This document provides information on the treatment of schizophrenia including:
- Core symptoms of schizophrenia and their association with brain circuits.
- The development of antipsychotic medications from first-generation to second-generation drugs.
- Principles of selecting and prescribing antipsychotics including individualizing treatment, safety, tolerability, and cost considerations.
- Factors to consider when choosing an antipsychotic such as a patient's medical history, adherence, and life stage. Relevant receptor profiles and side effects of different antipsychotics are discussed.
Treating Treatment Refractory Depression With TMS, Transcranial Magnetic Stimulation. TMS is for patients suffering from depression who have not achieved satisfactory improvement from prior antidepressant treatment. These slides show research and anecdotes taken from actual results of patients who've tried TMS.
Brand name : NAMENDA
US FDA Approval :October 2003
NMDA (N-methyl-D-aspartate) receptor antagonist
Indicated for the treatment of moderate to severe Alzheimer’s Disease
Recent advances in the management of Parkinson's Disease (PD)Sudhir Kumar
Parkinson's disease is a neurodegenerative disease causing severe disability. In the past 10-15 years, a lot of new medicines and treatments have become successful in helping patients with PD. The current review focuses in all approved treatments for PD
Treating Treatment Refractory Depression With TMS, Transcranial Magnetic Stimulation. TMS is for patients suffering from depression who have not achieved satisfactory improvement from prior antidepressant treatment. These slides show research and anecdotes taken from actual results of patients who've tried TMS.
Brand name : NAMENDA
US FDA Approval :October 2003
NMDA (N-methyl-D-aspartate) receptor antagonist
Indicated for the treatment of moderate to severe Alzheimer’s Disease
Recent advances in the management of Parkinson's Disease (PD)Sudhir Kumar
Parkinson's disease is a neurodegenerative disease causing severe disability. In the past 10-15 years, a lot of new medicines and treatments have become successful in helping patients with PD. The current review focuses in all approved treatments for PD
It may contain a brief intoduction of disease, etiology, types of parkinson disease, clinical findings, dignosis, pathophysiology, treatment, drug classification and their mechanisms of actions.
Similar to Hani hamed dessoki art, antipsychotic (20)
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Prof. Hani Hamed Dessoki, M.D.Psychiatry
Prof. Psychiatry
Chairman of Psychiatry Department
Beni Suef University
Supervisor of Psychiatry Department
El-Fayoum University
APA member
5. Developments in the Treatment
of Schizophrenia
’30s
’40s
’50s
’60s
Haloperidol
Electroconvulsive Fluphenazine
Thioridazine
therapy
Loxapine
Perphenazine
Chlorpromazine
First Generation
Antipsychotics
(FGAs)
’70s
’80s
’90s & ’00
’06-’08
Clozapine Risperidone
Olanzapine
Quetiapine
Ziprasidone
Aripiprazole
Asenapine
Bifeprunox
Paliperidone
Iloperidone
Second Generation
Antipsychotics
(SGAs)
6. Introduction
Knowing how antipsychotic drugs work at specific
receptor sites helps the clinician select the drug of
choice for an individual patient.
Older and newer antipsychotics show, in general,
approximately the same efficacy in countering
psychotic symptoms.
7. Principles of Antipsychotic Access,
Efficient Utilization and Prescribing
1.
Treatment with antipsychotic medications, like any
other treatment, should be individualized in order to
optimally promote recovery.
2.
Treatment with antipsychotic medication should be
as effective, safe and well-tolerated as possible.
3.
Treatment with antipsychotic medication should
consider personal preference and vulnerabilities.
8. Principles cont’d
4. Treatment with antipsychotic medication should
provide value in terms of improved quality of
life to the consumer.
5. Treatment choices should be informed by the
best current evidence and must evolve in
response to new information.
6. Cost considerations should guide
antipsychotic medication selection if the
preceding principles are met.
9. Binding to Receptors
Agonists & Antagonists bind competitively - beware misunderstandings
from binding data without further functional analysis
Endogenous agonists often bind weakly (enthalpy driven)
Successful antagonists often bind tightly (entropy driven)
Agonist
Partial
Agonist
Antagonist
Inverse
Partial
Agonist
Inverse
Agonist
12. loosely bound;
fast release from
receptor
tightly bound;
slow release
from receptor
DA receptor
Drug
psychlotron.org.uk
Typical vs. atypical
13. Difference Between Low and High
States cont’d
The affinity, or more precisely, the dissociation
constant (K) of dopamine for the high-affinity
state of the D2 receptor is between 1.7 and 1.8
nM (nanomoles of dopamine per liter of water).
The traditional antipsychotics generally have
dissociation constants lower than 1.75 nM, which
means that they are more tightly bound to D2
compared with dopamine.
14. Does 65% Occupancy Need to Be
Maintained Full Time? (cont.)
The new so-called atypical antipsychotics, such as
clozapine, quetiapine, amisulpride, and remoxipride
merely "block and run” (but at different speeds).
For instance, the atypical, sertindole, and olanzapine, dissociates
from the D2 receptor more slowly than clozapine or quetiapine, but
more quickly than haloperidol or chlorpromazine.
15. Relative Binding of Antipsychotics
To D2 Receptors
K at D2 (nM)
100
10
Quetiapine
Clozapine
Olanzapine
Sertindole
“Loose”
“Intermediate”
Dopamine K (1.5nM)
1
Risperidone
Ziprasidone
Chlorpromazine
Haloperidol
Fluphenazine
0.1
“Tight”
16. Relevant Occupancy
The blockade needed to alleviate psychotic
symptoms is approximately two thirds or 65% of
the population of D2 receptors (e.g. basal ganglia
or striatum).
When fewer than 60% of receptors are occupied
(ie, when subthreshold doses are prescribed or
when medication is not taken as prescribed), the
symptoms of psychosis return.
17. Motor Side Effects
The emergence of motor side effects with using of
typical antipsychotics depends on the exact
percentage of occupied D2 receptors (80%
occupancy of D2).
However, patients on the new atypical compound,
Sertindole and aripiprazole, may not exhibit
parkinsonism even with 90% occupation of D2
receptors.
18. Motor Side Effects (Cont.)
In general, for first-generation antipsychotics, the
effective dose range before motor side effects set is
relatively narrow.
So raising the dose of haloperidol, for instance,
from 2 mg per day to 4 mg per day may
overshoot the 80% occupancy place a patient over
the threshold for the development of EPS.
19. Does 65% Occupancy Need to Be Maintained
Full Time? (cont.)
Brain imaging studies indicate that the traditional
antipsychotics stay attached to dopamine D2
receptors for at least 1 or 2 days following an oral
dose (daily administration is unnecessary & problematic).
Receptor proliferation not only requires
progressively higher doses in order to maintain
efficacy but, in addition, is probably responsible for the
development of tardive dyskinesia.
20. Does 65% Occupancy Need to Be Maintained
Full Time? cont’d
Clozapine and quetiapine should be taken daily.
Sertindole, olanzapine and risperidone should
probably be taken every second day.
Haloperidol and chlorpromazine every third day.
Thus maintaining intermittent 65% occupancy.
21. Why Psychotic Symptoms Wane With
Age?
Under untreated conditions, the number of
receptors diminishes as the person ages.
This explains, perhaps, the age-related reduction of speed of
arousal, of peaks of pleasure, of frequency of impulsive behavior -all experiences mediated by dopamine.
22. Why Higher Doses Are Required Over
Time
In patients treated over long periods of time with
antidopaminergic drugs, receptor proteins adapt
to blockade by creating more D2 receptors
(receptor proliferation).
So that, in chronically treated schizophrenia
patients, receptor numbers rise and
maintenance doses increase at the same time.
23. Choosing antipsychotic & why?
Treating patients who are undergoing stress.
Treating first episode
Treating non adherent patients
Treating patients with a family history of
osteoporosis
Treating cardiac patients or those with a
family history of cardiac disease.
24. Choosing antipsychotic & why?
(cont.)
Treating patients with a family history of
diabetes
Avoiding obesity
Treating patients with sexual dysfunction
Treating treatment refractory patients
Treating women
Treating child and adolescents
25. Treating Patients Who Are Undergoing
Stress
Those whose stress levels are high (ie, increased
levels of endogenous dopamine are being
released) may find that the attachment period to the
receptor of these 2 drugs (quetiapine and clozapine)
is too short for symptom control.
The therapeutic concentration of the antipsychotic in
the presence of abundant dopamine will need to be
proportionally higher than that needed in periods of
calm.
26. Treating First Episodes
Young patients with a first episode of psychosis
respond equally well to first- and secondgeneration drugs, but tolerability of the drug regime
is especially important in this population.
27. Treating Non Adherent Patients
Patients known to be non adherent to regular
medication will do better on those drugs that are
relatively tightly bound to the D2 receptor (where
relapse due to a brief period of noncompliance is a lesser risk).
Monthly depot medication is still the treatment of
choice for the extremely non adherent.
28. Problems Hinder Achieving
Non adherence to treatment
41% Compliant
39%
Non- compliant
20%
Partially compliant
Medication compliance is poor in
patients with Schizophrenia
Coldham EL, et al. Acta Psychiatr Scand 2002;106:286–90
29. NICE guidelines;
For people with newly diagnosed (first episode)
schizophrenia,
National Clinical Practice Guideline Number 82. National Institute
for Health and Clinical Excellence 2009.
30. Treating Patients With a Family History of
Osteoporosis
Patients with a family history of osteoporosis are best
not treated with drugs that raise prolactin levels.
This is especially true for women because they
develop osteoporosis at a younger age than men.
Normal serum prolactin levels are considered to be
between 5 and 25 micrograms/L.
31. Potential consequences of prolactin
elevation
Erectile
dysfunction
Amenorrhoea
Gynaecomastia
Loss of libido
Impotence
Prolactin
Elevation
Osteoporosis
bone density
Galactorrhoea
32. Treating Cardiac Patients or Those With a Family
History of Cardiac Disease
The QTc interval (approximate range is 350-440 milliseconds [ms])
represents the duration of ventricular depolarization and repolarization.
It is generally accepted that QTc intervals exceeding 500 ms are associated
with an increased risk of a lethal paroxysmal ventricular tachycardia
(torsades de pointes).
34. Treating Patients With a Family History of
Diabetes
The base rate of diabetes in the schizophrenia
population is thought to be between 5.6% and 6.7%.
It is substantially higher than in the general
population, probably because of relative inactivity
and the high prevalence of smoking, poor diet and
obesity.
35. Treating Patients With a Family History
of Diabetes cont’d
The novel antipsychotics have more propensity for
inducing insulin resistance: clozapine, olanzapine,
and quetiapine cause the highest rates of diabetes;
sertindole, risperidone and ziprasidone are
associated with lower rates.
Patients with a family history of diabetes and with
other concurrent risk factors should be treated with
sertindole, risperidone, or ziprasidone.
36. Metabolic Highway
Stahl S M, Essential Psychopharmacology (2002)
Metabolically un friendly antipsychotics
37. Avoiding Obesity
Weight gain increases not only the risk of diabetes,
but also of coronary artery disease, a variety of
cancers, gallbladder disease, gout, osteoarthritis,
sexual dysfunction, infertility, and sleep apnea.
Weight gain has a pronounced negative effect on
self-esteem and affects compliance with
antipsychotics.
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Change from baseline weight (KG)
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Short-Term (10 Weeks) Treatment
5
4
3
2
1
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40. Treating Patients With Sexual Dysfunction
Approximately half of all people taking antipsychotic
drugs complain about sexual dysfunction but the
mechanisms are poorly understood.
Hyperprolactinemia seems to play a large part in
the causation.
41. Treating Patients With Sexual
Dysfunction cont’d
A decline in erectile frequency was found to
be especially prevalent in patients treated
with risperidone.
Women's sexuality is as affected as that of
men.
42. Sertindole
• Sertindole is not associated with decreased libido, erection or
orgasm
• This is due to its ability to maintain prolactin levels within
normal limits
• 22% of male sertindole patients experience a decreased
ejaculatory volume (DEV)
• However, a discontinuation rate of 3% due to DEV indicates
that DEV is not a barrier to continuing treatment
• Sertindole does not cause decreased fertility
van Kammen 1996, Kasper 2002,
Summary of product characteristics 2010
43. Treating Treatment-Refractory Patients
While all the new drugs have been alleged to show superior efficacy
to the older drugs, this claim has only been convincingly
substantiated for clozapine .
This poses a problem for patients with a personal or family history
of type 2 diabetes or cardiovascular illness who have not
responded to standard treatment (so, monitor of cholesterol, triglycerides
and sugar levels).
44. Treating Women (Pregnancy)
FDA: “Use in Pregnancy”- Drug categories
Category A: Controlled studies show no risk
Category B: No evidence of risk in humans
Category C: Risk to humans cannot be ruled out
Category D: positive evidence of risk but it is possible in some
situations the benefits may outweigh the risks {benifit > risk}
Category X: Toxic, Contraindicated in pregnancy. Risks
outweigh the benefits in almost every situation {risk > benifit}
A drug-free first trimester is ideal but not always achievable.
45. Treating Women (Pregnancy)
Because of rising estrogen levels at this time and
estrogen modulation of the dopamine receptor, there
is relative protection against psychotic relapse .
If antipsychotics are necessary, low-dose haloperidol
has the best safety record throughout pregnancy,
with dose reduction prior to the anticipated day of
birth (to facilitate labor and minimize drug
withdrawal effects in the neonate).
Clozapine is unwise during pregnancy because of the
theoretical possibility of seizure induction and
agranulocytosis in the fetus.
46. Treating Women (Lactation) cont’d
Breast feeding will mean that the baby is exposed to
the drug to some extent (infant sedation levels will need
monitoring).
No long-term developmentally adverse effects on
children exposed to the older antipsychotics.
Women with psychosis who may temporarily benefit
from high prolactin levels (those who do not want to
conceive or, conversely, postpartum women whose milk is
insufficient for breast feeding) may preferentially benefit
from first-generation antipsychotics or risperidone.
47. Antipsychotics during adolescents
and childhood
A frequently used antipsychotic medication in the
treatment of Tourette’s is Risperdal and
Haloperidol .
Monitor for extrapyramidal symptoms, akathisia,
and acute dystonias as well as longer-term side
effects such as tardive dyskinesia and gynecomastia
in males.
Other atypical antipsychotics that have been used in
the treatment of Tourette’s Disorder include
Seroquel, Zyprexa, amd Aripiprazole.
48. When Serdolect???
Patients are likely to benefit from Sertindole:
If positive/negative symptoms are not controlled
If sedation, EPS or TD are present
If they experience excessive weight gain
If they are experiencing anticholinergic side effects
If their sexual functioning is impaired
If their cognitive function is impaired
49. Take-home Messages
• Conventional antipsychotic drugs bind
tightly to the dopamine D2 receptors,
thereby eliciting EPS, elevated prolactin
and tardive dyskinesia.
• The atypical antipsychotic attach more
loosely to the D2 receptors, thus resulting
in less or no EPS, elevation of prolactin,
and risk of tardive dyskinesia.
50. Shift in Risk Perception
of Antipsychotics
Past Areas of
Concern
Current Medical Realities
Diabetes
Weight Gain
Weight
Gain
Sedation
Tardive
Dyskinesia
Insulin
Resistance
CHD
Prolactin
Hyperlipidemia
Prolactin
TD
Hyperlipidemia
Insulin
Resistance
Sedation
Coronary Heart
Disease
51. Take-home Messages
Good clinical practice involves using
both types of medication at different
times, depending on the specific needs
of the patient taking in consideration
Efficacy, Safety and Tolerability.
54. Future of Behavioral Health has
Arrived
Patients with depression and anxiety are frustrated with drug
treatments because of poor response (up to 5 trials).
Also, some of these medications increase anxiety, resistance to
treatment, insomnia, and sexual dysfunction.
Sometimes they may quit medications.
It is better to choose psychotropic medications based on the individual
genetic characteristics, metabolizing pathways leading to better
medication tolerance.
This give the patient the confidence to continue treatment.
Test can done by a simple cheek swab (Assure Rx- GeneSightRx).
55.
56. Future
The FDA has approved several drug labels to contain information
about pharmacogenetic biomarkers.
Currently, approximately 17% of these pharmacogenetic labels are for
psychiatric drugs, and most of them contain information about the
CYP450 enzymes.
However, most of these labels do not offer any clinical
recommendations or require the use of this information before
treatment prescription.
The ultimate goal of future studies is to expand the pharmacogenetic
information on antidepressant labels and incorporate them into wide
clinical use.
However, there are several limitations that need to be considered
before the field can advance to this stage.
57. Probiotics
Probiotics may offer an alternative treatment
option for depression and other psychiatric
disorders, new research suggests.
Investigators reviewed studies that examined the
effect of "psychobiotics," live organisms that when
ingested may produce health benefits in patients
suffering from mental illness.
58. Probiotics
Several preclinical studies showed a link between
specific probiotics and beneficial behavioral
effects.
These included one in which rats with depressive
behaviors resulting from maternal separation
displayed normalized behavior and an improved
immune response after ingesting
the Bifidobacterium infantis probiotic.
"
59. Probiotics
Dr. Dinan noted that there are approximately 1 to
2 kg of bacteria in the adult gut that are capable
of producing hundreds of essential chemicals.
"Our preclinical studies suggest that depression is
also associated with an alteration in the
microbiota.
Psychobiotics are good bacteria that have the
potential to increase microbial diversity and treat
the symptoms of depression," he said.
The review is published in the November 15 issue
of Biological Psychiatry.