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1.
Plast Reconstr Surg ; 145(2): 316e-323e, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985627

RESUMO

BACKGROUND: Perioperative use of opioids is common in surgical practice and frequently results in troublesome opioid-related side effects that often lead to suboptimal postsurgical outcomes. As such, multiple studies have sought to identify alternatives that may reduce reliance on opioid-based perioperative pain management. Recently, it has been shown that patient education and patient involvement in care positively impact surgical outcomes. This study evaluates how patient education regarding the role of endogenous beta-endorphins in reducing pain and the opposing effect of opioid analgesics impacts opioid consumption and mood after surgery. METHODS: Patients scheduled for breast augmentation were divided into two groups, A and B. Both groups received identical multimodal anesthesia regimens; however, only patients in group B were educated on the role of endogenous beta-endorphins in pain control and mood enhancement, and how opioids block their action. RESULTS: Patients in the group receiving preoperative education on the analgesic and mood-enhancing role of endogenous beta-endorphins and how opioids block their action consumed significantly less opioids and had better postsurgical outcomes as determined by self-reported measures of pain level and mood/sense of well-being. CONCLUSIONS: The findings of this study suggest that opioid use was significantly reduced and patients' mood/sense of well-being was significantly enhanced when patients received preoperative education on the oppositional relationship between beta-endorphins and opioids. Such patient education may be linked to a significant reduction in opioid use and improved patient mood/sense of well-being, especially when combined with opioid-free multimodal anesthesia. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.


Assuntos
Afeto/efeitos dos fármacos , Analgésicos Opioides/efeitos adversos , Mamoplastia , Manejo da Dor/métodos , Educação de Pacientes como Assunto/métodos , Adulto , Feminino , Humanos , Estudos Prospectivos , Adulto Jovem
2.
J Consult Clin Psychol ; 87(10): 872-886, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31556664

RESUMO

OBJECTIVE: Prescribed opioids for chronic pain management contribute significantly to the opioid crisis. There is a need to understand the real-world benefits that, despite risks, lead chronic pain patients to persist in opioid use. Negative reinforcement models of addiction posit that individuals use substances to reduce aversive states but have seldom been applied to prescribed opioids. Using ecological momentary assessment, we examined reciprocal associations between opioid use and physical pain, for which opioids are prescribed, and negative affect (NA), for which they are not. METHOD: Chronic low back pain patients on long-term opioid therapy (n = 34) without significant past-year opioid misuse reported multiple times daily via smartphone over 2 weeks (nobservations = 2,285). We hypothesized that pain and NA would be positively associated with subsequent opioid use, and that use would be negatively associated with subsequent pain and NA. RESULTS: Time-lagged multilevel models indicated that participants were more likely to use opioids and in larger doses following elevated pain and NA. There was also an interaction of concurrent pain and NA on opioid dose. In turn, participants reported reduced pain and NA following larger doses. Additionally, individuals at high risk for opioid misuse, compared with low risk, took larger doses following pain, but also experienced smaller subsequent pain and NA reductions. CONCLUSIONS: Opioid use was bidirectionally associated with pain and NA. Findings fit negative reinforcement models associated with risk of developing opioid use disorder. Educating patients and providers about negative reinforcement may help reduce opioid use and opioid-associated risks. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Afeto/efeitos dos fármacos , Analgésicos Opioides/efeitos adversos , Dor Crônica/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/psicologia , Adulto , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/uso terapêutico , Dor Crônica/psicologia , Avaliação Momentânea Ecológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico
3.
Expert Opin Drug Saf ; 18(10): 915-923, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31373245

RESUMO

Introduction: Muscarinic receptor antagonists, 5α-reductase inhibitors and α1-adrenoceptor antagonists are frequently used drug classes for the treatment of lower urinary tract symptoms including those of overactive bladder syndrome and benign prostatic enlargement/benign prostatic obstruction. Areas covered: The authors review the evidence for adverse effects of these drug classes on cognitive function, mood and other functions of the central nervous system and discuss such effects against the evidence for mechanistic plausibility. Expert opinion: Muscarinic antagonists carry a risk for impaired cognition and other brain functions that differs quantitatively between compounds, being highest with oral formulations of oxybutynin. 5□-Reductase inhibitors can cause depressive symptoms even at low doses and starting several months after discontinuation of treatment. The evidence for α1-adrenoceptor antagonists and specifically tamsulosin to cause dementia is controversial and lacks mechanistic plausibility. We recommend that physicians treating patients with lower urinary tract symptoms carefully monitor mental status prior to prescribing and periodically thereafter.


Assuntos
Inibidores de 5-alfa Redutase/efeitos adversos , Antagonistas de Receptores Adrenérgicos alfa 1/efeitos adversos , Antagonistas Muscarínicos/efeitos adversos , Inibidores de 5-alfa Redutase/administração & dosagem , Antagonistas de Receptores Adrenérgicos alfa 1/administração & dosagem , Afeto/efeitos dos fármacos , Animais , Cognição/efeitos dos fármacos , Relação Dose-Resposta a Droga , Humanos , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Masculino , Antagonistas Muscarínicos/administração & dosagem , Hiperplasia Prostática/tratamento farmacológico , Tansulosina/efeitos adversos , Tansulosina/uso terapêutico , Bexiga Urinária Hiperativa/tratamento farmacológico
4.
Acta Neuropsychiatr ; 31(4): 193-201, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31159897

RESUMO

OBJECTIVE: Bipolar disorder (BD) is a debilitating, lifelong neuropsychiatric illness characterised by unsteady mood states which vacillate from (hypo)mania to depression. Despite the availability of pharmaceutical agents which can be effective in ameliorating the acute affective symptoms and prevent episodic relapse, BD is inadequately treated in a subset of patients. The endocannabinoid system (ECS) is known to exert neuromodulatory effects on other neurotransmitter systems critical in governing emotions. Several studies ranging from clinical to molecular, as well as anecdotal evidence, have placed a spotlight on the potential role of the ECS in the pathophysiology of BD. In this perspective, we present advantages and disadvantages of cannabis use in the management of illness course of BD and provide mechanistic insights into how this system might contribute to the pathophysiology of BD. RESULTS: We highlight the putative role of selective cannabinoid receptor 2 (CB2) agonists in BD and briefly discuss findings which provide a rationale for targeting the ECS to assuage the symptoms of BD. Further, data encourage basic and clinical studies to determine how cannabis and cannabinoids (CBs) can affect mood and to investigate emerging CB-based options as probable treatment approaches. CONCLUSION: The probable role of the ECS has been almost neglected in BD; however, from data available which suggest a role of ECS in mood control, it is justified to support conducting comprehensive studies to determine whether ECS manipulation could positively affect BD. Based on the limited available data, we suggest that activation of CB2 may stabilise mood in this disorder.


Assuntos
Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/fisiopatologia , Encéfalo/fisiopatologia , Canabinoides/uso terapêutico , Cannabis , Endocanabinoides/fisiologia , Endocanabinoides/uso terapêutico , Afeto/efeitos dos fármacos , Afeto/fisiologia , Encéfalo/efeitos dos fármacos , Humanos , Extratos Vegetais/uso terapêutico , Receptor CB1 de Canabinoide/antagonistas & inibidores , Receptor CB1 de Canabinoide/fisiologia , Receptor CB2 de Canabinoide/agonistas , Receptor CB2 de Canabinoide/fisiologia
5.
Mediators Inflamm ; 2019: 6212934, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31210750

RESUMO

Background: Systemic inflammation impairs cognitive performance, yet the brain networks mediating this process remain to be elucidated. The purpose of the current study was to use resting-state functional magnetic resonance imaging (fMRI) to explore changes in the functional connectivity in a lipopolysaccharide- (LPS-) induced systemic inflammation animal model. Materials and Methods: We used the regional homogeneity (ReHo) method to examine abnormal brain regions between the control and LPS groups and then considered them as seeds of functional connectivity analysis. Results: Compared with the control group, our study showed that (1) LPS impaired mood function, as reflected by a depression-like behavior in the forced swim test; (2) LPS induced significantly increased ReHo values in the anterior cingulate cortex (ACC) and caudate putamen (CPu); (3) the ACC seed showed increased functional connectivity with the retrosplenial cortex, superior colliculus, and inferior colliculus; and (4) the right CPu seed showed increased functional connectivity with the left CPu. Linear regression analysis showed a LPS-induced depression-like behavior which was associated with increased ReHo values in the ACC and right CPu. Moreover, the LPS-induced depression-like behavior was related to increased functional connectivity between the right CPu and left CPu. Conclusion: This is the first study to show that systemic inflammation impairs mood function that is associated with an altered resting-state functional network based on ReHo analysis, providing evidence of the abnormal regional brain spontaneous activity which might be involved in inflammation-related neurobehavioral abnormalities.


Assuntos
Afeto/efeitos dos fármacos , Depressão/metabolismo , Inflamação/fisiopatologia , Lipopolissacarídeos/toxicidade , Animais , Depressão/induzido quimicamente , Ensaio de Imunoadsorção Enzimática , Inflamação/metabolismo , Imagem por Ressonância Magnética , Masculino , Ratos , Ratos Sprague-Dawley
6.
Psychopharmacology (Berl) ; 236(8): 2413-2423, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31165207

RESUMO

RATIONALE: Methamphetamine (MA) use is steadily increasing and thus constitutes a major public health concern. Women seem to be particularly vulnerable to developing MA use disorder, as they initiate use at a younger age and transition more quickly to problematic use. Initial drug responses may predict subsequent use, but little information exists on potential gender differences in the acute effects of MA prior to dependence. OBJECTIVE: We examined gender differences in the acute effects of MA on subjective mood and reward-related behavior in healthy, non-dependent humans. METHODS: Men (n = 44) and women (n = 29) completed 4 sessions in which they received placebo or MA under double-blind conditions twice each. During peak drug effect, participants completed the monetary incentive delay task to assess reaction times to cues signaling potential monetary losses or gains, in an effort to determine if MA would potentiate reward-motivated behavior. Cardiovascular and subjective drug effects were assessed throughout sessions. RESULTS: Overall, participants responded more quickly to cues predicting incentivized trials, particularly large-magnitude incentives, than to cues predicting no incentive. MA produced faster reaction times in women, but not in men. MA produced typical stimulant-like subjective and cardiovascular effects in all participants, but subjective ratings of vigor and (reduced) sedation were greater in women than in men. CONCLUSIONS: Women appear to be more sensitive to the psychomotor-related behavioral and subjective effects of MA. These findings provide initial insight into gender differences in acute effects of MA that may contribute to gender differences in problematic MA use.


Assuntos
Afeto/efeitos dos fármacos , Estimulantes do Sistema Nervoso Central/farmacologia , Metanfetamina/farmacologia , Tempo de Reação/efeitos dos fármacos , Recompensa , Caracteres Sexuais , Adolescente , Adulto , Afeto/fisiologia , Transtornos Relacionados ao Uso de Anfetaminas/psicologia , Sinais (Psicologia) , Método Duplo-Cego , Feminino , Voluntários Saudáveis , Humanos , Masculino , Motivação/efeitos dos fármacos , Motivação/fisiologia , Tempo de Reação/fisiologia , Adulto Jovem
7.
Psychopharmacology (Berl) ; 236(11): 3363-3370, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31209507

RESUMO

RATIONALE: One risk factor for alcohol and substance misuse is hypomanic experiences, or periods of mood elevation. Young people who report hypomanic states are more likely to develop bipolar disorder (BP), and BP and other mood disorders increase the risk of addiction. We recently reported that young adults with a history of mood elevation experience less subjective effects from a low dose of alcohol, which may be predictive of future alcohol use. The finding with alcohol raised the question of whether this dampened response to a drug also applies to other drugs, such as amphetamine. OBJECTIVE: This study assessed responses of d-amphetamine in healthy young adults with varying experiences of mood elevation, as measured by the Mood Disorders Questionnaire (MDQ). METHODS: Healthy 18-19-year-olds (N = 30) with a range of MDQ scores participated in three 4-h laboratory sessions in which they received placebo, 10 mg, or 20 mg d-amphetamine. They completed mood questionnaires and cardiovascular measures. RESULTS: Individuals with higher MDQ scores reported less stimulation and euphoria after 10 mg, but not 20 mg, d-amphetamine, than individuals with lower scores. MDQ scores were not related to cardiovascular responses to the drug. CONCLUSIONS: A history of mood elevation experiences or hypomania states is related to dampened response to a low dose of a psychostimulant drug, extending previous findings with dampened response to alcohol. This phenotype for mood disorders of dampened responses to drugs may contribute to risk for subsequent drug use or misuse.


Assuntos
Comportamento Aditivo/diagnóstico , Comportamento Aditivo/psicologia , Estimulantes do Sistema Nervoso Central/administração & dosagem , Dextroanfetamina/administração & dosagem , Euforia/efeitos dos fármacos , Adolescente , Afeto/efeitos dos fármacos , Afeto/fisiologia , Comportamento Aditivo/induzido quimicamente , Estimulantes do Sistema Nervoso Central/efeitos adversos , Dextroanfetamina/efeitos adversos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Euforia/fisiologia , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
8.
Nutrients ; 11(4)2019 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-30987242

RESUMO

n-3 polyunsaturated fatty acids (PUFAs) have been shown to have preventive effects against depression. In this study, we aimed to investigate the associations between the intake of n-3 PUFAs and depression among people according to sex and weight status. We utilized cross-sectional data from the Shika study in Japan. The study was conducted between 2013 and 2016. Data were collected from adults older than 65 years. Invitation letters were distributed to 2677 individuals, 2470 of whom participated in the study (92.3%). We assessed depressive states using the Japanese short version of the Geriatric Depression Scale (GDS-15). We assessed the intake of n-3 PUFAs using the validated food frequency questionnaire. One thousand six hundred thirty-three participants provided data, among which 327 (20.0%) exhibited depressive symptoms. When we performed the stratified analysis by sex and weight status, there were significant inverse relationships between total n-3 PUFAs, individual n-3 PUFAs, and n-3/n-6 PUFAs ratio and depressive symptoms in overweight/obese females. No correlations were observed between n-3 PUFAs intake and depressive states in males. The results demonstrated a relationship between n-3 PUFAs deficiencies and depressive states, particularly in overweight/obese females. Dietary modifications may help to prevent depressive symptoms in overweight/obese females.


Assuntos
Afeto/efeitos dos fármacos , Peso Corporal , Depressão/epidemiologia , Suplementos Nutricionais , Ácidos Graxos Ômega-3/administração & dosagem , Obesidade/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Depressão/diagnóstico , Depressão/prevenção & controle , Depressão/psicologia , Ácidos Graxos Ômega-3/deficiência , Feminino , Avaliação Geriátrica/métodos , Humanos , Japão , Masculino , Avaliação Nutricional , Inquéritos Nutricionais , Estado Nutricional , Obesidade/diagnóstico , Obesidade/fisiopatologia , Obesidade/terapia , Prognóstico , Fatores de Proteção , Fatores de Risco , Fatores Sexuais
9.
Nutrients ; 11(4)2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30986970

RESUMO

Cognitive impairment is strongly associated with functional outcomes in psychiatric patients. Involvement of n-3 long chain polyunsaturated fatty acid (n-3 LC-PUFA), in particular docosahexaenoic acid (DHA), in brain functions is largely documented. DHA is incorporated into membrane phospholipids as structural component, especially in the central nervous system where it also has important functional effects. The aim of this review is to investigate the relationship between DHA and cognitive function in relation to mental disorders. Results from few randomized controlled trials (RCTs) on the effects of DHA (alone or in combination) in psychotic, mood and neurodevelopmental disorders, respectively, suggest that no conclusive remarks can be drawn.


Assuntos
Encéfalo/efeitos dos fármacos , Fármacos do Sistema Nervoso Central/uso terapêutico , Transtornos Cognitivos/tratamento farmacológico , Cognição/efeitos dos fármacos , Ácidos Docosa-Hexaenoicos/uso terapêutico , Transtornos Mentais/tratamento farmacológico , Afeto/efeitos dos fármacos , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Transtornos Cognitivos/metabolismo , Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/psicologia , Ácidos Docosa-Hexaenoicos/metabolismo , Humanos , Transtornos Mentais/metabolismo , Transtornos Mentais/fisiopatologia , Transtornos Mentais/psicologia , Transtornos do Humor/tratamento farmacológico , Transtornos do Humor/metabolismo , Transtornos do Humor/fisiopatologia , Transtornos do Humor/psicologia , Transtornos do Neurodesenvolvimento/tratamento farmacológico , Transtornos do Neurodesenvolvimento/metabolismo , Transtornos do Neurodesenvolvimento/fisiopatologia , Transtornos do Neurodesenvolvimento/psicologia
10.
Holist Nurs Pract ; 33(3): 155-162, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30973435

RESUMO

This study was conducted to determine the dietary supplement (DS) use in gastrointestinal symptom management, and its effect on hopelessness levels in patients with irritable bowel syndrome (IBS). The universe of this cross-sectional study consisted of 132 patients presenting at the polyclinic, while the sample consisted of 127 patients who meet the inclusion criteria to study. Data were collected using a patient identification form including sociodemographic characteristics and DS use, the Gastrointestinal Symptom Rating Scale, and the Beck Hopelessness Scale. The frequency of DS use in the last year among patients with IBS was 73.2%. Younger, women, those with graduate education, and those with better economic status were found to prefer more DS (P < .0001). Nausea and decreased passage of stools were predictors of DS use with a rate of 40.9% (R = 0.409, P < .0001). The patients were found to use mint oil (35.6%), mint juice (24.6%), lemon (20.5%) for nausea, and apricots (48.2%) and dietary fibers (16.9%) for decreased passage of stools. Patients who did not use DSs were found to be more hopeless (P < .03). It was found that 73.2% of patients with IBS used DSs. Patients who did not use DSs were found to be more hopeless. DSs with proven effectiveness can be integrated into medical treatments.


Assuntos
Suplementos Nutricionais/normas , Esperança/efeitos dos fármacos , Síndrome do Intestino Irritável/dietoterapia , Síndrome , Dor Abdominal/dietoterapia , Adulto , Afeto/efeitos dos fármacos , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos
11.
Int J Rheum Dis ; 22(6): 986-994, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30968534

RESUMO

AIM: Depression is a common mental disorder in rheumatoid arthritis (RA) patients and may provoke the onset of poor clinical prognoses. In view of this, whether or not the use of Chinese herbal medicines (CHMs) can alleviate the risk of depression still remains unclear. We conducted a longitudinal cohort study to evaluate the association between CHMs us and depression risk among RA patients. METHOD: Using claims data from the National Health Insurance of Taiwan, we identified 6609 newly diagnosed RA patients aged 20 years or older between 1998 and 2010. From this sample, we recruited 3386 CHM users and randomly selected 3223 controls using propensity scores matching from the remaining cases as the non-CHMs users. They were followed until the end of 2012 to record depression incidence. A Cox proportional hazards regression model was used to compute the hazard ratio (HR) of depression with regard to the use of CHMs. RESULTS: During the 15-year follow-up, 249 CHM users and 314 non-CHM users developed depression, representing an incidence rate of 9.33 and 14.98, respectively, per 1000 person-years. We found that use of CHMs was associated with lower risk of depression by 38% (95% confidence interval 0.54-0.76). The most predominant effect was observed in those receiving CHMs for over 2 years (adjusted HR 0.34). Seven commonly prescribed CHMs could lessen the risk of depression: Chuan-niu-xi, Jie-geng, San-qi, Jia-wei-xia-yao-san, Dang-gui-nian-tong-tang, Zhi-gan-cao-tang, and Suan-zao-ren-tang. CONCLUSION: This study supports that adding CHMs into conventional therapy may prevent subsequent depression risk for RA patients.


Assuntos
Afeto/efeitos dos fármacos , Antidepressivos/uso terapêutico , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Depressão/prevenção & controle , Medicamentos de Ervas Chinesas/uso terapêutico , Demandas Administrativas em Assistência à Saúde , Adulto , Idoso , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/epidemiologia , Artrite Reumatoide/psicologia , Bases de Dados Factuais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Taiwan/epidemiologia , Fatores de Tempo , Resultado do Tratamento
12.
Neuropharmacology ; 151: 55-63, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30946847

RESUMO

BACKGROUND: Pharmacotherapies targeting motivational aspects of feeding and palatable food reward, while sparing mood and cognitive function, represent an alluring approach to reverse obesity and maintain weight loss in an obesogenic environment. A novel glucagon-like peptide-1/dexamethasone (GLP-1/Dexa) conjugate, developed to selectively activate glucocorticoid receptors in GLP-1 receptor-expressing cells was shown to decrease food intake and lower body weight in obese mice. Here, we investigate if this novel drug candidate modulates the rewarding properties of food and if it affects behavioral indices of mood and memory. METHODS: C57Bl6 mice treated with the GLP-1/Dexa conjugate, GLP-1 or vehicle lever-pressed for high-fat, high sugar (HFHS) food rewards in an operant task. Alterations in food-motivated behavior were also assessed following a HFHS diet withdrawal manipulation (switch to chow). The effects of repeated GLP-1/Dexa conjugate, GLP-1 or vehicle on free-feeding intake, body weight, anxiodepressive behaviors (elevated-plus maze, open field test & forced swim test), memory (novel object recognition) and mRNA expression of reward-relevant markers in the nucleus accumbens were also evaluated in mice fed a HFHS diet for 12 weeks. RESULTS: Mice treated with a GLP-1 analogue displayed a transient (4 h) reduction in their motivation to lever press for HFHS reward, whereas treatment with equimolar doses of GLP-1/Dexa delivered a superior and sustained (20 h) suppression of food-motivated behavior. GLP-1/Dexa also inhibited food reward following withdrawal from the HFHS diet. These benefits coincided with related transcriptional changes of dopaminergic markers in the nucleus accumbens. Importantly, repeated GLP-1/Dexa treatment during a HFHS diet caused weight loss without affecting anxiodepressive behavior and memory. CONCLUSION: Via its actions to blunt the rewarding effects of palatable food without affecting mood and recognition memory, GLP-1-directed targeting of dexamethasone may serve as a promising and safe anti-obesity strategy.


Assuntos
Afeto/efeitos dos fármacos , Dexametasona/farmacologia , Alimentos , Peptídeo 1 Semelhante ao Glucagon/farmacologia , Memória/efeitos dos fármacos , Motivação/efeitos dos fármacos , Recompensa , Animais , Condicionamento Operante/efeitos dos fármacos , Ingestão de Alimentos/efeitos dos fármacos , Camundongos
13.
Int Clin Psychopharmacol ; 34(3): 143-150, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30907774

RESUMO

Some women affected by mood disorders experience mood instability during the premenstrual phase. Assuming that fluctuations in drug serum levels may contribute to the worsening of mood symptoms, we carried out a systematic review of available studies that investigated changes in lithium and valproate levels in relation to menstrual phases. We selected five studies; four of which assessed menstrual fluctuations in lithium serum levels and one in valproate levels. Study samples included women in their fertile age affected by bipolar disorder, epilepsy as well as healthy ones. Preliminary results showed a close relationship between cyclic premenstrual exacerbation of affective symptoms and a significant decrease in lithium levels during the luteal phase, despite stable oral doses, in bipolar women. In healthy women, lithium levels were influenced by neither menstrual cycle phases nor oral contraceptives use. Valproate serum levels in epileptic women showed a small, nonsignificant decline during the mid-luteal phase. Pharmacokinetic sex differences in adsorption, volume distribution, hepatic metabolism, and renal excretion of mood stabilizers have been supposed to partly explain such menstrual serum level fluctuations. A better understanding in this field could help to counteract the distress related to premenstrual phase, improving therapeutic management of mood disorders in women.


Assuntos
Afeto/efeitos dos fármacos , Transtorno Bipolar/tratamento farmacológico , Lítio/sangue , Ciclo Menstrual/psicologia , Ácido Valproico/sangue , Feminino , Humanos , Masculino , Transtornos do Humor
14.
Neuropharmacology ; 150: 153-163, 2019 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-30926450

RESUMO

Accumulating evidence indicates that exposure to general anesthetics during infancy and childhood can cause persistent cognitive impairment, alterations in synaptic plasticity, and, to a lesser extent, increased incidence of behavioral disorders. Unfortunately, the developmental parameters of susceptibility to general anesthetics are not well understood. Adolescence is a critical developmental period wherein multiple late developing brain regions may also be vulnerable to enduring general anesthetic effects. Given the breadth of the adolescent age span, this group potentially represents millions more individuals than those exposed during early childhood. In this study, isoflurane exposure within a well-characterized adolescent period in Sprague-Dawley rats elicited immediate and persistent anxiety- and impulsive-like responding, as well as delayed cognitive impairment into adulthood. These behavioral abnormalities were paralleled by atypical dendritic spine morphology in the prefrontal cortex (PFC) and hippocampus (HPC), suggesting delayed anatomical maturation, and shifts in inhibitory function that suggest hypermaturation of extrasynaptic GABAA receptor inhibition. Preventing this hypermaturation of extrasynaptic GABAA receptor-mediated function in the PFC selectively reversed enhanced impulsivity resulting from adolescent isoflurane exposure. Taken together, these data demonstrate that the developmental window for susceptibility to enduring untoward effects of general anesthetics may be much longer than previously appreciated, and those effects may include affective behaviors in addition to cognition.


Assuntos
Afeto/efeitos dos fármacos , Anestésicos Gerais/farmacologia , Comportamento Animal/efeitos dos fármacos , Cognição/efeitos dos fármacos , Isoflurano/farmacologia , Plasticidade Neuronal/efeitos dos fármacos , Animais , Espinhas Dendríticas/efeitos dos fármacos , Comportamento Exploratório/efeitos dos fármacos , Comportamento Impulsivo/efeitos dos fármacos , Masculino , Córtex Pré-Frontal/efeitos dos fármacos , Células Piramidais/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley
15.
Urologe A ; 58(3): 248-253, 2019 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-30762077

RESUMO

Based on new evidence, we discuss the risk of central nervous side effects, mainly reduced cognition/dementia and depressive symptoms during the use of drugs for the treatment of lower urinary symptoms suggestive of benign prostatic hyperplasia. Cognitive impairments during use of muscarinic antagonists are well documented and mechanistically well understood, but their occurrence differs quantitatively between members of this drug class. The occurrence of depressive symptoms while using 5α-reductase inhibitors only became known recently but has now been observed consistently in several studies and is mechanistically plausible; it appears to occur with similar incidence when using dutasteride and finasteride. A moderate increase in new diagnoses of dementia has recently been reported from a single study upon use of tamsulosin but not other α1-adrenoceptor antagonists. The plausibility of a mechanistic cause-effect relationship is only moderate, and the association could be explained based on selection bias. Overall, physicians should be alert for the occurrence of central nervous side effects during the treatment of lower urinary tract symptoms.


Assuntos
Inibidores de 5-alfa Redutase , Afeto , Cognição , Finasterida , Hiperplasia Prostática , Inibidores de 5-alfa Redutase/efeitos adversos , Inibidores de 5-alfa Redutase/uso terapêutico , Afeto/efeitos dos fármacos , Cognição/efeitos dos fármacos , Finasterida/efeitos adversos , Finasterida/uso terapêutico , Humanos , Sintomas do Trato Urinário Inferior , Masculino , Hiperplasia Prostática/tratamento farmacológico
17.
Drug Alcohol Depend ; 196: 79-85, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30754022

RESUMO

BACKGROUND: Flavored cigar sales have increased in recent years in the U.S. African American young adults (AAYAs) have high prevalence of smoking flavored cigars and dual use with cigarettes, but the predictors of use are unclear. We examined the predictors of flavored cigar smoking among AAYA dual users. METHODS: We analyzed data from an Ecological Momentary Assessment (EMA) study that captured near real-time affect, smoking cues, and tobacco smoking from eight text-messaging surveys per day over two weeks. Sixty-three AAYA (ages 18-29) dual users of cigarettes and cigars recorded 1205 cigar smoking moments. Multivariable Generalized Estimating Equations were used to assess the predictors of smoking cigars with flavors and specific flavor types. RESULTS: Half of the participants were women (49.2%) and aged between 18-24 (46.7%). Over the two-weeks, almost all (98.4%) participants smoked flavored cigars, and 64.2% of the cigars smoked were flavored. Alcohol (34.4%) was the most frequently smoked flavor type followed by sweet (23.4%) and mint (5.7%). Feeling stressed (AOR = 1.07) and bored (AOR = 1.10) predicted smoking alcohol flavors. Blunt smoking positively predicted smoking sweet flavors (AOR = 4.79), but negatively predicted smoking alcohol flavors (AOR = 0.40). CONCLUSIONS: Smoking flavored cigars, especially alcohol-flavored cigars, was prevalent among AAYA dual users in this study. This group might use specific flavors for different purposes including smoking blunts and boosting mood. Efforts to reduce cigar use need to tackle these risk factors and the increased marketing and low-cost pricing of cigars. A federal ban of cigar flavors might reduce the appeal of cigar products.


Assuntos
Afro-Americanos/psicologia , Fumar Charutos/psicologia , Fumar Charutos/tendências , Avaliação Momentânea Ecológica , Aromatizantes , Produtos do Tabaco , Adolescente , Adulto , Afeto/efeitos dos fármacos , Afeto/fisiologia , Fumar Charutos/epidemiologia , Feminino , Humanos , Masculino , Fatores de Risco , Inquéritos e Questionários , Paladar/efeitos dos fármacos , Paladar/fisiologia , Adulto Jovem
18.
Behav Pharmacol ; 30(2 and 3-Spec Issue): 229-238, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30632994

RESUMO

Catalepsy - an immobile state in which individuals fail to change imposed postures - can be induced by haloperidol. In rats, the pattern of haloperidol-induced catalepsy is very similar to that observed in Parkinson's disease (PD). As some PD symptoms seem to depend on the patient's emotional state, and as anxiety disorders are common in PD, it is possible that the central mechanisms regulating emotional and cataleptic states interplay. Previously, we showed that haloperidol impaired contextual-induced alarm calls in rats, without affecting footshock-evoked calls. Here, we evaluated the influence of distinct aversive stimulations on the haloperidol-induced catalepsy. First, male Wistar rats were subjected to catalepsy tests to establish a baseline state after haloperidol or saline administration. Next, distinct cohorts were exposed to open-field; elevated plus-maze; open-arm confinement; inescapable footshocks; contextual conditioned fear; or corticosterone administration. Subsequently, catalepsy tests were performed again. Haloperidol-induced catalepsy was verified in all drug-treated animals. Exposure to open-field, elevated plus-maze, open-arm confinement, footshocks, or administration of corticosterone had no significant effect on haloperidol-induced catalepsy. Contextual conditioned fear, which is supposed to promote a more intense fear, increased catalepsy over time. Our findings suggest that only specific defensive circuitries modulate the nigrostriatal system mediating the haloperidol-induced cataleptic state.


Assuntos
Afeto/efeitos dos fármacos , Catalepsia/fisiopatologia , Medo/efeitos dos fármacos , Animais , Comportamento Animal/efeitos dos fármacos , Condicionamento Clássico/efeitos dos fármacos , Modelos Animais de Doenças , Antagonistas de Dopamina/farmacologia , Haloperidol/farmacologia , Masculino , Doença de Parkinson/metabolismo , Ratos , Ratos Wistar
19.
Gynecol Endocrinol ; 35(5): 422-426, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30668208

RESUMO

It is not clear whether oral contraceptive (OC) treatment affects premenstrual symptoms in women. The aim of the present study was to evaluate changes in premenstrual symptoms (PMS) in women starting to use or discontinuing the use of OCs. Twenty-four healthy women with no previous diagnosis of premenstrual dysphoric disorder were included in this study with a prospective crossover design. Nineteen women completed daily ratings of somatic and mood symptoms during two hormonally different cycles, during a normal menstrual cycle and while using OCs. The menstrual cycle phases were hormonally verified and the low-dose, monophasic OCs were used in a 21/7 regimen. The onset of OC use significantly decreased premenstrual somatic symptoms, but it did not affect mood symptoms. In the women who discontinued OC use, no significant changes in neither somatic nor mood symptoms appeared in the premenstrual phase.


Assuntos
Afeto/efeitos dos fármacos , Anticoncepcionais Orais Hormonais/administração & dosagem , Ciclo Menstrual/efeitos dos fármacos , Adulto , Estudos Cross-Over , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Hormônio Luteinizante/sangue , Ciclo Menstrual/sangue , Progesterona/sangue , Estudos Prospectivos , Adulto Jovem
20.
Behav Neurosci ; 133(1): 98-109, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30688487

RESUMO

Given the increasing prevalence of and severity of complications associated with obesity, there is great need for treatments resulting in prolonged weight loss. Long-term maintenance of weight loss requires sustained changes in food-intake and energy-expenditure strategies, which are unfortunately often taxing, resulting in a return to predieting weight. Therefore, drug therapies may facilitate greater adherence to a restricted diet and prolong weight loss. One such drug is rapamycin (RAP), a mechanistic target of rapamycin (mTOR) inhibitor. Here, we show that a single injection of RAP dampens the hyperphagic response in calorically restricted rats when they are returned to free feed immediately or 10 days after injection. Moreover, we demonstrate that a single injection of RAP given to calorically restricted rats prevents body-weight regain when animals are returned to free feed either immediately or 10 days after injection. Furthermore, we extend our previous findings that RAP does not produce malaise or illness and show that RAP does not produce any behavioral deficits that may inhibit an animal from eating. Thus, we suggest that mTOR may be a useful target in obesity research, given that its inhibition may decrease the hyperphagic response following caloric restriction. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Hiperfagia/prevenção & controle , Sirolimo/administração & dosagem , Ganho de Peso/efeitos dos fármacos , Afeto/efeitos dos fármacos , Animais , Restrição Calórica , Ingestão de Alimentos/efeitos dos fármacos , Masculino , Ratos Sprague-Dawley
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