The effects of duloxetine augmentation on clozapine in the treatment of negative symptoms in treatment resistant schizophrenia

The negative symptoms of schizophrenia have always been a challenge in treatment. The intensity and chronicity of these symptoms has direct impact on the life quality and treatment response. Current psychopharmacological agents have not offered a satisfactory result in addressing the negative symptoms of schizophrenia. The clinicians struggle with the approaches that can be utilized to target the negative symptoms of schizophrenia as no well-defined evidence exist. We present a case of treatment resistant schizophrenia with negative symptoms that responded well with augmentation of Duloxetine to Clozapine treatment.

COVID-19 and mental health: challenges and first conclusions

Under the conditions of the COVID-19 pandemic, a rapid change in the epidemiological situation, and introduced quarantine measures, there are conditions for a sharp deterioration in the mental health of a wide range of people. There are specific stressors that negatively affect mental health; there are population groups that are more vulnerable to psychological stress and the development of pathological psychological defense reactions; there is a sharp rise in the number of cases of heterogeneous mental disorders (depression, anxiety, post-traumatic stress disorders, etc.) among the population and healthcare workers in the foci of infection. The manifestation or exacerbation of mental illness in turn contributes to the spread of viral infection and is associated with a more frequent development of somatic complications and a poor prognosis. The practical problem is to choose effective psychopharmacological agents for the relief and treatment of mental disorders, by taking into account the need to combine the agents with antiviral drugs in somatically weakened COVID-19 patients.

Serotonergic, Dopaminergic, and Noradrenergic Modulation of Erotic Stimulus Processing in the Male Human Brain

Human sexual behavior is mediated by a complex interplay of cerebral and spinal centers, as well as hormonal, peripheral, and autonomic functions. Neuroimaging studies identified central neural signatures of human sexual responses comprising neural emotional, motivational, autonomic, and cognitive components. However, empirical evidence regarding the neuromodulation of these neural signatures of human sexual responses was scarce for decades. Pharmacological functional magnetic resonance imaging (fMRI) provides a valuable tool to examine the interaction between neuromodulator systems and functional network anatomy relevant for human sexual behavior. In addition, this approach enables the examination of potential neural mechanisms regarding treatment-related sexual dysfunction under psychopharmacological agents. In this article, we introduce common neurobiological concepts regarding cerebral sexual responses based on neuroimaging findings and we discuss challenges and findings regarding investigating the neuromodulation of neural sexual stimulus processing. In particular, we summarize findings from our research program investigating how neural correlates of sexual stimulus processing are modulated by serotonergic, dopaminergic, and noradrenergic antidepressant medication in healthy males.

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) reviews current knowledge and controversies of PTSD. The history, nosology, epidemiology, pathophysiology, risk factors, diagnosis, and treatment of post-traumatic stress disorder are described in detail. Also covered are the evidence-based treatments for PTSD, including all psychopharmacological agents (such as antidepressants and antipsychotics) as well as individual psychotherapies. The book delves into a vast array of cases involving at-risk groups such as minorities and offers a closer look at the coverage of PTSD across the world. The authors present state-of-the-art findings in genetics, epigenetics, neurotransmitter function, and brain imaging to provide the most current and thorough review of this burgeoning field.

USE OF CLUSTER ANALYSIS FOR EVALUATION OF ACUTE POISONING REHABILITATION TREATMENT EFFICIENCY

Observations of 153 patients admitted to the toxicological department of the N.V. Sklifosovsky Research Institute for Emergency Medicine after severe poisoning with psychopharmacological agents (36), cauterizing fluids (67) and neurotoxicants (drugs of the opium group, ethanol and psychopharmacological agents) (50) were summarized. A hierarchical cluster analysis was used to assess the systemic response of the body to a chemical injury of varying severity and the treatment used. The data obtained shows that taking into account the complexity of the response of homeostasis indicators to various impacts the characteristics of the shifts to the manifestations of mentioned acute poisonings and treatment measures in the rehabilitation period with the use of cluster analysis should be evaluated using data that indicates changes in the strength of the bonds (proximity levels) both for individual indicators and for the values of intrasystemic connections in individual systems and between them. Cluster analysis provides an opportunity to obtain new information about the pathogenesis of the studied poisonings and also has predictive capabilities. Changes in the assessed indicators obtained by cluster analysis correspond to their shifts in the process of one dimensional analysis, positive results of treatment (reduction of treatment duration) and, therefore, are recommended for practical use.

USING FACTOR ANALYSIS FOR ASSESSING THE EFFICIENCY OF TREATMENT OF ACUTE POISONING IN THE REHABILITATION STAGE

Observations of 153 patients admitted to the rehabilitation toxicological department of the Sklifosovsky Research Institute for Emergency Medicine after severe poisoning with psychopharmacological agents (36), cauterizing fluids (67) and neurotoxicants (drugs of the opium group, ethanol and psychopharmacological agents) (50) were summarized. To assess the systemic response of the body to a chemical injury of varying severity and the treatment used, the factor analysis method was used. For all of the estimated pathological conditions, high hemorrheological abnormalities are of high informational importance, especially during poisoning with psychopharmacological agents. The factor of endotoxicosis also has a noticeable effect, to the greatest extent during poisoning with psychopharmacological agents and cauterizing fluids. During the development of encephalopathy, the importance of blood viscosity, apoptosis and immune status is of informative significance. Factor analysis makes it possible to obtain new information on the pathogenesis of the studied poisonings. The data on the information value of the indicators used, obtained by the factor analysis, is in accordance with positive clinical results (shortening the hospitalization of patients), and therefore are recommended for practical use.

Evidence-based treatment of mania

Bipolar mania can be one of the most challenging psychiatric illnesses to treat, as it requires the clinician to make rapid and accurate decisions; have a reliable way of evaluating progress and treatment response; and possess keen psychotherapeutic skills. Therefore, the importance of staying updated on the clinical evidence of the various treatment options, which serves as the basis to individualize treatment on the day-to-day progress or deterioration of the manic patient. This chapter presents a review available on the evidence of different psychopharmacological agents including typical antipsychotics, lithium, antiepileptic drugs and atypical antipsychotics, and FDA-approved dosages. This review also includes these agents’ effects on fertility and recommendations about their use during pregnancy and lactation. Bipolar disorder continues to be a complex psychiatric condition, yet the progress in treatment options for the manic phase has evolved such that we have more options than ever before.