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1.
Int Immunopharmacol ; 93: 107436, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33556667

RESUMO

Early life stress is associated with various complications. Auraptene has significant antioxidant and anti-inflammatory effects. This study aimed to assess the probable underlying mechanisms that mediate changes in the behavior, hippocampus, heart and serum in the mouse model of maternal separation (MS) stress. We evaluated the possible protective effects of auraptene in these changes focusing on inflammatory response and oxidative state. Mice were treated with auraptene (5, 10, and 50 mg/kg). In addition, anxiety-like behaviors were evaluated using behavioral tests; including open field test (OFT) and elevated plus maze (EPM). Hippocampus and heart samples were assessed histopathologically. Levels of malondialdehyde (MDA) and antioxidant capacity, as well as nitrite levels, were measured in serum, heart, and hippocampal tissues. Moreover, gene expression of inflammatory markers (Il-1ß and Tlr-4) was evaluated in the heart and hippocampus. Results showed that auraptene reversed the negative effects of MS on behavior (increased time spent in central zone of the OFT and time and entries to the open arms of the EPM). Auraptene mitigated adverse effects of MS on the hippocampus (increased diameter and decreased percentage of dark neurons in the CA3 area). Accordingly, auraptene decreased MDA and nitrite levels and increased the antioxidant capacity in serum, and hippocampal samples. However, we observed different effects for different doses of auraptene in the heart samples. We concluded that MS is associated with anxiety-like behavior and cellular/molecular modifications in the heart, hippocampus and serum. We found that auraptene exerted protective effects against these negative effects of MS in mouse.


Assuntos
Anti-Inflamatórios/uso terapêutico , Antioxidantes/uso terapêutico , Ansiedade de Separação/tratamento farmacológico , Cumarínicos/uso terapêutico , Coração/fisiologia , Hipocampo/patologia , Estresse Psicológico/tratamento farmacológico , Animais , Comportamento Animal , Modelos Animais de Doenças , Hipocampo/efeitos dos fármacos , Humanos , Interleucina-1beta/metabolismo , Privação Materna , Camundongos , Estresse Oxidativo/efeitos dos fármacos
2.
Eur J Pharmacol ; 881: 173192, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32413348

RESUMO

Depressive disorders are both prevalent and debilitating, and a proportion of patients have treatment resistance to classic antidepressants. Recent evidence has implicated the intracellular WNT signaling pathway as having a key role in the pathogenesis of major depressive disorder. In the present study, we investigated the role of ß-catenin and transcription factor-4 (TCF4) in the depression-like and anxiety-like behaviors exhibited by mice exposed to maternal separation, or chronic mild stress. Both rodent models of childhood and adulthood stress showed depression and anxiety-like behaviors. During the last three weeks of medication, we applied AMBMP (2-Amino-4-[3,4- (methylenedioxy)benzylamino]-6-(3-methoxyphenyl)pyrimidine) to the maternal separation and chronic stress model for the first time. The drug alleviated the depression-like index in saccharin preference test (SPT) and forced swim test (FST), and anxiety-like index in open field test (OFT) and elevated-plus maze (EPM), and reversed the disruption of ß-catenin and TCF4 in stressed mice by upregulating the WNT pathway specifically. Therefore, the WNT pathway may be involved in the mediation of patient recovery and could be a target for novel antidepressants.


Assuntos
Ansiolíticos/farmacologia , Antidepressivos/farmacologia , Ansiedade de Separação/tratamento farmacológico , Comportamento Animal/efeitos dos fármacos , Benzodioxóis/farmacologia , Encéfalo/efeitos dos fármacos , Depressão/tratamento farmacológico , Privação Materna , Pirimidinas/farmacologia , Estresse Psicológico/tratamento farmacológico , Via de Sinalização Wnt/efeitos dos fármacos , Animais , Ansiedade de Separação/metabolismo , Ansiedade de Separação/psicologia , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Doença Crônica , Depressão/metabolismo , Depressão/psicologia , Modelos Animais de Doenças , Feminino , Preferências Alimentares/efeitos dos fármacos , Locomoção/efeitos dos fármacos , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Camundongos Endogâmicos C57BL , Estresse Psicológico/metabolismo , Estresse Psicológico/psicologia , Natação , Fator de Transcrição 4/metabolismo , beta Catenina/metabolismo
3.
Medicine (Baltimore) ; 97(39): e12140, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30278489

RESUMO

Dexmedetomidine is a highly selective α2 receptor agonist, this study aimed to investigate the effects of different doses of intranasal dexmedetomidine on the preoperative sedation and postoperative agitation in pediatric with total intravenous anesthesia (TIVA) for adenoidectomy with or without tonsillectomy.This is a double-blind placebo-controlled randomized trial. Pediatric were randomly divided into the D1, D2, and S groups, each group contained 30 patients. Twenty-five to 40 minutes before surgery, the D1 and D2 groups received intranasally dexmedetomidine 1 µg kg or 2 µg kg, respectively, while the S group received saline of the same volume. A unified protocol of TIVA induction and maintenance was used for the three groups. The preoperative sedation, behavior of separation from parents, postoperative agitation, and postoperative pain of the children were evaluated.The proportions of satisfactory sedation in the D1, D2, and S groups were 63.3%, 76.7%, and 0%, respectively. There was a statistically significant difference between D1 and S groups (P = .000) and D2 versus S groups (P = .000), while there was no statistically significant difference between D1 and D2 groups (P = .399). As for scale on the behavior of separation from parents, there was a statistically significant difference between D1 and S groups (P = .009) and D2 versus S groups (P = .009), whereas there was no significant difference between D1 and D2 groups (P = 1). The incidence of postoperative agitation in the D1, D2, and S groups was 43.3%, 30.0%, and 63.3%, respectively, and there was a statistical difference between D2 and S groups (P = .010). There was a significant difference in the Pediatric Anesthesia Emergence Delirium (PAED) scale between D2 and S groups (P = .029). The Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) in the D2 group was significantly lower than the S group (P = .013).The intranasal dexmedetomidine of 1 or 2 µg kg 25 to 40 minute before induction of anesthesia both could deliver effective preoperative sedation, reducing the children's distress of separation from parents. Moreover, intranasal dexmedetomidine of 2 µg kg could deliver more effective postoperative analgesia and reduce postoperative agitation, without prolonging postoperative recovery or causing severe adverse events.


Assuntos
Adenoidectomia/efeitos adversos , Dexmedetomidina/administração & dosagem , Hipnóticos e Sedativos/administração & dosagem , Agitação Psicomotora/tratamento farmacológico , Tonsilectomia/efeitos adversos , Administração Intranasal , Anestesia Geral/efeitos adversos , Anestesia Geral/métodos , Ansiedade de Separação/tratamento farmacológico , Ansiedade de Separação/epidemiologia , Criança , Pré-Escolar , Dexmedetomidina/efeitos adversos , Método Duplo-Cego , Delírio do Despertar/tratamento farmacológico , Delírio do Despertar/epidemiologia , Feminino , Humanos , Hipnóticos e Sedativos/efeitos adversos , Masculino , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/epidemiologia , Satisfação do Paciente/estatística & dados numéricos , Agitação Psicomotora/epidemiologia , Agitação Psicomotora/etiologia
4.
J Affect Disord ; 232: 349-357, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29510352

RESUMO

BACKGROUND: Saffron has antidepressant and anxiolytic effects in adults with mild-to-moderate depression. However, this is the first study examining its mood-related effects in teenagers. METHODS: In this 8-week, randomised, double-blind, placebo-controlled study, youth aged 12-16 years, with mild-to-moderate anxiety or depressive symptoms were given tablets containing placebo or a saffron extract (affron®, 14 mg b.i.d). The youth and parent versions of the Revised Child Anxiety and Depression Scale (RCADS) were used as outcome measures. RESULTS: 80 participants were enrolled and 68 completed the study. Based on youth self-reports, affron® was associated with greater improvements in overall internalising symptoms (p = 0.049), separation anxiety (p = 0.003), social phobia (p = 0.023), and depression (p = 0.016). Total internalising scores decreased by an average of 33% compared to 17% in the placebo group (p = 0.029). However, parental reports of improvements were inconsistent as mean improvements in RCADS scores were greater in the saffron group (40% vs 26%) (p = 0.026), although no other significant differences were identified. affron® was well-tolerated and there was a trend of reduced headaches in participants on the active treatment. LIMITATIONS: The use of a self-report instrument, limited study duration, single treatment dose, and non-clinical sample used in this study limit the generalisability of study findings. CONCLUSION: The administration of a standardised saffron extract (affron®) for 8 weeks improved anxiety and depressive symptoms in youth with mild-to-moderate symptoms, at least from the perspective of the adolescent. However, these beneficial effects were inconsistently corroborated by parents.


Assuntos
Ansiedade/tratamento farmacológico , Crocus , Depressão/tratamento farmacológico , Fitoterapia , Extratos Vegetais/uso terapêutico , Adolescente , Antidepressivos/uso terapêutico , Ansiedade/complicações , Ansiedade de Separação/complicações , Ansiedade de Separação/tratamento farmacológico , Criança , Depressão/complicações , Método Duplo-Cego , Feminino , Humanos , Masculino , Pais/psicologia , Fobia Social/complicações , Fobia Social/tratamento farmacológico , Autorrelato , Resultado do Tratamento
5.
Depress Anxiety ; 34(12): 1085-1095, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29071764

RESUMO

BACKGROUND: Separation anxiety disorder was recently recognized by fifth edition of the Diagnostic and Statistical Manual of Mental Disorders as a diagnosis in adults, but no publications to date have characterized a sample of patients seeking treatment for adult separation anxiety disorder (ASAD) or assessed treatment efficacy. We hypothesized that vilazodone, a selective serotonin reuptake inhibitor (SSRI) and serotonin 1a (5HT1a ) receptor partial agonist, would have efficacy in ASAD, because SSRIs have appeared efficacious in children with mixed diagnoses including separation anxiety disorder and in animal models of separation anxiety. METHODS: In this pilot study, 24 adults (ages 18-60) with a principal diagnosis of ASAD were randomized to 12 weeks of double-blind treatment with vilazodone (n = 13) or placebo (n = 11). Outcome was assessed by an independent evaluator and self-ratings, and analyzed with mixed effect models. RESULTS: This sample was predominantly female (67%), with comorbid psychiatric disorders (58%), and adult onset of separation anxiety disorder (62%). Response rates at week 12 did not differ significantly between groups. Across all time points, the vilazodone group evidenced greater improvement on the Structured Clinical Interview for Separation Anxiety Symptoms (P = .026) and the Quality of Life Enjoyment and Satisfaction Questionnaire (P = .011), and trends toward greater improvement on the Adult Separation Anxiety Questionnaire (P = .054) and the Clinical Global Impression-Change Scale (P = .086), all with large between-group effect sizes. CONCLUSIONS: Findings demonstrate feasibility of a clinical trial in ASAD, and they suggest that vilazodone may have efficacy in the treatment of ASAD and warrants further study.


Assuntos
Ansiedade de Separação/tratamento farmacológico , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Agonistas do Receptor 5-HT1 de Serotonina/farmacologia , Cloridrato de Vilazodona/farmacologia , Adolescente , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Projetos Piloto , Agonistas do Receptor 5-HT1 de Serotonina/administração & dosagem , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Cloridrato de Vilazodona/administração & dosagem , Adulto Jovem
6.
J Child Adolesc Psychopharmacol ; 27(1): 29-37, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-28165762

RESUMO

OBJECTIVE: This is a feasibility study evaluating the safety, tolerability, and potential anxiolytic efficacy of the α2 agonist guanfacine extended-release (GXR) in children and adolescents with generalized anxiety disorder (GAD), separation anxiety disorder (SAD), or social phobia/social anxiety disorder. METHODS: Youth aged 6-17 years with a primary diagnosis of GAD, SAD, and/or social anxiety disorder were treated with flexibly dosed GXR (1-6 mg daily, n = 62) or placebo (n = 21) for 12 weeks. The primary aim of this study was to determine the safety and tolerability of GXR in youth with anxiety disorders, which involved the analysis of treatment-emergent adverse events (TEAEs), the emergence of suicidal ideation and behaviors, vital signs, and electrocardiographic/laboratory parameters. Exploratory efficacy measures included dimensional anxiety scales (Pediatric Anxiety Rating Scale [PARS] and Screen for Child Anxiety Related Emotional Disorders [SCARED]), as well as the Clinical Global Impression-Improvement (CGI-I) scale. As this was an exploratory study, no inferential statistical analyses were performed. RESULTS: GXR was safe and well tolerated. Treatment-related mean ± standard deviation changes in heart rate (GXR: 1.8 ± 12 beats per minute [bpm] decrease; placebo: 0.5 ± 11 bpm decrease), systolic blood pressure (GXR: 2.3 ± 11 mm Hg decrease; placebo: 1.7 ± 11 mm Hg decrease), or diastolic blood pressure (GXR: 1.3 ± 9 mm Hg decrease; placebo: 0.9 ± 7 mm Hg increase) were similar between treatment groups. TEAEs, including headache, somnolence/fatigue, abdominal pain, and dizziness, were consistent with the known safety profile of GXR. No differences were observed between treatment groups for PARS and SCARED scores, although at endpoint, a higher proportion of subjects receiving GXR versus placebo demonstrated CGI-I scores ≤2 (54.2% vs. 31.6%), as rated by the clinician investigator. CONCLUSIONS: GXR was well tolerated in pediatric subjects with GAD, SAD, and/or social anxiety disorder. ClinicalTrials.gov Identifier: NCT01470469.


Assuntos
Transtornos de Ansiedade/tratamento farmacológico , Ansiedade de Separação/tratamento farmacológico , Guanfacina/uso terapêutico , Fobia Social/tratamento farmacológico , Adolescente , Agonistas de Receptores Adrenérgicos alfa 2/administração & dosagem , Agonistas de Receptores Adrenérgicos alfa 2/efeitos adversos , Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Transtornos de Ansiedade/fisiopatologia , Criança , Preparações de Ação Retardada , Relação Dose-Resposta a Droga , Método Duplo-Cego , Estudos de Viabilidade , Feminino , Guanfacina/administração & dosagem , Guanfacina/efeitos adversos , Humanos , Masculino , Projetos Piloto , Escalas de Graduação Psiquiátrica , Ideação Suicida , Resultado do Tratamento
7.
Indian J Pharmacol ; 48(4): 430-433, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27756956

RESUMO

AIM: The aim of this study was to analyze the ethyl acetate extract of Nerium indicum (NIE) flower for its antioxidant effect in anxious Sprague-Dawley rats. MATERIALS AND METHODS: Animals were divided into six groups (n = 6) and treated with 200 mg/kg and 400 mg/kg p.o. of NIE for 21 days to assess its preventive and curative effects. Anxiety was induced by isolating animals socially for 21 days. Elevated plus maze (EPM) and light and dark model were used for measuring anxiety in animals. Oxidative stress parameters such as lipid peroxidation (LPO), superoxide dismutase (SOD), catalase (CAT), and reduced glutathione (GSH) in blood and brain tissue homogenate were monitored after 21 days of social isolation in animals. RESULTS: Rats were treated with NIE 200 mg/kg and 400 mg/kg p.o. Both the treatments showed a significant (P < 0.001) increase in the number of open arm entries and time spent in open arm in EPM when compared with the negative control. Results also demonstrated that there was a significant (P < 0.001) increase in the number of lightbox entries and time spent in light box in light and dark model when compared with negative control. There was a significant (P < 0.001) improvement in endogenous anti-oxidants such as SOD, CAT, reduced GSH, and decreased levels of LPO in blood and brain tissue when compared with the negative control. CONCLUSION: The present study suggests the role of NIE in the treatment of anxiety, possibly by modulating the oxidative stress.


Assuntos
Ansiolíticos/uso terapêutico , Antioxidantes/uso terapêutico , Ansiedade de Separação/tratamento farmacológico , Nerium/química , Estresse Oxidativo/efeitos dos fármacos , Extratos Vegetais/uso terapêutico , Animais , Ansiolíticos/isolamento & purificação , Antioxidantes/administração & dosagem , Ansiedade de Separação/metabolismo , Encéfalo/efeitos dos fármacos , Encéfalo/enzimologia , Encéfalo/metabolismo , Modelos Animais de Doenças , Flores/química , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Extratos Vegetais/isolamento & purificação , Ratos Sprague-Dawley
8.
BMC Vet Res ; 11: 80, 2015 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-25889323

RESUMO

BACKGROUND: Canine separation-related problems (SRP) (also described as "separation anxiety" or "separation distress") are among the most common behavioural complaints of dog owners. Treatment with psychoactive medication in parallel with a behaviour modification plan is well documented in the literature, but it is unknown if this is associated with an improvement in underlying affective state (emotion and mood) or simply an inhibition of the behaviour. Cognitive judgement bias tasks have been proposed as a method for assessing underlying affective state and so we used this approach to identify if any change in clinical signs during treatment was associated with a consistent change in cognitive bias (affective state). Five dogs showing signs of SRP (vocalising - e.g. barking, howling-, destruction of property, and toileting - urination or defecation- when alone) were treated with fluoxetine chewable tablets (Reconcile™) and set on a standard behaviour modification plan for two months. Questionnaires and interviews of the owners were used to monitor the clinical progress of the dogs. Subjects were also evaluated using a spatial cognitive bias test to infer changes in underlying affect prior to, and during, treatment. Concurrently, seven other dogs without signs of SRP were tested in the same way to act as controls. Furthermore, possible correlations between cognitive bias and clinical measures were also assessed for dogs with SRP. RESULTS: Prior to treatment, the dogs with SRP responded to ambiguous positions in the cognitive bias test negatively (i.e. with slower running speeds) compared to control dogs (p < 0.05). On weeks 2 and 6 of treatment, SRP dogs displayed similar responses in the cognitive bias test to control dogs, consistent with the possible normalization of affect during treatment, with this effect more pronounced at week 6 (p > 0.05). Questionnaire based clinical measures were significantly correlated among themselves and with performance in the cognitive bias test. CONCLUSION: These results demonstrate for the first time that the clinical treatment of a negative affective state and associated behaviours in a non-human species can produce a shift in cognitive bias. These findings demonstrate how the outcome of an intervention on a clinical problem can be evaluated to determine not only that the subject's behaviour has improved, but also its psychological state (welfare).


Assuntos
Ansiedade de Separação/tratamento farmacológico , Comportamento Animal/efeitos dos fármacos , Doenças do Cão/tratamento farmacológico , Fluoxetina/uso terapêutico , Administração Oral , Animais , Ansiedade de Separação/psicologia , Discriminação Psicológica , Cães , Feminino , Fluoxetina/administração & dosagem , Masculino , Otimismo , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico
9.
Eur J Pharmacol ; 746: 252-7, 2015 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-25435080

RESUMO

Several studies have shown that glycine transporter 1 (GlyT1) inhibitors have anxiolytic actions. There are two types of glycine receptor: the strychnine-sensitive glycine receptor (GlyA) and the strychnine-insensitive glycine receptor (GlyB); however, which receptor is the main contributor to the anxiolytic actions of GlyT1 inhibitors is yet to be determined. Here, we clarified which glycine receptor is the main contributor to the anxiolytic effects of GlyT1 inhibitors by using maternal separation-induced ultrasonic vocalization (USV) by rat pups as an index of anxiety. We confirmed that administration of the benzodiazepine diazepam or the selective serotonin reuptake inhibitor escitaloplam, which are both clinically proven anxiolytics, or the GlyT1 inhibitor SSR504734 (2-chloro-N-[(S)-phenyl[(2S)-piperidin-2-yl] methyl]-3-trifluoromethyl benzamide), decreases USV in rat pups. In addition, we showed that another GlyT1 inhibitor, ALX5407 ((R)-N-[3-(4'-fluorophenyl)-3(4'-phenylphenoxy)propyl]sarcosine) also decreases USV in rat pups. SSR504734- or ALX5407-induced decreases in USV were dose-dependently reversed by administration of the GlyA antagonist strychnine, whereas the diazepam- or escitalopram-induced decreases in USV were not. Furthermore, GlyT1-induced decreases in USV were not reversed by administration of the GlyB antagonist L-687,414. Together, these results suggest that GlyA activation is the main contributor to the anxiolytic actions of GlyT1 inhibitors and that the anxiolytic actions of diazepam and escitalopram cannot be attributed to GlyA activation. Our findings provide new insights into the importance of the activation of GlyA in the anxiolytic effects of GlyT1 inhibitors.


Assuntos
Ansiolíticos/uso terapêutico , Ansiedade de Separação/tratamento farmacológico , Proteínas da Membrana Plasmática de Transporte de Glicina/antagonistas & inibidores , Privação Materna , Moduladores de Transporte de Membrana/uso terapêutico , Receptores de Glicina/agonistas , Vocalização Animal/efeitos dos fármacos , Animais , Animais Recém-Nascidos , Ansiolíticos/administração & dosagem , Ansiolíticos/efeitos adversos , Ansiolíticos/química , Ansiedade de Separação/etiologia , Benzamidas/administração & dosagem , Benzamidas/efeitos adversos , Benzamidas/antagonistas & inibidores , Benzamidas/uso terapêutico , Temperatura Corporal/efeitos dos fármacos , Relação Dose-Resposta a Droga , Interações Medicamentosas , Proteínas da Membrana Plasmática de Transporte de Glicina/metabolismo , Moduladores de Transporte de Membrana/administração & dosagem , Moduladores de Transporte de Membrana/efeitos adversos , Moduladores de Transporte de Membrana/química , Terapia de Alvo Molecular , Piperidinas/administração & dosagem , Piperidinas/efeitos adversos , Piperidinas/antagonistas & inibidores , Piperidinas/uso terapêutico , Pirrolidinonas/uso terapêutico , Ratos Sprague-Dawley , Receptores de Glicina/antagonistas & inibidores , Receptores de Glicina/metabolismo , Sarcosina/administração & dosagem , Sarcosina/efeitos adversos , Sarcosina/análogos & derivados , Sarcosina/antagonistas & inibidores , Sarcosina/uso terapêutico , Estricnina/farmacologia , Ultrassom
11.
Int Clin Psychopharmacol ; 29(5): 274-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24743562

RESUMO

The objective of this study was to assess the response of subsyndromal separation anxiety (SSSA) symptoms to methylphenidate (MPH) treatment in patients with attention-deficit/hyperactivity disorder (ADHD). A group of patients with ADHD and SSSA (n=42), aged 8-17 years, received 12 weeks of MPH treatment. The severity of SSSA symptoms was assessed using appropriate scales including the Screen for Child Anxiety Related Emotional Disorders and the specially designed Child and Adolescent Separation Anxiety Scale (CASAS). The severity of ADHD symptoms was assessed using the ADHD Rating Scale. The severity of ADHD and separation anxiety reduced significantly and significant positive correlations were found between the changes in ADHD Rating Scale and the total CASAS scores (P=0.012), as well as other relevant subscales of Screen for Child Anxiety Related Emotional Disorders and CASAS. The MPH-related attenuation in the severity of ADHD was associated with a corresponding improvement in separation anxiety related to school. SSSA symptomatology may be secondary to ADHD and thus the alleviation in ADHD symptoms achieved by MPH treatment results in corresponding relief in separation anxiety.


Assuntos
Ansiolíticos/uso terapêutico , Ansiedade de Separação/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Inibidores da Captação de Dopamina/uso terapêutico , Metilfenidato/uso terapêutico , Adolescente , Comportamento do Adolescente/efeitos dos fármacos , Ansiolíticos/administração & dosagem , Ansiolíticos/efeitos adversos , Ansiedade de Separação/epidemiologia , Ansiedade de Separação/fisiopatologia , Ansiedade de Separação/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Estimulantes do Sistema Nervoso Central/administração & dosagem , Estimulantes do Sistema Nervoso Central/efeitos adversos , Criança , Comportamento Infantil/efeitos dos fármacos , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Inibidores da Captação de Dopamina/administração & dosagem , Inibidores da Captação de Dopamina/efeitos adversos , Monitoramento de Medicamentos , Feminino , Humanos , Israel/epidemiologia , Masculino , Metilfenidato/administração & dosagem , Metilfenidato/efeitos adversos , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença
12.
Behav Brain Res ; 253: 274-9, 2013 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-23906765

RESUMO

Animals exposed to an early adverse event may be more susceptible to a second source of stress later in life, and these stressors may have additive deleterious effects. Sleep deprivation is known to be a stressor, affecting multiple body functions such as the cognition. Modafinil enhances working memory and attention in healthy non-sleep deprived subjects and in animal models of sleep deprivation. The first aim of the present study was to investigate the effects of maternal separation (MS) combined with paradoxical sleep deprivation (PSD) in adulthood on recognition memory in rats. Second, we aimed to evaluate whether the administration of modafinil would be able to ameliorate memory deficits induced by MS and PSD. Wistar rat pups were initially distributed into MS and handling (H) groups, with their litters standardized in 4 females and 4 males. In adulthood, the male rats were submitted to PSD or control condition, being redistributed afterwards in modafinil- or vehicle-treatment immediately after the training session of object recognition task. PSD did not potentiate the cognitive deficit due to MS. However, modafinil was able to recover memory impairments associated to PSD and also to MS in the neonatal period. This study demonstrates for the first time that modafinil ameliorates cognitive deficits associated to MS and to PSD in adulthood, independent from MS in the neonatal period.


Assuntos
Ansiedade de Separação/tratamento farmacológico , Ansiedade de Separação/psicologia , Compostos Benzidrílicos/farmacologia , Estimulantes do Sistema Nervoso Central/farmacologia , Transtornos Cognitivos/tratamento farmacológico , Privação do Sono/tratamento farmacológico , Privação do Sono/psicologia , Análise de Variância , Animais , Transtornos Cognitivos/psicologia , Feminino , Manobra Psicológica , Modafinila , Gravidez , Ratos , Ratos Wistar , Reconhecimento Psicológico/efeitos dos fármacos , Estresse Psicológico/tratamento farmacológico , Estresse Psicológico/psicologia
13.
J Consult Clin Psychol ; 81(5): 859-64, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23750468

RESUMO

OBJECTIVE: We examined the therapeutic relationship with cognitive-behavioral therapists and with pharmacotherapists for youth from the Child/Adolescent Anxiety Multimodal Study (Walkup et al., 2008). The therapeutic relationship was examined in relation to treatment outcomes. METHOD: Participants were 488 youth (ages 7-17 years; 50% male) randomized to cognitive-behavioral therapy (CBT; Coping Cat), pharmacotherapy (sertraline), their combination, or placebo pill. Participants met criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). The therapeutic relationship was assessed by youth report at Weeks 6 and 12 of treatment using the Child's Perception of Therapeutic Relationship scale (Kendall et al., 1997). Outcome measures (Pediatric Anxiety Rating Scale; Research Units on Pediatric Psychopharmacology Anxiety Study Group, 2002; and Clinical Global Impressions Scales; Guy, 1976) were completed by independent evaluators blind to condition. RESULTS: For youth who received CBT only, a stronger therapeutic relationship predicted positive treatment outcome. In contrast, the therapeutic relationship did not predict outcome for youth receiving sertraline, combined treatment, or placebo. CONCLUSION: A therapeutic relationship may be important for anxious youth who receive CBT alone.


Assuntos
Transtornos de Ansiedade/terapia , Ansiedade de Separação/terapia , Terapia Cognitivo-Comportamental/normas , Relações Profissional-Paciente , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Sertralina/farmacologia , Adolescente , Transtornos de Ansiedade/tratamento farmacológico , Ansiedade de Separação/tratamento farmacológico , Criança , Terapia Combinada , Feminino , Humanos , Masculino , Transtornos Fóbicos/tratamento farmacológico , Transtornos Fóbicos/terapia , Placebos , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Sertralina/administração & dosagem , Resultado do Tratamento
14.
PLoS One ; 8(1): e54152, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23326588

RESUMO

OBJECTIVES: The purpose of this study is to examine the use of prescribed psychoactive medications in a prospective cohort of children shortly after they entered foster homes; and to identify demographics, maltreatment history, psychiatric diagnoses including ADHD comorbidity, and level of aggression that contribute to prescribed use of stimulant and atypical antipsychotic medication over time. METHODS: The sample included N = 252 children (nested in 95 sibling groups) followed for three years up to 4 yearly waves. RESULTS: Nearly all (89%) met criteria for at least one of eight psychiatric diagnoses and 31% (75/252) used one or more prescribed psychoactive medications. Over half (55%) were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD); of these 38% used stimulants and 36% used atypical antipsychotics. Of the 75 medicated children, 19% received ≥3 different classes of drugs over the course of the study. Stimulants (69%) and atypical antipsychotics (65%) were the most frequently used drugs among medicated children. Adjusted odds ratios (AOR) showed that male gender (AOR = 3.2; 95% CI = 1.5-9.3), African American vs Latino ethnicity (AOR = 5.4; 95% CI = 2.1-14.2), ADHD regardless of Oppositional Defiant (ODD) or Conduct (CD) comorbidity (AOR = 6.0, 95% CI = 1.3-27.5), ODD or CD (AOR = 11.1, 95% CI = 2.1-58.6), and Separation Anxiety (AOR = 2.0, 95% CI = 1.0-4.0) psychiatric disorders were associated with the use of prescribed stimulants; while male gender (AOR = 3.8, 95% CI = 1.5-9.3), African American vs Latino (AOR = 5.1, 95% CI = 1.2-9.2) or Mixed/Other ethnicity (AOR = 3.3, 95% CI = 1.9-13.7), ADHD regardless of ODD or CD comorbidity (AOR = 5.8, 95% CI = 1.2-28.7), ODD or CD (AOR = 13.9, 95% CI = 3.3-58.5), Major Depression/Dysthymia (AOR = 2.8, 95% CI = 1.1-6.7) psychiatric disorders, and history of sexual abuse (AOR = 4.6, 95% CI = 1.3-18.4) were associated with the use of prescribed atypical antipsychotics. CONCLUSION: The aggressive use of atypical antipsychotics, which has unknown metabolic risks, suggests that the efficacy and safety of such treatment strategies for psychiatrically ill children in foster care should be monitored.


Assuntos
Antipsicóticos , Ansiedade de Separação/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Adolescente , Negro ou Afro-Americano/psicologia , Antipsicóticos/administração & dosagem , Antipsicóticos/efeitos adversos , Ansiedade de Separação/epidemiologia , Ansiedade de Separação/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Estimulantes do Sistema Nervoso Central/administração & dosagem , Estimulantes do Sistema Nervoso Central/efeitos adversos , Criança , Pré-Escolar , Comorbidade , Feminino , Cuidados no Lar de Adoção , Hispânico ou Latino/psicologia , Humanos , Masculino , Estudos Prospectivos
15.
J Dev Behav Pediatr ; 33(6): 456-68, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22772819

RESUMO

OBJECTIVE: Cross-sectional research indicates high rates of mental health concerns among youth with perinatal HIV infection (PHIV), but few studies have examined emerging psychiatric symptoms over time. METHODS: Youth with PHIV and peer comparisons who were HIV-exposed but uninfected or living in households with HIV-infected family members (HIV-affected) and primary caregivers participated in a prospective, multisite, longitudinal cohort study. Groups were compared for differences in the incidence of emerging psychiatric symptoms during 2 years of follow-up and for differences in psychotropic drug therapy. Logistic regression models were used to evaluate the association of emerging symptoms with HIV status and psychosocial risk factors. RESULTS: Of 573 youth with study entry assessments, 92% attended at least 1 annual follow-up visit (PHIV: 296; comparisons: 229). A substantial percentage of youth who did not meet symptom criteria for a psychiatric disorder at study entry did so during follow-up (PHIV = 36%; comparisons = 42%). In addition, those who met criteria at study entry often met criteria during follow-up (PHIV = 41%; comparisons = 43%). Asymptomatic youth with PHIV were significantly more likely to receive psychotropic medication during follow-up than comparisons. Youth with greater HIV disease severity (entry CD4% <25% vs 25% or more) had higher probability of depression symptoms (19% vs 8%, respectively). CONCLUSIONS: Many youth in families affected by HIV are at risk for development of psychiatric symptoms.


Assuntos
Atitude Frente a Saúde , Infecções por HIV/congênito , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Soropositividade para HIV/congênito , Soropositividade para HIV/psicologia , Transmissão Vertical de Doenças Infecciosas , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Grupo Associado , Adolescente , Fármacos Anti-HIV/efeitos adversos , Fármacos Anti-HIV/uso terapêutico , Ansiedade de Separação/tratamento farmacológico , Ansiedade de Separação/epidemiologia , Ansiedade de Separação/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/tratamento farmacológico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Estudos de Casos e Controles , Criança , Filho de Pais Incapacitados/psicologia , Estudos Transversais , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Uso de Medicamentos , Feminino , Infecções por HIV/tratamento farmacológico , Soropositividade para HIV/tratamento farmacológico , Soropositividade para HIV/transmissão , Humanos , Incidência , Estudos Longitudinais , Masculino , Transtornos Mentais/epidemiologia , Determinação da Personalidade/estatística & dados numéricos , Psicometria , Psicotrópicos/uso terapêutico , Meio Social , Estigma Social , Carga Viral
18.
J Affect Disord ; 133(3): 371-80, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21093062

RESUMO

BACKGROUND: Comorbid anxiety disorders are highly prevalent in bipolar disorder and have been shown to have serious negative impacts on the course of illness. The pharmacological treatment of anxiety can interact with the bipolar disorder and has not been proven effective. As such, many have recommended the psychological treatment of anxiety. This paper reviews the literature on psychological treatments for anxiety comorbid to bipolar disorder. METHOD: The Medline, PsychInfo and Web of Science databases were thoroughly examined for relevant treatment studies. RESULTS: Despite frequent recommendations in the literature, surprisingly few have studied the psychological treatment of comorbid anxiety in bipolar disorders. Nevertheless, preliminary results suggest that comorbid anxiety disorders can be effectively treated in a bipolar clientele using cognitive-behavioral therapy, mindfulness-based cognitive-behavioral therapy or relaxation training. In contrast, interpersonal, family therapy and psychoeducation alone would not seem to be beneficial treatment alternatives for anxiety. Cognitive-behavioral therapy appears to reduce the symptoms of obsessive-compulsive disorder, generalized anxiety disorder, panic disorder, post-traumatic stress disorder and general symptoms of anxiety among patients with bipolar disorder. However, the long-term maintenance of anxiety treatment effects may be somewhat reduced and adaptations may be called for to augment and sustain benefits. CONCLUSIONS: There is an urgent need for randomized controlled trials of different forms of psychotherapy for anxiety disorders comorbid to bipolar disorder. Until such trials are available, the most promising approach would appear to be the sequential or modular CBT-based treatment of the anxiety disorder.


Assuntos
Transtornos de Ansiedade/terapia , Transtorno Bipolar/terapia , Psicoterapia/métodos , Ansiolíticos/uso terapêutico , Ansiedade , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Ansiedade de Separação/tratamento farmacológico , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Terapia Cognitivo-Comportamental , Comorbidade , Humanos , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/tratamento farmacológico , Transtorno de Pânico/epidemiologia , Prevalência , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Transtornos de Estresse Pós-Traumáticos/epidemiologia
19.
Can Vet J ; 51(4): 380-4, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20592826

RESUMO

Dogs hospitalized in veterinary clinics are likely to show signs of separation-induced anxiety from hospitalization. The study assessed the effect of dog-appeasing pheromone (DAP) on 10 typical separation-related behavioral signs in hospitalized dogs. A DAP treated group (n = 24) was compared with a placebo control group (n = 19). There was overall amelioration of the signs without 'vigilance' and 'anorexia' in the DAP-treated dogs; marked decreases were noted in elimination (P = 0.038), excessive licking (P = 0.005), and pacing (P = 0.017). The results suggest that the use of DAP could decrease separation-induced anxiety, distress, and fear in inpatients, and possibly facilitate recovery in hospitalized dogs.


Assuntos
Antidepressivos/uso terapêutico , Ansiedade de Separação/tratamento farmacológico , Doenças do Cão/tratamento farmacológico , Feromônios/uso terapêutico , Animais , Comportamento Animal/efeitos dos fármacos , Doenças do Cão/psicologia , Cães , Método Duplo-Cego , Feminino , Masculino , Resultado do Tratamento
20.
Psychiatr Pol ; 43(2): 213-22, 2009.
Artigo em Polonês | MEDLINE | ID: mdl-19697791

RESUMO

INTRODUCTION: Psychodynamic psychopharmacology offers possibility of implementation of psychodynamic thinking and interpretations in the process of pharmacotherapy of mental disorders. It can be helpful in improving results of treatment and solving difficulties in it's course. METHOD: The case report of a female patient after psychotic episode is presented. During the treatment with quetiapine the patient presented complains about adverse effects like weight gain and somnolence. These symptoms (at least partially) resulted from her emotional problems and changed after psychodynamic interpretation. After stopping the medication the patient's reactions to stress and process of separation from her mother changed dramatically. It was probably due to the discontinuation of medication. RESULTS: In some cases adverse events of medication have not only biological but also emotional roots. If properly recognized they can be interpreted and changed by psychological tools. CONCLUSIONS: Psychodynamic psychopharmacology can be useful in deeper understanding and solving problems in the process of pharmacotherapy of mental disorders.


Assuntos
Antipsicóticos/efeitos adversos , Ansiedade de Separação/tratamento farmacológico , Dibenzotiazepinas/efeitos adversos , Psicoses Induzidas por Substâncias/etiologia , Adulto , Antipsicóticos/administração & dosagem , Dibenzotiazepinas/administração & dosagem , Feminino , Humanos , Fumarato de Quetiapina
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