Akram Ghantous’ Post

In honor of National Drug and Alcohol Facts Week, take a deep dive into how alcohol misuse affects women, including stats about use, risk factors, breast cancer, and more. https://bit.ly/3vqQ3Ez

The Role of CYP2B6 Genotype in Methadone Dosage for Opioid Addiction Treatment This is the Summarized version to fit Social Media, The full post along with the Pubmed link to the study can be found on our blog here: https://lnkd.in/en9F62gq In a recent study conducted in Pereira, Colombia, researchers investigated the impact of the CYP2B6 516G>T polymorphism on methadone dosage in patients undergoing Methadone Maintenance Treatment (MMT). This genetic marker was used to tailor methadone dosages, aiming to optimize treatment effectiveness and reduce costs. Key Findings: Dosage Reduction: Patients with specific CYP2B6 genotypes required lower methadone dosages, starting from the second week of treatment. Heroin and Cocaine Use: There was a 64% reduction in the use of heroin and cocaine/crack in both conventional and genetically guided groups, with no significant difference between them. Safety Profile: No significant correlation was found between methadone dosage and QTc intervals, which are indicators of heart rhythm abnormalities. Quality of Life: The study observed no difference in the quality of life perceptions between the two groups. Conclusion: The study suggests that using pharmacogenetic insights can lead to more precise methadone dosing, potentially enhancing treatment efficacy while managing costs, although the direct impact on patient retention and quality of life requires further investigation. Contact HWOANY at 1-888-995-3405 https://lnkd.in/ePzvet3q #MAT #OpioidAddiction #Recovery #Health #Wellness

Exciting news for the world of addiction medicine! A recent paper published in Nature supports an earlier study that shows simvastatin, a membrane cholesterol reducer and exosome production inhibitor, as a potential treatment for opioid use disorder. Check out the article here: https://lnkd.in/gFZKH7m7. The earlier study, published in 2015, can be found here: https://lnkd.in/gmsVnXdy. This could be a game-changer in the fight against opioid addiction.

Medical Doctors, Geneticists and Other Experts Call on CMS to Deny Coverage, and FDA to Rescind Approval of Invalid Genetic Test for Opioid Addiction Test Approved by FDA, Based on Science that Has Largely Been Abandoned by Main Stream Genetics, Does not Predict Addiction Risk and Could Lead to Opioid Overprescribing WASHINGTON, D.C. – A recently approved genetic test that claims to predict risk of opioid addiction is based on old genetic studies that have largely been abandoned. A broad coalition of geneticists and doctors, other experts said in a letter sent to the U.S. Food and Drug Administration (FDA) urging the agency to retract approval and a letter to the Centers for Medicare and Medicaid Services (CMS) requesting denial of coverage. The test, called AvertD, was approved despite opposition from the FDA’s expert advisory committee, which voted 11-2 against approval. FDA surprised observers by approving the test despite this widespread opposition. The test identifies 15 genetic markers. However, an independent scientific review of these markers states that AvertD does not predict risk of opioid addiction better than chance. Notably, false-negative results from AvertD may encourage harmful use of opioids and false positive results could wrongly brand patients as prone to addiction. https://lnkd.in/gCC98YTT

Why aren't we all taking LSD during therapy sessions? For most people who have tried anything similar in a non-clinical setting ("party" doesn't quite cover the numerous contexts LSD and other drugs are taken in), the potential psychological benefits for its controlled use in therapy are incredibly clear. Compouds like LSD or magic muchrooms create new connections and allow people to see life in new ways, almost like conscious dreaming. People have flashes of inspiration, life goals and meaning take a new shape. Psilocybin, the active ingredient in magic mushrooms, showed positive results in patients with depression in a study presented at the American Society of Clinical Oncology (ASCO) annual meeting earlier this week. So why are drugs like LSD, magic mushrooms or even MDMA* still seen as a new, almost underground treatments? The US "war on drugs" blocked research into psilocybin and many other high-potential treatments for a long time. After some (dodgy) experiments in the 60s, the hard crackdown on 'hippies' and the drugs they were taking went in full force. And they've continued to tell kids all drugs are bad ever since. There is wide variation in approach to bans in Europe, but research also halted here. The Commission's mental health strategy focuses on prevention and good mental health, but people who live with mental illness still need support. That's 1 in 8 people according to the World Health Organization. So why aren't we looking towards drugs that support and catlyse radical shifts in combination with therapy, rather than long-term treatments? Time to catch up In Europe the movement is starting, and in the US psychiadelics are being accelerated. Earlier this year, the European Medicines Agency told MEPs that psychiadelic treatments require the same data as other treatments and encouraged developers to get in touch. The US has decided to fast-track psilocybin for depression. It's a start, and I hope that after 50 years of missed research, approving psychiadelics will happen quickly. Sources: https://lnkd.in/gQ_gvTqS https://lnkd.in/gssqCJxW *Yes, LSD and MDMA will not have the same effect nor work in the same way, but the life-altering perspective shift they can both bring is valuable for treatment

EXENATIDE ONCE WEEKLY FOR ALCOHOL USE DISORDER INVESTIGATED IN RANDOMIZED, PLACEBO-CONTROLLED CLINICAL TRIAL The glucagon-like peptide-1 (GLP-1) receptor agonist exenatide reduces alcohol consumption in rodents and nonhuman primates, and now a recent study of 127 human patients revealed that exenatide significantly attenuated fMRI alcohol cue reactivity in the ventral striatum and septal area, which are crucial brain areas for drug reward and addiction. In addition, dopamine transporter availability was lower in the exenatide group compared with the placebo group. Exploratory analyses revealed that exenatide significantly reduced heavy drinking days and total alcohol intake in a subgroup of obese patients (BMI > 30 kg/m2). Published in the high impact, peer reviewed Journal of Clinical Investigation (JCI). #glp1 #alcoholusedisorder #alcoholaddiction #addiction #obesity

No surprising as most antidepressant drugs cause weight gain/ obesity, causing insulin resistenz, causing obesity, worsening depression. According to recent studies GLP-1-analoges help in the treatment of addiction due to their effect on the hippocampus/ limbic system. Thus in addition to physical activity as an effective, simple and cheap part of depression treatment, GLP-1-analogues and support by a diatitian should be considered to boost treatment success‼️ #obesitykillsactnow

Very interesting exploratory post-hoc analysis of the landmark escitalopram vs. #psilocybin trial published in 2021 by Carhart-Harris et al. There has been growing discussion about about the impact of discontinuation of SSRI/SNRI therapy prior to initiation of psilocybin treatment for depression. This analysis helps shed light on some of the nuances and future considerations for this common practice. The analysis showed that SSRI/SNRI discontinuation prior to psilocybin or escitalopram treatment resulted in worsening depressive symptoms at baseline assessment (very interesting to note as this is a standard procedure for #psychedelic research). It also showed that the antidepressant properties of psilocybin were dampened in individuals discontinuing medications compared to those entering the trial unmedicated. Those who stopped medications also seemed to have a more robust response to escitalopram. One of the more interesting observations was related to the subjective psychedelic effects experienced between groups. There wasn't a significant difference in reported effects when comparing unmedicated individuals and medication discontinuers. Put plainly, subjects were able to experience a classic psychedelic trip regardless of their pretreatment status. However, the blunted antidepressant effect in the medication discontinuation group was still notable, raising more questions about the underlying mechanisms contributing to the efficacy of psilocybin. The interplay between treatment as usual is an important one that requires further understanding. Receptor down-regulation/lingering discontinuation symptoms were possibly at play here and could certainly contribute to the blunted antidepressant effect observed in the psilocybin group. I'll be very curious to see how this will play out in actual practice. Intuitively, maintaining treatment when safe and appropriate seems like the way to go and this a practice already employed in clinical settings. There are so many considerations and, as always, I'm very interested to see how psychedelic research continues to progress!

Pharmacogenomic testing for major depressive disorder (MDD) could save the health system $956 million and improve the life expectancy and quality of life of thousands of depressed people if it’s implemented in British Columbia, let alone the rest of Canada (Ghanbarian et al., 2023). A recent study shows that pharmacogenomic testing, which identifies gene variations that influence the metabolism of antidepressant medications, could make the often lengthy trial-and-error process of finding the best prescription for each individual more cost and time effective—reducing the number of patients who have only partial or no response to antidepressants by 37% and the frequency of adverse effects (Ghanbarian et al., 2023). Pharmacogenomic-guided treatment is still disputed and more research is needed to confirm these preliminary findings. #mentalhealth #mentalhealthmatters #mentalhealthawareness #depression #pharmacogenomics #pharmacy #antidepressant #psychology  (Ghanbarian et al., 2023) https://lnkd.in/es9-Qcav