Migréna je časté invalidizující onemocnění. Celosvětová prevalence migrény se odhaduje mezi 10-15 %. Migréna často propuká již v dětském věku, kdy je poměr dívek a chlapců kloněn k vyššímu počtu u chlapců, během puberty se pak počty vyrovnávají. S pokračujícím věkem se poměr kloní více k ženskému pohlaví. Nejvíce však postihuje dospělé v produktivním věku, kde již výrazně převažují ženy nad muži. V České republice je více než milion migreniků. Většina z nich trpí migrénou epizodickou, nejméně dvacet procent z nich pak trpí formou chronickou, která se významně odráží na kvalitě života nemocného i jeho rodiny. V léčbě migrény zažíváme v posledních letech revoluci. Máme k dispozici specifickou medikaci akutní i profylaktickou v různých formách podání.

Migraine is a frequent disabling disease. The worldwide prevalence of migraine is estimated to be between 10-15 %. Migraines often start already in childhood, when the ratio of girls to boys tends to be higher in boys, and during puberty the numbers even out. As age continues, the ratio leans more towards the female sex. However, it mostly affects adults of working age, where women already significantly outnumber men. There are more than a million migrainers in the Czech Republic. Most of them suffer from episodic migraine, while at least twenty percent of them suffer from the chronic form, which significantly affects the quality of life of the patient and her/his family. In recent years, we have experienced a revolution in the treatment of migraine. We have available specific acute and prophylactic medication in various forms of administration.

• Klíčová slova
• atogepant, rimegepant,
• MeSH
• antagonisté CGRP receptorů * farmakologie   klasifikace   terapeutické užití   MeSH
• antiflogistika nesteroidní farmakologie   terapeutické užití   MeSH
• lidé MeSH
• migréna * diagnóza   farmakoterapie   patofyziologie   MeSH
• tryptaminy farmakologie   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

BACKGROUND: Monoamine oxidase (MAO) inhibitors can interact with selective serotonin reuptake inhibitors (SSRIs)/serotonin-norepinephrine reuptake inhibitors (SNRIs). There is clinical interest surrounding use of ozanimod with SSRIs/SNRIs because the major metabolites of ozanimod are weak inhibitors of MAO-B in vitro. OBJECTIVE: To evaluate the incidence of treatment-emergent adverse events (TEAEs) potentially related to serotonin accumulation (SA) during concomitant ozanimod and SSRI/SNRI use by performing analyses of data from an open-label, oral ozanimod 0.92 mg trial (DAYBREAK; NCT02576717). METHODS: SA narrow (serotonin syndrome, neuroleptic malignant syndrome, and hyperthermia malignant) and broad (terms potentially associated with SA) MedDRA v24.0 searches were performed using TEAE data from participants with relapsing multiple sclerosis who entered DAYBREAK from phase 3 studies (cutoff February 1, 2022). Incidences of TEAEs matching terms from each search were stratified by SSRI/SNRI use. RESULTS: Of 2257 DAYBREAK participants, 274 (12.1%) used an SSRI/SNRI. No participants had TEAEs matching the SA narrow search terms. There was no significant difference in the percentage of participants with ⩾1 TEAE matching the SA broad search for those on versus off SSRIs/SNRIs (on: 12.4%, n = 34/274; off: 15.6%, n = 310/1982, nominal p = 0.1630). CONCLUSION: MedDRA searches showed no increase in TEAEs potentially associated with SA with concomitant SSRI/SNRI and ozanimod use.

• MeSH
• antidepresiva škodlivé účinky   MeSH
• indany * MeSH
• inhibitory zpětného vychytávání serotoninu a noradrenalinu * škodlivé účinky   MeSH
• lidé MeSH
• oxadiazoly * MeSH
• roztroušená skleróza * chemicky indukované   MeSH
• selektivní inhibitory zpětného vychytávání serotoninu škodlivé účinky   MeSH
• serotonin MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Patients with alcohol use disorder (AUD) who seek treatment show highly variable outcomes. A precision medicine approach with biomarkers responsive to new treatments is warranted to overcome this limitation. Promising biomarkers relate to prefrontal control mechanisms that are severely disturbed in AUD. This results in reduced inhibitory control of compulsive behavior and, eventually, relapse. We reasoned here that prefrontal dysfunction, which underlies vulnerability to relapse, is evidenced by altered neuroelectric signatures and should be restored by pharmacological interventions that specifically target prefrontal dysfunction. To test this, we applied our recently developed biocompatible neuroprosthesis to measure prefrontal neural function in a well-established rat model of alcohol addiction and relapse. We monitored neural oscillations and event-related potentials in awake alcohol-dependent rats during abstinence and following treatment with psilocybin or LY379268, agonists of the serotonin 2A receptor (5-HT2AR), and the metabotropic glutamate receptor 2 (mGluR2), that are known to reduce prefrontal dysfunction and relapse. Electrophysiological impairments in alcohol-dependent rats are reduced amplitudes of P1N1 and N1P2 components and attenuated event-related oscillatory activity. Psilocybin and LY379268 were able to restore these impairments. Furthermore, alcohol-dependent animals displayed a dominance in higher beta frequencies indicative of a state of hyperarousal that is prone to relapse, which particularly psilocybin was able to counteract. In summary, we provide prefrontal markers indicative of relapse and treatment response, especially for psychedelic drugs.

• MeSH
• alkoholismus * farmakoterapie   patofyziologie   MeSH
• aminokyseliny MeSH
• bicyklické sloučeniny heterocyklické * farmakologie   MeSH
• biologické markery MeSH
• evokované potenciály účinky léků   MeSH
• krysa rodu rattus MeSH
• modely nemocí na zvířatech * MeSH
• prefrontální mozková kůra * účinky léků   patofyziologie   metabolismus   MeSH
• psilocybin * farmakologie   MeSH
• receptory metabotropního glutamátu MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• čakry,
• MeSH
• adaptace na tmu * MeSH
• lidé MeSH
• meditace metody   MeSH
• melatonin terapeutické užití   MeSH
• oči MeSH
• oční nemoci terapie   MeSH
• poruchy zraku terapie   MeSH
• relaxační terapie metody   MeSH
• senzorická deprivace MeSH
• spirituální terapie metody   MeSH
• zrak MeSH
• Check Tag
• lidé MeSH

Effort-based decision-making is particularly relevant to psychiatric conditions where motivation deficits are prominent features. Despite its clinical significance, the neurochemical mechanisms of this cognitive process remain unclarified. This study explores the impact of serotonin synthesis inhibition (PCPA) and modulation of serotonin release and 5-HT1A receptor agonism (8-OH-DPAT) on effort-based decision-making in rats. Adult male rats were trained in a modified T-maze task where they could obtain a high reward for climbing a mesh barrier or a low reward for no extra effort. Following training, rats received either acute 8-OH-DPAT treatment or subchronic PCPA treatment and were tested on their choices between high- and low-effort arms. The goal-arm choices and goal-arm entrance latencies were recorded. Next, homovanillic acid and 5-hydroxyindoleacetic acid, metabolites of dopamine and serotonin, respectively, were quantified in the rats' prefrontal cortex, striatum, and hippocampus. 8-OH-DPAT significantly increased low-effort, low-reward choices and increased goal-arm latency. In contrast, PCPA treatment did not affect these measures. Both PCPA and 8-OH-DPAT significantly decreased 5-hydroxyindoleacetic acid levels in the prefrontal cortex and the hippocampus. 8-OH-DPAT treatment was also associated with decreased homovanillic acid levels in the hippocampus. Our findings suggest that the overall reduction of serotonin levels alone does not affect effort-based decision-making and highlights the possible role of the hippocampus and the 5-HT1A receptor in this cognitive process.

• MeSH
• 8-hydroxy-2-(di-N-propylamino)tetralin * farmakologie   MeSH
• agonisté serotoninového receptoru 5-HT1 farmakologie   MeSH
• bludiště - učení účinky léků   fyziologie   MeSH
• chování zvířat účinky léků   MeSH
• krysa rodu rattus MeSH
• odměna MeSH
• potkani Sprague-Dawley MeSH
• rozhodování * fyziologie   účinky léků   MeSH
• serotonin * metabolismus   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Sedmačtyřicetiletá pacientka byla hospitalizována pro svoji 5. depresivní epizodu v rámci periodické depresivní poruchy, současnou těžkou fázi se suicidálními ideacemi. Opakované pokusy antidepresivní léčby byly neúspěšné a pacientka plánovala eutanazii v zahraničí. Celkové skóre 8položkové verze Sheehanovy škály suicidality (S-STS 10.0) bylo 28. Mimo depresivní poruchy sužovaly pacientku četné somatické komorbidity. Pro závažné suicidální ideace jsme zahájili akutní léčbu ketaminem 2× týdně, nejdříve intranasálně a později subkutánně. Po 4 aplikacích ketaminu byla pacientka propuštěna do ambulantní udržovací léčby. Tam se po 9. aplikaci ustálil interval subkutánní aplikace ketaminu na frekvenci 1× týdně. Od 14. aplikace přešla pacientka na i. m. aplikaci ketaminu, kterou hodnotila jako efektivnější. V době publikace kazuistiky trvá udržovací léčba ketaminem 12 měsíců. Poslední hodnota celkového skóre suicidality S-STS 10.0 byla 6. Jedná se o redukci celkového skóre suicidality o více než 70 %. Dlouhodobá léčba ketaminem byla efektivnější v léčbě rezistentní deprese se suicidálními ideacemi než kombinace antidepresiv.

A 47-year-old female patient was hospitalized for her 5th depressive episode within periodic depressive disorder, the current phase severe with suicidal ideation. Despite repeated treatment with antidepressants, she considered euthanasia abroad. She had reached a total score of 28 on the 8-item version of the Sheehan Suicidality Scale (S-STS 10.0). In addition to depressive disorders, the patient suffered from numerous somatic comorbidities. We started acute treatment with ketamine twice a week, first intranasally and later subcutaneously. After four applications of ketamine, the patient was discharged to outpatient maintenance treatment. Considering the duration of ketamine ́s effect, the interval of once per week was established after nine applications and the patient switched to i. m. applications, which she rated as more effective compared do s.c. Ketamine maintenance treatment lasts 12 months at the time of publication. The last value of the total suicidality score of the S-STS 10.0 was 6. This is a reduction of the total score by more than 70%. Long-term treatment with ketamine was more effective in treating treatment resistant depression with suicidal ideation than a combination of antidepressants.

• MeSH
• antidepresiva aplikace a dávkování   škodlivé účinky   MeSH
• bolest farmakoterapie   komplikace   MeSH
• chování sebezraňující etiologie   farmakoterapie   MeSH
• depresivní poruchy * etiologie   farmakoterapie   komplikace   patologie   MeSH
• ketamin * aplikace a dávkování   MeSH
• klinická studie jako téma MeSH
• komorbidita MeSH
• lidé středního věku MeSH
• lidé MeSH
• migréna farmakoterapie   komplikace   terapie   MeSH
• sebevražedné myšlenky MeSH
• tryptaminy škodlivé účinky   terapeutické užití   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• práce podpořená grantem MeSH

Executive function deficits, common in psychiatric disorders, hinder daily activities and may be linked to diminished neural plasticity, affecting treatment and training responsiveness. In this pioneering study, we evaluated the feasibility and preliminary efficacy of psilocybin-assisted frontal-midline theta neurofeedback (NF), a neuromodulation technique leveraging neuroplasticity, to improve executive functions (EFs). Thirty-seven eligible participants were randomized into an experimental group (n = 18) and a passive control group (n = 19). The experimental group underwent three microdose sessions and then three psilocybin-assisted NF sessions, without requiring psychological support, demonstrating the approach's feasibility. NF learning showed a statistical trend for increases in frontal-midline theta from session to session with a large effect size and non-significant but medium effect size dynamical changes within sessions. Placebo effects were consistent across groups, with no tasks-based EF improvements, but significant self-reported gains in daily EFs-working memory, shifting, monitoring and inhibition-showing medium and high effect sizes. The experimental group's significant gains in their key training goals underscored the approach's external relevance. A thorough study with regular sessions and an active control group is crucial to evaluate EFs improvement and their specificity in future. Psilocybin-enhanced NF could offer significant, lasting benefits across diagnoses, improving daily functioning. This article is part of the theme issue 'Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation'.

• MeSH
• dospělí MeSH
• exekutivní funkce * účinky léků   MeSH
• lidé MeSH
• mladý dospělý MeSH
• neurofeedback * metody   MeSH
• psilocybin * farmakologie   MeSH
• studie proveditelnosti * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Migréna je záchvatovité neurologické onemocnění s výrazným dopadem na kvalitu života pacientů. Prevalence migrény se celosvětově pohybuje kolem 17 % u žen a 6 % u mužů, nejčastěji se vyskytuje mezi 30. a 40. rokem života. Migréna je druhou nejčastější příčinou disability po vertebrogenních onemocněních a třetí nejčastější neurologické onemocnění vůbec. Představuje tak pro společnost významnou ekonomickou zátěž, proto potřebujeme co nejdokonalejší a nejúčinnější terapii. V posledních třech letech máme již takovou léčbu k dispozici ve formě monoklonálních protilátek.

Migraine is an attack-like neurological disease with a significant impact on patients' quality of life. The prevalence of migraine worldwide is around 17% in women and 6% in men, with the most frequent occurrence between 30 and 40 years of age. Migraine is the second most common cause of disability after vertebrogenic disorders and the third most common neurological disorder overall. It represents a significant economic burden on society, which is why we need the most sophisticated and effective therapies. In the last three years, we already have such a treatment available in the form of monoclonal antibodies.

• MeSH
• biologická terapie MeSH
• humanizované monoklonální protilátky farmakologie   terapeutické užití   MeSH
• lidé MeSH
• migréna bez aury diagnóza   MeSH
• migréna s aurou diagnóza   MeSH
• migréna * diagnóza   farmakoterapie   prevence a kontrola   MeSH
• monoklonální protilátky farmakologie   terapeutické užití   MeSH
• tryptaminy farmakologie   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Proper fetal development requires tight regulation of serotonin concentrations within the fetoplacental unit. This homeostasis is partly maintained by the placental transporter OCT3/SLC22A3, which takes up serotonin from the fetal circulation. Metformin, an antidiabetic drug commonly used to treat gestational diabetes mellitus, was shown to inhibit OCT3. We, therefore, hypothesized that its use during pregnancy could disrupt placental serotonin homeostasis. This hypothesis was tested using three experimental model systems: primary trophoblast cells isolated from the human term placenta, fresh villous human term placenta fragments, and rat term placenta perfusions. Inhibition of serotonin transport by metformin at three concentrations (1 μM, 10 μM, and 100 μM) was assessed in all three models. The OCT3 inhibitor decynium-22 (100 μM) and paroxetine (100 μM), a dual inhibitor of SERT and OCT3, were used as controls. In primary trophoblasts, paroxetine exhibited the strongest inhibition of serotonin uptake, followed by decynium-22. Metformin showed a concentration-dependent effect, reducing serotonin uptake by up to 57 % at the highest concentration. Its inhibitory effect was less pronounced in fresh villous fragments but remained statistically significant at all concentrations. In the perfused rat placenta, metformin demonstrated a concentration-dependent effect, reducing placental serotonin uptake by 44 % at the highest concentration tested. Our findings across all experimental models show inhibition of placental OCT3 by metformin, resulting in reduced serotonin uptake by the trophoblast. This sheds light on mechanisms that may underpin metformin-mediated effects on fetal development.

• MeSH
• biologický transport účinky léků   MeSH
• hypoglykemika farmakologie   MeSH
• krysa rodu rattus MeSH
• kultivované buňky MeSH
• lidé MeSH
• metformin * farmakologie   MeSH
• oktamerní transkripční faktor 3 metabolismus   MeSH
• placenta * metabolismus   účinky léků   MeSH
• potkani Wistar MeSH
• proteiny přenášející organické kationty MeSH
• serotonin * metabolismus   MeSH
• těhotenství MeSH
• trofoblasty * metabolismus   účinky léků   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

There are currently no pharmacological treatments for cocaine use disorder. Recently there has been a great deal of interest in the potential of psychedelic drugs such as psilocybin to treat psychiatric disorders. Human studies have indicated that a single administration of psilocybin can have long-lasting effects. Few preclinical studies have examined a role for psilocybin in addiction models. The goal of the current study was to determine whether psilocybin would enhance extinction following cocaine self-administration in male and female mice and rats and thus result in an attenuation of cue-induced drug-seeking. In experiments in mice, 16 female and 19 male mice underwent 8d of cocaine self-administration (0.5 mg/kg/infusion) and extinction training. Immediately following extinction trials, mice were injected with vehicle or 1.0 mg/kg psilocybin. Following the conclusion of extinction training, mice were tested for cue-induced reinstatement. In experiments in rats, 24 female and 23 male rats underwent 15d of cocaine self-administration (0.8 mg/kg/infusion) and extinction training. Immediately following extinction trials, rats were injected with vehicle, 1.0 mg/kg psilocybin, or 2.5 mg/kg psilocybin. Following the conclusion of extinction training, rats were tested for cue-induced reinstatement. Psilocybin administered following extinction trials had no effect, as both female and male mice and rats demonstrated significant cue-induced reinstatement. These data suggest that psilocybin is ineffective at altering cocaine-seeking behavior in the paradigm and doses used in the current study. It remains to be seen whether treatment with psilocybin under different conditions may be useful in the long-standing goal of finding pharmacotherapies to treat CUD.

• MeSH
• autoaplikace * MeSH
• chování při shánění drogy * účinky léků   MeSH
• extinkce (psychologie) * účinky léků   MeSH
• halucinogeny * farmakologie   aplikace a dávkování   MeSH
• inhibitory vychytávání dopaminu farmakologie   aplikace a dávkování   MeSH
• kokain * farmakologie   aplikace a dávkování   MeSH
• krysa rodu rattus MeSH
• myši inbrední C57BL MeSH
• myši MeSH
• operantní podmiňování účinky léků   MeSH
• podněty * MeSH
• pohlavní dimorfismus MeSH
• poruchy spojené s užíváním kokainu farmakoterapie   psychologie   MeSH
• potkani Sprague-Dawley MeSH
• psilocybin * farmakologie   aplikace a dávkování   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• myši MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH