Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 24
Filter
1.
Journal of Clinical Psychiatry ; 83(5):29, 2022.
Article in English | MEDLINE | ID: covidwho-2024669

ABSTRACT

Objective: While psychiatric disorders have been recognized as a risk factor for COVID-19 outcomes, the impact of substance use disorders (SUD) on COVID-19 outcomes has not, to date, been examined in a systematic manner. We examined the association between SUD (cannabis, cocaine, alcohol, opioid, and benzodiazepine) as well as psychiatric diagnoses (schizophrenia, mood disorders, anxiety disorders) and COVID-19 outcomes in a large, retrospective cohort study. Methods: COVID-19-positive patients admitted to a large health care system in the US between January and December 2020 were included in this study. SUD and psychiatric diagnoses were identified from urine toxicology reports and ICD-10 diagnosis codes in the electronic medical record, respectively. Multivariable logistic regression was performed controlling for potential confounders such as age, race, sex, smoking status, and medical comorbidities. COVID-19-relevant outcomes included mortality, need for intensive care unit (ICU) admission, need for ventilatory support, length of hospitalization, and number of hospitalizations. Results: Among COVID-19 patients (N = 6,291), those with SUD were more likely to require ICU admission (adjusted odds ratio [AOR] = 1.46, P = .003) and ventilatory support (AOR = 1.49, P = .01). The association between SUD and ICU admission was driven by alcohol use disorder (AUD), whereas that between SUD and ventilatory support was driven by both AUD and opioid use disorder (OUD). Patients with SUD were more likely to have a longer mean maximum length of hospitalization (11.32 vs 8.62 days, P < .0001) and a greater mean number of hospital admissions in 2020 (2.96 vs 2.33, P < .0001). These associations were significant for cannabis use disorder, AUD, OUD, and benzodiazepine use disorder. The association with greater number of admissions was also significant for cocaine use disorder. Patients with psychiatric diagnoses were also more likely to have a greater maximum length of hospitalization (11.93 vs 8.39 days, P < .0001) and hospital admissions (2.72 vs 2.31, P < .0001). These associations were significant for schizophrenia, mood disorders, and anxiety disorders. Conclusions: COVID-19 patients with SUD had greater likelihood of requiring critical interventions, such as ICU admission and ventilatory support. SUD and psychiatric diagnoses were also associated with a longer duration of hospitalization and greater number of hospital admissions. These findings identify COVID-19 patients with SUD and psychiatric comorbidities as a high-risk group.

2.
Marine Drugs ; 20(8):493, 2022.
Article in English | ProQuest Central | ID: covidwho-2023892

ABSTRACT

Sleep deficiency is now considered an emerging global epidemic associated with many serious health problems, and a major cause of financial and social burdens. Sleep and mental health are closely connected, further exacerbating the negative impact of sleep deficiency on overall health and well-being. A major drawback of conventional treatments is the wide range of undesirable side-effects typically associated with benzodiazepines and antidepressants, which can be more debilitating than the initial disorder. It is therefore valuable to explore the efficiency of other remedies for complementarity and synergism with existing conventional treatments, leading to possible reduction in undesirable side-effects. This review explores the relevance of microalgae bioactives as a sustainable source of valuable phytochemicals that can contribute positively to mood and sleep disorders. Microalgae species producing these compounds are also catalogued, thus creating a useful reference of the state of the art for further exploration of this proposed approach. While we highlight possibilities awaiting investigation, we also identify the associated issues, including minimum dose for therapeutic effect, bioavailability, possible interactions with conventional treatments and the ability to cross the blood brain barrier. We conclude that physical and biological functionalization of microalgae bioactives can have potential in overcoming some of these challenges.

3.
BMC Public Health ; 22(1): 1446, 2022 07 29.
Article in English | MEDLINE | ID: covidwho-1968565

ABSTRACT

The COVID-19 pandemic has had a significant impact on daily life, affecting both physical and mental health. Changes arising from the pandemic may longitudinally impact health-related behaviors (HRB). As different HRBs co-occur, in this study, we explore how six HRBs - alcohol (past-week and binge-drinking), tobacco, marijuana, benzodiazepine use, and unhealthy food consumption - were grouped and changed over time during the COVID-19 pandemic. A sample of 1038 university students and staff (18 to 73 years old) of two universities completed an online psychometrically adequate survey regarding their recalled HRB (T0, pre-COVID-19 pandemic) and the impact of COVID-19 on their behaviors during July (T1) and November (T2). Latent Transition Analysis (LTA) was used to identify HRB cluster membership and how clusters changed across T0, T1, and T2. Four clusters emerged, but remained mainly stable over time: 'Lower risk' (65.2-80%), 'Smokers and drinkers' (1.5-0.01%), 'Binge-drinkers and marijuana users' (27.6-13.9%), and 'Smokers and binge-drinkers' (5.6-5.8%). Participants who moved from one cluster to another lowered their HRB across time, migrating from the 'Binge-drinkers and marijuana users' cluster to 'Lower risk'. Participants in this cluster were characterized as less affected economically by the COVID-19 pandemic, with lower reported stress levels, anxiety, depression, and loneliness than the other clusters. Our results provide evidence of how HRBs clustered together and transitioned longitudinally during the COVID-19 pandemic. HRB clustering across time offers a valuable piece of information for the tailoring of interventions to improve HRB.


Subject(s)
COVID-19 , Adolescent , Adult , Aged , COVID-19/epidemiology , Cluster Analysis , Health Behavior , Humans , Middle Aged , Pandemics , Universities , Young Adult
5.
BJPsych Open ; 8(S1):S168-S169, 2022.
Article in English | ProQuest Central | ID: covidwho-1902547

ABSTRACT

AimsThis is a re-audit of Benzodiazepine and Z-hypnotic drugs prescriptions in two community treatment teams (CTTs) in the Cumbria Northumberland Tyne and Wear (CNTW) Trust, comparing with previous audits in 2009, 2017 and 2018 to check whether areas of good practice were maintained, and progress was made.MethodsWe reviewed caseloads of four CNTW consultants in the two CTTs which included 554 patient encounters with 60 encounters where benzodiazepines or z-drugs were prescribed. Nine missing data sets brought the total audit sample to 51. For these 51, prescribing information was gathered from RiO and assessed against standards derived from CNTW Trust Policy and BNF prescribing guidance. To be compliant, 90–100% of prescriptions needed to meet the standard.ResultsOverall, the rate of prescribing of benzodiazepines and Z- drugs increased from previous audit (7% in 2018, now 10.8%). Good areas of practice maintained were as follows (all 100%): all teams were compliant in prescribing within BNF limits, refrained from prescribing diazepam in 10 mg formulation, and no pregnant/post-partum women were prescribed these medications.Although non-compliant, there were clear improvements in documenting indicated use (2018: 61.65%, 2021: 80.8%), and providing prescriptions of <4 weeks in duration (2018: 58.2%, 2021: 79.2%)Key areas of concern were as follows: poor documentation of indication, duration of treatment and plans for review/discontinuation (compliance ranged from 31.5% - 81.2% in these areas). There was poor documentation of what verbal advice was given (0–16.9%), and lack of clearly documented tapering/discontinuation plans for those on long-term prescriptions (16.1%). The provision of written advice reduced from previous audit (2018: 10.7%, 2021: 5.8%). As 41/51 encounters were via telephone or video due to COVID-19 pandemic, this may have impacted on results.ConclusionDespite improvement in some areas, there remains scope for ongoing improvement in other areas. To improve these, we plan to produce and distribute an educational email to all prescribers, including the following: information on this audit and its findings, prescribing guidelines, relevant e-links to patient information leaflets as well as the audit proforma used for this audit, to encourage prescribers to undertake self-directed practice. A poster will be distributed, highlighting prescribing guidelines and standards, to be printed and displayed in clinical areas as reminder of prescribing responsibilities and the importance of documentation. Prescribers will be encouraged to participate in a small quiz to test learning. Efficacy of these measures will be assessed with a re-audit in one years’ time.

6.
Vestnik KAZNMU ; 3:315-320, 2021.
Article in Russian | GIM | ID: covidwho-1897932

ABSTRACT

Introduction. Due to the significant similarity between the symptoms of SARS-CoV-2 acute respiratory syndrome and panic disorder (PD), diagnosis presents significant difficulties. PD tend to develop chronically, with lifelong relapses. Purpose of the work: to identify the features of the clinical manifestation of PD in the presence of COVID-19 and to substantiate the optimal therapy regimen. Methods. We analyzed the data of 86 patients who were diagnosed with PD when they applied for a consultative neurological appointment CF UMC from May 2020 to May 2021. Panic disorder was screened according to the Sheehan Anxiety Rating Scale (ShARS). Results. Among the patients there were 54 (62.8%) women and 32 (37.2%) men. On the ShARS scale, severe anxiety disorder (80 points and higher) was identified in 39 (45.3%), in the rest anxiety (from 30 to 80 points) was clinically expressed. The diagnosis of PD in 21 (24.4%) was diagnosed earlier than contracting a covid infection. The rest were exposed for the first time to 26 (30.2%) patients who had not previously visited a neurologist and 39 (45.3%) patients who visited a neurologist with diagnoses of somatoform autonomic dysfunction, vascular cephalgia, migraine, obsessive-compulsive disorder. A history of bronchial asthma was observed in 13 (15.1%) cases. The types of panic attacks were regarded as large (extensive) PR (4 symptoms or more) - in 55 (64%), in other cases as symptomatically poor. The peculiarity of the course of PR against the background of SARS-CoV-2 is determined by the occurrence of hypochondriac phobias against the background. At the same time, agoraphobia and avoidant behavior characteristic of PD were not observed. Conclusion. The use of benzodiazepines for anxiolytic purposes, anti-asthma drugs may be counterproductive in the treatment of anxiety disorders. The iatrogenic risk is superimposed on possible hypokalemia, prolongation of the QTc interval, arterial hypertension caused by COVID-19. Evaluation of the results of the neuropharmacological analysis and the appointment of drugs with anxiolytic action Bifren, in more severe cases of Pregabin in PR showed a clinical positive effect.

7.
European Journal of Hospital Pharmacy. Science and Practice ; 29(Suppl 1):A90-A91, 2022.
Article in English | ProQuest Central | ID: covidwho-1874589

ABSTRACT

Background and importanceA reference panel of antimicrobial consumption indicators was published in 2019 by a committee from the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC).Aim and objectivesTo calculate 2020 hospital antimicrobial consumption indicators and carry out a comparative analysis of these consumption indicators with those observed in the previous 2 years.Material and methodsBased on the panel, 10 antimicrobial consumption indicators were selected. The unit of measurement for the consumption was the number of defined daily doses per 100 stays (DDD/100e).ResultsAntibacterials overall consumption (OC) 1.5% (86.5 to 85.2) decrease in 2019;and 4.7% increase in 2020 compared to 2019 (89.2).Antifungals OC 3% decrease in 2019 (7.05 to 6.84);26% increase in 2020 compared to 2019 (8.65).Carbapenems: in 2019, consumption decreased by 4.2% (10.17 to 9.74);in 2020 it increased by 2% compared to 2019 (9.94).Fluoroquinolones: maintained overall 37.4% decrease (13.01 in 2018, 10.83 in 2019 and 8.14 in 2020).Fosfomycin: maintained overall increase of 27.6% (0.49 in 2018, 0.65 in 2019 and 0.62 in 2020).Aminoglycosides: maintained overall decrease of 40.7% (3.27 in 2018, 2.32 in 2019 and 1.94 in 2020).Colistin: 12.8% decrease in 2019 (1.09 to 0.95), and an 8.4% increase in 2020 compared to 2019 (1.03).Anti-pseudomonal cephalosporins: maintained overall increase of 19% (2.11 in 2018, 2.47 in 2019 and 2.51 in 2020).Amoxicillin-clavulanate/piperacillin-tazobactam ratio: maintained decrease of 47% compared to 2018 (4.34 in 2018, 3.54 in 2019 and 2.26 in 2020).Fluconazole/equinocandins ratio: 24% rise in 2019 (4.14 to 5.45);in 2020 it decreased by 16% (4.57).Conclusion and relevanceDuring 2020, a change in trend has been perceived in a series of antimicrobial consumption indicators, with higher antibacterials and antifungals OC, carbapenems and colistin consumption, and a decreased fluconazole/equinocandins ratio. This change in trend could be related to the increase of multiresistant bacterial and fungal infections associated with COVID-19.The downward trend in the consumption of fluoroquinolones and aminoglycosides and the upward trend in anti-pseudomonal cephalosporins and fosfomycin was maintained. Interventions carried out through the antimicrobial stewardship programme aimed at optimising and/or de-escalating empirical antimicrobial treatment may be behind this trend.The amoxicillin-clavulanate/piperacillin-tazobactam ratio may have been influenced by frequent piperacillin-tazobactam stock-outs in the years studied.References and/or acknowledgements1. Gutiérrez-Urbón JM.Indicadores del uso hospitalario de antimicrobianos basados en el consumo. Farm Hosp 2019;43(3):94–100.Conflict of interestNo conflict of interest

8.
BMJ Open ; 11(9), 2021.
Article in English | ProQuest Central | ID: covidwho-1842922

ABSTRACT

IntroductionThe COVID-19 pandemic has driven unprecedented social and economic reform in efforts to curb the impact of disease. Governments worldwide have legislated non-essential service shutdowns and adapted essential service provision in order to minimise face-to-face contact. We anticipate major consequences resulting from such policies, with marginalised populations expected to bear the greatest burden of such measures, especially those with substance use disorders (SUDs).Methods and analysisWe aim to conduct (1) a scoping review to summarise the available evidence evaluating the impact of the COVID-19 pandemic on patients with SUDs, and (2) an evidence map to visually plot and categorise the current available evidence evaluating the impact of COVID-19 on patients with SUDs to identify gaps in addressing high-risk populations.Ethics and disseminationEthics approval is not required for this scoping review as we plan to review publicly available data. This is part of a multistep project, whereby we intend to use the findings generated from this review in combination with data from an ongoing prospective cohort study our team is leading, encompassing over 2000 patients with SUDs receiving medication-assisted therapy in Ontario prior to and during the COVID-19 pandemic.

9.
Journal of Clinical Medicine ; 11(9):2435, 2022.
Article in English | ProQuest Central | ID: covidwho-1842885

ABSTRACT

Background: The dissemination of recommendations on low-value care alone may not lead to physicians’ behavioral changes. The aim of this study was to evaluate whether a multifaceted behavioral intervention among internal medicine residents could reduce low-value care in hospitalized patients. Methods: A pre–post quality improvement intervention was conducted at the Internal Medicine Division of La Tour hospital (Geneva, Switzerland) from May 2020 to October 2021. The intervention period (3 months) consisted of a multifaceted informational intervention with audits and educative feedback about low-value care. The pre- and post-intervention periods including the same six calendar months were compared in terms of number of blood samples per patient day, prescription rates of benzodiazepines (BZDs) and proton pump inhibitors (PPIs), as well as safety indicators including potentially avoidable readmissions, premature deaths and complications. results: A total of 3400 patients were included in this study;1095 (32.2%) and 1155 (34.0%) were, respectively, hospitalized during the pre- and post-intervention periods. Patient characteristics were comparable between the two periods. Only the number of blood tests per patient day and the BZD prescription rate at discharge were significantly reduced in the post-intervention phase (pre: 0.54 ± 0.43 vs. post: 0.49 ± 0.60, p ≤ 0.001;pre: 4.2% vs. post: 1.7%, p = 0.003, respectively). PPI prescription rates remained comparable. Safety indicators analyses revealed no significant differences between the two periods of interest. Conclusions: Our results demonstrate a modest but statistically significant effect of a multifaceted educative intervention in reducing the number of blood tests and the BZD prescription rate at discharge in hospitalized patients. Limiting low-value services is very challenging and additional long-term interventions are necessary for wider implementation.

10.
Br J Clin Pharmacol ; 88(4): 1567-1589, 2022 02.
Article in English | MEDLINE | ID: covidwho-1840337

ABSTRACT

AIMS: Growing evidence suggests an association between the use of sedative-hypnotic medications and risk of dementia. The aim of this study is to examine this association using a meta-analysis approach. METHODS: MEDLINE (PubMed) and Scopus were systematically searched for studies published in English only. The quality of studies was evaluated using the Newcastle-Ottawa scale, and an overall odds ratio was pooled using a random-effects model. RESULTS: A total of 35 articles were included in the analysis. Pooled odds ratios (ORs) for dementia from all records were (OR; 1.33, 95% CI 1.19-1.49) for benzodiazepine (BZD) combined use (Subgroup-1), (OR: 1.46, 95% CI 1.23-1.73) for short-acting BZD use (Subgroup-2), (OR: 1.72, 95% CI 1.48-1.99) for long-acting BZD use (Subgroup-3), (OR: 1.13, 95% CI 0.97-1.32) for BZDs without specification of duration of action (Subgroup-4), (OR: 1.64, 95% CI 1.13-2.38) for the combined BZDs and Z-drugs, (OR: 1.43, 95% CI 1.17-1.74) for Z-drugs only, (OR: 1.14, 95% CI 0.88-1.46) for antidepressant use, (OR: 0.97, 95% CI 0.68-1.39) for antipsychotic use and (OR: 0.98, 95% CI 0.85-1.13) for anticonvulsant use. When sensitivity analysis was performed, association between overall use of BZDs and short-acting BZDs with the increased risk of dementia disappeared after exclusion of studies that were not adjusted for age covariate (OR: 1.2, 95% CI 1.0-1.44) and (OR: 1.22, 95% CI 0.75-2.01), respectively. Adjustment for protopathic bias by introduction of a lag period showed no evidence of increased risk of dementia with the use of BZDs (Subgroup-1) (OR: 1.14, 95% CI 0.82-1.58), Z-drugs (OR: 1.29, 95% CI 0.78-2.13), and combined BZDs and Z-drugs (OR: 1.51, 95% CI 0.91-2.53). Combined use of BZDs and Z-drugs showed more positive association when only studies of non-user design were analysed (OR: 2.75, 95% CI 2.23-3.39). CONCLUSIONS: All the investigated sedative-hypnotics showed no association with increased risk of dementia except for BZDs. However, the observed association with BZDs did not persist after exclusion of studies with potential reverse causation and confounding by indication. Therefore, this association needs to be assessed carefully in future research.


Subject(s)
Dementia , Hypnotics and Sedatives , Antidepressive Agents/therapeutic use , Benzodiazepines/adverse effects , Dementia/chemically induced , Dementia/drug therapy , Dementia/epidemiology , Humans , Hypnotics and Sedatives/adverse effects , Odds Ratio
11.
Irish Medical Journal ; 114(9), 2021.
Article in English | GIM | ID: covidwho-1837217

ABSTRACT

Aims: To describe the characteristics, symptoms and outcomes for patients with COVID-19 referred to a hospital-based specialist palliative care service and to describe communication and visiting practices. Methods: A descriptive cross-sectional retrospective study, which is a part of the ANTICIPATE study project. Results: 50 patients were referred;49 included in analysis. 38 patients died. 27 patients were male;median age was 81 years. On referral, median Charlson Comorbidity Index was 6;median Australia-modified Karnofsky Performance Status score was 20%. Median number of days from referral to death was 2. Common baseline symptoms (n) were dyspnoea (35), agitation (23), and pain (13). Opioids (100%), benzodiazepines (97.1%) and neuroleptics (61.8%) were most commonly used medications to achieve symptom control. 13/19 patients with serial data had a decrease in Palliative Care Problem Severity Score. 26 patients received a family visit before death;8 had virtual forms of contact. 9 patients had family present at time of death. Conclusion: The short interval from referral to Specialist Palliative Care and death indicates the need for prompt service response. Data on visiting highlights challenges of providing psychosocial support.

12.
Case Reports in Neurology ; 14(1):25-30, 2022.
Article in English | ProQuest Central | ID: covidwho-1823985

ABSTRACT

Acute toxic leukoencephalopathy (ATL) and delayed post-hypoxic leukoencephalopathy (DPHL) are two possible adverse entities related to opioid intoxication (OI), each having a distinct clinical course. While ATL shows a monophasic course with gradual neurological deterioration, DPHL has a distinct biphasic course. We report a case of ATL along with a case of DPHL happening in young male patients with OI, including their clinical courses as well as imaging characteristics with comparable time intervals. Initially, both leukoencephalopathies typically show magnetic resonance imaging findings with confluent and symmetric white matter (WM) abnormalities in the periventricular regions on T2 and fluid-attenuated inversion recovery images along with restricted diffusion on diffusion-weighted imaging. The DPHL patient however also presented with WM cystic substance loss in the deterioration phase, several weeks after hospital admission, which was previously described in a case of DPHL. Interestingly, similar WM changes have recently been observed in virus-associated necrotizing disseminated acute leukoencephalopathy in patients with coronavirus disease 2019 which may suggest a common pathophysiological mechanism. Knowing the distinct imaging features of ATL and DPHL along with their typical clinical courses can provide a faster and more reliable differentiation between these two entities.

13.
Pharmacopsychiatry ; 55(1):40-47, 2022.
Article in English | APA PsycInfo | ID: covidwho-1772432

ABSTRACT

Introduction: The SARS-CoV-2 pandemic with psychiatric comorbidities leads to a scenario in which the use of psychotropic drugs may be required. This requires the support of evidence-based medicine to take into account possible interactions between antidepressants, mood stabilizers, benzodiazepines, and coronavirus infection treatments. Methods: Three databases were consulted: (a) Lexicomp Drug Interactions, (b) Micromedex Solutions Drugs Interactions, (c) Liverpool Drug Interaction Group for COVID-19 therapies. The CredibleMeds QTDrugs List was also queried. Hydroxychloroquine, chloroquine, azithromycin, lopinavir-ritonavir, remdesivir, favipiravir, tocilizumab, baricitinib, anakinra, and dexamethasone - drugs used for SARS-CoV-2-were analyzed, and consensus recommendations are made. Results: The potential interactions of agomelatine, desvenlafaxine, duloxetine, milnacipran, and vortioxetine with COVID-19 treatments shall be considered less risky. Antidepressant interactions with hydroxychloroquine, chloroquine, and azithromycin enhance the risk of QT prolongation, and ECG monitoring is advised for most antidepressants. Antidepressants with lopinavir/ ritonavir involve multiple CYP enzyme interactions (except with milnacipran). Gabapentin, oxcarbazepine, pregabalin, topiramate, and zonisamide are safe treatment options that have no significant interactions with COVID-19 treatments. Lithium is contraindicated with hydroxychloroquine, chloroquine, and azithromycin. Precaution should be taken in using valproic acid with lopinavir-ritonavir. The use of benzodiazepines does not present a risk of drug interaction with COVID-19 treatments, except lopinavir/ritonavir. Conclusions: Clinicians prescribing antidepressants, mood stabilizers/anticonvulsants, and benzodiazepines, should be aware of the probable risk of drug-drug interaction with COVID- 19 medications and may benefit from heeding these recommendations for use to ensure patient safety. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

14.
Symmetry ; 14(3):579, 2022.
Article in English | ProQuest Central | ID: covidwho-1765925

ABSTRACT

In this paper, the authors describe a set of dynamic chromatography experiments on chiral HPLC columns, and in the range from room temperature to −50 °C for four 1,4-benzodiazepines, extracting the data for the best analytical conditions for their enantiomeric separation. [...]I want to express my great appreciation for the efficient assistance provided to me by Amelia Sun and the Editorial Office of Symmetry. Abbreviations PXRD: powder X-ray diffraction;ESI: electrospray ionization;HPLC: high-performance liquid chromatography;DFT: density functional theory;VCD: vibrational circular dichroism;ECD: electronic circular dichroism;CD: circular dichroism.

15.
Australas Psychiatry ; 30(3): 334-337, 2022 06.
Article in English | MEDLINE | ID: covidwho-1685906

ABSTRACT

OBJECTIVE: This study aims to investigate whether COVID-19 has led to increased usage of benzodiazepines in acute psychiatric settings. METHOD: We evaluated the rates of benzodiazepine usage in two acute psychiatric inpatient units over a period of two years, 2019 and 2020 (the year of the pandemic). Rates of oral atorvastatin usage over the same period were used as a comparator. RESULTS: We saw a significant increase in the usage of benzodiazepines in the period between April and December 2020 compared to the same period in 2019 despite a decline in the total number of admissions in 2020. Usage peaked further at the time of eased pandemic restrictions which coincided with higher rates of emergency department mental health (MH) presentations and acute MH hospital admissions. We also noticed higher rates of substance use disorder recorded on admission. Hospital leave restrictions due to COVID-19 also led to further restrictions on smoking. CONCLUSION: Benzodiazepine usage increased in the context of the COVID-19 pandemic. The study encourages more research to better understand the impact of the pandemic on acute psychiatric settings.


Subject(s)
COVID-19 , Benzodiazepines/therapeutic use , Humans , Inpatients , Pandemics , SARS-CoV-2
16.
Asian J Psychiatr ; 69: 103004, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1637202

ABSTRACT

Catatonia has been reported as one among many neuropsychiatric manifestations associated with COVID-19 infection. Catatonia and COVID-19 co-occurrence remain clinical concerns, often posing challenges pertaining to diagnosis, and especially management. Limited information is available regarding the appropriate approaches to the management of catatonia in COVID-19 infection, particularly with reference to the safety and efficacy of benzodiazepines and Electro-convulsive therapy (ECT). We present our experience of five patients with catatonia consequent to heterogeneous underlying causes and concurrent COVID-19 infection, who received care at the psychiatric COVID unit of our tertiary care psychiatric hospital. An interesting observation included varying underlying causes for catatonia and the potential role that COVID-19 infection may have played in the manifestation of catatonia. In our experience, new-onset catatonia with or without pre-existing psychiatric illness and concurrent COVID-19 can be safely and effectively managed with lorazepam and/or ECTs. However, critical to the same is the need to implement modified protocols that integrate pre-emptive evaluation for COVID-19 disease and proactive monitoring of its relevant clinical parameters, thereby permitting judicious and timely implementation of catatonia-specific treatment options.


Subject(s)
COVID-19 , Catatonia , Electroconvulsive Therapy , Catatonia/diagnosis , Catatonia/etiology , Catatonia/therapy , Hospitals, Psychiatric , Humans , SARS-CoV-2 , Tertiary Healthcare
17.
Brown University Psychopharmacology Update ; 33(2):8-8, 2022.
Article in English | Academic Search Complete | ID: covidwho-1629289
18.
Front Psychiatry ; 12: 731297, 2021.
Article in English | MEDLINE | ID: covidwho-1581168

ABSTRACT

Some first investigations have focused on the consequences of the COVID-19 pandemic for the general mental health after its outbreak in 2020. According to multiple self-reporting surveys, symptoms of stress, anxiety, and depression have risen worldwide. Even some studies based on health care records start to be published, providing more objective and statistically reliable results. Additionally, concerns have been raised, to what extend the access to mental health care has been compromised by the COVID-19 outbreak. The aim of this study was to detect changes in prescription trends of common psychotropic medications in the Swedish region of Scania. The monthly dispensed amounts of selected pharmaceuticals were compared from January 2018 until January 2021, regarding the prescription trends before and after the outbreak of COVID-19. Using an interrupted time series analysis for each medication, no general trend changes were observed. On the one hand, a possible deterioration of the general mental health could not be confirmed by these results. On the other hand, the access to mental health care did not seem to be impaired by the pandemic. When interpreting findings related to the COVID-19 pandemic, regional differences and country-specific approaches for coping with the pandemic should be considered. The Swedish population, for instance, never experienced a full "lock-down" and within Sweden the time point of the outbreak waves differed regionally. In general, the effects of the COVID-19 outbreak on mental health are still unclear and need to be investigated further in an international comparison.

19.
British Columbia Medical Journal ; 63(10):434-435, 2021.
Article in English | Web of Science | ID: covidwho-1558215
20.
Drug Alcohol Depend ; 229(Pt A): 109176, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1517124

ABSTRACT

BACKGROUND: COVID-19 and resulting mitigation measures in the United States (US) brought about limited access to medical care that has been linked to increases in mental health problems, excessive substance use, and drug overdoses. The increase in co-prescription of benzodiazepines and opioids may indicate population-level changes in health behaviors that can be exacerbated by limited access, hence necessitating the tracking of these drugs during COVID-19. We evaluated the impact of the declaration of COVID-19 as a US national emergency on prescription patterns in 2020. METHODS: Prescriptions of benzodiazepines and opioids were analyzed using data aggregated on a weekly basis across 38 states over the January 2019-December 2020 period. Data were from Bamboo Health Prescription Drug Monitoring Program and covered all individuals regardless of insurance status. Generalized additive models estimated the effects of the March 13, 2020 declaration on proportion of prescriptions to all controlled substances by comparing volumes before to after the week of March 13 in 2020 (range: January 27-May 24) and comparing this trend to its 2019 counterpart. RESULTS: When comparing the January 27-March 9 period to the March 16-May 24 period in 2020, there was a statistically significant 2.0% increase in the proportion of benzodiazepine dispensations to all controlled substances, and a significant 1.7% mean decrease in proportion of opioid dispensations to all controlled substances. A significant return approaching pre-declaration levels was observed only for opioids (beginning week of May 18, 2020). CONCLUSIONS: The results suggest significant impacts of the COVID-19 pandemic on dispensations of benzodiazepines and opioids across the US. Continued monitoring of prescription trends and maintenance of adequate and accessible access to mental healthcare are important for understanding public health crises related to substance use.


Subject(s)
Analgesics, Opioid , COVID-19 , Analgesics, Opioid/therapeutic use , Benzodiazepines , Controlled Substances , Drug Prescriptions , Humans , Pandemics , SARS-CoV-2 , United States/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL