Search PubMed⌕ Search

Biomedical subjects

Heather Ashton

Publications and source records attributed to Heather Ashton.

5 recordsLinked to original sources
PubMed2006

The adult psychiatrist's dilemma: psychostimulant use in attention deficit/hyperactivity disorder.

Children who have taken psychostimulants long term for attention deficit/hyperactivity disorder (ADHD) are now presenting at adult psychiatry clinics at an age at which bipolar disorder and schizophrenia may first appear and at which pregnancy is a possibility. Doctors who may have little experience in the management of ADHD or use of psychostimulants are faced with decisions on whether to continue or withdraw medication. A literature search conducted to clarify these issues revealed that, although psychostimulants are generally efficacious in ADHD, the risks of withdrawal reactions and of possible long-term effects such as drug addiction, psychosis and depression, or effects in pregnancy, have not been adequately investigated. In particular, there is little information on the effects of withdrawal and no firm guidelines on methods of psychostimulant discontinuation. There is a need for further research to clarify the pharmacological issues involved in the drug treatment of ADHD and for overlapping arrangements between child and adult psychiatry clinics in the management of ADHD.

Adult↗
PubMed2005

The diagnosis and management of benzodiazepine dependence.

PURPOSE OF REVIEW: Despite repeated recommendations to limit benzodiazepines to short-term use (2-4 weeks), doctors worldwide are still prescribing them for months or years. This over-prescribing has resulted in large populations of long-term users who have become dependent on benzodiazepines and has also led to leakage of benzodiazepines into the illicit drug market. This review outlines the risks of long-term benzodiazepine use, gives guidelines on the management of benzodiazepine withdrawal and suggests ways in which dependence can be prevented. RECENT FINDINGS: Recent literature shows that benzodiazepines have all the characteristics of drugs of dependence and that they are inappropriately prescribed for many patients, including those with physical and psychiatric problems, elderly residents of care homes and those with comorbid alcohol and substance abuse. Many trials have investigated methods of benzodiazepine withdrawal, of which the keystones are gradual dosage tapering and psychological support when necessary. Several studies have shown that mental and physical health and cognitive performance improve after withdrawal, especially in elderly patients taking benzodiazepine hypnotics, who comprise a large proportion of the dependent population. SUMMARY: Benzodiazepine dependence could be prevented by adherence to recommendations for short-term prescribing (2-4 weeks only when possible). Withdrawal of benzodiazepines from dependent patients is feasible and need not be traumatic if judiciously, and often individually, managed.

Journal Article↗
PubMed2003

GABA-ergic drugs: exit stage left, enter stage right.

Drugs that enhance gamma-aminobutyric acid (GABA) activity by interacting at post-synaptic GABA(A) receptors have long been used as hypnotics, sedatives, tranquillizers and anticonvulsants. In this category, benzodiazepines rapidly gained pride of place, replacing barbiturates and becoming the most commonly prescribed of all drugs in the Western world in the 1970s. However, problems such as dependence and withdrawal reactions became apparent in the 1980s, and it seemed that the usefulness of drugs with this mode of action was limited. Recently, focus has shifted to a new group of drugs with GABA-ergic actions mediated through various mechanisms not directly involving the GABA(A) receptor. These drugs include gabapentin, vigabatrin, tiagabine, lamotrigine, pregabalin and others. Although originally developed as anticonvulsants for epilepsy, they appear to have wider applications for use in affective disorders, especially bipolar depression, anxiety disorders and pain conditions. The current information on the properties and therapeutic potential of this new generation of GABA-ergic drugs is reviewed. It remains to be seen whether long-term use leads to tolerance, dependence and withdrawal or discontinuation reactions.

Animals↗
PubMed1984

Effects of transcutaneous electrical nerve stimulation and aspirin on late somatosensory evoked potentials in normal subjects.

The effects on late somatosensory evoked potentials (SEPs) of transcutaneous nerve stimulation (TENS) and aspirin (600 mg), compared with placebo, were studied in 32 young, healthy male and female volunteers. SEPs were produced by electrical stimulation of the median nerve at moderate, non-painful, intensities. There was a reduction in the peak-to-peak amplitude of the late components N1P2 (N1 latency: 100-160 msec; P2 latency: 160-260 msec) of the SEP in all groups over time. TENS but not aspirin produced further significant changes compared with placebo, including a fall in N1P2 amplitude, an increase in N1 latency, and a decrease in the total excursion of the SEP between 25 and 450 msec after stimulus onset.

Adult↗