Cohen C

References (4)

Title : Antidepressant and antipsychotic prescribing in primary care for people with dementia - Drummond_2018_Can.Fam.Physician_64_e488
Author(s) : Drummond N , McCleary L , Freiheit E , Molnar F , Dalziel W , Cohen C , Turner D , Miyagishima R , Silvius J
Ref : Can Fam Physician , 64 :e488 , 2018
Abstract : OBJECTIVE: To use data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) to evaluate the prevalence of antidepressant and antipsychotic prescriptions among patients with no previous depression or psychosis diagnoses, and to identify the factors associated with the use of these drugs in this population. DESIGN: Retrospective cohort study using data derived from CPCSSN. SETTING: Primary care practices associated with CPCSSN. PARTICIPANTS: Patients who were born before 1949; who were associated with a CPCSSN primary care practitioner between October 1, 2007, and September 30, 2013; and whose electronic medical records contained data from at least 6 months before and 12 months after the date of dementia diagnosis. MAIN OUTCOME MEASURES: Prescription for an antidepressant or antipsychotic medication in the absence of a depression or psychosis diagnosis. Multivariable models were fitted to determine estimated odds ratios (ORs) and were adjusted for age and sex. RESULTS: Of the 3252 patients without a depression diagnosis, 8.5% received a new prescription for an antidepressant in the 12 months following their diagnosis of dementia. Prescribing was reduced in association with older age (OR of 0.86 per 5-year age increase, P=.001) and male sex (OR=0.77, P=.056), and prescribing increased in association with prescription of cholinesterase inhibitor medications (OR=1.57, P=.003). Of the 4262 patients without a diagnosis of psychosis, 6.1% received a new prescription for an antipsychotic in the 12 months following their diagnosis of dementia. Higher rates of antipsychotic prescriptions were reported in men (OR=1.31, P=.046), those receiving a prescription for steroids (OR=1.90, P=.037), and those diagnosed with Parkinson disease (OR 1.58, P=.051). CONCLUSION: A substantial number of patients with dementia are being prescribed antidepressant or antipsychotic medications by their primary care practitioners without evidence of depression or psychosis in their electronic medical records.
ESTHER : Drummond_2018_Can.Fam.Physician_64_e488
PubMedSearch : Drummond_2018_Can.Fam.Physician_64_e488
PubMedID: 30429194

Title : Diagnosis and treatment of dementia: 5. Nonpharmacologic and pharmacologic therapy for mild to moderate dementia - Hogan_2008_CMAJ_179_1019
Author(s) : Hogan DB , Bailey P , Black S , Carswell A , Chertkow H , Clarke B , Cohen C , Fisk JD , Forbes D , Man-Son-Hing M , Lanctot K , Morgan D , Thorpe L
Ref : Cmaj , 179 :1019 , 2008
Abstract : BACKGROUND: Practising physicians frequently seek advice on the most effective interventions for dementia. In this article, we provide practical guidance on nonpharmacologic and pharmacologic interventions for the management of mild to moderate dementia based on recommendations from the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia.
METHODS: We developed evidence-based guidelines using systematic literature searches, with specific criteria for the selection and quality assessment of articles, and a clear and transparent decision-making process. We selected articles published from January 1996 to December 2005 that dealt with the management of mild to moderate stages of Alzheimer disease and other forms of dementia. Recommendations based on the literature review were drafted and voted on. Consensus required 80% or more agreement by participants. Subsequent to the conference, we searched for additional articles published from January 2006 to April 2008 using the same major keywords and secondary search terms. We graded the strength of the evidence using the criteria of the Canadian Task Force on Preventive Health Care.
RESULTS: We identified 1615 articles, of which 954 were selected for further study. From a synthesis of the evidence in these studies, we made 48 recommendations for the management of mild to moderate dementia (28) and dementia with a cerebrovascular component (8) as well as recommendations for addressing ethical issues (e.g., disclosure of the diagnosis) (12). The updated literature review did not change these recommendations. An exercise program is recommended for patients with mild to moderate dementia. Physicians should decide whether to prescribe a cholinesterase inhibitor on an individual basis, balancing anticipated benefits with the potential for harm. For mild mood and behavioural concerns, nonpharmacologic approaches should be considered first.
INTERPRETATION: Although the available therapies for dementia can help with the management of symptoms, there is a need to develop more effective interventions.
ESTHER : Hogan_2008_CMAJ_179_1019
PubMedSearch : Hogan_2008_CMAJ_179_1019
PubMedID: 18981443

Title : SSR591813, a novel selective and partial alpha4beta2 nicotinic receptor agonist with potential as an aid to smoking cessation - Cohen_2003_J.Pharmacol.Exp.Ther_306_407
Author(s) : Cohen C , Bergis OE , Galli F , Lochead AW , Jegham S , Biton B , Leonardon J , Avenet P , Sgard F , Besnard F , Graham D , Coste A , Oblin A , Curet O , Voltz C , Gardes A , Caille D , Perrault G , George P , Soubrie P , Scatton B
Ref : Journal of Pharmacology & Experimental Therapeutics , 306 :407 , 2003
Abstract : (5aS,8S,10aR)-5a,6,9,10-Tetrahydro,7H,11H-8,10a-methanopyrido[2',3':5,6]pyrano[2, 3-d]azepine (SSR591813) is a novel compound that binds with high affinity to the rat and human alpha4beta2 nicotinic acetylcholine receptor (nAChR) subtypes (Ki = 107 and 36 nM, respectively) and displays selectivity for the alpha4beta2 nAChR (Ki, human alpha3beta4 > 1000, alpha3beta2 = 116; alpha1beta1deltagamma > 6000 nM and rat alpha7 > 6000 nM). Electrophysiological experiments indicate that SSR591813 is a partial agonist at the human alpha4beta2 nAChR subtype (EC50 = 1.3 micro M, IA =19% compared with the full agonist 1,1-dimethyl-4-phenyl-piperazinium). In vivo findings from microdialysis and drug discrimination studies confirm the partial intrinsic activity of SSR591813. The drug increases dopamine release in the nucleus accumbens shell (30 mg/kg i.p.) and generalizes to nicotine or amphetamine (10-20 mg/kg i.p.) in rats, with an efficacy approximately 2-fold lower than that of nicotine. Pretreatment with SSR591813 (10 mg/kg i.p.) reduces the dopamine-releasing and discriminative effects of nicotine. SSR591813 shows activity in animal models of nicotine dependence at doses devoid of unwanted side effects typically observed with nicotine (hypothermia and cardiovascular effects). The compound (10 mg/kg i.p.) also prevents withdrawal signs precipitated by mecamylamine in nicotine-dependent rats and partially blocks the discriminative cue of an acute precipitated withdrawal. SSR591813 (20 mg/kg i.p.) reduces i.v. nicotine self-administration and antagonizes nicotine-induced behavioral sensitization in rats. The present results confirm important role for alpha4beta2 nAChRs in mediating nicotine dependence and suggest that SSR591813, a partial agonist at this particular nAChR subtype, may have therapeutic potential in the clinical management of smoking cessation.
ESTHER : Cohen_2003_J.Pharmacol.Exp.Ther_306_407
PubMedSearch : Cohen_2003_J.Pharmacol.Exp.Ther_306_407
PubMedID: 12682217

Title : Failure of behavioral dependence induction and oral nicotine bioavailability in rats - Le Houezec_1989_Physiol.Behav_45_103
Author(s) : Le Houezec J , Martin C , Cohen C , Molimard R
Ref : Physiol Behav , 45 :103 , 1989
Abstract : As failure to induce behavioral dependence to oral nicotine (0.31 mM) might be caused by taste aversion. Sixteen rats were presented nicotine around the taste aversion threshold (0.025 mM then 0.05 mM) as only source of fluid for 10 weeks. Eight of them had undergone portacaval anastomosis (PCA) to increase bioavailability of nicotine by preventing liver first-pass. Weekly choice sessions between nicotine and water demonstrated neither aversion nor preference for nicotine. In 10 control and 11 PCA rats accustomed to drink 0.31 mM nicotine, plasma nicotine was determined after 3 ml/kg intragastric nicotine-solution. In both groups, 0.05 mM nicotine did not lead to detectable levels but 0.31 mM nicotine led to peak levels higher than seen in man after smoking. Similar levels were recorded after spontaneous nicotine drinking in 8 isolated and 18 grouped normal rats accustomed to 0.31 mM nicotine. Drinking nicotine for at least 10 weeks did not induce behavioral dependence in these rats. This cannot be explained by poor nicotine bioavailability by oral route.
ESTHER : Le Houezec_1989_Physiol.Behav_45_103
PubMedSearch : Le Houezec_1989_Physiol.Behav_45_103
PubMedID: 2727123