Current and Future Therapeutic Options in Pain Management: Multi-mechanistic Opioids Involving Both MOR and NOP Receptor Activation
AbstractOpioids are widely used in chronic pain management, despite major concerns about their risk of adverse events, particularly abuse, misuse, and respiratory depression from overdose. Multi-mechanistic opioids, such as tapentadol and buprenorphine, have been widely studied as a valid alternative to traditional opioids for their safer profile. Special interest was focused on the role of the nociceptin opioid peptide (NOP) receptor in terms of analgesia and improved tolerability. Nociceptin opioid peptide receptor agonists were shown to reinforce the antinociceptive effect of mu opioid receptor (MOR) agonists and modula...
Source: CNS Drugs - May 26, 2022 Category: Neurology Source Type: research
Current Principles in the Management of Drug-Resistant Epilepsy
AbstractDrug-resistant epilepsy is associated with poor health outcomes and increased economic burden. In the last three decades, various new antiseizure medications have been developed, but the proportion of people with drug-resistant epilepsy remains relatively unchanged. Developing strategies to address drug-resistant epilepsy is essential. Here, we define drug-resistant epilepsy and emphasize its relationship to the conceptualization of epilepsy as a symptom complex, delineate clinical risk factors, and characterize mechanisms based on current knowledge. We address the importance of ruling out pseudoresistance and cons...
Source: CNS Drugs - May 20, 2022 Category: Neurology Source Type: research
Antidrug Antibodies Against Biological Treatments for Multiple Sclerosis
AbstractThe development of antidrug antibodies (ADAs) is a major problem in several recombinant protein therapies used in the treatment of multiple sclerosis (MS). The etiology of ADAs is multifaceted. The predisposition for a breakdown of immune tolerance is probably genetically determined, and many factors may contribute to the immunogenicity, including structural properties, formation of aggregates, and presence of contaminants and impurities from the industrial manufacturing process. ADAs may have a neutralizing capacity and can reduce or abrogate the bioactivity and therapeutic efficacy of the drug and cause safety is...
Source: CNS Drugs - May 19, 2022 Category: Neurology Source Type: research
Assessment and Management of Cognitive Function in Patients with Prostate Cancer Treated with Second-Generation Androgen Receptor Pathway Inhibitors
AbstractPreservation of cognitive function is an important outcome in oncology. Optimal patient management requires an understanding of cognitive effects of the disease and its treatment and an efficacious approach to assessment and management of cognitive dysfunction, including selection of treatments to minimize the risk of cognitive impairment. Awareness is increasing of the potentially detrimental effects of cancer-related cognitive dysfunction on functional independence and quality of life. Prostate cancer occurs most often in older men, who are more likely to develop cognitive dysfunction than younger individuals; th...
Source: CNS Drugs - May 6, 2022 Category: Neurology Source Type: research
Central Neuropathic Pain Syndromes: Current and Emerging Pharmacological Strategies
AbstractCentral neuropathic pain is caused by a disease or lesion of the brain or spinal cord. It is difficult to predict which patients will develop central pain syndromes after a central nervous system injury, but depending on the etiology, lifetime prevalence may be greater than 50%. The resulting pain is often highly distressing and difficult to treat, with no specific treatment guidelines currently available. This narrative review discusses mechanisms contributing to central neuropathic pain, and focuses on pharmacological approaches for managing common central neuropathic pain conditions such as central post-stroke p...
Source: CNS Drugs - May 5, 2022 Category: Neurology Source Type: research
Correction to: The Potential of N ‑Acetyl‑L‑Cysteine (NAC) in the Treatment of Psychiatric Disorders
(Source: CNS Drugs)
Source: CNS Drugs - April 28, 2022 Category: Neurology Source Type: research
Impact of 3-Monthly Long-Acting Injectable Paliperidone Palmitate in Schizophrenia: A Retrospective, Real-World Analysis of Population-Based Health Records in Spain
ConclusionsPP3M was more effective than OAs and monthly LAIs in improving clinical outcomes for patients with schizophrenia in a real-world setting in Spain. (Source: CNS Drugs)
Source: CNS Drugs - April 23, 2022 Category: Neurology Source Type: research
Dual Orexin Receptor Antagonists (DORAs) as an Adjunct Treatment for Smoking Cessation
AbstractSmoking is recognized as the most avoidable cause for multiplicity of chronic diseases. However, smoking cessation rates remain low, in part due to the limited target engagement of the currently approved medications for smoking cessation. Sleep is a promising focus for increasing smoking cessation rates because smokers ’ sleep problems are exacerbated during the first week of smoking abstinence and are associated with poor smoking cessation outcomes. Furthermore, the currently approved smoking cessation pharmacological agents varenicline and nicotine replacement treatment exacerbate sleep problems beyond what wo ...
Source: CNS Drugs - April 22, 2022 Category: Neurology Source Type: research
Correction to: Calcium, Magnesium, Potassium and Sodium Oxybates (Xywav ®) in Sleep Disorders: A Profile of Its Use
(Source: CNS Drugs)
Source: CNS Drugs - April 21, 2022 Category: Neurology Source Type: research
Evaluation of Individual Items of the Patient Health Questionnaire (PHQ-9) and Montgomery-Asberg Depression Rating Scale (MADRS) in Adults with Treatment-Resistant Depression Treated with Esketamine Nasal Spray Combined with a New Oral Antidepressant
ConclusionImprovement in mean total scores in those treated with esketamine plus AD compared with placebo plus AD are important results to confirm efficacy. The odds of improving in those treated with esketamine plus AD was at least two times greater than with placebo plus AD on three patient- and two clinician-reported individual symptoms of TRD. These findings provide patient-relevant quantification of the esketamine plus AD treatment benefit, adding understanding as to which symptoms are most improved with treatment.Trial RegistrationClinicalTrials.gov identifier: NCT02418585; first posted 16 April 2015. (Source: CNS Drugs)
Source: CNS Drugs - April 20, 2022 Category: Neurology Source Type: research
Effect of FT218, a Once-Nightly Sodium Oxybate Formulation, on Disrupted Nighttime Sleep in Patients with Narcolepsy: Results from the Randomized Phase III REST-ON Trial
ConclusionsThe clinically beneficial, single nighttime dose of ON-SXB significantly improved disrupted nighttime sleep in patients with narcolepsy.Clinical Trial RegistrationClinicalTrials.gov NCT02720744. (Source: CNS Drugs)
Source: CNS Drugs - April 5, 2022 Category: Neurology Source Type: research
Calcium, Magnesium, Potassium and Sodium Oxybates (Xywav ®) in Sleep Disorders: A Profile of Its Use
AbstractCalcium, magnesium, potassium and sodium oxybates (Xywav®; hereafter referred to as lower-sodium oxybate), a new oxybate formulation with a greatly reduced sodium burden compared with previously approved sodium oxybate (Xyrem®), is approved for the treatment of cataplexy and excessive daytime sleepiness (EDS) in adults and children aged ≥ 7 years with narcolepsy, and is the first drug approved for the treatment of idiopathic hypersomnia in adults in the USA. In two pivotal, double-blind, placebo-controlled, phase 3 trials of randomized-withdrawal design, lower-sodium oxybate effectively improved cataplexy and...
Source: CNS Drugs - March 31, 2022 Category: Neurology Source Type: research
Role of Pharmacogenomics in Individualizing Treatment for Alzheimer ’s Disease
AbstractThe development of Alzheimer ’s disease therapeutics has been challenging, with 99% of clinical trials failing to find a significant difference between drug and placebo. While the quest continues for more effective treatments, there is emerging evidence that pharmacogenetic considerations are important factors in regard to me tabolism, efficacy, and toxicity of drugs. Currently, there are five US Food and Drug Administration-approved drugs for the treatment of Alzheimer’s disease; three acetylcholinesterase inhibitors, memantine, and aducanumab. Introducing a limited genetic panel consisting of APOE4, CYP2D6*10...
Source: CNS Drugs - March 30, 2022 Category: Neurology Source Type: research
The Potential of N-Acetyl-L-Cysteine (NAC) in the Treatment of Psychiatric Disorders
AbstractN-acetyl-L-cysteine (NAC) is a compound of increasing interest in the treatment of psychiatric disorders. Primarily through its antioxidant, anti-inflammatory, and glutamate modulation activity, NAC has been investigated in the treatment of neurodevelopmental disorders, schizophrenia spectrum disorders, bipolar-related disorders, depressive disorders, anxiety disorders, obsessive compulsive-related disorders, substance-use disorders, neurocognitive disorders, and chronic pain. Whilst there is ample preclinical evidence and theoretical justification for the use of NAC in the treatment of multiple psychiatric disorde...
Source: CNS Drugs - March 22, 2022 Category: Neurology Source Type: research
The Potential of N-Acet ³yl-L-Cysteine (NAC) in the Treatment of Psychiatric Disorders
AbstractN-acetyl-L-cysteine (NAC) is a compound of increasing interest in the treatment of psychiatric disorders. Primarily through its antioxidant, anti-inflammatory, and glutamate modulation activity, NAC has been investigated in the treatment of neurodevelopmental disorders, schizophrenia spectrum disorders, bipolar-related disorders, depressive disorders, anxiety disorders, obsessive compulsive-related disorders, substance-use disorders, neurocognitive disorders, and chronic pain. Whilst there is ample preclinical evidence and theoretical justification for the use of NAC in the treatment of multiple psychiatric disorde...
Source: CNS Drugs - March 22, 2022 Category: Neurology Source Type: research
