83 results on '"Deheul, S."'
Search Results
2. B-300 Importance of Clinical Chemistry and Metabolism Parameters for the Management of Patient With Chronic Nitrous Oxide Intoxication
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Grzych, G, primary, Gernez, E, additional, Marchand, D, additional, Deheul, S, additional, Zerimech, F, additional, Masso, V, additional, Bennis, A, additional, Diesnis, R, additional, Joncquel, M, additional, Kim, I, additional, Niguet, J, additional, Guichard, J, additional, Girot, M, additional, and Tard, C, additional
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- 2023
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3. Intoxication au protoxyde d’azote : des consommations en augmentation aux conséquences lourdes
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Gernez, E., primary, Deheul, S., additional, Joncquel, M., additional, Tard, C., additional, Douillard, C., additional, and Grzych, G., additional
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- 2022
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4. L’acide méthylmalonique : un marqueur spécifique de l’intoxication chronique au protoxyde d’azote ?
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Grzych, G., primary, Gernez, E., additional, Deheul, S., additional, and Kim, I., additional
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- 2022
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5. Intoxication au protoxyde d’azote : des consommations en augmentation aux conséquences lourdes
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Gernez, E., Deheul, S., Joncquel, M., Tard, C., Douillard, C., and Grzych, G.
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- 2023
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6. Complications liées à l’usage de substances psychoactives chez les mineurs : analyse des profils via les données des centres français d’addictovigilance
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Batisse, A., Nogue, E., Daveluy, A., Fournier-Choma, C., Fouilhé Sam-Laï, N., Deheul, S., Chevallier, C., Lacroix, C., Gibaja, V., Aquizerate, A., Pain, S., Jouanjus, E., Picot, M.C., and Peyrière, H.
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- 2023
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7. Chemsex : point de vue de la toxicologie analytique
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Gish, A., Saint-Omer, A., Hakim, F., Grenier, C., Hennart, B., Lenski, M., Beauval, N., Wiart, J.-F., Richeval, C., Humbert, L., Deheul, S., Allorge, D., and Gaulier, J.-M.
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- 2023
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8. Que savons-nous de la toxicité récréative du protoxyde d’azote ? Une réponse des Hauts-de-France
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Deheul, S., primary, Béné, J., additional, Karam, A., additional, Gras, V., additional, Masmoudi, K., additional, Gautier, S., additional, Tard, C., additional, Hoornaert, O., additional, Lebouvier, T., additional, Simonin, C., additional, Ménard, O., additional, Caous, A.S., additional, Nisse, P., additional, Meguig, S., additional, Tison, J., additional, Azzouz, R., additional, and Carton, L., additional
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- 2021
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9. TDAH de l’adulte et troubles addictifs, vers l’identification d’un profil psychopathologique ?
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Carton, L., primary, Bastien, A., additional, Dondaine, T., additional, Deheul, S., additional, Bordet, R., additional, Cottencin, O., additional, Gautier, S., additional, and Ménard, O., additional
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- 2019
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10. Données cliniques et analytiques d’une intoxication involontaire par un cannabinoïde de synthèse (5F-ADB, ou 5F-MDMB-PINACA) présent dans un e-liquide
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Salle, S., primary, Sevestre, C., additional, Richeval, C., additional, Phanithavong, M., additional, Le Boisselier, R., additional, Humbert, L., additional, Wiart, J.-F., additional, Menard, O., additional, Deheul, S., additional, Allorge, D., additional, and Gaulier, J.-M., additional
- Published
- 2019
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11. New psychoactive substances: French addictovigilance data between 2009 and 2017
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Batisse, A., primary, Eiden, C., additional, Le Boisselier, R., additional, Tournebize, J., additional, Boucher, A., additional, Fauconneau, B., additional, Deheul, S., additional, Fouilhé, N., additional, Frauger, E., additional, Peyriere, H., additional, Djezzar, S., additional, Richard, N., additional, and Monzon, E., additional
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- 2019
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12. Identification des métabolites de la méthylènedioxy-α-pyrrolidinohexanophénone (MDPHP) et données de concentrations dans les poils corporels : à propos d’un cas d’intoxication d’un slameur
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Richeval, C., primary, Phanithavong, M., additional, Humbert, L., additional, Wiart, J.-F., additional, Deheul, S., additional, Baillieux, M., additional, Pawlak, G., additional, Allorge, D., additional, and Gaulier, J.-M., additional
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- 2019
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13. Prescriptions hors AMM supervisées de méthylphénidate dans le TDAH de l’adulte
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Carton, L., primary, Dondaine, T., additional, Deheul, S., additional, Marquié, C., additional, Brigadeau, F., additional, Amad, A., additional, Devos, D., additional, Danel, T., additional, Bordet, R., additional, Cottencin, O., additional, Gautier, S., additional, and Ménard, O., additional
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- 2019
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14. Cardiomyopathie de Takotsubo chez un consommateur régulier de 4-fluoroamphétamine
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Deheul, S., primary, Richeval, C., additional, Carton, L., additional, Caous, A.-S., additional, Humbert, L., additional, Wiart, J.-F., additional, Tison, J., additional, Allorge, D., additional, Puymirat, E., additional, and Gaulier, J.-M., additional
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- 2018
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15. La soumission chimique dans le Nord-Pas-de-Calais : état des lieux des cas de 2011 à 2015
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Caous, A.-S., primary, Carton, L., additional, Deheul, S., additional, Gaulier, J.-M., additional, Allorge, D., additional, Humbert, L., additional, Richeval, C., additional, Wiart, J.-F., additional, Locquet, L., additional, Garabédian, C., additional, Delannoy, Y., additional, Cornez, R., additional, Hédouin, V., additional, Marillier, M., additional, Djezzar, S., additional, and Bordet, R., additional
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- 2017
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16. « Purple drank » : un cocktail dangereux
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Deheul, S., primary, Wiart, J.-F., additional, Richeval, C., additional, Carton, L., additional, Caous, A.-S., additional, Humbert, L., additional, Allorge, D., additional, Reynaert, J.-C., additional, Morbidelli, P., additional, and Gaulier, J.-M., additional
- Published
- 2017
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17. Analyses capillaires d’un cas d’intoxication par la diphénidine et le 5-MeO-DALT fournissant des données sur les concentrations dans les cheveux de nombreux nouveaux produits de synthèse
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Wiart, J.-F., primary, Nachon-Phanithavong, M., additional, Richeval, C., additional, Vanhoye, X., additional, Caous, A.-S., additional, Carton, L., additional, Deheul, S., additional, Humbert, L., additional, Allorge, D., additional, and Gaulier, J.-M., additional
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- 2017
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18. Extensive levamisole-induced vasculitis
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Desvignes, C., primary, Becquart, C., additional, Launay, D., additional, Terriou, L., additional, Patenotre, P., additional, Deheul, S., additional, Peytavin, G., additional, Dupin, N., additional, Delaporte, E., additional, and Staumont-Sallé, D., additional
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- 2017
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19. Surdosage associant paracétamol et ibuprofène : comment interpréter la valeur de la paracétamolémie ?
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Nisse, P., primary, Deheul, S., additional, Garat, A., additional, Tison, J., additional, and Mathieu-Nolf, M., additional
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- 2016
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20. Apport d’une stratégie analytique combinant des approches in vitro, in silico et in vivo dans un cas de polyintoxication impliquant deux nouvelles drogues de synthèse
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Phanithavong, M., primary, Richeval, C., additional, Boumrah, Y., additional, Caous, A.-S., additional, Deheul, S., additional, Humbert, L., additional, and Allorge, D., additional
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- 2015
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21. Purpura vasculaire et abus de cocaïne : penser au lévamisole
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Desvignes, C.C., primary, Becquart, C., additional, Launay, D., additional, Azib, S., additional, Patenotre, P., additional, Deheul, S., additional, Peytavin, G., additional, Dupin, N., additional, Delaporte, E., additional, and Staumont-Sallé, D., additional
- Published
- 2014
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22. Factors associated with the use of benzodiazepine and opioid prescription drug in the student population: a cross-sectional study.
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Thomas C, Dondaine T, Caron C, Bastien A, Chérot N, Deheul S, Gautier S, Cottencin O, Moreau-Crépeaux S, Bordet R, and Carton L
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- Humans, Female, Male, Cross-Sectional Studies, Young Adult, Adult, Adolescent, Substance-Related Disorders epidemiology, Surveys and Questionnaires, France epidemiology, Prescription Drug Misuse statistics & numerical data, Prescription Drugs, Attention Deficit Disorder with Hyperactivity epidemiology, Benzodiazepines adverse effects, Benzodiazepines therapeutic use, Analgesics, Opioid adverse effects, Analgesics, Opioid therapeutic use, Students psychology
- Abstract
The misuse of benzodiazepines and opioid medications is frequent in students. To improve our understanding of this behavior, we aimed to identify factors associated with separate and concomitant use of these substances. Anonymous self-reported questionnaires were e-mailed to students enrolled at a French university between March and July 2021, covering: sociodemographic characteristics, academics, psychoactive substance use, ADHD symptomatology (adulthood and childhood), and psychiatric/psychological or addiction follow-up. Factors associated with the use of benzodiazepines and opioid medications included female sex (OR = 1.41 [1.08; 1.86]) and OR = 1.38 [1.06; 1.79], respectively), older age (OR = 1.65 [1.04; 2.6] and OR = 2.17 [1.4; 3.36], respectively), current psychiatric/psychological follow-up (OR = 6.53 [5.18; 8.24] and OR= 1.5 [1.12; 2.0], respectively), ADHD symptomatology (OR= 2.33 [1.71;3.16] and OR= 1.61 [1.15; 2.24], respectively), polyconsumption (tobacco use for benzodiazepine users, OR = 1.38 [1.04; 1.82]; alcohol use OR = 1.67 [1.17; 2.39] and tobacco use OR = 1.62 [1.23; 2.14] for opioid users). These factors were even more strongly associated with the concomitant use of benzodiazepines and opioid medications: older age (OR = 3.64 [2.22; 5.99]), female sex (OR = 1.54 [1.1; 2.14]), grade repetition (OR = 1.7 [1.14; 2.54]), psychiatric/psychological follow-up (OR = 4.51 [3.35;6.06]), ADHD symptomatology (OR = 5.3 [3.69; 7.63]), polyconsumption (tobacco use OR = 2.05 [1.39; 3] and cannabis use, OR = 2.07 [1.97; 4.16]. The factors associated with the use of benzodiazepines and prescription opioids identified in this study could lead to the development of targeted prevention methods., (© 2024. The Author(s).)
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- 2024
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23. Substance use disorder of equimolar oxygen-nitrous oxide mixture in French sickle-cell patients: results of the PHEDRE study.
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Gérardin M, Rousselet M, Couec ML, Masseau A, Aquizerate A, Authier N, Deheul S, Roussin A, Micallef J, Djezzar S, Feuillet F, Jolliet P, Grall-Bronnec M, and Victorri-Vigneau C
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- Humans, Analgesics therapeutic use, Nitrous Oxide therapeutic use, Nitrous Oxide adverse effects, Oxygen, Pain drug therapy, Anemia, Sickle Cell drug therapy, Substance-Related Disorders epidemiology, Substance-Related Disorders complications, Substance-Related Disorders drug therapy
- Abstract
Background: In many countries, nitrous oxide is used in a gas mixture (EMONO) for short-term analgesia. Cases of addiction, with significant misuse, have been reported in hospitalized patients. Patients suffering from sickle cell disease (SCD) could represent a high-risk population for substance use disorder (SUD) due to their significant pain crisis and repeated use of EMONO. The objective of the PHEDRE study was to assess the prevalence of SUD for EMONO in French SCD patients., Results: A total of 993 patients were included. Among 339 EMONO consumers, only 38 (11%) had a SUD, with very few criteria, corresponding mainly to a mild SUD due to a use higher than expected (in quantity or duration) and relational tensions with the care teams. Almost all patients (99.7%) were looking for an analgesic effect, but 68% of patients were also looking for other effects. The independent risks factors associated with at least one SUD criterion were: the feeling of effects different from the expected therapeutic effects of EMONO, at least one hospitalization for vaso occlusive crisis in the past 12 months and the presence of a SUD for at least one other analgesic drug., Conclusions: The use of EMONO was not problematic for the majority of patients. Manifestations of SUD that led to tensions with healthcare teams should alert and lead to an evaluation, to distinguish a true addiction from a pseudoaddiction which may be linked to an insufficient analgesic treatment related to an underestimation of pain in SCD patients., Trial Registration: Clinical Trials, NCT02580565. Registered 16 October 2015, https://clinicaltrials.gov/., (© 2024. The Author(s).)
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- 2024
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24. Ipomoea species, glorious but dangerous plants: A case-series.
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Huleux L, Lefebvre E, Azzouz R, Charuel L, Caous AS, Deheul S, Victorri-Vigneau C, Le Boisselier R, Bordet R, Thorigné S, and Carton L
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- 2024
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25. Could psychostimulant drug use among university students be related to ADHD symptoms? A preliminary study.
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Caron C, Dondaine T, Bastien A, Chérot N, Deheul S, Gautier S, Cottencin O, Moreau-Crépeaux S, Bordet R, and Carton L
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- Adult, Humans, Universities, Students, Attention Deficit Disorder with Hyperactivity epidemiology, Attention Deficit Disorder with Hyperactivity drug therapy, Central Nervous System Stimulants adverse effects, Substance-Related Disorders drug therapy
- Abstract
We aimed to explore if psychostimulant use among student could be linked to attention deficit-hyperactivity disorder (ADHD) symptoms using a self-administered questionnaire sent by email to French students in 2021. Participants were asked about their psychostimulant use and the presence of ADHD symptoms using the Wender Utah Rating Scale and the Adult Self-Report Scale. Among the 4431 respondents, the prevalence of psychostimulant use was concerning and significantly associated with ADHD symptoms. This association could be related to undiagnosed ADHD or to psychobehavioral impairments induced by psychostimulant use underlining the need of ADHD screening and targeted prevention measures., Competing Interests: Declaration of Competing Interest OC: speaker or chairman at industry symposia (Janssen, Recordati, Indivior) The other authors have no competing interest to disclose., (Copyright © 2023. Published by Elsevier B.V.)
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- 2024
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26. An overview of the use of psychoactive substances among students at the University of Lille during the COVID-19 health crisis: Results of the PETRA study.
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Carton L, Bastien A, Chérot N, Caron C, Deheul S, Cottencin O, Gautier S, Moreau-Crépeaux S, Dondaine T, and Bordet R
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- Humans, Analgesics, Opioid, Nitrous Oxide, Pandemics, Students, Benzodiazepines, N-Methyl-3,4-methylenedioxyamphetamine, COVID-19 epidemiology, Substance-Related Disorders epidemiology, Cocaine, Cannabis, Hallucinogens
- Abstract
Objectives: Students represent a population at risk for substance abuse. That risk may have been exacerbated by the COVID-19 pandemic. We aimed to describe substance abuse among students and to compare consumption according to the university field., Methods: A self-administered questionnaire was sent by email to all students at the University of Lille, France, between March and July 2021. This anonymous questionnaire included questions about sociodemographic characteristics, university courses and the use of psychoactive substances (frequency, reasons, routes of administration) since the first university year., Results: Among the 4431 students who responded (response rate 6.1%), eighty percent declared having used alcohol since the first university year, 34% cannabis, 15.4% benzodiazepines, 14.7% opioid drugs, 7.5% cocaine, 6.8% nitrous oxide and 6.5% MDMA. More than 20% of the users of cannabis, benzodiazepines, amphetamines and cocaine reported having already felt dependent. Recreational use was described by more than 10% of benzodiazepine or opioid drug users. Nitrous oxide use was significantly more frequent in the health and sport field ( p < 0.001). Tobacco, benzodiazepine, cannabis and MDMA uses were significantly more frequent in the humanities and social sciences/art, language and literature fields ( p < 0.001)., Conclusion: Prevention measures focusing on alcohol, cannabis, illicit psychostimulants, nitrous oxide and prescription drugs are required in the student population.
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- 2023
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27. [Nitrous oxide poisoning: Increasing consumption with serious consequences].
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Gernez E, Deheul S, Joncquel M, Tard C, Douillard C, and Grzych G
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- Humans, Nitrous Oxide, Drug-Related Side Effects and Adverse Reactions
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- 2023
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28. Comparison of biomarker for diagnosis of nitrous oxide abuse: challenge of cobalamin metabolic parameters, a retrospective study.
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Grzych G, Deheul S, Gernez E, Davion JB, Dobbelaere D, Carton L, Kim I, Guichard JC, Girot M, Humbert L, Bennis A, Joncquel M, Chieux V, Joly A, Nasserdine P, Trillot N, Douillard C, Pigny P, and Tard C
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- Humans, Vitamin B 12, Nitrous Oxide adverse effects, Retrospective Studies, Methylmalonic Acid, Biomarkers, Substance-Related Disorders complications, Vitamin B 12 Deficiency chemically induced, Vitamin B 12 Deficiency diagnosis
- Abstract
Background: Recreational use of nitrous oxide (N
2 O) leads to neurological disorders including combined subacute degeneration of spinal cord, psychological disorders, and thrombosis. Serum or urine N2 O assays could not be routinely performed. Hence, it is necessary to investigate other biological markers such as metabolic markers. We aimed here to challenge the three main biological markers used for the diagnosis of nitrous oxide abuse as total vitamin B12, homocysteine, and methylmalonic acid., Methods: We retrospectively collected clinical and biological data from 52 patients with known, documented chronic N2 O abuse and associated clinical signs (peripheral neuropathy disability score or thrombosis event). Sera and plasma total vitamin B12, methylmalonic acid (MMA), and homocysteine were performed to identify the most specific marker of chronic N2 O intoxication and related clinical outcomes., Results: Plasma homocysteine was almost consistently increased in case of N2 O chronic consumption, whereas MMA increase and total vitamin B12 decrease are not systematically found. Our results showed that none of the markers are correlated with levels of N2 O consumptions. However, homocysteine and MMA are correlated with clinical severity, but MMA seems to be a better marker of clinical severity., Conclusion: There is no specific marker of nitrous oxide abuse according to levels of consumption, total vitamin B12 decrease could not be used either as consumption or as severity marker. However, we showed that homocysteine is consistently increased and could be used as marker of recent N2 O consumption. On the other hand, we showed that MMA could be used as a marker of clinical gravity., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)- Published
- 2023
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29. Plasma Methionine and Clinical Severity in Nitrous Oxide Consumption.
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Gernez E, Deheul S, Tard C, Joncquel M, Douillard C, and Grzych G
- Abstract
In the last few years, there has been an increase in the recreational use of nitrous oxide (N2O), which can lead to neurological symptoms such as sensory or motor disorders. The literature links these symptoms to a functional inactivation of vitamin B12 by oxidation of its cobalt ion, which prevents the vitamin B12 from acting as a cofactor for methionine synthase. Thus, demyelination related to methionine deficiency could be responsible for the neurological disorders associated with N2O consumption, including the combined sclerosis of the spinal cord. We aimed to study the correlation between the plasma methionine levels and clinical severity observed in N2O users. We retrospectively collected clinical and biological data from 93 patients who chronically consumed N2O. The patients were divided into four groups based of the severity of their clinical symptoms (based on their Peripheral Neuropathy Disability (PND) score). The plasma amino acids measurement, including methionine, were performed systematically by liquid chromatography coupled with mass spectrometry. Plasma methionine is significantly correlated with the clinical severity (Spearman coefficient: −0.42; p-value < 10−5), however, the average methionine level in the four groups is within the physiological values (N: 16−23 µmol/L). There is a significant inverse correlation between plasma methionine and homocysteine (Spearman coefficient: −0.57; p-value < 10−9), which confirms the action of nitrous oxide on the methionine synthase. A decrease in plasma methionine cannot be imputed as the only mechanism involved in the pathophysiology of the neurological disorders in nitrous oxide consumption. In addition, there are few therapeutic indications for the use of methionine. Thus, we should be careful concerning the potential use of methionine in nitrous oxide consumption. As a consequence, other pathophysiological mechanisms probably need to be identified in order to find potential therapeutic targets.
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- 2022
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30. Myeloneuropathy induced by recreational nitrous oxide use with variable exposure levels.
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Largeau B, Karam A, Potey C, Caous AS, Tard C, Carton L, Kuchcinski G, Gautier S, Deheul S, and Bordet R
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- Adolescent, Adult, Ataxia, Female, Humans, Male, Nitrous Oxide adverse effects, Vitamin B 12 adverse effects, Young Adult, Nervous System Diseases, Peripheral Nervous System Diseases chemically induced, Substance-Related Disorders complications
- Abstract
Background and Purpose: Although several case series have described nitrous-oxide-associated neurological disorders, a comprehensive assessment of exposure characteristics (e.g., time to onset, level of exposure) in substance abusers has not been performed. The aim of this study was to describe the onset patterns of recreational use of nitrous-oxide-induced neurological disorders., Methods: All cases of neurological disorders related to nitrous oxide recreational use reported to the Hauts-de-France addictovigilance center between January 2019 and August 2020 were selected. Only cases requiring hospitalization with informative data to perform the nitrous oxide causality assessment were included., Results: A total of 20 cases from five hospitals were included. The male-to-female ratio was 6:1 and the median age was 19 years (range 16-34). The neurological presentation (myeloneuropathy 64%, 7/11; sensorimotor neuropathy 36%, 4/11) included for all patients gait disorders due to proprioceptive ataxia and limb hypoesthesia. The median dose used per occasion was 100 cartridges (range 5-960; n = 19). The median time from the start of nitrous oxide use to the onset of neurological symptoms was 6 months (range 0.7-54; n = 16). The cumulative dose was significantly higher in patients with damage to all four limbs than in patients with lower limb symptoms only (p = 0.042)., Conclusions: A low intermittent exposure may be sufficient to cause neurological damage in some subjects, suggesting that, at the population level, there is no safe exposure to nitrous oxide in recreational settings. The severity of neurological impairment could increase once used at high doses and for prolonged durations of nitrous oxide., (© 2022 European Academy of Neurology.)
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- 2022
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31. Biological markers and metabolic impact of chronic nitrous oxide consumption
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Grzych G, Deheul S, Davion JB, Lemonnier F, Dobbelaere D, Carton L, Kim I, Guichard JC, Girot M, Humbert L, Joly A, Douillard C, and Tard C
- Subjects
- Biomarkers, Humans, Nitrous Oxide adverse effects, Oxygen Consumption
- Published
- 2022
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32. Nitrous oxide abuse in the emergency practice, and Review of toxicity mechanisms and potential markers.
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Joncquel Chevalier-Curt M, Grzych G, Tard C, Lannoy J, Deheul S, Hanafi R, Douillard C, and Vamecq J
- Abstract
Nitrous oxide (N
2 O) toxicity is a concern common to several medical fields. Here, retrospective study of four N2 O abuses with neurological signs in the emergency practice provides a preliminary basis for a metabolic Discussion/Review. This latter highlights N2 O abuse as pathology of DNA/RNA/protein methylations, for instance consistent with impairments of protein arginine methyltransferases involved in myelinogenesis and myelopathy in patients. Basically, pathogenesis starts with oxidation by N2 O of coordinated cobalamine cobalt ions at enzyme sites with impairments of vitamin-B12-dependent pathways. Methionine synthase (methylcobalamine) and methymalonyl-CoA mutase (adenosylcobalamine) are inactivated and cofactor-depleted, respectively. The number of impacted pathways (folate cycle, methylation cycle, S-adenosylmethionine-dependent methyltransferases, transulfuration pathway, Krebs cycle fueling by methylmalonyl-CoA, glutathione synthesis) explains the variety of potential research/laboratory markers, and may provide new clues and future angles to explore N2 O toxicity. Overall, homocysteine measurements obviously help diagnosis of N2 O abuses. Additional markers may include vitamin-B12, methionine, methylmalonate, dimethylglycine, sarcosine, S-adenosylmethionine to S-adenosylhomocysteine ratio, various S-adenosylamino acids, S-adenosylmethionine-dependent cellular methylations, and additional analytes (propionylcarnitine, propionylglycine, cystathionine and derived metabolites, methylated amino acids [eg arginine], betaine)., (Copyright © 2022 Elsevier Ltd. All rights reserved.)- Published
- 2022
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33. Chemsex practice in France: An update in Addictovigilance data.
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Batisse A, Eiden C, Deheul S, Monzon E, Djezzar S, and Peyrière H
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- Adult, France epidemiology, Humans, Male, Middle Aged, Pharmacoepidemiology, Public Health, Surveys and Questionnaires, HIV Infections, Substance-Related Disorders epidemiology
- Abstract
Background: Complications related to Chemsex practice (consumption of psychoactive substances in sexual context) were first assessed by the French Addictovigilance Network in 2014. In response to the deaths reported in 2016, a new expert report was commissioned to update the complications and evolution of Chemsex-related practices in France., Methods: Between January 2008 and August 2017, all Chemsex cases collected through the French Addictovigilance Network's epidemiological tools were analyzed. Comparison of data between two periods (before and after 2014) was performed to assess the evolution of practices., Results: Over the entire survey period, 235 Chemsex cases were identified, all of them in men, with a mean ± SD age of 39 ± 11 years, including 24 deaths (10.2%). An increase in the number of reported cases was observed from one in 2008 to 50 in the first 8 months of 2017. The main medical histories include human immunodeficiency virus (HIV; 45%) and hepatitis C (20%) infections, and substance use disorders (36%). In those 235 cases, 345 psychoactive substances were identified, mainly cathinones. Polydrug use was reported in 75% of cases. The main complications were substance use disorders (63%), acute neurological or cardiovascular intoxications (50%), various psychiatric disorders (39%), and viral and bacterial infections (18%). γ-Butyrolactone (GBL) was present in 95% of comas. An increase in the number of deaths was observed during the survey period., Conclusion: The French Addictovigilance Network, via this pharmacoepidemiological surveillance, warns public health authorities in order to support harm reduction programs and the management of Chemsexers., (© 2021 Société Française de Pharmacologie et de Thérapeutique.)
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- 2022
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34. [Methylmalonic acid: Specific marker of chronic nitrous oxide abuse?]
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Grzych G, Gernez E, Deheul S, and Kim I
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- Humans, Nitrous Oxide adverse effects, Vitamin B 12, Methylmalonic Acid, Vitamin B 12 Deficiency
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- 2022
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35. Increase in pregabalin recreational use in adolescents in France.
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Dufayet L, Care W, Deheul S, Laborde-Casterot H, Nisse P, Langrand J, and Vodovar D
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- Adolescent, Adult, Age Factors, Child, Female, France epidemiology, Humans, Male, Risk Assessment, Risk Factors, Substance-Related Disorders diagnosis, Substance-Related Disorders psychology, Adolescent Behavior, Illicit Drugs, Pregabalin, Recreational Drug Use trends, Substance-Related Disorders epidemiology
- Abstract
Introduction: Misuse/abuse of pregabalin is increasing worldwide. French Poison Control Centers (PCCs) recently received several unusual calls regarding the recreational use of pregabalin in adolescents. This study aims to describe this new and specific population of pregabalin misusers., Methods: We extracted all cases of pregabalin intentional exposures reported to the French National Database of Poisonings (FNDP) from 2004 to 2020. We compared the proportion of recreational exposure to pregabalin between adolescents (10-17 years) and adults (>18 years). We reviewed all cases of pregabalin recreational exposures in adolescent in order to describe the characteristics of this population., Results: During the study period, 382 cases of acute intentional exposure to pregabalin were reported in adolescents and 1188 in adults, 94/382 (24.6%) and 43/1188 (3.6%) were pregabalin recreational use, respectively ( p < .0001). Almost all cases of pregabalin recreational use in adolescent were reported from 2018 (86/94; 91%). Most of those adolescent patients were males (male/female ratio - 5.3:1) and the median age was 15 years (range: 11-17.8). They were homeless or living in migrant shelters in most of the cases (73/90, 81%). Two-third of these exposures (62/94; 66%) involved other toxicant(s) than pregabalin. Most of the patients remains asymptomatic (10/94; 11%), or developed minor to moderate neurological symptoms (76/94; 81%). Eight developed severe symptoms (8/94; 8%) including coma (5/8) or generalized seizures (2/8). Five patients (5/8) required oro-tracheal intubation. No fatality was reported., Conclusions: We observed a sharp increase in pregabalin recreational use in adolescents in France. It should lead to prevention campaigns, targeted at the population at risk described in this study.
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- 2021
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36. Poppers Use and High Methaemoglobinaemia: 'Dangerous Liaisons'.
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Barrangou-Poueys-Darlas M, Gerardin M, Deheul S, Istvan M, Guerlais M, Fan, Jolliet P, Dejoie T, and Victorri-Vigneau C
- Abstract
Poppers are legal and largely used in France despite severe side effects, such as methaemoglobinaemia (MetHbia). Our work aimed to assess the prevalence of poppers consumers among patients with a MetHbia higher than or equal to 5% in French university hospitals and its evolution before and after the legalization of poppers in France. We conducted a national multicentre observational retrospective study. All patients for whom at least one MetHbia measurement was performed from 2012 to 2017 in university hospitals where the French addictovigilance network (FAN) is implanted were included. For each MetHbia measurement exceeding or equal to 5%, a return to the clinical file was made by the FAN to assess poppers consumption. We calculated the prevalence of MetHbia exceeding or equal to 5% and 25% and the prevalence of poppers consumption before and after the legalization. A total of 239 (0.14%) patients had a MetHbia level exceeding or equal to 5% with 25 (10.46%) cases of poppers consumption. Poppers consumption represented 68.4% (13 out of 19) of cases with MetHbia greater than or equal to 25%. Poppers consumption among patients with MetHbia exceeding or equal to 5% increased after the legalization from 4.76% to 11.67% (prevalence ratio PR = 2.45, 95% CI = [0.98-8.37], p -value = 0.190). The proportion of patients with a MetHbia level of 25% or more increased after the legalization from 4.76% to 8.63% (PR = 1.81, 95% CI = [0.68-6.82], p -value = 0.374). The use of poppers is very frequently reported by patients with MetHbia greater than or equal to 25%.
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- 2021
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37. Warning on increased serious health complications related to non-medical use of nitrous oxide.
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Micallef J, Mallaret M, Lapeyre-Mestre M, Daveluy A, Victorri-Vigneau C, Peyrière H, Debruyne D, Deheul S, Bordet R, Chevallier C, Perault-Pochat MC, Le Boisselier R, Libert F, Chaouachi L, and Gillet P
- Subjects
- Humans, Nitrous Oxide adverse effects
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- 2021
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38. Descriptive analysis of sickle cell patients living in France: The PHEDRE cross-sectional study.
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Gerardin M, Rousselet M, Couec ML, Masseau A, Guerlais M, Authier N, Deheul S, Roussin A, Micallef J, Djezzar S, Feuillet F, Jolliet P, and Victorri-Vigneau C
- Subjects
- Adolescent, Adult, Aged, Anemia, Sickle Cell complications, Anemia, Sickle Cell diagnosis, Anemia, Sickle Cell psychology, Child, Child, Preschool, Cross-Sectional Studies, Drug Prescriptions statistics & numerical data, Female, France epidemiology, Humans, Male, Middle Aged, Pain diagnosis, Pain etiology, Pain Management statistics & numerical data, Pain Measurement, Quality of Life, Severity of Illness Index, Treatment Outcome, Young Adult, Analgesics therapeutic use, Anemia, Sickle Cell drug therapy, Pain drug therapy, Pain Management methods, Psychotropic Drugs therapeutic use
- Abstract
Background: Sickle cell disease (SCD) induces chronic haemolytic anaemia and intermittent vaso-occlusion that results in tissue ischaemia causing acute, severe pain episodes that can lead to frequent hospitalizations. These consequences can have repercussions on family, social, school and/or professional life. Here, we present some of the results of the PHEDRE study (Pharmacodépendance Et DREpanocytose-drug dependence and sickle-cell disease), which is the largest study of patients with SCD in France. This paper intends to describe characteristics of the French SCD population. We also aimed to assess the impact of the disease on the lives of patients using objective and subjective variables., Methods: The PHEDRE study was a national multicentric observational study. Adults, adolescents and children with a confirmed SCD diagnosis were included in the study by their referring doctor. Then, they were interviewed by phone about their socioeconomic status, about the impact of the disease on their lives and about their analgesic and psychoactive drug use., Results: The study population consisted of 872 patients (28% were minors). Seventy-two percent of adults were active, and all minors were in school. Many patients presented criteria of severe SCD. Seventy-five percent were homozygous SS, 15% were double heterozygotes SC and 8% were heterozygotes Sβthal, 87% received specific treatment, 58% were hospitalized at least once for vaso-occlusive crisis in the past 12 months, and the number of analgesic drugs taken averaged 3.8. Seventy-five percent of patients reported academic or professional consequences related to their SCD, and 52% reported social consequences., Conclusions: The impact of SCD on patients' lives can be significant, nevertheless their social integration seems to be maintained. We highlighted respect of recommendations regarding analgesic treatments and only a few patients used tobacco, alcohol or cannabis., Trial Registration: Clinical Trials, NCT02580565; https://clinicaltrials.gov/ Registered 16 October 2015., Competing Interests: The authors have declared that no competing interests exist.
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- 2021
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39. Hair analysis can support the follow-up addiction care after acute New Psychoactive Substances intoxication: Illustration by two cases.
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Lagoutte-Renosi J, Richeval C, Phanithavong M, Wiart JF, Castex E, Vanhoy X, Hakim F, Deheul S, Tournebize J, Allorge D, and Gaulier JM
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- Adult, Drug-Related Side Effects and Adverse Reactions diagnosis, Follow-Up Studies, Hair chemistry, Humans, Male, Psychotropic Drugs toxicity, Substance-Related Disorders diagnosis, Drug-Related Side Effects and Adverse Reactions etiology, Hair Analysis methods, Psychotropic Drugs analysis, Substance-Related Disorders etiology
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- 2021
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40. Augmentation des complications sanitaires graves lors de l’usage non-médical du protoxyde d’azote en France.
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Micallef J, Mallaret M, Lapeyre-Mestre M, Daveluy A, Victorri-Vigneau C, Peyrière H, Debruyne D, Deheul S, Bordet R, Chevallier C, Perault-Pochat MC, Le Boisselier R, Libert F, Chaouachi L, and Gillet P
- Subjects
- France, Humans, Pharmacovigilance, Nitrous Oxide, Substance-Related Disorders
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- 2021
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41. Takotsubo cardiomyopathy as a consequence of 4-fluoroamphetamine Mono-intoxication documented by toxicological analyses.
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Aly SM, Deheul S, Puymirat E, Richeval C, Allorge D, and Gaulier JM
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- Adult, Amphetamine-Related Disorders diagnosis, Cardiovascular Agents therapeutic use, Humans, Male, Substance Abuse Detection, Takotsubo Cardiomyopathy diagnostic imaging, Takotsubo Cardiomyopathy drug therapy, Takotsubo Cardiomyopathy physiopathology, Treatment Outcome, Amphetamine-Related Disorders complications, Amphetamines poisoning, Central Nervous System Stimulants poisoning, Takotsubo Cardiomyopathy chemically induced, Ventricular Function, Left drug effects
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- 2021
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42. Acute Psychosis Related to Baclofen in a Patient Treated for Binge Eating Disorder Highlights the Urgent Need to Regulate Off-Label Prescriptions.
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Ricoux O, Carton L, Ménard O, Deheul S, Gautier S, Bordet R, and Cottencin O
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- Drug Prescriptions standards, France, Humans, Male, Middle Aged, Baclofen adverse effects, Binge-Eating Disorder drug therapy, GABA-B Receptor Agonists adverse effects, Off-Label Use legislation & jurisprudence, Psychoses, Substance-Induced etiology
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- 2019
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43. [Supervised off-label prescribing of methylphenidate in adult ADHD].
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Carton L, Dondaine T, Deheul S, Marquié C, Brigadeau F, Amad A, Devos D, Danel T, Bordet R, Cottencin O, Gautier S, and Ménard O
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- Adult, Central Nervous System Stimulants administration & dosage, Central Nervous System Stimulants adverse effects, Drug Prescriptions, Electrocardiography, Female, France, Humans, Male, Medication Therapy Management, Methylphenidate administration & dosage, Methylphenidate adverse effects, Neuropsychological Tests, Patient Care Team, Psychiatric Status Rating Scales, Referral and Consultation, Treatment Outcome, Attention Deficit Disorder with Hyperactivity drug therapy, Central Nervous System Stimulants therapeutic use, Methylphenidate therapeutic use, Off-Label Use
- Abstract
Objective: Off-label prescription is a common practice in psychiatry, raising health and economic concerns. Collegial consultation could allow a framed prescription of treatments that are not authorized in specific indications. Attention Deficit Hyperactivity in adult populations (ADHD) is a striking example of a pathology where off-label prescription is frequent. First considered to be a childhood disorder, the awareness of this condition in adults is increasing, leading to the development of new clinical practices and treatments. However, the adult ADHD diagnosis and its management are still emerging in France despite a high prevalence. Treatment of adult ADHD relies on methylphenidate prescription, but the initiation of this drug is not authorized in adult populations. Methylphenidate is a central nervous system stimulant that is structurally close to amphetamine and acts as a norepinephrine and dopamine reuptake inhibitor. Due to these pharmacological properties, neuropsychiatric and cardiovascular side-effects could occur. Furthermore, its addictive potential has led France to classify it as a psychoactive drug, dispensed via secured prescription. The first prescription and the one-year follow-up are restricted to neurologists, paediatrics, psychiatrists and sleep disorders specialists at hospital. The objective of this article is to propose a multidisciplinary framework for the off-label prescription of methylphenidate in adult ADHD., Methods: The Multidisciplinary Advice Consultation for Exceptional Addiction Treatments (Consultation d'Avis Multidisciplinaire de Traitements d'Exception en Addictologie CAMTEA) was first set up in Lille for the prescription of baclofen in alcohol dependence and was then extended to topiramate in binge eating disorder. This procedure has been adapted to the particularities of ADHD in adult populations, the differential diagnosis (bipolar disorder, depressive disorder, anxious disorder, personality disorder, substance use disorder) and the co-morbidities requiring a full psychiatric and neuropsychological assessment. Moreover, a particular attention has been paid to the monitoring of neuropsychiatric, cardiovascular and misuse risk because of the potential side-effects of methylphenidate., Results: The proposed prescription framework is structured into several specialized consultations. A first psychiatric evaluation aims to diagnose adult ADHD, using the French version of the Diagnostisch Interview Voor ADHD 2.0 questionnaire (DIVA 2.0), and to assess the quality of life impact with the Weiss Functional Inventory Rating Scale (WIFRS). It also searches for the presence of differential diagnosis or co-morbidities. The second appointment consists of a pharmacological evaluation that aims to search for contraindications and potential drug interaction. A neuropsychological evaluation based on standardized tests (Weschler Adulte Intelligence Scale [WAIS IV], Conner's Continuous Performance Test 3 [CPT] and the Minnesota Multiphasic Personnality Inventory [MMPI]) is also required to evaluate neurocognitive disabilities and personality features. Once the parameters of the different assessments have been collected, the synthesis is presented during a multidisciplinary meeting in order to assess the risk-benefit ratio for each patient. Several specialties are involved in this multidisciplinary meeting: psychiatry, addictology, general medicine, addictovigilance, pharmacovigilance and neuropsychology. One strategy among three possibilities can be decided: (1) contraindication to treatment with methylphenidate, (2) attention deficit disorder that does not require medication management, and (3) indication of treatment with methylphenidate with the choice of the pharmacological form (immediate or prolonged release). A biological check-up and an electrocardiogram are carried out systematically before any treatment. If the decision is made to initiate treatment, it is started at the lowest dosage and followed by a titration phase. A weekly follow-up is carried out during the titration phase in order to assess treatment efficacy and safety. After treatment stabilization, the general practitioner can carry out the renewal, and the patient will be reassessed within the framework of the multidisciplinary consultation every 3 months., Conclusion: When an off-label prescription is being considered, it must comply with the basic rules of good clinical practice, and the benefit/risk ratio should be constantly reassessed. The proposed multidisciplinary framework, adapted to the characteristics of adult ADHD and the pharmacological properties of methylphenidate, appears to be an interesting strategy to meet the requirements of the good clinical practice. The complementary assessments carried out and the collegial framework allow enhancing the patient's follow-up and minimize the drug risk, particularly in the psychiatric, addictive and cardiovascular adverse events. Finally, this framework could also help the monitoring of other off-label treatments for ADHD, such as atomoxetine or guanfacine., (Copyright © 2018 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)
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- 2019
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44. Detecting the diverted use of psychoactive drugs by adolescents and young adults: A pilot study.
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Jouanjus E, Falcou A, Deheul S, Roussin A, and Lapeyre-Mestre M
- Subjects
- Adolescent, Adult, Age Factors, Antitussive Agents adverse effects, Codeine adverse effects, Female, France, Humans, Ketamine adverse effects, Male, Pharmacies statistics & numerical data, Pharmacovigilance, Pilot Projects, Promethazine adverse effects, Sex Factors, Substance-Related Disorders epidemiology, Substance-Related Disorders etiology, Substance-Related Disorders prevention & control, Surveys and Questionnaires statistics & numerical data, Young Adult, Antitussive Agents chemistry, Nonprescription Drugs adverse effects, Prescription Drug Diversion prevention & control, Prescription Drugs adverse effects, Psychotropic Drugs adverse effects
- Abstract
Purpose: The increasing trend of diversion of nonprescription drugs (NPDs) by adolescents or young adults is worrying. We implemented this pilot study before a national investigation to identify requests for suspected recreational use of psychoactive drugs made by young subjects to community pharmacies., Methods: Thirty-eight French community pharmacies were asked to complete questionnaire (with age, gender of subjects; name, form, quantity of drugs) for each suspect request formulated by subjects under 26. Besides, pharmacists were asked about the regulatory measures they thought useful to decrease this diverted use by young people. Nineteen pharmacies participated. The study covered from December 12, 2016 to January 23, 2017., Results: Forty-one requests mentioning 51 drugs were reported. They concerned males (85%) aged 20 years old on average, including 6 minors. The most frequent age class was that comprised between 18 and 20 years old. Codeine-containing drugs (29 reports) and promethazine (17 reports), the main components of the popular cocktail "Purple drank," were the most requested, followed by dextromethorphan (3 reports). Fifteen drugs were requested in syrup form. One request concerned the prescription drug ketamine. Pharmacists suggested to schedule the concerned NPDs to prescription-only drugs and to increase the education of students as well as the public., Conclusions: Codeine and promethazine, the main components of the popular cocktail Purple drank, were the most requested. Suspect requests of psychoactive drugs made by adolescents or young adults in community pharmacies should be carefully surveyed and combined to the monitoring of falsified prescriptions., (© 2018 John Wiley & Sons, Ltd.)
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- 2018
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45. [Pharmaceutical cognitive doping in students: a chimeric way to get-a-head?]
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Carton L, Cabé N, Ménard O, Deheul S, Caous AS, Devos D, Cottencin O, and Bordet R
- Subjects
- Female, Humans, Illicit Drugs, Male, Pharmacoepidemiology, Prevalence, Universities, Young Adult, Nootropic Agents, Performance-Enhancing Substances, Students
- Abstract
For students, the pressing demands for memorization, top-level performance, and peer competition create an environment favorable for pharmaceutical cognitive doping behavior. We aimed to describe recent practices and the benefit / risk ratio of such behavior and to discuss the issues at stake. The prevalence of pharmaceutical cognitive doping among students has been reported from 1.3% to 33% across studies, with variations depending on country and definition of pharmaceutical cognitive doping. The therapeutic classes most frequently cited as being diverted for doping purposes are psychostimulants and nootropics (methylphenidate, modafinil, piracetam), corticosteroids, sedative drugs and beta-blockers. Some illegal substances such as cannabis, amphetamines and cocaine are also consumed in order to boost mental function. Finally, over-the-counter products, such as caffeine-based tablets or energy drinks, or alcohol, are also widely used by students whose motivations involve enhanced performance, concentration, memory, and staying awake during the revision and exam period. However, the expected (often fantasized) effectiveness of these products does not correspond to the reality of a modest controversial impact on cognitive performance. There appears to be an emerging profile of the student more inclined to doping behavior. Cognitive doping thus raises the question of its regulation, opening a debate opposing, on one hand, individual freedom and supposed collective benefits and, on the other hand, health consequences, educational (in)equality, and the risk of tarnished academic success. Strengthening school and university medicine, through prevention campaigns and the identification of subjects at risk, is essential to limit the extent, risk, and damages associated with such practices., (Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.)
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- 2018
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46. On-the-ground application of the 'temporary recommendation for use' regulatory measure on off-label use of baclofen for alcohol dependence in France: a regional survey of community pharmacies.
- Author
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Auffret M, Rolland B, Caous AS, Gaboriau L, Deheul S, Bordet R, and Gautier S
- Subjects
- Alcoholism diagnosis, Alcoholism physiopathology, Alcoholism psychology, Attitude of Health Personnel, Baclofen adverse effects, Drug Prescriptions, France, GABA-B Receptor Agonists adverse effects, Government Regulation, Health Care Surveys, Health Knowledge, Attitudes, Practice, Humans, Pharmacists, Policy Making, Practice Patterns, Physicians', Professional Role, Program Evaluation, Alcoholism drug therapy, Baclofen therapeutic use, Community Pharmacy Services legislation & jurisprudence, Drug and Narcotic Control legislation & jurisprudence, GABA-B Receptor Agonists therapeutic use, Off-Label Use legislation & jurisprudence
- Abstract
The 'temporary recommendation for use' (TRU) is a French novel regulatory measure for off-label drug. The first TRU to be issued by the French drug agency (in March 2014) pertained to the off-label use of baclofen for alcohol dependence (AD). We performed a questionnaire-based survey of the on-the-ground application of the baclofen TRU among community pharmacies in northern France. A pharmacist from 70 of the 219 pharmacies contacted (response rate: 32.0%) completed the questionnaire. The mean ± standard deviation number of off-label baclofen prescriptions for AD was 2.3 ± 2.2 per pharmacy per month. 65.2% of these prescriptions were issued by primary care physicians. 65.7% of the pharmacists had never seen 'TRU' written on the prescription, and 80.3% delivered a prescription without checking whether the patient had been included by the prescriber in the TRU. The main criterion used to identify off-label prescribing was the patient's medical history (according to 74.6% of pharmacists) and the prescription of an above-threshold dose (73.1%). 87.1% of the pharmacists were aware of the baclofen TRU, and 42.9% had actually read the document. 17.9% of the pharmacists estimated that the TRU had changed their attitude to off-label baclofen prescription, and 29.9% (20 out of 67) of them wanted to be more involved in the TRU process. Community pharmacists were well informed about the off-label use of baclofen for AD and the TRU. However, a majority of baclofen prescribers did not fulfill the TRU requirements while a majority of pharmacists did not exert any control over these off-label prescriptions. In practice, in 2015 the TRU measure had thus a limited impact on both the baclofen prescribing and delivery practices., (© 2017 Société Française de Pharmacologie et de Thérapeutique.)
- Published
- 2018
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47. The dose-effect relationship of baclofen in alcohol dependence: A 1-year cohort study.
- Author
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Pignon B, Labreuche J, Auffret M, Gautier S, Deheul S, Simioni N, Cottencin O, Bordet R, Duhamel A, and Rolland B
- Subjects
- Adult, Alcohol Drinking, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Humans, Male, Middle Aged, Proportional Hazards Models, Treatment Outcome, Alcohol Deterrents administration & dosage, Alcoholism drug therapy, Baclofen administration & dosage
- Abstract
Objective: Our aim is to study the relationship between dose of baclofen and effectiveness in alcohol dependence., Methods: Two hundred two patients with alcohol dependence, who received baclofen treatment for drinking reduction, were followed up for 1 year. For each patient-month of treatment, the maximum daily dose of baclofen (DDB) and average weekly alcohol consumption (AWAC) were calculated. We defined a favorable drinking outcome as an AWAC under 200 g/w for at least 2 consecutive months. We divided the DDB of each patient-month into 3 categories (low dose: <90 mg/d, medium dose: 90-150 mg/d, and high dose: >150 mg/d) and investigated the relationship between reaching a favorable outcome and the concurrent DDB category in a time-varying Cox regression analysis. Hazard ratios (HRs) were adjusted based on age, sex, and initial AWAC., Results: One hundred forty subjects were followed during at least 1 month. Of these patients, 58 (41%) had a favorable drinking outcome. In comparison to low dose, medium dose was associated with a decreased rate of favorable drinking outcome (HR = 0.42; 95% CI [0.20, 0.88]), whereas no difference was found with high dose (HR = 1.31; 95% CI [0.65, 2.64])., Conclusion: The relationship between dose of baclofen and favorable drinking outcome was U-shaped, that is, was increased at low and high doses compared to medium doses., (Copyright © 2017 John Wiley & Sons, Ltd.)
- Published
- 2017
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48. Authors' Reply to Alain Braillon's Comment on "Proactive regional pharmacovigilance system versus national spontaneous reporting for collecting safety data on concerning off-label prescribing practices: An example with baclofen and alcohol dependence in France''.
- Author
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Auffret M, Labreuche J, Duhamel A, Deheul S, Cottencin O, Bordet R, Gautier S, and Rolland B
- Subjects
- Adverse Drug Reaction Reporting Systems, France, Humans, Off-Label Use, Pharmacovigilance, Alcoholism, Baclofen
- Published
- 2017
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49. Proactive Regional Pharmacovigilance System Versus National Spontaneous Reporting for Collecting Safety Data on Concerning Off-Label Prescribing Practices: An Example with Baclofen and Alcohol Dependence in France.
- Author
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Auffret M, Labreuche J, Duhamel A, Deheul S, Cottencin O, Bordet R, Gautier S, and Rolland B
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Baclofen administration & dosage, Databases, Factual, Female, France, GABA-B Receptor Agonists administration & dosage, GABA-B Receptor Agonists adverse effects, Humans, Male, Middle Aged, Off-Label Use, Young Adult, Adverse Drug Reaction Reporting Systems statistics & numerical data, Alcoholism drug therapy, Baclofen adverse effects, Pharmacovigilance
- Abstract
Introduction: Off-label prescribing (OLP) may raise serious safety concerns that traditional spontaneous reporting of adverse drug reactions (ADRs) may not identify in a timely manner. In France, the 'Multidisciplinary Consultation Service for Off-Label Prescribing in Addiction Medicine' (CAMTEA) is a proactive regional system established to identify ADRs associated with the OLP of baclofen for alcohol dependence., Objective: The aim was to demonstrate, using the French pharmacovigilance database (FPVD), that CAMTEA allowed for the reporting of a substantial amount of ADRs, comparable in nature to those provided via spontaneous reporting., Method: The 2012-2013 FPVD notifications associated with baclofen OLP were extracted. The ten most frequent types of ADRs among 'serious' and 'non-serious' reports were listed. The frequency of each type of ADR was compared between CAMTEA and spontaneous reporting, and the magnitudes of the differences were assessed using standardized differences., Results: A total of 428 baclofen reports (1043 ADRs) were identified, among which 221 (51.64%) originated from CAMTEA. The ten most frequent ADRs in 'serious' reports were (1) confusion (17.3%), (2) seizures (11.5%), (3) drowsiness/sedation (11.5%), (4) agitation (10.9%), (5) coma (9.6%), (6) hallucinations (7.7%), (7) falls (7.1%), (8) behavioral disorders (5.8%), (9) withdrawal syndrome (5.1%), and (10) space-time disorientation (5.1%). A standardized difference of <0.2 was identified for six out of the ten most frequent 'serious' ADRs, and eight of the ten 'non-serious' ADRs., Conclusion: A proactive regional pharmacovigilance system could collect a substantial amount of safety data on a specific OLP practice. The profile of the ADRs collected was similar to that seen in the nationwide spontaneous reporting system.
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- 2017
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50. Phone-based safety monitoring of the first year of baclofen treatment for alcohol use disorder: the BACLOPHONE cohort study protocol.
- Author
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Rolland B, Auffret M, Labreuche J, Lapeyre-Mestre M, Dib M, Kemkem A, Grit I, Drelon M, Duhamel A, Cabe N, Vabret F, Guillin O, Baguet A, Masquelier C, Dervaux A, Deheul S, Bordet R, Carton L, Cottencin O, Jardri R, and Gautier S
- Subjects
- Alcohol Drinking prevention & control, Algorithms, Baclofen administration & dosage, Cohort Studies, Drug Monitoring methods, Follow-Up Studies, France, GABA-B Receptor Agonists administration & dosage, Humans, Off-Label Use, Prospective Studies, Surveys and Questionnaires, Alcoholism drug therapy, Baclofen adverse effects, GABA-B Receptor Agonists adverse effects, Telephone
- Abstract
Background: In France, baclofen is frequently used off-label for alcohol use disorder (AUD). Baclofen has been associated with diverse adverse events (AEs), but the causality of these AEs has never been properly assessed., Methods/design: BACLOPHONE is a prospective multicenter cohort study conducted in the Hauts-de-France and Normandie French regions. BACLOPHONE consists of the phone-based monitoring of 792 patients during their first year of baclofen treatment for AUD. Two initial phone interviews assess the medical history, current medications, and substance use as well as complete the alcohol use identification test (AUDIT) and severity of alcohol dependence questionnaire (SADQ). Daily alcohol use and baclofen doses are noted throughout the follow-up. For every reported AE, additional phone interviews determine the seriousness of the AE, the causality of baclofen using validated causality algorithms, and the final outcome. The main objective of the study is to determine the rate of patients who stop baclofen due to an AE during the first year of treatment., Discussion: BACLOPHONE will provide important safety data on baclofen as a complement to the forthcoming efficacy data of randomized clinical trials.
- Published
- 2017
- Full Text
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