Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.841
Filtrar
1.
Adv Exp Med Biol ; 1191: 121-140, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002926

RESUMO

Discovery of innovative anxiolytics is severely hampering. Existing anxiolytics are developed decades ago and are still the therapeutics of choice. Moreover, lack of new drug targets forecasts a severe jeopardy in the future treatment of the huge population of CNS-diseased patients. We simply lack the knowledge on what is wrong in brains of anxious people (normal and diseased). Translational research, based on interacting clinical and preclinical research, is extremely urgent. In this endeavor, genetic and genomic approaches are part of the spectrum of contributing factors. We focus on three druggable targets: serotonin transporter, 5-HT1A, and GABAA receptors. It is still uncertain whether and how these targets are involved in normal and diseased anxiety processes. For serotonergic anxiolytics, the slow onset of action points to indirect effects leading to plasticity changes in brain systems leading to reduced anxiety. For GABAA benzodiazepine drugs, acute anxiolytic effects are found indicating primary mechanisms directly influencing anxiety processes. Close translational collaboration between fundamental academic and discovery research will lead to badly needed breakthroughs in the search for new anxiolytics.


Assuntos
Ansiolíticos/uso terapêutico , Transtornos de Ansiedade/fisiopatologia , Ansiedade/fisiopatologia , Descoberta de Drogas , Neurotransmissores/metabolismo , Pesquisa Médica Translacional , Ansiolíticos/farmacologia , Ansiedade/tratamento farmacológico , Ansiedade/metabolismo , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/metabolismo , Humanos
2.
Adv Exp Med Biol ; 1191: 169-184, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002929

RESUMO

This chapter describes the various animal models that seem relevant to the development of anxiolytic drugs, as well as the human models of induced anxiety, or more precisely the panic inducers including cholecystokinin. It is also mentioned the theoretical model of Deakin and Graeff which seems to keep all its relevance. The knock animals are evoked as relevant tools as well as a new optogenetic technique that needs to be used in this field.


Assuntos
Ansiolíticos , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/psicologia , Ansiedade/tratamento farmacológico , Ansiedade/psicologia , Modelos Animais de Doenças , Descoberta de Drogas , Animais , Ansiolíticos/farmacologia , Ansiolíticos/uso terapêutico , Colecistocinina/efeitos adversos , Humanos , Optogenética
3.
Adv Exp Med Biol ; 1191: 347-365, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002937

RESUMO

Anxiety disorders, including panic disorder/agoraphobia (PDA), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and others, are the most prevalent mental disorders. In this paper, recommendations are given for the psychopharmacological treatment of these disorders which are based on comprehensive treatment guidelines, meta-analyses, and systematic reviews of available randomized controlled studies. Anxiety disorders can effectively be treated with psychotherapy, pharmacotherapy, or a combination of both. First-line drugs are the selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Benzodiazepines are not recommended for routine use due to their possible addiction potential. Other treatment options include the calcium modulator pregabalin, tricyclic antidepressants, buspirone, moclobemide, and others. Drug treatment can be combined with psychological treatments. Novel treatment strategies include medications that act on GABA, glutamate, and other neurotransmitter systems. After remission, medications should be continued for 6 to 12 months.


Assuntos
Ansiolíticos/uso terapêutico , Transtornos de Ansiedade/tratamento farmacológico , Inibidores de Captação de Serotonina/uso terapêutico , Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico , Humanos , Psicoterapia
4.
Adv Exp Med Biol ; 1191: 561-576, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002946

RESUMO

Recent data has linked anxiety and its disorders in late life to increased morbidity and mortality, especially related to a higher cardiovascular burden and an increased cognitive decline. Clinically, anxiety symptoms may be more difficult to elicit in older adults who are less accurate in identifying anxiety symptoms and tend to minimize symptoms and to attribute symptoms to physical illness. Although SSRIs have proven more effective than psychotherapy in late-life anxiety, many elderly anxious subjects prefer psychotherapeutic interventions. These interventions appear to work best when tailored for the needs, expectations, and cultural background of older anxious subjects.


Assuntos
Transtornos de Ansiedade , Idoso , Ansiolíticos/uso terapêutico , Ansiedade/complicações , Ansiedade/diagnóstico , Ansiedade/psicologia , Ansiedade/terapia , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Doenças Cardiovasculares/complicações , Comorbidade , Humanos , Psicoterapia , Inibidores de Captação de Serotonina/uso terapêutico
5.
Medicine (Baltimore) ; 99(1): e18524, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895787

RESUMO

Within the southern region of the Netherlands, the Maastricht Study is an on-going observational prospective population-based cohort study that focuses on the etiology of Type 2 diabetes mellitus (T2DM). Representativeness of the participating population is a crucial but often an unknown factor in population-based cohort studies such as the Maastricht Study. We therefore aimed to assess the representativeness of the study population by comparing drug utilization of the participants of the Maastricht Study with the general population of the Netherlands.Since T2DM patients were oversampled in this study, a sampling method was applied in order to ensure a similar distribution of T2DM over the study population. Drug use in the study population was compared with drug use in the population of the Netherlands, using a Z-test to compare 2 independent proportions.In general, drug use in the study was similar compared with national data. However, in the age group 65 to 74 years total drug use was lower in the study population (833/1000 persons) versus nationwide data (882/1000 persons). The use of pulmonary medications was lower (104/1000 persons vs 141/1000 persons) and the use of hypnotics/anxiolytics was higher (90/1000 persons vs 36/1000 persons) in the Maastricht Study as compared with national data.Drug use in the Maastricht Study population is largely comparable to that in the total Dutch population aged 45 to 74. Therefore, data on drug use by participants in the Maastricht Study can be used to perform studies assessing outcomes associated with drug use.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Uso de Medicamentos/estatística & dados numéricos , Saúde da População/estatística & dados numéricos , Idoso , Ansiolíticos/uso terapêutico , Feminino , Humanos , Hipnóticos e Sedativos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Estudos Prospectivos , Fármacos do Sistema Respiratório/uso terapêutico
6.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(10): 111-120, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31793552

RESUMO

The high prevalence of anxiety disorders around the world leads to a high interest in the study of anxiety. At the moment, a lot of knowledge about the pathogenesis and therapy of anxiety disorders has been accumulated, which is well covered in modern domestic and world medical literature. It is known that many areas of the brain are involved in the modulation of anxiety, among which the amygdala is considered the key in the modulation of anxiety and fear. A large body of evidence supports the involvement of different neurotransmitter systems in the processes of anxiogenesis-anxiolysis (GABA, monoamines, glutamate, neuropeptides, neurosteroids). This article provides an analysis of methods of pharmacological impact on each of these systems, which serve to optimize the already known strategies of anxiolytic therapy.


Assuntos
Ansiolíticos , Transtornos de Ansiedade , Tonsila do Cerebelo/efeitos dos fármacos , Tonsila do Cerebelo/fisiopatologia , Ansiolíticos/uso terapêutico , Ansiedade , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/tratamento farmacológico , Medo , Humanos
7.
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
8.
Artigo em Russo | MEDLINE | ID: mdl-31851171

RESUMO

AIM: To study the effects of nooclerin (deanol aceglumate) on the structure of sleep disturbances in children with tension-type headache (TTH). MATERIAL AND METHODS: A blind randomized placebo-controlled study of the efficacy of nooclerin (deanol aceglumate), prescribed for 2 months to prevent TTH, was carried out. The study included 60 patients (30 boys and 30 girls), aged 9-16 years, with TTH. Patients were randomized into the nooclerin group (n=30) and the placebo group (n=30). Sleep disturbances were assessed before and after treatment with the Sleep Disturbance Scale for Children (SDSC). RESULTS: There was a significant positive dynamics (reduced total score on SDSC (p<0.001) and a significant decrease in the scores on scales 'Disorders of initiating and maintaining sleep', 'Disorders of excessive somnolence' (p<0.001), 'Sleep wake transition disorders' (p<0.01)) in the nooclerin group. No significant positive changes were detected in the placebo group. CONCLUSION: An anxiolytic action of nooclerin was confirmed. Further studies of the drug in child neurology and psychiatry using larger groups of patients are needed.


Assuntos
Ansiolíticos , Deanol , Glutamatos , Transtornos do Sono-Vigília , Cefaleia do Tipo Tensional , Adolescente , Ansiolíticos/uso terapêutico , Criança , Deanol/uso terapêutico , Feminino , Glutamatos/uso terapêutico , Humanos , Masculino , Sono , Transtornos do Sono-Vigília/congênito , Transtornos do Sono-Vigília/tratamento farmacológico , Cefaleia do Tipo Tensional/complicações , Cefaleia do Tipo Tensional/tratamento farmacológico
9.
Medicine (Baltimore) ; 98(40): e17375, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577741

RESUMO

Achieving abstinence in schizophrenic smokers using a combination of medications and cognitive behavioral therapy is feasible; however, abstinence rates are significantly lower compared to the general population and studies are scanty. Additionally, maintaining sustained abstinence and preventing relapse is a major limiting factor and represents key tasks in managing tobacco dependence in schizophrenic patients. Several theories have been postulated to explain the higher tendency of tobacco use among schizophrenic individuals. Schizophrenic patients may use nicotine as a "self-medication" strategy to improve negative symptoms of schizophrenia. However, studies suggest that although nicotine may act as an anxiolytic acutely, chronic use of nicotine may lead to increased anxiety with the possibility of increased catecholamines, which is confirmed with the prevalence of tachycardia and hypertension in smokers in general. On this basis, the main objective of our present study was to assess anxiety in schizophrenic smoking and nonsmoking patients by comparing the number of anxiety and agitation episodes and evaluating the amount of antianxiety/antiagitation medication used by each group. A separate objective was to document the unmet needs of smoking cessation programs in treating schizophrenic patients. Consequently, in the present retrospective cohort study, it was observed that schizophrenic smokers tend to have higher anxiety episodes and utilize as-needed medications at a higher frequency compared to nonsmokers for the relief of anxiety and agitation symptoms. Further research is warranted to examine these results on a larger scale.


Assuntos
Ansiedade/epidemiologia , Fumar Cigarros/epidemiologia , Esquizofrenia/epidemiologia , Ansiolíticos/uso terapêutico , Antipsicóticos/uso terapêutico , Ansiedade/tratamento farmacológico , Feminino , Humanos , Masculino , Estudos Retrospectivos , Esquizofrenia/tratamento farmacológico , Fumantes , Abandono do Hábito de Fumar/métodos
10.
Artigo em Russo | MEDLINE | ID: mdl-31626171

RESUMO

AIM: To evaluate anxiolytic action of GB-115, a low-affinity blocker of central cholecystokinin receptors, used in tablets in a dose of 1 mg for the treatment of patients with anxiety disorders in order to determine effective dose, safety, tolerability and efficacy in clinical settings. MATERIAL AND METHODS: The study included 31 patients (22 women, 9 men) diagnosed with generalized anxiety disorder (GAD, F41.1 according to ICD-10), aged from 22 to 53 years. The duration of treatment was 21 days. The Hamilton Anxiety Rating scale, Psychopathologic symptoms severity evaluation scale (PSSES), Spilberger State-Anxiety Inventory, Multidimensional Fatigue Inventory (MFI), Clinical Global Impression scale (CGI), computerized battery for evaluation of cognitive functions ('NS-Psychotest') were used. RESULTS AND CONCLUSION: The effective dose of GB-115 was determined at 6 mg per day. Drug action is characterized by fast onset of anxiolytic effect with stimulating properties and beneficial effect on sleep disturbances and autonomic symptoms. GB-115 treatment was associated with favorable changes in attention parameters, reaction time and overall performance. In contrast to first-line drugs for GAD treatment (SSRIs and SNRIs), GB-115 does not induce initial overactivation, anxiety and sleep disturbances. GB-115 is safe and has a good tolerability.


Assuntos
Ansiolíticos , Transtornos de Ansiedade , Receptores da Colecistocinina , Adulto , Ansiolíticos/efeitos adversos , Ansiolíticos/uso terapêutico , Transtornos de Ansiedade/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Receptores da Colecistocinina/antagonistas & inibidores , Resultado do Tratamento , Adulto Jovem
11.
J Pediatr Orthop ; 39(10): 500-504, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31599858

RESUMO

BACKGROUND: Opioids are commonly used after posterior spinal instrumented fusion (PSIF) for adolescent idiopathic scoliosis (AIS). Prescription opioids use can potentially lead to misuse, abuse, dependence, and overdose death. Prolonged opioid use has not been extensively studied in the postoperative AIS population. The purpose of this study is to identify risk factors associated with prolonged opioid use after PSIF for AIS. METHODS: A large insurance database was queried for AIS patients undergoing PSIF. Patients with prolonged postoperative opioid use were defined as those receiving new prescriptions for an opioid medication >6 weeks following the date of surgery, up to 8 months postoperatively. Preoperative and intraoperative risk factors for prolonged opioid use were then examined, including the number of spinal levels fused, preoperative opioid prescriptions, demographic variables, pertinent comorbidities (anxiety, depression, attention deficit hyperactivity disorder, and autism) and other preoperative prescriptions (anxiolytics, antidepressants, nonopioid analgesics, neuropathic medications, and attention deficit hyperactivity disorder medications). Each variable's independent risk for prolonged postoperative opioid use was examined utilizing a multivariable binomial regression analysis. P<0.05 was considered statistically significant. RESULTS: A total of 511 patients were included in the study. Of this 50 patients (9.78%) were found to have prolonged opioid use following scoliosis surgery. Preoperative opioid use (odds ratio, 2.93; P<0.001) was the most significant predictor of prolonged postoperative opioid use. In addition, female sex, obesity, a preoperative diagnosis of anxiety and a preoperative prescription for a muscle relaxer were also significant positive risk factors for prolonged postoperative opioid use. Several factors were found to be protective against prolonged postoperative opioid use. Fewer total fusion levels, compared with ≥13 levels, had a significantly lower risk of prolonged opioid use. Preoperative anxiolytic and antidepressant use were also both negative predictors of prolonged opioid use. CONCLUSIONS: Efforts at addressing preoperative opioid use, anxiety, obesity, and providing multimodal pain management strategies should be considered to reduce additional postoperative opioid prescriptions after PSIF for AIS. LEVEL OF EVIDENCE: Level III-retrospective comparative study.


Assuntos
Analgésicos Opioides/uso terapêutico , Dor Pós-Operatória/tratamento farmacológico , Escoliose/epidemiologia , Escoliose/cirurgia , Fusão Vertebral/efeitos adversos , Demandas Administrativas em Assistência à Saúde , Adolescente , Ansiolíticos/uso terapêutico , Antidepressivos/uso terapêutico , Ansiedade/tratamento farmacológico , Ansiedade/epidemiologia , Criança , Comorbidade , Feminino , Humanos , Masculino , Relaxantes Musculares Centrais/uso terapêutico , Obesidade/epidemiologia , Dor Pós-Operatória/etiologia , Período Pós-Operatório , Período Pré-Operatório , Fatores de Proteção , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
12.
Medicine (Baltimore) ; 98(37): e17186, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517876

RESUMO

BACKGROUND: Ashwagandha (Withania somnifera (L.) Dunal) is a herb traditionally used to reduce stress and enhance wellbeing. The aim of this study was to investigate its anxiolytic effects on adults with self-reported high stress and to examine potential mechanisms associated with its therapeutic effects. METHODS: In this 60-day, randomized, double-blind, placebo-controlled study the stress-relieving and pharmacological activity of an ashwagandha extract was investigated in stressed, healthy adults. Sixty adults were randomly allocated to take either a placebo or 240 mg of a standardized ashwagandha extract (Shoden) once daily. Outcomes were measured using the Hamilton Anxiety Rating Scale (HAM-A), Depression, Anxiety, and Stress Scale -21 (DASS-21), and hormonal changes in cortisol, dehydroepiandrosterone-sulphate (DHEA-S), and testosterone. RESULTS: All participants completed the trial with no adverse events reported. In comparison with the placebo, ashwagandha supplementation was associated with a statistically significant reduction in the HAM-A (P = .040) and a near-significant reduction in the DASS-21 (P = .096). Ashwagandha intake was also associated with greater reductions in morning cortisol (P < .001), and DHEA-S (P = .004) compared with the placebo. Testosterone levels increased in males (P = .038) but not females (P = .989) over time, although this change was not statistically significant compared with the placebo (P = .158). CONCLUSIONS: These findings suggest that ashwagandha's stress-relieving effects may occur via its moderating effect on the hypothalamus-pituitary-adrenal axis. However, further investigation utilizing larger sample sizes, diverse clinical and cultural populations, and varying treatment dosages are needed to substantiate these findings. TRIAL REGISTRATION: Clinical Trials Registry-India (CTRI registration number: CTRI/2017/08/009449; date of registration 22/08/2017).


Assuntos
Ansiolíticos/uso terapêutico , Ansiedade/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Estresse Psicológico/tratamento farmacológico , Adulto , Ansiolíticos/efeitos adversos , Ansiedade/metabolismo , Sulfato de Desidroepiandrosterona/metabolismo , Método Duplo-Cego , Feminino , Humanos , Hidrocortisona/metabolismo , Masculino , Fitoterapia , Extratos Vegetais/efeitos adversos , Estresse Psicológico/metabolismo , Testosterona/metabolismo , Resultado do Tratamento
14.
Artigo em Russo | MEDLINE | ID: mdl-31407691

RESUMO

Anxiety occurs in about one third of people over 65 years of age. However, its identification in this age has significant difficulties. The clinical manifestations, pathogenetic mechanisms, approaches to the diagnosis and treatment of various types of anxiety are described in the article. Particular attention is paid to the comorbidity of anxiety disorders in elderly patients. A comprehensive approach to the treatment of elderly patients with anxiety includes psychotherapeutic and pharmacotherapeutic approaches. Special attention should be paid to the efficacy and safety of the drugs, which is especially important in this category of patients.


Assuntos
Ansiolíticos , Transtornos de Ansiedade , Idoso , Ansiolíticos/uso terapêutico , Ansiedade , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/tratamento farmacológico , Comorbidade , Humanos , Psicotrópicos
16.
Biol Pharm Bull ; 42(8): 1268-1274, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31366864

RESUMO

Increasing evidence shows depression relevant to oxidative stress and inflammation. Anti-inflammatory strategies or antioxidants have led to the development of new antidepressants. Brazilin is a natural product from the Chinese traditional medicine Caesalpinia sappan L., exerting anti-inflammatory, antioxidant, anti-platelet concentration, and anti-cancer effects. While the antidepressant effect of brazilin is largely unknown. In present study, we investigated the effects of brazilin on H2O2-induced oxidative injury in PC12 cells and on depression- and anxiety-like behaviors of chronically mild stressed (CMS)-induced depression mice. It was found that brazilin pre-treatment (both 10 and 20 µM) significantly increased cell viability and decreased cell apoptosis in H2O2-treated PC12 cells. Furthermore, repetitive administration of brazilin to CMS-induced depression mice by intraperitoneal injection (10 mg/kg) made the mice significantly lose their latency of feeding in novelty-suppressed feeding test (NSF), have more the sucrose preference in sucrose preference test (SPT), and more time spent in the central zone without affecting their crossing activity in open field test (OFT). These results suggested that brazilin can play a role in antidepressant and anxiolytic-like behaviors for CMS-induced depression mice probably through inhibiting the oxidative stress. Therefore, brazilin is worth to be further explored for treating depressive and anxiety disorders.


Assuntos
Ansiolíticos/uso terapêutico , Antidepressivos/uso terapêutico , Ansiedade/tratamento farmacológico , Benzopiranos/uso terapêutico , Depressão/tratamento farmacológico , Estresse Psicológico/tratamento farmacológico , Animais , Ansiolíticos/farmacologia , Antidepressivos/farmacologia , Comportamento Animal/efeitos dos fármacos , Benzopiranos/farmacologia , Sobrevivência Celular/efeitos dos fármacos , Peróxido de Hidrogênio/farmacologia , Masculino , Camundongos Endogâmicos ICR , Estresse Oxidativo/efeitos dos fármacos , Células PC12 , Ratos
17.
Biol Pharm Bull ; 42(9): 1575-1580, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31257273

RESUMO

Cedrol has been reported to be effective in reducing anxiety of male mice. The limited application of females in animal models of anxiety makes it difficult to systematically investigate new drug substitutes with potential anxiolytic activity. In the present study, we investigated the behavioral response of female ICR mice to cedrol after intraperitoneal (i.p.) administration using the elevated plus maze (EPM) and the light-dark box (LDB) test, followed by determination of neurochemical changes in brain. The data suggested that cedrol at dose of 1200-1600 mg·kg-1 exhibited anxiolytic activity on the female mice, as reflected by greater percentage of entries into the open arms and time spent in the open arms in the EPM, and greater transitions between chambers and percentage of time spent in the light chamber in the LDB. Cedrol increased the level of 5-hydroxytryptamine (5-HT), decreased the level of dopamine (DA), reduced the ratio of 5-hydroxyindoleacetic acid (5-HIAA)/5-HT and increased the ratio of 3,4-dihydroxyphenyl acetic acid (DOPAC)/DA, compared with the control group, indicative of an anxiolytic-like effect on female mice via the 5-HTnergic or DAnergic pathways.


Assuntos
Ansiolíticos/farmacologia , Ansiolíticos/uso terapêutico , Ansiedade/tratamento farmacológico , Encéfalo/efeitos dos fármacos , Neurotransmissores/metabolismo , /uso terapêutico , Ácido 3,4-Di-Hidroxifenilacético/metabolismo , Animais , Ansiedade/metabolismo , Comportamento Animal/efeitos dos fármacos , Monoaminas Biogênicas/metabolismo , Encéfalo/metabolismo , Feminino , Ácido Homovanílico/metabolismo , Ácido Hidroxi-Indolacético/metabolismo , Aprendizagem em Labirinto/efeitos dos fármacos , Camundongos Endogâmicos ICR , Atividade Motora/efeitos dos fármacos
18.
PLoS One ; 14(7): e0219778, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31295318

RESUMO

In recent years there has been increased attention to child neurodevelopment in studies on medication safety in pregnancy. Neurodevelopment is a multifactorial outcome that can be assessed by various assessors, using different measures. This has given rise to a debate on the validity of various measures of neurodevelopment. The aim of this review was twofold. Firstly we aimed to give an overview of studies on child neurodevelopment after prenatal exposure to central nervous system acting medications using psychotropics and analgesics as examples, giving special focus on the use and validity of outcome measures. Secondly, we aimed to give guidance on how to conduct and interpret medication safety studies with neurodevelopment outcomes. We conducted a systematic review in the MEDLINE, Embase, PsycINFO, Web of Science, Scopus, and Cochrane databases from inception to April 2019, including controlled studies on prenatal exposure to psychotropics or analgesics and child neurodevelopment, measured with standardised psychometric instruments or by diagnosis of neurodevelopmental disorder. The review management tool Covidence was used for data-extraction. Outcomes were grouped as motor skills, cognition, behaviour, emotionality, or "other". We identified 110 eligible papers (psychotropics, 82 papers, analgesics, 29 papers). A variety of neurodevelopmental outcome measures were used, including 27 different psychometric instruments administered by health care professionals, 15 different instruments completed by parents, and 13 different diagnostic categories. In 23 papers, no comments were made on the validity of the outcome measure. In conclusion, establishing neurodevelopmental safety includes assessing a wide variety of outcomes important for the child's daily functioning including motor skills, cognition, behaviour, and emotionality, with valid and reliable measures from infancy through to adolescence. Consensus is needed in the scientific community on how neurodevelopment should be assessed in medication safety in pregnancy studies. Review registration number: CRD42018086101 in the PROSPERO database.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Espectro Autista/tratamento farmacológico , Transtornos do Neurodesenvolvimento/tratamento farmacológico , Efeitos Tardios da Exposição Pré-Natal/tratamento farmacológico , Adolescente , Adulto , Ansiolíticos/efeitos adversos , Ansiolíticos/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/fisiopatologia , Comportamento/efeitos dos fármacos , Criança , Desenvolvimento Infantil/efeitos dos fármacos , Pré-Escolar , Cognição/efeitos dos fármacos , Feminino , Humanos , Lactente , Testes de Inteligência , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/fisiopatologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Psicometria , Psicotrópicos/efeitos adversos , Psicotrópicos/uso terapêutico , Adulto Jovem
19.
J Ethnopharmacol ; 242: 112060, 2019 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-31279865

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Aloysia polystachya (Griseb.) Moldenke (Verbenaceae) is a plant traditionally used as medicine for anxiety symptoms. This activity was confirmed in preclinical studies. However, its efficacy was never studied in human clinical trials. AIM OF THE STUDY: We aimed to test the hypothesis that the herbal medicine of A. polystachya is superior to placebo for the treatment of anxiety-related symptoms in adults after 8 weeks. PATIENTS AND METHODS: This was a randomized, double-blind, placebo-controlled, phase-2 clinical trial. Fifty-four adults with self-reported anxiety symptoms were randomly allocated to receive either capsules containing A. polystachya powdered leaves (300 mg, twice a day) or placebo (maltodextrin), for 8 weeks. The intensity of anxiety symptoms was assessed by the Hamilton Anxiety Ranking Scale (HAM-A) at baseline and after 2, 4 and 8 weeks. All analyses were adjusted for physical activity (assessed by the International Physical Activity Questionnaire [IPAQ], short version) and gender. RESULTS: We confirmed the presence of acteoside (chromatographic analysis) and carvone and limonene (gas chromatography) as major constituents in our plant material. Only patients that received A. polystachya experienced a significant decrease in their HAM-A scores, with none or mild side-effects. CONCLUSION: Administration of powdered leaves of A. polystachya, rich in acteoside, carvone and limonene, to adults with anxiety symptoms was significantly superior to placebo in decreasing HAM-A scores after 8 weeks. This finding confirms the ethnopharmacological use of this plant for anxiety symptoms.


Assuntos
Ansiolíticos/uso terapêutico , Ansiedade/tratamento farmacológico , Preparações de Plantas/uso terapêutico , Verbenaceae , Adulto , Ansiolíticos/química , Cápsulas , Método Duplo-Cego , Feminino , Glucosídeos/análise , Glucosídeos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Óleos Voláteis/análise , Óleos Voláteis/uso terapêutico , Fenóis/análise , Fenóis/uso terapêutico , Fitoterapia , Folhas de Planta/química , Preparações de Plantas/química , Pós
20.
J Coll Physicians Surg Pak ; 29(8): 697-701, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31358085

RESUMO

OBJECTIVE: To determine the effectiveness of preoperative administration of gabapentin in reduction of acute postoperative pain, morphine consumption and preoperative anxiety and sedation in obese patients undergoing laparoscopic sleeve gastrectomy. STUDY DESIGN: Double-blinded randomised control trial. PLACE AND DURATION OF STUDY: King Khalid University Hospital, King Saud University Riyadh, Saudi Arabia, from July 2014 to January 2017. METHODOLOGY: Fifty patients undergoing sleeve gastrectomy were enrolled in the study. The subjects received either 1200 mg gabapentin or placebo 2 hours before surgery. The amount of morphine consumption and postoperative pain at 4, 8,12,16, 20 and 24 hours of surgery were measured. Preoperative anxiety and sedation were recorded at 2 hours interval after the drug administration. RESULTS: There was no significant difference in patient characteristics in both groups. 24 hours PCA morphine consumption was significantly lower in gabapentin group than in the placebo group, 15.08±4.55 vs. 27.80±2.51 (p=0.001). Preoperative VAS anxiety, pre- verses post-drug, was significantly lower in gabapentin group 5.80±1.11 vs. 3.52±1.00 (p=0.001) than in placebo group 6.08 1.28 vs. 6.28 1.24 (p=0.635). Preoperative sedation score was not different in both groups. CONCLUSION: Preoperative oral gabapentin was effective in reducing the postoperative pain, morphine consumption and preoperative anxiety in morbid obese patients undergone laparoscopic sleeve gastrectomy.


Assuntos
Analgésicos/uso terapêutico , Ansiolíticos/uso terapêutico , Ansiedade/tratamento farmacológico , Gabapentina/uso terapêutico , Gastrectomia/métodos , Laparoscopia/métodos , Obesidade Mórbida/cirurgia , Adolescente , Adulto , Analgésicos Opioides/administração & dosagem , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Cuidados Pré-Operatórios , Arábia Saudita
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA