Herb-drug interactions in neuropsychiatric pharmacotherapy – a review of clinically relevant findings

2021 ◽  
Vol 19 ◽  
Author(s):  
Tram T. Le ◽  
Sarah R. McGrath ◽  
Pius S. Fasinu
Keyword(s):  
Prescription Drugs ◽  
Relevant Literature ◽  
Neuropsychiatric Disorders ◽  
Clinical Consequence ◽  
Metabolizing Enzymes ◽  
Herbal Products ◽  
Pharmacodynamic Interactions ◽  
Accessible Information ◽  
Clinical Consequences ◽  
The Central Nervous System

: The management of neuropsychiatric disorders relies heavily on pharmacotherapy. The use of herbal products as complimentary medicine, often concomitantly, is common among patients taking prescription neuropsychiatric drugs. Herb-drug interaction, a clinical consequence of this practice, may jeopardize the success of pharmacotherapy in neuropsychiatry. Besides the well-known ability of phytochemicals to inhibit and/or induce drug-metabolizing enzymes and transport proteins, several phytoconstituents are capable of exerting pharmacological effects on the central nervous system. The consequent pharmacokinetic and pharmacodynamic interactions with orthodox medications often result in deleterious clinical consequences. This study reviewed the relevant literature and identified 13 commonly used herbal products – celery, echinacea, ginkgo, ginseng, hydroxycut, kava, kratom, moringa, piperine, rhodiola, St John’s wort, terminalia/commiphora ayurvedic mixture and valerian – which have shown clinically relevant interactions with prescription drugs used in the management of neuropsychiatric disorders. The clinical focus is aimed to provide easily accessible information that will be of interest to clinicians, researchers, and the drug-consuming public.

RAS in the Central Nervous System: Potential Role in Neuropsychiatric Disorders

2018 ◽  
Vol 25 (28) ◽  
pp. 3333-3352 ◽  
Author(s):  
Natalia Pessoa Rocha ◽  
Ana Cristina Simoes e Silva ◽  
Thiago Ruiz Rodrigues Prestes ◽  
Victor Feracin ◽  
Caroline Amaral Machado ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Central Nervous System ◽  
Nervous System ◽  
Therapeutic Potential ◽  
Neuropsychiatric Disorders ◽  
Extensive Literature ◽  
Ang Ii ◽  
Mas Receptor ◽  
The Central Nervous System ◽  
The Brain

Background: The Renin-Angiotensin System (RAS) is a key regulator of cardiovascular and renal homeostasis, but also plays important roles in mediating physiological functions in the central nervous system (CNS). The effects of the RAS were classically described as mediated by angiotensin (Ang) II via angiotensin type 1 (AT1) receptors. However, another arm of the RAS formed by the angiotensin converting enzyme 2 (ACE2), Ang-(1-7) and the Mas receptor has been a matter of investigation due to its important physiological roles, usually counterbalancing the classical effects exerted by Ang II. Objective: We aim to provide an overview of effects elicited by the RAS, especially Ang-(1-7), in the brain. We also aim to discuss the therapeutic potential for neuropsychiatric disorders for the modulation of RAS. Method: We carried out an extensive literature search in PubMed central. Results: Within the brain, Ang-(1-7) contributes to the regulation of blood pressure by acting at regions that control cardiovascular functions. In contrast with Ang II, Ang-(1-7) improves baroreflex sensitivity and plays an inhibitory role in hypothalamic noradrenergic neurotransmission. Ang-(1-7) not only exerts effects related to blood pressure regulation, but also acts as a neuroprotective component of the RAS, for instance, by reducing cerebral infarct size, inflammation, oxidative stress and neuronal apoptosis. Conclusion: Pre-clinical evidence supports a relevant role for ACE2/Ang-(1-7)/Mas receptor axis in several neuropsychiatric conditions, including stress-related and mood disorders, cerebrovascular ischemic and hemorrhagic lesions and neurodegenerative diseases. However, very few data are available regarding the ACE2/Ang-(1-7)/Mas receptor axis in human CNS.

scholarly journals Caprine Arthritis Encephalitis Virus Is Associated with Renal Lesions

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1051
Author(s):  
Brian G. Murphy ◽  
Diego Castillo ◽  
Asli Mete ◽  
Helena Vogel ◽  
Dayna Goldsmith ◽  
...  
Keyword(s):  
Renal Injury ◽  
Binding Sites ◽  
Encephalitis Virus ◽  
Clinical Consequence ◽  
Viral Isolate ◽  
Viral Promoter ◽  
Caprine Arthritis Encephalitis Virus ◽  
Renal Lesions ◽  
Cardiac Lesions ◽  
The Central Nervous System

Caprine arthritis encephalitis virus (CAEV) is a monocyte/macrophage-tropic lentivirus that primarily infects goats resulting in a well-recognized set of chronic inflammatory syndromes focused on the joint synovium, tissues of the central nervous system, pulmonary interstitium and mammary gland. Clinically affected animals generally manifest with one or more of these classic CAEV-associated tissue lesions; however, CAEV-associated renal inflammation in goats has not been reported in the peer-reviewed literature. Here we describe six goats with chronic, multisystemic CAEV infections in conjunction with CAEV-associated renal lesions. One of the animals had CAEV antigen-associated thrombotic arteritis resulting in infarction of both the kidney and heart. These goats had microscopic evidence of inflammatory renal injury (interstitial nephritis) with detectable renal immunolabeling for CAEV antigen in three of six animals and amplifiable proviral sequences consistent with CAEV in all six animals. Cardiac lesions (vascular, myocardial or endocardial) were also identified in four of six animals. Within the viral promoter (U3) region, known transcription factor binding sites (TFBSs) were generally conserved, although one viral isolate had a duplication of the U3 A region encoding a second gamma-activated site (GAS). Despite the TFBS conservation, the isolates demonstrated a degree of phylogenetic diversity. At present, the clinical consequence of CAEV-associated renal injury is not clear.

scholarly journals Intracerebral haemorrhage in Down syndrome: protected or predisposed?

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 876 ◽  
Author(s):  
Lewis Buss ◽  
Elizabeth Fisher ◽  
John Hardy ◽  
Dean Nizetic ◽  
Jurgen Groet ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Intracerebral Haemorrhage ◽  
Early Onset ◽  
Epidemiological Data ◽  
Haemorrhagic Stroke ◽  
Brain Parenchyma ◽  
Chromosome 21 ◽  
Clinical Consequence ◽  
Increased Risk ◽  
The Central Nervous System

Down syndrome (DS), which arises from trisomy of chromosome 21, is associated with deposition of large amounts of amyloid within the central nervous system. Amyloid accumulates in two compartments: as plaques within the brain parenchyma and in vessel walls of the cerebral microvasculature. The parenchymal plaque amyloid is thought to result in an early onsetAlzheimer’s disease (AD) dementia, a phenomenon so common amongst people with DS that it could be considered a defining feature of the condition. The amyloid precursor protein (APP) gene lies on chromosome 21 and its presence in three copies in DS is thought to largely drive the early onset AD. In contrast, intracerebral haemorrhage (ICH), the main clinical consequence of vascular amyloidosis, is a more poorly defined feature of DS. We review recent epidemiological data on stroke (including haemorrhagic stroke) in order to make comparisons with a rare form of familial AD due to duplication (i.e. having three copies) of the APP region on chromosome 21, here called ‘dup-APP’, which is associated with more frequent and severe ICH. We conclude that although people with DS are at increased risk of ICH, this is less common than in dup-APP, suggesting the presence of mechanisms that act protectively. We review these mechanisms and consider comparative research into DS and dup-APP that may yield further pathophysiological insight.

scholarly journals Serotonin Syndrome in the Setting of Lamotrigine, Aripiprazole, and Cocaine Use

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Anupam Kotwal ◽  
Sarah L. Cutrona
Keyword(s):  
Cocaine Abuse ◽  
Serotonin Syndrome ◽  
Pharmacodynamic Interactions ◽  
Serotonergic Activity ◽  
Threatening Condition ◽  
Neuromuscular Abnormalities ◽  
Life Threatening ◽  
The Central Nervous System ◽  
Autonomic Hyperactivity ◽  
Toxicity Criteria

Serotonin syndrome is a potentially life-threatening condition associated with increased serotonergic activity in the central nervous system. It is classically associated with the simultaneous administration of two serotonergic agents, but it can occur after initiation of a single serotonergic drug or increasing the dose of a serotonergic drug in individuals who are particularly sensitive to serotonin. We describe a case of serotonin syndrome that occurred after ingestion of higher than prescribed doses of lamotrigine and aripiprazole, in addition to cocaine abuse. The diagnosis was established based on Hunter toxicity criteria and severity was classified as mild. The features of this syndrome resolved shortly after discontinuation of the offending agents. Serotonin syndrome is characterized by mental status changes, autonomic hyperactivity, and neuromuscular abnormalities along a spectrum ranging from mild to severe. Serotonin syndrome in our patient was most likely caused by the pharmacokinetic and pharmacodynamic interactions between lamotrigine, aripiprazole, and cocaine leading to increased CNS serotonergic activity.

Topical issues of interaction of psychotropic drugs

2021 ◽  
pp. 27-38
Author(s):  
Artur Udalisovich Karimov ◽  
Maxim Leonidovich Maximov ◽  
Dmitry Germanovich Semenikhin ◽  
Linar Arturovich Karimov
Keyword(s):  
Mental Disorders ◽  
Psychotropic Drugs ◽  
Review Article ◽  
Internal Organs ◽  
Pharmacodynamic Interactions ◽  
Number Of Patients ◽  
The Central Nervous System ◽  
Practical Information ◽  
Somatic Diseases ◽  
Qualitative Changes

In mental patients with concomitant somatic pathology, psychotropic drugs are prescribed in combination with other drugs used in the treatment of various somatic diseases. As well as a large number of patients with somatic diseases, they receive therapy aimed at correcting mental disorders. At the same time, it is important to take into account the possibility of cross-influence of such pharmacotherapy on the functions of the central nervous system and internal organs, as well as the peculiarities of drug interactions between drugs. According to the mechanism of development, there are pharmaceutical, pharmacokinetic and pharmacodynamic interactions of drugs. The result of the interaction of drugs is more often a change in the intensity of the effect of drugs, less often there are qualitative changes in their action. The review article provides up-to-date practical information on the interaction of drugs for the treatment of mental disorders with drugs of other groups.

Large intraventricular epidermoid with bobble head doll syndrome in an adult

2017 ◽  
Vol 31 (2) ◽  
pp. 229-232
Author(s):  
Amit Agrawal
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Unusual Case ◽  
Relevant Literature ◽  
The Central Nervous System ◽  
Intracranial Epidermoid ◽  
Slow Growing

Abstract Intracranial epidermoid tumors are rare (0.2-1.8%), histologically benign, slow-growing, congenital neoplasms of the central nervous system arising from the retained ectodermal implants. We report an unusual case of intra third ventricular epidermoid in an adult presenting with the Bobble-head doll syndrome and review the relevant literature.

scholarly journals Pharmacokinetic Interactions of Herbs with Cytochrome P450 and P-Glycoprotein

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Hyun-Jong Cho ◽  
In-Soo Yoon
Keyword(s):  
Cytochrome P450 ◽  
Glycoprotein P ◽  
Metabolizing Enzymes ◽  
Herbal Products ◽  
P Glycoprotein ◽  
Concurrent Use ◽  
Substrate Drug ◽  
And Function

The concurrent use of drugs and herbal products is becoming increasingly prevalent over the last decade. Several herbal products have been known to modulate cytochrome P450 (CYP) enzymes and P-glycoprotein (P-gp) which are recognized as representative drug metabolizing enzymes and drug transporter, respectively. Thus, a summary of knowledge on the modulation of CYP and P-gp by commonly used herbs can provide robust fundamentals for optimizing CYP and/or P-gp substrate drug-based therapy. Herein, we review ten popular medicinal and/or dietary herbs as perpetrators of CYP- and P-gp-mediated pharmacokinetic herb-drug interactions. The main focus is placed on previous works on the ability of herbal extracts and their phytochemicals to modulate the expression and function of CYP and P-gp in severalin vitroandin vivoanimal and human systems.

Large intramedullary abscess of the spinal cord associated with an epidermoid cyst without dermal sinus

2007 ◽  
Vol 7 (3) ◽  
pp. 357-361 ◽  
Author(s):  
Rüdiger Gerlach ◽  
Michael Zimmermann ◽  
Elvis Hermann ◽  
Matthias Kieslich ◽  
Stefan Weidauer ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Epidermoid Cyst ◽  
Relevant Literature ◽  
Systemic Infection ◽  
Signs And Symptoms ◽  
Dermal Sinus ◽  
Imaging Features ◽  
Intramedullary Abscess ◽  
First Case ◽  
The Central Nervous System

✓ An intramedullary abscess of the spinal cord (IASC) represents a rare disease associated with a potentially devastating outcome. Few cases involving children suffering from an IASC have been reported in the neurosurgical literature. In the majority of the reported pediatric cases there were either congenital abnormalities, such as a dermal sinus, or signs of local infections leading to a secondary hemopoietic spread. The authors report the case of an 18-month-old girl with an extensive IASC associated with an epidermoid cyst extending from T-11 to S-2 without evidence of a dermal sinus or history of clinically apparent systemic infection. To their knowledge, this is the first case report of an IASC without a condition facilitating either direct contamination via a dermal sinus or hemopoietic spread from an infectious focus outside the central nervous system. Signs and symptoms, the clinical course, and imaging features are discussed and the relevant literature is reviewed.

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