scholarly journals Importance of genomic studies for drug withdrawal with mental toxicities

2011 ◽  
Vol 1 (1) ◽  
pp. 11 ◽  
Author(s):  
Da Yong Lu ◽  
Ting-Ren Lu
Keyword(s):  
Side Effects ◽  
Clinical Evidence ◽  
Drug Withdrawal ◽  
Antidepressant Treatment ◽  
Genetic Characteristics ◽  
Genetic Status ◽  
Genomic Studies ◽  
New Drug Development ◽  
Low Incidence ◽  
Incident Rate

Undesired side-effects and toxicities of drugs, especially in the area of new-drug development, are negligibleless, unpredicable and often disastrous once being encountered. The suicidal behavior caused by antidepressant treatment is a typical of clinical evidence recently being discovered. We previously hypothesized that patients’ genetic status would decide the suicidal incident rate of antidepressants - it is pharmacogenetics of antidepressants may contribute of this toxicity in patients. In this review, we discuss this problem by comparing many strings of pharmacogenomics evidence of antidepressants recently being published with many other strings of evidence such as drug withdrawal with hepatotoxicity. We argue herein that pharmacogenetics may be very useful in drug withdrawal for mental toxicity. Because this is low-incidence toxicities, which are more reliable on human’s genetic characteristics. We stress the importance of genomics studies for drug withdrawal in future.

Severe Drooling and Treatment With Botulinum Toxin

2012 ◽  
Vol 21 (1) ◽  
pp. 15-21
Author(s):  
Merete Bakke ◽  
Allan Bardow ◽  
Eigild Møller
Keyword(s):  
Botulinum Toxin ◽  
Side Effects ◽  
Health Risk ◽  
Flow Rate ◽  
Clinical Evidence ◽  
Acetylcholine Release ◽  
Psychosocial Problems ◽  
Rate Reduction ◽  
Local Inhibition ◽  
Surgical Treatments

Severe drooling is associated with discomfort and psychosocial problems and may constitute a health risk. A variety of different surgical and non-surgical treatments have been used to diminish drooling, some of them with little or uncertain effect and others more effective but irreversible or with side effects. Based on clinical evidence, injection with botulinum toxin (BTX) into the parotid and submandibular glands is a useful treatment option, because it is local, reversible, and with few side effects, although it has to be repeated. The mechanism of BTX is a local inhibition of acetylcholine release, which diminishes receptor-coupled secretion and results in a flow rate reduction of 25–50% for 2–7 months.

Probiotics for the Chemoprotective Role Against the Toxic Effect of Cancer Chemotherapy

2021 ◽  
Vol 21 ◽  
Author(s):  
Aafrin Waziri ◽  
Charu Bharti ◽  
Mohammed Aslam ◽  
Parween Jamil ◽  
Aamir Mirza ◽  
...  
Keyword(s):  
Side Effects ◽  
Clinical Management ◽  
Clinical Evidence ◽  
Unmet Need ◽  
Chemotherapeutic Agents ◽  
Antitumor Effects ◽  
Anti Cancer ◽  
Different Types ◽  
Growth Promoting ◽  
High Degree

Background: The processes of chemo- and radiation therapy-based clinical management of different types of cancers are associated with toxicity and side effects of chemotherapeutic agents. So, there is always an unmet need to explore agents to reduce such risk factors. Among these, natural products have generated much attention because of their potent antioxidant and antitumor effects. In the past, some breakthrough outcomes established that various bacteria in the human intestinal gut are bearing growth-promoting attributes and suppressing the conversion of pro-carcinogens into carcinogens. Hence, probiotics integrated approaches are nowadays being explored as rationalized therapeutics in the clinical management of cancer. Methods: Here, published literature was explored to review chemoprotective roles of probiotics against toxic and side effects of chemotherapeutics. Results: Apart from excellent anti-cancer abilities, probiotics are bearing and alleviate toxicity and side effects of chemotherapeutics, with a high degree of safety and efficiency. Conclusion: Preclinical and clinical evidence suggested that due to the chemoprotective roles of probiotics against side effects and toxicity of chemotherapeutics, their integration in chemotherapy would be a judicious approach.

The Efficacy and Tolerability of Combined Antidepressant Treatment in Different Depressive Subgroups

1993 ◽  
Vol 162 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Sinead O'brien ◽  
Patrick McKeon ◽  
Myra O'regan
Keyword(s):  
Treatment Group ◽  
Side Effects ◽  
Major Depression ◽  
Orthostatic Hypotension ◽  
Antidepressant Treatment ◽  
Combined Treatment ◽  
Endogenous Depression ◽  
Double Blind Study ◽  
Double Blind ◽  
Global Improvement

Eighty patients admitted to hospital with major depression were randomly allocated to six weeks of treatment with tranylcypromine, amitriptyline, or tranylcypromine and amitriptyline in combination, in a double-blind study. Scores on the HRSD improved significantly in all three groups, but there were no differences between the three groups. Patients on tranylcypromine and amitriptyline combined improved more according to their self-ratings after six weeks, and response was earlier as measured by a clinical global improvement scale. Those with endogenous depression improved more than those with neurotic depression, irrespective of treatment group. Combined treatment was less well tolerated than single treatments and gave rise to more side-effects, although there was no serious toxicity. Orthostatic hypotension was observed more frequently in patients on combined treatment. This group also experienced a significant increase in weight and prolongation of the P-R interval on ECG.

scholarly journals Design and Implementation of Antidepressant Decision Making Aids

2012 ◽  
Vol 3 (2) ◽  
Author(s):  
Beth DeJongh ◽  
Robert Haight
Keyword(s):  
Decision Making ◽  
Side Effects ◽  
Sexual Dysfunction ◽  
Antidepressant Treatment ◽  
Decision Aids ◽  
Antidepressant Medication ◽  
Weight Changes ◽  
Patient Centered ◽  
Medication Selection ◽  
Clinical Systems

Objectives: To create easy to understand, antidepressant medication decision making aids and describe the process used to develop the aids for patients diagnosed with depression. Methods: In collaboration with the Institute for Clinical Systems Improvement (ICSI), antidepressant medication decision making aids were developed to enhance patient and physician communication about medication selection. The final versions of the aids were based on design methods created by Dr. Victor M. Montori (Mayo Clinic) and discussions with patients and providers. Five physicians used prototype aids in their outpatient clinics to assess their usefulness. Results: Six prototype antidepressant medication decision making aids were created to review potential side-effects of antidepressant medications. The side effects included were those patients feel are most bothersome or may contribute to premature discontinuation of antidepressant treatment, including: weight changes, sexual dysfunction, sedation, and other unique side effects. The decision aids underwent several revisions before they were distributed to physicians. Physicians reported patients enjoyed using the decision aids and found them useful. The sexual dysfunction card was considered the most useful while the daily administration schedule card was felt to be the least useful. Conclusions: Physicians found the antidepressant decision making aids helpful and felt they improved their usual interactions with patients. The aids may lead to more patient-centered treatment choices and empower patients to become more directly involved in their treatment. Whether the aids improve patient's medication adherence needs to be addressed in future studies.   Type: Student Project

Guidelines for treating depressive illness with antidepressants: A statement from the British Association for Psychopharmacology

1993 ◽  
Vol 7 (1_suppl) ◽  
pp. 19-23 ◽  
Author(s):  
Stuart A. Montgomery ◽  
P. Bebbington ◽  
P. Cowen ◽  
W. Deakin ◽  
P. Freeling ◽  
...  
Keyword(s):  
Side Effects ◽  
Depressed Mood ◽  
Antidepressant Treatment ◽  
Depressive Illness ◽  
Social Impairment ◽  
Self Blame ◽  
The Core ◽  
The Right ◽  
Therapeutic Doses ◽  
Core Symptoms

Depression is a common illness which affects some 3% of the population per year. At least 25% of those with marked depression do not consult their general practitioner and in half of those who do the illness is not detected. Depression is easy to recognize when four or five of the core symptoms have been present for 2 weeks which often coincides with some occupational and social impairment. The core symptoms are depressed mood, loss of interest or pleasure, loss of energy or fatigue, concentration difficulties, appetite disturbance, sleep disturbance, agitation or retardation, worthlessness or self blame and suicidal thoughts. A diagnosis of depression is made when five of these core symptoms, one of which should be depressed mood or loss of interest or pleasure, have been present for 2 weeks. Four core symptoms are probably sufficient. Response to antidepressants is good in those with more than mild symptoms. When there are only few or very mild depressive symptoms evidence of response to antidepressants is more uncertain. Antidepressants are effective, they are not addictive and do not lose efficacy with prolonged use. The newer antidepressants have fewer side effects than the older tricyclics, they are better tolerated and lead to less withdrawals from treatment. They are less cardiotoxic and are safer in overdose. Antidepressants should be used at full therapeutic doses. Treatment failure is often due to too low a dose being used in general practice. It may be difficult to reach the right dose with the older tricyclics because of side effects. To consolidate response, treatment should be continued for at least 4 months after the patient is apparently well. Stopping the treatment before this is ill-advised as the partially treated depression frequently returns. Most depression is recurrent. Long-term antidepressant treatment is effective in reducing the risk of new episodes of depression and should be continued to keep the patient well.

Potential Phytochemical Nanoemulsions in the Treatment of Oral Cancer and Oral Health

2022 ◽  
pp. 330-353
Author(s):  
Dharmeswar Barhoi ◽  
Sweety Nath Barbhuiya ◽  
Sarbani Giri
Keyword(s):  
Natural Products ◽  
Radiation Therapy ◽  
Oral Health ◽  
Side Effects ◽  
Oral Cancer ◽  
Medicinal Plants ◽  
Drug Development ◽  
Health Management ◽  
Free Form ◽  
New Drug Development

Oral cancer is one of the most common types of cancer, and lifestyle factors like extensive consumption of tobacco, betel quid, and alcohol are the major etiological factors of oral cancer. Treatment of oral cancer includes surgery, radiation therapy, and chemotherapy, but this treatment possesses lots of side effects. Therefore, scientists and medical experts are utilizing natural products and medicinal plants for new drug development. Natural products and phytochemicals showed better efficacy with less toxicity. However, most of the phytochemicals showed poor permeability and less bioavailability. To combat this problem, scientists developed nanosized nanoemulsions of phytochemicals to treat various ailments. Nanoemulsions of phytochemicals exhibited better efficacy than their free form due to increased permeability and bioavailability. Numerous phytopharmaceuticals have been formulated for nanoemulsions to date and tested for their anticancer potential against various cancers, including oral cancer and oral health management.

Sotalol hydrochloride (Betapace): a new antiarrhythmic drug

1993 ◽  
Vol 2 (5) ◽  
pp. 397-406
Author(s):  
CS Dunnington
Keyword(s):  
Side Effects ◽  
Antiarrhythmic Drug ◽  
Action Potential Duration ◽  
Antihypertensive Agent ◽  
Left Ventricular ◽  
Monophasic Action Potential ◽  
Class Iii ◽  
Cardiac Tissues ◽  
Supraventricular Tachyarrhythmias ◽  
Low Incidence

Sotalol hydrochloride (Betapace), recently released by the Food and Drug Administration for general use, is used to treat a variety of ventricular and supraventricular tachyarrhythmias. The drug's dominant action is the result of combined nonselective beta-adrenergic antagonism (Class II effect) and monophasic action potential duration prolongation in all cardiac tissues (Class III effect). It causes less left ventricular depression than propranolol and has a low incidence of toxicity. It is a useful addition to the antiarrhythmic drug armamentarium. This article reviews the drug's pharmacokinetic, pharmacodynamic and electrophysiologic properties, clinical uses and potential side effects. Reports on the drug's use as an antianginal and antihypertensive agent are also discussed.

scholarly journals MEDICINAL HERBS AND PHYTOCHEMICALS USED IN THE TREATMENT OF DEPRESSION: A REVIEW

2019 ◽  
pp. 8-14
Author(s):  
APOORVA HA ◽  
SEEMA MEHDI ◽  
KRISHNA KL ◽  
NABEEL K
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Clinical Evidence ◽  
Emotional State ◽  
Well Being ◽  
New Approach ◽  
Treatment Of Depression ◽  
Primary Hypothesis ◽  
The Brain ◽  
Additional Option

Depression is a condition of no mood and loss of interest in any activity that can diminish a person’s thinking, conduct, tendencies, emotional state, and a sense of well-being. Although there is a conventional class of medication which have been beneficial in the treatment of depression, current studies have reported having side effects which can be minimized by the intervention of herbs and phytochemicals. Most of the studies have proven the various mechanisms and have started to research a very ground-breaking method by glancing the ancient treatmen. Where this new approach of using the herbs and phytochemicals has shown better results alone and in combination with conventional drugs which has shown lesser adverse effects. The practice of phytomedicine is an additional option for the treatment of depression. In the various segments of treating the depression, the mainstream can be a breakthrough including phytoconstituents. In this aspect, there are many contributions for the treatment of the depression acting to the neuronal level signaling and the phytoconstituents also have shown some basic mechanisms in the treatment of depression as that of the conventional medications following some primary hypothesis and signaling pathways and life interactions that effects the brain in either way to treat the depression in all sort of way. Clinical evidence is required to provide backing to the safety and effectiveness of herbs and phytochemicals alone or in combination with currently available drugs to overcome the reported side effects during the treatment of depression.

Combinations of Morphine with Ketamine for Patient-controlled Analgesia

2003 ◽  
Vol 98 (5) ◽  
pp. 1195-1205 ◽  
Author(s):  
Gorazd Sveticic ◽  
Andrea Gentilini ◽  
Urs Eichenberger ◽  
Martin Luginbühl ◽  
Michele Curatolo
Keyword(s):  
Lumbar Spine ◽  
Side Effects ◽  
Drug Concentration ◽  
Optimization Procedure ◽  
Hip Surgery ◽  
Patient Controlled Analgesia ◽  
Pain Scores ◽  
Lockout Interval ◽  
Novel Method ◽  
Low Incidence

Background According to previous studies, the addition of ketamine to morphine for intravenous patient-controlled analgesia (PCA) may be beneficial. The authors developed and applied a new model to optimize the combination of morphine, ketamine, and a lockout interval for PCA after lumbar spine and hip surgery. Methods One-hundred two patients undergoing lumbar spine or hip surgery participated in the study. The analgesic effect of PCA during 48 h after surgery was optimized under restrictions dictated by side effects. Initially, eight combinations of morphine, ketamine (expressed as drug concentration in the solution administered), and a lockout interval (i.e., minimal allowed time between two consecutive PCA boluses) were empirically chosen and investigated. To determine subsequent combinations, an optimization model was applied until three consecutive steps showed no decrease in pain score. Results The authors analyzed 12 combinations with an allowed morphine and ketamine range in a PCA solution of 0-2 mg/ml and a lockout interval range of 5-12 min. During the optimization procedure, a reduction in mean pain scores with a low incidence of side effects was observed. The procedure converged to a morphine-to-ketamine ratio of 1:1 and a lockout interval of 8 min. Conclusions Using a novel method to analyze drug combinations, the study supports combinations of morphine with ketamine in a ratio of 1:1 and a lockout interval of 8 min for postoperative PCA following spine and hip surgery.

Comparison of the efficacy of moclobemide and fluvoxamine in elderly patients with a severe depressive episode

1993 ◽  
Vol 8 (6) ◽  
pp. 319-324 ◽  
Author(s):  
JP Bocksberger ◽  
JP Gachoud ◽  
J Richard ◽  
Ρ Dick
Keyword(s):  
Side Effects ◽  
Elderly Patients ◽  
Psychomotor Retardation ◽  
Antidepressant Effect ◽  
Reversible Inhibitor ◽  
Double Blind Study ◽  
Double Blind ◽  
New Class ◽  
Low Incidence ◽  
To Receive

SummaryIn a double-blind study carried out on elderly patients (older than 65 years) the efficacy and tolerability of the new antidepressant moclobemide was compared. Moclobemide belongs to a new class of substances called RIMA (Reversible inhibitor of the monoamine oxidase type A). Fluvoxamine, a selective reuptake-inhibitor of 5-HT, belongs to a class of antidepressants known for their better tolerability compared to tricyclic especially with elderly patients. Forty elderly patients (mean age 75 years) with major depression (according to DSM III) were randomized to receive either moclobemide (300 mg) or fluvoxamine (100 mg) twice daily. Dosages were increased when necessary on day 8, to a maximum of 450 mg moclobemide or 200 mg fluvoxamine and in most cases were maintained at these levels for the remainder of the study period (four weeks). Moclobemide was more effective than fluvoxamine showing a marked antidepressant effect and an earlier effect on psychomotor retardation. The two drugs were well tolerated showing a low incidence of side effects.

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