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'All Scientific Hands On Deck' To End The Opioid Crisis

By Nora Volkow (Director, NIDA) and Francis Collins (Director, NIH) In 2015, 2 million people had a prescription opioid use disorder and 591,000 suffered from a heroin use disorder; prescription drug misuse alone cost the nation $78.5 billion in health care, law enforcement, and lost productivity. But while the scope of the crisis is staggering, it is not hopeless. We understand opioid addiction better than many other drug use disorders; there are effective strategies that can be implemented right now to save lives and to prevent and treat opioid addiction. At the National Rx Drug Abuse and Heroin Summit in Atlanta, GA last month, lawmakers and representatives from healthcare, law enforcement, and many private stakeholders from across the nation affirmed a strong commitment to end the crisis. Research will be a critical component of achieving this goal. Today in the New England Journal of Medicine, we laid out a plan to accelerate research in three crucial areas: overdose reversal, addiction treatment, and pain management. First, there is a need to develop additional overdose-reversal interventions and improved formulations of naloxone to reduce mortality. Naloxone is very effective at reversing overdoses, but bystanders may not reach the person in time and the usual doses given may not be powerful or long-lasting enough to reverse overdoses on fentanyl and other highly potent synthetic opioids. In addition to new or differently formulated antagonists of the mu-opioid r...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news

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Altered levels and function of gamma-aminobutyric acidergic  interneurons that coexpress the neuropeptide somatostatin (SST) are consistently found in major depressive disorder (MDD). In this review, Fee et al. (pages 549--559) highlight evidence linking SST cell deficits to cortical inhibitory deficits underlying emotion and cognitive disruptions in MDD, f ocusing on recent insights into SST cell roles in cortical microcircuits. They then discuss the putative origins of SST cell deficits and implications for targeting this cellular pathology in the development of antidepressant therapies.
Source: Biological Psychiatry - Category: Psychiatry Tags: In This Issue Source Type: research
Pain insists upon being attended to. God whispers to us in our pleasures, speaks in our consciences, but shouts in our pains. It is his megaphone to rouse a deaf world.
Source: Biological Psychiatry - Category: Psychiatry Authors: Tags: Clinical Commentary Source Type: research
Major depressive disorder involves aberrant affective processing, the normalization of which has been associated with treatment in both pharmacological and cognitive behavioral interventions (1,2). In this issue of Biological Psychiatry, Young et al. (3) present data suggesting that the normalization of affective processing via a real-time functional magnetic resonance imaging (fMRI) neurofeedback intervention may be the mechanism underlying treatment response. A randomized trial of neurofeedback training patients with major depressive disorder to upregulate their amygdala activity during positive autobiographical memory r...
Source: Biological Psychiatry - Category: Psychiatry Authors: Tags: Commentary Source Type: research
Slightly more than 10% of pregnant women experience a major depressive episode (MDE) in pregnancy and slightly less than 10% of women have a MDE in the year postdelivery (1,2). Many women do not receive treatment because of concerns about the safety of antidepressant medication in pregnancy or while breastfeeding. Others find behavioral approaches too costly or time-consuming and do not access these treatments. Thus, understanding the biology and factors that can trigger an MDE or sustain it among vulnerable women may help women avoid or manage the condition.
Source: Biological Psychiatry - Category: Psychiatry Authors: Tags: Commentary Source Type: research
The noninvasive brain stimulation technique known as transcranial direct‐current stimulation (tDCS) did not demonstrate noninferiority to escitalopram in a 10‐week trial of patients with depression. The study's electrical stimulation group also experienced more adverse events, including onset of mania in two participants. Study results were published June 29 in the New England Journal of Medicine.
Source: The Brown University Psychopharmacology Update - Category: Psychiatry Tags: Depression Treatment Source Type: research
Abstract Somatic mutation analysis of human cancers has become the standard of practice. Whether screening for single gene variants or sequencing hundreds of cancer-related genes, this genomic information is the basis for precision medicine initiatives in oncology. Genomic profiling results in information that allows oncologists to make a more educated selection of appropriate therapeutic strategies that more often combine traditional cytotoxic chemotherapy and radiation with novel targeted therapies. Here we discuss the nuances of implementing somatic mutation testing in a clinical setting. PMID: 28921651 [PubMed - in process]
Source: The Journal of Clinical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: J Clin Pharmacol Source Type: research
Abstract Antibody-drug conjugates (ADCs) represent an innovative therapeutic approach that provides novel treatment options and hope for patients with cancer. By coupling monoclonal antibodies (mAbs) to cytotoxic small-molecule payloads with a plasma-stable linker, ADCs offer the potential for increased drug specificity and fewer off-target effects than systemic chemotherapy. As evidence for the potential of these therapies, many new ADCs are in various stages of clinical development. Because their structure poses unique challenges to pharmacokinetic and pharmacodynamic characterization, it is critical to recogniz...
Source: The Journal of Clinical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: J Clin Pharmacol Source Type: research
Abstract RNA-based therapeutic technologies represent a rapidly expanding class of therapeutic opportunities with the power to modulate cellular biology in ways never before possible. With RNA-targeted therapeutics, inhibitors of previously undruggable proteins, gene expression modulators, and even therapeutic proteins can be rationally designed based on sequence information alone, something that is not possible with other therapeutic modalities. The most advanced RNA therapeutic modalities are antisense oligonucleotides (ASOs) and small interfering RNAs. Particularly with ASOs, recent clinical data have demonstra...
Source: The Journal of Clinical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: J Clin Pharmacol Source Type: research
Abstract Immuno-oncology works through activation of the patient's immune system against cancer, with several advantages over other treatment approaches, including cytotoxic agents and molecular-targeted therapies. The most notable feature of immuno-oncology treatments is the nature of the patient responses achieved, which can be more durable and sustained than with other modalities. Increased understanding of immune system complexity has provided a number of opportunities to advance several strategies for the development of immuno-oncology therapies. This review outlines the clinical pharmacology characteristics ...
Source: The Journal of Clinical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: J Clin Pharmacol Source Type: research
Abstract Pediatric drug development in the United States has grown under the current regulations made permanent by the Food and Drug Administration Safety and Innovation Act of 2012. Over 1200 pediatric studies have now been submitted to the US FDA, but there is still a high rate of failure to obtain pediatric labeling for the indication pursued. Pediatric oncology represents special problems in that the disease is most often dissimilar to any cancer found in the adult population. Therefore, the development of drug dosing in pediatric oncology patients represents a special challenge. Potential approaches to pediat...
Source: The Journal of Clinical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: J Clin Pharmacol Source Type: research
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