ROLE OF DRUG DISCOVERY IN CENTRAL NERVOUS SYSTEM DISORDERS: AN OVERVIEW

Central nervous system (CNS) stimulants are drugs, which produce a response that could be used to alleviate a particular medical condition. These are the agents, which speed up to treat conditions characterized by lack of adrenergic stimulation, including narcolepsy and neonatal apnea. The majority of CNS stimulants is chemically similar to the neurohormone norepinephrine and simulates the traditional "fight or flight" syndrome associated with sympathetic nervous system arousal. A small figure of added members of the CNS stimulant class do not fall into definite chemical groups. The review on central nervous system stimulants gives detail study of CNS stimulant drugs, their mechanism of action and in vivo models of CNS stimulants. The brain is a delicate tissue, and advancement built very effective methods to guard it. Unfortunately, the same mechanisms that protect it against intrusive chemicals can also upset therapeutic interventions. Many current medications are rendered unsuccessful in the treatment of cerebral maladies due to our incapability to efficiently deliver and sustain them within the brain. KEYWORDS: CNS Stimulants, Blood brain barrier (BBB), Drug toxicity, Drug Safety

Changes in medical use of central nervous system stimulants among US adults, 2013 and 2018: a cross-sectional study

ObjectiveTo assess the 5-year changes in the adult medical use of central nervous system (CNS) stimulants with higher risk of dependence and evaluate the population characteristics of users and their medical and/or neurological conditions.DesignCross-sectional study.SettingAnnual US Medical Expenditure Panel Survey, a stratified random sample of approximately 30 000 persons designed to produce national population estimates. It focuses on reported medical spending, medical services used, health status and prescription medications.ParticipantsAdults age 19 years and older who reported obtaining one or more prescriptions for amphetamine or methylphenidate products during two survey years, 2013 and 2018.Main outcomes measuresPrescriptions obtained, the specific stimulant product and annual treatment days of drug supplied.ResultsIn 2018, an estimated 4.1 million US adults (95% CI 3.4 million to 4.8 million) reported prescriptions for CNS stimulants, having filled a mean of 7.3 (95% CI 6.8 to 7.8) prescriptions with a mean of 226 (95% CI 210 to 242) days’ supply. Compared with 2013, the estimated number of adults reporting using CNS stimulants in 2018 increased by 1.8 million (95% CI 1.0 million to 2.7 million) or 79.8%. Most 2018 adult stimulant users reported taking psychoactive medication for one or more mental, behavioural or neurodevelopment disorders. Overall, 77.8% (95% CI 72.6% to 83.0%) reported some medication for adult attention deficit disorder, 26.8% (95% CI 22.2% to 31.5%) took medication for anxiety, 25.1% (95% CI 19.9% to 30.3%) for depression and 15.3% (95% CI 9.8% to 20.8%) indicated drug treatment for other mental or neurological disorders. Adult CNS stimulant use was higher in females, in younger age cohorts and among individuals of white race/ethnicity.ConclusionsAdult medical use of prescription stimulants increased markedly in 5 years and occurred in a population often reporting multiple mental or neurological disorders. Further action is needed to understand and manage this new resurgence in drugs with high risks of dependence.

The Impact of Persistent Irritability on the Medication Treatment of Paediatric Attention Deficit Hyperactivity Disorder

This study compares the efficacy and tolerability of central nervous system (CNS) stimulants in children with attention deficit hyperactivity disorder (ADHD) with and without prominent irritability (IRR) over the course of 30 months. This is a secondary analysis of a study examining growth patterns in medication naïve children with ADHD subsequently treated with CNS stimulants (predominantly OROS-Methylphenidate, up to 54 mg per day) for 30 months. Participants had to meet full diagnostic criteria for ADHD and been treated with CNS stimulants for under 30 days. Children were classified as IRR if they were rated as pretty much or very much on either of the “often angry” or easily annoyed” items plus “lose temper,” items of the Disruptive Behavior Disorders Rating Scale (DBDRS). Structured ratings of ADHD symptoms, impairment, side effects, and symptoms of oppositional defiant disorder (ODD) were collected every 2–12 weeks for the duration of the study. Medication use was measured by pill count and parent report. The IRR group comprised 28% of all participants. The IRR group had significantly higher levels of ADHD and ODD symptoms, impairment, and side effects ratings at baseline. In the IRR group, ODD symptoms, emotional lability, and impairment significantly decreased for participants with higher medication use. Total side effects increased for non-IRR participants with higher medication use. Emotional side effects decreased for IRR participants with higher medication use. Central nervous system stimulants were a tolerable and efficacious treatment in treatment naïve youth with ADHD with irritability.Clinical Trials Registration: NCT01109849

A REVIEW ON THE CONCEPT OF HRIDYA IN AYURVEDA: LOOKING BEYOND CARDIO TONICS

The term Hridya is used in different contexts with reference to different articles with diverse characteristics. Unlike the various Ayurvedic terms which can be more or less understood by the term itself, the term Hridya need a more elucidation. It is vital to screen these basic terms and find their meanings in different aspects for better discernment of Hridya in Ayurveda Hence this article attempts to illuminate the concept Hridya and the diversities in the Hridya dravyas mentioned in different contexts. On critical analysis of the literature and recent studies it can be understood that Ayurveda has included heart and brain in the umbrella term ‘Hridaya’. The Hridya dravyas can thus be understood as Cardiac or Central Nervous System (CNS) stimulants which evoke stimulation through various chemo-sensory pathways. Overall, commentaries describe Hridya as something pleasing or that which is good for the body. All the pleasurable sensations of the body attained by virtue of taste, smell, touch and by mere sight can be comprised under the concept Hridya and the act and articles which impart the pleasurable sensation can be understood as Hridya dravyas. As such the classical textbooks have references of food articles, flowers, fragrances, etc. described as Hridya dravyas as they have the ability impart the pleasurable sensation in common. While portraying the concept Hridya, the motor, sensory and psychological components should be taken contemplated. Any stimuli that impart a sense of pleasure to the respective sense organ and hence impart a sense of pleasure in Hridaya can be considered as Hridya.

The Abuse of Central Nervous System Stimulants and its Impact on the Youth of Eastern Nigeria

The class of drugs designated as central nervous system (CNS) stimulants includes the four social drugs that find use among some youth of Eastern Nigeria; caffeine, nicotine, cocaine and marijuana. CNS stimulants increase or enhance the activity of monoamines (such as dopamine and nor epinephrine) in the brain, which leads to increased heart rate, blood pressure, and respiration. They also have a high potential for addiction. Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because these drugs change the brain structure and function. The aim of this review is to answer the following questions: What are the common types of CNS stimulants abused in Eastern Nigeria? What prompts people to start taking these drugs? Why do people become addicted to these drugs? How does CNS stimulant abuse gain foothold in Eastern Nigeria? What are the implications of this drug taking for the users and the development of youth? How does the abuse of these stimulants affect the Eastern Nigerian society? How can the use of CNS stimulants among youth of eastern Nigeria be prevented or discouraged? Is there any treatment available for the youth addicted to CNS stimulants in Eastern Nigeria?

Does Prenatal Exposure to CNS Stimulants Increase the Risk of Cardiovascular Disease in Adult Offspring?

Prenatal exposure to an adverse uterine environment can have long lasting effects on adult offspring through DNA methylation, histone acetylation, and other epigenetic effects that alter gene expression and physiology. It is well-known that consumption of CNS stimulants such as caffeine, nicotine, amphetamines, and cocaine during pregnancy can adversely impact the offspring. However, most work in this area has focused on neurological and behavioral outcomes and has been limited to assessments in young offspring. The impact of prenatal exposure to these agents on the adult cardiovascular system has received relatively little attention. Evidence from both animal and human studies indicate that exposure to CNS stimulants during the gestational period can negatively impact the adult heart and vasculature, potentially leading to cardiovascular diseases later in life. This review discusses our current understanding of the impact of prenatal exposure to cocaine, methamphetamine, nicotine, and caffeine on the adult cardiovascular system.

CNS Stimulants Currently Available for Treatments in Patients Suffering with Worldwide Pandemic of Coronavirus Disease

Outbreak of Coronavirus disease is worldwide pandemic declared by WHO. Patients either suffered from coronavirus infection or not both are physically and mentally disturbed. Patient whom suffered with such pandemic diseases or infections, have a greater risk of mental illnesses such as depression, attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), schizophrenia and mania.CNS stimulants are psychoactive drugs available from resources like from nature (herbal/crude drugs) or from synthetic routes, are used to treat such diseases.In current research, extensive research review is done to find the best CNS stimulants currently available for treatments for such diseases. It is concluded from this research that stimulants that prescribed more frequently are amphetamine, methylphenidate and lisdexamfetamine. Moreover, stimulants that are not prescribed or illicit are like cocaine as such agents caused highly dependency, tolerance and addiction.International Journal of Human and Health Sciences Vol. 05 No. 02 April’21 Page: 148-153

0774 Factors Associated With The Continuous Use Of Psychotropic Treatments For Narcolepsy

Introduction Narcolepsy is a debilitating disorder characterized by excessive sleepiness and cataplexy episodes. There is no cure for this disease. Current treatments focus on controlling the symptoms with CNS stimulants for sleepiness and antidepressants and/or CNS depressants for cataplexy. This study examines the factors that can contribute to the cessation of narcolepsy treatment. Methods The study includes 291 narcoleptic individuals who were interviewed twice, approximately five to seven years apart, in Wave 1 (W1) and Wave 2 (W2). Telephone interviews were conducted with the help of the Sleep-EVAL system; narcolepsy individuals were initially evaluated and diagnosed by a Sleep Specialist. Results At W1, 49.2% of narcoleptic individuals were taking a CNS stimulant; at W2, 37% of narcoleptic individuals were taking a CNS stimulant. The use was chronic (i.e., present at W2 and W1) for 52.7% of the W2 subjects. CNS depressants were used by 19.1% at W1 and 17% at W2. Of the W1 subjects, 67.6% still reported using CNS depressants at W2. In terms of antidepressants, 38.6% and 29.6% of subjects reported using these medications at W1 and W2 respectively. Of those taking antidepressants at W2, 58.9% reported chronic use (ie, were also on antidepressants at W1). At least one of the aforementioned medication classes was used by 72% of participants at W1 and 56.1% at W2. Chronicity of nocturnal awakenings (RR: 2.7), the frequency of cataplexy episodes (RR: 2.3) and the chronicity of hypnopompic hallucinations (RR: 2.8) were associated with long-term use of narcolepsy treatment. Conclusion Narcolepsy treatments are mostly taken to long term. Some narcoleptics individuals were able to reduce or stop treatment either because the intensity of symptoms decreased or because they developed coping mechanisms to deal with the symptoms. Support NIH (R01NS044199), the Arrillaga Foundation and Jazz Pharmaceuticals Inc.