Examining the Use of Antidepressants for Adolescents with Depression/Anxiety Who Regularly Use Cannabis: A Narrative Review

Depression and anxiety disorders are two of the most common and growing mental health concerns in adolescents. Consequently, antidepressant medication (AD) use has increased widely during the last decades. Several classes of antidepressants are used mainly to treat depression, anxiety, and obsessive-compulsive disorders by targeting relevant brain neurochemical pathways. Almost all randomized clinical trials of antidepressants examined patients with no concomitant medications or drugs. This does not address the expected course of therapy and outcome in cannabis users. Cannabis is the most commonly used illicit substance globally. Substantial changes in its regulation are recently taking place. Many countries and US states are becoming more permissive towards its medical and recreational use. The psychological and physiological effects of cannabis (mainly of its major components, tetrahydrocannabinol (THC) and cannabidiol (CBD)) have been extensively characterized. Cannabis use can be a risk factor for depressive and anxiety symptoms, but some constituents or mixtures may have antidepressant and/or anxiolytic potential. The aim of this literature review is to explore whether simultaneous use of AD and cannabis in adolescence can affect AD treatment outcomes. Based on the current literature, it is reasonable to assume that antidepressants are less effective for adolescents with depression/anxiety who frequently use cannabis. The mechanisms of action of antidepressants and cannabis point to several similarities and conjunctions that merit future investigation regarding the potential effectiveness of antidepressants among adolescents who consume cannabis regularly.

Intellectual mapping of studies on obsessive-compulsive disorder (OCD): A machine learning study (Preprint)

BACKGROUND Background: This study examines the relationship between obsessive-compulsive disorder (OCD) and other medical conditions and their role in the development or treatment of this disorder OBJECTIVE A co-word analysis study examines the status and intellectual structure of obsessive-compulsive disorder. Furthermore, given the multiplicity of outputs obtained from this type of study, the results can be connected to various fields related to the disease, and other related diseases can be identified through visualization. Drawing the intellectual structure in emerging and declining fields, the level of development and maturity, thematic networks and determining the thematic relationship of OCD with other diseases, the role of genetic factors, the role of complementary medicine in the treatment of this disease, etc. are among some contributions of this research project METHODS Materials and Methods: The articles published from 1975 to 2021 were retrieved by searching the related keywords in multiple databases including PubMed, Scopus, Web of Science (WoS), and Embase according to their thematic coverage and scope. Finally, after removing repeated articles and standardization, a total of 1820 papers were analyzed using R and SciMAT software. RESULTS A total of 4191 keywords plus (ID) and 3242 author keywords (DE) were reported in the journals. Moreover, these articles were published by 7482 authors, of which 111 articles were written by single authors and the collaborative coefficient (CC) was 4.36. Neuropsychopharmacology International Clinical, Psychopharmacology, and Journal of Clinical Psychopharmacology are the most influential journals publishing OCD articles. CONCLUSIONS Given the increasing prevalence of obsessive-compulsive disorders (OCDs), finding the most effective methods with the lowest prescribed dose of the drug and the most therapeutic effect is extremely important. To this end, the present study indicated that the prognosis of inherited OCD disorders, as well as the response to treatment, can be examined by analyzing the genetic sequence and finding polymorphism cases. Furthermore, complementary medicine as one of the scientific schools plays an important role in OCD diagnosis and adjuvant treatment using food and herbs and other treatment methods.

Functional neurologic disorders in an adult with propionic acidemia: a case report

Background Inborn errors of metabolism are often characterized by various psychiatric syndromes. Previous studies tend to classify psychiatric manifestations into clinical entities. Among inborn errors of metabolism, propionic acidemia (PA) is a rare inherited organic aciduria that leads to neurologic disabilities. Several studies in children with PA demonstrated that psychiatric disorders are associated to neurological symptoms. To our knowledge, no psychopathological description in adult with propionic acidemia is available. Case presentation We aimed to compare the case of a 53-year-old woman with PA, to the previous psychiatric descriptions in children with PA and in adults with other inborn errors of metabolism. Our patient presented a large variety of signs: functional neurologic disorders, borderline personality traits (emotional dyregulation, dissociative and alexithymic trends, obsessive-compulsive disorders), occurring in a context of neurodevelopmental disorder. Conclusion Clinical and paraclinical examinations are in favor of a mild mental retardation since childhood and disorders of behavior and personality without any definite psychiatric syndrome, as already described in other metabolic diseases (group 3). Nonetheless, further studies are needed to clarify the psychiatric alterations within adult patients with PA.

A “GENERAL THEORY OF MENTAL SUFFERING”, AND THE ROLE OF AN INNOVATIVE NARRATIVE THERAPEUTIC APPROACH

This article proposes alternative understandings of certain structuralist informed (Diagnostic and Statistical Manual of Mental Disorders - DSM-IIIrd to 5th Eds.) configurations of mental disorders. Life’s negative discourses and the mind’s captive responses present a “general theory of mental suffering” which phenomena are classified as modernist, DSM mental disorders, such as addictions, depression, and obsessive-compulsive disorders. Recent research has indicated that the psychedelic drug, psilocybin, has produced safe and effective outcomes for these mental suffering states. In this context, the article draws on the concept of brain plasticity order, firstly, to identify the means for a person to move away from subjection of life’s negative, dominant discourses that “capture” the brain, and then to intentionally move towards more acceptable, preferred, ethical subjectivities. These explanations, using the phenomenon of depression, provide the foundation for further proposals that an innovative form of narrative therapy could be a safe, effective and meaningful approach for persons in relationship with other similar ways of mental suffering, such as, anxiety, addiction, obsessive-compulsive disorder, and anorexia nervosa.