, Paul H. Soloff et al.

Are sedatives and hypnotics associated with increased suicide risk of suicide in the elderly

Abstract: While antidepressant-induced suicidality is a concern in younger age groups, there is mounting evidence that these drugs may reduce suicidality in the elderly. Regarding a possible association between other types of psychoactive drugs and suicide, results are inconclusive. Sedatives and hypnotics are widely prescribed to elderly persons with symptoms of depression, anxiety, and sleep disturbance. The aim of this case-control study was to determine whether specific types of psychoactive drugs were associated with suicide risk in late life, after controlling for appropriate indications. The study area included the city of Gothenburg and two adjacent counties (total 65+ population 210 703 at the start of the study). A case controlled study of elderly (65+) suicides was performed and close informants for 85 suicide cases (46 men, 39 women mean age 75 years) were interviewed by a psychiatrist. A population based comparison group (n = 153) was created and interviewed face-to-face. Primary care and psychiatric records were reviewed for both suicide cases and comparison subjects. All available information was used to determine past-month mental disorders in accordance with DSM-IV. Antidepressants, antipsychotics, sedatives and hypnotics were associated with increased suicide risk in the crude analysis. After adjustment for affective and anxiety disorders neither antidepressants in general nor SSRIs showed an association with suicide. Antipsychotics had no association with suicide after adjustment for psychotic disorders. Sedative treatment was associated with an almost fourteen-fold increase of suicide risk in the crude analyses and remained an independent risk factor for suicide even after adjustment for any DSM-IV disorder. Having a current prescription for a hypnotic was associated with a four-fold increase in suicide risk in the adjusted model. Sedatives and hypnotics were both associated with increased risk for suicide after adjustment for appropriate indications. Given the extremely high prescription rates, a careful evaluation of the suicide risk should always precede prescribing a sedative or hypnotic to an elderly individual.

The interrelation between premenstrual syndrome and major depression: results from a population-based sample.

Abstract: Research about the relationship between premenstrual syndrome (PMS) and major depression is limited. This study examined the relationship between moderate to severe PMS and major depression in a population-based sample of women of reproductive age. The objectives of the study were to assess the association between premenstrual syndrome and major depression, to analyse how PMS and major depression differ and to characterise the group of women who report both PMS and major depression. Data were obtained from the Swiss Health Survey 2007. Included in the analysis was data from women under the age of 55 without hysterectomy and who answered the questions on PMS symptoms. The population-based sample consisted of 3518 women. Weighted prevalence rates were calculated and relative risk ratios for PMS, major depression and women who reported both PMS and major depression, were calculated with logistic multinominal logit regression. The prevalence of major depression was 11.3% in women screening positive for moderate PMS and 24.6% in women screening positive for severe PMS. Compared to women without any of these conditions, women who reported moderate to severe alcohol consumption had a lower risk for PMS. Women reporting use of antidepressants, and use of oral contraceptives had a higher risk for major depression compared to women without any of these conditions. Women reporting work dissatisfaction had a higher risk for PMS. A higher relative risk to report both PMS and major depression compared to women without PMS or major depression was related to factors such as high psychological distress, low mastery, psychotropic drug consumption, and low self-rated health. The results suggested that women who suffer from both PMS and major depression are more impaired compared to women with only one disorder. The results further indicated that PMS and major depression are different disorders that can, however, co-occur.

Importance of early weight changes to predict long-term weight gain during psychotropic drug treatment.

Abstract: BACKGROUND: Psychotropic drugs can induce substantial weight gain, particularly during the first 6 months of treatment. The authors aimed to determine the potential predictive power of an early weight gain after the introduction of weight gain-inducing psychotropic drugs on long-term weight gain. METHOD: Data were obtained from a 1-year longitudinal study ongoing since 2007 including 351 psychiatric (ICD-10) patients, with metabolic parameters monitored (baseline and/or 1, 3, 6, 9, 12 months) and with compliance ascertained. International Diabetes Federation and World Health Organization definitions were used to define metabolic syndrome and obesity, respectively. RESULTS: Prevalences of metabolic syndrome and obesity were 22% and 17%, respectively, at baseline and 32% and 24% after 1 year. Receiver operating characteristic analyses indicated that an early weight gain > 5% after a period of 1 month is the best predictor for important long-term weight gain (≥ 15% after 3 months: sensitivity, 67%; specificity, 88%; ≥ 20% after 12 months: sensitivity, 47%; specificity, 89%). This analysis identified most patients (97% for 3 months, 93% for 12 months) who had weight gain ≤ 5% after 1 month as continuing to have a moderate weight gain after 3 and 12 months. Its predictive power was confirmed by fitting a longitudinal multivariate model (difference between groups in 1 year of 6.4% weight increase as compared to baseline, P = .0001). CONCLUSION: Following prescription of weight gain-inducing psychotropic drugs, a 5% threshold for weight gain after 1 month should raise clinician concerns about weight-controlling strategies.