Addiction Rehab: The Pharmacogenetics of Antipsychotic-Induced Adverse Events.

The pharmacogenetics of antipsychotic-induced adverse events.

Filed under: Addiction Rehab

Curr Opin Psychiatry. 2013 Mar; 26(2): 144-150
Müller DJ, Chowdhury NI, Zai CC

PURPOSE OF REVIEW: Antipsychotic drugs are effective in alleviating a variety of symptoms and are medication of first choice in schizophrenia. However, a substantial interindividual variability in side effects often requires a lengthy ‘trial-and-error’ approach until the right medication is found for the right patient. Genetic factors have long been hypothesized to be involved and identification of related gene variants could be used to predict and tailor drug treatment. RECENT FINDINGS: This review highlighting the most recent genetic findings was conducted on the two most common and most well-studied side effects: antipsychotic-induced weight gain and tardive dyskinesia. SUMMARY: Regarding weight gain, most promising and most consistent findings were obtained in the serotonergic system (HTR2C) and with hypothalamic leptin-melanocortin genes, in particular with one variant close to the melanocortin-4-receptor (MC4R) gene. With respect to tardive dyskinesia, most interesting findings were generally obtained in genes related to the dopaminergic system (dopamine receptors D2 and D3), and more recently with glutamatergic system genes. Overall, genetic studies have been successful in identifying strong findings, in particular for antipsychotic-induced weight gain and to some extent for tardive dyskinesia. Apart from the need for replication studies in larger and well-characterized samples, the next challenge will be to create predictive algorithms that can be used for clinical practice.
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A randomized trial evaluating a parent based intervention to reduce college drinking.

Filed under: Addiction Rehab

J Subst Abuse Treat. 2013 Jan 28;
Doumas DM, Turrisi R, Ray AE, Esp SM, Curtis-Schaeffer AK

This study evaluated the effectiveness of a parent based intervention (PBI) in reducing drinking among first year college students (N=443). Students were assigned to one of three conditions: PBI, PBI plus booster brochures (PBI-B), and an assessment only control group (CNT). At a 4-month post-intervention follow-up, results indicated students in the PBI-B group reported significantly less drinking to intoxication and peak drinking relative to the PBI group and CNT group. No significant differences were found between the PBI group and CNT group. Results provide further support for PBIs to reduce college student drinking and suggest that a booster brochure increases the effectiveness of PBIs.
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Adherence to Pharmacological Treatment of Chronic Nonmalignant Pain in Individuals Aged 65 and Older.

Filed under: Addiction Rehab

Pain Med. 2013 Jan 31;
Markotic F, Cerni Obrdalj E, Zalihic A, Pehar R, Hadziosmanovic Z, Pivic G, Durasovic S, Grgic V, Banozic A, Sapunar D, Puljak L

BACKGROUND: Medication nonadherence is a frequent problem in the treatment of chronic conditions. OBJECTIVE: To study the adherence to pharmacological treatment of chronic nonmalignant pain, as well as factors and patient attitudes related to nonadherence in patients aged ?65 years. METHODS: The cross-sectional study was conducted with a self-administered questionnaire among 100 patients aged ?65 years by five family physicians at the Health Care Centre Mostar, Bosnia and Herzegovina. RESULTS: According to their own statements, 57% of the patients were nonadherent, while 84% exhibited some form of nonadherence on the Morisky scale. The patients reported a mean pain intensity of 6.6?±?2.2 on a visual analog scale. The most common deviation from the prescribed therapy was self-adjustment of the dose and medical regimen based on the severity of pain. Polymedication correlated positively with nonadherence. Nonsteroidal anti-inflammatory drugs were the most frequently prescribed medications. The majority of the participants (59%) believed that higher pain intensity indicates progression of the disease, and half of the participants believed that one can easily become addicted to pain medications. Nonadherence was associated with patient attitudes about addiction to analgesics and ability of analgesics to control pain. CONCLUSION.: High pain intensity and nonadherence found in this study suggest that physicians should monitor older patients with chronic nonmalignant pain more closely and pay more attention to patients’ beliefs regarding analgesics to ensure better adherence to pharmacological therapy.
HubMed – addiction


Oral health behavior of drug addicts in withdrawal treatment.

Filed under: Addiction Rehab

BMC Oral Health. 2013 Jan 31; 13(1): 11
Shekarchizadeh H, Khami MR, Mohebbi SZ, Virtanen JI

ABSTRACT: BACKGROUND: Oral health behavior (OHB), one major factor contributing to proper oral health status, has been addressed insufficiently in addiction literature. The aim of our study was to investigate OHB and its determinants among drug addicts in withdrawal treatment. METHODS: Through a stratified cluster sampling method, we collected the data from 685 patients in withdrawal treatment in Tehran using self-administered questionnaires on OHB components and conducting interviews about patients’ characteristics and addiction history. The T-test, ANOVA, and a linear regression model served for statistical analysis. RESULTS: Of the patients, 48% reported brushing their teeth less than once a day, more than 90% used fluoride toothpaste almost or always, and 81% flossed their teeth rarely or never. Eating sugary products twice a day or more was reported by 57% of the patients and 85% of them were current smokers. Poor OHB was associated with male gender, lower education, being addicted mainly to crystalline heroin, starting drug abuse at a younger age, and having a longer history of addiction (p < .05). CONCLUSION: Poor OHB was found among the participants in drug withdrawal treatment. Preventive strategies on oral health should be planned and be integrated into other health promotion programs for addicts along with their withdrawal treatment taking into account special groups at higher risk. HubMed – addiction



Filed under: Addiction Rehab

Rev Med Suisse. 2013 Jan 9; 9(368): 8-11
Besson J, Grivel J, Tomei A, Gothuey I, Andronicos M, Babel H, Nunweiler S

What’s new in addiction medicine in 2012? The news are presented according three axes: first, in the field of neuroscience, the process of extinction of addiction memories. Then in the clinical field, a reflexion is reported on how to treat addiction in psychiatric hospitals. At last, in the area of teaching, an e-learning development with a virtual patient shows a great interest in addiction psychiatry.
HubMed – addiction


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