An Update on Psychopharmacological Treatment of Autism Spectrum Disorder

While behavioral interventions remain the mainstay of treatment of autism spectrum disorder (ASD), several potential targeted treatments addressing the underlying neurophysiology of ASD have emerged in the last few years. These are promising for the potential to, in future, become part of the mainstay treatment in addressing the core symptoms of ASD. Although it is likely that the development of future targeted treatments will be influenced by the underlying heterogeneity in etiology, associated genetic mechanisms influencing ASD are likely to be the first targets of treatments and even gene therapy in the future for ASD. In this article, we provide a review of current psychopharmacological treatment in ASD including those used to address common comorbidities of the condition and upcoming new targeted approaches in autism management. Medications including metformin, arbaclofen, cannabidiol, oxytocin, bumetanide, lovastatin, trofinetide, and dietary supplements including sulforophane and N-acetylcysteine are discussed. Commonly used medications to address the comorbidities associated with ASD including atypical antipsychotics, serotoninergic agents, alpha-2 agonists, and stimulant medications are also reviewed. Targeted treatments in Fragile X syndrome (FXS), the most common genetic disorder leading to ASD, provide a model for new treatments that may be helpful for other forms of ASD.

Diagnosing and treating depression and anxiety in patients with cardiovascular disorders and diabetes mellitus in primary healthcare: is training of physicians enough for improvement?

INTRODUCTION. Common mental disorders - anxiety and depression - are prevalent among patients with cardiovascular disease (CVD) and diabetes mellitus type 2 (DM) and can negatively influence treatment outcomes and healthcare expenses. Despite the importance of management of depression and anxiety in primary care facilities, the diagnostics and treatment of these disorders remain insufficient in the Russian Federation. OBJECTIVE. To explore whether the rates of referrals to psychiatrist and indicated pharmacological treatment received due to depression or anxiety among patients with CVD and DM will significantly change in the primary healthcare facility after the training of primary care physicians (PCPhs) to deal with comorbid depression and anxiety (including the algorithm for referral to a psychiatrist). METHODS. Patients in primary care outpatient settings with diagnoses of CVD and DM passed screening on anxiety and depression using the Hospital Anxiety and Depression Scale (HADS), and information about the indicated treatment for anxiety or depression was collected when present (Sample 1: n = 400). The educational programme for PCPhs on diagnostics of anxiety and depression was then performed, and PCPhs were instructed to refer patients with HADS 7 to a psychiatrist. After the training, the second sample was collected (Sample 2: n = 178) using the same assessments as for Sample 1. The independent expert (psychiatrist) evaluated whether the patients had received the indicated pharmacological treatment, according to the screening criteria used in the study for anxiety and depression for both samples. RESULTS. The proportions of patients with borderline abnormal and abnormal HADS scores ( 7) were 365 (91.2%) and 164 (92.1%) in Sample 1 and Sample 2, respectively. In Sample 1, among patients with HADS 7, 119 (29.8%) received psychopharmacological treatment, but in only 46 (38.7%) cases it was indicated in compliance with the screening criteria. In Sample 2, among patients with HADS 7, 59 (33.1%) received psychopharmacological treatment, and in only 14 (23.7%) cases was it indicated in compliance with the screening criteria. The differences in the indicated pharmacological treatment were not statistically significant, and no one from Sample 2 with HADS 7 met a psychiatrist through PCPh referral. CONCLUSIONS. Anxiety and depression are prevalent in patients with CVD and DM treated in primary care facilities, but these patients may not be receiving the indicated pharmacological treatment. Barriers to referral and the use of psychiatric consultation exist despite the focused training of PCPhs and the straightforward referral protocol provided.

A Case Report on Alcohol Dependence Syndrome with Cannabis Addiction

Background: Alcohol dependence syndrome (ADS) and Cannabis use disorder (CUD) are every now and again co-happening or comorbid substance issues in the two young people and grown-ups. Indications of cross-over between ADS and CUD in people as they slowly move from pre-adulthood to adulthood. The researchers reasoned that the two substance-related issues are comorbid, albeit the closeness of their association ordinarily shifts over the long haul. Aim and Objective: The purpose of this case report is to determine the first-line approach for a person with alcohol dependence syndrome with cannabis addiction who has been referred to a public mental health facility for treatment. To identifying symptoms of ADS with cannabis addiction early, providing treatment and preventing possible complications. Methods: Knowledge used to write this case description was gathered from PubMed outlets, search hand, searching college and personal libraries looking for research techniques and case report texts, engaging in or writing many case reports with experience. Results: The patient was taken psychopharmacological treatment Anti- Anxiety drugs Lorazepam along with Tab. Benalgis, Tab. Neurobion fort and psycho social therapy, coping strategies, family therapy, yoga, cognitive behavioural therapy, medication. After those symptoms was minimized. Conclusion: Patients achieve positive outcomes not only through the support of their treatment management, but also through adaptation and family support. Then, with appropriate psychophysiological treatment, the patient gave a positive response and gradually all the planned goals were achieved. Finally, the patient was discharged and he is currently being monitored.

A Clinical Case Report: Schizophrenia

Background: Schizophrenia (SCZ) is a serious mental disorder in which people take reality as abnormally. SCZ may cause in combination of hallucination, delusions, and extremely disorder thinking and behaviour that impairs daily functioning and cannot be disabling. There are different reasons of SCZ this may be as of Genes, Environment or Change in Brain Structures.In India around 3/1000 people were affected due to SCZ Aim: The purpose of this case report is to determine the first line approach for a person with SCZ who has been referred to a public mental health facility for treatment. Objective: To identifying symptoms of SCZ early, providing treatment and preventing possible complications. Methods: Knowledge used to write this case description was gathered from PubMed outlets, search hand, searching college and personal libraries looking for research techniques and case report texts, engaging in or writing many case reports with experience. Results: The patient was taken psychopharmacological treatment antipsychotic drugs olanzapine, Risperidone along with antidepressant Sertraline and psycho social therapy, coping strategies, family therapy, yoga, cognitive behavioural therapy, medication. After those symptoms was minimized. Conclusion: Patients achieve positive outcomes not only through the support of their treatment management, but also through adaptation and familysupport. subsequently, with appropriate psychophysiological treatment, the patient gave a positive response and gradually all the planned goalswere achieved. Finally, the patient was discharged and she is currently beingmonitored.

The Utility of Pharmacogenetics Testing in Psychiatric Populations

The implementation of pharmacogenetic tests including multiple gene variants has shown promising potential as a decision-making tool for optimizing psychopharmacological treatment regimens and reducing treatment costs. However, the varying clinical validity of gene variants included in pharmacogenetic test batteries, and inconsistencies in their translation into medical recommendations between commercially available pharmacogenetic tests, complicates their rational implementation. Thus, there is a need for well-designed, reproducible studies documenting the clinical significance of the various genetic variants.