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  1. Article ; Online: One-Year Outcomes Following Intravenous Ketamine Plus Digital Training Among Patients with Treatment-Resistant Depression: A Secondary Analysis of a Randomized Clinical Trial.

    Price, Rebecca B / Wallace, Meredith L / Mathew, Sanjay J / Howland, Robert H

    JAMA network open

    2023  Volume 6, Issue 5, Page(s) e2312434

    MeSH term(s) Humans ; Ketamine/therapeutic use ; Depression/drug therapy ; Excitatory Amino Acid Antagonists/therapeutic use ; Administration, Intravenous
    Chemical Substances Ketamine (690G0D6V8H) ; Excitatory Amino Acid Antagonists
    Language English
    Publishing date 2023-05-01
    Publishing country United States
    Document type Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Letter
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.12434
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  2. Article ; Online: Diet, atherosclerosis, and helmintic infection in Tsimane.

    Howland, Robert H

    Lancet (London, England)

    2017  Volume 390, Issue 10107, Page(s) 2034

    MeSH term(s) Atherosclerosis ; Diet ; Humans
    Language English
    Publishing date 2017-10-26
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(17)31955-4
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  3. Article ; Online: Association Between Vitamin D Status and Cognitive Decline.

    Howland, Robert H

    JAMA neurology

    2016  Volume 73, Issue 6, Page(s) 762

    MeSH term(s) Cognitive Dysfunction ; Humans ; Neuropsychological Tests ; Vitamin D ; Vitamin D Deficiency
    Chemical Substances Vitamin D (1406-16-2)
    Language English
    Publishing date 2016--01
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2702023-X
    ISSN 2168-6157 ; 2168-6149
    ISSN (online) 2168-6157
    ISSN 2168-6149
    DOI 10.1001/jamaneurol.2016.0553
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  4. Article: Methylene Blue: The Long and Winding Road from Stain to Brain: Part 1.

    Howland, Robert H

    Journal of psychosocial nursing and mental health services

    2016  Volume 54, Issue 9, Page(s) 21–24

    Abstract: Methylene blue, first discovered and used as a dye in the textile industry, has long been used for biological staining in histology, bacteriology, and hematology. Because of its unique physiochemical properties, it was the first synthetic drug used in ... ...

    Abstract Methylene blue, first discovered and used as a dye in the textile industry, has long been used for biological staining in histology, bacteriology, and hematology. Because of its unique physiochemical properties, it was the first synthetic drug used in medicine, having been used to treat malaria more than one century ago. Methylene blue was also one of the first drugs used for the treatment of patients with psychosis at the end of the 19th century and was the lead drug in the serendipitous development of phenothiazine antipsychotic drugs in the mid-20th century. It was studied in bipolar disorder in the 1980s and has been investigated in neurodegenerative disorders in recent years. The history of methylene blue from its discovery as a dye to its use as a stain and then its therapeutic application in medicine is an example of how a drug's use can evolve over time through careful observation, clinical needs, serendipity, and the integration of concepts from different disciplines. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 21-24.].
    Language English
    Publishing date 2016-09-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 225817-1
    ISSN 1938-2413 ; 0279-3695
    ISSN (online) 1938-2413
    ISSN 0279-3695
    DOI 10.3928/02793695-20160818-01
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  5. Article: Deprescribing to Reduce Medication Use: Will This Help Your Patient?

    Howland, Robert H

    Journal of psychosocial nursing and mental health services

    2016  Volume 54, Issue 11, Page(s) 21–24

    Abstract: Polypharmacotherapy is a commonly used, but frequently criticized, clinical practice. Deprescribing is the process of discontinuing inappropriate or unnecessary medications, with the goals of decreasing adverse events and drug-drug interactions, ... ...

    Abstract Polypharmacotherapy is a commonly used, but frequently criticized, clinical practice. Deprescribing is the process of discontinuing inappropriate or unnecessary medications, with the goals of decreasing adverse events and drug-drug interactions, simplifying medication regimens to enhance adherence, and reducing costs associated with medication use while maintaining or improving clinical outcomes. Studies of groups of patients suggest that deprescribing medication is feasible and safe, but individual experiences are masked by group data. Although deprescribing can decrease medication exposure, evidence of the effectiveness of deprescribing medication on improving clinical outcomes is conflicting or lacking. Medication necessity or appropriateness should be assessed on a case-by-case basis and from visit to subsequent visit over time. Deprescribing medication should be accompanied by vigilant monitoring for adverse drug withdrawal effects or relapse of an underlying condition. [Journal of Psychosocial Nursing and Mental Health Services, 54 (11), 21-24.].
    Language English
    Publishing date 2016-11-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 225817-1
    ISSN 1938-2413 ; 0279-3695
    ISSN (online) 1938-2413
    ISSN 0279-3695
    DOI 10.3928/02793695-20161024-04
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  6. Article: Antidepressant, Antipsychotic, and Hallucinogen Drugs for the Treatment of Psychiatric Disorders: A Convergence at the Serotonin-2A Receptor.

    Howland, Robert H

    Journal of psychosocial nursing and mental health services

    2016  Volume 54, Issue 7, Page(s) 21–24

    Abstract: Antidepressant, atypical antipsychotic, and hallucinogen drugs mediate their actions in part by interactions with the serotonin-2A (5HT2A) receptor. Serotonergic hallucinogen drugs, such as psilocybin, bind most potently as agonists at the 5HT2A receptor, ...

    Abstract Antidepressant, atypical antipsychotic, and hallucinogen drugs mediate their actions in part by interactions with the serotonin-2A (5HT2A) receptor. Serotonergic hallucinogen drugs, such as psilocybin, bind most potently as agonists at the 5HT2A receptor, producing profound changes in perception, mood, and cognition. Some of these drugs have been or are currently being investigated in small Phase 2 studies for depression, alcoholism, smoking cessation, anxiety, and posttraumatic stress disorder. However, unlike the synergistic effects of combining antidepressant and atypical antipsychotic drugs, the potential therapeutic effects of hallucinogen drugs may be attenuated by the concurrent use of these medications because antidepressant and atypical antipsychotic drugs desensitize and/or down-regulate 5HT2A receptors. This finding has important implications for optimizing the potential therapeutic use of hallucinogen drugs in psychiatry. [Journal of Psychosocial Nursing and Mental Health Services, 54(7), 21-24.].
    Language English
    Publishing date 2016-07-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 225817-1
    ISSN 1938-2413 ; 0279-3695
    ISSN (online) 1938-2413
    ISSN 0279-3695
    DOI 10.3928/02793695-20160616-09
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  7. Article: Can Declining Rates of Dementia Be Explained by the Increased and Widespread Use of Psychotropic Medications?

    Howland, Robert H

    Journal of psychosocial nursing and mental health services

    2016  Volume 54, Issue 3, Page(s) 25–29

    Abstract: Dementia, once described as the "silent epidemic," is now well known and greatly feared. Although the total number of dementia cases will increase worldwide because of increased life expectancy, eight population-based studies of dementia incidence or ... ...

    Abstract Dementia, once described as the "silent epidemic," is now well known and greatly feared. Although the total number of dementia cases will increase worldwide because of increased life expectancy, eight population-based studies of dementia incidence or prevalence have suggested a declining age-specific risk in the United States and Europe during the past three decades. Many different psychotropic drugs have been introduced since the mid-1950s, and their clinical use has broadened and increased dramatically over time. Antidepressant drugs, second-generation antipsychotic drugs, lithium, valproate, carbamazepine, lamotrigine, electroconvulsive therapy, and exercise have all been found to activate or regulate various intracellular neurotrophic and neuroprotective processes. They promote neurogenesis and are protective in models of neurodegenerative diseases and ischemia. Because of their neurotrophic and neuroprotective effects, the widespread use of psychotropic drugs provides a plausible explanation for declining rates of dementia that have been observed.
    MeSH term(s) Dementia/drug therapy ; Dementia/epidemiology ; Drug Utilization/trends ; Europe ; Humans ; North America ; Psychotropic Drugs/pharmacology ; Psychotropic Drugs/therapeutic use
    Chemical Substances Psychotropic Drugs
    Language English
    Publishing date 2016-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 225817-1
    ISSN 1938-2413 ; 0279-3695
    ISSN (online) 1938-2413
    ISSN 0279-3695
    DOI 10.3928/02793695-20160219-04
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  8. Article: Oxazepam for the Treatment of Substance Abuse and Depression: Is it Appropriate?

    Howland, Robert H

    Journal of psychosocial nursing and mental health services

    2016  Volume 54, Issue 5, Page(s) 21–24

    Abstract: Distinguishing itself from other benzodiazepine drugs, oxazepam has an interesting pharmacological and clinical profile, including binding effects on the translocator protein (TSPO) and a relatively favorable safety and abuse liability profile. TSPO is ... ...

    Abstract Distinguishing itself from other benzodiazepine drugs, oxazepam has an interesting pharmacological and clinical profile, including binding effects on the translocator protein (TSPO) and a relatively favorable safety and abuse liability profile. TSPO is found in the brain (where it is involved in neurosteroid synthesis), but is also expressed in the heart and other peripheral tissues. Oxazepam is potentially useful in the treatment of substance abuse, especially in conjunction with the cortisol synthesis inhibitor metyrapone, and can be considered an appropriate medication to use in the treatment of depression. The oxazepam/metyrapone combination has been piloted in cocaine-dependent patients and should be investigated in patients with depression. Expression of cardiac TSPO is altered by different stress conditions, and drugs binding to TSPO may have cardioprotective effects. The possibility of oxazepam, alone or together with antidepressant drugs, having a positive effect on cardiac function in patients with depression should also be studied. [Journal of Psychosocial Nursing and Mental Health Services, 54(5), 21-24.].
    Language English
    Publishing date 2016-05-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 225817-1
    ISSN 1938-2413 ; 0279-3695
    ISSN (online) 1938-2413
    ISSN 0279-3695
    DOI 10.3928/02793695-20160420-03
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  9. Article: Pimavanserin: An Inverse Agonist Antipsychotic Drug.

    Howland, Robert H

    Journal of psychosocial nursing and mental health services

    2016  Volume 54, Issue 6, Page(s) 21–24

    Abstract: Approximately all clinically useful antipsychotic drugs have known activity as dopamine receptor antagonists, but many of these drugs also are inverse agonists at the serotonin-2A (5HT2A) receptor. Pimavanserin is an inverse agonist at the 5HT2A receptor, ...

    Abstract Approximately all clinically useful antipsychotic drugs have known activity as dopamine receptor antagonists, but many of these drugs also are inverse agonists at the serotonin-2A (5HT2A) receptor. Pimavanserin is an inverse agonist at the 5HT2A receptor, with a lower binding affinity at the serotonin-2C receptor and sigma 1 receptor, but no significant binding to dopamine or other receptors. Because of its unique pharmacology, pimavanserin was approved for the treatment of psychosis associated with Parkinson's disease, and it has a low risk for exacerbating motor symptoms compared to standard antipsychotic medications. Whether pimavanserin can treat psychotic symptoms in schizophrenia, psychotic depression, psychotic mania, delirium, or drug-induced psychosis, is not known. Based on its inverse agonist effect at 5HT2A receptors, pimavanserin may have potential for treating symptoms associated with the use of hallucinogen drugs and for treating akathisia associated with antipsychotic medications. [Journal of Psychosocial Nursing and Mental Health Services, 54 (6), 21-24.].
    Language English
    Publishing date 2016-06-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 225817-1
    ISSN 1938-2413 ; 0279-3695
    ISSN (online) 1938-2413
    ISSN 0279-3695
    DOI 10.3928/02793695-20160523-01
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  10. Article: Antidepressant Drugs and the Risk of Intracranial Bleeding: Parsing an Observational Study.

    Howland, Robert H

    Journal of psychosocial nursing and mental health services

    2016  Volume 54, Issue 2, Page(s) 21–24

    Abstract: Observational studies have suggested that antidepressant drug use is associated with a small but increased risk of intracranial bleeding. Because of the widespread use of antidepressant drugs and the potential public health significance of this finding, ... ...

    Abstract Observational studies have suggested that antidepressant drug use is associated with a small but increased risk of intracranial bleeding. Because of the widespread use of antidepressant drugs and the potential public health significance of this finding, the current article critically evaluates the methodology and findings of a recently published observational study. Observational studies reveal associations, but cannot establish causality. Establishing causality from observed associations requires evidence from different scientific perspectives. Claims arising from observational studies are likely to be wrong, especially for small effects, because of bias and confounding. Statistical testing does not prove the validity of an association, nor does a meta-analysis of multiple observational studies. A valid association may not be clinically meaningful if the magnitude of the effect is small or the outcome is rare. Based on a critical analysis of these observational studies, it is concluded that the risk of intracranial bleeding associated with antidepressant drugs is likely to be a false alarm. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 21-24.].
    Language English
    Publishing date 2016-02-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 225817-1
    ISSN 1938-2413 ; 0279-3695
    ISSN (online) 1938-2413
    ISSN 0279-3695
    DOI 10.3928/02793695-20160119-07
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