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1.
AAPS PharmSciTech ; 22(3): 102, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33712901

RESUMO

Sceletium tortuosum is one of the most promising medicinal plant species for treating anxiety and depression. Traditionally, aerial parts are chewed (masticatory herbal medicine) providing fast relief and rendering the masticatory route for delivery, ideal. This study intended formulating novel medicated chewing gum containing S. tortuosum to alleviate depression and anxiety. S. tortuosum extract was formulated into directly compressed medicated chewing gum (MCG) containing different Health-in-Gum® (HIG) bases through process optimization with the SeDeM Diagram Expert System. Physical properties of MCGs were characterized, and specialized drug release studies performed. According to the manufacturer, only HIG-03 was specifically developed for direct compression; however, the SeDeM System was successfully applied to all HIG-bases investigated. HIG-01 and HIG-04 are also considered useful in direct compression as no considerable differences in these MCG formulations' physical properties were recognized. Inclusion of a lubricant, however, is deemed essential, and MCG comprising HIG-01, most suited for direct compression. Dissolution experiments found only two alkaloids used as markers, mesembrine and mesembrenone, were released in quantifiable concentrations regardless formulation constituents. Novel directly compressed MCG-containing S. tortuosum extract was successfully formulated by which the biologically active phytochemicals of S. tortuosum can be scientifically delivered through the traditionally applied mastication method.


Assuntos
Aizoaceae/química , Ansiolíticos/administração & dosagem , Antidepressivos/administração & dosagem , Goma de Mascar , Ansiolíticos/uso terapêutico , Antidepressivos/uso terapêutico , Composição de Medicamentos , Liberação Controlada de Fármacos , Excipientes , Sistemas Especialistas , Lubrificantes , Extratos Vegetais/administração & dosagem , Extratos Vegetais/química , Extratos Vegetais/uso terapêutico , Pós
2.
J Ethnopharmacol ; 265: 113316, 2021 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32866569

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Calea zacatechichi is a plant with an extensive popular and ritual use in Mexico. In healthy volunteers, it induces well-being and tranquility senses, and facilitates superficial stages of sleep. However, anxiolytic, and antidepressant-like effects and changes on the sleep-waking stages have not been explored. AIM: To determine anxiolytic and antidepressant-like effects of an aqueous extract of C. zacatechichi (CZ) in rodents and to analyze their effects on hippocampal activity in the rat sleep-waking cycle. MATERIAL AND METHODS: CZ anxiolytic- and antidepressant-like effects were evaluated in several mice and rat behavioral paradigms. CZ effects on temporal distribution of sleep were described, and hippocampus EEG frequency patterns were analyzed during the sleep-waking cycle; absolute and relative powers were analyzed during Rapid Eye Movements (REM) and non-REM sleep stages. CZ chemical analysis was performed by UPLC-ESI-MS. RESULTS: CZ produced specific and robust anxiolytic- and antidepressant-like effects in mice and rats, similar to those of prototypical drugs, at doses ranging from 0.5 to 50 mg/kg. CZ at 100 mg/kg produced visible mild sedative effects in rats, associated with a significant increase in Slow Wave Sleep episodes during a 6 h recording, and enhanced fast frequencies of hippocampus (gamma-band:31-50 Hz) during REM sleep. CONCLUSION: Results could support the well-being and tranquility senses reported by healthy consumers, and to explain the oneiric content during dreams and some improvements in cognitive processes described by consumers. Anxiolytic- and antidepressant-like effects of this species, reported for first time in this study could improve some aspects of mental health.


Assuntos
Ansiolíticos/farmacologia , Antidepressivos/farmacologia , Asteraceae/química , Extratos Vegetais/farmacologia , Animais , Ansiolíticos/administração & dosagem , Ansiolíticos/isolamento & purificação , Antidepressivos/administração & dosagem , Antidepressivos/isolamento & purificação , Comportamento Animal/efeitos dos fármacos , Cognição/efeitos dos fármacos , Relação Dose-Resposta a Droga , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Masculino , México , Camundongos , Extratos Vegetais/administração & dosagem , Ratos , Ratos Wistar , Sono/efeitos dos fármacos , Sono REM/efeitos dos fármacos
3.
BMJ Case Rep ; 13(12)2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33328211

RESUMO

A 30-year-old man with no significant previous or family psychiatric history became severely anxious about his health after a positive COVID-19 test. Physical symptoms of COVID-19 were mild, with no evidence of hypoxia or pneumonia, throughout his illness. He was admitted to a quarantine facility. He remained highly anxious, and 1 week later, he developed paranoid delusions and auditory hallucinations (his first psychotic episode). He was treated with lorazepam 1 mg four times a day, mirtazapine 30 mg nocte and risperidone 1 mg two times a day. His psychotic symptoms lasted 1 week. He stopped psychiatric medication after 4 weeks and had remained well when reviewed 3 months later. A Diagnostic and Statistical Manual of Mental Disorders fifth edition diagnosis of brief psychotic disorder with marked stressor (brief reactive psychosis) was made. Anxiety about his health and social isolation appeared the main aetiological factors but an inflammatory component cannot be excluded. The case highlights that first episode psychosis can be associated with mild COVID-19.


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos Psicóticos/psicologia , Adulto , Ansiolíticos/administração & dosagem , Antipsicóticos/administração & dosagem , Transtornos de Ansiedade/tratamento farmacológico , Humanos , Lorazepam/administração & dosagem , Masculino , Mirtazapina/administração & dosagem , Pandemias , Transtornos Psicóticos/tratamento farmacológico , Catar , Quarentena/psicologia , Risperidona/administração & dosagem
4.
AAPS PharmSciTech ; 21(6): 213, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32737624

RESUMO

The acceptability and palatability of a dosage form are extremely important to improve patient compliance. Mixing oral solid dosage forms with food carriers is often necessary to ease swallowing and provide the taste-masking effect. The present research investigated how a liquid or semisolid carrier influences the disintegration time and drug dissolution rate of pellets and minitablets with diazepam. The disintegration of pellets and minitablets in liquid carriers (water, milk and apple juice) was determined using a texture analyser. Dissolution tests were performed for the dosage forms dispersed in gel vehicles (2% carmellose and 0.5% carbomer gels) or applesauce. The disintegration of minitablets in water and apple juice was fast (1 min), but it slowed to 3 and 5 min in milk and gel vehicles, respectively. The pellets disintegrated in liquid carriers within 3 min. The drug dissolution rate in 0.1 M HCl depended on the gel viscosity in this medium. The preserved high viscosity of a carmellose gel inhibited the dissolution of diazepam. On the other hand, the viscosity of the carbomer gel decreased rapidly, and in effect, the dissolution rate of diazepam from the incorporated pellets or minitablets was comparable to the dissolution from loose pellets or minitablets. Graphical abstract.


Assuntos
Ansiolíticos/administração & dosagem , Diazepam/administração & dosagem , Excipientes/administração & dosagem , Comprimidos , Administração Oral , Carboximetilcelulose Sódica , Formas de Dosagem , Humanos , Solubilidade , Viscosidade
7.
Nitric Oxide ; 99: 1-6, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32194244

RESUMO

Sodium nitroprusside (SNP) is a nitric oxide (NO) donor which actually is under assessment as a potential candidate for the treatment of schizophrenia. It is well documented that anxiety symptoms are a prominent future in various psychiatric diseases comprising schizophrenia. Prior research has shown that acute challenge with SNP (1-3 mg/kg) induced anti-anxiety effects in rats but these effects at high doses were confounded by sedation and were disappeared after repeated application of it. It is still unknown if administration of a lower SNP dose range, either acutely or sub-chronically, could induce anxiolytic-like behaviour. The present study was designed to investigate this issue in rats. For this aim, the light/dark and the open field tests were used. Acute challenge with SNP (0.1 and 0.3 mg/kg, 30 min before testing) did not affect rodents' performance in the above mentioned behavioural paradigms. Conversely, rats treated sub-chronically with SNP (0.1 and 0.3 mg/kg, once per day, for 5 consecutive days), displayed longer time spent in the light chamber of the light/dark box and in the central area of the open field with respect to their vehicle-treated counterparts. Interestingly, SNP did not influence the first latency to enter the dark chamber and the number of transitions between the light and dark compartments of the apparatus in the light/dark test and did not modify the number of squares crossed, grooming episodes and rearings in the open field test. Finally, acute administration of SNP (0.1, 0.3 and 1 mg/kg, 10 min before testing) also did not influence rats' performance in the light/dark test. The present results indicate that short-term repeated but not acute application of a range of low doses of the NO donor SNP in a dose-independent manner induced an anti-anxiety behaviour in the rat which was not accompanied by undesired effects.


Assuntos
Ansiolíticos/uso terapêutico , Ansiedade/tratamento farmacológico , Doadores de Óxido Nítrico/uso terapêutico , Nitroprussiato/uso terapêutico , Animais , Ansiolíticos/administração & dosagem , Comportamento Animal/efeitos dos fármacos , Relação Dose-Resposta a Droga , Masculino , Doadores de Óxido Nítrico/administração & dosagem , Nitroprussiato/administração & dosagem , Ratos Wistar
8.
Acta Pharm ; 70(3): 387-397, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32074069

RESUMO

The aim of this study was to compare the effects of acute (a single injection) and chronic (21 consecutive days) treatments with chrysin 2, 4, and 8 µmol kg-1 on anxiety-like behavior and Fos immunoreactivity in the lateral septum nucleus (LSN), a structure that is involved in the regulation of anxiety, in male Wistar rats. These effects were compared with the clinically effective anxiolytic diazepam 7 µmol kg-1. The results showed that acute, but not chronic treatment, with 4 µmol kg-1 chrysin exerted anxiolytic- and anti- depressant-like effects with these effects being similar to that of diazepam. Also, none of the above-mentioned treatments did alter Fos immunoreactivity in the LSN, but a tendency towards the reduction of this variable was detected with chrysin 4 µmol kg-1 and diazepam 7 µmol kg-1. Altogether, results suggest that chrysin exerts anxiolytic-like effects, however, it can produce pharmacological tolerance after repeated use, similar to benzodiazepines.


Assuntos
Ansiedade/tratamento farmacológico , Comportamento Animal/efeitos dos fármacos , Flavonoides/farmacologia , Núcleos Septais/efeitos dos fármacos , Animais , Ansiolíticos/administração & dosagem , Ansiolíticos/farmacologia , Antidepressivos/administração & dosagem , Antidepressivos/farmacologia , Diazepam/farmacologia , Flavonoides/administração & dosagem , Masculino , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos , Ratos Wistar
9.
Psychopharmacology (Berl) ; 237(4): 1121-1130, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31915861

RESUMO

RATIONALE: Stress is a risk factor for psychosis and treatments which mitigate its harmful effects are needed. Cannabidiol (CBD) has antipsychotic and anxiolytic effects. OBJECTIVES: We investigated whether CBD would normalise the neuroendocrine and anxiety responses to stress in clinical high risk for psychosis (CHR) patients. METHODS: Thirty-two CHR patients and 26 healthy controls (HC) took part in the Trier Social Stress Test (TSST) and their serum cortisol, anxiety and stress associated with public speaking were estimated. Half of the CHR participants were on 600 mg/day of CBD (CHR-CBD) and half were on placebo (CHR-P) for 1 week. RESULTS: One-way analysis of variance (ANOVA) revealed a significant effect of group (HC, CHR-P, CHR-CBD (p = .005) on cortisol reactivity as well as a significant (p = .003) linear decrease. The change in cortisol associated with experimental stress exposure was greatest in HC controls and least in CHR-P patients, with CHR-CBD patients exhibiting an intermediate response. Planned contrasts revealed that the cortisol reactivity was significantly different in HC compared with CHR-P (p = .003), and in HC compared with CHR-CBD (p = .014), but was not different between CHR-P and CHR-CBD (p = .70). Across the participant groups (CHR-P, CHR-CBD and HC), changes in anxiety and experience of public speaking stress (all p's < .02) were greatest in the CHR-P and least in the HC, with CHR-CBD participants demonstrating an intermediate level of change. CONCLUSIONS: Our findings show that it is worthwhile to design further well powered studies which investigate whether CBD may be used to affect cortisol response in clinical high risk for psychosis patients and any effect this may have on symptoms.


Assuntos
Ansiedade/tratamento farmacológico , Canabidiol/administração & dosagem , Transtornos Psicóticos/tratamento farmacológico , Comportamento Social , Estresse Psicológico/tratamento farmacológico , Adolescente , Adulto , Ansiolíticos/administração & dosagem , Antipsicóticos/administração & dosagem , Ansiedade/sangue , Ansiedade/psicologia , Método Duplo-Cego , Feminino , Humanos , Hidrocortisona/sangue , Masculino , Transtornos Psicóticos/sangue , Transtornos Psicóticos/psicologia , Fatores de Risco , Fala/efeitos dos fármacos , Fala/fisiologia , Estresse Psicológico/sangue , Estresse Psicológico/psicologia , Resultado do Tratamento , Adulto Jovem
10.
Pharmacogenomics ; 21(2): 111-123, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31957548

RESUMO

Introduction: Phenazepam therapy can often be ineffective and some patients develop dose-related adverse drug reactions. Aim. The purpose of this research was to study the effect of the CYP2C19*2 (681G>A, rs4244285) in patients with anxiety disorders and alcohol dependence taking phenazepam therapy. Materials & methods: Patients (175 males, average age: 37.16 ± 7.84 years) received phenazepam in tablet form for 5 days. Genotyping was performed by real-time polymerase chain reaction. Results: The statistically significant differences in the UKU Side-Effect Rating Scale scores on the fifth day of therapy: (CYP2C19*1/*1) 2.00 [1.00; 2.00), (CYP2C19*1/*2) 7.00 (7.00; 7.00), (CYP2C19*2/*2) 9.00 (8.00; 9.00), p < 0.001. Conclusion: This study demonstrated the different efficacy and safety of phenazepam in patients with different genotypes of CYP2C19*2.


Assuntos
Alcoolismo/genética , Transtornos de Ansiedade/tratamento farmacológico , Benzodiazepinas/administração & dosagem , Citocromo P-450 CYP2C19/genética , Adulto , Alcoolismo/patologia , Ansiolíticos/administração & dosagem , Ansiolíticos/efeitos adversos , Transtornos de Ansiedade/genética , Transtornos de Ansiedade/patologia , Benzodiazepinas/efeitos adversos , Feminino , Genótipo , Humanos , Masculino
11.
Biochem Biophys Res Commun ; 523(2): 299-306, 2020 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-31864709

RESUMO

Anxiety is recognized as primary clinical phenotype of psychiatric disorders. However, many patients with anxiety have not yet received effective treatment. Our previous study demonstrated that hippocampal nNOS-CAPON interaction is implicated in anxiety-related behaviors, and blocking nNOS-CAPON interaction in the hippocampus produces anxiolytic-like effects. Here, ZLc-002, a small molecule inhibitor of nNOS-CAPON coupling, was evaluated for anxiolytic-like properties after systemic administered using anxiety behavioral tests, including open-field (OF), elevated plus maze (EPM), novelty-suppressed feeding (NSF) and light-dark (LD) tests. We reported that ZLc-002 when administered intraperitoneally at the dose of 40 or 80 mg/kg/d for 14 days produces anxiolytic-like effects. Furthermore, the similar effects of ZLc-002 were observed when administered intravenously at the dose of 10, 20 or 40 mg/kg/d for 7 days. More importantly, the mice dosing with 80 mg/kg/d ZLc-002 intraperitoneally or 40 mg/kg/d ZLc-002 intravenously for 3 days exerted significant behavioral effects. However, intragastric administration with ZLc-002 was devoid of effect on anxiety behaviors, even at high doses. Furthermore, intraperitoneal or intravenous treatment of ZLc-002 significantly disrupted the interaction between nNOS and CAPON in the hippocampus of adult mice, and there was a significant anxiolytic-like effect of ZLc-002 at day 3 after intrahippocampal microinjection. Our results verified that systemic administration of putative small molecule inhibitor of nNOS-CAPON can be used for the treatment of anxiety disorders.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/antagonistas & inibidores , Ansiolíticos/administração & dosagem , Óxido Nítrico Sintase Tipo I/antagonistas & inibidores , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Animais , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/metabolismo , Comportamento Animal/efeitos dos fármacos , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Inibidores Enzimáticos/administração & dosagem , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Injeções Intraperitoneais , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos ICR , Óxido Nítrico Sintase Tipo I/metabolismo
12.
Psychopharmacology (Berl) ; 237(3): 735-743, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31786647

RESUMO

Taurine (TAU) is a ß-amino sulfonic acid with pleiotropic roles in the brain, including the neuromodulatory activity via GABAergic and glycinergic agonism. This molecule is found at high concentrations in energy drinks and is often mixed with alcohol in beverages. Although TAU has a neuroprotective role in the brain, the putative risks of mixing TAU and EtOH are not fully understood. Here, we investigated whether TAU modulates locomotor and anxiety-like behavior in adult zebrafish by using the novel tank and light-dark tests following acute EtOH exposure at anxiogenic and anxiolytic concentrations. Zebrafish were individually exposed to water (control), TAU (42, 150, and 400 mg/L), and EtOH (0.25% (v/v) and 1% (v/v)) both independently and cotreated for 1 h. EtOH 0.25% and TAU produced U-shape anxiolytic-like behavior in the light-dark test, TAU 42 and 400 positively modulated EtOH effects, and TAU 150 exerted a protective effect. All TAU concentrations counteracted EtOH 1%-induced locomotion impairment, as well as the anxiogenic-like behavior. Finally, all TAU concentrations when given independently or cotreated with EtOH 0.25% and 1% decreased the risk assessment of the lit compartment. Principal component analyses revealed that exploration and anxiety-like responses were the main behaviors that contribute to the effects of TAU and EtOH. Overall, we demonstrate that TAU differently modulates EtOH-induced anxiolytic- and anxiogenic-like behaviors depending on the concentration, suggesting a complex mechanism underlying TAU and EtOH interactions.


Assuntos
Ansiedade/induzido quimicamente , Ansiedade/prevenção & controle , Etanol/administração & dosagem , Locomoção/efeitos dos fármacos , Taurina/administração & dosagem , Animais , Ansiolíticos/administração & dosagem , Ansiedade/psicologia , Encéfalo/efeitos dos fármacos , Encéfalo/fisiologia , Relação Dose-Resposta a Droga , Etanol/toxicidade , Feminino , Locomoção/fisiologia , Masculino , Peixe-Zebra
13.
Anesth Analg ; 130(1): 224-232, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31498189

RESUMO

BACKGROUND: In the perioperative context, benzodiazepines are widely used as anxiolytics. They affect cognition in general, but it is unclear whether the effects of a small dose of the short-acting benzodiazepine midazolam can be assessed objectively. To address this scientific question, we conducted a prospective observational study in adults 55-73 years of age. Using both validated psychometric and functional imaging techniques, we determined whether a 2-mg intravenous (IV) dose of midazolam affects cognitive function. METHODS: We measured the effect of 2 mg IV of midazolam with both the well-established Repeatable Battery for the Assessment of Neuropsychological Status test and resting-state functional magnetic imaging (rs-fMRI) in older adults. RESULTS: Midazolam reduces immediate and delayed memory and has a profound and robust effect on rs-fMRI. Baseline resting-state connectivity predicts memory decline after midazolam administration. CONCLUSIONS: Observed effects of midazolam on brain networks were statistically significant even in a small group of volunteers. If validated by other investigators, resting-state brain connectivity may have utility as a measure to predict sensitivity to midazolam in older adults.


Assuntos
Ansiolíticos/administração & dosagem , Encéfalo/efeitos dos fármacos , Cognição/efeitos dos fármacos , Midazolam/administração & dosagem , Fatores Etários , Idoso , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Feminino , Humanos , Infusões Intravenosas , Imagem por Ressonância Magnética , Masculino , Memória de Curto Prazo/efeitos dos fármacos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estudos Prospectivos , Repressão Psicológica
14.
Nutr Neurosci ; 23(1): 16-26, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29712539

RESUMO

Objectives: Campomanesia pubescens (DC) O.BERG (Myrtaceae) fruits contain high levels of flavonoids and are widely consumed by the South American population. In the central nervous system (CNS), some flavonoids act as modulators of GABA-A receptors and monoamine oxidase inhibitors, resulting in anxiolytic antidepressants effects, respectively. The objective of the present study was to evaluate the anxiolytic and antidepressant effects of ethanolic extract of C. pubescens fruits (EEFCP) in rats.Methods: In order to prove the antidepressant effect of the EEFCP, rats were submitted to the chronic mild stress model, to the sucrose preference test (SPT), and the forced swimming test. To test the anxiolytic effects, the Elevated plus-maze (EPM), open field (OF), and Marble-Burying models were used.Results: After 2 weeks of treatment, imipramine 25 mg/kg, EEFCP 250 mg/kg, and EEFCP 500 mg/kg reversed the anhedonic behavior measured by SPT and significantly reduced the immobility time of animals under stress. In addition, treatment with diazepam 2 mg/kg, EEFCP 250 mg/kg, and EEFCP 500 mg/kg increased the percentage of entries and time spent on the open arms of the EPM, increased locomotion, rearing, and reduced the grooming time in OF.Discussion: The chemical analysis of the EEFCP indicated high content of flavonoids and the behavioral analysis revealed an antidepressant and anxiolytic effect, suggesting that these phytochemicals may be involved with these actions in the CNS.


Assuntos
Ansiolíticos/administração & dosagem , Antidepressivos/administração & dosagem , Comportamento Animal/efeitos dos fármacos , Flavonoides/administração & dosagem , Myrtaceae/química , Extratos Vegetais/administração & dosagem , Estresse Psicológico/psicologia , Animais , Etanol/química , Flavonoides/isolamento & purificação , Frutas/química , Masculino , Compostos Fitoquímicos/isolamento & purificação , Ratos Wistar
15.
Sci Rep ; 9(1): 18042, 2019 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-31792285

RESUMO

A systematic review and network-meta analysis (NMA) were performed to estimate significance of the anxiolytic effect of lavender essential oil taken as silexan capsules versus other comparators (i.e., placebo/paroxetine/lorazepam). The outcome of interest was Hamilton Anxiety Scale (HAMA). Weighted mean differences (WMD) were calculated to estimate the treatment effect at the confidence interval of 95%. League tables were generated using treatment effect, for all pairwise comparisons, where WMD < 0 favors the column-defining treatment. Five studies were identified with a total of 524 participants receiving treatment with silexan 80 mg and 121 participants taking silexan 160 mg. The NMA results indicated that consumption of silexan 160 mg resulted in higher decline of HAMA score [WMD -1.14 (-1.10, 3.39)] in comparison to silexan 80 mg, placebo [-2.20 (-4.64, 0.24)] and paroxetine [-1.24 (-5.34, 2.85)]. The effect of silexan 80 mg was observed to be same as that of paroxetine. Overall, silexan 160 mg was noticed to be a more efficient treatment giving significant decline in HAMA score across other comparators. However, no improvements in HAMA score was observed for the group receiving lorazepam 0.5 mg when compared to silexan 160 mg, silexan 80 mg, paroxetine 20 mg, and placebo.


Assuntos
Ansiolíticos/administração & dosagem , Transtornos de Ansiedade/tratamento farmacológico , Lavandula/química , Óleos Voláteis/administração & dosagem , Óleos Vegetais/administração & dosagem , Transtornos de Ansiedade/diagnóstico , Cápsulas , Humanos , Lorazepam/administração & dosagem , Metanálise em Rede , Paroxetina/administração & dosagem , Determinação da Personalidade/estatística & dados numéricos , Resultado do Tratamento
16.
Medicine (Baltimore) ; 98(51): e18188, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860965

RESUMO

AIM: We compared the effects of 50% N2O and N2O titration in burn management to alleviate pain and anxiety associated with burn dressing. METHODS: In this single-blind prospective randomized controlled trial, 70 stable adult burn patients were randomized to 2 groups during May 2015 to January 2016. The experimental group was titrated with N2O ranging from 30% to the ideal sedation concentration before dressing change until the end. The control group was treated with 50% N2O 2 minutes before dressing change until the end. Pain, anxiety, vital signs, and the highest concentrations of N2O inhaled were recorded at 1 minute before N2O inhalation (T0), dismantling of outer (T1), inner dressings (T2), debridement (T3), drug-smearing (T4), bandaging (T5), and 10 minutes after completion of the procedure (T6). RESULTS: The pain and anxiety scores in the experimental group performed significantly less than the control group during T2-T6. The systolic blood pressure in T2 and the heart rate at T2 and T3 varied significantly between the 2 groups. The highest N2O concentrations of the experimental group were mainly 60% to 70% at T2 (87.9%), T3 (87.9%), and T4 (81.8%). CONCLUSION: N2O titration significantly reduced pain and anxiety in burn patients, with minimal side effects.


Assuntos
Analgésicos não Entorpecentes/uso terapêutico , Ansiolíticos/uso terapêutico , Queimaduras/terapia , Óxido Nitroso/uso terapêutico , Administração por Inalação , Adolescente , Adulto , Idoso , Analgésicos não Entorpecentes/administração & dosagem , Ansiolíticos/administração & dosagem , Ansiedade/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Óxido Nitroso/administração & dosagem , Manejo da Dor , Método Simples-Cego , Adulto Jovem
17.
BMJ Open ; 9(11): e033161, 2019 11 28.
Artigo em Inglês | MEDLINE | ID: mdl-31784448

RESUMO

OBJECTIVES: The aim of this study was to investigate the efficacy, tolerability, safety, and impact on quality of life (QoL) and functional status of vortioxetine treatment for patients with generalised anxiety disorder (GAD) by performing a meta-analysis of randomised controlled trials (RCTs). DESIGN: Systematic review and meta-analysis. DATA SOURCES: Data mining was conducted in January 2019 across PubMed, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials Cochrane Library, Web of science and ClinicalTrials.gov. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: All published RCTs, which assessed the effect of vortioxetine treatment for patients with GAD when compared with a placebo group, were included. DATA EXTRACTION AND SYNTHESIS: Relevant data were extracted and synthesised narratively. Results were expressed as standardised mean differences or ORs with 95% CIs. RESULTS: Our meta-analysis showed that multiple doses (2.5, 5 and 10 mg/day) of vortioxetine did not significantly improve the response rates, compared with placebo (OR 1.16, 95% CI 0.84 to 1.60, p=0.38; OR 1.41, 95% CI 0.82 to 2.41, p=0.21; and OR 1.05, 95% CI 0.76 to 1.46, p=0.75). Moreover, there was no statistically significant difference regarding the remission rates, discontinuation for any reason rates, discontinuation due to adverse events rates, Short-Form 36 Health Survey scores or Sheehan Disability Scale scores between administration of multiple doses (2.5, 5 and 10 mg/day) of vortioxetine and placebo. CONCLUSIONS: Although our results suggest that vortioxetine did not improve the GAD symptoms, QoL and functional status impairment of patients with GAD, it was safe and well tolerated. Clinicians should interpret and translate our data with caution, as the meta-analysis was based on a limited number of RCTs.


Assuntos
Ansiolíticos/administração & dosagem , Transtornos de Ansiedade/tratamento farmacológico , Qualidade de Vida/psicologia , Vortioxetina/administração & dosagem , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Ensaios Clínicos Controlados Aleatórios como Assunto , Indução de Remissão
18.
Prof Inferm ; 72(3): 181-186, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31883569

RESUMO

INTRODUCTION: Coronary interventions and electrophysiology procedures may be painful both during and shortly after the procedure. AIM: To assess the onset of pain and anxiety in patient undergoing coronary interventions and electrophysiology procedures; to describe the administration (frequency, timing, dosage and outcomes) of analgesics and anxiolytics before, during and after the procedure. METHODS: A descriptive multicenter study was carried out. Pain and anxiety were measured with a 10-point visual analogue scale (VAS) before, during, after the procedure and for the following 24 hours. Patient were asked to rate their satisfaction for the information received and pain control. RESULTS: Data on 230 patients were collected. The most performed procedure was the transradial coronary catheterization (68.7%). The pacemaker/defibrillator implantation resulted the most painful procedure (median 4, IQR 3-6) and also the most anxious (median 5, IQR 2-6). 13 Patients received an analgesic during the procedure for a low-to-severe pain; during the following 24 hours 34 patients (5 undergoing transradial coronary catheterization and 29 the implant of pacemaker/cardiac-defibrillator) suffered from severe pain and with the exception of 5, all requested pain relief. Satisfaction for pain control was inadequate for patients who underwent electrophysiology procedures and 55 patients would have needed more information on pain. CONCLUSION: Pain control and patient satisfaction may be improved, pre-procedural anxiety needs more attention and better information on the procedure should be provided.


Assuntos
Analgésicos/administração & dosagem , Ansiolíticos/administração & dosagem , Ansiedade/prevenção & controle , Dor Processual/prevenção & controle , Idoso , Ansiedade/etiologia , Cateterismo Cardíaco/efeitos adversos , Cateterismo Cardíaco/métodos , Técnicas Eletrofisiológicas Cardíacas/efeitos adversos , Técnicas Eletrofisiológicas Cardíacas/métodos , Feminino , Humanos , Masculino , Medição da Dor , Dor Processual/epidemiologia , Dor Processual/psicologia , Satisfação do Paciente
19.
Biomolecules ; 9(12)2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31861240

RESUMO

Since cisplatin therapy is usually accompanied with numerous toxicities, including neurotoxicity, that involve tissue oxidative damage, the aim of this study was to evaluate the possible protective effect of N-acetylcysteine (NAC) on the anxiogenic response to cisplatin (CIS). Thirty-two male Wistar albino rats divided into four groups (control, cisplatin, NAC, and CIS + NAC). All treatments were delivered intraperitoneally. On day one, the control and cisplatin groups received saline while the NAC and CIS + NAC groups were administered with NAC (500 mg/kg). On the fifth day, the control group received saline while the CIS group was treated with cisplatin (7.5 mg/kg), the NAC group again received NAC (500 mg/kg), and the CIS + NAC group was simultaneously treated with cisplatin and NAC (7.5 and 500 mg/kg, respectively). Behavioral testing, performed on the tenth day in the open field (OF) and elevated plus maze (EPM) tests, revealed the anxiogenic effect of cisplatin that was significantly attenuated by NAC. The hippocampal sections evaluation showed increased oxidative stress (increased lipid peroxidation and decline in antioxidant enzymes activity) and proapoptotic action (predominantly by diminished antiapoptotic gene expression) following a single dose of cisplatin. NAC supplementation along with cisplatin administration reversed the prooxidative and proapoptotic effects of cisplatin. In conclusion, the results obtained in this study confirmed that antioxidant supplementation with NAC may attenuate the cisplatin-induced anxiety. The mechanism of anxiolytic effect achieved by NAC may include the decline in oxidative damage that down regulates increased apoptosis and reverses the anxiogenic action of cisplatin.


Assuntos
Acetilcisteína/farmacologia , Ansiolíticos/farmacologia , Ansiedade/induzido quimicamente , Ansiedade/tratamento farmacológico , Cisplatino/efeitos adversos , Substâncias Protetoras/farmacologia , Acetilcisteína/administração & dosagem , Acetilcisteína/química , Animais , Ansiolíticos/administração & dosagem , Ansiolíticos/química , Antineoplásicos/administração & dosagem , Antioxidantes/administração & dosagem , Comportamento Animal/efeitos dos fármacos , Cisplatino/administração & dosagem , Masculino , Estresse Oxidativo/efeitos dos fármacos , Substâncias Protetoras/administração & dosagem , Substâncias Protetoras/química , Ratos , Ratos Wistar
20.
Int J Clin Pharm ; 41(6): 1526-1535, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31595447

RESUMO

Background Benzodiazepines are commonly prescribed medications, especially among elderly, despite known risks and guidelines focused on short term usage. There is an increased trend of benzodiazepine consumption in Croatia. Consumption of anxiolytics in 2015 and 2016 in Croatia can almost entirely be ascribed to benzodiazepines, with diazepam being the most commonly prescribed drug, followed by alprazolam. Objective The aim of this study was to examine benzodiazepine utilization habits among the Croatian population. Setting This study was conducted on the national level, based on digital prescribing data. Method Data regarding the prescription of anxiolytics in Croatia was sourced and analyzed from the Croatian Health Insurance Fund database for the years 2015 and 2016. Drugs included in the study were classified according to The Anatomical and Therapeutic Classification of Medicines System, and consist of several chemical therapeutic subgroups (N05BA, N05BC, N05CD, N05CF). Main outcome measures The prescribing frequency of the most often prescribed benzodiazepines in Croatia. Results The total number of benzodiazepine prescriptions was 5,085,695 in 2015, and 5,294,075 in 2016; this represents a 208,380 increase in prescriptions, or 4.1% more than the previous year. The number of patients who utilized benzodiazepines showed an increase from 860,664 (8.67%) in 2015 to 876,046 (8.76%) in 2016. In relation to gender, benzodiazepine consumption was higher among female patients in all age groups, with the number of utilized benzodiazepine prescriptions per patient being highest in the oldest age group (80 +), comprising 7 prescriptions per patient in a 12 months period. Conclusion Increased utilization and long-term treatment with benzodiazepines remains a serious challenge for the health care system in Croatia. National prescription guidelines, improved control of benzodiazepine usage and prescriptions, along with restricted release drug lists, should all be considered as potential measures to rationalize benzodiazepine prescription, control unnecessary expenditure in the country and improve the well-being of the patients.


Assuntos
Ansiolíticos/administração & dosagem , Benzodiazepinas/administração & dosagem , Padrões de Prática Médica/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Croácia , Bases de Dados Factuais , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Fatores Sexuais , Adulto Jovem
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