Statins are among the most widely used drug classes in the world. Apart from their basic mechanism of action, which is lowering cholesterol levels, many pleiotropic effects have been described so far, such as anti-inflammatory and antiatherosclerotic effects. A growing number of scientific reports have proven that these drugs have a beneficial effect on the functioning of the nervous system. The first reports proving that lipid-lowering therapy can influence the development of neurological and psychiatric diseases appeared in the 1990s. Despite numerous studies about the mechanisms by which statins may affect the functioning of the central nervous system (CNS), there are still no clear data explaining this effect. Most studies have focused on the metabolic effects of this group of drugs, however authors have also described the pleiotropic effects of statins, pointing to their probable impact on the neurotransmitter system and neuroprotective effects. The aim of this paper was to review the literature describing the impacts of statins on dopamine, serotonin, acetylcholine, and glutamate neurotransmission, as well as their neuroprotective role. This paper focuses on the mechanisms by which statins affect neurotransmission, as well as on their impacts on neurological and psychiatric diseases such as Parkinson’s disease (PD), Alzheimer’s disease (AD), vascular dementia (VD), stroke, and depression. The pleiotropic effects of statin usage could potentially open floodgates for research in these treatment domains, catching the attention of researchers and clinicians across the globe.
Venlafaxine (VEN) is considered to be one of the most effective antidepressants. It belongs to the group of serotonin (5-HT) and noradrenaline (NA) reuptake inhibitors (SNRIs). NA and 5-HT have receptors on the surface of platelets and are involved in platelet aggregation. In this case study, we present the case of a patient treated for one of the types of myeloproliferative neoplasm (MPN), essential thrombocythemia (ET), in whom VEN was added to pharmacotherapy during the treatment of a severe episode of depression with psychotic symptoms. We observed a gradual reduction in platelet count when increasing the dose of VEN. We also present a narrative review of literature about the effect of VEN on platelet counts and activity. We conclude that, in the group of patients taking VEN, attention should be paid to the rare adverse effect of a decrease in the number of platelets.
Community psychiatry is an effective and increasingly popular form of care for patients with mental disorders. Due to sanitary restrictions imposed by the COVID-19 pandemic, psychiatric rehabilitation programs had to adapt to the highly specific requirements and modify the offer of therapeutic activities for patients. Above all the activities focused on, social interactions were limited. The aim of the study was to assess the effectiveness of the modified rehabilitation program in light of the introduced sanitary restrictions due to COVID-19. This prospective observational single-centered study involved 41 patients diagnosed with organic mental disorders, psychotic disorders, affective disorders and anxiety disorders. The patients participated in a 6-week rehabilitation program which included varied forms of physical exercise, cognitive training, psychological training and Small Group Therapy. The quality-of-life assessment and the intensity of depression and anxiety symptoms were measured using standardized scales: Hospital Scale of Anxiety and Depression (HADS) and Short Form Health Survey (SF-36) at two time points before the initiation of the rehabilitation process and at the end of the program’s participation period. Median HADS D before admission to the rehabilitation center was 9 (IQR 6–12), and 5 (IQR 3–9) after 6-week participation (p < 0.05). Median SF-36 at the beginning of rehabilitation was 93 (IQR 80–106) and 73 (IQR 53–95) at the end of the evaluation period (p < 0.05), Median HADS-A at the start of rehabilitation was 11 (IQR 9–14) and 9 (IQR 6–12) after final assessment (p > 0.05). The gender and age of the participants did not influence the results of the utilized standardized evaluation tools (p > 0.05 for both). We observed an improvement in the participants’ subjective assessment of the intensity of the depression symptoms and the quality of life after partaking in the available activities. There was no clear benefit regarding the subjective assessment of the intensity of anxiety symptoms among the study participants resulting from the introduction to the program.
Wpływ pandemii COVID-19 na przebieg schizofrenii -przegląd literaturyThe impact of the COVID-19 pandemic on the schizophrenia: a literature review
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