Mirtazapine: A One-Stop Strategy for Treatment of Opioid Withdrawal Symptoms

Cureus, Journal Year: 2023, Volume and Issue: unknown

Published: Aug. 20, 2023

Public health efforts to reduce the opioid overdose epidemic and treat use disorder (OUD) have met with challenges associated current non-standardized approaches managing withdrawal symptoms, such as itching, jitteriness, anxiety, depression, craving, vomiting, diarrhea, insomnia, anorexia. These symptoms pose substantial obstacles safe initiation of medications for OUD, maintenance long-term sobriety, prevention relapse. In clinical practice, multiple (polypharmacy) are prescribed manage these including ondansetron promethazine vomiting nausea, loperamide Lomotil hydroxyzine doxepin pruritus, benzodiazepines, Z-drugs, melatonin benzos, tricyclic antidepressants (TCAs), various serotonergic agents anxiety. This polypharmacy is an increased risk adverse drug-drug interactions drug events, medical costs, odds medication non-adherence We propose alternative single medication, mirtazapine, a noradrenergic specific receptor antagonist, that can be used myriad withdrawal. Case series, studies, trials shown mirtazapine effective treating nausea resulting from etiologies, hyperemesis gravidarum chemotherapy-induced emesis. Other evidence supports salutary effects on itching craving. Research findings support mirtazapine’s beneficial diarrhea consequence its modulating receptors mediating mood gastrointestinal symptoms. There also supporting efficacy potent non-addictive sleep aid, which presents itself solution insomnia The review extant literature one-drug strategy variety has much potential decrease polypharmacy, relapse, healthcare cost increase likelihood prolonged sobriety better quality life people living OUD.

Language: Английский

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Management of neuropsychiatric symptoms in dementia

Current Opinion in Neurology, Journal Year: 2023, Volume and Issue: 36(5), P. 498 - 503

Published: Aug. 7, 2023

Purpose of review The purpose is to the results and clinical implications recent studies neuropathology in relation neuropsychiatric symptoms (NPS) Alzheimer's disease related dementias, discuss new therapeutic approaches based on evidence from trials. Recent findings In a large autopsy series national consortium, multiple neuropathologies dementia subtypes were common increased severity specific NPS during life was associated with greater across diagnoses. Based three trials, brexpiprazole, which an antipsychotic dopamine serotonin receptor partial agonism properties, recently approved for treatment agitation by U.S. Food Drug Administration (FDA). Its profile indicates modest efficacy high safety. Brexpiprazole has not been compared other antipsychotics that are commonly prescribed treat dementia, though none them have this indication. Other drugs showed positive Phase 2 trials being tested 3 These include cannabinoids drug combinations inhibit dextromethorphan metabolism peripherally, thereby increasing its bioavailability brain. Apathy several types there initial methylphenidate, psychostimulant, may be efficacious good tolerability. Summary Greater understanding associations between can improve management these disorders. addition approval brexpiprazole optimism about medications ongoing Along short-term improvement, altering adverse impact long-term prognosis remains important challenge field.

Language: Английский

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AXS-05: an investigational treatment for Alzheimer’s disease-associated agitation

Expert Opinion on Investigational Drugs, Journal Year: 2022, Volume and Issue: 31(8), P. 773 - 780

Published: June 28, 2022

Agitation is common in patients with Alzheimer's disease (AD). Although nonpharmacologic de-escalation strategies are recommended as first-line treatment, medication often needed to treat agitation. Currently, there no FDA-approved medications for this indication. Psychotropics used agitation include antipsychotics, which notable their efficacy but also potential cause serious side effects. AXS-05, a combination of dextromethorphan and bupropion, currently being investigated indication.This review will discuss the pharmacology AXS-05 available clinical trial results from completed Phase I II/III studies assessing compound AD. Ongoing research investigating indication be highlighted. Resources PubMed, Embase, clinicaltrials.gov, literature on manufacturer's website.Early released data indicate that may useful option AD it appears generally well tolerated. especially helpful comorbid depression, when considering separate phase III safety treatment depression.

Language: Английский

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A pragmatic, multicentre, double-blind, placebo-controlled randomised trial to assess the safety, clinical and cost-effectiveness of mirtazapine and carbamazepine in people with Alzheimer’s disease and agitated behaviours: the HTA-SYMBAD trial

Health Technology Assessment, Journal Year: 2023, Volume and Issue: unknown, P. 1 - 108

Published: Oct. 1, 2023

Agitation is common and impacts negatively on people with dementia carers. Non-drug patient-centred care first-line treatment, but we need other treatment when this fails. Current evidence sparse safer effective alternatives to antipsychotics.

Language: Английский

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Treating Depression in Dementia Patients: A Risk or Remedy—A Narrative Review

Geriatrics, Journal Year: 2024, Volume and Issue: 9(3), P. 64 - 64

Published: May 15, 2024

The diagnosis of depression in dementia patients leads to an increase the burden disease. To treat this patient group, antidepressants are frequently used; however, there is not any proof their therapeutic effectiveness, and use may be potentially harmful. This narrative review aims summarize existing evidence regarding role treating patients.

Language: Английский

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