No abstract available.
Psychotropic Drugs*

Abstract.
Psychotropic Drugs

The Prime Minister promulgated the dicision N0 95/200/QD-TTG dated 15th August 2000 on the correction of some content of regulation of labelling drugs that circulate in home country and imported or exported promulgated together with dicision No. 178/1999/QD-TTg dated August 1999 by Prime Minister
Pharmaceutical Preparations ; Psychotropic Drugs ; toxicity

PURPOSE: The purpose of this study was to assess the knowledge of pharmacists practicing in Palestine of issues related to using psychotropic medications in older people. METHODS: The study was conducted with a cross-sectional observational design using a questionnaire. A total of 400 pharmacists responded to a 19-statement knowledge test related to the use of psychotropic medications in older people. The study was conducted from July 2016 to February 2017. The reliability and internal consistency of the study tool was assessed using the test-retest method and the Cronbach alpha. Categorical groups were compared using the chi-square test and the Spearman rank correlation. RESULTS: On the 19-statement knowledge test, the median score was 55.3% with an interquartile range of 21.9%. In a comparison of the demographic and practice-related variables of the pharmacists who scored ≥ 50% on the 19-statement knowledge test with those who scored < 50%, age, gender, and having taken a course on psychotropic medications were found to be significantly associated with performance, as shown by the chi-square test and Spearman correlation. CONCLUSION: Pharmacists practicing in Palestine possess less than optimal knowledge of issues related to the use of psychotropic medications in older people. Continuing educational interventions and/or training might be helpful in improving pharmacists' knowledge of issues related to using psychotropic medications in older people.
Arabs* ; Cross-Sectional Studies* ; Geriatrics ; Humans ; Methods ; Pharmacists ; Psychotropic Drugs

The selective serotonin reuptake inhibitor fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and other psychiatric disorders. In the few years, there have been several reports of adverse effects encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced three cases of extrapyamidal symptoms were developed when administered fluoxetine alone and with neuroleptics. We conclude that there is a probable or possible causal relationship between fluoxetine and extrapyramidal side effects. The pathogenesis of such adverse reactions, which may be hetero-geneous, is unknown, but it has been suggested that they might be caused by serotonergically mediated inhibition of dopaminergic transmission. From reports in those cases, it appears that fluoxetine alone may be associated with extrapyramidal side reactions. Furthermore the potential for increased levels of concomitant psychotropic medicines and increased side effects, should be borne in mind.
Antipsychotic Agents ; Depression ; Fluoxetine* ; Psychomotor Agitation ; Psychotropic Drugs ; Serotonin

Many psychotropic drugs are marketed and prescribed as a racemate form in a mixture of the stereoisomers. A chiral center or a center of unsaturation of carbon atoms in the chemical structures creates various stereoisomers of the psychotropic drugs, including antidepressants such as fluoxetine and venlafaxine, etc. The stereochemical significances of enantiomers on the pharmacokinetics and pharmacodynamics of several psychotropic drugs and their relationships with pharmacogenetic polymorphisms were reviewed. The single enantiomer drugs will be increasing more in the market shares replacing the racemic drugs by chiral switching, which is driven by the development of the analytical and preparative resolution techniques and will be of much benefit to the treatment from low dosages, simple dose-response curve, few adverse reactions, and so on.
Antidepressive Agents ; Carbon ; Fluoxetine ; Pharmacokinetics ; Psychotropic Drugs* ; Stereoisomerism ; Venlafaxine Hydrochloride

The rapid development of psychotropic drugs and great advancement in psychopharmacology during the past recent years has altered the strategy of pharmacotherapy for major psychiatric disorders, and in turn, an active development of various clinical practice guidelines or algorithm has taken place. However, there could be problems with applying the foreign guidelines directly to our clinical situation, due to the differences in racial characteristics, socioeconomic conditions, government policy, and clinical practices. In addition, the changes of circumstances outside of clinical situation in Korea may distort clinical practices and may go even against the trend of recent psychopharmacology. As a solution to such problems, Korean Medication Algorithm Project for Major Psychiatric Disorders (KMAP) was launched with the support from the Korean Society of Psychopharmacology and Korean Academy of Schizophrenia. However, since clinical practice guidelines and algorithms contain not only the advantages, but also disadvantages and risks, sufficient consideration must precede the development of algorithms. Hence, this review provides a discussion on the definition of clinical guideline and its limitation, its advantages and disadvantages, and the need for the development of clinical guideline in psychiatric field. Also, developing source, dissemination and implementation of clinical practice guidelines were also discussed. We hope that this review can make the purpose of KMAP clear and elicit the productive criticism on Korean algorithm.
Drug Therapy ; Hope ; Korea ; Psychopharmacology ; Psychotropic Drugs ; Schizophrenia

Psychiatric disorders are among the most debilitating of all medical illnesses. Whilst there are drugs that can be used to treat these disorders, they give sub-optimal recovery in many people and a significant number of individuals do not respond to any treatments and remain treatment resistant. Surprisingly, the mechanism by which psychotropic drugs cause their therapeutic benefits remain unknown but likely involves the underlying molecular pathways affected by the drugs. Hence, in this review, we have focused on recent findings on the molecular mechanism affected by antipsychotic, mood stabilizing and antidepressant drugs at the levels of epigenetics, intracellular signalling cascades and microRNAs. We posit that understanding these important interactions will result in a better understanding of how these drugs act which in turn may aid in considering how to develop drugs with better efficacy or increased therapeutic reach.
Antidepressive Agents ; Antipsychotic Agents ; Epigenomics ; MicroRNAs ; Psychotropic Drugs*

OBJECTIVE: To analyze the relationship between seizure threshold (ST) and psychotropic drugs in patients treated with ECT. METHODS: We examined clinical data from 43 patients. ST was titrated at each treatment session. We examined associations between ST and psychotropic drugs using multivariate correlation analyses. Data are presented as initial ST, the difference in ST between the first and 10th sessions (ΔST(10th)), and the mean difference in ST between the first and last sessions (mean ΔST(last)). RESULTS: Multivariate regression analyses showed associations between initial ST and the total chlorpromazine-equivalent dose of antipsychotics (β=0.363, p<0.05). The total fluoxetine-equivalent dose of antidepressants was associated with ΔST(10th) (β=0.486, p<0.01) and mean ΔST(last) (β=0.472, p<0.01). CONCLUSION: Our study elucidated possible effects of psychotropic drugs on ST shifts. Larger doses of antipsychotics were associated with higher initial ST, whereas higher doses of antidepressants were associated with stronger shifts in ST.
Antidepressive Agents ; Antipsychotic Agents ; Electroconvulsive Therapy* ; Humans ; Psychotropic Drugs* ; Seizures*

Objective: To describe the concordance of the consultees with the Consultation-Liaison Psychiatry Services recommendations and diagnosis. Methodology: Review of 138 medical records of patients referred to the CL Psychiatry Service between January-December 2000 at the UP-PGH. The initial psychiatric consultation notes and the discharge summary were reviewed for specific concordance of consultants recommendations for diagnostic action and use of psychotropic drugs with consultees implementing such recommendations and including the psychiatric diagnosis in the final diagnosis. The program EPI-INFO 6 was used in data analysis. Results: Among the 4 percent of cases with recommendations for diagnostic action, there was only 50 percent concordance with the consultees. Of the 56 percent of cases with recommendations for use of psychotropic drugs there was a 79 percent concordance with the consultees. Representations for psychiatric diagnosis in the discharge summary revealed concordance in 32 percent of the cases, partial concordance in 6 percent and non-concordance in 62 percent of the cases. Conclusion: Diagnostic work-ups and referrals to other clinical services were not usually included in the management plan of the psychiatrist. Only half of the consultees followed such recommendations. Despite the fact that most consultees requested for an evaluation, only a third gave a representation of the psychiatrists diagnosis in the discharge summary. Suggesting that the consultees were more able to place the psychiatric issue within the familiar context of the medical model, there was a relatively higher concordance for recommendations for psychotropic drugs. This work highlights the wide latitude for improvement for psychiatric consultations in the general hospital setting.
Human ; Male ; Female ; MENTAL DISORDERS ; PSYCHOTROPIC DRUGS ; REFERRAL AND CONSULTATION