scholarly journals Neuropsychiatric Consequences of Lipophilic Beta-Blockers

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 155
Author(s):  
Sabina Alexandra Cojocariu ◽  
Alexandra Maștaleru ◽  
Radu Andy Sascău ◽  
Cristian Stătescu ◽  
Florin Mitu ◽  
...  
Keyword(s):  
Side Effects ◽  
Beta Blockers ◽  
Point Of View ◽  
Current Evidence ◽  
Therapeutic Effects ◽  
Posttraumatic Stress Syndrome ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Central Nervous System ◽  
Neuropsychiatric Side Effects

Beta-blockers are a class of drugs with important benefits in cardiovascular pathology. In this paper, we aim to highlight their adverse and therapeutic effects in the neuropsychiatric field. With respect to permeability, we would like to mention that most beta-blockers are lipophilic and can cross the blood–brain barrier. Observational studies show the presence of neuropsychiatric side effects when taking beta-blockers, and is the reason for which caution is recommended in their use in patients with depressive syndrome. From a therapeutic point of view, most current evidence is for the use of beta-blockers in migraine attacks, essential tremor, and akathisia. Beta-blockers appear to be effective in the treatment of aggressive behavior, beneficial in the prevention of posttraumatic stress syndrome and may play a role in the adjuvant treatment of obsessive–compulsive disorder, which is refractory to standard therapy. In conclusion, the relationship between beta-blockers and the central nervous system appears as a two-sided coin. Summarizing the neuropsychiatric side effects of beta-blockers, we suggest that clinicians pay special attention to the pharmacological properties of different beta-blockers.

Obsessive—Compulsive Disorder as a 5-HT Subsystem-Related Behavioural Disorder

1989 ◽  
Vol 155 (S8) ◽  
pp. 15-24 ◽  
Author(s):  
D. L. Murphy ◽  
J. Zohar ◽  
C. Benkelfat ◽  
M. T. Pato ◽  
T. A. Pigott ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Serotonin Uptake ◽  
Selective Serotonin ◽  
Therapeutic Effects ◽  
Obsessive Compulsive ◽  
Neurotransmitter System ◽  
Compulsive Disorder ◽  
Uptake Inhibitors ◽  
Anxiety Depression ◽  
Abnormal Brain

Involvement of the brain serotonin (5-HT) neurotransmitter system in obsessive-compulsive disorder (OCD) was originally suggested on the basis of therapeutic effects found with the semi-selective serotonin uptake inhibitor, clomipramine. More recent studies directly comparing clomipramine with non-selective or norepinephrine-selective uptake inhibitors, such as desipramine or nortriptyline, as well as studies with new, more selective serotonin uptake inhibitors, including fluvoxamine and fluoxetine, have supported that hypothesis. Clomipramine's antiobsessional effect has been augmented with the serotonin precursor, L-tryptophan, or with lithium, which has prominent serotonergic effects. Patients whose OCD symptoms improved on clomipramine worsened when the drug was discontinued (regardless of duration of therapy) and improved when clomipramine was reinstituted. OCD symptoms also worsened when metergoline, a 5-HT antagonist, was given to patients who had improved with clomipramine. Metergoline given alone had no effect. Administration of m-chlorophenylpiperazine (m-CPP), a 5-HT receptor agonist, to untreated OCD patients increased their anxiety, depression, and dysphoria, and exacerbated their OC symptoms. After 4 months of clomipramine therapy, m-CPP failed to produce the same behavioural effects, suggesting an alteration of a 5-HT subsystem (possibly downregulation of some 5-HT receptors). The data reviewed suggest an important role for an abnormal brain 5-HT subsystem in patients with OCD.

The Antidepressant Effects of 5-HT Uptake Inhibitors

1989 ◽  
Vol 155 (S8) ◽  
pp. 32-40 ◽  
Author(s):  
Anna Åberg-Wistedt
Keyword(s):  
Side Effects ◽  
Clinical Studies ◽  
Human Platelets ◽  
Obsessive Compulsive ◽  
Functional Roles ◽  
Compulsive Disorder ◽  
Uptake Inhibitors ◽  
Antidepressant Effects ◽  
5 Ht Uptake ◽  
Review Reports

The functional roles of monaminergic transmitters in depression have been widely studied during the past decade. Data from that research suggest that lower levels of the 5-HT metabolite, 5-HIAA, in the cerebrospinal fluid; 5-HT uptake in human platelets; and platelets [3H]-imipramine binding sites occur in depressed patients. In recent years several potent and selective 5-HT uptake inhibitors have become available for clinical studies. The first shown to have antidepressant effects, zimelidine, was followed by similar compounds such as femoxetine, fluvoxamine, Citalopram, indalpine, fluoxetine, paroxetine, and sertraline. The effectiveness of serotonin inhibitors in treating other disorders, such as obsessive–compulsive disorder, anxiety, and panic disorder, has also been demonstrated. This review reports the data from clinical studies with these agents. The 5-HT uptake inhibitors are devoid of anticholinergic properties and have not produced weight gain or sedative side-effects, but may have another profile of side-effects. Headache, nausea, and vomiting have been reported, however.

scholarly journals Outlook of applying of virtual reality (VR) technologies in the treatment of patients with mental disorders (review of foreign literature)

2021 ◽  
pp. 18-24
Author(s):  
V. V. Freize ◽  
L. V. Malyshko ◽  
G. I. Grachev ◽  
V. B. Dutov ◽  
N. V. Semenova ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Virtual Reality ◽  
Side Effects ◽  
Mental Disorders ◽  
English Language ◽  
Obsessive Compulsive ◽  
Safe Method ◽  
Phobic Disorders ◽  
Compulsive Disorder ◽  
Russian Psychiatry

The purpose of the study was to summarize data from foreign studies about the use of virtual reality (VR) technology in the treatment of patients with various mental disorders.Materials and methods: we selected and analyzed articles from MEDLINE / PubMed databases during the period from 2000 till 2020, as well as relevant references in the bibliography of the analyzed articles. 45 articles were included in further analysis from 575 English-language articles.Results: The use of VR technologies in the treatment of mental disorders appears to be one of the promising directions in psychiatry. The successfulness of these methods in patients with eating disorders, anxiety-phobic disorders, and obsessive-compulsive disorder is supported to be evidentiary information. There is evidence of the effectiveness of such methods in patients with schizophrenia, particularly, one of the most significant results is an increase in social functioning. The absence of side effects data makes it possible to consider t VR therapy as a safe method. It is needed to make further study the areas of application of VR therapy and conduct research to identify possible side effects of this method.Conclusion: The obtained results are important for drawing attention to the prospect of using VR technologies in Russian psychiatry and demonstrate the need for further study of this method.

Speculations on Antineuronal Antibody-Mediated Neuropsychiatric Disorders of Childhood

PEDIATRICS ◽  
1994 ◽  
Vol 93 (2) ◽  
pp. 323-326 ◽  
Author(s):  
Susan E. Swedo ◽  
Henrietta L. Leonard ◽  
Louise S. Kiessling
Keyword(s):  
Sleep Disturbances ◽  
Obsessive Compulsive ◽  
Behavioral Disturbances ◽  
Obsessive Compulsive Symptoms ◽  
Antineuronal Antibodies ◽  
Compulsive Disorder ◽  
Clinical Observations ◽  
Neurological Abnormalities ◽  
Group A ◽  
The Central Nervous System

Several converging lines of evidence suggest that some behavioral and neurological abnormalities of childhood may be mediated through antineuronal antibodies.1-3 These antineuronal antibodies appear to arise in response to group A [beta]-hemolytic streptococcal (GABHS) infections and to cross-react with cells within the central nervous system (CNS).4 Based on clinical observations of children with Sydenham's chorea, Tourette's syndrome (TS), and/or obsessive-compulsive disorder (OCD), we hypothesize that neuroimmunological dysfunction secondary to anti-neuronal antibodies may result in behavioral disturbances, such as anxiety, emotional lability, obsessive compulsive symptoms, hyperactivity, and sleep disturbances; and neurological abnormalities, such as motor and phonic tics, ballismus, chorea, and choreiform movements.

Neurostimulation therapies

2020 ◽  
pp. 217-232
Author(s):  
Daniel W. O’Connor ◽  
Christos Plakiotis ◽  
Peter Farnbach
Keyword(s):  
Cognitive Impairment ◽  
Deep Brain Stimulation ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Magnetic Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Treatment Of Depression ◽  
Electrical Impulses ◽  
The Brain

Electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS) all entail the delivery of electrical impulses to the brain with the aim of relieving mental disorders. ECT is an effective treatment of depression, mania and catatonia and, to a lesser extent, of schizophrenia. Its side effects, principally cognitive impairment, are mitigated through the use of individually tailored, unilateral delivery. TMS is more convenient but of lesser effectiveness. DBS, while reversible and thus safer than lesional surgery, is a major undertaking that is reserved at present for profoundly disabling depression, obsessive-compulsive disorder (OCD), and Tourette’s syndrome.

Neurobiology and Treatment of OCD

2013 ◽  
pp. 646-661
Author(s):  
Susanne E. Ahmari ◽  
H. Blair Simpson
Keyword(s):  
Environmental Factors ◽  
Behavioral Therapy ◽  
Treatment Strategies ◽  
Current Evidence ◽  
Evidence Based ◽  
Preclinical Studies ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Evidence Based Treatments ◽  
Genetic And Environmental Factors

Obsessive Compulsive Disorder (OCD) is a chronic, disabling disorder with a lifetime prevalence of up to 2-3%, and is a leading cause of illness-related disability. OCD is characterized by recurrent intrusive thoughts, images, or impulses (obsessions) that cause anxiety or distress, and repetitive mental or behavioral acts (compulsions). Though the etiology of OCD is unclear, current evidence implicates both genetic and environmental factors in its development. Our understanding of the neurobiology underlying OCD is still evolving, with convergent evidence from clinical and preclinical studies highlighting the importance of abnormalities in cortico-striatal-thalamo-cortical (CSTC) circuits. Evidence-based treatments for OCD include both pharmacotherapy and cognitive-behavioral therapy. This chapter will review the etiology and neurobiology of OCD, and will provide an overview of treatment strategies.

Neuropeptides and anxiety: focus on cholecystokinin

1994 ◽  
Vol 40 (2) ◽  
pp. 315-318 ◽  
Author(s):  
R B Lydiard
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Potential Role ◽  
Obsessive Compulsive ◽  
Cck Receptors ◽  
Compulsive Disorder ◽  
Therapeutic Uses ◽  
Recent Developments ◽  
The Central Nervous System ◽  
New Compounds

Abstract Cholecystokinin (CCK), a gastrin-like neuropeptide, exists in the central nervous system in several forms. The octapeptide (CCK-8) occurs in predominantly sulfated form (CCK-8S), and the tetrapeptide (CCK-4) occurs in smaller but significant quantities. This review highlights recent developments in preclinical and clinical research into the potential role for CCK in mediating anxiety states. Relevant animal and human studies of administration of CCK agonists are discussed, as well as recent data regarding the concentration of CCK-8S in cerebrospinal fluid from patients with panic disorder, bulimia nervosa, and obsessive compulsive disorder. Finally, the development of agents that specifically antagonize CCK receptors will be described, as will potential therapeutic uses for these new compounds.

TMS in the study and treatment of anxiety disorders

2012 ◽  
Author(s):  
Benjamin Greenberg ◽  
Sarah H. Lisanby
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Therapeutic Effects ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Systematic Testing ◽  
Compulsive Disorder ◽  
Current State ◽  
Post Traumatic ◽  
Disorder Treatment

A few studies of transcranial magnetic stimulation (TMS) as an anxiety disorder treatment have been reported. In treatment studies, the focal application of TMS in the treatment of anxiety disorders has been guided by the present understanding of the neurocircuitry underlying these disorders. This article reviews the current state of the literature on the uses of TMS in the study and treatment of anxiety disorders, and discusses the implications for understanding their patho-etiology. Investigation of the possible therapeutic effects of repetitive TMS in obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), or any anxiety disorder remains at a preliminary stage. There have been promising initial observations in OCD, which require systematic testing in controlled studies. As far as PTSD is concerned, the available data suggest that additional TMS work is required. The observations need to be replicated in controlled settings to determine whether this approach will have value in treating anxiety disorders.

Anorgasmia from Clomipramine in Obsessive-Compulsive Disorder

1987 ◽  
Vol 151 (1) ◽  
pp. 107-112 ◽  
Author(s):  
W. O. Monteiro ◽  
H. F. Noshirvani ◽  
I. M. Marks ◽  
P.T. Lelliott
Keyword(s):  
Side Effects ◽  
Sexual Function ◽  
Obsessive Compulsive Disorder ◽  
Structured Interview ◽  
Controlled Study ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Men And Women ◽  
Compulsive Disorder ◽  
Sexual Side Effects

Forty-six patients with obsessive-compulsive disorder undergoing a double-blind controlled study of clomipramine and placebo were interviewed to assess changes in sexual function. Of 33 patients with previously normal orgasm, nearly all of the 24 on clomipramine developed total or partial anorgasmia; none of the 9 on placebo did so. Anorgasmia persisted with minimal tolerance over the five months that clomipramine was taken. Men and women were equally affected. Sexual side-effects are easily missed without a structured interview, and can detract from the value of drug treatment.

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