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Specific Arterial Disease
Published in Wilmer W Nichols, Michael F O'Rourke, Elazer R Edelman, Charalambos Vlachopoulos, McDonald's Blood Flow in Arteries, 2022
Serotonin has no effect on normal coronary arteries at low concentrations but causes constriction at high doses; in contrast, patients with stable angina pectoris show generalized constriction at all concentrations (Golino et al., 1991; McFadden et al., 1991), while patients with variant angina show more marked arterial narrowing with localized epicardial coronary spasm (McFadden et al., 1991). Serotonin contracts also cerebral arteries. The effects are considered to be due to activation of the 5HT2 receptor (Connor et al., 1989; Hillis and Lange, 1991). The serotonin agonist sumatriptan affects 5HT1 receptors, which are usually not present in the heart but which are present in cerebral vessels (Olesen, 1994; Raskin, 1994). This drug is extremely effective in the treatment of migrainous headache (Bateman, 2000).
Mystical States achieved through Psychedelics: The Origins, Classical, and Contemporary Use of Psychedelics
Published in Andrew C. Papanicolaou, A Scientific Assessment of the Validity of Mystical Experiences, 2021
Psychedelics come in many varieties. Those that are most frequently used—the so-called “classical” psychedelics—are primarily, though not exclusively, serotonin agonists, that is they bind to serotonin receptors, mainly the receptor 5-HT 2A. This is known because serotonin antagonists, that is, chemicals that block the effects of serotonin also block the effects of these psychotropic drugs.
Serotonin Metabolism in Functional Somatic Illness
Published in Peter Manu, The Psychopathology of Functional Somatic Syndromes, 2020
Three years later, British investigators from Maudsley Hospital and King’s College Hospital, London, conducted a well-designed study evaluating central serotonergic neurotransmission in chronic fatigue syndrome (Cleare et al., 1995). The innovative dimension of this study was to stimulate the serotonergic pathways in the hypothalamus with challenge with fenfluramine, a serotonin-agonist substance. The fenfluramine challenge is known to elevate the level of both cortisol and prolactin in healthy individuals (O’Keane et al., 1991; Feeney et al., 1993; Gorard et al., 1993). In contrast, the change in prolactin and cortisol levels in response to this neuroendocrine challenge is almost undetectable in patients with major depression (O’Keane and Dinan, 1991).
Current and emerging drug treatment strategies to tackle invasive community-associated methicillin-resistant Staphylococcus aureus (MRSA) infection: what are the challenges?
Published in Expert Opinion on Pharmacotherapy, 2023
Antonio Vena, Nadia Castaldo, Laura Magnasco, Martina Bavastro, Alessandro Limongelli, Daniele Roberto Giacobbe, Matteo Bassetti
Linezolid represents an ideal option for the intravenous-to-oral treatment switch, particularly for patients with pneumonia or skin and soft tissue infections due to MRSA [63,64]. Major drawbacks include the potential risk of myelosuppression, neuropathy, and lactic acidosis [65,66]. In addition, in patients taking linezolid along with serotonin agonists, there is a small but documented risk for serotonin syndrome. Because of this risk, clinicians often have to decide whether to discontinue either linezolid or a selective serotonin reuptake inhibitor in situations in which both medications are administered [65–67]. Finally, daptomycin represents a good alternative to vancomycin for the treatment of most CA-MRSA infections (except for pneumonia due to the inactivation of daptomycin by the pulmonary surfactant). The drug is widely used in clinical practice, but because of a once-daily intravenous administration, it does not represent the ideal option for early-discharge policies and for the treatment of outpatients.
Predicting serotonin toxicity in serotonin reuptake inhibitor overdose
Published in Clinical Toxicology, 2023
Joyce Cooper, Stephen B. Duffull, Geoffrey K. Isbister
The most common medications resulting in serotonin toxicity are the widely prescribed selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Other medications implicated include serotonin precursors, monoamine oxidase inhibitors (MAOIs), serotonin agonists and drugs that cause serotonin release. Diagnosis of serotonin toxicity has been problematic, initially with Sternbach’s over-inclusive criteria [5]. In 2003, Dunkley et al. published the Hunter serotonin toxicity criteria based on a review of over 2000 cases following SSRI overdose which provided more specific and sensitive criteria for diagnosis [6]. Serotonin toxicity results in neuromuscular excitation, seen as clonus, myoclonus, hyper-reflexia and/or tremor; autonomic hyperactivity including tachycardia, diaphoresis, fever and/or mydriasis; and altered mental state such as confusion, excitement and/or agitation [6].
The Use of Psilocybin in the Treatment of Psychiatric Disorders with Attention to Relative Safety Profile: A Systematic Review
Published in Journal of Psychoactive Drugs, 2023
Andrew Troy Hodge, Suporn Sukpraprut-Braaten, Matthew Narlesky, Robert C. Strayhan
When ingested, psilocybin can cause subjective, dose-dependent psychoactive effects in the individual that have been described as having hallucinogenic and anxiolytic properties (NCBI 2021b Psilocybine). The drug has the ability to invoke profound, lasting changes in the cognition, perception, and emotion of those who consume it and many report a long-term improvement in their mental health after having used the drug (Nichols and Barker 2016; Patra 2016). Taking psilocybin has been characterized as a “pleasant and positive spiritual and mystical experience” which users typically remember as personally meaningful due to the changes the experience with the drug brings about on their behavior and attitude that last long after the drug has been metabolized and excreted (Patra 2016). Chemically, psilocybin belongs to a group of organic biomolecules called tryptamines that naturally occur in the human body and are metabolized from the amino acid tryptophan (NCBI 2021b Tryptamine). It acts as a serotonin agonist mainly at the 5-HT2A and 5-HT2C receptors, in a sense, mimicking the effects of serotonin (NCBI 2021a Psilocybine; Patra 2016; Passie et al. 2002). Additionally, psilocybin indirectly acts on the dopaminergic system via stimulating the release of dopamine in the caudate nucleus and putamen (Dinis-Oliveira 2017; Vollenweider, Vontobel, and Hell et al. 1999).