Publications by authors named "Shalini Arunogiri"

Aims: This study tested the efficacy and safety of a 12-week course of lisdexamfetamine in reducing methamphetamine use, an outcome which is associated with improvements in health and wellbeing, in people dependent on methamphetamine.

Design, Setting And Participants: This study was a randomised double-blind placebo-controlled trial conducted in six specialist outpatient clinics in Adelaide, Melbourne, Newcastle and Sydney, Australia (2018-2021). Participants were164 adults with methamphetamine dependence, reporting at least 14 use days out of the previous 28 days (62% male, 38% female, < 1% other; mean age 39 years).

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Introduction: Post-traumatic stress disorder and substance use disorders commonly co-occur and are associated with worse health outcomes. Currently, only psychosocial therapies are specifically recommended for use in the co-occurring population, but these come with numerous barriers to access and engagement. This study aims to identify potential pharmacological treatments to enhance treatment options and outcomes for this population.

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Introduction: A minority of addiction patients receive appropriate treatment directly from trained professionals in addiction medicine. Most countries have not recognized addiction medicine (AM) as a specialty in its own right or within psychiatry/other specialties. Therefore, the effectiveness and organization of AM training around the world need to be improved.

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Article Synopsis
  • - This study analyzed a statewide ambulance database to define "frequent presenters" in mental health emergencies, aiming to settle the lack of consensus on what constitutes frequent use of emergency services.
  • - Results showed that frequent presenters (attending 5 to 39 times annually) are typically more likely to be female, deal with self-harm, face social disadvantages, and often require police involvement.
  • - Despite various definitions, the methods used to identify these frequent presenters were found to be unreliable over time, suggesting that future research should focus on dynamic and adaptable definitions.
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Objective: Subjective cognitive complaints have been reported in women during perimenopause and the Everyday Memory Questionnaire - Revised (EMQ-R) has been recently evaluated as a standardized instrument to measure subjective cognitive changes. The purpose of this study was to identify potential cut-off points for the EMQ-R retrieval subscale and attentional subscale, and to assess the validity of these cut-off points in detecting objective cognitive changes associated with reported subjective cognitive complaints.

Method: After screening, 232 perimenopausal women were included in the analyses.

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Article Synopsis
  • - The research aimed to create and evaluate a fact sheet to help women understand and manage cognitive symptoms associated with menopause, emphasizing a collaborative approach involving both women experiencing menopause and healthcare professionals.
  • - During the development process, participants identified a significant need for educational resources, and feedback highlighted common themes regarding cognitive symptoms and a desire for strategies to enhance cognitive health.
  • - The final evaluation of the fact sheet indicated strong acceptance among users, along with requests for more information, particularly on hormone therapy, emphasizing the need for further research into effective treatment options.
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Article Synopsis
  • Midlife is an important time to help improve memory and thinking skills, especially for middle-aged women going through menopause.
  • Researchers looked at different studies to see how cognitive training (CT) can help boost these skills in healthy adults.
  • The results showed that CT can really help with things like remembering words, understanding information, and problem-solving abilities.
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Objective: Women face considerable barriers in pursuing careers in academic psychiatry.

Methods: A group of Australian and New Zealand academic women psychiatrists convened in September 2022 to identify and propose solutions to increase opportunities for women in academic psychiatry.

Results: Limiting factors were identified in pathways to academia including financial support, engagement and coordination between academia and clinical services, and flexible working conditions.

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Background: There are no approved pharmacotherapies for methamphetamine use disorder. Two preliminary phase 2 randomised controlled trials have found mirtazapine, a tetracyclic antidepressant, to be effective in reducing methamphetamine use. The proposed Tina Trial is the first phase 3 placebo-controlled randomised trial to examine the effectiveness and safety of mirtazapine as an outpatient pharmacotherapy for methamphetamine use disorder.

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Introduction: Inducting buprenorphine from methadone has traditionally involved initial opioid withdrawal, with risk of mental state deterioration in patients with serious mental illness (SMI). Micro-dosing of buprenorphine, with small incremental doses, is a novel off-label approach to transitioning from methadone and does not require a period of methadone abstinence. Given the limited literature about buprenorphine microdosing, we aimed to evaluate the feasibility and safety of inducting buprenorphine in a series of patients on methadone with SMI.

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Issue Addressed: Substance use and mental illness remain critical issues for young Australians, however, engagement with evidence-based health resources is challenging among this age group. This study aimed to develop engaging, useful digital health resources, underpinned by neuroscience principles, to build awareness of the harms of electronic cigarettes (e-cigarettes) and concurrent alcohol and antidepressant use.

Methods: A mixed-methods approach was adopted to co-design two evidence-based videos resources.

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Introduction: Despite increased prevalence of methamphetamine in road trauma, it remains unclear how its use translates to an increased risk of traffic-related harm. Exploration of psychosocial factors may thus help identify relevant predictors of dangerous driving behaviour among people who regularly consume methamphetamine.

Methods: Licenced individuals who report predominant and sustained methamphetamine use (at least 1-time/month for 6 months at heaviest use) were recruited from the Australian community and via targeted campaign (Eastern Health).

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Introduction: Contingency management (CM) is the most effective treatment for reducing methamphetamine use. We sought to understand why CM has not been taken up to manage methamphetamine use disorder in Australia.

Methods: Six focus groups (4-8 participants per group) were conducted with health workers from agencies in Australia that provided drug-related health care to people who use methamphetamine.

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Background: Long-acting injectable depot buprenorphine has become an important treatment option for the management of opioid dependence. However, little is known about patients' experiences of depot buprenorphine and its embodied effects. This qualitative study aims to explore patients' experiences of depot buprenorphine treatment, including how it feels within the body, experiences of dosing cycles across time, and how this form of treatment relies on wider ecologies of care beyond the clinical encounter.

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Ketamine is a restricted and regulated medication in Australia and New Zealand, which has implications when considering treatment for patients with treatment-resistant depression and a history of illicit drug use, abuse or dependence. Regulations governing prescription of ketamine for treatment-resistant depression vary between jurisdictions in Australia and New Zealand, though most restrict use in those with drug dependence. There is substantial variation in definitions of drug dependence used in each jurisdiction, and between the legal and clinical definitions, with the latter specified in the current International Classification of Diseases, Eleventh Revision and , Fifth Edition.

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Addiction medicine is a dynamic field that encompasses clinical practice and research in the context of societal, economic, and cultural factors at the local, national, regional, and global levels. This field has evolved profoundly during the past decades in terms of scopes and activities with the contribution of addiction medicine scientists and professionals globally. The dynamic nature of drug addiction at the global level has resulted in a crucial need for developing an international collaborative network of addiction societies, treatment programs and experts to monitor emerging national, regional, and global concerns.

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Article Synopsis
  • Cannabis use disorder (CUD) is becoming more prevalent, leading to various health and social issues, and a Phase IIa trial showed that cannabidiol (CBD) could effectively reduce non-prescribed cannabis use.
  • A Phase III clinical trial will evaluate the long-term effects of CBD treatment on patients with moderate-to-severe CUD over 12 weeks, with follow-ups at 24 weeks, involving 250 participants from multiple clinics in Australia.
  • The trial will assess both primary (self-reported cannabis use and urine analysis) and secondary endpoints (including severity of CUD, withdrawal symptoms, quality of life, etc.), along with qualitative interviews with Aboriginal participants for insight into their treatment experiences.
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Objective: Alcohol use disorders confer a significant burden of disease and economic cost worldwide. However, the utilisation of pharmacotherapies to manage alcohol use disorder is poor. We aimed to conduct a systematic review of economic evaluation studies of alcohol use disorder pharmacotherapies.

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Objective: Brain fog (ie, memory complaints and concentration difficulties) is frequently reported during the menopausal transition. There is lack of standardized scales available to measure brain fog across the menopausal transition. This study aimed to evaluate the factor structure of the Everyday Memory Questionnaire-Revised (EMQ-R) and to determine the most commonly reported everyday cognitive symptoms in a menopausal population.

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Introduction: Youth drinking rates have declined over the past 15 years while self-reported psychological distress has increased, despite a well-recognised positive relationship between the two. The current study aimed to identify changes in the relationship between psychological distress and alcohol use in adolescents from 2007 to 2019.

Methods: This study used survey responses from 6543 Australians aged 14-19 years who completed the National Drug Strategy Household Survey in 2007, 2010, 2013, 2016 or 2019.

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