Nootropics: Emergents drugs associated with new clinical challenges

2017 ◽  
Vol 41 (S1) ◽  
pp. s877-s878 ◽  
Author(s):  
H. Saiz Garcia ◽  
L. Montes Reula ◽  
A. Portilla Fernandez ◽  
V. Pereira Sanchez ◽  
N. Olmo Lopez ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Psychiatric Patients ◽  
Mental Performance ◽  
Neuroprotective Effects ◽  
Beneficial Effects ◽  
Secondary Messenger ◽  
Common Term ◽  
History Of ◽  
Competing Interest ◽  
Smart Drug

IntroductionThe “nootropic” or simplified as a “smart drug”, is a common term that will tag along with the compound responsible for the enhancement of mental performance. Certain individuals with a history of mental or substance use disorders might be particularly vulnerable to its adverse effects.MethodologyA review was conducted aiming to clarify the mechanisms associated of how these drugs increase mental functions including memory, motivation, concentration, and attention; and which kind of individuals are at risk of developing adverse effects when taking these drugs. The literature search was conducted in PubMed data reviewing articles dating between 2015 and 2016.Results– Glutaminergic Signalling, Cholinergic System, Amyloid Precursor Protein and Secondary Messenger may be related to the cognitive enhancement achieved by Nootropics. Others, like insulin and angiotensin receptor may involved too.– Some of them, like Ginkgo biloba, seem to have neuroprotective effects observed in human and animal models, acting as antioxidant and antiapoptotic, also inducing inhibition effects against caspase-3 activation and amyloid-aggregation toward Alzheimer's disease.– Synthetic nootropics, a lab created compound such as piracetam, especially in people with history of drug abuse, may be associated with psychiatric exacerbations of some patients.ConclusionsYoung adults all over Europe, especially university students, are starting to use nootropic drugs to improve their academic results. Some of them seem to have beneficial effects over mental health but others are sometimes related with sudden and unexplained exacerbations in stable psychiatric patients. It is important to early identify symptoms and to treat them properly.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Who are the Europeans admitted to psychiatric hospital in Tunisia?

2017 ◽  
Vol 41 (S1) ◽  
pp. S698-S698
Author(s):  
U. Ouali ◽  
K. Ben Neticha ◽  
R. Jomli ◽  
A. Ouertani ◽  
F. Nacef
Keyword(s):  
Psychiatric Care ◽  
Psychiatric Patients ◽  
Insurance Coverage ◽  
University Hospital ◽  
Public Authorities ◽  
Early Action ◽  
Duration Of Hospitalization ◽  
History Of ◽  
Competing Interest ◽  
Almost All

IntroductionA large number of foreign travellers and expatriates visits or lives in Tunisia.ObjectivesTo explore socio-demographic, clinical and therapeutic characteristics of European patients admitted to psychiatric care in Tunisia.MethodsThis is a retrospective, descriptive study on all European patients admitted to Razi psychiatric university hospital, which is situated at the outskirts of the capital Tunis, between 2000 and 2015.ResultsA total of 44 Europeans was admitted. Most frequent nationalities were: French and Germans (19 and 16 patients). The stay in Tunisia was mainly due to pathologic travel (17 subjects) and tourism (13 subjects). In total, 25 patients travelled without being accompanied. Average age was 51.3 years with extremes from 16 to 78 years. A history of psychiatric disorder was found in 15 patients, of whom almost all had stopped treatment. A majority (19 patients) was diagnosed with bipolar I disorder, and 8 patients suffered from schizophrenia. Average duration of hospitalization was 19 days. A total of, 22 patients were repatriated for medical reasons. Major difficulties during hospitalization were the language barrier, difficulties to contact family members or former treating psychiatrists for further information on the patient and his medical history, and the lack of insurance covering repatriation for medical reasons.ConclusionPsycho-education and early action on the precipitating factors could help to prevent psychiatric illness or relapse in these patients. Furthermore, attention of public authorities should be drawn to incomplete insurance coverage in many psychiatric patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Neuroprotective Role of Hypothermia in Acute Spinal Cord Injury

Biomedicines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 104
Author(s):  
Hasan Al-Nashash ◽  
Angelo H. ALL
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Time Window ◽  
Clinical Settings ◽  
Neuroprotective Effects ◽  
Beneficial Effects ◽  
Cord Injury ◽  
Neuroprotective Strategy ◽  
History Of ◽  
Local Hypothermia

Even nowadays, the question of whether hypothermia can genuinely be considered therapeutic care for patients with traumatic spinal cord injury (SCI) remains unanswered. Although the mechanisms of hypothermia action are yet to be fully explored, early hypothermia for patients suffering from acute SCI has already been implemented in clinical settings. This article discusses measures for inducing various forms of hypothermia and summarizes several hypotheses describing the likelihood of hypothermia mechanisms of action. We present our objective neuro-electrophysiological results and demonstrate that early hypothermia manifests neuroprotective effects mainly during the first- and second-month post-SCI, depending on the severity of the injury, time of intervening, duration, degree, and modality of inducing hypothermia. Nevertheless, eventually, its beneficial effects gradually but consistently diminish. In addition, we report potential complications and side effects for the administration of general hypothermia with a unique referment to the local hypothermia. We also provide evidence that instead of considering early hypothermia post-SCI a therapeutic approach, it is more a neuroprotective strategy in acute and sub-acute phases of SCI that mostly delay, but not entirely avoid, the natural history of the pathophysiological events. Indeed, the most crucial rationale for inducing early hypothermia is to halt these devastating inflammatory and apoptotic events as early and as much as possible. This, in turn, creates a larger time-window of opportunity for physicians to formulate and administer a well-designed personalized treatment for patients suffering from acute traumatic SCI.

scholarly journals Improved neurocognitive performance in FIV infected cats following treatment with the p75 neurotrophin receptor ligand LM11A-31

2020 ◽  
Author(s):  
Jonathan E. Fogle ◽  
Lola Hudson ◽  
Andrea Thomson ◽  
Barbara Sherman ◽  
Margaret Gruen ◽  
...  
Keyword(s):  
Nervous System ◽  
Adverse Effects ◽  
Open Field ◽  
Neurotrophin Receptor ◽  
Novel Object Recognition ◽  
P75 Neurotrophin Receptor ◽  
Sensory Thresholds ◽  
Neuroprotective Effects ◽  
Novel Object ◽  
Beneficial Effects

AbstractHIV rapidly infects the central nervous system (CNS) and establishes a persistent viral reservoir within microglia, perivascular macrophages and astrocytes. Inefficient control of CNS viral replication by antiretroviral therapy results in chronic inflammation and progressive cognitive decline in up to 50% of infected individuals with no effective treatment options. Neurotrophin based therapies have excellent potential to stabilize and repair the nervous system. A novel non-peptide ligand, LM11A-31, that targets the p75 neurotrophin receptor (p75NTR) has been identified as a small bioavailable molecule capable of strong neuroprotection with minimal side effects. To evaluate the neuroprotective effects of LM11A-31 in a natural infection model, we treated cats chronically infected with feline immunodeficiency virus (FIV) with 13 mg/kg LM11A-31 twice daily over a period of 10 weeks and assessed effects on cognitive functions, open field behaviors, activity, sensory thresholds, plasma FIV, cerebrospinal fluid (CSF) FIV, peripheral blood mononuclear cell provirus, CD4 and CD8 cell counts and general physiology. Between 12 and 18 months post-inoculation, cats began to show signs of neural dysfunction in T maze testing and novel object recognition, which were prevented by LM11A-31 treatment. Anxiety-like behavior was reduced in the open field and no changes were seen in sensory thresholds. Systemic FIV titers were unaffected but treated cats exhibited a log drop in CSF FIV titers. No significant adverse effects were observed under all conditions. The data indicate that LM11A-31 is likely to be a potent adjunctive treatment for the control of neurodegeneration in HIV infected individuals.Author SummaryThere are no effective treatments to halt the progression of most neurodegenerative diseases including HIV-associated neurodegeneration. Neurotrophins have the potential to provide strong neuroprotection but it has been difficult to develop usable interventions. A new drug, LM11A-31, that targets the p75 neurotrophin receptor has been developed that provides potent neuroprotection, is orally bioavailable and has the potential to prevent disease progression. The current studies were designed to evaluate the effects of the compound in an animal model of active HIV infection in preparation for a human clinical trial. Treatment of chronically infected animals with LM11A-31 normalized deficits in T maze performance, novel object recognition and open field behavior with no measurable adverse effects. Potential adverse effects associated with natural neurotrophins such as changes in sensory perception and increased systemic viral burden were not observed. A decrease in CSF FIV titers and a slight improvement in the CD4:CD8 ratio suggested that LM11A-31 may have beneficial effects beyond the anticipated neuroprotective effects. These findings are similar to beneficial effects seen in other animal models of neurodegeneration and CNS injury and support the use of LM11A-31 as an adjunctive neuroprotective agent for the treatment of HIV infected individuals.

In-Patient and Post-Discharge Suicides in Tyrol 2004–2011

2017 ◽  
Vol 41 (S1) ◽  
pp. S292-S292
Author(s):  
E.A. Deisenhammer ◽  
E.M. Behrndt ◽  
G. Kemmler ◽  
C. Haring ◽  
C. Miller
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
High Risk Population ◽  
Post Discharge ◽  
Patient Status ◽  
History Of ◽  
Competing Interest ◽  
Commit Suicide

IntroductionPsychiatric patients constitute a high-risk population for suicide. In-patient status and the period after discharge are of particular interest concerning risk assessment.ObjectiveTo assess risk factors for in-patient and post-discharge suicides.MethodsThe Tyrol suicide register was linked with the registers of three psychiatric departments/hospitals of the region. Suicides were categorized according to whether the suicide was committed during a hospital stay or within 12 weeks after discharge or whether the suicide subject had not recently been hospitalized. Groups were compared with regard to demographic and clinical variables. Further, case-control comparisons were performed for the in-patient and post-discharge groups.ResultsDuring the study period (2004–2011) 30 in-patients, 89 post-discharge and 592 not recently hospitalized suicides were identified. Groups differed in terms of gender distribution, history of suicide attempts, warning signals and suicide methods. Compared with controls matched for a number of variables, in-patient suicides were significantly more suicidal and depressed at admission, reported more often a recent life event and showed less often aggressive behavior and plans for the future. Post-discharge suicides had more often a history of attempted suicide, depressive and thought disorder symptomatology, a ward change and an unplanned discharge and less often a scheduled appointment with a non-psychiatric physician.ConclusionsSuicide victims differ with regard to whether they die during, shortly after or not associated with a hospitalization. Compared to controls there are specific risk factors for those who commit suicide during a hospital stay and within 12 weeks after discharge.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Views of schizophrenia patients on the effects of cannabis on their mental health

2015 ◽  
Vol 21 (2) ◽  
pp. 5 ◽  
Author(s):  
Rishie Kumar Parshotam ◽  
Pierre M Joubert
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Adverse Effects ◽  
Cannabis Use ◽  
Negative Effects ◽  
Statistical Manual ◽  
Beneficial Effects ◽  
Text Revision ◽  
Diagnostic And Statistical Manual ◽  
History Of

<p><strong>Background</strong>. Cannabis use may trigger or perpetuate clinical features of schizophrenia in vulnerable individuals, thereby contributing to the morbidity of schizophrenia and its burden of disease. These findings have mostly not considered the views of schizophrenia patients on cannabis use and its effect on their mental health.  </p><p><strong>Methods</strong>. A semi-structured 16-point opinion-type questionnaire was formulated from the results of a previous qualitative study on schizophrenia patients’ opinions about cannabis use. The questionnaire was applied to 60 participants from an inpatient schizophrenia population at Weskoppies Hospital, Pretoria, South Africa, who had a <em>Diagnostic and Statistical Manual of Mental Disorders</em>, 4th edition (text revision) (DSM-IV-TR) diagnosis of schizophrenia and a documented history of cannabis use. </p><p><strong>Results</strong>. According to participants’ responses, 61.7% admitted to suffering from a mental illness, 95.0% admitted to using cannabis in the past, and 20.0% of participants admitted to the current use of cannabis. Over half (51.7%) of the participants responded that cannabis had adverse effects on their mental health, 26.7% that their mental illness was caused by using an illicit drug other than cannabis, 26.7% that only impure cannabis had adverse effects on their mental health, and 48.3% that only using too much cannabis had bad effects on their mind. A high percentage (58.3%) of participants responded that cannabis use helped reduce tension, 56.7% that it helped reduce anxiety, 66.7% that it helped to lift their mood, 63.3% that it helped them to relax, 60.0% that it helped to relieve their boredom, 43.3% that it helped them feel more energetic, 58.3% that it helped them sleep better, 13.3% that it helped reduce auditory hallucinations, and 31.7% that the beneficial effects of cannabis outweighed its negative effects. </p><p><strong>Conclusion</strong>. Most of the participants who responded that they were not using cannabis currently had positive views about its effects on their mental health, despite responding that cannabis may have adverse effects on their mental health. This is a worrisome outcome, since those participants who feel that cannabis has more beneficial than detrimental effects might not remain abstinent.</p>

Analysis of ECT indications in the hospitalized psychiatric patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S375-S375
Author(s):  
A. Mihaljevic Peles ◽  
M. Bajs Janovic ◽  
A. Strucic ◽  
S. Janovic
Keyword(s):  
Psychiatric Patients ◽  
Treatment Resistance ◽  
Previous Treatment ◽  
Clinical Judgement ◽  
First Episode ◽  
Controlled Clinical Trials ◽  
Negative Image ◽  
History Of ◽  
Competing Interest ◽  
Psychiatric Department

IntroductionElectroconvulsive therapy (ECT) has been considered a treatment option for the treatment resistance, mania, depression, suicidality and schizophrenia. It has been still controversial due to the lack of controlled clinical trials and unknown biological basis but also because of the negative image from the history of the treatment.ObjectiveSpecifics of the clinical judgement on when and for which patients’ indications, ECT was a treatment choice.Aim of the study was to evaluate indications for the ECT treatment in the hospitalized psychiatric patients at the psychiatric department.MethodFor all the patient cases in the last 7 years at the department (n = 326), data was analyzed regarding age, gender, number of hospitalizations, age of first episode, diagnose, previous treatment, leading indication for ECT and outcome after the ECT, regarding following treatment.ResultsThe leading indication for ECT was psychosis and/or pharmacological treatment resistance, followed by suicidality. Patients with psychosis were younger than patients with other diagnoses when receiving ECT treatment. Regarding the results, indications for ECT had been partially differentiated from expected guidelines. Outcomes after the ECT were favorable in terms of better controlling the symptoms, lowering exacerbation frequency and intensity and partially, functioning.ConclusionStudies on ECT indications and outcome could provide further insight on efficacy of the treatment, and possible improvements in clinical assessment on eligible patients who could benefit from the ECT treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Ketogenic diet reduces alcohol withdrawal symptoms in humans and alcohol intake in rodents

2021 ◽  
Vol 7 (15) ◽  
pp. eabf6780
Author(s):  
Corinde E. Wiers ◽  
Leandro F. Vendruscolo ◽  
Jan-Willem van der Veen ◽  
Peter Manza ◽  
Ehsan Shokri-Kojori ◽  
...  
Keyword(s):  
Ketogenic Diet ◽  
Alcohol Withdrawal ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Anterior Cingulate ◽  
Dorsal Anterior Cingulate Cortex ◽  
Beneficial Effects ◽  
Alcohol Cues ◽  
History Of ◽  
To Receive

Individuals with alcohol use disorder (AUD) show elevated brain metabolism of acetate at the expense of glucose. We hypothesized that a shift in energy substrates during withdrawal may contribute to withdrawal severity and neurotoxicity in AUD and that a ketogenic diet (KD) may mitigate these effects. We found that inpatients with AUD randomized to receive KD (n = 19) required fewer benzodiazepines during the first week of detoxification, in comparison to those receiving a standard American (SA) diet (n = 14). Over a 3-week treatment, KD compared to SA showed lower “wanting” and increased dorsal anterior cingulate cortex (dACC) reactivity to alcohol cues and altered dACC bioenergetics (i.e., elevated ketones and glutamate and lower neuroinflammatory markers). In a rat model of alcohol dependence, a history of KD reduced alcohol consumption. We provide clinical and preclinical evidence for beneficial effects of KD on managing alcohol withdrawal and on reducing alcohol drinking.

scholarly journals AZP2006, a new promising treatment for Alzheimer’s and related diseases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
N. Callizot ◽  
C. Estrella ◽  
S. Burlet ◽  
A. Henriques ◽  
C. Brantis ◽  
...  
Keyword(s):  
Therapeutic Application ◽  
Neuroprotective Effects ◽  
Beneficial Effects ◽  
Potential Therapeutic Application ◽  
Promising Treatment ◽  
Central Synapses ◽  
First Time ◽  
Pgrn Level

AbstractProgranulin (PGRN) is a protein with multiple functions including the regulation of neuroinflammation, neuronal survival, neurite and synapsis growth. Although the mechanisms of action of PGRN are currently unknown, its potential therapeutic application in treating neurodegenerative diseases is huge. Thus, strategies to increase PGRN levels in patients could provide an effective treatment. In the present study, we investigated the effects of AZP2006, a lysotropic molecule now in phase 2a clinical trial in Progressive Supranuclear Palsy patients, for its ability to increase PGRN level and promote neuroprotection. We showed for the first time the in vitro and in vivo neuroprotective effects of AZP2006 in neurons injured with Aβ1–42 and in two different pathological animal models of Alzheimer’s disease (AD) and aging. Thus, the chronic treatment with AZP2006 was shown to reduce the loss of central synapses and neurons but also to dramatically decrease the massive neuroinflammation associated with the animal pathology. A deeper investigation showed that the beneficial effects of AZP2006 were associated with PGRN production. Also, AZP2006 binds to PSAP (the cofactor of PGRN) and inhibits TLR9 receptors normally responsible for proinflammation when activated. Altogether, these results showed the high potential of AZP2006 as a new putative treatment for AD and related diseases.

scholarly journals Long-Term Caloric Restriction Attenuates β-Amyloid Neuropathology and Is Accompanied by Autophagy in APPswe/PS1delta9 Mice

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 985
Author(s):  
Luisa Müller ◽  
Nicole Power Guerra ◽  
Jan Stenzel ◽  
Claire Rühlmann ◽  
Tobias Lindner ◽  
...  
Keyword(s):  
Caloric Restriction ◽  
Neuroprotective Effect ◽  
Resonance Spectroscopy ◽  
Neuroprotective Effects ◽  
Beneficial Effects ◽  
Positron Emission ◽  
Pet Ct ◽  
Amyloid Aβ ◽  
Β Amyloid

Caloric restriction (CR) slows the aging process, extends lifespan, and exerts neuroprotective effects. It is widely accepted that CR attenuates β-amyloid (Aβ) neuropathology in models of Alzheimer’s disease (AD) by so-far unknown mechanisms. One promising process induced by CR is autophagy, which is known to degrade aggregated proteins such as amyloids. In addition, autophagy positively regulates glucose uptake and may improve cerebral hypometabolism—a hallmark of AD—and, consequently, neural activity. To evaluate this hypothesis, APPswe/PS1delta9 (tg) mice and their littermates (wild-type, wt) underwent CR for either 16 or 68 weeks. Whereas short-term CR for 16 weeks revealed no noteworthy changes of AD phenotype in tg mice, long-term CR for 68 weeks showed beneficial effects. Thus, cerebral glucose metabolism and neuronal integrity were markedly increased upon 68 weeks CR in tg mice, indicated by an elevated hippocampal fluorodeoxyglucose [18F] ([18F]FDG) uptake and increased N-acetylaspartate-to-creatine ratio using positron emission tomography/computer tomography (PET/CT) imaging and magnet resonance spectroscopy (MRS). Improved neuronal activity and integrity resulted in a better cognitive performance within the Morris Water Maze. Moreover, CR for 68 weeks caused a significant increase of LC3BII and p62 protein expression, showing enhanced autophagy. Additionally, a significant decrease of Aβ plaques in tg mice in the hippocampus was observed, accompanied by reduced microgliosis as indicated by significantly decreased numbers of iba1-positive cells. In summary, long-term CR revealed an overall neuroprotective effect in tg mice. Further, this study shows, for the first time, that CR-induced autophagy in tg mice accompanies the observed attenuation of Aβ pathology.

Salicylate toxicity from chronic bismuth subsalicylate use

2020 ◽  
Vol 13 (11) ◽  
pp. e236929
Author(s):  
Sheliza Halani ◽  
Peter E Wu
Keyword(s):  
Emergency Department ◽  
Adverse Effects ◽  
Hearing Impairment ◽  
Reference Range ◽  
The Elderly ◽  
Intravenous Fluids ◽  
Over The Counter ◽  
Bismuth Subsalicylate ◽  
Salicylate Concentration ◽  
History Of

A 79-year-old man presented to the emergency department with a 1-week history of worsening confusion, falls and hearing impairment. An initial workup for infectious, metabolic and structural causes was unrevealing. However, further history discovered that he had been ingesting one to two bottles of Pepto-Bismol (bismuth subsalicylate) daily for gastro-oesophageal reflux symptoms. On his second day of admission, the plasma salicylate concentration was 2.08 mmol/L (reference range 1.10–2.20 mmol/L), despite no sources of salicylate in hospital. He was diagnosed with chronic salicylate toxicity and Pepto-Bismol use was discontinued. The patient was treated supportively with isotonic intravenous fluids only and plasma salicylate concentration fell to less than 0.36 mmol/L. Concurrently, all his symptoms resolved. This case highlights the potential adverse effects of over-the-counter medications. The diagnosis of chronic salicylate toxicity is challenging, specifically in the elderly and in undifferentiated presentations, as it can be missed if not suspected.

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