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  1. Article ; Online: Psychopharmacology in the Elderly: Why Does Age Matter?

    Balaram, Kripa / Balachandran, Silpa

    The Psychiatric clinics of North America

    2022  Volume 45, Issue 4, Page(s) 735–744

    Abstract: A growing percentage of the population is aging, with a large subset of this group meeting criteria for one or more neuropsychiatric disorders. Generally, physiological changes due to aging affect most of the pharmacokinetic processes in the body, with ... ...

    Abstract A growing percentage of the population is aging, with a large subset of this group meeting criteria for one or more neuropsychiatric disorders. Generally, physiological changes due to aging affect most of the pharmacokinetic processes in the body, with age-related physiologic changes in cardiovascular, gastric, hepatic, and renal function leading to changes in the pharmacokinetics of medications that can affect the absorption, distribution, accumulation, and clearance and elimination of various medications. This article aims to discuss the common pharmacodynamic and pharmacokinetic changes associated with physiologic aging and their impacts on the use of psychotropic medications in the elderly.
    MeSH term(s) Humans ; Aged ; Psychopharmacology ; Psychotropic Drugs/therapeutic use ; Aging/physiology
    Chemical Substances Psychotropic Drugs
    Language English
    Publishing date 2022-10-14
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 431518-2
    ISSN 1558-3147 ; 0193-953X
    ISSN (online) 1558-3147
    ISSN 0193-953X
    DOI 10.1016/j.psc.2022.07.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The effects of substance use on severe acute respiratory syndrome coronavirus infection risks and outcomes.

    Balaram, Kripa / Marwaha, Raman / Kaelber, David C

    Current opinion in psychiatry

    2021  Volume 34, Issue 4, Page(s) 386–392

    Abstract: Purpose of review: Severe acute respiratory syndrome coronavirus (SARS-CoV2) infection rates are currently occurring at alarmingly accelerated rates. There is also a long-standing and concurrent rise in the prevalence and severity of substance use ... ...

    Abstract Purpose of review: Severe acute respiratory syndrome coronavirus (SARS-CoV2) infection rates are currently occurring at alarmingly accelerated rates. There is also a long-standing and concurrent rise in the prevalence and severity of substance use disorders (SUD). Therefore, the intersection between these two conditions needs to be carefully considered to ensure a more effective delivery of healthcare.
    Recent findings: Generally, those with SUDs are more likely to have higher risk social determinants of health factors. Therefore, these patients are more likely to have barriers that can create difficulties in following appropriate infection control measures which in turn increases the risk of exposure to SARS-CoV2. In addition, these individuals have higher rates of medical comorbidities which increases the risk of all adverse outcomes, including mortality, from SARS-CoV2 infection.
    Summary: Individuals with SUDs are at increased risk of both contracting SARS-CoV2 infection and suffering from worse outcomes afterwards. Though these risks of adverse outcomes are specific of SARS-CoV2 infection, the risk of exposure to other infectious diseases is increased in this population too. Healthcare providers and policymakers should then consider how to better protect this at-risk population and alleviate this increased disease burden.
    MeSH term(s) COVID-19/complications ; COVID-19/pathology ; COVID-19/therapy ; Humans ; Patient Outcome Assessment ; RNA, Viral ; Risk ; Risk Factors ; SARS-CoV-2 ; Substance-Related Disorders/complications ; Substance-Related Disorders/pathology
    Chemical Substances RNA, Viral
    Language English
    Publishing date 2021-05-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645162-7
    ISSN 1473-6578 ; 0951-7367
    ISSN (online) 1473-6578
    ISSN 0951-7367
    DOI 10.1097/YCO.0000000000000711
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Benzodiazepine use among older adults.

    Gupta, Aarti / Bhattacharya, Gargi / Balaram, Kripa / Tampi, Deena / Tampi, Rajesh R

    Neurodegenerative disease management

    2020  Volume 11, Issue 1, Page(s) 5–8

    MeSH term(s) Accidental Falls ; Aged ; Benzodiazepines/adverse effects ; Female ; Humans ; Male
    Chemical Substances Benzodiazepines (12794-10-4)
    Language English
    Publishing date 2020-11-10
    Publishing country England
    Document type Journal Article
    ISSN 1758-2032
    ISSN (online) 1758-2032
    DOI 10.2217/nmt-2020-0056
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  4. Article: Pimavanserin for the treatment of psychosis in Alzheimer's disease: A literature review.

    Srinivasan, Shilpa / Tampi, Rajesh R / Balaram, Kripa / Kapoor, Arushi

    World journal of psychiatry

    2020  Volume 10, Issue 7, Page(s) 162–174

    Abstract: Background: Alzheimer's disease (AD) is among the most prevalent forms of dementia in the world and neuropathological studies suggest similar high prevalence of mixed (AD + vascular) dementias. Approximately 25%-50% of individuals with AD develop ... ...

    Abstract Background: Alzheimer's disease (AD) is among the most prevalent forms of dementia in the world and neuropathological studies suggest similar high prevalence of mixed (AD + vascular) dementias. Approximately 25%-50% of individuals with AD develop psychosis sometime during their illness. The presence of psychosis in AD worsens outcomes. Currently there are no United States Food and Drug Administration (FDA) approved medications for the treatment of psychosis in AD. Pimavanserin, a novel atypical antipsychotic medication, was approved by the FDA for the treatment of hallucinations and delusions associated with Parkinson disease psychosis and is currently in clinical trials for the treatment of psychosis in AD.
    Aim: To evaluate the existing literature regarding the use of pimavanserin for treating psychosis among individuals with AD.
    Methods: A literature review of clinical studies of pimavanserin treatment for psychosis in individuals with AD was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Trials were identified by systematically searching PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus through October 2019. The 5-point Jadad scoring system was used to assess the methodologic quality of the randomized placebo-controlled trials.
    Results: A total of 499 citations were retrieved and pooled in EndNote and de-duplicated to 258 citations. This set was uploaded to Covidence for screening. Two separate screeners (Srinivasan S and Tampi RR) evaluated the titles, abstracts, and full text of eligible articles. Of the identified 258 abstracts, 98 articles underwent full text review and 2 publications from 1 randomized controlled trial (RCT) were included in the final analysis. The quality of evidence was assessed to be of good methodologic quality, scoring 4 out of 5 using the 5-point Jadad questionnaire with the Jadad Scoring calculation. This systematic review found only one RCT that evaluated the use of pimavanserin for the treatment of psychosis among individuals with AD. This phase 2 trial resulted in two publications, the second of which was a subgroup analysis from the original study. The evidence from these two publications showed that pimavanserin improves psychotic symptoms among individuals with AD when compared to placebo at week 6.
    Conclusion: Pimavanserin may be a pharmacologic consideration for the treatment for psychosis in AD. Additional RCTs are needed to assess the evidence of effectiveness before pimavanserin is considered a standard treatment.
    Keywords covid19
    Language English
    Publishing date 2020-07-19
    Publishing country United States
    Document type Journal Article
    ISSN 2220-3206
    ISSN 2220-3206
    DOI 10.5498/wjp.v10.i7.162
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Chlamydia trachomatis and Adverse Pregnancy Outcomes: Meta-analysis of Patients With and Without Infection.

    Olson-Chen, Courtney / Balaram, Kripa / Hackney, David N

    Maternal and child health journal

    2018  Volume 22, Issue 6, Page(s) 812–821

    Abstract: Objectives: We conducted a meta-analysis to determine the association between Chlamydia trachomatis and adverse perinatal outcomes.: Methods: Electronic databases were searched between 1970 and 2013. Included studies reported perinatal outcomes in ... ...

    Abstract Objectives: We conducted a meta-analysis to determine the association between Chlamydia trachomatis and adverse perinatal outcomes.
    Methods: Electronic databases were searched between 1970 and 2013. Included studies reported perinatal outcomes in women with and without chlamydia. Summary odds ratios were calculated using fixed- and random-effects models. Study bias was assessed using a Funnel Plot and Begg's test.
    Results: Of 129 articles identified, 56 studies met the inclusion criteria encompassing 614,892 subjects. Chlamydia infection in pregnancy was associated with preterm birth (OR = 1.27, 95% CI 1.05, 1.54) with a large quantity of heterogeneity (I
    Conclusions: This review provides evidence that chlamydia in pregnancy is associated with a small increase in the odds of multiple adverse pregnancy outcomes. The literature is complicated by heterogeneity and the fact that the association may not hold in higher quality and prospective studies or those that use more contemporary nucleic acid testing.
    MeSH term(s) Adult ; Chlamydia Infections/diagnosis ; Chlamydia Infections/epidemiology ; Chlamydia Infections/microbiology ; Chlamydia trachomatis ; Female ; Fetal Membranes, Premature Rupture/epidemiology ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Small for Gestational Age ; Obstetric Labor, Premature/epidemiology ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Complications, Infectious/microbiology ; Pregnancy Outcome/epidemiology ; Premature Birth
    Language English
    Publishing date 2018-02-02
    Publishing country United States
    Document type Journal Article ; Meta-Analysis
    ZDB-ID 1339905-6
    ISSN 1573-6628 ; 1092-7875
    ISSN (online) 1573-6628
    ISSN 1092-7875
    DOI 10.1007/s10995-018-2451-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Substance use disorders among older adults: A review of randomized controlled pharmacotherapy trials.

    Tampi, Rajesh R / Chhatlani, Aarti / Ahmad, Hajra / Balaram, Kripa / Dey, Joel / Escobar, Ricardo / Lingamchetty, Thejasvi

    World journal of psychiatry

    2019  Volume 9, Issue 5, Page(s) 78–82

    Abstract: Substance use disorders (SUDs) are a growing problem among older adults. Acamprosate, disulfiram, and naltrexone are United States Food and Drug Administration (referred to as FDA) approved for the treatment of alcohol use disorder, and buprenorphine is ... ...

    Abstract Substance use disorders (SUDs) are a growing problem among older adults. Acamprosate, disulfiram, and naltrexone are United States Food and Drug Administration (referred to as FDA) approved for the treatment of alcohol use disorder, and buprenorphine is approved for the treatment of opiate use disorder among adults. However, the data on the use of these medications for the treatment of SUDs among older adults are unclear from randomized controlled trials (referred to as RCTs). A review of the literature indicates that there are only two RCTs that evaluated the use of pharmacologic agents for SUDs among older adults (≥ 50 years). One trial evaluated the use of naltrexone when compared to placebo for the treatment of alcohol use disorder among individuals, 50-70 years in age. The other trial evaluated the use of naltrexone or placebo as adjuncts with sertraline in the treatment of alcohol use disorder among individuals older than 55 years in age. Both trials indicated that the use of naltrexone reduced the rates of relapse among older adults with alcohol use disorder. However, we did not identify any RCTs that studied the use of buprenorphine, acamprosate, or disulfiram for SUDs among older adults. Based on available evidence, it would be safe to conclude that limited data indicate some efficacy for naltrexone in the treatment of alcohol use disorder among older adults. However, data from controlled trials on the use of other medications that are FDA approved for the treatment of SUDs among younger adults are nonexistent among older adults with SUDs.
    Language English
    Publishing date 2019-09-19
    Publishing country United States
    Document type Editorial
    ISSN 2220-3206
    ISSN 2220-3206
    DOI 10.5498/wjp.v9.i5.78
    Database MEDical Literature Analysis and Retrieval System OnLINE

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