[Epidemiology of hallucinogenic drug use in the Netherlands]. / Epidemiologie van het gebruik van psychedelica in Nederland.

BACKGROUND: In recent years there was a renewed interest in psychedelic substances.
AIM: To present an overview of what is known about the use of classic psychedelic drugs and 'atypical' psychedelic drugs (i.e. entactogen/empathogenic drugs like mdma and dissociative drugs such as ketamine) in the Netherlands.
METHOD: Data from a Dutch adult general population survey from 2016 and 2018 and other surveys - mainly among nightlife attendees - were used to provide prevalence estimates and user characteristics. In addition to that, data from several Dutch monitoring systems were included for information on problematic psychedelic drug use, health emergencies and psychedelic drug markets.
RESULTS: The last year prevalence of ecstasy among Dutch adults was 2.9%, making it the most used psychedelic in the general population. For hallucinogenic mushrooms/truffles, lsd, 2C-B and ketamine, the last year prevalence estimate ranged between 0.2 and 0.6%. For all psychedelic substances, higher use rates were found among men, young adults between 20-29 years old, adults with higher education, and inhabitants of urban areas. In different groups of nightlife attendees, psychedelic substance use prevalence was greater than that of the general population. Data from various sources suggested an increase in the number of ketamine users.
CONCLUSION: Apart from ecstasy, the use of psychedelic substances is relatively low in the general population. In subgroups of the Dutch population, ketamine use increased in recent years. Further research is needed to gain a better understanding of the use of psychedelics in the Netherlands, particularly in subpopulations.

[Morbidity due to smoking in The Netherlands: an estimated 90,000 clinical hospital admissions in 2005]. / Ziekte door roken in Nederland: naar schatting 90 duizend klinische ziekenhuisopnamen in 2005.

OBJECTIVE: To estimate the number of hospital admissions due to smoking tobacco. DESIGN: Theoretical study based on data from the Dutch National Medical Registration. METHOD: Attributive fractions were determined based on the percentages of smokers and ex-smokers and the relative risks for certain diseases. Applying the attributive fractions to the number of hospital admissions provided an estimation of the number of tobacco-related hospital admissions. RESULTS: In 2005, there were 89,800 clinical hospital admissions in the Netherlands that could be attributed to smoking in the age group 35 years or more. This amounts to 7.5% of all hospital admissions in this age group. CONCLUSION: A large number of hospital admissions can be attributed to smoking.

Monitoring of alcohol and drugs under scrutiny: output and shortcomings.

A major focus of Dutch addiction policy is to improve the monitoring of substance use and addiction - which surveys and registrations are important for the monitoring of alcohol and drugs problems, and what information is generated or needs to be generated by these monitors? Three methods were used: an inventorisation of existing monitoring projects, a survey among experts in the field of alcohol and drugs to study the information needs, and a study on the output and shortcomings of the existing monitors. Sixty monitors and 13 'umbrella' monitors were found. Experts formulated the needs of 11 topics which were matched with the output of the monitors. Coverage of the nature and extent of use in general is good. Shortcomings apply to the use and accessibility of the monitors, as well as to their completeness, standardisation and content. Especially questions with respect to problem use, treatment demand/need of help and user careers cannot be answered sufficiently with the existing information.

Differential effects of amitriptyline, nefazodone and paroxetine on performance and brain indices of visual selective attention and working memory.

RATIONALE: Antidepressants may vary widely in their potential to impair cognitive and psychomotor functions. Little is known about their effects on event-related brain potentials (ERPs).OBJECTIVES. To compare the effects of three pharmacologically different antidepressants on performance and ERPs in tasks of selective attention and working memory. METHODS: Subjects were treated for 8 days with amitriptyline (sedative/anticholinergic TCA), nefazodone (5-HT(2) receptor antagonist), paroxetine (SSRI) and placebo, in a double-blind, crossover design. Measurements were carried out on day 1 and 8 of each treatment period. A task was used in which memory load (two and four items) and attention (focused, divided) were orthogonally varied. RESULTS: On day 1 amitriptyline increased reaction times (focused attention) and the percentage of misses (load 4>load 2) and false alarms. Sensitivity (A') was reduced as a function of memory load. Effects were greatly diminished on day 8. The ERP analysis yielded a reduced early frontal positive difference wave related to memory load (day 1). Attention-related search negativity was slightly prolonged. P3 latency (stimulus evaluation time) was prolonged. P3 amplitude was reduced (mainly on day 8) suggesting diminished attention capacity. Nefazodone increased reaction times and miss rates and reduced sensitivity (A') on day 8 only. Paroxetine speeded responses on day 1 and slightly increased miss rates on day 8. Performance effects of nefazodone and paroxetine did not interact with the task factors. Search negativity and P3 measures were not affected. CONCLUSIONS: The results suggest that the pharmacologically selective serotonergic antidepressants lack the specific memory and attention deficits seen with amitriptyline. Both performance and ERP data suggest that paroxetine and nefazodone may influence response-related processes, while for nefazodone an effect on other processes cannot be excluded.

Acute and subchronic effects of nefazodone and imipramine on highway driving, cognitive functions, and daytime sleepiness in healthy adult and elderly subjects.

The acute and subchronic effects of two dosages of a new serotonergic antidepressant, nefazodone, and those of the tricyclic imipramine were examined in a double-blind, crossover, placebo-controlled study. Twenty-four healthy subjects from two age groups (12 adults and 12 elderly from both sexes) received the four treatments (nefazodone, 100 and 200 mg twice daily; imipramine, 50 mg twice daily; and placebo) for 7 days with a 7-day washout period. Measurements were performed after the morning doses on day 1 and day 7. These included a standard over-the-road highway driving test, a psychomotor test battery, and sleep latency tests. Blood samples were taken on both days and analyzed to determine concentrations of parent drugs and their major metabolites. The main results showed that the reference drug, imipramine, had a detrimental effect after a single dose on lateral position control in the driving test, primarily in the adult group, that diminished after repeated dosing. Minor impairment on psychomotor test performance was found with both days. On the other hand, a single administration of both doses of nefazodone did not impair highway driving performance (even showed some improvement) and had no or only minor effects on psychomotor performance. After repeated dosing, nefazodone 200 mg twice daily (but not the 100-mg dose) produced slight impairment of lateral position control; dose-related impairment of cognitive and memory functions was found. The effects of nefazodone were generally in the same direction in both age groups. Significant correlations were found between steady-state concentrations of nefazodone in plasma (200-mg, twice-daily condition) as well as imipramine, and reaction time changes in a memory scanning task. Neither drug appeared to induce daytime sleepiness as measured by the sleep latency tests.

A cetirizina pertence à nova geraçåo de anti-histamínicos?: uma investigaçåo de seus efeitos agudos e subcrônicos sobre a conduçåo de veículo em rodovia, o desempenho em testes psicométricos e a sonolência diurna / Does cetirizine belong to the new generation of antihistamines?: an investigation into its acute and subchronic effects on highway driving, psychometric test performance and daytime sleepiness

Vinte e sete voluntários saudáveis do sexo masculino participam deste ensaio duplo-cego cruzado em cinco etapas, que foi realizado para comparar um novo antagonista seletivo dos receptores de H1 - a cetirizina (10 mg q.d.) - e a terfenadina (60 mg b.i.d. e 120 mg q.d.) a um antagonista dos receptores de H1 mais tradicional, a tripolidina (5 mg b.i.d.), e a placebo. Os medicamentos foram administrados durante quatro dias consecutivos e os participantes foram testados no 1§ e no 4§ dias. No teste, os participantes já dirigiram um veículo equipado com instrumentos de mediçåo em uma rodovia de 100 Km, tentando manter uma velocidade constante (90 km/h) e um posionamento lateral estável na faixa de trafégo da direita. A seguir, foram submetidos a três testes computadorizados da memória. No 4§ dia de tratamento, a latência do sono foi medida antes e após o teste de direçåo. Em ambos os dias, a triprolidina comprometeu significativamente o desempenho dos participantes nos testes de direçåo e psicométricos, além de reduzir a latência, em comparaçåo com placebo, no 4§ dia de tratamento. A administraçåo de 60 m g b.i.d. de terfenadina comprometeu o desempenho psicométrico após o tratamento subcronico. Conclui-se que a cetirizina, com a terfenadina, pertence å classe mais recente de antihistamínicos e pode ser administrada com segurança a pacientes que continuam suas atitudes diárias

Therapeutic effects and effects on actual driving performance of chronically administered buspirone and diazepam in anxious outpatients.

Two groups of 12 outpatients each (six men and six women) with generalized anxiety disorder, participated in this study. Each patient was treated single-blind with placebo during the first 7 days (baseline), followed by a double-blind drug treatment period of 4 consecutive weeks (active) and ending again with 7 days single-blind placebo treatment (washout). One group received buspirone 5 mg three times a day in the first week and continued with 10 mg in the morning, 5 mg in the afternoon, and 5 mg in the evening during the second, third, and fourth weeks. The other group received diazepam 5 mg three times a day in all 4 weeks. On the evening of the seventh day of each treatment week the Hamilton Rating Scale for Anxiety and the Symptom Check List (90 items) were applied to assess the therapeutic effects, followed by an on-the-road driving test that started 1.5 hours after the last drug or placebo intake. The test consisted of operating an instrumented vehicle over a 100 kilometer highway circuit while attempting to maintain a constant speed and a steady lateral position within the right traffic lane. Two patients in the diazepam group were unable to complete their test after the first and second treatment week, respectively, because of serious sedative reactions. Both buspirone and diazepam were equally effective in reducing overall anxiety symptoms. The specific profiles showed that buspirone also reduced concomitant depressive symptoms and symptoms of interpersonal sensitivity and anger-hostility. In contrast, diazepam was found to be slightly more effective in reducing somatic symptoms and to positively affect sleep disturbances. Moreover, abrupt discontinuation of diazepam resulted in a relapse of psychic anxiety symptoms comparable with the placebo-baseline level and a partial relapse of somatic anxiety symptoms. Chronic treatment with buspirone had no significant effects on lateral position and speed control. In contrast, diazepam significantly impaired control of lateral position in the first 3 weeks of treatment. There was no significant impairment in the fourth treatment week and the placebo-washout week. Speed control was significantly impaired only in the first week. The relevance of the trend toward decreasing performance impairment during chronic treatment remains to be established.