Current Psychopharmacology - Volume 11, Issue 1, 2022

Various clinical results are obtained regarding the effects of cerebellar GABA transmission on spinocerebellar ataxias. Based on animal studies, it is proposed that balanced GABAergic transmission between GABA and other neurotransmitters such as glutamate may lead to more promising results in treating such conditions.

A deficit in brain serotonin (5-hydroxytryptamine; 5-HT) is implicated in a number of psychiatric illnesses, including depression. The treatment efficacy of this highly prevalent brain disorder is not adequate largely due to the depletion of serotonin stores. Tryptophan, an essential amino acid, is the sole precursor of serotonin; its systemic or oral administration increases serotonin synthesis because tryptophan hydroxylase, the rate-limiting enzyme of 5-HT biosynthesis, is physiologically unsaturated with its substrate. The present article targets the importance of tryptophan supplementation in treating serotonin deficiency and improving therapeutic intervention for depression and other serotonin deficiency brain disorders.

Background: Repeated cocaine administration changes histone acetylation and methylation on Lys residues and Deoxyribonucleic acid (DNA) within the nucleus accumbens (NAc). Recently Nestler’s group explored histone Arg (R) methylation in reward processing models. Damez- Werno et al. (2016) reported that during human investigations and animal self-administration experiments, the histone mark protein-R-methyltransferase-6 (PRMT6) and asymmetric dimethylation of R2 on histone H3 (H3R2me2a) decreased in the rodent and cocaine-dependent human NAc. Overexpression of PRMT6 in D2-MSNs in all NAc neurons increased cocaine seeking, whereas PRMT6 overexpression in D1-MSNs protects against cocaine-seeking. Hypothesis: The hypothesis is that dopaminylation (H3R2me2a binding) occurs in psychostimulant use disorder (PSU), and the binding inhibitor Srcin1, like the major DRD2 A2 allelic polymorphism, protects against psychostimulant seeking behavior by normalizing nucleus accumbens (NAc) dopamine expression. Discussion: Numerous publications confirmed the association between the DRD2 Taq A1 allele (30-40 lower D2 receptor numbers) and severe cocaine dependence. Lepack et al. (2020) found that acute cocaine increases dopamine in NAc synapses, and results in histone H3 glutamine 5 dopaminylation (H3Q5dop) and consequent inhibition of D2 expression. The inhibition increases with chronic cocaine use and accompanies cocaine withdrawal. They also found that the Src kinase signaling inhibitor 1 (Srcin1 or p140CAP) during cocaine withdrawal reduced H3R2me2a binding. Consequently, this inhibited dopaminylation induced a “homeostatic brake.” Conclusion: The decrease in Src signaling in NAc D2-MSNs, (like the DRD2 Taq A2 allele, a well- known genetic mechanism protective against SUD) normalizes the NAc dopamine expression and decreases cocaine reward and motivation to self-administer cocaine. The Srcin1 may be an important therapeutic target.

Attention deficit hyperactive disorder or ADHD is a common disorder among children, and if not identified early, it may affect the child’s later life. Pharmacotherapy in ADHD has been linked to the emergence of other emotional disorders. Children who get pharmacological treatment are more likely to continue taking these medications until adulthood, increasing their risk of acquiring other psychological problems. As a result, the majority of ADHD patients are eventually prescribed numerous medicines to manage emotional difficulties as well. Thus, AI tools are seen to be a boon for ADHD patients and clinicians. There have been emerging approaches in using artificial intelligence tools to diagnose and treat ADHD in recent years. Different algorithms and medical devices are used for greater accuracy and precision. The various neural networks detect complex signals in the human brain and analyze them. As it is a neurodevelopmental disorder, AI gives the best tools for proper diagnosis and treatment. Virtual and physical branches of AI are a great help to the patient. This review article focuses on the use of various AI models and tools that employ ADHD symptoms, MRI scans, and EEG signals, using electroencephalogram sensors to monitor brain activity, to help physicians better manage this prevalent neurodevelopmental disorder.

Ageing comes with degeneration in many biological activities like impairment of cognition, intelligence, attention, and memory. The decline in all those mental capabilities would be due to the abnormal changes in neuronal architecture with increasing age, chronic oxidative stress, inflammatory state of the tissue, and nutritional deficiency. Nootropics or smart drugs enhance memory, attention, creativity, and cognitive performance by affecting the synthesis and receptor binding of neurotransmitters in the brain, especially dopamine, serotonin, gamma-aminobutyric acid, glutamate, and acetylcholine. Nootropics have shown their positive effects in Parkinson’s, autism, Alzheimer’s, and Huntington's disease, where impaired memory is the primary concern. The synthetic class of nootropics has limitations and reported exacerbation of other brain disorders (off label effects) or therapeutic failure in some instances. Nutraceuticals are dietary derived vitamins, minerals, herbal products, proteins, marine products, and probiotics. The health benefits derived from nutraceuticals are increased brain blood flow, reduced inflammation in nervous tissues, detoxified toxins from the brain, balanced neurotransmitter turnover rate, corrected neuronal and receptor damages and prompt synaptic transmission, good antioxidant properties and power of improving neuroplasticity of the brain that combats neurodegeneration. The demand for effective nootropics will remain high as the number of cases is being increased tremendously.

Introduction: The mainstay of pharmacological management of opioid dependence is opioid substitution treatment. Methadone is a long-acting opioid agonist, which is used for detoxification and maintenance of opioid-dependent people. Objective: Objective of the present evaluation included a comparison between methadone and acetaminophen codeine plus clonidine for management of opioid withdrawal symptoms. Methods: All patients of an acute ward of a psychiatric hospital, who met dual diagnosis of primary psychiatric disorder plus opioid use disorder, were selected as accessible sample for the current evaluation. Duration of assessment was around eleven months and the study was performed according to a single-blind plan. Among 96 patients, cases, who were using methadone, before their recent admission in hospital, continued their substitution treatment according to the recommended dosage and formulation till release (n = 42). The remaining group of patients, had been given acetaminophen codeine plus clonidine, as substitution treatment, during their inpatient management (n = 54). The primary outcome measures were the ‘Cross-Cutting Symptom Measure’ and the ‘Subjective Opiate Withdrawal Scale’, which were scored at baseline, week 1 and week 2. The study was performed according to the ‘per-protocol’ analysis, and the assessor was blind with respect to the said protocols. Results: While the mean total score of primary outcome measures decreased significantly in both groups, the between-group analysis did not show any significant difference between these two groups in a head-to-head analysis. Conclusion: Acetaminophen codeine plus clonidine was as good as methadone for management of opioid withdrawal symptoms in inpatient setting.

Background: Psychotropic polypharmacy is particularly common, which puts psychiatric patients at high risk for developing drug-drug interactions. Objective: We aimed to study potential interactions between psychotropic medications prescribed within the outpatient psychiatry setting. Methods: This was an audit study, which targeted a sample of outpatient prescriptions ordered within the outpatient clinics of the main psychiatry hospital in Bahrain over 2017. We studied the grades and correlates of interactions between psychotropic drugs. Results: The total number of prescriptions in our sample was 992 (56.1% males, 43.9% females). Psychotropic polypharmacy was detected in 842 prescriptions (84.9%). Potential interactions between psychotropic drugs were observed in 550 prescriptions (56.4%). The degree of interaction was minor in 43 prescriptions (7.8%), significant in 419 prescriptions (76.2%), and serious in 88 prescriptions (16%). Schizoaffective disorder subjects were the most likely to suffer from interactions (64.6%), whereas prescriptions issued for those who had schizophrenia contained the least number of interactions (51.6%). The total number of interactions was strongly associated with polypharmacy (p < .001) and gender (p < .01), but not with age (p > .05) or diagnosis (p > .05). Conclusion: High prevalence of polypharmacy and interactions between psychotropic medications were observed in our sample, particularly of the significant grade.

Background: Diabetes mellitus refers to comorbidities associated with reduced release of the brain-derived neurotropic factor and disruption in the metabolism of neurotransmitters leading to depression and cognitive impairment. Allopathic medications are available for the treatment of diabetes, but there is no cure and multiple adverse effects adhere to it. The therapeutic effects of co-administered chamomile with saffron may reverse diabetes and its complications. Co-administration of chamomile and saffron is effective against diabetes and related complications. Methods: The present study sought to test the hypothesis, conducted on eighty Sprague-Dawley rats randomly divided into eight groups (n=10), including healthy controls, diabetic controls, methanolic extract treatment groups and water decoction treatment groups with respective dosage once a day for two weeks. The dose of a single herb group in methanolic extract and water decoction was saffron 10 mg/kg and chamomile 30 mg/kg, while co-administered groups received both herbs in half doses, saffron 5 mg/kg and chamomile 15 mg/kg. Two widely used tests for the assessment of memory (elevated plus maze and novel object recognition) were used to assess the mood and memory (cognitive) performance after the treatment. Results: It was observed that all treatment groups exhibited antidiabetic effects with improved mood and enhanced memory, high antioxidant profile, increased brain-derived neurotropic factor and acetylcholine concentration. However, the effects were greater in the co-administered groups of saffron and chamomile, especially the combined water decoction group. Conclusion: The study provides the successful results of co-administration of chamomile and saffron to alleviate diabetes and related complications.