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See detailThe synthetic cannabinoids phenomenon
Karila, Laurent; Benyamina, Amine; Blecha, L et al

in Current Pharmaceutical Design (2016), 22(42), 6420-6425

« Spice » is generally used to describe the diverse types of herbal blends that encompass synthetic cannabinoids on the market. The emergence of smokable herbal products containing synthetic cannabinoids ... [more ▼]

« Spice » is generally used to describe the diverse types of herbal blends that encompass synthetic cannabinoids on the market. The emergence of smokable herbal products containing synthetic cannabinoids, which mimic the effects of cannabis, appears to become increasingly popular, in the new psychoactive substances landscape. In 2014, the existence of 134 different types of synthetic cannabinoids were reported by the European Union Early Warning System. These drugs are mainly sold online as an alternative to controlled and regulated psychoactive substances. They appear to have a life cycle of about 1-2 years before being replaced by a next wave of products. Legislation controlling these designer drugs has been introduced in many countries with the objective to limit the spread of existing drugs and control potential new analogs. The majority of the synthetic cannabinoids are full agonists at the CB1 receptor and do not contain tobacco or cannabis. They are becoming increasingly popular in adolescents, students and clubbers as an abused substance. Relatively high incidence of adverse effects associated with synthetic cannabinoids use has been documented in the literature. Numerous fatalities linked with their use and abuse have been reported. In this paper, we will review the available data regarding the use and effects of synthetic cannabinoids in humans in order to highlight their impact on public health. To reach this objective, a literature search was performed on two representative databases (Pubmed, Google Scholar), the Erowid Center website (a US non-profit educational organization that provides information about psychoactive plants and chemicals), and various governmental websites. The terms used for the database search were: "synthetic cannabinoids", "spice", "new psychoactive substances", and/or "substance use disorder", and/or "adverse effects", and/or "fatalities". The search was limited to years 2005 to 2016 due to emerging scientific literature at this period Health professionals should take into account that limited scientific evidence is available regarding the effect of synthetic cannabinoids use in humans. It thus urges to launch more systematic epidemiological studies, to develop and validate screening procedures, and to investigate the neurobiological and psychological correlates and risk factors associated to synthetic cannabinoids use and misuse. [less ▲]

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See detailSystems medicine approaches for the definition of complex phenotypes in chronic diseases and ageing. From concept to implementation and policies.
Bousquet, Jean; Jorgensen, Christian; Dauzat, Michel et al

in Current pharmaceutical design (2014), 20(38), 5928-44

Chronic diseases are diseases of long duration and slow progression. Major NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, rheumatologic diseases and mental health ... [more ▼]

Chronic diseases are diseases of long duration and slow progression. Major NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, rheumatologic diseases and mental health) represent the predominant health problem of the Century. The prevention and control of NCDs are the priority of the World Health Organization 2008 Action Plan, the United Nations 2010 Resolution and the European Union 2010 Council. The novel trend for the management of NCDs is evolving towards integrative, holistic approaches. NCDs are intertwined with ageing. The European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) has prioritised NCDs. To tackle them in their totality in order to reduce their burden and societal impact, it is proposed that NCDs should be considered as a single expression of disease with different risk factors and entities. An innovative integrated health system built around systems medicine and strategic partnerships is proposed to combat NCDs. It includes (i) understanding the social, economic, environmental, genetic determinants, as well as the molecular and cellular mechanisms underlying NCDs; (ii) primary care and practice-based interprofessional collaboration; (iii) carefully phenotyped patients; (iv) development of unbiased and accurate biomarkers for comorbidities, severity and follow up of patients; (v) socio-economic science; (vi) development of guidelines; (vii) training; and (viii) policy decisions. The results could be applicable to all countries and adapted to local needs, economy and health systems. This paper reviews the complexity of NCDs intertwined with ageing. It gives an overview of the problem and proposes two practical examples of systems medicine (MeDALL) applied to allergy and to NCD co-morbidities (MACVIA-LR, Reference Site of the European Innovation Partnership on Active and Healthy Ageing). [less ▲]

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See detailInternet addiction: a systematic review of epidemiological research for the last decade.
Kuss, D. J.; Griffiths, M. D.; Karila, L. et al

in Current pharmaceutical design (2014), 20(25), 4026-52

In the last decade, Internet usage has grown tremendously on a global scale. The increasing popularity and frequency of Internet use has led to an increasing number of reports highlighting the potential ... [more ▼]

In the last decade, Internet usage has grown tremendously on a global scale. The increasing popularity and frequency of Internet use has led to an increasing number of reports highlighting the potential negative consequences of overuse. Over the last decade, research into Internet addiction has proliferated. This paper reviews the existing 68 epidemiological studies of Internet addiction that (i) contain quantitative empirical data, (ii) have been published after 2000, (iii) include an analysis relating to Internet addiction, (iv) include a minimum of 1000 participants, and (v) provide a full-text article published in English using the database Web of Science. Assessment tools and conceptualisations, prevalence, and associated factors in adolescents and adults are scrutinised. The results reveal the following. First, no gold standard of Internet addiction classification exists as 21 different assessment instruments have been identified. They adopt official criteria for substance use disorders or pathological gambling, no or few criteria relevant for an addiction diagnosis, time spent online, or resulting problems. Second, reported prevalence rates differ as a consequence of different assessment tools and cut-offs, ranging from 0.8% in Italy to 26.7% in Hong Kong. Third, Internet addiction is associated with a number of sociodemographic, Internet use, and psychosocial factors, as well as comorbid symptoms and disorder in adolescents and adults. The results indicate that a number of core symptoms (i.e., compulsive use, negative outcomes and salience) appear relevant for diagnosis, which assimilates Internet addiction and other addictive disorders and also differentiates them, implying a conceptualisation as syndrome with similar etiology and components, but different expressions of addictions. Limitations include the exclusion of studies with smaller sample sizes and studies focusing on specific online behaviours. Conclusively, there is a need for nosological precision so that ultimately those in need can be helped by translating the scientific evidence established in the context of Internet addiction into actual clinical practice. [less ▲]

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See detailSexual addiction or hypersexual disorder: different terms for the same problem? A review of the literature.
Karila, Laurent; Wery, Aline; Weinstein, Aviv et al

in Current pharmaceutical design (2014), 20(25), 4012-20

Sexual addiction, which is also known as hypersexual disorder, has largely been ignored by psychiatrists, even though the condition causes serious psychosocial problems for many people. A lack of ... [more ▼]

Sexual addiction, which is also known as hypersexual disorder, has largely been ignored by psychiatrists, even though the condition causes serious psychosocial problems for many people. A lack of empirical evidence on sexual addiction is the result of the disease's complete absence from versions of the Diagnostic and Statistical Manual of Mental Disorders. However, people who were categorized as having a compulsive, impulsive, addictive sexual disorder or a hypersexual disorder reported having obsessive thoughts and behaviors as well as sexual fantasies. Existing prevalence rates of sexual addiction-related disorders range from 3% to 6%. Sexual addiction/ hypersexual disorder is used as an umbrella construct to encompass various types of problematic behaviors, including excessive masturbation, cybersex, pornography use, sexual behavior with consenting adults, telephone sex, strip club visitation, and other behaviors. The adverse consequences of sexual addiction are similar to the consequences of other addictive disorders. Addictive, somatic and psychiatric disorders coexist with sexual addiction. In recent years, research on sexual addiction has proliferated, and screening instruments have increasingly been developed to diagnose or quantify sexual addiction disorders. In our systematic review of the existing measures, 22 questionnaires were identified. As with other behavioral addictions, the appropriate treatment of sexual addiction should combine pharmacological and psychological approaches. Psychiatric and somatic comorbidities that frequently occur with sexual addiction should be integrated into the therapeutic process. Group-based treatments should also be attempted. [less ▲]

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See detailThe potential interest of topiramate in addictions
Thorens, G.; Billieux, Joël UL; Manghi, R. et al

in Current Pharmaceutical Design (2011), 17(14), 1410-1415

Topiramate is one of the currently most promising compounds in the field of addiction medicine. This paper discusses its potential utility related to a phase model of addiction development, focusing on ... [more ▼]

Topiramate is one of the currently most promising compounds in the field of addiction medicine. This paper discusses its potential utility related to a phase model of addiction development, focusing on the assumption that addiction is a continuous process involving different neurobiological pathways, depending on the stage of addiction. A specific emphasis will be made on the development of dysfunctional automatic behaviors in the late stage of addiction and the central role of glutamate and AMPA receptors. The aim is to propose that if too broad an effect of anti-addiction medication is expected (such as anti-craving, anti-relapse and preventive effects), the results might be disappointing. The speculative specific efficacy of topiramate in addiction is described. ©2011 Bentham Science Publishers Ltd. [less ▲]

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