Antidepressant Pharmacotherapy: Prescription Practices in Psychiatric Resident Care

Background: Research on treatment of depression has raised concerns regarding adequacy of medication trials and rationality of drug choice. Little data exists regarding pharmacotherapy by psychiatric residents. As practice habits begun in training will likely persist after graduation, examination of residents\u27 antidepressant use may ultimately improve treatment by psychiatrists. Methods: Charts of new patients presenting to the Wake Forest University Psychiatry Resident Clinic were reviewed. Survey was made of medications prescribed to 112 patients diagnosed with major depression, dysthymia, depressive disorder NOS, adjustment disorder with depressed mood, or bipolar disorder with a documented depression during the studied period. Drug choice and maximum dose were noted. Results: Most-prescribed antidepressants included sertraline, trazodone, citalopram, mirtazapine, venlafaxine, and bupropion. The most used tricyclic antidepressant was amitriptyline (n=7), with an average highest dose of 110.7 mg per day. No MAOIs were prescribed. Augmentation treatment with lithium was prescribed twice and thyroid hormone once. No patients received ECT. Conclusions: Depressed patients in this resident clinic were treated primarily with SSRIs and other newer antidepressants. Little use was made of TCAs, MAOIs, ECT or traditional augmentation strategies. Further research should aim to determine whether more education in older antidepressant treatment modalities should be emphasized

Religious Involvement, the Serotonin Transporter Promoter Polymorphism, and Drug Use in Young Adults

We examine whether the genetic basis for religious involvement is common to the genetic basis for drug use/abuse, helping to explain the inverse relationship between religiosity and drug use. To test this hypothesis, we analyzed data on 2,537 young adult siblings participating in Wave III of the National Longitudinal Study of Adolescent Health on whom both genetic characteristics and religious participation were collected. Religion/spirituality was assessed with four measures: frequency of attendance at religious services and other religious youth meetings, frequency of private prayer, self-rated importance of religion and spirituality, and self-reported history of a life-changing spiritual experience. Each religious measure was examined individually and combined together into a summary scale. Illicit drug use (including prescription drug abuse) was assessed. Polymorphisms of the promoter region of the serotonin transporter gene, SLC6A4 (i.e., LL, SL, SS genotypes) were determined. Results indicated that (1) all religious measures were inversely related to drug use/abuse, (2) the SLC6A4 genotypes SS and SL were less common among those who were more religious, especially among non-whites, and (3) SS/SL genotypes were less common among those who used illegal drugs. Despite being less likely to have the protective SS/SL genotype, religious adolescents were still less likely to use drugs. (4) There was no evidence that the serotonin transporter genotype mediated the relationship between religiosity and illegal drug use. These findings suggest that genetic factors play a role in religiosity, especially in non-whites, and that both genotype and religiosity independently predict substance abuse

Occupational Therapy Strategies for Postural Orthostatic Tachycardia Syndrome

Effectiveness of occupational therapy strategies with adults with postural orthostatic tachycardia syndrome

Informed consent for research in Borderline Personality Disorder

<p>Abstract</p> <p>Background</p> <p>Previous research on informed consent for research in psychiatric patients has centered on disorders that affect comprehension and appreciation of risks. Little has been written about consent to research in those subjects with Borderline Personality Disorder, a prevalent and disabling condition.</p> <p>Discussion</p> <p>Despite apparently intact cognition and comprehension of risks, a borderline subject may deliberately choose self-harm in order to fulfill abnormal psychological needs, or due to suicidality. Alternatively, such a subject may refuse enrollment due to transference or the desire to harm him or herself. Such phenomena could be precipitated or prevented by the interpersonal dynamics of the informed consent encounter.</p> <p>Summary</p> <p>Caution should be exercised in obtaining informed consent for research from subjects with Borderline Personality Disorder. A literature review and recommendations for future research are discussed.</p

Aquaglyceroporin-3’s expression and cellular localization is differentially modulated by hypoxia in prostate cancer cell lines

Aquaporins are required by cells to enable fast adaptation to volume and osmotic changes, as well as microenvironmental metabolic stimuli. Aquaglyceroporins play a crucial role in supplying cancer cells with glycerol for metabolic needs. Here, we show that AQP3 is differentially expressed in cells of a prostate cancer panel. AQP3 is located at the cell membrane and cytoplasm of LNCaP cell while being exclusively expressed in the cytoplasm of Du145 and PC3 cells. LNCaP cells show enhanced hypoxia growth; Du145 and PC3 cells display stress factors, indicating a crucial role for AQP3 at the plasma membrane in adaptation to hypoxia. Hypoxia, both acute and chronic affected AQP3′s cellular localization. These outcomes were validated using a machine learning classification approach of the three cell lines and of the six normoxic or hypoxic conditions. Classifiers trained on morphological features derived from cytoskeletal and nuclear labeling alongside corresponding texture features could uniquely identify each individual cell line and the corresponding hypoxia exposure. Cytoskeletal features were 70–90% accurate, while nuclear features allowed for 55–70% accuracy. Cellular texture features (73.9% accuracy) were a stronger predictor of the hypoxic load than the AQP3 distribution (60.3%)

Setting an agenda for disability research in Australia: organisation-led and targeted consultation report

This report presents the results of the Phase 2b consultation conducted with 974 individuals from 21 non-government organisations (NGOs), including service providers and disabled peoples’ organisations (DPOs), the First Nations-focused National Disability Research Agenda survey and online focus groups and in-depth interviews with people with augmentative and alternative communication needs. It is part of multi-phase research agenda setting exercise that has been conducted to understand existing disability research in Australia and consult with the disability sector to understand their priorities for disability research. This research was funded by the National Disability Research Partnership (NDRP) to underpin their development of an agenda for Australian disability research over the next decade

High performance liquid chromatography tandem mass spectrometry dual extraction method for identification of green tea catechin metabolites excreted in human urine

The simultaneous analysis of free-form and conjugated flavonoids in the same sample is difficult but necessary to properly estimate their bioavailability. A method was developed to optimise the extraction of both free and conjugated forms of catechins and metabolites in a biological sample following the consumption of green tea. A double-blind randomised controlled trial was performed in which 26 volunteers consumed daily green tea and vitamin C supplements and 24 consumed a placebo for 3 months. Urine was collected for 24h at 4 separate time points (pre- and post-consumption) to confirm compliance to the supplementation and to distinguish between placebo and supplementation consumption. The urine was assessed for both free and conjugated metabolites of green tea using LC-MS2 analysis, after a combination extraction method, which involved an ethyl acetate extraction followed by an acetonitrile protein precipitation. The combination method resulted in a good recovery of EC-O-sulphate (91±7%), EGC-O-glucuronide (94±6%), EC (95±6%), EGC (111±5%) and ethyl gallate (74±3%). A potential total of 55 catechin metabolites were investigated, and of these, 26 conjugated (with methyl, glucuronide or sulphate groups) and 3 free-form (unconjugated) compounds were identified in urine following green tea consumption. The majority of EC and EGC conjugates significantly increased post-consumption of green tea in comparison to baseline (pre-supplementation) samples. The conjugated metabolites associated with the highest peak areas were O-methyl-EC-O-sulphate and the valerolactones M6/M6'-O-sulphate. In line with previous studies, EC and EGC were only identified as conjugated derivatives, and EGCG and ECG were not found as mono-conjugated or free-forms. In summary, the method reported here provides a good recovery of catechin compounds and is appropriate for use in the assessment of flavonoid bioavailability, particularly for biological tissues that may contain endogenous deconjugating enzymes