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ABSTRACT OBJECTIVE: Investigate whether the use of psychoactive drugs would be a predictor of incidence of functional disability among seniors living in community. METHODS: It is a population-based longitudinal study, developed between January 1, 1997 and December 31, 2011, with older adults living in community. The association between the use of psychoactive drugs and the development of functional disability for instrumental (IADLs) and basic (BADLs) activities of daily living was tested using the extended Cox proportional hazards model, which considers the measure of exposure of interest throughout the follow-up period. The analyses were stratified by sex and adjusted by sociodemographic characteristics, health behavior and health conditions. RESULTS: After multivariate adjustment, the use of two or more psychoactive drugs in the female stratum was associated with disability for both IADLs (HR = 1.58; 95%CI 1.17–2.13) and BADLs (HR = 1.43; 95%CI 1.05–1.94), the use of benzodiazepines was associated with disability for IADLs (HR = 1.32; 95%CI 1.07–1.62), and the use of antidepressants was associated with disability for both IADLs (HR = 1.51; 95%CI 1.16–1.98) and BADLs (HR = 1.44; 95%CI 1.10–1.90). In the male stratum, the use of antipsychotics was associated with disability for IADLs (HR = 3.14; 95%CI 1.49–6.59). CONCLUSIONS: The study showed a prospective association between the use of psychoactive drugs and functional disability. These results indicate the need to carefully assess the prescription of psychoactive drugs for older adults and monitor their usage in order to detect damages to the health of users.

The number of new psychoactive substances (NPS) increases rapidly, harming society and fuelling the need for alternative testing strategies. These should allow the ever-increasing number of drugs to be tested more effectively for their toxicity and psychoactive effects. One proposed strategy is to complement rodent models with zebrafish (Danio rerio) larvae. Yet, our understanding of the toxicokinetics in this model, owing to the waterborne drug exposure and the distinct physiology of the fish, is incomplete. We here explore the toxicokinetics and behavioral effects of an NPS, meta-chlorophenylpiperazine (mCPP), in zebrafish larvae. Uptake kinetics of mCPP, supported by toxicokinetic modeling, strongly suggested the existence of active transport processes. Internal distribution showed a dominant accumulation in the eye, implying that in zebrafish, like in mammals, melanin could serve as a binding site for basic drugs. We confirmed this by demonstrating significantly lower drug accumulation in two types of hypo-pigmented fish. Comparison of the elimination kinetics between mCPP and previously characterized cocaine demonstrated that drug affinities to melanin in zebrafish vary depending on the structure of the test compound. As expected from mCPP-elicited responses in rodents and humans, zebrafish larvae displayed hypoactive behavior. However, significant differences were seen between zebrafish and rodents with regard to the concentration-dependency of the behavioral response and the comparability of tissue levels, corroborating the need to consider the organism-internal distribution of the chemical to allow appropriate dose modeling while evaluating effects and concordance between zebrafish and mammals. Our results highlight commonalities and differences of mammalian versus the fish model in need of further exploration.

Orthostatic hypotension (OH) is defined as an abnormal blood pressure reduction when standing and is frequently diagnosed in older adults. Pharmacological therapy is one 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. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Investigate whether the use of psychoactive drugs would be a predictor of incidence of functional disability among seniors living in community. METHODS: It is a population-based longitudinal study, developed between January 1, 1997 and December 31, 2011, with older adults living in community. The association between the use of psychoactive drugs and the development of functional disability for instrumental (IADLs) and basic (BADLs) activities of daily living was tested using the extended Cox proportional hazards model, which considers the measure of exposure of interest throughout the follow-up period. The analyses were stratified by sex and adjusted by sociodemographic characteristics, health behavior and health conditions. RESULTS: After multivariate adjustment, the use of two or more psychoactive drugs in the female stratum was associated with disability for both IADLs (HR = 1.58; 95%CI 1.17-2.13) and BADLs (HR = 1.43; 95%CI 1.05-1.94), the use of benzodiazepines was associated with disability for IADLs (HR = 1.32; 95%CI 1.07-1.62), and the use of antidepressants was associated with disability for both IADLs (HR = 1.51; 95%CI 1.16-1.98) and BADLs (HR = 1.44; 95%CI 1.10-1.90). In the male stratum, the use of antipsychotics was associated with disability for IADLs (HR = 3.14; 95%CI 1.49-6.59). CONCLUSIONS: The study showed a prospective association between the use of psychoactive drugs and functional disability. These results indicate the need to carefully assess the prescription of psychoactive drugs for older adults and monitor their usage in order to detect damages to the health of users. [ABSTRACT FROM AUTHOR]

The consumption of psychoactive pharmaceuticals has increased worldwide, and wastewater treatment plants are not able to eliminate them from the effluent. An extensive review was carried out to assess the environmental risk (ERA model) based on secondary data about potential impacts on non-target organisms of seven psychoactive drugs consumed worldwide (alprazolam, bromazepam, citalopram, clonazepam, diazepam, lorazepam, and oxazepam). Risk quotients (RQs) were calculated according to the European Medicines Agency (EMA) on ERA of Medicinal Products For Human Use based on (i) the predicted and measured environmental concentrations (PEC and MEC, respectively) of the psychoactive drug in surface water, groundwater, and wastewater effluent and (ii) the predicted no-effect concentration (PNEC) derived from ecotoxicological assays or ECOSAR software. Furthermore, this study reviews and discusses non-standardized ecotoxicity assays, such as sublethal and behavioral effects on different organisms. In total, 903 MEC entries of psychoactive drugs and 162 data on ecotoxicological assays were gathered from the literature survey addressing behavioral effects (115), acute/chronic effects (35), and sublethal effects (12). Citalopram and diazepam were the only substances that are likely to pose an environmental risk (RQ > 1) to surface waters. Even though there is considerable amount of data on behavioral effects of psychoactive drugs to aquatic species, results are currently not integrated into the EMA risk assessment framework. The large amount of data on psychoactive drug concentrations and effects on non-target organisms collected, interpreted, and discussed in the present study should be used as a baseline for future improvement of ERA strategies. [ABSTRACT FROM AUTHOR]

Consciousness-altering behaviour is, to a first approximation, a universal phenomenon; practically all human societies have experimented with altered states of consciousness (ASCs) in some form. In this article, we review the neuroscientific and psychological evidence in favour of the transient hypofrontality theory (THT), a general brain mechanism that can account for a great number of phenomenological features shared by all ASCs (Dietrich, 2003). The theory is based on the conceptualization of brain areas and mental abilities into a functional hierarchy with the top layers in the prefrontal cortex contributing the most sophisticated elements of the conscious experience. Analogous to peeling an onion, the THT simply postulates that alteration to consciousness involves the progressive downregulation of brain networks supporting the highest cognitive capacities, down the functional hierarchy, one phenomenological subtraction at a time, to those supporting more basic ones. Accordingly, ASCs are principally due to a transient state of hypoactivity, of various depths and extent, in networks of the prefrontal cortex. Given the universality of ASCs, we ask why hypofrontality might have evolved. [ABSTRACT FROM AUTHOR]

Medical student wellness has emerged as an important issue in medical education.Objective: To evaluate the gender influence on psychiatric and/or psychological follow-up, psychotropic and illicit drug consumption, addictive behaviors, quality of life and motives for consumption in a large multicentric national sample of medical students.Methods: Medical students of the 35 French Medicine faculties were recruited through mailing lists and social networks between December 2016 and May 2017 and fulfilled Internet anonymized questionnaires.Results: Overall, 10,985 medical students were included in the present study (mean age 21.8 years, 9640 (87.8%) women). Compared to men, women were found to smoke tobacco and cannabis less frequently (aOR = 0.8 [0.7-0.9], p < 0.0001 and aOR = 0.3 [0.3-0.4], p < 0.0001 respectively), to have lower rate of alcohol use disorders (aOR = 0.7 [0.6-0.7], p < 0.0001). Men were also found to consume more frequently ecstasy, cocaine, mushrooms, amphetamine, LSD, codeine and ketamine (all p < 0.0001) for pleasure and novelty seeking, group effect, but also alleviating anxiety, sedative and stimulant effect and stress before exam (all p < 0.001) while women were more frequently followed-up by a psychiatrist and/or a psychologist (aOR = 2.0 [1.7-2.3],p < 0.0001), consumed more frequently anxiolytics (aOR = 1.6[1.3-1.9], p < 0.0001) and antidepressants (aOR = 1.4[1.1-1.9], p = 0.01), reported lower rates of physical and mental quality of life in all subscores (all p < 0.0001). They were more frequently exposed to sexual assault (aOR = 4.1 [2.5-6.9], p < 0.0001) and domestic violence (aOR = 1.6[1.1-2.5], p = 0.02) while men were more frequently exposed to physical assault (aOR = 0.4[0.4-0.5], p < 0.0001) during their medical studies.Conclusions: Medical students are mostly women. While men and women are both exposed to professional and personal stress with differences, men are more frequently involved in addictive behavior and psychoactive substance consumption while women are mostly followed-up by psychiatrist and/or psychologist and psychotropic drug consumers, with more impaired self-reported mental and physical quality of life scores. These results should orientate future health strategies for the prevention of later mental illness onset and stress at work in hospital. [ABSTRACT FROM AUTHOR]

A set of psychoactive drugs has been analyzed with the use of quantitative structure-activity/property relationships methods. The purpose of this study was to demonstrate both the common and differentiating characteristics of the above-mentioned chemical compounds, physicochemical as well as pharmacological based on the quantum chemical calculations and selected biological activity data and chromatographic retention parameters. During the study, the ab initio model of molecular modeling was performed and PCA, FA, and MLR as the types of chemometric approach. QSAR/QSPR models were proposed based on chosen statistically significant descriptors. The relationship between the structure and biological activity data was able to class and describe the psychoactive properties of the molecules studied. The applied chemometric approaches revealed the influential features of tested structures responsible for their pharmacological activity together with some additional physicochemical properties. [ABSTRACT FROM AUTHOR]

Tens of thousands of ED visits each year are related to synthetic psychoactive drug intoxication. Signs, symptoms, and treatment of toxicity with synthetic cathinones, synthetic cannabinoids, or dextromethorphan overlap greatly and can be challenging. This article describes signs and symptoms of psychoactive drug abuse and how to properly manage these symptoms. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva 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.)

Presently, it is observed the increase in the consumption of psychotropic drugs which are responsible for altering the brain nerve communications. For these drugs, there are storage, control, and dispensing specifications, since the sale is made through retention of the prescription. Thus, it is considered that the correct fulfillment for the correct dispensing, respecting the legal criteria, is fundamental. In the present study, was analyzed 627 special control prescriptions and the prescription's notifications for identifying the mistakes that unfeasible the commercialization. It was identified the dispensing of 80 different active ingredients, with higher predominance to the classes of antidepressants and benzodiazepines. Most of the prescriptions analyzed (90%) presented some inconsistency, since that, the most common is the lack of a date (60%). The other errors are related to the type of prescription, dosage excess or the absence of it, erasures and excessive amounts. It was concluded on the need for educational measures directed to the prescribers and, at the same time, it is revealed the importance of instructing pharmacists and attendants. The thematic analysis also contributes to the acquirement of knowledge about the pharmacological aspects of the most used classes of psychotropic drugs, fomenting the rational use of medicines update and promotion. [ABSTRACT FROM AUTHOR]

Objective: Reflect about Nursing and the use of psychoactive drugs in children and adolescents in situations of violation of rights and / or criminal situation, who are in the care of the Servicio Nacional de Menores, in the context of deaths in recent years. Methodology: Analytical-synthetic method; Bibliographical review, comprehensive reading, personal reflection and definition of concepts. Results: There are described the current situation of mental health of children and adolescents, the relationship with the Social Determinants of Health and related ethical perspectives for conflict resolution. Conclusions: The use of psychosocial interventions as the first line of treatment is considered in the reflection, besides the fact that the use of psychoactive drugs, if necessary, should be administered and supervised by professionals according to current regulations. [ABSTRACT FROM AUTHOR]

Breastfeeding women are excluded from clinical trials of psychoactive drugs because of ethical concerns. Animal testing, which often is predictive of adverse effects in humans, represents the only avenue available for assessing drug safety for human offspring exposed to drugs during lactation. I determined whether behavioral outcomes for children exposed during breastfeeding to antidepressants, anxiolytics, antipsychotics, anti-seizure medications, analgesics, sedatives, and marijuana can be predicted by rodent studies of offspring exposed to drugs during lactation. Animal data were available for only 10 of 80 CNS-active drugs canvassed. Behavioral deficits in adolescence or adulthood in rats and mice after various drug exposures during lactation included reductions in sexual behavior, increased anxiety, hyperactivity, and impaired learning and memory. Whether similar adverse effects will emerge in adulthood in children exposed to drugs during breastfeeding is unknown. Rodent research has the potential to forecast impairments in breastfed children long before information emerges from post-marketing reports and should be prioritized during preclinical drug evaluation by the FDA for new drugs and for drugs currently prescribed off-label for lactating women. [ABSTRACT FROM AUTHOR]

Dopaminergic system activity in limbic structures (reward system) is related to motivational processes and adaptation to changing environmental conditions. Stress conditions can cause dopaminergic dysfunction, reduce motivational processes and induce compensatory drug use. The susceptibility to stress is characterized by individual variability. Psychostimulants such as cocaine, amphetamine and its derivatives act as positive reinforcers, affecting mood changes. Prolonged use of psychoactive substances can cause persistent plastic changes in the limbic system (disruption of neurogenesis, neurons atrophy), resulting in addictions or other forms of psychopathology like mood disorders. One of the reason is dysregulation of the dopaminergic system and dysfunction of local dopamine release in the nucleus accumbens. Stress factors also inhibit neuronal plasticity. In turn, antidepressants may increase brainderived neurotrophic factor (BDNF) and TrkB receptors expression and improve neuronal proliferation, restoring proper functioning of the limbic regions. An important manifestation of the distinct functioning of the dopaminergic mesolimbic system is the difference between the sexes and the aging process. Epidemiological studies indicate that depression, anxiety disorders, and other emotional disorders often accompany drug abuse. The search for neurobiological basis of affective disorders and identification of factors, including epigenetic ones (interdependence of genetic and environmental factors), associated with different susceptibility to stress and predisposition to addiction to psychoactive substances is currently being carried out by many researches. Understanding the neurobiological factors of individual differences related to susceptibility to psychostimulants may aid in developing future therapies adapted to the patient's needs and more effective treatment of addiction. [ABSTRACT FROM AUTHOR]

In the last decades, one of the psychedelic substances which has gained high attention for its implications in several para-psychological phenomena (including out-of-body states, deep changes in sensory perception, mood, and thought, travels in "hyperspace", and meetings with disincarnate entities, as well as other "breakthrough experiences") is dimethyltryptamine (N,N-DMT, or simply DMT). High dose DMT-containing plants (like Psychotria viridis, in Quechua language Chacruna or Chacrona) are one of the two principal ingredients of the Ayahuasca, the visionary Amazonian brew reported to induce a range of paranormal experiences, but it can be found as well in a huge number of different natural sources, even some of animal origin - e.g., the Sonoran desert toad, in the form of 5-methoxy- N,N-dimethyltryptamine or 5-MeO-DMT. It was Rick Strassmann (born 1952), a medical doctor, psychiatrist and clinical psycho-pharmacologist, who had the virtue of giving a second birth to the academic interest in scientific research of psychedelics after the post-70's age of obscurantism lead by the American prohibitionist position on this field. Strassman is also the person who named this compound "the spirit molecule", in order to suggest the deeply psychospiritual implications concerning this substance. Here, we overview the scientific basis and evidences supporting the association between DMT and the pineal gland. [ABSTRACT FROM AUTHOR]

The number of new psychoactive substances (NPS) increases rapidly, harming society and fuelling the need for alternative testing strategies. These should allow the everincreasing number of drugs to be tested more effectively for their toxicity and psychoactive effects. One proposed strategy is to complement rodent models with zebrafish (Danio rerio) larvae. Yet, our understanding of the toxicokinetics in this model, owing to the waterborne drug exposure and the distinct physiology of the fish, is incomplete. We here explore the toxicokinetics and behavioral effects of an NPS, meta-chlorophenylpiperazine (mCPP), in zebrafish larvae. Uptake kinetics of mCPP, supported by toxicokinetic modeling, strongly suggested the existence of active transport processes. Internal distribution showed a dominant accumulation in the eye, implying that in zebrafish, like in mammals, melanin could serve as a binding site for basic drugs. We confirmed this by demonstrating significantly lower drug accumulation in two types of hypo-pigmented fish. Comparison of the elimination kinetics between mCPP and previously characterized cocaine demonstrated that drug affinities to melanin in zebrafish vary depending on the structure of the test compound. As expected from mCPP-elicited responses in rodents and humans, zebrafish larvae displayed hypoactive behavior. However, significant differences were seen between zebrafish and rodents with regard to the concentration-dependency of the behavioral response and the comparability of tissue levels, corroborating the need to consider the organism-internal distribution of the chemical to allow appropriate dose modeling while evaluating effects and concordance between zebrafish and mammals. Our results highlight commonalities and differences of mammalian versus the fish model in need of further exploration. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo 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.)

Rationale: Clinical studies have shown that some psychoactive recreational drugs have therapeutic applications in anxiety, depression, and schizophrenia. However, to date, there are few studies on the therapeutic potential efficacy of recreational drugs in compulsive neuropsychiatric disorders.Objectives: We explored the therapeutic potential of different psychoactive and psychedelic drugs in a preclinical model of compulsive behavior.Methods: Outbred male Wistar rats were selected as either high (HD) or low (LD) drinkers according to their behavior in schedule-induced polydipsia (SIP). Subsequently, we assessed the effects of acute administration of scopolamine (0.125, 0.25, and 0.5 mg/kg), methamphetamine (0.25, 0.5, 1.25, and 2.5 mg/kg), ketamine (1.25, 2.5, 5, and 10 mg/kg), cannabidiol (1 and 3 mg/kg), WIN21255–2 (0.5, 075, and 1 mg/kg), and AM404 (0.25 and 0.5 mg/kg) on compulsive drinking in SIP.Results: Scopolamine reduced dose-dependent compulsive drinking in HD compared with LD rats in SIP. Methamphetamine induced a dose-dependent inverted U-curve effect in both groups, in which lower doses increased and higher doses reduced compulsive drinking in SIP. Ketamine, cannabidiol, WIN21255-2, and AM404 did not have any relevant effects in SIP.Conclusions: These data provide new evidence that low doses of scopolamine and intermediate doses of methamphetamine might therapeutically reduce compulsive behaviors and suggest that there is not a direct participation of the endocannabinoid system in compulsive behavior on SIP. The research in the underlying neurochemical mechanisms of these psychoactive drugs might provide an additional insight on new therapeutic targets in compulsive neuropsychiatric disorders. [ABSTRACT FROM AUTHOR]

Background and aims: The comorbidity between gaming disorder (GD), psychiatric disorders, and the use of psychoactive substances is well established. However, little is known about hallucinations and dissociations among gamers. Game Transfer Phenomena (GTP) research have shown that non-clinical gamers experience cognitive/sensory intrusions with game content and discontinuity of sense of agency without being under the influence of substances in fully awake states. This study compares GD, hallucinations/dissociations and different forms of GTP among gamers with and without psychiatric diagnoses (Dx/noDx) and with and without drug experience (Drugs/noDrugs). Method: Online survey, N=1,301; Mage 28.14, SD=7.41, 83% male. Measures included items on positive symptoms of psychosis (CAPS), dissociations (DES) and sleep/dream-related phenomena (ISES), IGD-9 and GTPMDS. Results: Gamers with Dx compared to noDx showed significantly higher scores in hallucinations, GD, drug experience, and GTP manifesting as intrusive thoughts and misperceptions/imagery. The Drugs-group, compared to noDrugs, had significantly higher scores on hallucinations, dissociations, conflicts due to GD, GTP manifesting as dissociations/corporeal adaptations, cognitive mix-ups, intrusive thoughts, misperceptions/imagery and auditory intrusions. Conclusions: A wider range of manifestations of GTP appears to be more common in gamers with drug experience. The Dx and Drugs groups showed significantly higher scores in hallucinations, dissociations, and sleep/dream-related phenomena, but not for all manifestations of GTP, not even those GTP that some may consider more pathological, e.g., images hovering over people's heads. Future studies should investigate the relationship between GTP, specific psychiatric disorders and neural adaptative mechanics involving game features and prolonged playing that may explain many GTP experiences. [ABSTRACT FROM AUTHOR]

An introduction is presented which discusses articles in the issue on topics including lack of sleep is a public health epidemic linked to negative health outcomes and mental health issues, including substance use; and the need for greater attention to sleep health in substance use treatment.

In recent years in the world there is a tendency of quantity of persons who use drugs increase. Free availability of drugs of different groups for population is the main cause. Another trend associated with the consumption of drugs. All these factors led to the increased frequency of psychosis occurrence among consumers of psychoactive substances. In structure of such psychosis there are a variety of symptoms and syndromes. And since the number of drug users is quite broad in its structure - there are also persons with mental illness. This gives number of diagnostic difficulties. In this regard, the aim of the study was to trace the modern ideas of differential diagnosis of schizophrenia-like psychosis disorders due to the drug use. Materials and methods of research. In this work the content analysis of the modern representations of differential diagnosis of schizophrenia-like psychosis disorders as a result of the use of psychoactive substances was made. The problem of determination of primary and secondary nature of drug addiction in patients with psychotic disorders was indicated. Etiology and psychopathogenesis hypotheses of the addiction from psychoactive substances in the context of their correlation with endogenous mental pathology were defined. In the literature there is no clear diagnostic criteria that would allow distinguishing psychosis due to the use of drugs and endogenous psychosis, which is combined with the admission medicines. However, the attention of clinicians should be concentrated on the premorbid condition: the presence of hereditary family history, pathological behavior in childhood and adolescence. It was found that the majority of substances may cause one or more syndromes - delirium, dementia, and amnestic syndrome, delusional syndrome, hallucinatory syndrome, depressive syndrome, anxiety, and personality disorder, such disorders as schizophrenia-like psychosis disorders are not rare. Special attention was paid to the hypothesis of self-medication (self-medication hypothesis, SMH). According to this hypothesis, drugs can be used by patients to relief their mental disorders, which the people started by other drugs intake. For this reason, it is difficult to detect real Genesis of psychosis in this case. Therefore, psychoses due to the use of medications should be differentiated from psychosis due to other endogenous diseases, for example, in schizophrenia. Conclusion about the importance and relevance of differential diagnosis of schizophrenia-like psychosis disorders of different Genesis for psychiatrists and narcologists was made.

The problem of drug use, and especially drug addiction, is gradually becoming a major concern of many specialized intervention areas (clinics, counseling centers, therapy and detoxification etc.), as well as a field of great interest for the involvement of social work, especially in interdisciplinary teams (consisting of doctors, psychiatrists, psychotherapists, clinical psychologists, spiritual assistants etc.). With the intent to meet practical social workers, our approach - in a psychopathological and clinical vision - attempts to present some common classes of psychoactive substances used, their effects, psychosocial consequences and their therapy, important data to be known in a prophylactic perspective, as well as in social practice. [ABSTRACT FROM AUTHOR]

Chronic stress is known to affect many psychiatric disorders, and studies of responses to acute stress may reveal processes that ultimately lead to maladaptive responses to chronic stress. Many studies have used simulated public speaking tasks to induce stress in the laboratory and, of interest to this review, the tasks have been used to assess the effects of both therapeutic and nonmedical drugs on stress reactivity. Here we review 38 studies that examined effects of single doses of drugs on subjective, cardiovascular and hormonal responses to an acute social stressor in healthy volunteers. Most studies have used the Trier Social Stress Test (TSST), or variations on it involving public speaking or mental arithmetic. Pharmacological studies with the TSST (ph-TSST) have been conducted for three main reasons: i) to determine the clinical effectiveness of psychiatric medications to reduce stress responses, ii) to investigate the neurochemical mechanisms involved in the stress response, and iii) to determine whether drugs of abuse relieve, or occasionally worsen, responses to acute stress. The review indicates that standard anxiolytic medications consistently reduce subjective responses to the TSST, whereas single doses of antidepressants produce mixed effects. Mechanistic studies indicate that several neurotransmitter systems are involved in the stress response, including serotonin, norepinephrine, GABA, glutamate, opioids, and endocannabinoids. Among drugs of abuse, alcohol and cannabinoids exert some stress-dampening effects, whereas caffeine, nicotine, and amphetamines tend to increase stress responses. Comparing outcome measures of the responses to stress, subjective ratings of anxiety are among the most sensitive indices of the stress response, with cortisol levels second and cardiovascular responses least sensitive. We conclude that the TSST is a valuable tool to study the clinical effectiveness of medications for stress-related disorders, and that it is important to use standardized procedures to enable comparisons across studies. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo 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.)

This review focused on seven psychoactive drugs being six benzodiazepines (alprazolam, bromazepam, clonazepam, diazepam, lorazepam, and oxazepam) and one antidepressant (citalopram) widely consumed by modern society and detected in different aqueous matrices (drinking water, surface water, groundwater, seawater, estuary water, influent and effluent of wastewater treatment plants). The review included 219 selected scientific papers from which 1642 data/entries were obtained, each entry corresponding to one target compound in one aqueous matrix. Concentrations of all investigated drugs in all aqueous matrices varied from 0.14 to 840,000 ng L. Citalopram presented the highest concentrations in the aqueous matrices. Based on the Wilcoxon-Mann-Whitney test, differences between wastewater influents and effluents were not significant for most wastewater categories, suggesting that conventional wastewater treatment systems as such do not remove or remove partially these compounds. High-income countries showed much lower concentrations in surface water than the group formed by upper-middle-, lower-middle-, and low-income countries. Regarding analytical methods, solid-phase extraction (SPE) was by far the most used extraction method (83%) and performance liquid chromatography (HPLC) (73%) coupled to mass spectrometry (99%) the most common analytical method. Changes in behavior and in survival rates were the most common effects reported on bioindicators (aquatic species) due to the presence of these drugs in water. Concentrations of psychoactive drugs found in surface waters were most of the time within the range that caused measurable toxic effects in ecotoxicity assays. [ABSTRACT FROM AUTHOR]

In this work, the reaction of four benzodiazepines (diazepam, oxazepam, nordazepam and temazepam) during water chlorination was studied by means of liquid chromatography-quadrupole-time of flight-mass spectrometry (LC-QTOF-MS). For those compounds that showed a significant degradation, i.e. diazepam, oxazepam and nordazepam, parameters affecting to the reaction kinetics (pH, chlorine and bromide level) were studied in detail and transformation products were tentatively identified. The oxidation reactions followed pseudofirst-order kinetics with rate constants in the range of 1.8–42.5 M −1 s −1 , 0.13–1.16 M −1 s −1 and 0.04–20.4 M −1 s −1 corresponding to half-life values in the range of 1.9–146 min, 1.8–87 h and 2.5–637 h for oxazepam, nordazepam and diazepam, respectively, depending of the levels of studied parameters. Chlorine and pH affected significantly the reaction kinetics, where an increase of the pH resulted into a decrease of the reaction rate, whereas higher chlorine dosages led to faster kinetics, as expected in this case. The transformation of the studied benzodiazepines occurs mainly at the 1,4-diazepine 7-membered-ring, resulting in ring opening to form benzophenone derivatives or the formation of a 6-membered pyrimidine ring, leading to quinazoline derivatives. The formation of these by-products was also tested in real surface water samples observing kinetics of oxazepam degradation slower in river than in creek water, while the degradation of the two other benzodiazepines occurred only in the simpler sample (creek water). Finally, the acute and chronical toxicity and mutagenicity of precursors and transformation products were estimated using quantitative structure-activity relationship (QSAR) software tools: Ecological Structure Activity Relationships (ECOSAR) and Toxicity Estimation Software Tool (TEST), finding that some transformation products could be more toxic/mutagenic than the precursor drug, but additional test would be needed to confirm this fact. [ABSTRACT FROM AUTHOR]

Objective: To characterize the risk behavior of the psychoactive substances use in a youth population of Lisbon. Method: An observational, descriptive, cross-sectional study. Participants were 113 children and young people who responded to the Portuguese version of the Risk and Health Behavior questionnaire - Youth Risk Behavior Survey. Results: Participants with regard to age were between 9-13, most attending the 5th grade, living with parents, had good school performance, good relationship with colleagues while 1/4 refer problems. When concerned, recourse to the mother, but it is significant the attention of peers. As for the trial of psychoactive substances was found: 9.7% tobacco, 19.5% alcohol, other substances 5.3%. Conclusion: With regard to risk behavior stands primarily to early alcohol testing. Emerged as protective factors: family relationship and relationship with the school space. This age group may constitute the ideal time for prevention. [ABSTRACT FROM AUTHOR]

Objective: The age of using psychoactive drug has decreased in recent years while it has threatened children. This study considers types of psychoactive drugs used, risk factors and causal attributions among primary school 5th grade students in TRNC. Methods: The study was conducted with 2345 students during May and June 2015 in 75 public primary schools and two private primary schools that are dependent to Ministry of Education and Culture in TRNC. In this study, USA Department of Education 'California Healthy Kids Survey' was used by adapting to Turkish. Results: The study found the lifetime prevalence of cigarette use 10.9%, alcohol use 23.5% and illicit drug use 1.2%. Half of the students (51.3%) reported they have known name of an illicit drug other than cigarette and alcohol. The most known illicit drug is 'bonsai' (5.3%) among students. Living in a city, having brother/sister, having separate parents and being exposed to bad behaviour are predictive risk factors for using cigarette and alcohol. On the other hand, being male, being exposed to bad behaviour and physical violence are predictive risk factors for using illicit drugs. Conclusions: This study shows that the age of using psychoactive drug has decreased in TRNC and it even exists among primary school students like all over the world. This study proves that prevention studies for psychoactive drug use for children needs to be put into practice as soon as possible. [ABSTRACT FROM AUTHOR]

Introduction: Falls are frequent in the elderly, because they take medication that may increase the risk of falls, including psychotropic drugs. Aims: To explore the relationship between the use of psychotropic drugs and the occurrence of falls in institutionalized patients, and to identify the most used drugs in these patients. In addition, it was studied the risk associated with the psychotropic drugs and the risk of falls that they caused. Methods: A nested case-control study was performed from a cohort of polypharmacy patients residing in a nursing home. Cases were those having suffered a fall from August 2014 to December 2015, and controls were those without falls recorded. The exposure of psychoactive drugs was explored retrospectively in both groups. Information was collected in the database of the nursing home. Analysis focused on the odds ratio of falling per pharmacotherapy group, using confidence intervals set at 95%. Results: A sample of 22 patients, 9 cases and 13 controls, was analyzed: most patients were women, and the mean age was 82.3 years (SD=6.45). Residents used a mean of 11 medicines (SD=4.64). The most used pharmaceutical group and drug respectively were antipsychotics and quetiapine (59.1%, n=13; 45.5%, n=10). The OR determined in this study did not evidence any statistically significant association between the pharmacotherapeutic subgroups and/or drugs and increased risk of falling (quetiapine: OR=4.5; IC=0.730-27.739; atypical antipsychotics: OR=3.2; IC=0.540-18.980). Conclusion: Results were obtained in a restricted sample, leading to the incapacity of demonstrating significant associations. However, a trend between the use of psychotropic drugs and the risk of falls in the elderly was shown, identifying the most influential pharmacotherapeutic groups in falls. [ABSTRACT FROM AUTHOR]

Background. The new psychoactive drugs (NPD) are those that represent a danger to public health and are not prohibited by conventions on international narcotics. The concept also includes new contexts and new routes of consumption as well as novel ways of distribution, notably Internet. The risks associated with NPD consumption are largely unknown to users and to health care providers. Objective. To integrate the existing evidence regarding the main NPD in terms of description, epidemiology, psychopharmacology, medical complications and psychoactive effects. Method. To review relevant and updated clinical information on NPD obtained from specialized books and indexed scientific journals (PubMed/Medline, Google Scholar, Scopus), as well as official documents edited by international organizations dedicated to the epidemiologic analysis of drug abuse and Internet websites and forums managed by psychoactive substance users. Results. Aspects of clinical and pharmacological interest are described comprehensively, together with epidemiological data and risks associated to the consumption of the most relevant NPD: synthetic cannabinoids, synthetic cathinones, NBOMe series, indoleamines, piperazines, hallucinogenic mushrooms (Psilocybe SP.), synthetic opioids, plant products (khat, kratom, Salvia divinorum, ayahuasca) and dissociative anesthetics. Discussion and conclusion. The emergence of the NPD is a phenomenon on the rise with important consequences for public health. Learning about new trends in drug consumption and its potential risks should be essential for the medical professional. New research is needed in order to understand the phenomenon of the NPD and its pharmacological, clinical and legal implications. [ABSTRACT FROM AUTHOR]

Psychoactive drugs modulate learning and emotional processes in ways that could impact their recreational and medical use. Recent work has revealed how drugs impact different stages of processing emotional episodic memories, specifically encoding (forming memories), consolidation (stabilizing memories), and retrieval (accessing memories). Drugs administered before encoding may preferentially impair (e.g., GABA A sedatives including alcohol and benzodiazepines, Δ9-tetrahydrocannabinol or THC, ketamine), enhance (e.g., dextroamphetamine and dextromethamphetamine), or both impair and enhance (i.e., ± 3,4-methylenedioxymethylamphetamine or MDMA) emotionally negative and positive compared to neutral memories. GABA A sedatives administered immediately post-encoding (during consolidation) can preferentially enhance emotional memories, though this selectivity may decline or even reverse (i.e., preferential enhancement of neutral memories) as the delay between encoding and retrieval increases. Finally, retrieving memories under the effects of THC, dextroamphetamine, MDMA, and perhaps GABA A sedatives distorts memory, with potentially greater selectively for emotional (especially positive) memories. We review these effects, propose neural mechanisms, discuss methodological considerations for future work, and speculate how drug effects on emotional episodic memory may contribute to drug use and abuse. • Psychoactive drugs preferentially modulate the encoding of emotional memories. • Sedatives can preferentially enhance the consolidation of emotional memories. • Psychoactive drugs may preferentially distort the retrieval of emotional memories. [ABSTRACT FROM AUTHOR]

For both short-term and long-term treatment of bipolar disorder, lithium is a prototypical mood stabilizer. Lithium's neuroprotective properties were revealed by cumulative translational research, which opened the door to reforming the chemical as a treatment for neurodegenerative illnesses. The control of homeostatic systems such as oxidative stress, autophagy, apoptosis, mitochondrial function, and inflammation underlies lithium's neuroprotective characteristics. The fact that lithium inhibits the enzymes inositol monophosphatase (IMPase) and glycogen synthase kinase (GSK)-3 may be the cause of the various intracellular reactions. In this article, we review lithium's neurobiological properties, as demonstrated by its neurotrophic and neuroprotective capabilities, as well as translational studies in cells in culture and in animal models of Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), Prion disease, amyotrophic lateral sclerosis (ALS), ischemic stroke, and neuronal ceroid lipofuscinosis (NCL), discussing the justification for the drug's use in the treatment of these neurodegenerative disorders., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Singh et al.)

Neuroenhancement (NE) is the non-medical use of psychoactive substances to produce a subjective enhancement in psychological functioning and experience. So far empirical investigations of individuals’ motivation for NE however have been hampered by the lack of theoretical foundation. This study aimed to apply drug instrumentalization theory to user motivation for NE. We argue that NE should be defined and analyzed from a behavioral perspective rather than in terms of the characteristics of substances used for NE. In the empirical study we explored user behavior by analyzing relationships between drug options (use over-the-counter products, prescription drugs, illicit drugs) and postulated drug instrumentalization goals (e.g. improved cognitive performance, counteracting fatigue, improved social interaction). Questionnaire data from 1,438 university students were subjected to exploratory and confirmatory factor analysis to address the question of whether analysis of drug instrumentalization should be based on the assumption that users are aiming to achieve a certain goal and choose their drug accordingly or whether NE behavior is more strongly rooted in a decision to try or use a certain drug option. We used factor mixture modeling to explore whether users could be separated into qualitatively different groups defined by a shared ‘goal × drug option’ configuration. Our results indicate, first, that individuals’ decisions about NE are eventually based on personal attitude to drug options (e.g. willingness to use an over-the-counter product but not to abuse prescription drugs) rather than motivated by desire to achieve a specific goal (e.g. fighting tiredness) for which different drug options might be tried. Second, data analyses suggested two qualitatively different classes of users. Both predominantly used over-the-counter products, but ‘neuroenhancers’ might be characterized by a higher propensity to instrumentalize over-the-counter products for virtually all investigated goals whereas ‘fatigue-fighters’ might be inclined to use over-the-counter products exclusively to fight fatigue. We believe that psychological investigations like these are essential, especially for designing programs to prevent risky behavior.

Existe un interés creciente en los vegetales con efectos psicoactivos por parte de consumidores, con diferentes niveles de experiencia. Esto ha generado una necesidad de actualización de conocimientos del lado de los profesionales médicos y de otros responsables de la salud pública. Se trata, por lo general, de plantas de uso en ceremonias chamánicas con intención curativa, en rituales o simplemente de uso tradicional que han dado el salto al mundo occidental como nuevas drogas psicoactivas, en gran medida gracias a la facilidad de compra, venta, cultivo e intercambio de información que ofrece Internet. Recopilamos en este texto los vegetales con propiedades psicoactivas más relevantes, tanto por su frecuente mención en foros de usuarios o en portales destinados a la reducción de daños en el consumo de drogas, como por su aparición en textos científicos.

A prospective study was carried out, to identify the drug related problems and to prevent or to solve the negative outcomes associated with medication of the geriatric patients that consumed psychoactive drugs, who were hospitalized. The study was carried out according to the DADER Method of Pharmacotherapy Monitoring, adapted to the Hospital's environment and the theoretical rationale of the Third Consent of Granada was assumed, for the considerations related to the drug related problems and the negative outcomes associated with medication. Thirty five patients were included whose ages ranged between the 60 and 90 years. Thirty six negative associated outcomes were identified, in 34 patients that represented 97.14% incidence. A prevalence of the negative outcomes associated with the necessity was observed, followed by those associated with the security. The inadequate drug uses was the drug related problem that prevailed in the sample. The psychoactive drugs that were related with these results were mainly the anxiolytics, meprobamate and the neuroleptics. Some 82.35% of the interventions were accepted, achieving resolution of 47.06% of the negative outcomes associated with medication.Foi realizada uma pesquisa de intervenção, prospectiva, a fim de identificar problemas relacionados aos medicamentos e evitar ou resolver resultados negativos daí decorrentes, em pacientes idosos que faziam uso de medicamentos psicotrópicos e que foram internados. O estudo foi realizado de acordo com o método DADER para o acompanhamento farmacoterapêutico e assumiram-se os pressupostos teóricos do III Consenso de Granada, as considerações relacionadas com os problemas dos fármacos e os resultados negativos associados à medicação. Foram incluídos 35 pacientes com idades entre 60 e 90 anos. Trinta e seis RM foram identificados em 34 pacientes representando incidência de 97,14% e a prevalência foi observada para os resultados negativos associados com a necessidade, seguidos por aqueles relacionados à segurança. O uso indevido de fármacos foi os problema mais frequente na amostra. Os psicofármacos mais implicados foram os ansiolíticos, meprobamato e neurolépticos. Das intervenções, 82,35% foram aceitas, alcançando 47,06% de resolução dos resultados negativos associados à medicação.

Introduction: Poisoning is a common medico social problem nowadays and is often distressing for both family members and medical staff. The present study aims to evaluate the pattern of self poisoning with special preference to psychoactive drugs. Methodology: Study sample comprised of all episodes of self poisoning that had resulted in admission between January to December 2008.Pateints taking any toxic/pharmacological substance by accident or ignorance were excluded. Results: Out of 1206 patients admitted to accident and emergency during the study period, 140 were due to intentional poisoning (11.6%) Age of the patients varied from 16-65 years. The maximum incidence was between 21-30 years. The male: female ratio was 1.18:1.Most common substance used was organophosphate compound (OPC) (31.7%) followed by benzodiazepines (BZD) (20.7%) and household articles comprised of 18.5%. Multiple drug combinations with alcohol was 30%.Around 13.5% had history of mental illness. Conclusion: At present due to vast development in all fields of life like industries, medicine and agriculture, a significant number of new compounds have appeared as new poisonous substances, which have led to more number of poisoning cases. Although there are restrictions on sale of drugs in India, vulnerability to insecticide cannot be ignored.

Aim: Today use of different banned substances such as narcotic, psychoactive and energetic drugs are social problem that has created worry in different levels of human societies. The aim of present study was examined the prevalence of use of narcotic and psychoactive drugs among high school and university students also identifying of risk factors associated with the use of this materials. Method: The population of this descriptive survey study was all students of high school and university of Khodabandeh city. By cluster random sampling 580 students of high school and university selected and questionnaires distributed among them. After eliminating incomplete questionnaires 480 students remained as research sample. Results: In consideration of selected sample the most important reasons of using of narcotics are: enjoying and curiosity, exposed to bad environment like addicted friends and families, joblessness, economic problems, lack of information and loss of affection. Conclusion: The analysis of the results indicated the high prevalence of narcotic and drugs use and necessity of codification of preventive programs for these people.