Archive for category Mount Sinai School

Bipolar Patients with History of Pot Use Show Better Cognitive Skills


Bipolar Patients with History of Pot Use Show Better Cognitive SkillsIndividuals with bipolar disorder who also have a history of marijuana use demonstrate advanced neurocogitive skills compared to bipolar patients with no history of use, according to research published online in the journal Psychiatry Research.

Researchers from Zucker Hillside Hospital in Long Island, NY, along with colleagues at the Mount Sinai School of Medicine and the Albert Einstein College of Medicine in New York City compared the performance of 50 bipolar subjects with a history of marijuana use to 150 bipolar patients with no history of use with a series of standardized cognitive tests.

Patient groups were similar in regards to age, racial background, and highest education levels achieved. Bipolar patients with a history of marijuana use had similar age at onset as did study participants who had not smoked marijuana.

During the study, researchers discovered that participants with a history of smoking marijuana exhibited better neurocognitive performance than that of non-users, but there was no major difference on estimates of premorbid IQ.

“Results from our analysis suggest that subjects with bipolar disorder and history of (marijuana use) demonstrate significantly better neurocognitive performance, particularly on measures of attention, processing speed, and working memory.”

“These findings are consistent with a previous study that demonstrated that bipolar subjects with history of cannabis use had superior verbal fluency performance as compared to bipolar patients without a history of cannabis use. Similar results have also been found in schizophrenia in several studies,” said the authors.

“These data could be interpreted to suggest that cannabis use may have a beneficial effect on cognitive functioning in patients with severe psychiatric disorders. However, it is also possible that these findings may be due to the requirement for a certain level of cognitive function and related social skills in the acquisition of illicit drugs,” they said.

Source:  Psychiatry Research

 

 

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How Drugs for Schizophrenia Sow Seeds of Resistance


How Drugs for Schizophrenia Sow Seeds of ResistanceA new study has identified why certain drugs have mixed success in treating schizophrenia; effective at first, but with chronic administration becoming less and less so.

In the study, reported online in the journal Nature Neuroscience, scientists investigated the external genetic reasons (called epigenetic factors) that cause treatment-resistance to atypical antipsychotic drugs.

Use of antipsychotic drugs is the standard of care for schizophrenia. Researchers at Mount Sinai School of Medicine report that 30 percent of individuals with schizophrenia do not respond to currently available treatments.

Researchers discovered that, over time, an enzyme in the brains of schizophrenic patients, analyzed at autopsy, begins to compensate for the prolonged chemical changes caused by antipsychotics, resulting in reduced efficacy of the drugs.

“These results are groundbreaking because they show that drug resistance may be caused by the very medications prescribed to treat schizophrenia, when administered chronically,” said Javier Gonzalez-Maeso, Ph.D., lead investigator on the study.

Researchers found that an enzyme called HDAC2 was highly expressed in the brain of mice chronically treated with antipsychotic drugs, resulting in lower expression of the receptor called mGlu2 and a recurrence of psychotic symptoms. A similar finding was observed in the postmortem brains of schizophrenic patients.

In response, the research team administered a chemical called suberoylanilide hydroxamic acid (SAHA), which inhibits the entire family of HDACs. This treatment prevented the detrimental effect of the antipsychotic called clozapine on mGlu2 expression, and also improved the therapeutic effects of atypical antipsychotics in mouse models.

Previous research conducted by the team showed that chronic treatment with the antipsychotic clozapine causes repression of mGlu2 expression in the frontal cortex of mice, a brain area key to cognition and perception.

The researchers hypothesized that this effect of clozapine on mGlu2 may play a crucial role in restraining the therapeutic effects of antipsychotic drugs.

“We had previously found that chronic antipsychotic drug administration causes biochemical changes in the brain that may limit the therapeutic effects of these drugs,”said Gonzalez-Maeso. “We wanted to identify the molecular mechanism responsible for this biochemical change, and explore it as a new target for new drugs that enhance the therapeutic efficacy of antipsychotic drugs.”

Mitsumasa Kurita, Ph.D., a postdoctoral fellow at Mount Sinai and the lead author of the study, said, “We found that atypical antipsychotic drugs trigger an increase of HDAC2 in the frontal cortex of individuals with schizophrenia, which then reduces the presence of mGlu2, and thereby limits the efficacy of these drugs.”

As a result of these findings, Gonzalez-Maeso’s team is now developing compounds that specifically inhibit HDAC2 as adjunctive treatments to antipsychotics.

Source:The Mount Sinai Hospital/Mount Sinai School of Medicine

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