scholarly journals Pharmacogenomics: A focus on antidepressants and atypical antipsychotics

2016 ◽  
Vol 6 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Jonathan F. Lister
Keyword(s):  
Mental Health ◽  
Side Effects ◽  
Atypical Antipsychotics ◽  
Psychiatric Care ◽  
Clinical Effect ◽  
Genomic Data ◽  
Therapeutic Benefit ◽  
Elevated Risk ◽  
Response Side ◽  
Medication Efficacy

Abstract The study of pharmacogenomics is rapidly growing, particularly in the field of mental health. Understanding pharmacogenomic principles can be a challenge for many clinicians. Most mental health genomic data concentrates on variability (response, side effects) with antidepressants and atypical antipsychotics. Current pharmacogenomic practice and research primarily focuses on two areas: pharmacodynamics and pharmacokinetics. Based on the current literature, genetic polymorphisms of pharmacodynamics and pharmacokinetics parameters likely influence medication efficacy, therefore affecting the therapeutic benefit. Additionally, certain pharmacodynamic and pharmacokinetic polymorphisms have been linked to an elevated risk of side effects and adverse events with these medications. In this review, specific pharmacodynamic and pharmacokinetic polymorphisms related to antidepressants and atypical antipsychotics will be discussed, as well as the potential clinical effect these genomic abnormalities have within psychiatric care.

scholarly journals Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand

BJGP Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. bjgpopen20X101010 ◽  
Author(s):  
Graham Gulbransen ◽  
William Xu ◽  
Bruce Arroll
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Chronic Pain ◽  
New Zealand ◽  
Side Effects ◽  
Therapeutic Benefit ◽  
Cancer Symptoms ◽  
Positive Side ◽  
Patient Reported

BackgroundCannabidiol (CBD) is the non-euphoriant component of cannabis. In 2017, the New Zealand Misuse of Drugs Regulations (1977) were amended, allowing doctors to prescribe CBD. Therapeutic benefit and tolerability of CBD remains unclear.AimTo review the changes in self-reported quality of life measurements, drug tolerability, and dose-dependent relationships in patients prescribed CBD oil for various conditions at a single institution.Design & settingAn audit including all patients (n = 400) presenting to Cannabis Care, New Zealand, between 7 December 2017 and 7 December 2018 seeking CBD prescriptionsMethodIndications for CBD use were recorded at baseline. Outcomes included EuroQol quality of life measures at baseline and after 3 weeks of use, patient-reported satisfaction, incidence of side effects, and patient-titrated dosage levels of CBD.ResultsFour hundred patients were assessed for CBD and 397 received a prescription. Follow-up was completed on 253 patients (63.3%). Patients reported a mean increase of 13.6 points (P<0.001) on the EQ-VAS scale describing overall quality of health. Patients with non-cancer pain and mental-health symptoms achieved improvements to patient-reported pain and depression and anxiety symptoms (P<0.05). There were no major adverse effects. Positive side effects included improved sleep and appetite. No associations were found between CBD dose and patient-reported benefit.ConclusionThere may be analgesic and anxiolytic benefits of CBD in patients with non-cancer chronic pain and mental health conditions such as anxiety. CBD is well tolerated, making it safe to trial for non-cancer chronic pain, mental health, neurological, and cancer symptoms.

Psychiatric remuneration systems in Europe: an overview

2011 ◽  
Vol 08 (01) ◽  
pp. 09-15
Author(s):  
D. McDaid
Keyword(s):  
Mental Health ◽  
The Netherlands ◽  
Mental Health System ◽  
Psychiatric Care ◽  
Financial Instability ◽  
Service Utilisation ◽  
Service Users ◽  
Mental Health Systems ◽  
Adequate Information ◽  
Recent Developments

SummaryNew forms of psychiatric remuneration linked to levels of activity undoubtedly will have an increasing role to play in mental health systems right across Europe. Potentially they can be more efficient and promote choice, but valid concerns have been raised about their impact on the sustainability and nature of psychiatric care. This article looks in particular at recent developments in England and the Netherlands and reflects on how remuneration mechanisms may need to develop further both to improve efficiency and quality within the context of an ever more fragmented and multi-sectoral mental health system. Any introduction of activity- based reimbursement should be introduced gradually. This should be accompanied by investment in adequate information systems to help better understand service utilisation patterns, transitional funding safeguards to reduce the risk of financial instability and incentives/ contractual measures to ensure that services strive to offer services of the highest possible quality that meet the needs of service users.

scholarly journals Global mental health should engage with the ethics of involuntary admission

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Marisha N. Wickremsinhe
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Health Services ◽  
Clinical Ethics ◽  
Psychiatric Care ◽  
Global Mental Health ◽  
Mental Healthcare ◽  
Involuntary Admission ◽  
Persons With Disabilities ◽  
Psychosocial Disability

AbstractGlobal mental health, as a field, has focused on both increasing access to mental health services and promoting human rights. Amidst many successes in engaging with and addressing various human rights violations affecting individuals living with psychosocial disabilities, one human rights challenge remains under-discussed: involuntary inpatient admission for psychiatric care. Global mental health ought to engage proactively with the debate on the ethics of involuntary admission and work to develop a clear position, for three reasons. Firstly, the field promotes models of mental healthcare that are likely to include involuntary admission. Secondly, the field aligns much of its human rights framework with the UN Convention on the Rights of Persons with Disabilities, which opposes the discriminatory use of involuntary admission on the basis of psychosocial disability or impairment. Finally, global mental health, as a field, is uniquely positioned to offer novel contributions to this long-standing debate in clinical ethics by collecting data and conducting analyses across settings. Global mental health should take up involuntary admission as a priority area of engagement, applying its own orientation toward research and advocacy in order to explore the dimensions of when, if ever, involuntary admission may be permissible. Such work stands to offer meaningful contributions to the challenge of involuntary admission.

scholarly journals Beyond the high: Mapping patterns of use and motives for use of cannabis as medicine

2021 ◽  
pp. 145507252098596
Author(s):  
Sinikka L. Kvamme ◽  
Michael M. Pedersen ◽  
Sagi Alagem-Iversen ◽  
Birgitte Thylstrup
Keyword(s):  
Mental Health ◽  
Side Effects ◽  
Sleep Disturbances ◽  
Online Survey ◽  
Cannabis Use ◽  
Health Conditions ◽  
Convenience Sample ◽  
Mental Health Conditions ◽  
Patient Organisations ◽  
Patterns Of Use

Background: In Denmark the boundaries between cannabis as an illicit drug and licit medicine have shifted rapidly in recent years, affecting also policy. However, the vast majority of Danes, who use cannabis as medicine (CaM) continue to rely on the unregulated market for supply. This study explores patterns of use and motives for use of CaM in Denmark. Methods: An anonymous online survey was made available to a convenience sample of users of CaM from July 14, 2018 to November 1, 2018. Participants were recruited through patient organisations, social and public media, and the illegal open cannabis market. Results: Of the final sample ( n = 3,021), a majority were women (62.6%) and the mean age was 49 years. Most had no prescription for CaM (90.9%), a majority had no or limited previous experience with recreational cannabis use (63.9%), and had used CaM for two years or less (65.0%). The most common form of intake was oil (56.8%) followed by smoke (24.0%). CBD oil (65.0%) was used more than hash, pot or skunk (36.2%). Most frequent conditions treated were chronic pain (32.0%), sleep disturbances (27.5%), stress (23.7%), osteoarthritis (22.7%), anxiety (19.6%), and depression (19.6%). Overall, users experienced CaM to be effective in managing somatic and mental health conditions and reported relatively few side-effects. CBD oil only users were more likely to be women, older, have limited recreational experience and have initiated use recently. Conclusions: A new user group has emerged in Denmark that, for the most part, use illegally sourced CaM to treat a broad range of somatic and mental health conditions, often with experienced effect and relatively low level of side-effects. The prevalent use of low-potency CBD oil indicates an interest in effects beyond the high normally associated with cannabis use. More clinical research into the effects and side-effects of CaM is needed to draw the boundaries of the medical utility of cannabis.

Prescribing practices in psychiatric hospitals in Eastern Europe

2011 ◽  
Vol 26 (7) ◽  
pp. 414-418 ◽  
Author(s):  
V. Jordanova ◽  
N.P. Maric ◽  
V. Alikaj ◽  
M. Bajs ◽  
T. Cavic ◽  
...  
Keyword(s):  
Eastern Europe ◽  
Western Europe ◽  
Atypical Antipsychotics ◽  
Psychiatric Care ◽  
Anticholinergic Drug ◽  
Psychiatric Hospitals ◽  
Evidence Based ◽  
Prescribing Practices ◽  
The Mean ◽  
Clinical Records

AbstractBackgroundThere has been no evidence about the prescribing practices in psychiatric care in Eastern Europe.AimsTo examine the patterns of psychotropic prescribing in five countries of Eastern Europe.MethodWe conducted a one-day census of psychiatric treatments used in eight psychiatric hospitals in Albania, Croatia, Macedonia, Serbia and Romania. We examined clinical records and medication charts of 1304 patients.ResultsThe use of polypharmacy was frequent across all diagnostic groups. Only 6.8% of patients were on monotherapy. The mean number of prescribed drugs was 2.8 (SD 0.97) with 26.5% receiving two drugs, 42.1% receiving three drugs and 22.1% being prescribed four or more psychotropic drugs. Typical antipsychotics were prescribed to 63% and atypical antipsychotics to 40% of patients with psychosis. Older generations of antidepressants were prescribed to 29% of patients with depression. Anxiolitic drugs were prescribed to 20.4% and benzodiazepines to 68.5% of patients. One third of patients received an anticholinergic drug on a regular basis.ConclusionsOlder generation antipsychotics and antidepressants were used more frequently than in the countries of Western Europe. Psychotropic polypharmacy is a common practice. There is a need for adopting more evidence-based practice in psychiatric care in these countries.

The creative artist support group: a case study

2014 ◽  
Vol 13 (3) ◽  
pp. 142-145 ◽  
Author(s):  
Elliot Benjamin
Keyword(s):  
Mental Health ◽  
Support Group ◽  
Public Mental Health ◽  
Therapeutic Benefit ◽  
Humanistic Psychology ◽  
Content Type ◽  
Therapeutic Benefits ◽  
Artistic Theory ◽  
Creative Artists

Purpose – The purpose of this paper is to describe the therapeutic benefits of a community-based creative artists support group. The author is also the participant/facilitator of the group, which has been ongoing for the past eight months. The relevant experiences of three participants in the group have been chosen, to briefly illustrate the diverse kinds of social and therapeutic value that people with creative artistic inclinations may benefit from. Design/methodology/approach – The philosophy of the author's facilitation of this creative artist support group is based upon the humanistic psychology foundations of Carl Rogers and Abraham Maslow, as well as the author's previous work on the relationship of the creative artist to mental disturbance and mental health. Findings – The pragmatic illustrations of therapeutic benefit from participation in this creative artist support group are directly related to the humanistic supportive atmosphere that is described in this paper as a cornerstone of the Artistic Theory of Psychology. Originality/value – This paper is highly original in the context of the author's description of his Artistic Theory of Psychology, which utilizes the foundation for the “successful creative artist” as being successful in both one's chosen artistic realm as well as making a satisfactory adjustment to day-to-day life. It should also be noted that this paper has been written in the context of a “brief case study” as discussed in August 2013 with the Journal of Public Mental Health editor.

OLANZAPINE INDUCED AMENORRHEA REVERSED BY SWITCHING TO ARIPIPRAZOLE- A RARE CASE REPORT

2021 ◽  
pp. 50-51
Author(s):  
Ankit Halder ◽  
Navna Panchami ◽  
Abhishek Das
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Rare Case ◽  
Atypical Antipsychotics ◽  
Extrapyramidal Side Effects ◽  
Rare Case Report

Due to less extrapyramidal side-effects ,atypical antipsychotics use in psychiatry has increased a lot. But it is associated with other metabolic and endocrine side effects. Olanzapine is one such antipsychotic that less likely to cause hyperprolactinemia which can present as amenorrhea in patients.Here we present a rare case of olanzapine induced amenorrhoea reversed by switching to Aripiprazole.

Sign in / Sign up

Export Citation Format

Share Document