Sleeping disturbance constitutes a major problem occurring in 25% of people aged over 65. Among the most frequent reasons of insomnia one can mention the overuse of coffee, alcohol, smoking, using some drugs, stress, depression, neurosis, dementia, chronic diseases. Idiopathic insomnia constitutes less than 5% of cases. Before the treatment of insomnia is started, its cause should be found and it should be determined if it is transient or chronic. The treatment of insomnia can be based on pharmacotherapy and non-pharmacotherapy methods. Behavioural therapy is mentioned among non-pharmacotherapeutic methods. It aims at changing the sleep-related habits. Pharmacotherapeutic treatment (still mostly based on benzodiazepines) should not last longer than 2-3 weeks and drugs of short elimination T 1/2 (below 6 hours) should be used. Side-effects of this group of drugs should always be taken into consideration. It should be remembered that sleep disturbances can be symptoms of other diseases and their treatment cannot consist in prescribing hypnotics only.
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Neuropsychiatr Dis Treat
January 2025
Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, New York, NY, USA.
Peripartum depression (PPD) affects approximately one in every eight birthing individuals. Despite a high prevalence, PPD is underdiagnosed and undertreated. Several PPD treatment options exist including psychotherapies, conventional serotonergic-based antidepressants and alternative and integrative medicine approaches.
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Internal Medicine, Hospital Angeles Pedregal, Mexico City, MEX.
Prion disease is an uncommon entity characterized by exceptionally rapid neurodegenerative deterioration. There are three categories of prion disease: (1) sporadic: sporadic Creutzfeldt-Jakob disease (sCJD), sporadic fatal insomnia, and protease-sensitive prionopathy; (2) genetic: genetic Creutzfeldt-Jakob disease, familial fatal insomnia, and Gerstmann-Sträussler-Scheinker syndrome; and (3) acquired: Kuru, iatrogenic Creutzfeldt-Jakob disease, and variant Creutzfeldt-Jakob disease. Although it is an incurable disease, a specific pathophysiological mechanism exists involving neuronal loss, glial cell proliferation, absence of inflammatory response, development of vacuoles leading to a spongiform appearance, and the presence of prions.
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Department of Rehabilitation Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
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Department of Obstetrics and Gynecology, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, USA.
Mood disorders such as depressive or bipolar disorders are more common among women. This review provides the fundamentals of diagnosing and treating mood disorders throughout a woman's lifespan. The etiology of mood disorders is not well-understood, but genetic, social, environmental, and neurobiologic factors play roles.
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January 2025
Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
The United States Food and Drug Administration approved the xanomeline-trospium combination in September 2024 for treating schizophrenia, based in part on three double-blind, randomized placebo-controlled trials in adults with schizophrenia experiencing acute psychosis. This random-effects model pairwise meta-analysis of those three trials found that xanomeline-trospium was comparable to placebo in terms of all-cause discontinuation, discontinuation rate due to adverse events, Simpson-Angus Scale score change, Barnes Akathisia Rating Scale score change, body weight change, body mass index change, blood pressure change, serum total cholesterol change, blood glucose change, QTc interval changes, and the incidence of headache, somnolence, insomnia, dizziness, akathisia, agitation, tachycardia, gastroesophageal reflux disease, diarrhea, increased weight, and decreased appetite. However, xanomeline-trospium was associated with a higher incidence of at least one adverse event, dry mouth, hypertension, nausea, vomiting, dyspepsia, and constipation, and increased serum triglyceride compared with placebo.
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