The prevalence of reported CAM use among Quebec children with asthma remained modest (13%), with vitamins, homeopathy and acupuncture being the most popular modalities. CAM use was associated with preschool age, Asian ethnicity, episodic asthma and poor asthma control.
Anxiety disorders are more prevalent in females than males. The underlying reasons for this gender difference are unknown. Metabotropic glutamate receptors (mGluRs) have been linked to anxiety and it has been shown that interaction between estrogen receptors and mGluRs modulate sexual receptivity in rats. We investigated the role of mGluRs in anxiety-related behaviors in ovariectomized (OVX) female rats with (OVX+EB) or without (OVX) estradiol implants. We centrally infused (s)-3,5-dihydroxyphenylglycine (DHPG), a group I mGluR agonist, into the basolateral amygdala (BLA) of OVX+EB and OVX rats at 0.1 and 1.0 μM. Male rats that normally have low estradiol levels were used to compare with OVX rats. Generalized anxiety, explorative activity and detection and analysis of threat were analyzed in the elevated plus maze (EPM) and risk assessment behaviors (RABs). DHPG (1.0 μM) increased the percentage of time spent in- and entries into- the open arms in OVX+EB, but not in OVX females or male rats. Flat-back approaches and stretch-attend postures, two RABs, were significantly reduced by DHPG (0.1 and 1.0 μM) in OVX+EB female rats only. DHPG did not modulate rearing- and freezing, behaviors related to exploration and fear-like behavior, respectively. However, DHPG (1.0 μM) increased head dipping and decreased grooming behaviors in OVX female rats, suggesting a weak explorative modulation. The effects of DHPG observed in OVX+EB, were blocked by 50 μM of (RS)-1-Aminoindan-1,5-dicarboxylic acid (AIDA), a mGluR1 antagonist. AIDA and/or estradiol did not modulate anxiety and or RABs. Our results show that intra-BLA infusion of DHPG exerts an anxiolytic-like effect in OVX+EB, but not in OVX or male rats. This effect seems to depend upon mGluR1 subtype activation. Our findings led us to suggest that the effects observed in OVX+EB rats might be due to an interaction at the membrane level of estrogen receptors with mGlu1 within the BLA.
The lack of long-term medication adherence is a challenge in the treatment of bipolar disorder, particularly during the maintenance phase when symptoms are less prominent. The rate of nonadherence is ~20%–60% depending on how strict a definition is used. Nonadherence worsens the course of bipolar disorder and can add hundreds of thousands of dollars to the lifetime cost of treating the illness. Long-acting injectable (LAI) medication is an attractive alternative to daily dosing of oral medication, especially among patients who are ambivalent about treatment. The purpose of this paper is to review the evidence for the safety and efficacy of LAI aripiprazole, which was recently approved for the treatment of bipolar disorder. The approval was based on a single double-blind, placebo-controlled, multisite trial that recruited participants from 103 sites in 7 countries. A total of 731 participants with bipolar disorder were enrolled in the study. Out of that total, 266 were successfully stabilized on LAI aripiprazole and entered the randomization phase. Treatment-emergent adverse events were, for the most part, mild to moderate. Akathisia was the most common adverse event, which, combined with restlessness, was experienced by 23% of the sample. At the end of the 52-week study period, nearly twice as many LAI-treated participants remained stable compared to those treated with placebo. Stability during the maintenance phase is arguably the most important goal of treatment. It is during this period of relative freedom from symptoms that patients are able to build a meaningful and satisfying life. The availability of a new treatment agent, particularly one that has the potential to enhance long-term adherence, is a welcome development.
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