Effect of psychotropics on sleep continuity and sleep architecture.

Psychotropics affect the regulation of sleep and wake by influencing brain stem neurotransmitter systems. The monoaminergic systems are active during wake but diminish their activity when transitioning to sleep in response to increased gamma-aminobutyric acid activity. The cholinergic system is active both during wake and during rapid eye movement sleep. According to their mode of action, different classes of psychotropics can be understood to act differently on sleep continuity and sleep architecture. This review outlines the differences. Increased knowledge of the detailed sleep effects of psychotropics may improve the perceived subjective quality of sleep.

Psychiatric morbidity among men using anabolic steroids.

OBJECTIVE: The purpose of this study was to investigate the psychiatric morbidity among men with abuse of anabolic steroids. METHODS: The design is a retrospectively matched cohort study. Five hundred and fourty-five males, who tested positive for anabolic steroids in Danish fitness centers during the period January 3, 2006 to March 1, 2018, were matched with 5450 randomly chosen male controls. Data was cross-referenced with seven national registers pertaining to information about education, employment status, and psychiatric comorbidity. Main outcomes and measures were prescription of psychopharmacological treatment. RESULTS: The incidence of treatment with anxiolytics (HR: 2.34, 95% CI: 1.62-3.38) and antipsychotics (HR: 2.69, 95% CI: 1.99-3.63) displayed a remarkable increase in the years following doping sanction, compared to the control group. The prevalence of antidepressant use was already markedly elevated several years before doping sanction, but also displayed a higher incidence in the years following sanction (HR: 1.65, 95% CI: 1.28-2.13). The associations remained highly significant after controlling for socioeconomic factors. CONCLUSION: Anabolic steroids use is strongly associated with psychiatric morbidity.

[Information and misinformation about adverse drug reactions].

In this review, we critically discuss the information distributed to patients and doctors regarding adverse drug reactions. A major concern is that frequencies reported in the summary of product characteristics are not adjusted for the occurrence of side effects observed in the placebo group. Previous research has found that the understanding of the health hazards related to pharmacotherapy can be significantly improved by providing information on the frequencies of adverse drug reactions in both the active- and the placebo group.

[Treatment of gamma-hydroxybutyrate withdrawal].

Gamma-hydroxybutyrate (GHB) is a drug of abuse, for which physical addiction develops quickly. GHB withdrawal can develop into a life-threatening condition and has previously been treated mainly with benzodiazepines. These have not always proven effective, leading to long hospitalizations in intensive care units. Based on successful Dutch treatment results for using GHB to treat GHB withdrawal symptoms, we propose to implement a similar method in Denmark. The method requires an interdisciplinary effort for which The Danish Poison Information Centre should be consulted for expertise.

[Wilson disease often debuts with psychiatric symptoms].

We present a case of a 17-year-old girl initially suspected of having a psychiatric disease within the affective spectrum. However, thorough evaluation of the overall symptomatology, and a combination of repeated physical examinations and paraclinical testing led to the diagnosis of Wilson disease. This case emphasizes the importance of a broad diagnostic approach to psychiatric patients.