Ketamine and rapidly acting antidepressants: Breaking the speed of sound or light?

2018 ◽  
Vol 52 (11) ◽  
pp. 1026-1029 ◽  
Author(s):  
Michael Berk ◽  
Collen Loo ◽  
Christopher G Davey ◽  
Brian H Harvey
Keyword(s):  
Drugs Of Abuse ◽  
Critical Role ◽  
Rapid Onset ◽  
Onset Of Action ◽  
Delayed Onset ◽  
Adaptive Mechanisms ◽  
Psychotropic Agents ◽  
Current Therapies ◽  
Psychotropic Effects

There is an urgent need for rapidly acting antidepressants. Current therapies share a delayed onset of action, contrasting with drugs of abuse that have rapid psychotropic effects but cause tolerance and dependence. A key uncertainty is whether there is a finite speed limit imposed by the critical role of homeostatic adaptive mechanisms that underpin the efficacy and onset of available psychotropic agents and whether this is mutable with emerging agents with potential rapid onset, in particular ketamine.

Synthesis, Packaging, and Termination of Neurotransmitters

2017 ◽  
Author(s):  
Peggy Mason
Keyword(s):  
Molecular Weight ◽  
Synaptic Vesicles ◽  
Drugs Of Abuse ◽  
Low Molecular Weight ◽  
Stiff Person Syndrome ◽  
Catecholamine Synthesis ◽  
Vesicular Transporters ◽  
Psychotropic Effects ◽  
Gaba Synthesis

The synthesis, packaging, and termination of action of neurotransmitters are detailed. There are far more varieties of peptide neurotransmitters than there are of low-molecular-weight neurotransmitters. Yet low-molecular-weight neurotransmitters are the ubiquitous workhorses of the nervous system. Acetylcholine, the catecholamines norepinephrine and dopamine, serotonin, glutamate, and GABA are examined in some depth. The vesicular transporters that carry low-molecular-weight neurotransmitters from the cytoplasm into synaptic vesicles are covered. The role of monoamines in affect and mood and the psychotropic effects of monoaminergic drugs are discussed. Principles of catecholamine synthesis are applied to understand phenylketonuria. Uptake of monoamines into neurons is discussed in the context of amphetamine, cocaine, and other drugs of abuse. Stiff-person syndrome, which results from an impairment of GABA synthesis, is introduced. The modes of action for peptide and gaseous neurotransmitters are briefly covered.

scholarly journals Angiogenesis and its modulation in the pathophysiology and treatment of endometrial carcinoma

2011 ◽  
Vol 5 (1) ◽  
pp. 43 ◽  
Author(s):  
Craig A. Mayr ◽  
Dennis Yi-Shin Kuo ◽  
Gary L. Goldberg ◽  
June Yijuan Hou
Keyword(s):  
Endometrial Cancer ◽  
Critical Role ◽  
Good Prognosis ◽  
Advanced Stage ◽  
Gynecologic Malignancy ◽  
Tumor Mass ◽  
Stage Disease ◽  
Current Therapies ◽  
Pathologic Physiology

Endometrial cancer is the most common gynecologic malignancy in women. When detected early, this disease has a relatively good prognosis. However, advanced stage disease is associated with a poor outcome. Current therapies for advanced endometrial cancer include surgery, chemotherapy, radiotherapy, and hormonal therapy. Responses to these modalities are variable, but rarely exceed 20%. Angiogenesis plays a critical role in both the normal and the pathologic physiology of the human endometrium. Like a wide array of other tumors, the formation of new blood vessels to feed an enlarging tumor mass occurs in endometrial cancer. This review focuses on the role of angiogenesis and its inhibition in the pathophysiology and treatment of endometrial cancer.

scholarly journals An extended amygdala-midbrain circuit controlling cocaine withdrawal-induced anxiety and reinstatement

2021 ◽  
Author(s):  
Guilian Tian ◽  
May Hui ◽  
Desiree Macchia ◽  
Pieter Derdeyn ◽  
Alexandra Rogers ◽  
...  
Keyword(s):  
Drugs Of Abuse ◽  
Critical Role ◽  
Place Preference ◽  
Affective States ◽  
Cocaine Exposure ◽  
Cocaine Administration ◽  
Anxiety States ◽  
Midbrain Dopamine ◽  
Development Of Anxiety

While midbrain dopamine (DA) neuronal circuits are central to motivated behaviors, much remains unknown about our knowledge of how these circuits are modified over time by experience to facilitate selective aspects of experience-dependent plasticity. Most studies of the DA system in drug addiction focus on the role of the mesolimbic DA pathway from the ventral tegmental area (VTA) to the nucleus accumbens (NAc) in facilitating drug-associated reward. In contrast, less is known about how midbrain DA cells and associated circuits contribute to negative affective states including anxiety that emerge during protracted withdrawal from drug administration. Here, we demonstrate the selective role of a midbrain DA projection to the amygdala (VTADA-Amygdala) for anxiety that develops during protracted withdrawal from cocaine administration but does not participate in cocaine reward or sensitization. Our rabies virus-mediated circuit mapping approach revealed a persistent elevation in spontaneous and task-related activity of GABAergic cells from the bed nucleus of the stria terminals (BNST) and downstream VTADA-Amygdala cells that could be detected even after a single cocaine exposure. Activity in BNSTGABA cells was related to cocaine-induced anxiety but not reward or sensitization, and silencing the projection from these cells to the midbrain was sufficient to prevent the development of anxiety during protracted withdrawal following cocaine administration. We observed that VTADA-Amygdala cells, but not other midbrain DA cells, were strongly activated after a challenge exposure to cocaine, and found that activity in these cells was necessary for the expression of reinstatement of cocaine place preference. Lastly, the importance of activity in VTADA-Amygdala cells extends beyond cocaine, as these cells mediate the development of anxiety states triggered by morphine and a predator odor. Our results provide an exemplar for how to identify key circuit substrates that contribute to behavioral adaptations and reveal a critical role for BNSTGABA-VTADA-Amygdala pathway in anxiety states induced by drugs of abuse or natural experiences as well as cocaine-primed reinstatement of conditioned place preference.

Oral transmucosal fentanyl citrate for the treatment of breakthrough pain in cancer patients: An overview of its pharmacological and clinical characteristics

2005 ◽  
Vol 1 (1) ◽  
pp. 36 ◽  
Author(s):  
Kyriaki Mystakidou, MD, PhD ◽  
Emmanuela Katsouda, MD ◽  
Efi Parpa, BA, MA ◽  
Marinos L. Tsiatas, MD, PhD ◽  
Lambros Vlahos, MD, PhD
Keyword(s):  
Cancer Patients ◽  
Pain Treatment ◽  
Breakthrough Pain ◽  
Rapid Onset ◽  
Review Article ◽  
Brand Name ◽  
Fentanyl Citrate ◽  
Onset Of Action ◽  
Oral Transmucosal Fentanyl Citrate

Breakthrough pain is a transitory flare of pain occurring in most cancer patients against a background of otherwise controlled persistent pain. Treatment of breakthrough pain is a challenging phenomenon. Oral transmucosal fentanyl citrate (OTFC; brand name Actiqm, Cephalon Inc., West Chester, PA), a new opioid formulation with a unique delivery system, reflects the characteristics of breakthrough pain (rapid onset of action and short duration), making it an effective treatment for cancer patients who already receive opioids and experience flares of pain. This review article aims to present the role of oral transmucosal fentanyl citrate in the management of breakthrough pain in cancer patients. In particular, it is going to discuss the synthesis, clinical pharmacology, pharmacokinetic and pharmacodynamic properties, toxicity, and clinical efficacy of this novel agent.

scholarly journals Position Statement on Secukinumab in the Management of Plaque Psoriasis: The Malaysian Perspective

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Asmah Johar ◽  
Suganthi Thevarajah ◽  
Agnes Heng ◽  
Lee Chin Chan ◽  
Chin Chwen Ch’ng ◽  
...  
Keyword(s):  
Plaque Psoriasis ◽  
Treatment Options ◽  
Panel Discussion ◽  
Rapid Onset ◽  
Position Statement ◽  
Severe Psoriasis ◽  
Onset Of Action ◽  
History Of ◽  
Discussion Panel

Psoriasis is a chronic inflammatory skin disease affecting nearly 10% of dermatologic patients in Malaysia. Treatment options include topical agents and phototherapy as well as nonbiologic and biologic systemic therapy. Mild psoriasis can often be managed with topical agents. However, managing moderate to severe psoriasis is more challenging and may require systemic treatment with nonbiologics or biologics. Despite the availability of several biologics, there are many unmet clinical needs, which may be addressed by secukinumab, an IL-17A inhibitor. This position statement is based on an expert panel discussion and is intended to provide dermatologists an overview of existing options as well as to provide a better understanding of secukinumab and how it can be integrated into current practice. During the discussion, panel members examined current approaches and the role of secukinumab in plaque psoriasis management. Panel members estimated that up to 30% of patients have moderate to severe psoriasis but only 1-2% receive biologics. Highlights from the discussion were that (i) the threshold for biologic use should be lower, in line with international guidelines; (ii) studies have shown that secukinumab has several advantages over other biologics which are greater efficacy, sustained efficacy over time, rapid onset of action, and early evidence of possible disease-modifying potential; and (iii) ideal candidates for secukinumab are all patients of moderate to severe psoriasis, including those with history of treatment failure, difficult-to-treat patterns of psoriasis (nail, scalp, and palmoplantar psoriasis), psoriatic arthritis, and comorbidities and those aiming for clear skin. Panel members recommend that secukinumab be considered first line option among biologic therapies.

Addiction (Oxford Psychiatry Library)

2018 ◽  
Author(s):  
David J. Nutt ◽  
Liam J. Nestor
Keyword(s):  
Drugs Of Abuse ◽  
Critical Role ◽  
Brain Disorder ◽  
Comprehensive Overview ◽  
Brain Science ◽  
Pharmacological Targets ◽  
Variable Nature ◽  
Reward Dependence ◽  
The Brain

Part of the Oxford Psychiatry Library series, this resource is a clear and comprehensive overview of the brain science underpinning addiction that helps explain the current and future therapeutics for the range of addictions, using full colour images to enhance understanding. It focuses on the nature of addiction as a brain disorder that includes a range of different behavioural traits such as impulsivity and reward dependence, and discusses the critical role of kinetic and pharmacological factors. The also explains how the primary pharmacological targets of drugs of abuse are now understood, the relation to the variable nature of addiction to different substances, and how this may lead to new approaches to treatment.

scholarly journals Role of p.r.n. antimuscarinic medication in the treatment of antipsychotic-induced extrapyramidal movement disorders

1999 ◽  
Vol 23 (6) ◽  
pp. 368-369
Author(s):  
Luke Birmingham ◽  
Norman McClelland ◽  
Caroline Bradley
Keyword(s):  
Single Dose ◽  
Intravenous Injection ◽  
Antipsychotic Medication ◽  
Movement Disorders ◽  
Rapid Onset ◽  
Psychiatric Practice ◽  
Liquid Form ◽  
Onset Of Action ◽  
Extrapyramidal Effects

The antimuscarinic drugs procyclidine, orphenadrine, benzhexol and benztropine are used in psychiatric practice to alleviate the extrapyramidal effects of antipsychotic medication. These drugs may be prescribed on a regular, as-required or single-dose basis. They are usually taken by mouth, in tablet or liquid form, but for rapid onset of action procyclidine and benztropine can be given by intramuscular or intravenous injection.

scholarly journals Angiogenesis and its modulation in the pathophysiology and treatment of endometrial carcinoma

2011 ◽  
pp. 43-48
Author(s):  
Craig A. Mayr ◽  
Dennis Yi-Shin Kuo ◽  
Gary L. Goldberg ◽  
June Yijuan Hou
Keyword(s):  
Endometrial Cancer ◽  
Critical Role ◽  
Good Prognosis ◽  
Advanced Stage ◽  
Gynecologic Malignancy ◽  
Tumor Mass ◽  
Stage Disease ◽  
Current Therapies ◽  
Pathologic Physiology

Endometrial cancer is the most common gynecologic malignancy in women. When detected early, this disease has a relatively good prognosis. However, advanced stage disease is associated with a poor outcome. Current therapies for advanced endometrial cancer include surgery, chemotherapy, radiotherapy, and hormonal therapy. Responses to these modalities are variable, but rarely exceed 20%. Angiogenesis plays a critical role in both the normal and the pathologic physiology of the human endometrium. Like a wide array of other tumors, the formation of new blood vessels to feed an enlarging tumor mass occurs in endometrial cancer. This review focuses on the role of angiogenesis and its inhibition in the pathophysiology and treatment of endometrial cancer.

The Role of the SLP in Autism Spectrum Disorder Screening and Assessment

2008 ◽  
Vol 15 (2) ◽  
pp. 50-59 ◽  
Author(s):  
Amy Philofsky
Keyword(s):  
Language Development ◽  
Critical Role ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Children With Asd ◽  
Prevalence Estimates ◽  
Notable Increase ◽  
Screening Assessment ◽  
Critical Components

AbstractRecent prevalence estimates for autism have been alarming as a function of the notable increase. Speech-language pathologists play a critical role in screening, assessment and intervention for children with autism. This article reviews signs that may be indicative of autism at different stages of language development, and discusses the importance of several psychometric properties—sensitivity and specificity—in utilizing screening measures for children with autism. Critical components of assessment for children with autism are reviewed. This article concludes with examples of intervention targets for children with ASD at various levels of language development.

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