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[PMID]:29368813
[Au] Autor:Matthews PRL; Horder J; Pearce M
[Ad] Endereço:North Kildare Mental Health Service, Kildare West Wicklow MHS, Celbridge Community Health Centre, Shackleton Road, Celbridge, Co. Kildare, Ireland.
[Ti] Título:Selective noradrenaline reuptake inhibitors for schizophrenia.
[So] Source:Cochrane Database Syst Rev;1:CD010219, 2018 Jan 25.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Schizophrenia is frequently a chronic and disabling illness with a heterogeneous range of symptoms. The positive symptoms usually respond to antipsychotics but the cognitive and negative symptoms of schizophrenia are difficult to treat with conventional antipsychotics and significantly impact on quality of life and social outcomes. Selective noradrenaline reuptake inhibitors (NRIs) increase prefrontal dopamine and noradrenaline levels without significantly affecting subcortical dopamine levels, making them an attractive candidate for treating cognitive and negative symptoms. OBJECTIVES: To investigate the effects of selective noradrenaline reuptake inhibitors (NRIs), compared with a placebo or control treatment, for people with schizophrenia. SEARCH METHODS: We searched the Cochrane Schizophrenia Group's Trials Register (up to 7 February 2017) which is based on regular searches of MEDLINE, Embase, CINAHL, BIOSIS, AMED, PubMed, PsycINFO, and registries of clinical trials. There are no language, date, document type, or publication status limitation for inclusion of records into the register. We inspected references of all included studies for further relevant studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing NRIs with either a control treatment or placebo for people with schizophrenia or related disorders (such as schizoaffective disorder) by any means of diagnosis. We included trials that met our selection criteria and provided useable information. DATA COLLECTION AND ANALYSIS: We independently inspected all citations from searches, identified relevant abstracts, and independently extracted data from all included studies. For binary data we calculated risk ratio (RR), for continuous data we calculated mean difference (MD), and for cognitive outcomes we derived standardised mean difference (SMD) effect sizes, all with 95% confidence intervals (CI) and using a random-effects model. We assessed risk of bias for the included studies and used the GRADE approach to produce a 'Summary of findings' table which included our prespecified main outcomes of interest. MAIN RESULTS: Searching identified 113 records. We obtained the full text of 48 of these records for closer inspection. Sixteen trials, randomising a total of 919 participants are included. The majority of trials included adults with schizophrenia or similar illness who were inpatients, and while they were poorly characterised, most appeared to include patients with a chronic presentation. The intervention NRI in nine of the 16 trials was reboxetine, with atomoxetine and viloxazine used in the remaining trials. 14 trials compared NRIs with placebo. Only two trials provided data to compare NRIs against an active control and both compared reboxetine to citalopram but at 4 weeks and 24 weeks respectively so they could not be combined in a meta-analysis.One trial was described as 'open' and we considered it to be at high risk of bias for randomisation and blinding, three trials were at high risk of bias for attrition, six for reporting, and two for other sources of bias. Our main outcomes of interest were significant response or improvement in positive/negative mental state, global state and cognitive functioning, average cognitive functioning scores, significant response or improvement in quality of life and incidence of nausea. All data for main outcomes were short term.NRIs versus placeboMental state results showed significantly greater rates of improvement in negative symptoms scores (1 RCT, n = 50; RR 3.17, 95% CI 1.52 to 6.58; very low quality evidence) with NRIs on the PANSS negative. No data were reported for significant response or improvement in positive symptoms, but average endpoint PANSS positive scores were available and showed no difference between NRIs and placebo (5 RCTs, n = 294; MD -0.16, 95% CI -0.96 to 0.63; low-quality evidence). Improvement in clinical global status was similar between groups (1 RCT, n = 28; RR 0.99, 95% CI 0.45 to 2.20; very low quality evidence). Significant response or improvement in cognitive functioning data were not reported. Average composite cognitive scores showed no difference between NRIs and placebo (4 RCTs, n = 180; SMD 0.04, 95% CI -0.28 to 0.36; low-quality evidence). Significant response or improvement in quality of life data were not reported, however average endpoint scores from the GQOLI-74 were reported. Those receiving NRIs had better quality of life scores compared to placebo (1 RCT, n = 114; MD 9.36, 95% CI 7.89 to 10.83; very low quality evidence). All-cause withdrawals did not differ between the treatment groups (8 RCTs, n = 401, RR 0.94 95% CI 0.63 to 1.39; moderate-quality evidence). Rates of nausea were not greater with NRIs (3 RCTs, n = 176; RR 0.49, 95% CI 0.10 to 2.41; low-quality evidence). AUTHORS' CONCLUSIONS: Our results provide tentative very low quality evidence that compared to placebo, NRIs (specifically reboxetine) may have a benefit on the negative symptoms of schizophrenia. Limited evidence also suggests that NRIs have no effect on the positive symptoms of schizophrenia or cognitive functioning. NRIs appear generally well tolerated with no real differences in adverse effects such as nausea noted between NRIs and placebo. However, these results are based on short-term follow-up and are poor quality - there is need for more good-quality evidence. A large RCT of reboxetine over a longer period of time, focusing specifically on negative and cognitive symptoms as well as more detailed and comprehensive reporting of outcomes, including adverse events, is required.
[Mh] Termos MeSH primário: Inibidores da Captação Adrenérgica/uso terapêutico
Esquizofrenia/tratamento farmacológico
Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Cloridrato de Atomoxetina/uso terapêutico
Citalopram/uso terapêutico
Cognição/efeitos dos fármacos
Seres Humanos
Morfolinas/uso terapêutico
Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Viloxazina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Adrenergic Uptake Inhibitors); 0 (Morpholines); 0 (Serotonin and Noradrenaline Reuptake Inhibitors); 0DHU5B8D6V (Citalopram); 57WVB6I2W0 (Atomoxetine Hydrochloride); 5I5Y2789ZF (Viloxazine); 947S0YZ36I (reboxetine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD010219.pub2


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[PMID]:28744604
[Au] Autor:Dela Peña I; Dela Peña IJ; de la Peña JB; Kim HJ; Shin CY; Han DH; Kim BN; Ryu JH; Cheong JH
[Ad] Endereço:Department of Pharmacy, Uimyung Research Institute for Neuroscience, Sahmyook University, 26-21 Kongreung-2-dong, Hwarangro-815, Nowon-gu, Seoul, 139-742, Republic of Korea. idelapena@llu.edu.
[Ti] Título:Methylphenidate and Atomoxetine-Responsive Prefrontal Cortical Genetic Overlaps in "Impulsive" SHR/NCrl and Wistar Rats.
[So] Source:Behav Genet;47(5):564-580, 2017 Sep.
[Is] ISSN:1573-3297
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Impulsivity, the predisposition to act prematurely without foresight, is associated with a number of neuropsychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD). Identifying genetic underpinnings of impulsive behavior may help decipher the complex etiology and neurobiological factors of disorders marked by impulsivity. To identify potential genetic factors of impulsivity, we examined common differentially expressed genes (DEGs) in the prefrontal cortex (PFC) of adolescent SHR/NCrl and Wistar rats, which showed marked decrease in preference for the large but delayed reward, compared with WKY/NCrl rats, in the delay discounting task. Of these DEGs, we examined drug-responsive transcripts whose mRNA levels were altered following treatment (in SHR/NCrl and Wistar rats) with drugs that alleviate impulsivity, namely, the ADHD medications methylphenidate and atomoxetine. Prefrontal cortical genetic overlaps between SHR/NCrl and Wistar rats in comparison with WKY/NCrl included genes associated with transcription (e.g., Btg2, Fos, Nr4a2), synaptic plasticity (e.g., Arc, Homer2), and neuron apoptosis (Grik2, Nmnat1). Treatment with methylphenidate and/or atomoxetine increased choice of the large, delayed reward in SHR/NCrl and Wistar rats and changed, in varying degrees, mRNA levels of Nr4a2, Btg2, and Homer2, genes with previously described roles in neuropsychiatric disorders characterized by impulsivity. While further studies are required, we dissected potential genetic factors that may influence impulsivity by identifying genetic overlaps in the PFC of "impulsive" SHR/NCrl and Wistar rats. Notably, these are also drug-responsive transcripts which may be studied further as biomarkers to predict response to ADHD drugs, and as potential targets for the development of treatments to improve impulsivity.
[Mh] Termos MeSH primário: Comportamento Impulsivo/efeitos dos fármacos
Comportamento Impulsivo/fisiologia
Córtex Pré-Frontal/efeitos dos fármacos
[Mh] Termos MeSH secundário: Animais
Cloridrato de Atomoxetina/metabolismo
Transtorno do Deficit de Atenção com Hiperatividade/genética
Comportamento de Escolha
Modelos Animais de Doenças
Masculino
Metilfenidato/metabolismo
Córtex Pré-Frontal/metabolismo
Ratos
Ratos Endogâmicos SHR/genética
Ratos Endogâmicos SHR/metabolismo
Ratos Endogâmicos WKY/genética
Ratos Endogâmicos WKY/metabolismo
Ratos Wistar/genética
Ratos Wistar/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
207ZZ9QZ49 (Methylphenidate); 57WVB6I2W0 (Atomoxetine Hydrochloride)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1007/s10519-017-9861-3


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[PMID]:28659039
[Au] Autor:Quinn PD; Chang Z; Hur K; Gibbons RD; Lahey BB; Rickert ME; Sjölander A; Lichtenstein P; Larsson H; D'Onofrio BM
[Ad] Endereço:From the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, S
[Ti] Título:ADHD Medication and Substance-Related Problems.
[So] Source:Am J Psychiatry;174(9):877-885, 2017 Sep 01.
[Is] ISSN:1535-7228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Substance use disorders are major contributors to excess mortality among individuals with attention deficit hyperactivity disorder (ADHD), yet associations between pharmacological ADHD treatment and substance-related problems remain unclear. This study investigated concurrent and long-term associations between ADHD medication treatment and substance-related events. METHOD: The authors analyzed 2005-2014 commercial health care claims from 2,993,887 (47.2% female) adolescent and adult ADHD patients. Within-individual analyses compared the risk of substance-related events (i.e., emergency department visits related to substance use disorders) during months in which patients received prescribed stimulant medication or atomoxetine relative to the risk during months in which they did not. RESULTS: In adjusted within-individual comparisons, relative to periods in which patients did not receive ADHD medication, male patients had 35% lower odds of concurrent substance-related events when receiving medication (odds ratio=0.65, 95% CI=0.64-0.67), and female patients had 31% lower odds of concurrent substance-related events (odds ratio=0.69, 95% CI=0.67-0.71). Moreover, male patients had 19% lower odds of substance-related events 2 years after medication periods (odds ratio=0.81, 95% CI=0.78-0.85), and female patients had 14% lower odds of substance-related events 2 years after medication periods (odds ratio=0.86, 95% CI= 0.82-0.91). Sensitivity analyses supported most findings but were less consistent for long-term associations among women. CONCLUSIONS: These results provide evidence that receiving ADHD medication is unlikely to be associated with greater risk of substance-related problems in adolescence or adulthood. Rather, medication was associated with lower concurrent risk of substance-related events and, at least among men, lower long-term risk of future substance-related events.
[Mh] Termos MeSH primário: Cloridrato de Atomoxetina/efeitos adversos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia
Estimulantes do Sistema Nervoso Central/efeitos adversos
Transtornos Relacionados ao Uso de Substâncias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico
Comorbidade
Feminino
Seres Humanos
Masculino
Fatores Sexuais
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Central Nervous System Stimulants); 57WVB6I2W0 (Atomoxetine Hydrochloride)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170630
[St] Status:MEDLINE
[do] DOI:10.1176/appi.ajp.2017.16060686


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[PMID]:28658471
[Au] Autor:Lu Y; Sjölander A; Cederlöf M; D'Onofrio BM; Almqvist C; Larsson H; Lichtenstein P
[Ad] Endereço:Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden2Statistical Genetics, Genetics, and Computational Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
[Ti] Título:Association Between Medication Use and Performance on Higher Education Entrance Tests in Individuals With Attention-Deficit/Hyperactivity Disorder.
[So] Source:JAMA Psychiatry;74(8):815-822, 2017 Aug 01.
[Is] ISSN:2168-6238
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Individuals with attention-deficit/hyperactivity disorder (ADHD) are at greater risk for academic problems. Pharmacologic treatment is effective in reducing the core symptoms of ADHD, but it is unclear whether it helps to improve academic outcomes. Objective: To investigate the association between the use of ADHD medication and performance on higher education entrance tests in individuals with ADHD. Design, Setting, and Participants: This cohort study observed 61 640 individuals with a diagnosis of ADHD from January 1, 2006, to December 31, 2013. Records of their pharmacologic treatment were extracted from Swedish national registers along with data from the Swedish Scholastic Aptitude Test. Using a within-patient design, test scores when patients were taking medication for ADHD were compared with scores when they were not taking such medication. Data analysis was performed from November 24, 2015, to November 4, 2016. Exposures: Periods with and without ADHD medication use. Main Outcomes and Measures: Scores from the higher education entrance examination (score range, 1-200 points). Results: Among 930 individuals (493 males and 437 females; mean [SD] age, 22.2 [3.2] years) who had taken multiple entrance tests (n = 2524) and used ADHD medications intermittently, the test scores were a mean of 4.80 points higher (95% CI, 2.26-7.34; P < .001) during periods they were taking medication vs nonmedicated periods, after adjusting for age and practice effects. Similar associations between ADHD medication use and test scores were detected in sensitivity analyses. Conclusions and Relevance: Individuals with ADHD had higher scores on the higher education entrance tests during periods they were taking ADHD medication vs nonmedicated periods. These findings suggest that ADHD medications may help ameliorate educationally relevant outcomes in individuals with ADHD.
[Mh] Termos MeSH primário: Testes de Aptidão/estatística & dados numéricos
Cloridrato de Atomoxetina/farmacologia
Transtorno do Deficit de Atenção com Hiperatividade/psicologia
Estimulantes do Sistema Nervoso Central/farmacologia
Desempenho Psicomotor/efeitos dos fármacos
Sistema de Registros
[Mh] Termos MeSH secundário: Adulto
Cloridrato de Atomoxetina/uso terapêutico
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico
Estudos de Casos e Controles
Estimulantes do Sistema Nervoso Central/uso terapêutico
Feminino
Seres Humanos
Masculino
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Central Nervous System Stimulants); 57WVB6I2W0 (Atomoxetine Hydrochloride)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.1001/jamapsychiatry.2017.1472


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[PMID]:28445519
[Au] Autor:Warren CM; Wilson RC; van der Wee NJ; Giltay EJ; van Noorden MS; Cohen JD; Nieuwenhuis S
[Ad] Endereço:Institute of Psychology, Leiden University, Leiden, Netherlands.
[Ti] Título:The effect of atomoxetine on random and directed exploration in humans.
[So] Source:PLoS One;12(4):e0176034, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The adaptive regulation of the trade-off between pursuing a known reward (exploitation) and sampling lesser-known options in search of something better (exploration) is critical for optimal performance. Theory and recent empirical work suggest that humans use at least two strategies for solving this dilemma: a directed strategy in which choices are explicitly biased toward information seeking, and a random strategy in which decision noise leads to exploration by chance. Here we examined the hypothesis that random exploration is governed by the neuromodulatory locus coeruleus-norepinephrine system. We administered atomoxetine, a norepinephrine transporter blocker that increases extracellular levels of norepinephrine throughout the cortex, to 22 healthy human participants in a double-blind crossover design. We examined the effect of treatment on performance in a gambling task designed to produce distinct measures of directed exploration and random exploration. In line with our hypothesis we found an effect of atomoxetine on random, but not directed exploration. However, contrary to expectation, atomoxetine reduced rather than increased random exploration. We offer three potential explanations of our findings, involving the non-linear relationship between tonic NE and cognitive performance, the interaction of atomoxetine with other neuromodulators, and the possibility that atomoxetine affected phasic norepinephrine activity more so than tonic norepinephrine activity.
[Mh] Termos MeSH primário: Cloridrato de Atomoxetina/farmacologia
Comportamento de Escolha/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Cloridrato de Atomoxetina/sangue
Teorema de Bayes
Córtex Cerebral/efeitos dos fármacos
Córtex Cerebral/metabolismo
Comportamento de Escolha/fisiologia
Estudos Cross-Over
Método Duplo-Cego
Feminino
Jogo de Azar
Seres Humanos
Hidrocortisona/metabolismo
Masculino
Norepinefrina/metabolismo
Proteínas da Membrana Plasmática de Transporte de Norepinefrina/antagonistas & inibidores
Proteínas da Membrana Plasmática de Transporte de Norepinefrina/metabolismo
Efeito Placebo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Norepinephrine Plasma Membrane Transport Proteins); 57WVB6I2W0 (Atomoxetine Hydrochloride); WI4X0X7BPJ (Hydrocortisone); X4W3ENH1CV (Norepinephrine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0176034


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[PMID]:28371725
[Au] Autor:Stuhec M; Locatelli I
[Ad] Endereço:Department for Clinical Pharmacy, Ormoz Psychiatric Hospital, Ptujska 33, 9242 2270, Ormoz, Slovenia, European Union; Faculty of Pharmacy, University of Ljubljana, Askerceva cesta 7, SI-1000 Ljubljana, Slovenia, European Union. Electronic address: matejstuhec@gmail.com.
[Ti] Título:Age-related pharmacotherapy of attention deficit hyperactivity disorder in Slovenia in children and adolescents: A population-based study.
[So] Source:Eur Psychiatry;42:129-133, 2017 May.
[Is] ISSN:1778-3585
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There are no data on age-related pharmacotherapy for Attention Deficit Hyperactivity Disorder (ADHD) medication in children and adolescents in the most European countries. The main aim of this paper was to obtain that data for children and adolescents in Slovenia. METHOD: The number of ADHD drug prescriptions per patient was obtained from the health claims data on prescription drugs of the Health Insurance Institute of Slovenia for the study period (2003-2015). Three age groups were analyzed: 2-5 years, 6-12 years, and 13-17 years. Only immediate-release methylphenidate (IR-MPH), methylphenidate-osmotic release oral delivery system (OROS-MPH), and atomoxetine (ATX) were available and included in this study. RESULTS: Less than 50% of patients in Slovenia were treated with medication. The number of patients treated with MPH in the 6-12 age group remained approximately the same between 2007 and 2015 (604-729 patients). In the 13-17 age group, however that number increased 2-fold between 2003 and 2015, from 288 to 555. The number of patients treated with ATX in the 6-12 age group age group increased from 20 to 163 between 2007 and 2015. The number was similar in the 13-17 age group, increasing from 10 to 165 in the same period. In 2015, 21% of the patients from all age groups in this study were treated with ATX. CONCLUSIONS: The number of patients treated for ADHD increased rapidly in all age groups. Patients under the age of six are prescribed medication in Slovenia, which should be avoided.
[Mh] Termos MeSH primário: Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia
Estimulantes do Sistema Nervoso Central/uso terapêutico
Prescrições de Medicamentos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Cloridrato de Atomoxetina/uso terapêutico
Criança
Bases de Dados Factuais
Feminino
Seres Humanos
Masculino
Metilfenidato/uso terapêutico
Projetos de Pesquisa
Eslovênia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Central Nervous System Stimulants); 207ZZ9QZ49 (Methylphenidate); 57WVB6I2W0 (Atomoxetine Hydrochloride)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE


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[PMID]:28195837
[Au] Autor:Baykal S; Karakurt MN
[Ad] Endereço:*Department of Child and Adolescent Psychiatry, Faculty of Medicine, Namik Kemal University, Tekirdag; and †Department of Child and Adolescent Psychiatry, Samsun Mental Health Hospital, Samsun, Turkey.
[Ti] Título:The Effect of Atomoxetin Use in the Treatment of Attention-Deficit/Hyperactivity Disorder on the Symptoms of Restless Legs Syndrome: A Case Report.
[So] Source:Clin Neuropharmacol;40(2):93-94, 2017 Mar/Apr.
[Is] ISSN:1537-162X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Attention-deficit/hyperactivity disorder (ADHD) is frequently accompanied with sleep disorders such as obstructive sleep apnea, periodic limb movement disorder, restless legs syndrome (RLS), and circadian rhythm disorder. We have limited information about the effects of medical therapies used in the treatment of ADHD on RLS. This article discusses the effects of atomoxetine treatment on both disorders in a patient followed by diagnoses of ADHD and RLS.
[Mh] Termos MeSH primário: Cloridrato de Atomoxetina/uso terapêutico
Transtorno do Deficit de Atenção com Hiperatividade/complicações
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico
Síndrome das Pernas Inquietas/complicações
Síndrome das Pernas Inquietas/fisiopatologia
[Mh] Termos MeSH secundário: Inibidores da Captação Adrenérgica/uso terapêutico
Criança
Seres Humanos
Masculino
Síndrome das Pernas Inquietas/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenergic Uptake Inhibitors); 57WVB6I2W0 (Atomoxetine Hydrochloride)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170501
[Lr] Data última revisão:
170501
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170215
[St] Status:MEDLINE
[do] DOI:10.1097/WNF.0000000000000203


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[PMID]:28167075
[Au] Autor:Barygin OI; Nagaeva EI; Tikhonov DB; Belinskaya DA; Vanchakova NP; Shestakova NN
[Ad] Endereço:I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry RAS, Saint-Petersburg, Russia. Electronic address: Oleg_Barygin@mail.ru.
[Ti] Título:Inhibition of the NMDA and AMPA receptor channels by antidepressants and antipsychotics.
[So] Source:Brain Res;1660:58-66, 2017 Apr 01.
[Is] ISSN:1872-6240
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:It is known that some antidepressants and antipsychotics directly inhibit NMDA-type ionotropic glutamate receptors. In this study we systematically studied action of seven drugs (Fluoxetine, Citalopram, Desipramine, Amitriptyline, Atomoxetine, Chlorpromazine, and Clozapine) on NMDA receptors and Ca -permeable and -impermeable AMPA receptors in rat brain neurons by whole-cell patch-clamp technique. Except for weak effect of fluoxetine, all drugs were virtually inactive against Ca -impermeable AMPA receptors. Fluoxetine and desipramine significantly inhibited Ca -permeable AMPA receptors (IC =43±7 and 105±12µM, respectively). Desipramine, atomoxetine and chlorpromazine inhibited NMDA receptors in clinically relevant low micromolar concentrations, while citalopram had only weak effect. All tested medicines have been clustered into two groups by their action on NMDA receptors: desipramine, amitriptyline, chlorpromazine, and atomoxetine display voltage- and magnesium-dependent open channel blocking mechanism. Action of fluoxetine and clozapine was found to be voltage- and magnesium-independent. All voltage-dependent compounds could be trapped in closed NMDA receptor channels. Possible contribution of NMDA receptor inhibition by certain antidepressants and antipsychotics to their analgesic effects in neuropathic pain is discussed.
[Mh] Termos MeSH primário: Antidepressivos/farmacologia
Antipsicóticos/farmacologia
Encéfalo/efeitos dos fármacos
Neurônios/efeitos dos fármacos
Receptores de AMPA/antagonistas & inibidores
Receptores de N-Metil-D-Aspartato/antagonistas & inibidores
[Mh] Termos MeSH secundário: Amitriptilina/farmacologia
Animais
Cloridrato de Atomoxetina/farmacologia
Encéfalo/metabolismo
Clorpromazina/farmacologia
Citalopram/farmacologia
Desipramina/farmacologia
Relação Dose-Resposta a Droga
Avaliação Pré-Clínica de Medicamentos
Fluoxetina/farmacologia
Magnésio/metabolismo
Masculino
Potenciais da Membrana/efeitos dos fármacos
Potenciais da Membrana/fisiologia
N-Metilaspartato/farmacologia
Neurônios/metabolismo
Neurotransmissores/farmacologia
Ratos Wistar
Receptores de N-Metil-D-Aspartato/agonistas
Receptores de N-Metil-D-Aspartato/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidepressive Agents); 0 (Antipsychotic Agents); 0 (Neurotransmitter Agents); 0 (Receptors, AMPA); 0 (Receptors, N-Methyl-D-Aspartate); 01K63SUP8D (Fluoxetine); 0DHU5B8D6V (Citalopram); 1806D8D52K (Amitriptyline); 57WVB6I2W0 (Atomoxetine Hydrochloride); 6384-92-5 (N-Methylaspartate); I38ZP9992A (Magnesium); TG537D343B (Desipramine); U42B7VYA4P (Chlorpromazine)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170525
[Lr] Data última revisão:
170525
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170208
[St] Status:MEDLINE


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[PMID]:28092986
[Au] Autor:Hale GM; Valdes J; Brenner M
[Ad] Endereço:1 Nova Southeastern University College of Pharmacy, Palm Beach Gardens, FL, USA.
[Ti] Título:The Treatment of Primary Orthostatic Hypotension.
[So] Source:Ann Pharmacother;51(5):417-428, 2017 May.
[Is] ISSN:1542-6270
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To review the efficacy and safety of pharmacological and nonpharmacological strategies used to treat primary orthostatic hypotension (OH). DATA SOURCES: A literature review using PubMed and MEDLINE databases searching hypotension, non-pharmacological therapy, midodrine, droxidopa, pyridostigmine, fludrocortisone, atomoxetine, pseudoephedrine, and octreotide was performed. STUDY SELECTION AND DATA EXTRACTION: Randomized or observational studies, cohorts, case series, or case reports written in English between January 1970 and November 2016 that assessed primary OH treatment in adult patients were evaluated. DATA SYNTHESIS: Based on the chosen criteria, it was found that OH patients make up approximately 15% of all syncope patients, predominantly as a result of cardiovascular or neurological insults, or offending medication. Nonpharmacological strategies are the primary treatment, such as discontinuing offending medications, switching medication administration to bedtime, avoiding large carbohydrate-rich meals, limiting alcohol, maintaining adequate hydration, adding salt to diet, and so on. If these fail, pharmacotherapy can help ameliorate symptoms, including midodrine, droxidopa, fludrocortisone, pyridostigmine, atomoxetine, sympathomimetic agents, and octreotide. CONCLUSIONS: Midodrine and droxidopa possess the most evidence with respect to increasing blood pressure and alleviating symptoms. Pyridostigmine and fludrocortisone can be used in patients who fail to respond to these agents. Emerging evidence with low-dose atomoxetine is promising, especially in those with central autonomic failure, and may prove to be a viable alternative treatment option. Data surrounding other therapies such as sympathomimetic agents or octreotide are minimal. Medication management of primary OH should be guided by patient-specific factors, such as tolerability, adverse effects, and drug-drug and drug-disease interactions.
[Mh] Termos MeSH primário: Cloridrato de Atomoxetina/uso terapêutico
Pressão Sanguínea/efeitos dos fármacos
Droxidopa/uso terapêutico
Terapia por Exercício
Hipotensão Ortostática/tratamento farmacológico
Midodrina/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Cloridrato de Atomoxetina/administração & dosagem
Cloridrato de Atomoxetina/efeitos adversos
Ensaios Clínicos como Assunto
Relação Dose-Resposta a Droga
Droxidopa/administração & dosagem
Droxidopa/efeitos adversos
Interações Medicamentosas
Seres Humanos
Hipotensão Ortostática/induzido quimicamente
Midodrina/administração & dosagem
Midodrina/efeitos adversos
Postura
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
57WVB6I2W0 (Atomoxetine Hydrochloride); 6YE7PBM15H (Midodrine); J7A92W69L7 (Droxidopa)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170118
[St] Status:MEDLINE
[do] DOI:10.1177/1060028016689264


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[PMID]:28067776
[Au] Autor:Gahr M; Connemann BJ; Schönfeldt-Lecuona C; Zeiss R
[Ad] Endereço:Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany. maximilian.gahr@uni-ulm.de.
[Ti] Título:Sensitivity of Quantitative Signal Detection in Regards to Pharmacological Neuroenhancement.
[So] Source:Int J Mol Sci;18(1), 2017 Jan 05.
[Is] ISSN:1422-0067
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Pharmacological neuroenhancement (PNE) is a form of abuse and has not yet been addressed by methods of pharmacovigilance. In the present study, we tested if quantitative signal detection may be sensitive in regards to PNE. We evaluated the risk of drug abuse and dependence (DAAD) related to substances that are known to be used for PNE and divided this group into agents with (methylphenidate) and without a known abuse potential outside the field of PNE (atomoxetine, modafinil, acetylcholine esterase inhibitors, and memantine). Reporting odds ratios (RORs) were calculated using a case/non-case approach based on global and country-specific drug safety data from the Uppsala Monitoring Centre (UMC). Both control substances (diazepam and lorazepam) and methylphenidate were statistically associated with DAAD in all datasets (except methylphenidate in Italy). Modafinil was associated with DAAD in the total dataset (ROR, 2.7 (95% confidence interval (CI), 2.2-3.3)), Germany (ROR, 4.6 (95% CI, 1.8-11.5)), and the USA (ROR, 2.0 (95% CI, 1.6-2.5)). Atomoxetine was associated with DAAD in the total dataset (ROR, 1.3 (95% CI, 1.2-1.5)) and in the UK (ROR, 3.3 (95% CI, 1.8-6.1)). Apart from memantine, which was associated with DAAD in Germany (ROR, 1.8 (95% CI, 1.0-3.2)), no other antidementia drug was associated with DAAD. Quantitative signal detection is suitable to detect agents with a risk for DAAD. Its sensitivity regarding PNE is limited, although atomoxetine and modafinil, which do not have a known abuse potential outside PNE, and no antidementia drugs, whose use in PNE is presumably low, were associated with DAAD in our analysis.
[Mh] Termos MeSH primário: Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia
Metilfenidato/efeitos adversos
Farmacovigilância
[Mh] Termos MeSH secundário: Inibidores da Captação Adrenérgica/efeitos adversos
Cloridrato de Atomoxetina/efeitos adversos
Austrália/epidemiologia
Compostos Benzidrílicos/efeitos adversos
Canadá/epidemiologia
Estimulantes do Sistema Nervoso Central/efeitos adversos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/classificação
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia
Antagonistas de Aminoácidos Excitatórios/efeitos adversos
França/epidemiologia
Alemanha/epidemiologia
Seres Humanos
Itália/epidemiologia
Memantina/efeitos adversos
Espanha/epidemiologia
Transtornos Relacionados ao Uso de Substâncias/classificação
Transtornos Relacionados ao Uso de Substâncias/epidemiologia
Transtornos Relacionados ao Uso de Substâncias/etiologia
Reino Unido/epidemiologia
Estados Unidos/epidemiologia
Promotores da Vigília/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenergic Uptake Inhibitors); 0 (Benzhydryl Compounds); 0 (Central Nervous System Stimulants); 0 (Excitatory Amino Acid Antagonists); 0 (Wakefulness-Promoting Agents); 207ZZ9QZ49 (Methylphenidate); 57WVB6I2W0 (Atomoxetine Hydrochloride); R3UK8X3U3D (modafinil); W8O17SJF3T (Memantine)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170428
[Lr] Data última revisão:
170428
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170110
[St] Status:MEDLINE



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