Consumption of psychotropic drugs in Croatia before and during the COVID-19 pandemic: a 10-year longitudinal study (2012–2021)

Social Psychiatry and Psychiatric Epidemiology, Journal Year: 2023, Volume and Issue: 59(5), P. 799 - 811

Published: Oct. 17, 2023

Language: Английский

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Improving patient experience for people prescribed medicines with a risk of dependence or withdrawal: co-designed solutions using experience based co-design

BMC Primary Care, Journal Year: 2024, Volume and Issue: 25(1)

Published: Jan. 6, 2024

Significant concerns have been raised regarding how medications with a risk of dependence or withdrawal are managed and care is experienced by patients. This study sought to co-design solutions improve the experience for patients prescribed benzodiazepines, z-drugs, opioids chronic non-cancer pain, gabapentinoids antidepressants.

Language: Английский

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Aripiprazole, but Not Olanzapine, Alters the Response to Oxida-Tive Stress, Reducing the Activation of Mitogen-Activated Protein Kinases (MAPKs) and Promoting Cell Survival in FAO Cells

Published: July 2, 2024

Chronic administration of atypical antipsychotics (AAPs) is commonly associated with in-creased cardiovascular disease load. Although the increase in weight gain and related dis-ease risk generally considered main contributing factor, direct interference mi-tochondrial bioenergetics, particularly liver, where these drugs are catabolized, emerging as an additional relevant contributor to metabolic that needs be considered. In this study, we compared effects two AAPs disparate profiles, olanzapine (OLA), which obesogenic, aripiprazole (ARI), not, on response Fao cells oxidative stress. We found treated ARI sur-vive better a challenge H2O2 while OLA treatment has opposite effect. This en-hanced survival not reduction apoptosis rate. fact, display higher apoptotic rates than control exposed H2O2. Gene expression analysis pro anti-apoptotic factors revealed changes induced by were dampened cells, but suggesting reduced respon-siveness stimuli, notion was consistent activation MAPK STAT3 phosphorylation H2O2, enhanced their re-sponse Loss stress elevation mitochondrial production O2•-, known desensitizing factor. The physiological rele-vance increased O2•- further supported observed mitophagy flux likely mitochon-drial damage. An finding protected pro-teasome activity effect possibly preservation signaling function cells. sum, study highlights underlying alterations cell physiology derived from inter-ference function, de-sensitize signaling,

Language: Английский

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Patterns of antidepressant prescribing in and around pregnancy: a descriptive analysis in the UK Clinical Practice Research Datalink

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 8, 2024

Abstract Objective To describe the prevalence and patterns of antidepressant prescribing in around pregnancy. Design Drug utilisation study. Setting Primary care United Kingdom (UK). Population Women with a pregnancy between 1996 2018 UK Clinical Practice Research Datalink (CPRD) GOLD Pregnancy Register. Methods Using primary prescription records, we identified individuals who had been prescribed antidepressants described changing during over time. We defined ‘prevalent’ or ‘incident’ use, where users were both before pregnancy, newly then compared these two groups. also investigated characteristics associated discontinuation anytime post-pregnancy prescribing. Main outcome measures Antidepressant Results A total 1,033,783 pregnancies identified: 79,144 (7.7%) 15,733 (19.9%) users. increased from 3.2% to 13.4% 2018. Most women, users, discontinued (54.8% 59.9%, respectively). The majority those resumed 12 months after (53.0%). Younger age, previous stillbirth, higher deprivation more frequent Conclusions use appears be increasing UK. women at some point end but resumption was common. Funding Wellcome Trust 218495/Z/19/Z.

Language: Английский

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Aripiprazole, but Not Olanzapine, Alters the Response to Oxidative Stress in Fao Cells by Reducing the Activation of Mitogen-Activated Protein Kinases (MAPKs) and Promoting Cell Survival

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(20), P. 11119 - 11119

Published: Oct. 16, 2024

Prolonged use of atypical antipsychotics (AAPs) is commonly associated with increased cardiovascular disease risk. While weight gain and related health issues are generally considered the primary contributors to this risk, direct interference mitochondrial bioenergetics, particularly in liver where these drugs metabolized, emerging as an additional contributing factor. Here, we compared effects two AAPs disparate metabolic profiles on response Fao hepatoma cells oxidative stress: olanzapine (OLA), which obesogenic, aripiprazole (ARI), not. Results showed that treated ARI exhibited resistance H

Language: Английский

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The marked oscillatory pattern in prescription opioid utilization in Canada since 2000: Selected observations and questions for outcomes and policy

Pharmacoepidemiology and Drug Safety, Journal Year: 2023, Volume and Issue: 33(1)

Published: Dec. 29, 2023

From about 2000 onward, Canada has presented a remarkable pattern of population-level consumption controlled/prescription opioid substances, the medications chiefly used for pharmacotherapeutic treatment chronic pain. Based on International Narcotics Control Board (INCB) data, Canada's annual rate prescription opioids increased from 8713 Defined Daily Doses (DDD)/1 000 population/day in 2000–2002 to 34 444 DDD/1 000/day 2013–2015 (+295%) but then subsequently reverted and decreased 15 777 by 2019–2021 (−54%)1, 2 (see Figure 1). Other, more detailed examinations have generally confirmed this marked oscillatory while furthermore noting stark interprovincial differences utilization.3, 4 For most time, these drug utilization indicators rendered country with globally second-highest level only behind United States (US).1 recent levels rates near where they were two decades ago. The extreme oscillation utilization—involving several magnitudes rise-and-fall changes over relatively short time-period—are rather exceptional medication class widely dispensed disease-specific treatment.5-7 We will briefly examine selected drivers, outcomes, questions elementary developments related patterns public health policy perspective. Prescription are controlled principally utilized pharmaco-therapeutic care pain.1, 8, 9 Pre-2000, growing socio-medical movement had vocally drawn attention high prevalence, commonly inadequate or "under"-treatment pain North America urged proactive liberal employment its treatment.10 These efforts coincided availability new formulations (e.g., slow-release oxycodone/Oxycontin, others) which expanded menu strong early 2000s that promised effective "risk-free" problems, thus contributing rapid increases utilization.11, 12 Given multifold use post-2000, plausible assumption would be been associated some indications tangible improvements prevalence outcome and/or quality Canadian population. Available largely ecological unsystematic recognizing is not "curable" disease even treatment, however, do appear readily support this. example, results other studies vary, multiple cycles Community Health Survey (CCHS), large representative national household survey, indicated adult population actually increased, 16% >20% 2012/2014; similarly elevated cited 2019.13-15 Recent Pain Task Force reports (2019–2021) suggest range systemic challenges deficiencies availability, access into present notable availability.15-17 Moreover, samples patients found that, following implementation multitude regulation measures post-2012 restrict opioid-related risks harm, many experienced increasing difficulties accessing pressure taper off their therefore consequential source drugs nonmedically illicitly.18, 19 On basis, before considering possible adverse outcomes over-time major there appears little evidence, evidence considered, produced measurable population—a conclusion similar observations already given earlier so suggesting kind stagnation, regress, response problem challenge.20 By 2010, widespread signs morbidity mortality—for nonmedical use; hospitalizations; overdose fatalities—associated rising across Canada.21, 22 In—initially delayed hesitant—response action, governments regulators at different began implementing regulatory interventions high-risk harm included, example: defunding oxycodone high-dose formulations; strategy reduce drug-related harms; establishment expansion (provincial) narcotics monitoring programs; education programs "safer prescribing"; guideline pain.23-26 This essentially advised providers employ pharmacotherapy as restrained "last resort" measure care, pronounced reversal previous, iterations.4, 27, 28 In addition measures, saw extensive social reporting debate topics prescribing, harms deaths) actions, including through mass media.29, 30 While prescribing decrease 2012 2015 (depending province) it unclear implemented contributed what extent observed decreases utilization. Associations mostly effects examined specific individual interventions, comprehensive, system-level dynamics remain under-analyzed.24, 31, 32 contribution reductions attributed guidelines, became available 2017, i.e., after dispensing materialized.28, 33 Beyond this, equally under-analyzed factors heterogeneities throughout period. "strong" was reported highest Ontario (10.1 DDD/1000/day) lowest Manitoba (3.9 2005, Newfoundland (12.1 Quebec (6.5 2016, respectively, involving factor 2–2.5 varying provincial jurisdictions. diverse patternings occurred system ecology provinces independently define administer yet under umbrella national, framework fundamental shared standards parameters practice care.34 Overall, substantial knowledge gaps regarding evidence-based development psychotropic control. years, rapidly accelerating, epidemic toll fatalities proportions USA.35, 36 Nationally, death than 2.5-fold, 2831 (age-adjusted 7.8/100 000) 2016 8013 (21.3/100 2021, slightly 7328 (19.1/100 2022, projected 2023.37 vast majority deaths causally highly toxic potent illicit synthetic ([ISOs]; e.g., fentanyl analogs) overall >80% being fentanyl-related 2020 2022. pre-2015, caused shift ISOs-related around onward.38-41 However, potential dynamic drivers shifts ISOs massively accelerating conclusively understood. characterized ISO-epidemic independent "wave" among supply, consider developments, specifically contexts, may interactively change opioids.42, 43 Concretely, timing onset acceleration ISO-related onward precisely point subsequent declines (peak: 2019–2021) Canada2 Consequently, within brief supply volume medical sources reduced half, leaving populations patients, also users faced shrinking of—directly sourced diverted—prescription opioids.19, 44-46 It contracting opioids, contexts persistent demand large, opioid-habituated extra-medical user 20% general population) "supply shock" vis-à-vis subgroups demand.19, 42, 44, 47, 48 consequentially unfolding likely filled products distributed foreign, sources, propelling due pharmacological potency- toxicity-related risk characteristics.42, 49 Related analyses previously shown signals both correlations between deaths, well levels.50-52 words—and acknowledging brought benefits high/long-term dosing) especially patient initiates—the crisis tangibly system-based dispensing. "substitution effect" involved bear crucial implications policy-making just control vectors exist. undergone past 25 focus essential utilization-related outcomes. we appreciate alternative views hypotheses our Commentary exist (and should considered discussion), ready initial, markedly improved primary indicators. Rather, possibly facilitated consequences—including proliferation combined since 2015—on level. important lessons, jurisdictions still formulating policy. include strictly align practices best scientific diligently monitor desired effects, order promptly adjust regulations launch needed. Numerous aspects domains assessed contexts; potentially interactions dispensing, policy, limited analysis understanding.53 encourage further rigorous, comprehensive pharmaco-epidemiological post-2000. These, based topical perspectives should, of: data-level access, outcomes; mixes control; substitution arising sourcing dynamics. Such analytical insights derive post hoc, valuable Benedikt Fischer developed concept for, collected interpreted conducted writing editing manuscript. Tessa Robinson data collection interpretation, revised edited manuscript critical intellectual content. Both authors approved final submitted. work supported part CIHR grant number FRN-94814. declare no conflict interest.

Language: Английский

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Development and internal validation of a predictive model for prolonged intensive care unit stays in patients with psychotropic drug poisoning

Heart & Lung, Journal Year: 2024, Volume and Issue: 68, P. 350 - 358

Published: Sept. 10, 2024

Language: Английский

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SARIMA Statistical Model to Predict the Consumption of Anxiolytics as a Treatment for Mental Illnesses

WSEAS TRANSACTIONS ON COMPUTER RESEARCH, Journal Year: 2024, Volume and Issue: 12, P. 503 - 515

Published: Nov. 25, 2024

The prevalence of mental health diseases and excessive consumption anxiolytics has increased in the world. In this scenario, need arises to determine a model that describes behavior pharmacological Ecuador, addition allowing general be projected over time. With descriptive, exploratory, non-experimental methodological approach conditioned on obtaining statistical data from official national international organizations. population interest was generalized using flow-type temporal effective anxiolytics, consisting 144 monthly records period January 2011 December 2022. represent proportion people who consume relation total available statistics community care with illness disorders Ministry Public Health. sense, viable option is construction temporary SARIMA model. Due its nature management records, robust estimation chosen as an by applying machine learning efficiently decomposes extracts both seasonal trend components present data. Determining depends factor (months) presence marked tendency gradually increase time, situation must regulated because it represents drug dependence overdose. Furthermore, built presented adequate suitability when quantifying metrics: RMSE = 5.25% MAPE 1%. It concluded proposed explains Ecuador mitigate situations occurred affected person (anxiety or depression) last three months, according specification deterministic random identified estimated

Language: Английский

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New psychoactive substances as abuse drugs

Comprehensive analytical chemistry, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 1, 2024

Language: Английский

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Use of analgesics and psychotropic medication: Findings from the Lolland- Falster Health Study

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 30, 2024

Aim To descripe the use of analgesics and psychotropic medication, common medical diseases, alcohol consumption in adult persons living a rural-provincial area Denmark. Methods Using cross-sectional data from Lolland-Falster Health Study (LOFUS), we examined total 16,084 individuals aged 18 years above. Data on consumption, somatic psychiatric diseases were obtained self-administered questionnaires. Results At time survey, 23.4% subjects reported daily/almost daily and/or medication; women more than men, relative risk (RR) 1.62 (95% confidence interval (CI) 1.53–1.72). The was by 19.2%, antidepressants 4.7%, tranquilizers/sedative 3.5%, sleeping medication 2.4%. In addition, 7.3% frequent intake 5 + units alcohol; men women, RR 3.38 CI 2.97–3.85). total, 70.7% participants having or had at least one disease, 10.0% disease; together 71.8%. Out participants, 29% suffering osteoarthritis, but only third them analgesics; out 7% depressions, half antidepressants. Conclusions One fourth population Denmark analgesics/psychotropic high consumption. However, suffered disease almost three-fourths so there considerable gap between level pain relief agents, diseases. results may indicate that several conditions remain untreated inadequately managed general Lolland-Falster.

Language: Английский

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