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Shih-Yu Chen, Gopi Ravindran, Qichen Zhang, Steve Kisely, Dan Siskind
BACKGROUND: Clozapine is the most effective medication for treatment-refractory schizophrenia. However, it has a high burden of adverse events, including common adverse events such as sialorrhea. Sialorrhea can lead to severe physical complications such as aspiration pneumonia, as well as psychological complications including embarrassment and low self-esteem. Compromised adherence and treatment discontinuation can occur due to intolerability. There have been no meta-analyses examining strategies to mitigate clozapine-induced sialorrhea...
February 13, 2019: CNS Drugs
Yoichi Tanikawa, Mihoko Hagiwara-Nagasawa, Ryuichi Kambayashi, Ai Goto, Koki Chiba, Kumiko Kitta, Kiyotaka Hoshiai, Hiroko Izumi-Nakaseko, Atsuhiko T Naito, Atsushi Sugiyama
Fluvoxamine is a selective serotonin-reuptake inhibitor, of which IC50 values for serotonin- and noradrenaline-uptake process were reported to be 3.8 and 620 nmol/L, respectively, also known to directly inhibit cardiac Na+ , Ca2+ , and K+ channels. We characterized microminipig as a laboratory animal by analyzing fluvoxamine-induced cardiovascular and dermatological responses under halothane anesthesia. Fluvoxamine maleate was infused in doses of 0.1, 1, and 10 mg/kg over 10 min with a pause of 20 min (n = 4)...
February 8, 2019: Cardiovascular Toxicology
Kirstine Calloe, Salomé Rognant, Søren Friis, Catherine Shaughnessy, Dan A Klaerke, Dagmar Trachsel
BACKGROUND: The voltage-gated K+ -channel Kv 11.1 has a central role in cardiac repolarization. Blockage of Kv 11.1 has been linked to severe cardiovascular side effects, such as acquired long QT syndrome (aLQTS), torsade de pointes arrhythmia and sudden cardiac death (SCD). Kv 11.1 is susceptible to unspecific drug interactions due to the presence of two aromatic amino acids residing in the inner vestibule of the pore. These aromatic residues are also present in the equine orthologue of Kv 11...
January 8, 2019: Research in Veterinary Science
Hien Nguyen, Angel Pan, Craig Smollin, Lee F Cantrell, Tom Kearney
WHAT IS KNOWN: Cyproheptadine is a serotonin and histamine antagonist that has been suggested as a treatment for serotonin syndrome in case reports. OBJECTIVE: We sought to examine the differences between outcomes and treatment recommendations in patients who received and did not receive cyproheptadine for a probable serotonin syndrome. METHODS: A retrospective review of cases reported to the California Poison Control System between 2006 and 2017 involving cyproheptadine administration or consideration for treatment of a probable serotonin syndrome...
January 16, 2019: Journal of Clinical Pharmacy and Therapeutics
Matthew I Hardman, Juraj Sprung, Toby N Weingarten
Phenibut is a glutamic acid derivative with activity on the γ-aminobutyric acid (GABA) B and A, and β-phenethylamine receptors. It is prescribed in former Communist Bloc countries for anxiolysis and related psychiatric disorders. It can be easily obtained in Western countries, and is thought to have abuse potential. Abrupt discontinuation has been reported to precipitate an abstinence syndrome. A review of the literature identified 22 reported cases, many of which were notable for severe psychomotor agitation and requirements for aggressive pharmacologic treatment...
December 3, 2018: Bosnian Journal of Basic Medical Sciences
Faezeh Kadkhoda Mezerji, Fatemeh Moharreri, Amir Hooshang Mohammadpour, Sepideh Elyasi
OBJECTIVES: Insomnia and loss of appetite are the most common side effects of methylphenidate in patients with attention deficit/hyperactivity disorder (ADHD). The adverse effects may limit optimal dosing and patients' compliance with treatment leading to the discontinuation of treatment. This research evaluates the preventive effects of cyproheptadine on sleeping and appetite disorders induced by methylphenidate in ADHD children. METHODS: During this exploratory, randomised, double-blinded, placebo-controlled clinical trial, forty patients with ADHD diagnosis who had received methylphenidate randomly were assigned to participate in the cyproheptadine or the placebo group...
September 27, 2018: International Journal of Psychiatry in Clinical Practice
Niosha Saberi, Maryam Akhgari, Leila Bahmanabadi, Elham Bazmi, Zahra Mousavi
BACKGROUND: Nowadays with the growing popularity of herbal remedies across the world, large sections of population rely on herbal drug practitioners for their primary care. Therefore there is a need to ensure about the safety of herbal drugs and to detect adulteration with undeclared active pharmaceutical ingredients. Herbal drugs are used as first-line drug therapy in some instances. Unfortunately even if there are claims as to be natural, undeclared active pharmaceutical ingredients have been detected in these supplements...
September 21, 2018: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
Francisco José Batista-Lima, Felipe Macário Dos Santos Rodrigues, Kalinne Kelly Lima Gadelha, Daniel Maia Nogueira de Oliveira, Emanuella Feitosa Carvalho, Tatyanne Linhares Oliveira, Fernanda Carlos Nóbrega, Teresinha Silva Brito, Pedro Jorge Caldas Magalhães
β-Phenylethylamine (β-PEA) is a trace amine with chemical proximity to biogenic amines and amphetamines. It is an endogenous agonist of trace amine-associated receptors (TAARs) that acts as a neuromodulator of classic neurotransmitters in the central nervous system. At high concentrations, β-PEA contracts smooth muscle, and a role for TAARs in these responses has been postulated. The high dietary intake of trace amines has been associated with such symptoms as hypertension and migraine, especially after the intake of foods containing such compounds...
September 19, 2018: Clinical and Experimental Pharmacology & Physiology
Wendy Spettigue, Mark L Norris, Alexandre Santos, Nicole Obeid
Background: To date, little research has examined the effectiveness of either modified Family-Based Therapy or psychopharmacological treatments for patients diagnosed with avoidant/restrictive food intake disorder (ARFID), and there is little evidence to guide clinicians treating children and adolescents with ARFID. This case series describes the clinical presentations, treatments and outcomes of six patient diagnosed with ARFID who were treated sequentially by a child psychiatrist and adolescent medicine physician in a hospital-based eating disorder program...
2018: Journal of Eating Disorders
B U K Li
Cyclic vomiting syndrome (CVS) in children is characterized by frequent hospitalizations, multiple comorbidities, and poor quality of life. In the absence of robust data, the treatment of CVS remains largely empiric starting with the 2008 NASPGHAN Consensus Statement recommendations of cyproheptadine for children < 5 years of age and amitriptyline for those ≥ 5 years with propranolol serving as the second-line agent. Comprehensive management begins with lifestyle alterations, and extends to medications, supplements, and stress reduction therapies...
October 2018: European Journal of Pediatrics
Yomna A Salem, Mohammed E A Hammouda, Noha M Saleh, Mohamed A Abu El-Enin, Saadia M El-Ashry
A rapid, and highly sensitive analytical method were developed for the simultaneous determination of indacaterol maleate (IND) and glycopyrronium bromide (GLY) in their inhaler capsules. Valid ion-pairing chromatographic (IPC) method was performed for separation of GLY in presence of IND using C18 column and mobile phase consisting of acetonitrile: acidified deionized water (60:40% v/v) containing 0.02% sodium dodecyl sulfate (SDS) adjusted to pH 3.0 using OPA (orthophosphoric acid) isocratically eluted at 2...
November 5, 2018: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
Amber Kapuganti, Traci Turner, Christopher J Thomas
Introduction: This retrospective cohort study evaluated effects of buprenorphine/naloxone dose and concomitant use of selected sedating medications on treatment outcomes in patients with opioid use disorder. Methods: Patients enrolled in the buprenorphine/naloxone clinic at the study institution from 2009 until April 2013 were included. There were no exclusion criteria. Part 1 assessed treatment failure within 6 months and time to treatment failure with buprenorphine doses >8 mg and ≤8 mg...
November 2017: The mental health clinician
Tomoya Hirano, Takashi Fujiwara, Hideaki Niwa, Michitake Hirano, Kasumi Ohira, Yusuke Okazaki, Shin Sato, Takashi Umehara, Yuki Maemoto, Akihiro Ito, Minoru Yoshida, Hiroyuki Kagechika
The histone methyltransferase SET7/9 methylates not only histone but also non-histone proteins as substrates, and therefore, SET7/9 inhibitors are considered candidates for the treatment of diseases. Previously, our group identified cyproheptadine, used clinically as a serotonin receptor antagonist and histamine receptor (H1) antagonist, as a novel scaffold of the SET7/9 inhibitor. In this work, we focused on dibenzosuberene as a substructure of cyproheptadine and synthesized derivatives with various functional groups...
August 10, 2018: ChemMedChem
Terrance McGovern, Justin McNamee, Steven Marcus, Josh Kashani
Cyproheptadine is an H-1 antihistamine with anticholinergic and antiserotonergic effects. Cyproheptadine's most common use has been in the management cold-induced urticaria. It is often used in primary care for its side effect of appetite stimulation. Recently there has been increasing interest in its use in the treatment of drug-induced serotonin syndrome. Cyproheptadine overdose is uncommonly reported in the medical literature. We report the rare case of a pediatric cyproheptadine overdose with a confirmatory cyproheptadine level...
August 2017: Clinical practice and cases in emergency medicine
Kimberly Little, Christine M Lin, Paul M Reynolds
BACKGROUND Serotonin syndrome is a condition characterized predominantly by neuromuscular symptoms and altered thermoregulation in response to serotonergic overtone. Treatment is focused on withdrawal of serotonergic agents, which leads to resolution in the majority of cases. In the setting of serotonergic overdose, the onset of serotonin syndrome is usually within 4 to 13 h. Here, we report a case of delayed-onset serotonin syndrome in a patient who ingested a mixture of longer-acting serotonin agonists with serotonin antagonists...
May 25, 2018: American Journal of Case Reports
Sameer Hassamal, Karen Miotto, William Dale, Itai Danovitch
Tramadol is commonly prescribed for pain control because it presents a lower risk for addiction and respiratory depression compared to other opioids. However, tramadol's serotonin and norepinephrine reuptake inhibitory effects result in a unique adverse effect profile. Two such adverse events are serotonin syndrome and seizures. The prevalence of tramadol-induced serotonin syndrome and seizures is modest in the general population, but if left untreated, the morbidity and mortality can be high; therefore, prompt recognition and management is essential...
November 2018: American Journal of Medicine
Shuo Gu, Wing-Yu Fu, Amy K Y Fu, Estella Pui Sze Tong, Fanny C F Ip, Xuhui Huang, Nancy Y Ip
The receptor tyrosine kinase, erythropoietin-producing hepatocellular A4 (EphA4), was recently identified as a molecular target for Alzheimer's disease (AD). We found that blockade of the interaction of the receptor and its ligands, ephrins, alleviates the disease phenotype in an AD transgenic mouse model, suggesting that targeting EphA4 is a potential approach for developing AD interventions. In this study, we identified five FDA-approved drugs-ergoloid, cyproheptadine, nilotinib, abiraterone, and retapamulin-as potential inhibitors of EphA4 by using an integrated approach combining virtual screening with biochemical and cellular assays...
May 9, 2018: Scientific Reports
Christie Sun, Hannah Sweet, Alicia B Minns, Desiree Shapiro, Willough Jenkins
BACKGROUND: Neuroleptic malignant syndrome (NMS) and serotonin syndrome (SS) are serious medical conditions associated with commonly prescribed psychiatric medications. Although the mechanisms differ, they can be clinically difficult to distinguish. We report a case of a pediatric patient with complicated psychiatric history that developed features of both syndromes in the setting of polypharmacy. CASE: A 12-year-old boy with a history of developmental delay, attention-deficit hyperactivity disorder, and posttraumatic stress disorder presented to the emergency department with behavior changes consisting of delayed reactions, gait instability, drooling, and slowed movements...
April 24, 2018: Pediatric Emergency Care
Yan-Lin He, Kai Wang, Qian-Ru Zhao, Yan-Ai Mei
Cyproheptadine (CPH), a first-generation antihistamine, enhances the delayed rectifier outward K+ current (IK ) in mouse cortical neurons through a sigma-1 receptor-mediated protein kinase A pathway. In this study, we aimed to determine the effects of CPH on neuronal excitability in current-clamped pyramidal neurons in mouse medial prefrontal cortex slices. CPH (10 µmol/L) significantly reduced the current density required to generate action potentials (APs) and increased the instantaneous frequency evoked by a depolarizing current...
October 2018: Neuroscience Bulletin
Anne Donnet, Sylvain Redon
PURPOSE OF REVIEW: Cyclic vomiting syndrome (CVS) is a misrecognized and probably underdiagnosed episodic syndrome associated with migraine, occurring preferentially in childhood. Attacks are stereotyped for each individual, with predictable periodicity. This review summarizes recent clinical and paraclinical observations in this syndrome, and current approaches in explorations and therapeutics. RECENT FINDINGS: Clinical phenotype during prodromal, vomiting, and recovery phases contains visceral and neuropsychological symptoms, but also cranial and systemic symptoms...
March 19, 2018: Current Pain and Headache Reports
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