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  1. Article: Amantadine: a review of use in child and adolescent psychiatry.

    Hosenbocus, Sheik / Chahal, Raj

    Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent

    2013  Volume 22, Issue 1, Page(s) 55–60

    Abstract: Objective: To review published literature regarding the pharmacology and use of amantadine in child and adolescent psychiatry.: Method: A LITERATURE SEARCH OF SEVERAL DATABASES (PUBMED, PSYCHINFO, CINAHL, MEDLINE, PSYCARTICLES, BIOMEDICAL REFERENCE ... ...

    Abstract Objective: To review published literature regarding the pharmacology and use of amantadine in child and adolescent psychiatry.
    Method: A LITERATURE SEARCH OF SEVERAL DATABASES (PUBMED, PSYCHINFO, CINAHL, MEDLINE, PSYCARTICLES, BIOMEDICAL REFERENCE COLLECTION AND ACADEMIS SEARCH COMPLETE) WAS CONDUCTED WITH THE SEARCH TERMS: 'amantadine' with limits: English language, Human trials, all child (aged 0-18 years). The search was later expanded to include 'Adults' and additional relevant articles were selected from reference lists.
    Results: The psychotropic effect of amantadine is related to its antagonism of the N-methyl-D-aspartate (NMDA) receptor. It decreases the toxic effects of the glutamatergic neurotransmitter system which plays an important role in many psychiatric disorders. Two randomized controlled trials (RCTs) of amantadine were identified in children and adolescents. One reported beneficial effects in controlling the symptoms of irritability and hyperactivity in autistic disorder and the other described a significant impact in attention deficit hyperactivity disorder (ADHD). Two open label studies also reported positive effects in ADHD. A pilot study in children with enuresis reported significant reduction in wetting frequency. Studies in adults, with relevance to children and adolescents, reported effectiveness in resistant depression, obsessive compulsive disorder and in counteracting side effects of some psychotropic medications. RCTs found in traumatic brain injury indicated a neuroprotective effect and effectiveness in controlling agitation and aggression. Amantadine is well tolerated in children and adolescents, with an acceptable side effect profile, and considered safe for long term use.
    Conclusion: Amantadine shows potential for use as a safe alternative or as an augmenting agent for treating children with neuropsychiatric and various other disorders. Available data for such use, although promising, require further confirmation.
    Language English
    Publishing date 2013-02-06
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2381637-5
    ISSN 2293-6122 ; 1719-8429
    ISSN (online) 2293-6122
    ISSN 1719-8429
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Memantine: a review of possible uses in child and adolescent psychiatry.

    Hosenbocus, Sheik / Chahal, Raj

    Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent

    2012  Volume 22, Issue 2, Page(s) 166–171

    Abstract: Objective: To provide a review of published literature regarding the pharmacology of memantine and potential benefits for use in child and adolescent psychiatry.: Method: A LITERATURE SEARCH OF SEVERAL DATABASES (MEDLINE, PSYCHINFO, CINAHL, ... ...

    Abstract Objective: To provide a review of published literature regarding the pharmacology of memantine and potential benefits for use in child and adolescent psychiatry.
    Method: A LITERATURE SEARCH OF SEVERAL DATABASES (MEDLINE, PSYCHINFO, CINAHL, PSYCARTICLES) WAS CONDUCTED WITH THE SEARCH TERMS: 'memantine' with limits: English language, Human trials, all child (aged 0-18 years). The search was later expanded to include 'Adults' and relevant articles were also selected from reference lists.
    Result: The search did not find any well-controlled studies in children and adolescents except for open label trials, as monotherapy in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), as well as an augmenting agent in obsessive compulsive disorder (OCD). No study was found in anxiety disorders (AD), the most common psychiatric disorder in children or in mood disorders, both major depressive disorder (MDD) and bipolar disorder (BD). Studies in adults for those disorders with onset in childhood or adolescence, were also mostly open-label and as an add-on therapy. All the studies reported that memantine is a safe drug with minimal drug interactions and a very acceptable adverse effect profile comparable to placebo.
    Conclusion: Memantine has demonstrated beneficial effects in some childhood disorders but the evidence is too limited at present and does not provide enough support of its efficacy to advocate for its regular use in those conditions. Such use remains off-label until further validation of efficacy comes from blinded, randomized, placebo controlled studies.
    Language English
    Publishing date 2012-01-26
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2381637-5
    ISSN 2293-6122 ; 1719-8429
    ISSN (online) 2293-6122
    ISSN 1719-8429
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A review of executive function deficits and pharmacological management in children and adolescents.

    Hosenbocus, Sheik / Chahal, Raj

    Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent

    2012  Volume 21, Issue 3, Page(s) 223–229

    Abstract: Objective: To review both the functions and dysfunction of the executive system (ES) focusing on the extent of executive function (EF) deficits in most psychiatric disorders in children and adolescents and the possibility of such deficits acting as ... ...

    Abstract Objective: To review both the functions and dysfunction of the executive system (ES) focusing on the extent of executive function (EF) deficits in most psychiatric disorders in children and adolescents and the possibility of such deficits acting as markers for pharmacological management.
    Method: A LITERATURE REVIEW WAS CONDUCTED USING MEDLINE, PSYCHINFO, CINAHL, PSYCHARTICLES AND PUBMED WITH THE FOLLOWING KEYWORDS: executive function or dysfunction, pediatric or children or adolescents, psychopharmacology, psychotropic medications, attention deficit hyperactivity disorder (ADHD), depression, obsessive compulsive disorder, anxiety disorders, bipolar disorder, schizophrenia, autism spectrum disorders (ASD), fetal alcohol spectrum disorders (FASD). Due to the limited amount of specific information obtained for some childhood disorders, the search was broadened to include relevant adult literature where information was extrapolated.
    Results: Abundant literature was found on the nature of the ES and the executive dysfunctions in most psychiatric disorders in children and adolescents, but not so much on the use of medication. EF deficits were found to be more consistent in disorders such as ADHD, ASD and FASD than in the other disorders but were not specific enough for use as clinical markers for those disorders. For children with ADHD and ASD there was adequate information on the use of psychotropic medications and impact on some EF domains but information on the impact of medication on EF in the other disorders in children and adolescents was fairly limited. Medications acting on the dopaminergic system also showed positive effects on EF deficits and are commonly used in the treatment of EF disorders such as ADHD, ASD and FASD.
    Conclusion: Existing literature indicates that EF deficits underlie most psychiatric disorders in children and adolescents. However, there are so many executive functions linked to so many activities and circuits in the brain that it is hard to quantify them in a particular disorder for use as specific markers for that disorder. The ES uses dopamine as its main neurotransmitter and this has implications for clinical management. Dopamine agonists (e.g. stimulants) and antagonists (e.g. neuroleptics) are medications that have direct impact on the ES and are commonly used to treat EF disorders in children and adolescents while serotonergic medications e.g. selective serotonin reuptake inhibitors (SSRIs) have not been very successful in treating such disorders. Identifying EF deficits early could be useful in guiding management including the use of medication in those disorders.
    Language English
    Publishing date 2012-08-02
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2381637-5
    ISSN 2293-6122 ; 1719-8429
    ISSN (online) 2293-6122
    ISSN 1719-8429
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: SSRIs and SNRIs: A review of the Discontinuation Syndrome in Children and Adolescents.

    Hosenbocus, Sheik / Chahal, Raj

    Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent

    2010  Volume 20, Issue 1, Page(s) 60–67

    Abstract: Objective: To review the occurrence, clinical relevance and characteristics of the discontinuation syndrome in children and adolescents who have been on a selective serotonin reuptake inhibitor (SSRI) or a serotonin/norepinephrine re-uptake inhibitor ( ... ...

    Abstract Objective: To review the occurrence, clinical relevance and characteristics of the discontinuation syndrome in children and adolescents who have been on a selective serotonin reuptake inhibitor (SSRI) or a serotonin/norepinephrine re-uptake inhibitor (SNRI) for various conditions as an update for physicians prescribing these medications in this population.
    Method: An on-line literature search was done using MEDLINE, PubMed, CINAHL, PsychARTICLES, and PsychINFO with the following key words: selective serotonin reuptake inhibitors or SSRIs, serotonin/norepinephrine re-uptake inhibitors or SNRIs, discontinuation syndrome, pediatric or children or adolescents, occurrences and characteristics.
    Results: Not a single randomized placebo-controlled trial was found that addresses this condition solely in the child and adolescent population. A couple of papers written by the same authors indicate that children and adolescents taking an SSRI definitely experience discontinuation reactions that can be mild, moderate or severe when the medication is stopped suddenly or high doses are reduced substantially. Among the SSRIs paroxetine seems to be the worst offender and fluoxetine the least while sertraline and fluvoxamine tend to be intermediate. However, the most serious discontinuation reactions came from the SNRI venlafaxine. There was no study or reports found on citalopram, another SSRI that is commonly prescribed in children and youth. While the adult literature abounds with papers describing the different aspects of this condition including clinical features, diagnostic criteria, management and prevention, the limited information available to-date in children and adolescents indicate that the essential features of the discontinuation syndrome may not be significantly different than in adults. There were no specific characteristics identified relating to the child population.
    Conclusion: In considering the use of an SSRI in children, physicians must seriously weigh the not so clear benefits against the risks of adverse reactions including the discontinuation syndrome. The frequency and severity of this reaction seem dependent on the SSRI half-life and although children metabolize drugs much faster than adults the reactions to-date have been reported as similar. The use of fluoxetine with its long half-life appears safer in this respect with paroxetine and venlafaxine causing the most concerns. Patients and their families should be well informed of the risks of stopping the medication abruptly and instructed not to do so without consulting their physician. Physicians in Canada who are using these medications off-label in children need to be knowledgeable and vigilant about such adverse reactions. These could be avoided through adequate follow ups which will also ensure better adherence. They may benefit from this review even though the information comes mostly form the adult literature. More prospective studies are needed to clarify this issue and identify any specific features relating to the pediatric population.
    Language English
    Publishing date 2010-09-29
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2381637-5
    ISSN 2293-6122 ; 1719-8429
    ISSN (online) 2293-6122
    ISSN 1719-8429
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: A review of long-acting medications for ADHD in Canada.

    Hosenbocus, Sheik / Chahal, Raj

    Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent

    2009  Volume 18, Issue 4, Page(s) 331–339

    Abstract: Objective: To review and comment on the long-acting medications presently marketed in Canada for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in terms of design, composition, mode of action and efficacy including other long-acting ... ...

    Abstract Objective: To review and comment on the long-acting medications presently marketed in Canada for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in terms of design, composition, mode of action and efficacy including other long-acting products that are not yet available in Canada.
    Method: A literature review was conducted using MEDLINE, PsycInfo, CINAHL, and PubMed with additional information gathered from other sources.
    Results: The American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP) and the Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA) while endorsing the stimulants as first line medications to treat ADHD also recommended the use of long-acting once-a-day medication for better efficacy, convenience and adherence. Most studies rated the controlled release and the immediate release medications as similar in efficacy. However, long-acting medication was shown to be superior in terms of remission rates.
    Conclusion: When a child is receiving a long-acting medication for treatment of ADHD, he may feel less stigmatized, is more likely to be adherent and achieve remission. A child in remission can benefit from other treatment modalities thus improving long-term prognosis.
    Language English
    Publishing date 2009-11-02
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2381637-5
    ISSN 2293-6122 ; 1719-8429
    ISSN (online) 2293-6122
    ISSN 1719-8429
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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