[et_pb_section fb_built=”1″ _builder_version=”3.22.7″ custom_padding=”||5px|||”][et_pb_row _builder_version=”3.25″][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”3.27.4″]<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ specialty=”on” _builder_version=”3.22.3″ custom_padding=”24px|0px|25px|0px|false|false”][et_pb_column type=”3_4″ specialty_columns=”3″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_row_inner _builder_version=”3.25″][et_pb_column_inner saved_specialty_column_type=”3_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_blurb title=”Editoral in Hungarian ” url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/szerkesztsegi-level.pdf” url_new_window=”on” image=”https:\/\/mppt.hu\/wp-content\/uploads\/2019\/04\/pdf.png” icon_placement=”left” image_max_width=”105%” content_max_width=”1100px” _builder_version=”3.22.7″ header_font=”||||||||” header_font_size=”17px” header_line_height=”1.3em” body_font=”||on||||||” body_line_height=”1.3em” link_option_url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/szerkesztsegi-level.pdf” link_option_url_new_window=”on”]<\/p>\n
[\/et_pb_blurb][et_pb_toggle title=”Abstract” closed_toggle_text_color=”#000000″ closed_toggle_background_color=”rgba(0,0,0,0)” icon_color=”#0c71c3″ _builder_version=”3.22.7″ title_font=”|600|||||||” title_letter_spacing=”1px” text_orientation=”justified” custom_padding=”0px||10px” border_width_all=”0px” border_width_bottom=”1px”]<\/p>\n
A 20. sz\u00e1zad els\u0151 fel\u00e9ben a pszichoanalitikus gondolkod\u00e1s uralta a pszichi\u00e1tri\u00e1t \u00e9s t\u00e1gabb \u00e9rtelemben kult\u00farantropol\u00f3giai szempontb\u00f3l is meghat\u00e1rozta a korszak vil\u00e1gn\u00e9zet\u00e9t. Kopernikusz \u00e9s Darwin ut\u00e1n Freud fogalmazta meg az emberis\u00e9g harmadik n\u00e1rcisztikus t\u00e9ved\u00e9s\u00e9t, traum\u00e1j\u00e1t: nemcsak hogy nem vagyunk az Univerzum k\u00f6z\u00e9ppontja \u00e9s az \u00e1llatvil\u00e1gt\u00f3l sem k\u00fcl\u00f6nb\u00f6z\u00fcnk min\u0151s\u00e9gileg, de \u201enem vagyunk urak a saj\u00e1t h\u00e1zunkban sem\u201d. Az\u00f3ta a pszichi\u00e1tria sok v\u00e1ltoz\u00e1son ment kereszt\u00fcl, a korszer\u0171 biol\u00f3giai modellek \u00e9s a pszichofarmakonok elterjed\u00e9se elvezette a pszichi\u00e1tri\u00e1t a pszichoanal\u00edzist\u0151l a meta-anal\u00edzisek vil\u00e1g\u00e1ba. M\u00edg a klasszikus pszichoanal\u00edzis sor\u00e1n egy terapeuta egy p\u00e1ciens m\u00e9lyl\u00e9lektani anal\u00edzis\u00e9vel foglalkozott \u00e9veken kereszt\u00fcl, m\u00faltban rejl\u0151 titkokat, tabukat felt\u00e1rva, addig ma a meta-anal\u00edzisek sor\u00e1n a kutat\u00f3k t\u00f6bb ezer p\u00e1ciens klinikai vizsg\u00e1latai sor\u00e1n nyert adatait analiz\u00e1lj\u00e1k egyszerre, retrospekt\u00edv m\u00f3don. \u00a0\u00a0\u00a0\u00a0 Ma a meta-anal\u00edzisek kor\u00e1t \u00e9lj\u00fck. Sz\u00fcks\u00e9g\u00fcnk van meta-anal\u00edzisekre, hiszen a mintegy t\u00edzezer tudom\u00e1nyos foly\u00f3iratban \u00e9vente publik\u00e1lt k\u00f6r\u00fclbel\u00fcl k\u00e9t milli\u00f3 medicin\u00e1lis t\u00e9m\u00e1j\u00fa cikk \u00e1ttekint\u00e9se lehetetlen. Mert az adatok sz\u00e1mtalanok, hasznuk azonban gyakran k\u00e9ts\u00e9ges, alkalmazhat\u00f3s\u00e1guk pedig sokszor csek\u00e9ly. Az id\u0151nk azonban v\u00e9ges. Egy \u00e1ltal\u00e1nos orvosnak p\u00e9ld\u00e1ul napi minimum 19 cikket kellene elolvasnia, hogy a legfontosabb inform\u00e1ci\u00f3khoz hozz\u00e1jusson az adott szakter\u00fcleten. A meta-anal\u00edzisek (\u00f6sszegz\u0151 elemz\u00e9s) \u00e9s az alkalmazott \u00fajabb \u00e9s \u00fajabb statisztikai m\u00f3dszerek azonban lehet\u0151v\u00e9 teszik, hogy a sz\u00e1mos, k\u00fcl\u00f6nb\u00f6z\u0151 klinikai vizsg\u00e1lat eredm\u00e9nyei egy t\u00e9ma szempontj\u00e1b\u00f3l \u00f6sszehasonl\u00edthat\u00f3k \u00e9s egy\u00fcttesen \u00e9rt\u00e9kelhet\u0151k legyenek. \u00a0\u00a0\u00a0\u00a0 2009-ben t\u00f6bb jelent\u0151s meta-anal\u00edzis is napvil\u00e1got l\u00e1tott – kett\u0151 eredm\u00e9nyei a Lancet-ben is k\u00f6zl\u00e9sre ker\u00fcltek -, egyik az antipszichotikumokkal, egy m\u00e1sik az antidepressz\u00edvumokkal kapcsolatban. Az els\u0151 eredm\u00e9nyei kapcs\u00e1n Leucht megfogalmazta, hogy a hagyom\u00e1nyos t\u00edpusos-at\u00edpusos antipszichotikum megk\u00fcl\u00f6nb\u00f6ztet\u00e9s val\u00f3j\u00e1ban \u00e9rv\u00e9nytelen, \u00e9s az id\u0151belis\u00e9gen k\u00edv\u00fcl (miszerint els\u0151 \u00e9s m\u00e1sodik gener\u00e1ci\u00f3s) ennek a feloszt\u00e1snak \u00fagy t\u0171nik egy\u00e9b relevanci\u00e1ja nincs. Ann\u00e1l is ink\u00e1bb, mivel a m\u00e1sodik gener\u00e1ci\u00f3s k\u00e9sz\u00edtm\u00e9nyek rendk\u00edv\u00fcl heterog\u00e9nek, \u00edgy nem tekinthet\u0151k egy csoportnak, teh\u00e1t az at\u00edpusos antipszichotikum terminus haszn\u00e1lata – sokak szerint – a j\u00f6v\u0151ben ker\u00fclend\u0151. Tov\u00e1bb\u00e1, Leucht az egym\u00e1st\u00f3l f\u00fcggetlen meta-anal\u00edzisekre t\u00e1maszkodva kijelentette, hogy n\u00e9gy molekula (clozapin, olanzapin, risperidon, amisulprid) hat\u00e9konys\u00e1ga (efficacy) kiemelked\u0151, \u00e9s a t\u00f6bbi \u201eat\u00edpusos\u201d szerrel szemben val\u00f3ban effekt\u00edvebbnek bizonyul a negat\u00edv t\u00fcnetek kezel\u00e9s\u00e9ben, mint az els\u0151 gener\u00e1ci\u00f3s k\u00e9sz\u00edtm\u00e9nyek. \u00a0\u00a0\u00a0\u00a0 Az antidepressz\u00edvumok meta-anal\u00edzis\u00e9vel kapcsolatosan a Lancet 2009-es m\u00e1rciusi els\u0151 sz\u00e1m\u00e1nak c\u00edmlapj\u00e1n ez \u00e1llt: \u201eA sertralin lehet a legjobb v\u00e1laszt\u00e1s a k\u00f6zepes vagy s\u00falyos feln\u0151ttkori depresszi\u00f3s epiz\u00f3d akut kezel\u00e9s\u00e9ben, mivel ez a szer biztos\u00edtja a legjobb egyens\u00falyt a hat\u00e9konys\u00e1g, a toler\u00e1lhat\u00f3s\u00e1g \u00e9s a k\u00f6lts\u00e9ghat\u00e9konys\u00e1g ter\u00e9n\u201d. Ugyanakkor ez \u00e9v janu\u00e1rj\u00e1ban k\u00f6z\u00f6lte a JAMA annak a meta-anal\u00edzisnek az eredm\u00e9nyeit, amely arra h\u00edvja fel a figyelmet, hogy az antidepressz\u00edvumok tulajdonk\u00e9ppen alig tekinthet\u0151k hat\u00e9konyabbnak a plac\u00e9b\u00f3n\u00e1l az enyhe \u00e9s a k\u00f6zepesen s\u00falyos depresszi\u00f3ban. Jelent\u0151s hat\u00e9konys\u00e1gbeli elt\u00e9r\u00e9s csak a s\u00falyos depresszi\u00f3s \u00e1llapotokban \u00e9szlelhet\u0151 a gy\u00f3gyszer \u00e9s a placebo k\u00f6z\u00f6tt. Az\u00f3ta sz\u00e1mos tudom\u00e1nyos \u00e9s k\u00f6z\u00e9leti lapban, p\u00e9ld\u00e1ul a Newsweek-ben is olvashattuk a fenti JAMA tanulm\u00e1nyra adott reakci\u00f3kat. Ezek a komment\u00e1rok az esetleges metodikai (selection bias) \u00e9s statisztikai probl\u00e9m\u00e1k mellett sz\u00e1mos k\u00e9rd\u00e9st vetnek fel: vajon a modern hangulatjav\u00edt\u00f3k kor\u00e1ntsem olyan hat\u00e9konyak, mint ahogy eddig gondoltuk? Hogyan \u00e9rtelmezhet\u0151 az a paradox eredm\u00e9ny, hogy \u00e9ppen a s\u00falyos esetek gy\u00f3gyulnak meg, szemben az enyh\u00e9bb depresszi\u00f3val, hiszen a legt\u00f6bb szomatikus betegs\u00e9g (fert\u0151z\u00e9sek, daganatos betegs\u00e9gek, stb.) eset\u00e9ben a kev\u00e9sb\u00e9 s\u00falyos k\u00f3r\u00e1llapotok term\u00e9szetszer\u0171leg jobb progn\u00f3zissal b\u00edrnak. Vagy arr\u00f3l van sz\u00f3, hogy ezekben az esetekben a fenomenol\u00f3giailag hasonl\u00f3, b\u00e1r enyh\u00e9bb t\u00fcnetek h\u00e1tter\u00e9ben eg\u00e9szen m\u00e1s mechanizmusok \u00e1llnak \u00e9s a farmakol\u00f3giai hat\u00e1st\u00f3l nem is v\u00e1rhat\u00f3 \u201egy\u00f3gyul\u00e1s\u201d?\u00a0 \u00a0\u00a0\u00a0\u00a0 Ezen k\u00e9rd\u00e9sek megfontol\u00e1sa hozz\u00e1seg\u00edtheti a szakm\u00e1t, hogy az egyre t\u00f6bb kih\u00edv\u00e1ssal k\u00fczd\u0151 pszichi\u00e1tria \u00faj paradigm\u00e1kat dolgozzon ki. A fenti komment\u00e1rokb\u00f3l is kit\u0171nni l\u00e1tszik az a k\u00f6vetkeztet\u00e9s, hogy a kultur\u00e1lis, t\u00e1rsadalmi, szoci\u00e1lis vagy egzisztenci\u00e1lis neh\u00e9zs\u00e9gek, illetve az egzisztencialista, l\u00e9telm\u00e9leti alapprobl\u00e9m\u00e1k \u201emedikaliz\u00e1l\u00e1sa\u201d \u00e9s \u201epszichiatriz\u00e1l\u00e1sa\u201d ker\u00fclend\u0151. Kompetenci\u00e1nk hat\u00e1rainak vil\u00e1gosabb k\u00f6rvonalaz\u00e1sa legal\u00e1bbis r\u00e9szleges megold\u00e1st k\u00edn\u00e1lhatna erre a paradox helyzetre. Hiszen nyilv\u00e1nval\u00f3 k\u00e9ptelens\u00e9g, \u00e9s nem is v\u00e1rhat\u00f3, hogy egy p\u00e1rkapcsolati szak\u00edt\u00e1st, egy vesztes\u00e9get k\u00f6vet\u0151 gy\u00e1szfolyamatot, egy \u00e9letk\u00f6z\u00e9pi kr\u00edzist vagy egy szoci\u00e1lis ellehetetlen\u00fcl\u00e9st \u201emeggy\u00f3gy\u00edtson\u201d b\u00e1rmif\u00e9le gy\u00f3gyszer. A t\u00e1rsadalom – b\u00e1r ambivalensen viszonyul a pszichi\u00e1tri\u00e1hoz – rejtetten m\u00e9gis olyan elv\u00e1r\u00e1sokat t\u00e1maszt, hogy orvosok, pszichi\u00e1terek, ORSZI fel\u00fclvizsg\u00e1l\u00f3k vagy \u00e9ppen a gy\u00f3gyszerek oldj\u00e1k meg ezeket a probl\u00e9m\u00e1kat. Nagy a k\u00eds\u00e9rt\u00e9s kompetenci\u00e1nk \u00e9s lehet\u0151s\u00e9geink t\u00fal\u00e9rt\u00e9kel\u00e9s\u00e9re, \u00e9s k\u00e9rd\u00e9s, hogy vajon a pszichi\u00e1tria el tudja-e hat\u00e1rolni mag\u00e1t ezekt\u0151l a t\u00f6rekv\u00e9sekt\u0151l, mik\u00f6zben\u00a0 a gy\u00f3gyszergy\u00e1rt\u00f3k marketingtev\u00e9kenys\u00e9ge is ezir\u00e1nyba hat. Vajon a ment\u00e1lis zavarok krit\u00e9riumrendszer\u00e9nek fellaz\u00edt\u00e1sa kit \u00e9s mit szolg\u00e1l, bel\u00e1that\u00f3k-e ennek hosszabb t\u00e1v\u00fa k\u00f6vetkezm\u00e9nyei? Utalva \u00e9s tov\u00e1bb sz\u0151ve Faludi G\u00e1bor a Neuropsychopharmacologia Hungarica el\u0151z\u0151 sz\u00e1m\u00e1nak szerkeszt\u0151i level\u00e9ben k\u00f6zz\u00e9 tett gondolatait, a heterog\u00e9n, fenot\u00edpusosan k\u00fcl\u00f6nb\u00f6z\u0151 betegcsoportokon v\u00e9gzett vizsg\u00e1latok a JAMA-ban megjelenthez hasonl\u00f3 k\u00f6zlem\u00e9nyekhez vezetnek. A vizsg\u00e1latok metodik\u00e1j\u00e1nak jav\u00edt\u00e1sa csak r\u00e9szmegold\u00e1st jelenthet, hiszen enn\u00e9l l\u00e9nyegret\u00f6r\u0151bb, paradigm\u00e1lis v\u00e1ltoz\u00e1sok sz\u00fcks\u00e9gesek. B\u00e1r az \u00faj diagnosztikus rendszerekbe (DSM-5, BNO-11) be k\u00edv\u00e1nj\u00e1k \u00e9p\u00edteni a leg\u00fajabb tudom\u00e1nyos evidenci\u00e1kat, ezek m\u00e9gsem tudj\u00e1k integr\u00e1lni a neurobiol\u00f3giai kutat\u00e1sok kurrens eredm\u00e9nyeit, a kategorikus \u00e9s dimenzion\u00e1lis megk\u00f6zel\u00edt\u00e9seket, \u00e9s tov\u00e1bbra is sokkal ink\u00e1bb konszenzuson, mint bizony\u00edt\u00e9kokon alapulnak. Hab\u00e1r el\u0151remutat\u00f3, hogy \u00e9ppen n\u00e9h\u00e1ny napja tette k\u00f6zz\u00e9 hivatalosan is az APA a DSM-5 el\u0151zetes kivonat\u00e1t, mely az interneten is el\u00e9rhet\u0151 (www.dsm5.org), b\u00e1rki sz\u00e1m\u00e1ra hozz\u00e1f\u00e9rhet\u0151, s\u0151t komment\u00e1lhat\u00f3, v\u00e9lem\u00e9nyezhet\u0151, melyek alapj\u00e1n tov\u00e1bbi folyamatos v\u00e1ltoztat\u00e1s, finom\u00edt\u00e1s v\u00e1rhat\u00f3 2013-ra, a tervezett megjelen\u00e9sre. \u00a0\u00a0\u00a0\u00a0 A t\u00e1rsadalom \u00e9s benne a szakm\u00e1nk teh\u00e1t kitermelhet re\u00e1lis alternat\u00edv\u00e1kat a fenti probl\u00e9m\u00e1k megold\u00e1s\u00e1ra. Sokak szerint – visszakanyarodva kezd\u0151 gondolatunkhoz – a pszichi\u00e1tria hermeneutikus \u00e9s kapcsolati aspektus\u00e1nak, illetve a pszichoter\u00e1pi\u00e1s szeml\u00e9letnek az er\u0151s\u00edt\u00e9se ilyen lehet\u0151s\u00e9gnek k\u00edn\u00e1lkozik. Azonban a pszichoter\u00e1pi\u00e1knak is ugyan\u00fagy ki kell \u00e1llnia a hat\u00e9konys\u00e1gvizsg\u00e1latok \u00e9s az \u201eevidence based psychiatry\u201d pr\u00f3b\u00e1it, hogy elker\u00fclj\u00fck, azokat a buktat\u00f3kat, amelyeket a pszichofarmakonok eset\u00e9ben elk\u00f6vett\u00fcnk. \u00c9s arr\u00f3l sem feledkezhet\u00fcnk el, hogy a pszichoter\u00e1pi\u00e1k sem oldhatnak meg t\u00e1rsadalmi probl\u00e9m\u00e1kat, s az is k\u00e9rd\u00e9s, hogy a t\u00e1rsadalom, az eg\u00e9szs\u00e9g\u00fcgyi szolg\u00e1ltat\u00f3k, a biztos\u00edt\u00f3k \u00e9s az OEP hogyan is viszonyuln\u00e1nak az esetleges v\u00e1ltoz\u00e1sokhoz. A hat\u00e9konys\u00e1gkutat\u00e1s, a k\u00f6lts\u00e9g-hat\u00e9konys\u00e1gi elemz\u00e9sek, a placebo kontroll\u00e1lt vizsg\u00e1latok, a \u201ehead-to-head\u201d \u00f6sszehasonl\u00edt\u00e1sok \u00e9ppoly nehezek – ha nem m\u00e9g problematikusabbak – a pszichoter\u00e1pi\u00e1k eset\u00e9ben, mint ahogy azt a pszichofarmakonokn\u00e1l megtapasztaltuk. De tal\u00e1n nincs is olyan messze, hogy a pszichoter\u00e1pi\u00e1k effektivit\u00e1s\u00e1t vizsg\u00e1l\u00f3 korszer\u0171 hat\u00e9konys\u00e1gi \u00e9s neurobiol\u00f3giai kutat\u00e1sok adatait, vagy a pszichoanal\u00edzisb\u0151l \u201ekifejlesztett\u201d b\u00e1linti \u201eorvosgy\u00f3gyszer\u201d farmakol\u00f3gi\u00e1j\u00e1t \u00e9s hat\u00e9konys\u00e1g\u00e1t meta-anal\u00edzisek elemzik \u00e9s valid\u00e1lj\u00e1k majd.<\/div>\n
[\/et_pb_toggle][et_pb_blurb title=”Mood, mood fluctuations and depression: role of the circadian rhythms” url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/hangulat-hangulatingadozasok-es-depresszio-a-cirkadian.pdf” url_new_window=”on” image=”https:\/\/mppt.hu\/wp-content\/uploads\/2019\/04\/pdf.png” icon_placement=”left” image_max_width=”105%” content_max_width=”1100px” _builder_version=”3.22.7″ header_font=”||||||||” header_font_size=”17px” header_line_height=”1.3em” body_font=”||on||||||” body_line_height=”1.3em” link_option_url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/hangulat-hangulatingadozasok-es-depresszio-a-cirkadian.pdf” link_option_url_new_window=”on”]<\/p>\n
R\u00f3bert B\u00f3dizs, Gy\u00f6rgy\u00a0 Purebl and Zolt\u00e1n Rihmer<\/p>\n
[\/et_pb_blurb][et_pb_toggle title=”Abstract” closed_toggle_text_color=”#000000″ closed_toggle_background_color=”rgba(0,0,0,0)” icon_color=”#0c71c3″ _builder_version=”3.22.7″ title_font=”|600|||||||” title_letter_spacing=”1px” text_orientation=”justified” custom_padding=”0px||10px” border_width_all=”0px” border_width_bottom=”1px”]<\/p>\n
The statement that circadian rhythmicity is an important component of mood regulation
as well as a drive of mood disorders is supported by a growing body of evidence. Diurnal
rhythms of the positive and negative components of mood as well as of the level of arousal
depend on the circadian phase, the homeostatic sleep regulatory mechanisms and the
harmonic interaction of the circadian and homeostatic processes. The chronopathological
symptoms which are typical in depression and explain the blunted mood of depressive
patients are of the phase-advance and phase-delay type characterized by a misalignment
between the circadian rhythms and the sleep-wake schedules, best described by the
phase-angle alterations. The abnormal phase angle between circadian rhythms and the
timing of the sleep period could emerge from an interaction of the chronotypes and other
constitutional factors with adverse environmental effects (inadequate zeitgebers) leading
to a disharmony between the diurnal components of mood regulation and consequent
extreme mood states. The aim of the chronotherapies of depression and of other affective
disorders is that of resynchronizing the circadian rhythms or in other words to reconstitute
the harmony between these subsystems. Pharmacological approaches, lifestyle changes
and specific chronotherapeutic interventions might help to achieve this goal.\u00a0<\/div>\n
Keywords<\/strong>: depression, chronobiology, circadian rhythms, mood<\/div>\n[\/et_pb_toggle][et_pb_blurb title=”Dopamine D4 receptor hypoxia sensitivity and child psychiatric disorders” url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/a-dopamin-d4-es-receptor-hipoxia.pdf” url_new_window=”on” image=”https:\/\/mppt.hu\/wp-content\/uploads\/2019\/04\/pdf.png” icon_placement=”left” image_max_width=”105%” content_max_width=”1100px” _builder_version=”3.22.7″ header_font=”||||||||” header_font_size=”17px” header_line_height=”1.3em” body_font=”||on||||||” body_line_height=”1.3em” link_option_url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/a-dopamin-d4-es-receptor-hipoxia.pdf” link_option_url_new_window=”on”]<\/p>\n
Viktor M\u00f3zes,Melinda\u00a0 Bence, M\u00e1ria Sasv\u00e1ri-Sz\u00e9kely, Gergely Keszler<\/p>\n
[\/et_pb_blurb][et_pb_toggle title=”Abstract” closed_toggle_text_color=”#000000″ closed_toggle_background_color=”rgba(0,0,0,0)” icon_color=”#0c71c3″ _builder_version=”3.22.7″ title_font=”|600|||||||” title_letter_spacing=”1px” text_orientation=”justified” custom_padding=”0px||10px” border_width_all=”0px” border_width_bottom=”1px”]<\/p>\n
Attention-deficit hyperactivity disorder (ADHD) is one of the most frequent child
psychiatric problems with a complex genetic and environmental background. According
to the prevailing view, main factors of the disorder are prefrontal dopamine deficiency
and incomplete central dopaminergic functioning. Twin studies suggest substantial
heritability in the background of the disease, and the studied candidate genes involve
components of the dopamine system. Moreover, various noxious pre- and perinatal
environmental impacts have been implicated in the pathogenesis of ADHD. Here we
review experimental results from epidemiological, tissue and animal studies that assigned a causal role to fetal hypoxia in the development of ADHD and pointed out that
the dopaminergic neurotransmission is sensitive to hypoxia. Allelic variants of the D4
dopamine receptor (DRD4) are well characterized risk factors of ADHD. Recently we have
reported that hypoxia enhanced the promoter activity of DRD4 gene several fold. These
observations suggest that the effect of hypoxia on the dopaminergic neurotransmission
might be an important factor in the pathomechanism of ADHD.<\/div>\n
Keywords<\/strong>: dopamine D4 receptor, hypoxia, ADHD, psychiatric genetics,
neurotransmission<\/div>\n[\/et_pb_toggle][et_pb_blurb title=”Epilepsy and Dependence” url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/epilepszia-es-fueggseg.pdf” url_new_window=”on” image=”https:\/\/mppt.hu\/wp-content\/uploads\/2019\/04\/pdf.png” icon_placement=”left” image_max_width=”105%” content_max_width=”1100px” _builder_version=”3.22.7″ header_font=”||||||||” header_font_size=”17px” header_line_height=”1.3em” body_font=”||on||||||” body_line_height=”1.3em” link_option_url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/epilepszia-es-fueggseg.pdf” link_option_url_new_window=”on”]<\/p>\n
Maria Martinove<\/p>\n
[\/et_pb_blurb][et_pb_toggle title=”Abstract” closed_toggle_text_color=”#000000″ closed_toggle_background_color=”rgba(0,0,0,0)” icon_color=”#0c71c3″ _builder_version=”4.6.6″ title_font=”|600|||||||” title_letter_spacing=”1px” text_orientation=”justified” custom_padding=”0px||10px” border_width_all=”0px” border_width_bottom=”1px”]<\/p>\n
<\/div>\n
Epilepsy is relatively frequent neurological condition. Its prevalence is assumed to be about 1%, and it would be interesting to see how many of these people have comorbid substance dependence disorder. The manifestation of epilepsy exhibits a seizure-like condition with typical neurological and psychical symptoms, which are induced by pathological electric discharges in brain. The population of addicts is known to have higher prevalence of seizures, found not only in alcohol abusers, but also in illicit drug users. The aim of our paper is to give an overview of the prevalence rates of this serious health condition in patients with substance dependence treated at the OL\u00daP NPO, Predn\u00e1 Hora. The author compares two groups of patients: with and without the epileptic seizures. Alcohol addicts prevailed in both groups. Each 8th treated dependent patient had at least one epileptic seizure. Nearly the same percent of dependent patients in both groups (43,6% vs. 40,9%) holds a driving license, thus they probably also drive a motor vehicle. Is there any person who would initiate withdrawal of driving license from such patients? Frequent somatic diseases in more than one half of the group with seizures (more than 62%) highlight the fact that this group of patients requires thorough and financially probably more demanding health care.<\/div>\n
<\/strong><\/div>\nKeywords:<\/strong>\u00a0epilepsy, dependence<\/div>\n[\/et_pb_toggle][et_pb_blurb title=”The effects of Duloxetine on \u03b2-actin stress response in rat brain” url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/a-duloxetin-hatasa-a-a946-aktin.pdf” url_new_window=”on” image=”https:\/\/mppt.hu\/wp-content\/uploads\/2019\/04\/pdf.png” icon_placement=”left” image_max_width=”105%” content_max_width=”1100px” _builder_version=”3.22.7″ header_font=”||||||||” header_font_size=”17px” header_line_height=”1.3em” body_font=”||on||||||” body_line_height=”1.3em” link_option_url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/a-duloxetin-hatasa-a-a946-aktin.pdf” link_option_url_new_window=”on”]<\/p>\n
Szabina Sz\u0171cs , Magdolna\u00a0<\/sup>P\u00e1k\u00e1ski, \u00c1gnes\u00a0<\/sup>Domokos, J\u00e1nos\u00a0<\/sup>ifj. K\u00e1lm\u00e1n, S\u00e1ra K\u00e1lm\u00e1n, D\u00e9nes\u00a0<\/sup>Garab, Botond\u00a0<\/sup>Penke, Gyula\u00a0<\/sup>Szab\u00f3, Zolt\u00e1n Janka and J\u00e1nos\u00a0<\/sup>K\u00e1lm\u00e1n<\/p>\n[\/et_pb_blurb][et_pb_toggle title=”Abstract” closed_toggle_text_color=”#000000″ closed_toggle_background_color=”rgba(0,0,0,0)” icon_color=”#0c71c3″ _builder_version=”3.22.7″ title_font=”|600|||||||” title_letter_spacing=”1px” text_orientation=”justified” custom_padding=”0px||10px” border_width_all=”0px” border_width_bottom=”1px”]<\/p>\n
Depression is a frequent prodromal symptom of Alzheimer\u2019s disease (AD). Stress factors
play an important role in the etiopathology of both diseases, since increased corticosteroid levels caused by chronic stress indirectly induce neuronal damage. The aim of our
experiments was to evaluate the changes induced by stress in the transcription of amyloid
precursor protein (APP), mitogen activated protein kinase-1 (MAPK-1) and \u03b2-actin, of which
the latest plays a leading role in synaptic plasticity. Additionally we intended to examine
how duloxetine – a serotonin-norepinephrin reuptake inhibitor type antidepressant \u2013
would modify the stress-induced changes. Wistar rats were exposed to immobilization
stress for five hours daily through 21 days, while part of the animals received 45 mg\/bwkg
of duloxetine. At the end of the third week total RNA was purified from the cortex and
hippocampus. The amount of \u03b2-actin, APP and MAPK-1 mRNA was determined by real
time PCR method. On protein level, semiquantitative measurement was performed by
Western blot. The expression of \u03b2-actin mRNA in the animals exposed to stress was four
times as intense as in the control group. The increase in the \u03b2-actin mRNA levels was
repressed by the duloxetine treatment. In the case of APP and MAPK-1 no changes were
detected. According to the Western blot results, the antidepressant treatment slightly,
the drug along with the stress treatment strongly decreased the amount of the \u03b2-actin
protein. Our findings indicate that antidepressant treatment with duloxetine could play
a protective role against the chronic stress-induced changes in the nervous system, such
as disorders of synaptic plasticity, and the consequent cognitive dysfunctions in case of both affective disorders and AD.<\/div>\n
Keywords<\/strong>: Alzheimer\u2019s disease, immobilization stress, amyloid precursor protein,
\u03b2-actin, mitogen activated protein kinase, duloxetine<\/div>\n[\/et_pb_toggle][et_pb_blurb title=”Complex hallucination (visual-auditory) during coadministration of tramadol and clarithromycin” url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/kovacs_web.pdf” url_new_window=”on” image=”https:\/\/mppt.hu\/wp-content\/uploads\/2019\/04\/pdf.png” icon_placement=”left” image_max_width=”105%” content_max_width=”1100px” _builder_version=”3.22.7″ header_font=”||||||||” header_font_size=”17px” header_line_height=”1.3em” body_font=”||on||||||” body_line_height=”1.3em” link_option_url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/kovacs_web.pdf” link_option_url_new_window=”on”]<\/p>\n
G\u00e1bor\u00a0 Kov\u00e1cs and G\u00e1bor P\u00e9ter\u00a0<\/p>\n
[\/et_pb_blurb][et_pb_toggle title=”Abstract” closed_toggle_text_color=”#000000″ closed_toggle_background_color=”rgba(0,0,0,0)” icon_color=”#0c71c3″ _builder_version=”3.22.7″ title_font=”|600|||||||” title_letter_spacing=”1px” text_orientation=”justified” custom_padding=”0px||10px” border_width_all=”0px” border_width_bottom=”1px”]<\/p>\n
Acute manifestations of various psyhopathological symptoms require detailed differential diagnostic procedure, since their cause is found to be somatic in several cases.
These adverse events during the treatment are often the side effects of the prescribed
drugs or drug-drug interactions. In the presented case report, the patient had complex
visual-auditory hallucinations two days after the initiation of tramadol-clarithromycin
coadministration and these transient symptoms were repeated for two days. After the
interruption of the administration of these drugs, the symptoms disappeared in two
days, without the administration of any kind of psychotropics. These two drugs by themselves may cause hallucinations, and because both of them are metabolized by the same
enzyme (CYP 3A4) in the liver, symptoms were worsened by the drug-drug interaction.
The reason of this effect is that tramadol is the substrate and clarithromycin is the inhibitor
of the CYP 3A4 enzyme. Medical examination results (physical examination, ECG, blood
samples, CT scan, EEG) could not be causally related to the symptoms. Suspected risk
factors were the old age of the patient, the condition of his brain and the interactions
with other previously prescribed drugs. This case report calls the attention of clinicians
to the fact that in vitro drug-drug interactions in vivo can produce clinical manifestations
more often then taken into account.<\/div>\n
Keywords<\/strong>: tramadol, clarithromycin, drug-drug interaction, hallucination<\/div>\n[\/et_pb_toggle][et_pb_blurb title=”Difficulties of Changing Drugs \u2013 from Clozapine to Aripiprasol at Outpatient Department” url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/a-gyogyszervaltas-nehezsegei–clozapin.pdf” url_new_window=”on” image=”https:\/\/mppt.hu\/wp-content\/uploads\/2019\/04\/pdf.png” icon_placement=”left” image_max_width=”105%” content_max_width=”1100px” _builder_version=”3.22.7″ header_font=”||||||||” header_font_size=”17px” header_line_height=”1.3em” body_font=”||on||||||” body_line_height=”1.3em” link_option_url=”https:\/\/mppt.hu\/magazin\/pdf\/xii-evfevfolyam-1-szam\/a-gyogyszervaltas-nehezsegei–clozapin.pdf” link_option_url_new_window=”on”]<\/p>\n
Judit Radics<\/p>\n
[\/et_pb_blurb][et_pb_toggle title=”Abstract” closed_toggle_text_color=”#000000″ closed_toggle_background_color=”rgba(0,0,0,0)” icon_color=”#0c71c3″ _builder_version=”3.22.7″ title_font=”|600|||||||” title_letter_spacing=”1px” text_orientation=”justified” custom_padding=”0px||10px” border_width_all=”0px” border_width_bottom=”1px”]<\/p>\n
Although there are well-established psychiatric procedures available concerning switching
of antipsychotic drugs, in practice we often face a situation where we have to consider
not only the patient\u2019s demands, but also requests from relatives. In this article we describe
a case where we encountered this situation. Our patient was a 48-year-old married man
suffering from paranoid schizophrenia with extreme obesity. We had to consider the
modification of the antipsychotic treatment because of the patient\u2019s persistant residual
symptoms (significant lack of iniciative, serious under-motivation, emotional plainessness, considerable passivity) his overweight and its consequences (metabolic syndrome).
In our paper we describe the psychoeducational process and the clozapine\/aripiprazol
switch.<\/div>\n
Keywords<\/strong>: aripiprazol, clozapine, extreme obesity, switching of antipsychotics<\/div>\n[\/et_pb_toggle][\/et_pb_column_inner][\/et_pb_row_inner][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_image src=”https:\/\/mppt.hu\/wp-content\/uploads\/2019\/05\/cimlap-marc-2010-218×308.jpg” align_tablet=”center” align_phone=”” align_last_edited=”on|desktop” _builder_version=”3.23″ box_shadow_style=”preset3″][\/et_pb_image][\/et_pb_column][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"
Volume 12, Issue 1, March 2010Viktor V\u00f6r\u00f6sA 20. sz\u00e1zad els\u0151 fel\u00e9ben a pszichoanalitikus gondolkod\u00e1s uralta a pszichi\u00e1tri\u00e1t \u00e9s t\u00e1gabb \u00e9rtelemben kult\u00farantropol\u00f3giai szempontb\u00f3l is meghat\u00e1rozta a korszak vil\u00e1gn\u00e9zet\u00e9t. Kopernikusz \u00e9s Darwin ut\u00e1n Freud fogalmazta meg az emberis\u00e9g harmadik n\u00e1rcisztikus t\u00e9ved\u00e9s\u00e9t, traum\u00e1j\u00e1t: nemcsak hogy nem vagyunk az Univerzum k\u00f6z\u00e9ppontja \u00e9s az \u00e1llatvil\u00e1gt\u00f3l sem k\u00fcl\u00f6nb\u00f6z\u00fcnk min\u0151s\u00e9gileg, de \u201enem […]<\/p>\n","protected":false},"author":4,"featured_media":48324,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"project_category":[65],"project_tag":[],"class_list":["post-49335","project","type-project","status-publish","has-post-thumbnail","hentry","project_category-2010-en"],"_links":{"self":[{"href":"https:\/\/mppt.hu\/en\/wp-json\/wp\/v2\/project\/49335","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mppt.hu\/en\/wp-json\/wp\/v2\/project"}],"about":[{"href":"https:\/\/mppt.hu\/en\/wp-json\/wp\/v2\/types\/project"}],"author":[{"embeddable":true,"href":"https:\/\/mppt.hu\/en\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/mppt.hu\/en\/wp-json\/wp\/v2\/comments?post=49335"}],"version-history":[{"count":5,"href":"https:\/\/mppt.hu\/en\/wp-json\/wp\/v2\/project\/49335\/revisions"}],"predecessor-version":[{"id":49725,"href":"https:\/\/mppt.hu\/en\/wp-json\/wp\/v2\/project\/49335\/revisions\/49725"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/mppt.hu\/en\/wp-json\/wp\/v2\/media\/48324"}],"wp:attachment":[{"href":"https:\/\/mppt.hu\/en\/wp-json\/wp\/v2\/media?parent=49335"}],"wp:term":[{"taxonomy":"project_category","embeddable":true,"href":"https:\/\/mppt.hu\/en\/wp-json\/wp\/v2\/project_category?post=49335"},{"taxonomy":"project_tag","embeddable":true,"href":"https:\/\/mppt.hu\/en\/wp-json\/wp\/v2\/project_tag?post=49335"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}