Brain neurotransmitter dysfunctions involved in the pathophysiological processes of psychiatric disorders are likely to be reflected by concomitant alterations in sleep continuity and architecture. Since the corrective effects of psychotropic drugs on dysfunctional neurotransmission systems can be evidenced through polysomnographic recordings, one may consider sleep as a kind of "window" on the neurobiology of psychiatric disorders. During the last 10 years, major breakthroughs in our understanding of sleep-wake mechanisms have provided some indications on how psychotropic drugs could influence the sleep-wake cycle. In this review, recent inroads into the understanding of sleep regulatory neural mechanisms are introduced and discussed in terms of the effects of psychotropic drugs. The relationship between the pathophysiological process of a disease, its consequence on sleep, and the corrective effect of a psychotropic drug are exemplified by two psychopathological states: substance withdrawal and major depression. One may conclude that polysomnographic recordings are a unique noninvasive tool to analyze brain functioning, and are particularly well suited to evaluating the objective effects of new psychotropic drugs.
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http://dx.doi.org/10.31887/DCNS.2005.7.4/lstaner | DOI Listing |
Introduction: Although maintenance treatment is recommended for the prevention of relapse, in real-world settings, a subset of patients discontinue antipsychotics while having a good prognosis. The prediction of functional remission in patients with schizophrenia after antipsychotic discontinuation (FURSAD) study aims to obtain real-world knowledge regarding the characteristics of schizophrenia (SCZ) patients who achieve functional remission after antipsychotic discontinuation for 1 year or more. This study also aims to establish a prediction model to identify patients likely to benefit from antipsychotic discontinuation.
View Article and Find Full Text PDFPharmacol Res
December 2024
UniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia 5000, Australia. Electronic address:
Gut microbial dysbiosis or altered gut microbial consortium, in schizophrenia suggests a pathogenic role through the gut-brain axis, influencing neuroinflammatory and neurotransmitter pathways critical to psychotic, affective, and cognitive symptoms. Paradoxically, conventional psychotropic interventions may exacerbate this dysbiosis, with antipsychotics, particularly olanzapine, demonstrating profound effects on microbial architecture through disruption of bacterial phyla ratios, diminished taxonomic diversity, and attenuated short-chain fatty acid synthesis. To address these challenges, novel therapeutic strategies targeting the gut microbiome, encompassing probiotic supplementation, prebiotic compounds, faecal microbiota transplantation, and rationalised co-pharmacotherapy, show promise in attenuating antipsychotic-induced metabolic disruptions while enhancing therapeutic efficacy.
View Article and Find Full Text PDFZh Nevrol Psikhiatr Im S S Korsakova
December 2024
Siberian State Medical University, Tomsk, Russia.
The article presents theses of the resolution of the Interdisciplinary Council of Experts in Psychiatry and Neurology (Moscow, 2024) on the issue of comorbid anxiety disorders (AD) in patients with neurological pathologies. The authors highlight the high prevalence of comorbid ADs and their significant negative impact on the course of underlying diseases, such as epilepsy, pain syndromes and post-stroke conditions. Modern approaches to the diagnosis and treatment of ADs in this group of patients are discussed.
View Article and Find Full Text PDFZh Nevrol Psikhiatr Im S S Korsakova
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Research Center of Neurology, Moscow, Russia.
At the present stage, great progress has been achieved in understanding the mechanisms of the development of cerebral ischemia. This became possible due to the achievements of theoretical disciplines, in connection with which the general biological approach was formed in the study of pathogenesis of acute and chronic cerebrovascular disorders (CVD). The discovery of pathways of free radical oxidation in cerebral ischemia made it possible to substantiate and develop therapeutic strategies using drugs with antioxidant and neuroprotective activity.
View Article and Find Full Text PDFZh Nevrol Psikhiatr Im S S Korsakova
December 2024
S.D. Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan.
Chronic cerebral ischemia (CCI) is one of the most common forms of cerebrovascular disease, which affects a significant number of patients, often leading to disability, cognitive impairment and dementia. The analysis of modern data on the pathogenesis and risk factors for the development of CCI, as well as on the mechanisms of action of Mexidol on various links in the pathogenesis of CCI. A systematic search was conducted in the PubMed, MEDLINE and Google Scholar databases, on Russian and English-language sites with open access publications on the problem of CCI and on the drug Mexidol in the period from 2014 to 2024.
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