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Marvin the Paranoid Android and Alice in Wonderland
Published in Ornella Corazza, Andres Roman-Urrestarazu, Handbook of Novel Psychoactive Substances, 2018
Pierluigi Simonato, Attilio Negri, Marco Solmi, Rita Santacroce
She was admitted to our unit with the following pharmacologic treatment: sertraline (200 mg/die); valproic acid (900 mg /die); quetiapine (400 mg/die); aripiprazole (10 mg/die); clotiapine (40 mg/die); lorazepam (5 mg/die); and clonazepam (2 mg/die), and at her arrival, she also confirmed a dependence of lormetazepam. The assessment for substances was conducted through clinical interviews, collecting further anamnestic information both for ‘classic’ and ‘novel’ compounds (NPS).
Suboptimal palliative sedation in primary care: an exploration
Published in Acta Clinica Belgica, 2018
Peter Pype, Inge Teuwen, Fien Mertens, Marij Sercu, An De Sutter
In our study, midazolam was the drug most frequently used for palliative sedation, a choice being confirmed in literature [2,5,6,16,27]. Comparative studies with other drugs are lacking and therefore guidelines on PS are mostly based on expert opinions when it comes to recommendations on drug use [2,27,28]. It has been shown that higher doses of midazolam were significantly correlated with younger age, previous use of benzodiazepines and longer total time of sedation [8,25,29]. Other options are to add levomepromazine or clotiapine to the midazolam in case of non-responsiveness. De Graeff et al. suggest to use phenobarbital or propofol in case of high levels of patient agitation that is non-responsive to midazolam [2]. Phenobarbital has been used in our study in a minority of patients but also showed cases of suboptimal sedation. As such, our limited study cannot add to the discussion of drug preference. The small sample of cases does not allow us to perform statistics clarifying which patient characteristics might lead to higher odds of suboptimal sedation. A study by Morita et al. could not find statistically significant correlations between the effectiveness of the palliative sedation and patient characteristics [25]. In the light of the high number of suboptimal sedations in our study, despite the expert supervision and use of guidelines, it might be worthwhile reviewing how the guidelines can be optimized for use in primary care.
5-HT2A receptor-mediated Gαq/11 activation in psychiatric disorders: A postmortem study
Published in The World Journal of Biological Psychiatry, 2021
Yuji Odagaki, Masakazu Kinoshita, José Javier Meana, Luis F. Callado, Jesús A. García-Sevilla
A variety of psychotropic drugs had been detected by toxicological screening at autopsy, especially in patients with psychiatric disorders (Table 1). In the present study, the possible effects of antipsychotic agents (clozapine, thioridazine, quetiapine, olanzapine, periciazine, clotiapine, zuclopenthixol and risperidone), possessing common pharmacological properties as dopamine D2 receptor antagonists, were investigated. Almost all of these drugs are second-generation or atypical antipsychotics that are known to behave as a potent antagonist at 5-HT2A receptors as well.