Targeting circuits of sexual desire as a treatment strategy for hypoactive sexual desire disorder.

Hypoactive sexual desire disorder (HSDD) is hypothesized to be a disorder of the brain's reward circuitry. Neurotransmitters in reward circuits are thus therapeutic targets for improving sexual desire. Novel treatment strategies are to enhance dopamine (DA) actions, reduce serotonin (5-HT) actions, or both.

Clinical management of major depressive disorder.

Individuals with major depressive disorder (MDD) have high rates of disability, morbidity, and mortality, and are responsible for as many as one-fourth of all healthcare visits. Within primary care settings, 5% to 10% of adults have MDD, but only one-third of those are diagnosed. Thus, despite the devastating decrease in the quality-of-life and productivity of patients, depression is often under-diagnosed and therefore inadequately treated.

Norepinephrine and dopamine regulate signals and noise in the prefrontal cortex.

Norepinephrine and dopamine work in a cooperative yet reciprocal manner to regulate information processing at pyramidal neurons in the prefrontal cortex.

Vasomotor symptoms and depression in women, part 2. Treatments that cause remission and prevent relapses of major depressive episodes overlap with treatments for vasomotor symptoms.

Vasomotor symptoms may be linked to changing levels of estrogen, which can affect levels of neurotransmitters and neural proteins that modulate the risk of depression in some women, thus serving as harbingers of oncoming depression or signs of incomplete recovery from a major depressive episode (MDE).¹⁻⁴The question arises whether clinicians who normally diagnose and treat depression should also diagnose and treat vasomotor symptoms, and if so, how.

Preemptive analgesia: is pain less costly when you pre-pay for it?

Early treatment of pain could thwart the development of chronic persistent painful conditions.

Psychopharmacology of anticonvulsants: levetiracetam as a synaptic vesicle protein modulator.

A novel mechanism of action has recently been described for levetiracetam, a member of a new class of anticonvulsants. Levetiracetam binds selectively and with high affinity to a synaptic vesicle protein known as SV2A, thought to be involved with synaptic vesicle exocytosis and presynaptic neurotransmitter release.

Mechanism of action of alpha2delta ligands: voltage sensitive calcium channel (VSCC) modulators.

Voltage sensitive calcium channels (VSCCs) have unique structures and functions that distinguish them from other ion channels, especially the voltage sensitive sodium channels (VSSCs). Modulation of VSCCs by certain drugs such as pregabalin and gabapentin via binding to the alpha2delta subunits of VSCCs can lead to anticonvulsant, anxiolytic, and chronic pain-relieving actions.

Anticonvulsants and the relief of chronic pain: pregabalin and gabapentin as alpha(2)delta ligands at voltage-gated calcium channels.

Anticonvulsants that act as ligands at alpha(2)delta subunits of voltage-gated calcium channels are proving to be novel treatments for chronic pain.

Symptoms and circuits, part 3: schizophrenia.

Schizophrenia is composed of not only positive symptoms, but also cognitive and affective symptoms that contribute significantly to morbidity. Each of these symptoms may be mediated by a separate and distinct neuronal circuit.

Brainstorms: symptoms and circuits, part 2: anxiety disorders.

Numerous anxiety disorders may have malfunctioning neuronal circuits in common, which may account for the overlapping symptoms and frequent comorbidity of many anxiety disorders with one another.

Symptoms and circuits, part 1: major depressive disorder.

Major depressive disorder comprises multiple symptoms. Each symptom may be mediated by separate and distinct neuronal circuits.

Antidepressants and somatic symptoms: therapeutic actions are expanding beyond affective spectrum disorders to functional somatic syndromes.

Having expanded their original role as primary treatment for depression to preferred treatment for anxiety disorders, antidepressants are now emerging as potential therapeutic agents for many other disorders characterized by distressing or even painful somatic symptoms.

The ups and downs of novel antiemetic drugs, part 2: an illustration.

Novel antiemetic drugs block either neurokinin-1 receptors or serotonin-3 receptors. Research into the neuropharmacology of vomiting is providing insight into the ways substance P and serotonin interact within the central nervous system that could lead to additional applications of neurokinin-1 antagonists for the treatment of depression and stress.

The metabolic syndrome: psychopharmacologists should weigh the evidence for weighing the patient.

We are in the midst of a North American epidemic of obesity and type 2 diabetes. Since patients with psychiatric disorders who receive psychopharmacologic treatments may be at even greater risk than the general population for weight gain, dyslipidemia, and diabetes and their complications, psychopharmacologists now need standards for how to monitor and manage these risks.