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Objectives: Before drawing conclusions on the contribution of an effective intervention to daily practice and initiating dissemination, its quality and implementation in daily practice should be optimal. The aim of this process evaluation was to study these aspects alongside a randomized controlled trial investigating the effects of a multidisciplinary biannual medication review in long-term care organizations (NTR3569).Design: Process evaluation with multiple measurements.Setting: Thirteen units for people with dementia in six long-term care organizations in the Netherlands.Participants: Physicians, pharmacists, and nursing staff of participating units.Intervention: The PROPER intervention is a structured and biannually repeated multidisciplinary medication review supported by organizational preparation and education, evaluation, and guidance.Measurements: Web-based questionnaires, interviews, attendance lists of education sessions, medication reviews and evaluation meetings, minutes, evaluation, and registration forms.Results: Participation rates in education sessions (95%), medication reviews (95%), and evaluation meetings (82%) were high. The intervention's relevance and feasibility and applied implementation strategies were highly rated. However, the education sessions and conversations during medication reviews were too pharmacologically oriented for several nursing staff members. Identified barriers to implementation were required time, investment, planning issues, and high staff turnover; facilitators were the positive attitude of professionals toward the intervention, the support of higher management, and the appointment of a local implementation coordinator.Conclusion: Implementation was successful. The commitment of both higher management and professionals was an important factor. This may partly have been due to the subject being topical; Dutch long-term-care organizations are pressed to lower inappropriate psychotropic drug use. [ABSTRACT FROM AUTHOR]

Copyright of Bulletin of Legal Medicine / Adli Tıp Bülteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Cannabis products (marijuana, weed, hashish) are among the most widely abused psychoactive drugs in the world, due to their euphorigenic and anxiolytic properties. Recently, hair analysis is of great interest in analytical, clinical, and forensic sciences due to its non-invasiveness, negligible risk of infection and tampering, facile storage, and a wider window of detection. Hair analysis is now widely accepted as evidence in courts around the world. Hair analysis is very feasible to complement saliva, blood tests, and urinalysis. In this review, we have focused on state of the art in hair analysis of cannabis with particular attention to hair sample preparation for cannabis analysis involving pulverization, extraction and screening techniques followed by confirmatory tests (e.g., GC–MS and LC–MS/MS). We have reviewed the literature for the past 10 years’ period with special emphasis on cannabis quantification using mass spectrometry. The pros and cons of all the published methods have also been discussed along with the prospective future of cannabis analysis.

Raphaële Bachtarzi,1 Anne Sophie Boureau,1 Charlotte Mascart,1 Eric Batard,2,3 Emmanuel Montassier,2,3 Pascale Bémer,2,4 Céline Bourigault,2 Gilles Berrut,1 Laure de Decker,1,2 Guillaume Chapelet1,21Centre Hospitalier Universitaire de Nantes, Clinical Gerontology Department, Nantes F-44000, France; 2Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance bacterienne), Institut de Recherche en Santé (IRS2), Nantes F-44200, France; 3Centre Hospitalier Universitaire de Nantes, Emergency Department, Nantes F-44000, France; 4Centre Hospitalier Universitaire de Nantes, Bacteriology Department, Nantes F-44000, FranceBackground: The worldwide dissemination of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has become a major health concern. Previous studies have shown that psychoactive drugs have intrinsic antimicrobial activity and may play a role in the dissemination of antibiotic resistance. The objective of this study was to assess the association between prescriptions for psychoactive drug and urine colonization with ESBL-producing Enterobacteriaceae.Subjects: Ninety-five patients were included; 19 cases (urine colonization with an ESBL-producing Enterobacteriaceae) and 76 controls (urine colonization with non ESBL-producing Enterobacteriaceae); and were matched for age and gender.Methods: A retrospective 1:4 matched case–control study design was used. All patients colonized with an Enterobacteriaceae isolate in Nantes University Hospital from March to November 2014, were screened before inclusion in the study. Prescriptions data for psychoactive drugs were collected from the electronic medical records. Univariate and multivariate conditional logistic regression analyses were performed.Results: Thirty-seven patients (38.9%) were treated with psychoactive drugs, of whom 10 (52.6%) were in the ESBL-producing group and 27 (35.5%) were in the non-ESBL group. Mean (SD) age was 71.2 (23.1) years. In multivariate analyses, previous antimicrobial therapy within 6 months (OR=7.12, 95% CI 1.15–44.18; p=0.035) and previous colonization with an ESBL-producing organism (OR=44.87, 95% CI 1.26–1594.19; p=0.037) were associated with urine colonization with ESBL-producing Enterobacteriaceae.Conclusions: Our findings revealed that a history of previous antimicrobial therapy and previous colonization with ESBL-producing organisms are important risk factors in an elderly population. Psychoactive drugs were not associated with urinary carriage of ESBL-producing Enterobacteriaceae. Further studies are required to explore the relationship between psychoactive drugs and colonization with ESBL-producing Enterobacteriaceae.Keywords: ESBL, psychoactive drugs, antimicrobial resistance, elderly

BackgroundA common screening instrument for substance use disorders (SUDs) is the Drug Use Disorders Identification Test (DUDIT) which includes a short form regarding only drug consumption (DUDIT-C). We aim to assess if a German version of the DUDIT, adapted for adolescents, is a suitable screening instrument in a sample of adolescent psychiatric patients.MethodsN = 124 (54 female) German adolescent (M = 15.6 + 1.5 years) psychiatric patients completed the DUDIT and received a diagnostic interview (MINI-KID) assessing DSM-5 SUD criteria. A confirmatory factor analysis (CFA), receiver operating characteristic (ROC) curves, the area under the curve (AUC), and Youden’s Index were calculated.ResultsA two-factor model of the DUDIT shows the best model fit (CFI = 0.995, SRMR = 0.055, RMSEA = 0.059, WRMR = 0.603). The DUDIT as well as the DUDIT-C show high diagnostic accuracy, with AUC = 0.95 and AUC = 0.88, respectively. For the DUDIT a cut-off value of 8.5 was optimal (sensitivity = 0.93, specificity = 0.91, J = 0.84), while for the DUDIT-C the optimal cut-off value was at 1.5 (sensitivity = 0.86, specificity = 0.84, J = 0.70).ConclusionThis is the first psychometric evaluation of the DUDIT in German, adolescent psychiatric outpatients, using the DSM-5 diagnostic criteria. The DUDIT as well as the DUDIT-C are well suited for use in this population. Since in our sample only few patients presented with a mild or moderate SUD, our results need to be replicated in a sample of adolescents with mild SUD.

Predator-inducible defenses constitute a widespread form of adaptive phenotypic plasticity, and such defenses have recently been suggested linked with the neuroendocrine system. The neuroendocrine system is a target of endocrine disruptors, such as psychoactive pharmaceuticals, which are common aquatic contaminants. We hypothesized that exposure to an antidepressant pollutant, fluoxetine, influences the physiological stress response in our model species, crucian carp, affecting its behavioral and morphological responses to predation threat. We examined short- and long-term effects of fluoxetine and predator exposure on behavior and morphology in crucian carp. Seventeen days of exposure to a high dose of fluoxetine (100 µg/L) resulted in a shyer phenotype, regardless of the presence/absence of a pike predator, but this effect disappeared after long-term exposure. Fluoxetine effects on morphological plasticity were context-dependent as a low dose (1 µg/L) only influenced crucian carp body shape in pike presence. A high dose of fluoxetine strongly influenced body shape regardless of predator treatment. Our results highlight that environmental pollution by pharmaceuticals could disrupt physiological regulation of ecologically important inducible defenses. [ABSTRACT FROM AUTHOR]

"Plants of the Gods" is a term referring to the religious meaning members of many primitive cultures worldwide attribute to plants containing hallucinogenic or mind-altering substances. The plants are customarily considered sacred and consumed in religious rituals in an attempt to reach and communicate with gods or revered ancestors. They are frequently used in healing rites. Occasionally, they are used for purely recreational purposes, this being their main use in the modern societies of both industrialized and underdeveloped nations. However, it must be noted that the hallucinogenic or psychedelic experiences, recreational, are not always euphoric. Plants of the Gods: Their Sacred, Healing, and Hallucinogenic Powers is well-written, fully illustrated with color photographs, and contains a good index. It is an effective compilation of ethnographic, historic, and neuropharmacologic information on the hallucinogenic plants of planet Earth and the psychological and sociological impact they have, particularly in primitive societies. The behavioral side effects and toxic manifestations that may be associated with transient or permanent neurological deficits or psychiatric conditions place them in the realm of neuropsychiatry, when affected individuals present to the emergency room or are referred for medical consultation. [ABSTRACT FROM AUTHOR]

Background: A common screening instrument for substance use disorders (SUDs) is the Drug Use Disorders Identification Test (DUDIT) which includes a short form regarding only drug consumption (DUDIT-C). We aim to assess if a German version of the DUDIT, adapted for adolescents, is a suitable screening instrument in a sample of adolescent psychiatric patients. Methods: N = 124 (54 female) German adolescent (M = 15.6 + 1.5 years) psychiatric patients completed the DUDIT and received a diagnostic interview (MINI-KID) assessing DSM-5 SUD criteria. A confirmatory factor analysis (CFA), receiver operating characteristic (ROC) curves, the area under the curve (AUC), and Youden's Index were calculated. Results: A two-factor model of the DUDIT shows the best model fit (CFI = 0.995, SRMR = 0.055, RMSEA = 0.059, WRMR = 0.603). The DUDIT as well as the DUDIT-C show high diagnostic accuracy, with AUC = 0.95 and AUC = 0.88, respectively. For the DUDIT a cut-off value of 8.5 was optimal (sensitivity = 0.93, specificity = 0.91, J = 0.84), while for the DUDIT-C the optimal cut-off value was at 1.5 (sensitivity = 0.86, specificity = 0.84, J = 0.70). Conclusion: This is the first psychometric evaluation of the DUDIT in German, adolescent psychiatric outpatients, using the DSM-5 diagnostic criteria. The DUDIT as well as the DUDIT-C are well suited for use in this population. Since in our sample only few patients presented with a mild or moderate SUD, our results need to be replicated in a sample of adolescents with mild SUD. [ABSTRACT FROM AUTHOR]

To investigate the actions of lithium, valproate, lamotrigine and quetiapine on bioenergetic pathways in cultured NT2-N neuronal-like cells and C8-B4 microglial cells. NT2-N and C8-B4 cells were cultured and treated with lithium (2.5 mM), valproate (0.5 mM), quetiapine (0.05 mM) or lamotrigine (0.05 mM) for 24 hours. Gene expression and the mitochondrial bioenergetic profile were measured in both cell lines. In NT2-N cells, valproate increased oxidative phosphorylation (OXPHOS) gene expression, mitochondrial uncoupling and maximal respiratory capacity, while quetiapine decreased OXPHOS gene expression and respiration linked to ATP turnover, as well as decreasing the expression of genes in the citric acid cycle. Lamotrigine decreased OXPHOS gene expression but had no effect on respiration, while lithium reduced the expression of genes in the citric acid cycle. In C8-B4 cells, valproate and lithium increased OXPHOS gene expression, and valproate increased basal respiratory rate and maximal and spare respiratory capacities. In contrast, quetiapine significantly reduced basal respiratory rate and maximal and spare respiratory capacities. Overall our data suggest that some drugs used to treat neuropsychiatric and affective disorders have actions on a range of cellular bioenergetic processes, which could impact their effects in patients. [ABSTRACT FROM AUTHOR]

Orthostatic hypotension (OH) is defined as an abnormal blood pressure reduction when standing and is frequently diagnosed in older adults. Pharmacological therapy is one of the main causes of orthostatic blood pressure impairment, leading to iatrogenic OH. Indeed, several medications may induce hypotensive effects and influence the blood pressure response to orthostatism. Hypotensive medications may also overlap with other determinants of OH, thus increasing the burden of symptoms and the risk of complications. Potentially hypotensive medications include both cardiovascular and psychoactive drugs, which are frequently prescribed in older patients. According to the available evidence, the antihypertensive treatment “per se” does not seem to predispose to OH, even if a higher risk is associated with polypharmacy and drug classes such as with diuretics and vasodilators. As concerns psychoactive medications, OH is a well-known adverse effect of tricyclic antidepressants, trazodone and antipsychotics. The knowledge of hemodynamic consequences of drug therapy may be helpful to improve OH treatment. A medication review is advisable in all patients presenting with OH, particularly at advanced age, aiming at optimizing medical treatment with a view to minimize the risk of iatrogenic OH.

Introduction: Psychoactive drug is a worrisome and emerging global problem. This is a disturbing matter, especially in the case of medical students, as it affects not only their health and academic performance alone but their clinical efficiency as well. This study aims to determine the prevalence of psychoactive drug use among medical students in a medical college in Nepal. Methods: A descriptive cross-sectional study was conducted after receiving ethical clearance from the Institutional Review Committee (Ref: 258/19) among undergraduate medical students from December 2019 to June 2020. Convenience sampling was used to collect data. Data analysis was done in the Statistical Package for Social Sciences. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: The prevalence of psychoactive drug abuse was found to be 76 (44.2%) [CI= 43.6%–44.8%]. The study showed males 59 (59%) were more indulged in abuse than females 17 (23.6%). Alcohol 72 (41.86%) was the most commonly used, then was tobacco 24 (13.95%) followed by cannabis 17(9.88%). Only two students were sedative and opioid abusers. Pleasure 38 (31.70%) and experimentation 29 (24.20%) were the two major causes of substance abuse. Tobacco was used more frequently 14 (58.33%) used daily and found to have more financial and health-related issues in the last three months. Conclusions: Even almost half of the students were using some form of psychoactive drugs, the majority of them were occasional users. Proper counseling needs to be done to address this problem. Further study should be conducted to address the influencing factors and adverse outcomes.

Background Human aging is a universal and regular process characterized by uneven and steady progression, inevitably affecting to some extent all levels of biological organization. In the structure of acute exotoxicosis, patients of gerontological age range from 10.3 to 12.9%. After 60, with an increase of years, there is a growth of mortality rate from 9.8% in elderly patients to 25.5% in long-livers. A certain role in its genesis is played by the premorbid background, i.e. somatic diseases preceding and accompanying acute exotoxicosis.Aim of study To identify the role of concomitant diseases in the course and outcome of acute poisoning by psychoactive drugs in patients over 60. MATErIALS AnD METhODS We retrospectively analyzed hospital records of 99 patients aged 60 to 90 years who died from poisoning with psychoactive drugs at the N.V. Sklifosovsky Research Institute for Emergency Medicine in 2013–2016, as well as their autopsy, forensic and histological research data.Results In gerontological patients with acute poisoning with psychoactive drugs, the main premorbid background (100%) is atherosclerotic lesion of the heart and vessels of different degree and extent. In case of lethal outcomes, in toxicogenic stage of poisoning on primary electrocardiograms, myocardial ischemia was revealed in 76.9% of cases, heart rhythm disturbances were detected in all patients, most often in the form of supraventricular extrasystoles (38.4%) and atrial fibrillation (23.1%). In the deceased patients during the somatogenic stage of poisoning, cardiac conduction disorders (31.3%) prevailed. Concomitant chronic lesions of the bronchopulmonary system, including terminal bronchi, contributed to the development of hypostatic pneumonia and its long, migratory course. In 50% of cases, large and small droplet fatty liver disease was detected, which could have a negative effect on the course of poisoning, altering biotransformation of toxicants.Conclusion Atherosclerotic lesion of the heart and vessels, as well as chronic bronchopulmonary disease and fatty liver disease are the main premorbid background factors, which have a negative effect on the course and outcome of acute poisoning with psychoactive drugs.

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Antidepressants, antiepileptics, mood stabilizers, and antipsychotics are extremely broadly used psychoactive drugs. These drug terms are universally used in the literature. However, the indications of these drugs have broadened substantially and overlap. The mismatch between drug classification and clinical uses causes a lot of confusion in communication and renders literature searches increasingly difficult. Therefore, we propose to drop the above terms altogether and replace them by simple mechanistic terms. Antidepressants are re-named as norepinephrine/serotonin (NE/5-HT) enhancers, antiepileptics comprising drugs with different mechanisms become neuronal inhibitors with pleiotropic effects (NIPEs), and antipsychotics become antagonists at multiple G protein–coupled receptors (mGPCR antagonists). Alkali metal ions, comprising lithium, are integrated into NIPEs. The terms "typical/first-generation/conventional" and "atypical/second-generation/non-conventional" antipsychotics should be dropped, because the original criterion for distinction, i.e., the presence and absence of extrapyramidal motor effects, respectively, is not valid anymore. The suggested changes in drug nomenclature have already been implemented into a recent textbook (Seifert R, Basic Knowledge of Pharmacology). The revised nomenclature ensures consistency with other fields of pharmacology and assignment of drug classes to indications without causing confusion. The authors acknowledge that the change in drug nomenclature is a cultural process that will take time and openly discuss the problems associated with the proposal. Ultimately, international learned societies will have to agree on a new nomenclature. [ABSTRACT FROM AUTHOR]

Specific absorbance (A¦) is defined as the maximum absorbance of a 1% solution over a 1-cm path length measured via spectroscopy. Finding a reliable value for specific absorbance for a drug provides an important tool for the quantitative verification of concentration of analytical standards. Although many new drugs have emerged within the last ten years, many either do not have a reliable value for A¦, or a value simply has never been published. This work focused on determining the quantitative value of the specific absorbance of six psychoactive drugs using ultraviolet-visible spectroscopy, as well as comparing A¦ values of drugs purchased in 2017 to A¦ of their counterparts purchased in 2019. The drugs analyzed included Iloperidone, Risperidone, Aripiprazole, Vilazodone, Vortioxetine and Suvorexant. [ABSTRACT FROM AUTHOR]

The paper presents literary and original data on the problems of falling for elderly patients. The relationship between the occurrence of a fall and the initiation of drug therapy with a known negative effect on the risk of falling is considered. Data on the frequency and structure of falls by patients with cardiovascular diseases over the age of 75 who received treatment at a multidisciplinary hospital are presented. The data analysis showed a tendency of fall prevalence: a fall was observed in 33.8% of patients in the first 5 days of the hospital stay. This may be associated with a high drug burden and the prescription of new drugs to the patient. The study noted that the therapy was chosen on the first day. Additional drugs were often prescribed, which led to the polypharmacy state. Analysis of individual groups of drugs allowed reliable confirmation of the relationship between the prescription of drugs that increase the fall risk and occurrence in relation to the ophthalmic form of β-blockers (p = 0.04). Polypharmacy as a risk factor of falling in gerontological patients, which was described in the scientific literature, also confirmed the negative effect in our study. Thus, patients who are newly administered drugs known to have negative effect on fall development can be attributed to the risk group for falling. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Data on the relationship between fall and psychoactive drug use among Turkish older people are limited. This study aims to investigate the prevalence of falls and the associations between psychoactive drug use and falls in communitydwelling Turkish older people. METHODS: This single center study was performed using the medical records of subjects aged over 65 years admitted to the geriatric care unit. Demographic and lifestyle factors, clinical characteristics, medications, and data on mood, cognitive status, and functional performance were obtained from the comprehensive geriatric assessment records. Based on a fall history in the last 12 months, subjects were grouped as fallers and non-fallers. Subjects treated with a psychoactive drug were identified. RESULTS: Among the total of 429 subjects, there were 184 (42.9%) fallers and 245 (57.1%) non-fallers. Of those, 33.3% were on psychoactive drug treatment. The proportion of psychoactive drug users was higher in the fallers group compared to non-fallers (45.1% vs. 24.5%, p<0.001). Multivariable logistic regression analysis showed age =75 years (OR=1.83; CI: 1.09-3.09; p=0.023), female gender (OR=2.70; CI: 1.6-4.50; p<0.001), and psychoactive drug use (OR=2.14; CI: 1.32- 3.48; p=0.002) as independent predictors of falls. CONCLUSION: We found that about one-third of geriatric outpatients were on psychoactive drug treatment in Turkey that was independently associated with the risk of falls. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the neurotoxicity of psychoactive abused 2,5-dimethoxy-substituted phenethylamines "2C series" in monoaminergic neurons. Methods: After the exposure to "2C series", 2,5-dimethoxy-4-propylthiophenethylamine (2C-T-7), 2,5-dimethoxy-4-isopropylthiophenethylamine (2C-T-4), 2,5-dimethoxy-4-ethylthiophenthylamine (2C-T-2), 2,5-dimethoxy-4-iodophenethylamine (2C-I) or 2,5-dimethoxy-4-chlorophenethylamine (2C-C), we examined their neurotoxicity, morphological changes, and effects of concomitant exposure to 3,4-methylenedioxymethamphetamine (MDMA) or methamphetamine (METH), using cultured neuronal dopaminergic CATH.a cells and serotonin-containing B65 cells. Results: Single dose exposure to "2C series" for 24 h showed significant cytotoxicity as increase in lactate dehydrogenase (LDH) release from both monoaminergic neurons: 2C-T-7, 2C-C (EC50; 100 µM) > 2C-T-2 (150 µM), 2C-T-4 (200 µM) > 2C-I (250 µM) in CATH.a cells and 2C-T-7, 2C-I (150 µM) > 2C-T-2 (250 µM) > 2C-C, 2C-T-4 (300 µM) in B65 cells. The "2C series"-induced neurotoxicity in both cells was higher than that of MDMA or METH (EC50: ≥ 1–2 mM). In addition, apoptotic morphological changes were observed at relatively lower concentrations of "2C series". The concomitant exposure to non-toxic dose of MDMA or METH synergistically enhanced 2C series drugs-induced LDH release and apoptotic changes in B65 cells, but to a lesser extent in CATH.a cells. In addition, the lower dose of 2C-T-7, 2C-T-2 or 2C-I promoted reactive oxygen species production in the mitochondria of B65 cells, even at the early stages (3 h) without apparent morphological changes. Conclusion: The 2,5-dimethoxy-substitution of "2C series" induced severe neurotoxicity in both dopaminergic and serotonin-containing neurons. The non-toxic dose of MDMA or METH synergistically enhanced its neurotoxicity in serotonergic neurons. [ABSTRACT FROM AUTHOR]

Rationale, aims, and objectives: Falls are among the major problems occurring in hospital setting, when drugs are viewed as important modifiable risk factor of falling. The aim was to analyse the effect of pharmacotherapy on the risk of falls in hospitalized patients. Methods: A multicentre prospective case‐control study was conducted in 2017 retrieving data from four hospitals in South Bohemia, Czech Republic. An online database was constructed to collect patient and fall‐related data. Each fall that occurred during hospitalization was assigned to appropriate controls (no fall during hospitalization) based on gender, age, length of hospitalization, and the number of drugs. Univariate and multivariate correlations were performed with a significance level of P <.05. Results: A total of 222 fall cases (107 males; median age, 81 y) and 1076 controls (516 males; median age, 80 y) were included. According to the first ATC level classification, drugs from groups S, N, and P were significantly associated with fall‐related risk compared with controls (P <.05); further analysis of ATC levels showed that only psycholeptics (N05), antipsychotics (N05A), and tiapride were significantly associated with falls. Regression analysis revealed use of psycholeptics N05 (OR = 2.06; 95% CI, 1.56‐2.76), or ophthalmologicals S01 (OR = 2.72; 95% CI, 1.37‐5.41), as factors with the highest fall‐related risk. Conclusions: Apart from the commonly considered fall‐risk increasing drugs, other groups, such as ophthalmologicals, should also be considered; however, regarding clinical practice, it is difficult to evaluate the effects of individual drugs in the context of other risk factors of falls, due to the multifactorial nature of falls. [ABSTRACT FROM AUTHOR]

Individuals who use anabolic-androgenic steroids (AAS) may engage in concurrent psychoactive drug use recreationally and/or as an additional training aid. Aside from cannabis, individuals who use AAS most commonly report concurrent use of stimulants such as amphetamines and cocaine. In this study, we examine demographic characteristics, frequency of heavy drinking, and nightclubbing in a sample of 993 men from the Global Drug Survey 2015 who reported both AAS and psychoactive drug use before exploring the relationship between motivation for AAS use and the propensity to concurrently engage with stimulant-type substances. Results of a logistic regression analysis suggest that the propensity for concurrent use of AAS and stimulants is greater when AAS use is motivated by weight loss goals, while performance goals are associated with reduced odds of concurrent stimulant use. Identifying individuals who are at risk of polydrug use and associated harms can inform targeted harm reduction strategies. [ABSTRACT FROM AUTHOR]

Objective: The abuse of psychoactive drugs and addiction to them have been a growing problem in the world. Article 188/6 of the Turkish Criminal Code numbered 5237 states 'The provisions of this article shall apply to any substance whose production is subject to the approval of official authorities or whose sales is subject to the prescription issued by the authorized physician, and to other substances causes a narcotic or stimulant effect. However, the imposed penalty can be reduced to half.' and warrants a penalty, indicating that such drugs will be considered in the context of 'narcotic drugs' in case of an abuse. The aim of this study was to investigate the types and frequency of psychoactive drug abuse cases which reflected to the judicial authorities in Turkey. Methods: The files that have been examined by the 5th Specialization Committee of the Turkish Council of Forensic Medicine between January 01st 2012 and January 01st 2019, within the scope of Article 188/6 of the Turkish Criminal Code numbered 5237, were reviewed in this study. The files were evaluated in respect to the distribution of the abused drugs, other narcotic substances detected with these drugs, drug forms and quantities. Results: A total of 1710 reports were examined in the study. The most frequently abused drug group was benzodiazepines, and the most frequently abused members were clonazepam, diazepam and alprazolam. Pregabalin, gabapentin, buprenorphine and quetiapine were the other drugs that took the first place in terms of abuse frequency. The most common narcotic substances detected with drugs were cannabis, synthetic cannabinoids and methylenedioxymethamphetamine. Buprenorphine and pregabalin were the most seized drugs at the crime scenes and on the suspects. Gabapentin was the one encountered most in the biological samples. Discussion: In the light of the data obtained, it can be said that the abused drug profiles may change over time and these changes may be affected by foreign currents. In order to reduce drug abuse, strict follow-up of psychoactive drug prescriptions, attention of the clinicians to the indications, dosage and usage of the drugs that may be abused, a detailed medical investigation of the patients' medical histories, briefing of the patients about the drugs with the potential for addiction, increasing the penalties on the persons who possess such drugs by prescription and then sell them on the streets, and detection and monitoring of the toxicity and death data related to psychoactive drugs are essential in fighting against drugs on a scientific basis. [ABSTRACT FROM AUTHOR]

Introduction: Immunoassays are the 1st stage of clinical and forensic toxicology examinations. The aim of the research was to evaluate the suitability of CEDIA (cloned enzyme donor immmunoassay) for the detection of selected drugs such as amphetamine, tetrahydrocannabinol (THC) metabolite: tetrahydrocanabinolic acid (11-nor-9-carboxy- 9-tetrahydrocannabinol - THC-COOH). Materials and methods: Blood samples were examined for the presence of the selected psychoactive drugs, similar in effect to alcohol. Whole blood samples were centrifuged, and the obtained plasma was analysed using CEDIA and LC-MS/MS. Results: We observed a strong correlation between amphetamine levels measured with CEDIA and the reference technique (LC-MS/MS), and a lack correlation for THC-COOH levels. Cloned enzyme donor immmunoassay did not provide false positive results - positive samples in CEDIA were also positive in LC-MS/MS, which demonstrated the high specificity of CEDIA. Conclusions: Considering the high specificity in tests for amphetamine and cannabinoids, CEDIA can be used as a qualitative method in forensic and clinical analysis. This study demonstrates a linearity only for amphetamine detection, which may suggest the need for further verification of the results of other assays offered by the manufacturer. Only serum/plasma can be analysed with CEDIA, which makes this technique unsuitable for highly degraded samples. [ABSTRACT FROM AUTHOR]

The authors aim to shed light on the pathways for recovery from problematic use of psychoactive substances when a psychoactive substance turns out to be, paradoxically, the medicine. Keywords: psychedelic; ritual; ayahuasca; plant medicine; psychoactive drugs EN psychedelic ritual ayahuasca plant medicine psychoactive drugs 1 3 3 12/08/21 20211203 NES 211203 The Research Topic here presented is based on first-hand clinical experiences and ethnographic and observational fieldwork studies on practices used or inspired by traditional medicines related in particular to the so-called psychedelics; these are substances known to trigger non-ordinary states of consciousness, which are currently getting more attention in medicine as reflected by the increase in clinical research and a shift in attitude and opinion among public spheres. [Extracted from the article]

Determination of psychoactive substances (PAS) and/or their metabolites in surface waters is crucial for environmental risk assessment, and disclosure of their enantiomeric fractions (EF) allows discrimination between consumption, direct disposal, and synthesis pathways. The aim of this study was to develop and validate an indirect method by gas chromatography coupled to mass spectrometry (GC–MS) based on derivatization using (R)-(−)-α-methoxy-α-(trifluoromethyl) phenylacetyl chloride as chiral derivatization reagent, for enantiomeric quantification of amphetamine (AMP), methamphetamine (MAMP), 3,4-methylenedioxymethamphetamine (MDMA), norketamine, buphedrone (BPD), butylone, 3,4-dimethylmethcathinone (3,4-DMMC), 3-methylmethcathinone, and quantification of 1-benzylpiperazine and 1-(4-metoxyphenyl)-piperazine. The method allowed to evaluate the occurrence, spatial distribution, and the EF of the target chiral PAS in Portuguese surface waters and in effluents from 2 wastewater treatment plants (WWTP). For that, water samples were pre-concentrated by solid phase extraction using OASIS® MCX cartridges, derivatized and further analyzed by GC–MS. Both enantiomers of AMP, (R)-MDMA, (S)-MAMP, and the first eluted enantiomer of BPD (configuration not assigned) were found in surface waters, while effluent samples showed both enantiomers of MDMA, (S)-MAMP, (R)-AMP, and the first eluted enantiomer of BPD and 3,4-DMMC. According to our knowledge, this is the first multiresidue analytical method by CG–MS enrolling cathinones, amphetamines, and piperazines. The presence of illicit synthetic cathinones in Douro River estuary is here reported for the first time, along with other amphetamine derivatives. The potential of the method to monitor consumption of the target PAS was demonstrated.

Tina Hovgaard Lützen,1 Bodil Hammer Bech,2 Jesper Mehlsen,3 Claus Høstrup Vestergaard,1 Lene Wulff Krogsgaard,1 Jørn Olsen,4 Mogens Vestergaard,1 Oleguer Plana-Ripoll,5 Dorte Rytter2 1Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark; 2Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark; 3Coordinating Research Centre, Frederiksberg Hospital, Frederiksberg, Denmark, 4Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark; 5National Center for Register-based Research, Aarhus University, Aarhus V, Denmark Aim: No association between human papilloma virus (HPV) vaccination and numerous diseases has been found. Still, a large number of Danish women are reporting suspected adverse events. Other factors may play a role, and the aim of this study is to examine the association between psychiatric conditions, general practitioner (GP) attendance and indicators of psychological symptoms prior to HPV vaccination and the risk of referral to an HPV center following vaccination. Study design and setting: Register-based, matched case–control study. Cases were identified from five Danish, regional HPV centers, and health data for cases and controls were obtained from national registries. Participants: Cases were defined as women referred to an HPV center between January 1, 2015 and December 31, 2015 (n=1,496). Each case was matched with five controls on age, region and time of first vaccine registration. The total study population consisted of 8,976 women. Results: Overall, women above 18 years who had been referred to an HPV center were more likely to have used psychiatric medication (odds ratio [OR]: 1.88 [95% CI 1.48–2.40]) or to have been hospitalized because of a psychiatric disorder within 5 years prior to the first vaccine registration (OR: 2.13 [95% CI 1.59–2.86]). Specifically, referred women were more likely to have used antipsychotics, antidepressants, attention deficit hyperactivity disorder (ADHD) medication or anxiolytics, and to have been hospitalized for affective disorders or anxiety, but not to have been hospitalized for schizoid, ADHD or eating disorders. In addition, they were more likely to have had talk therapy or psychometric test performed prior to vaccination (OR: 1.72 [95% CI 0.1.35–2.18] and OR: 1.67 [95% CI 1.30–2.13], respectively). Referred women of all ages had higher use of GP before vaccination. Population attributable fraction analyses indicated that psychiatric medication, hospitalization due to a psychiatric disorder and use of talk therapy, or psychometric test “explained” 13%, 10%, 12% and 11% of the referrals, respectively. Results did not change substantially when adjusted for potential confounders. Conclusion: Women referred to HPV centers because of suspected adverse events after vaccination more often had preexisting psychiatric conditions, psychological symptoms or frequent GP attendance prior to HPV vaccination. Keywords: papillomavirus vaccines, adverse drug events, psychoactive drugs, general practice

Synthetic cannabinoids which is a subgroup of cannabinoids are commonly used for recreational drug use throughout the whole world. Although both marijuana and synthetic cannabinoids stimulate the same receptors, cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2), studies have shown that synthetic cannabinoids are much more potent than marijuana. The longer use of synthetic cannabinoids can cause severe physical and psychological symptoms that might even result in death, similar to many known illicit drugs. Main treatment options mostly involve symptom management and supportive care. The aim of this article is to discuss clinical and pharmacological properties of the increasingly used synthetic cannabinoids. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(3.000): 317-328]

The main objective for this article is to explore how users of psychoactive drugs experience time and the role psychoactive drugs play in the management and construction of time. The data in this study consists of different kinds of written documents such as anecdotal accounts and scientific articles and reports which was collected using a purposeful sampling technique. One important result is that time is experienced and constructed differently among users of legal drugs compared to users of illegal drugs. The use of heroin is for example associated with shrinking time-horizons and being afraid of looking back and looking ahead, while smoking cigarettes is correlated with killing chronological time and instituting a parenthesis in normative time. Another conclusion is that users of illegal drugs experience greater problems synchronizing social and subjective time compared to users of legal substances. The results of my study also suggest that drug users´ experiences of time are intertwined with the social context and social meanings of drug use.

Pruritus is a frequent complaint both in dermatology and general medicine. This burdensome symptom has a complex and multifactorial pathogenesis, with the key involvement of central nervous system in its development. Psychoactive drugs (psychopharmaceuticals) encompass several therapeutic groups utilized mainly in psychiatry. However, these drugs are occasionally used in dermatological practice and may contribute to alleviation of pruritus in a variety of cutaneous and extracutaneous disorders. This review article summarizes the role of H1‐antihistamines, antidepressants, antipsychotics and antiepileptics in managing pruritus. [ABSTRACT FROM AUTHOR]

A number of cross-sectional studies report extensive use of psychiatric services and high healthcare costs in autistic youths. However, little is known about how the use of these services evolves from the time of diagnosis, as children grow up. Our objectives were to investigate the use, costs, and predictors of psychiatric services following autism spectrum diagnosis. We built a cohort of 1227 newly diagnosed autism spectrum individuals identified in the Quebec (Canada) Régie de l'assurance maladie du Québec administrative database (January 1998 to December 2010). Mean number and cost per individual of psychiatric healthcare use (hospitalizations, medical visits, psychoactive drug use) were calculated yearly for 5 years following autism spectrum diagnosis. Mean number of psychiatric visits decreased over time by more than threefold (7.5 vs 2.1 visits) from year 1 to year 5, whereas psychoactive drug use increased from 16.0 to 25.2 claims. Psychiatric hospitalizations decreased during follow-up, but still represented the greatest costs per individual (CAD9820 for year 1; CAD4628 for year 5). Antipsychotics represented over 50% of drug costs. Mixed-effect model with repeated measures showed that previous psychoactive drug use was the strongest predictor of greater psychiatric healthcare cost during follow-up (odds ratio: 9.96; 95% confidence interval: 7.58–13.10). These trends contrast with guidelines advocating cautious prescribing of antipsychotics with periodical re-assessment of their benefit. [ABSTRACT FROM AUTHOR]

This study investigates barriers to utilization of drug abuse treatment by female street sex workers in Nigeria. Twenty-seven (n = 27) street sex workers were recruited through venue-based snow-ball sampling. In-depth, individual interviews were conducted, and transcripts were subjected to thematic, inductive and data-driven analysis. Sex workers use psychoactive drugs to manage the hazards of street sex work, including guilt, stigma, and violence. While a few denied drug-related harms, doubted treatment efficacy and evinced self-efficacy in managing drug problems, the majority of sex workers recognized drug-related harms and the need for treatment. Inadequate information on services, financial and time cost of treatment, fear of police arrest, stigma and lack of male partner support posed as barriers to drug abuse treatment. Social and structural barriers to treatment utilization violate sex workers' rights to health and exacerbate drug-related harms. Findings highlight the need for changes in policy and societal perceptions of sex work, and multi-level, rights-based interventions to remove barriers to drug abuse treatment for female street sex workers. [ABSTRACT FROM AUTHOR]

Driving under the influence of alcohol and/or psychoactive substances increases the risk of severe, even fatal motor vehicle accidents. The aim of this descriptive study was to present the impact of alcohol and/or psychoactive substances on fatal road traffic accidents (RTAs) during the period 2011–2017. For this purpose, the toxicological investigation reports from the Department of Forensic Medicine and Toxicology of the University of Athens were used. In total, 1,841 (32.2%) of the autopsies conducted by the Department of Forensic Medicine and Toxicology of the National and Kapodistrian University of Athens over a 7-year period (2011–2017) were victims of fatal RTAs. Blood and urine samples were collected and analyzed for the presence of alcohol and psychoactive substances. The results were classified according to sex, age, victim (car driver, motorcyclist, pedestrian, or passenger) and the date the accident occurred (day, month and year). In total, 40.7% of the RTA-related fatalities were associated with alcohol consumption, among which 20.3% were car drivers. Of these, 87.3% were male victims. A higher frequency of RTA-related fatalities associated with a blood alcohol concentration (BAC) >110 mg/dl was encountered in younger compared with older age groups. Psychoactive substances were detected in 348 (18.9%) of the victims (cannabis in 46.6% of these, benzodiazepines in 25.9%, opiates in 16.4% and cocaine in 11.1% of these). The percentage of the RTA-related victims that had consumed alcohol in combination with other psychoactive substances was 4.5%. On the whole, the findings of this study suggest that alcohol and psychoactive substances are probably risk factors for RTA-related fatalities. [ABSTRACT FROM AUTHOR]

Background: Survey data on adolescent drug use trends have limitations evaluating the impact of drug use on health and may lag current trends. The objective was to describe National Poison Data System (NPDS) trends, medical outcomes, and healthcare encounters from adolescent exposures of traditional and novel psychoactive drugs.Methods: Retrospective review of adolescent (10-18 years of age) exposure calls to all U.S. poison centers, from January 1, 2007 through December 31, 2017, using generic codes for traditional and novel psychoactive drugs. Descriptive statistics and univariate Poisson regression modeling were used for analysis.Results: There were 49,757 exposure calls for the included psychoactive drugs. The median age was 16 years (IQR 15,17), 64% were male, and the majority were evaluated in a healthcare facility (92%). Marijuana had the most exposure calls (36.6%), followed by synthetic cannabinoids (e.g., spice; 21.3%). There were 181 (<1%) deaths; the highest fatality rates were from fentanyl, 2C drugs (phenylethylamine derivatives), and heroin. LSD exposure calls have had the most significant increase over the past 10 years.Conclusion: U.S. Poison Centers reported almost 50,000 exposure calls and 181 deaths over 10 years for adolescent exposures of both traditional and novel psychoactive drugs, demonstrating the significant health impact on this vulnerable population. Opioids and 2C drugs contributed to the highest mortality rates, moderate/major symptoms and healthcare utilization, and LSD had the most significant increase in calls. Multi-source surveillance methodology is critical in understanding the public health impact on drug abuse in the adolescent population. [ABSTRACT FROM AUTHOR]

Phenibut is a neuropsychotropic drug that was discovered in Russia. Chemically, it is known as β-phenyl-γ-aminobutyric acid (GABA). It is available in powdered and capsule form. It has anxiolytic and nootropic effects. It acts as a GABA-mimetic, primarily at GABA G and, to some extent, at GABAA receptors. It also stimulates dopamine and antagonizes β-phenylethylamine, a putative endogenous anxiogenic. Phenibut is widely used in Russia to relieve tension, anxiety, and fear, to improve sleep in psychosomatic or neurotic patients or regular individuals with insomnia, as well as a pre- or post-operative medication. It is also used in therapy of disorders characterized by asthenia and in cases of insomnia and anxiety. [ABSTRACT FROM AUTHOR]

A rapid, sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination and quantification of 12 psychotropic drugs and metabolites in hair was developed and validated. After freeze grinding with methanol, the supernatant was determined by LC-MS/MS using an Allure PFPPropyl column (100 × 2.1 mm, 5 μm) with a gradient elution of acetonitrile and 10 mmol/L ammonium acetate with 0.1% formic acid, and in the subsequent analysis using multiple reaction monitoring (MRM) mode, two ion transitions were monitored for each analyte. The limits of detection ranged from 0.002 to 0.05 ng/mg, and the limits of quantitation were in the range of 0.005-0.1 ng/mg. Good linearity (r > 0.995) was observed for all analytes over the linear range. Acceptable intraday and interday precision (RSD ≤ 20%) and accuracy (85.3%-112.9%) were achieved. This method of detection was applied to the analysis of guinea pig hair roots after a single dose of quetiapine. Quetiapine and 7-hydroxyquetiapine were both detected in guinea pig hair roots from 5 min post administration. The concentration of quetiapine (10.3-1733.8 ng/mg) was much higher than that of 7-hydroxyquetiapine (0.1-40.6 ng/mg) in the hair roots of guinea pigs, and higher concentrations of quetiapine and 7-hydroxyquetiapine occurred in black hair root than in that of white and brown. The animal experiment demonstrated that hair roots may be a good specimen for proving acute quetiapine poisoning when other biological matrices are not available. [ABSTRACT FROM AUTHOR]

In the last years, the debate on the use of psychedelics in psychotherapeutic settings has intensified, attracting a lot of interest and attention from the scholarly community as well as from clinicians and paving the way for new therapeutic paradigms. Besides classical addictions and addictive behaviors, there exist forms of addictions, the so-called new addictions or behavioral addictions, whose characterization is not linked so much to substances but to widespread and socially accepted activities such as games, shopping, internet use, sex, love relationships, work and exercises, physical activities or sports. Among the various addictions, the gambling disorder is the first form of behavioral addictions officially recognized by the DSM-V, in accordance with a wealth of neurobiological and clinical data showing the activation in patients of the gratification systems (especially dopamine). Orthos, as intensive residential intervention program envisaging a non-moralistic approach to gambling, can be combined with the administration of psilocybin, a substance characterized by a very low potential for abuse, modulating brain areas and networks affected by addictive behaviors. Therefore, our proposal would be to start treating behavioral addictions combining psilocybin administration with existential-humanistic psychotherapy, like Orthos. [ABSTRACT FROM AUTHOR]

Abstract The knowledge on the presence of pharmaceutical compounds, and possible risks, in coastal and marine systems is still limited. This study represents the first attempt at monitoring psychoactive pharmaceuticals (PaPs) (benzodiazepines and anxiolytics) and illicit drugs (IDs) in the Rías Baixas coastal area of Northwestern Spain, an area of economic and ecological relevance, leader in shellfish production. Fourteen PaPs and 9 IDs were detected in the water samples with venlafaxine (59%), benzoylecgonine (40%), EDDP (40%), and citalopram (36%) showing the highest detection frequencies. The highest concentrations were measured for venlafaxine (291 ng L−1), benzoylecgonine (142 ng L−1), lorazepam (95.9 ng L−1), and citalopram (92.5 ng L−1). Risk assessment, based on hazard quotients suggested that venlafaxine, citalopram, sertraline, and EDDP were present in concentrations potentially able to cause chronic effects in exposed organisms. Based on the results obtained further monitoring of venlafaxine, citalopram, and EDDP in coastal waters is recommended. Graphical abstract Image 1 Highlights • Psychoactive and illicit drugs were present in 13 of the 22 sampled sites above LOD. • Ten drugs detected for the first time in coastal waters. • Venlafaxine, benzoylecgonine, EDDP, and citalopram were the most ubiquitous drugs. • Concentrations of venlafaxine, citalopram, sertraline and EDDP resulted in HQ > 1. • Venlafaxine led to HQ up to 128 and above 1 in 36% of the studied sites. [ABSTRACT FROM AUTHOR]

Abstract There is concern that psychoactive drugs present in the aquatic environment could affect the behaviour of fish, and other organisms, adversely. There is considerable experimental support for this concern, although the literature is not consistent. To investigate why, fish were exposed to three concentrations of the synthetic opiate tramadol for 23–24 days, and their anxiolytic behaviour in a novel tank diving test was assessed both before and after exposure. The results were difficult to interpret. The positive control drug, the anti-depressant fluoxetine, produced the expected results: exposed fish explored the novel tank more, and swam more slowly while doing so. An initial statistical analysis of the results provided relatively weak support for the conclusion that both the low and high concentrations of tramadol affected fish behaviour, but no evidence that the intermediate concentration did. To gain further insight, UK and Japanese experts in ecotoxicology were asked for their independent opinions on the data for tramadol. These were highly valuable. For example, about half the experts replied that a low concentration of a chemical can cause effects that higher concentrations do not, although a similar number did not believe this was possible. Based both on the inconclusive effects of tramadol on the behaviour of the fish and the very varied opinions of experts on the correct interpretation of those inconclusive data, it is obvious that more research on the behavioural effects of tramadol, and probably all other psychoactive drugs, on aquatic organisms is required before any meaningful risk assessments can be conducted. The relevance of these findings may apply much more widely than just the environmental risk assessment of psychoactive drugs. They suggest that much more rigorous training of research scientists and regulators is probably required if consensus decisions are to be reached that adequately protect the environment from chemicals. Graphical abstract Unlabelled Image Highlights • Fish were exposed to the psychoactive drugs tramadol and fluoxetine. • Alteration of fish behaviour was assessed in a novel tank diving test. • The results were not easy to interpret with confidence. • Ecotoxicological experts reached different conclusions based on the same results. • Determining whether or not psychoactive drugs alter the behaviour of fish is difficult. [ABSTRACT FROM AUTHOR]

The main objective for this article is to explore how users of psychoactive drugs experience time and the role psychoactive drugs play in the management and construction of time. The data in this study consists of different kinds of written documents such as anecdotal accounts and scientific articles and reports which was collected using a purposeful sampling technique. One important result is that time is experienced and constructed differently among users of legal drugs compared to users of illegal drugs. The use of heroin is for example associated with shrinking time-horizons and being afraid of looking back and looking ahead, while smoking cigarettes is correlated with killing chronological time and instituting a parenthesis in normative time. Another conclusion is that users of illegal drugs experience greater problems synchronizing social and subjective time compared to users of legal substances. The results of my study also suggest that drug users' experiences of time are intertwined with the social context and social meanings of drug use. [ABSTRACT FROM AUTHOR]

This study investigates the performance of carbon nitride (CN) photocatalysts immobilized on 3D printed cylindrical supports for the removal of selected emerging pollutants, namely venlafaxine (VFX), citalopram (CTP), fluoxetine (FXT), and carbamazepine (CBZ), due to their rising consumption as antidepressants and the significant concerns for public health and the environment, mainly due to the direct impact of their presence in surface waters. The CN photocatalysts were synthesized using two precursors (dicyandiamide and urea), forming four different CN materials. Among the immobilized CN photocatalysts tested, the bulk CN prepared from urea (CNB-U/PLA) revealed the highest efficiency for the removal of VFX as the target antidepressant (above 90% after 30 min), which was ascribed to the lower recombination of photogenerated charges of this photocatalyst. The reuse tests confirmed the robust and effective photocatalytic performance of the CNB-U/PLA photocatalyst over multiple cycles, while its versatility with different support configurations demonstrates its adaptability and broad potential for various photocatalytic applications. The simultaneous removal of the four antidepressants was performed at low concentrations (1.8 μM), employing the most efficient immobilized photocatalyst (CNB-U/PLA), yielding remarkably high conversion rates (above 90% for VFX, CTP, and FXT, and around 70% for CBZ, after 60 min) under visible irradiation. The results demonstrate the ability of the immobilized CN system to effectively eliminate contaminants with different chemical properties. This study emphasizes the potential of this approach for comprehensive emerging pollutants removal, highlighting its significance in water treatment and environmental remediation strategies. [Display omitted] • Innovative immobilization of carbon nitride in a poly(lactic acid) cylindrical support. • Urea, a g-C 3 N 4 precursor, avoids needing a posterior exfoliation thermal step. • Outstanding removal of different antidepressants under visible irradiation. • Immobilized g-C 3 N 4 photocatalysts exhibit exceptional stability and reusability. [ABSTRACT FROM AUTHOR]