Biomedical subjects

P Farvolden

Publications and source records attributed to P Farvolden.

6 recordsLinked to original sources

PubMed2003

Recent developments in the psychobiology and pharmacotherapy of depression: optimising existing treatments and novel approaches for the future.

Effective antidepressants include monoamine oxidase inhibitors and tricyclic antidepressants, selective serotonin re-uptake inhibitors and novel agents, including serotonin and noradrenaline re-uptake inhibitors. Although effective, current treatments most often produce partial symptomatic improvement (response) rather than symptom resolution and optimal functioning (remission). While current pharmacotherapies target monoaminergic systems, different symptoms of major depressive disorder (MDD) may have distinct neurobiological underpinnings and other neurobiological systems are likely involved in the pathogenesis of MDD. In this article a review of current pharmacotherapeutic options for MDD, current understanding of the neurobiology and pathogenesis of MDD and a review of new and promising directions in pharmacological research will be provided. It is generally accepted that no single neurotransmitter or system is responsible for the dysregulation found in MDD. While agents that affect monoaminergic systems will likely continue to be first-line treatments for MDD for the foreseeable future, a number of new and novel agents, including corticotropin-releasing factor antagonists, substance P antagonists and antiglucocorticoids show considerable promise for refining treatment options. In order to better understand the neurobiology and treatment response of MDD, it is probable that more sophisticated theory-driven typologies of MDD will have to be developed.

Animals↗

PubMed2000

The neurobiology of social phobia: from pharmacotherapy to brain imaging.

Social phobia is a common psychiatric disorder that is often associated with significant psychiatric comorbidity and disability. There is currently considerable evidence for the efficacy of pharmacotherapy, especially the selective serotonin reuptake inhibitors, in the treatment of this disorder. In addition, researchers have recently begun to explore the underlying neurobiology of social phobia with results that will likely have important implications for future treatments. This article provides a review of the results to date of controlled medication trials. A review of chemical and neuroendocrine challenges, neurotransmitter functioning, and neuroimaging studies in social phobia is provided, followed by a discussion of the implications of these findings for future treatment and research.

Benzodiazepines↗

PubMed2000

Drugs in development for social anxiety disorder: more to social anxiety than meets the SSRI.

Individuals with social phobia (SP) fear and avoid a wide variety of social and performance situations in which they are exposed to unfamiliar persons or to possible scrutiny by others. The lifetime prevalence of SP is estimated to be as high as 13%. It is frequently co-morbid with and usually precedes the onset of other psychiatric illnesses and is associated with significant occupational and social impairment, including academic and vocational underachievement. Fortunately, there are effective treatments for this common and debilitating condition. There is currently considerable evidence for the efficacy of pharmacotherapy and especially the monoamine oxidase inhibitors (MAOIs) and selective serotonin re-uptake inhibitors (SSRIs) in the treatment of this disorder. However, SSRIs are generally preferred as the first-line treatment of choice due to the advantages of SSRIs over MAOIs in terms of safety and tolerability. Despite encouraging results, current treatments most often produce partial symptomatic improvement, rather than high end-state functioning. While current first line treatments for social phobia target the serotonergic system, it is important to remember that different social fears are likely to have different developmental roots and may be based on quite different neurobiological systems. In this article we provide a review of current pharmacotherapeutic options for SP, current knowledge of the neurobiology of SP, and a review of new and promising directions in pharmacological research. It is increasingly clear that serotonin (5-HT) is unlikely to be the whole story in SP and that other brain chemical systems, especially the dopaminergic, noradrenaline-corticotropin releasing hormone and gamma-aminobutyric acid (GABA) dependent systems, most probably have an important role to play in a substantial percentage of cases. A number of new and novel agents, including the substance P antagonists, GABA agonists and CRF antagonists show considerable promise in the treatment of SP. However, in order to enhance the understanding of the neurobiology and treatment response of SP, we need to develop more sophisticated theory-driven typologies of SP.

Animals↗

PubMed1999

Serotonergic agents in the treatment of social phobia in children and adolescents: a case series.

Serotonergic agents have become the treatment of choice for adult patients with social phobia. However, there are few reports of the use of these agents in the treatment of children and adolescents with this disorder. The pharmacological treatment of social anxiety in children and adolescents is briefly reviewed, and a consecutive series of child and adolescent patients who were treated with a variety of serotonin acting agents is described. Seven patients, aged 7 to 18 years, with a Primary DSM-IV diagnosis of generalized social phobia were treated with paroxetine, sertraline, or nefazodone for up to 7 months. Response to treatment was evaluated by retrospective chart review by the treating clinicians. All of the patients appeared to have a very positive clinical response to the serotonergic agents. No adverse events were reported and side effects were well tolerated. Results suggest that serotonergic agents may be an effective and safe treatment for children and adolescents with social phobia.

Adolescent↗

PubMed1999

The potential role of haloperidol in the treatment of trichotillomania.

BACKGROUND: Trichotillomania is categorized as an impulse control disorder in DSM-IV and is considered by some to be closely related to Obsessive Compulsive Disorder (OCD). We review the clinical phenomenology and pharmacological response of trichotillomania, and suggest that it may be more related to Tourette Syndrome than to OCD. Serotonin reuptake inhibitors (SRIs) are typically employed in the treatment of OCD, while neuroleptic medications such as haloperidol are typically used in the treatment of Tourette Syndrome. Evidence for the efficacy of treatment of trichotillomania with drugs typically used for OCD is equivocal. METHOD: Nine patients with trichotillomania were treated with haloperidol. Six patients unresponsive to SSRI medication had haloperidol added to their treatment. Three patients received only haloperidol. Response to treatment was assessed using descriptions of hair pulling, quantity of hair pulled, and severity of depilation at hair pulling sites. RESULTS: Eight of nine patients responded to haloperidol treatment, with seven experiencing complete or near complete cessation of hair pulling. LIMITATIONS: Inferences from the results of this study are limited by the lack of a control group, the small sample size, and the use of unstandardized ratings as measures of symptom severity. CONCLUSIONS: Results suggest that the addition of haloperidol to SSRIs or haloperidol alone may be effective in the treatment of trichotillomania. Results also encourage speculation about the relation between OCD, Tourette Syndrome, and trichotillomania.

Adult↗

PubMed1998

Dissociation in hypnosis and frontal executive function.

In a career of many searching conceptual insights, Kenneth Bowers drew an important distinction between 2 different dissociative theories of hypnosis: dissociated experience and dissociated control. We contrast these 2 views and discuss how a dissociated control theory can be integrated with current conceptions of frontal executive function. Then we use this frontal elaboration of the dissociated control theory to sketch out a provisional understanding of memory function associated with hypnosis and hypnotic suggestibility, with particular emphasis on unsuggested effects.

Dissociative Disorders↗