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Literatura académica sobre el tema "Neuromodulatory treatments"

Autor: Grafiati

Publicado: 10 de marzo de 2023

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Artículos de revistas sobre el tema "Neuromodulatory treatments"

Thomas, G. P., Y. Maeda y C. J. Vaizey. "Patient Responses to Different Neuromodulatory Treatments". Diseases of the Colon & Rectum 57, n.º 2 (febrero de 2014): e18. http://dx.doi.org/10.1097/dcr.0000000000000045.

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Finnegan, Martha y Declan McLoughlin. "Neurostimulatory, neuromodulatory and neurosurgical treatments in psychiatry". Medicine 44, n.º 12 (diciembre de 2016): 742–44. http://dx.doi.org/10.1016/j.mpmed.2016.09.009.

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Lynch, Marie y Declan McLoughlin. "Neurostimulatory, neuromodulatory and neurosurgical treatments in psychiatry". Medicine 48, n.º 12 (diciembre de 2020): 793–95. http://dx.doi.org/10.1016/j.mpmed.2020.09.010.

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Salib, Anne-Mary, Allen Ho, Eric Sussman, Arjun Pendharkar y Casey Halpern. "Neuromodulatory Treatments for Alcohol Use Disorder: A Review". Brain Sciences 8, n.º 6 (28 de mayo de 2018): 95. http://dx.doi.org/10.3390/brainsci8060095.

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Jensen, Mark P., Melissa A. Day y Jordi Miró. "Neuromodulatory treatments for chronic pain: efficacy and mechanisms". Nature Reviews Neurology 10, n.º 3 (18 de febrero de 2014): 167–78. http://dx.doi.org/10.1038/nrneurol.2014.12.

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Koek, Ralph J., Janine Roach, Nicholas Athanasiou, Mascha van 't Wout-Frank y Noah S. Philip. "Neuromodulatory treatments for post-traumatic stress disorder (PTSD)". Progress in Neuro-Psychopharmacology and Biological Psychiatry 92 (junio de 2019): 148–60. http://dx.doi.org/10.1016/j.pnpbp.2019.01.004.

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Miró, Jordi, Elena Castarlenas, Rocío de la Vega, Rubén Roy, Ester Solé, Catarina Tomé-Pires y Mark Jensen. "Psychological Neuromodulatory Treatments for Young People with Chronic Pain". Children 3, n.º 4 (6 de diciembre de 2016): 41. http://dx.doi.org/10.3390/children3040041.

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Kilian, Hannah M., Dora M. Meyer y Thomas E. Schlaepfer. "Putative novel neuromodulatory treatments for affective disorders – What might emerge?" Personalized Medicine in Psychiatry 17-18 (noviembre de 2019): 46–50. http://dx.doi.org/10.1016/j.pmip.2019.07.002.

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McGaugh, James L. "Significance and Remembrance: The Role of Neuromodulatory Systems". Psychological Science 1, n.º 1 (enero de 1990): 15–25. http://dx.doi.org/10.1111/j.1467-9280.1990.tb00060.x.

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It is now well known that the retention of newly-acquired information can be modulated by drugs or hormones administered shortly following training. It is generally thought that such treatments influence retention by modifying processes underlying the storage of information. The fact that susceptibility to posttraining memory modulation is seen in many species, including bees, fish, birds, and mammals, argues that some common time-dependent memory storage processes have been conserved in evolution. Recent research findings have provided strong support for the view that such susceptibility to posttraining influences provides opportunity for modulation of memory storage by endogenous neurohormonal systems. In rats and mice, posttraining administration of hormones such as epinephrine that are normally released by training experiences enhances subsequent retention. Comparable effects are found with posttraining administration of opiate receptor antagonists such as naloxone. Findings of recent experiments indicate that these treatments affect memory by influencing the release of norepinephrine within the amygdaloid complex. The endogenous regulation of memory storage appears to involve interaction of neurohormones and transmitters in activating brain systems involved in memory storage.

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May, Arne y Peter J. Goadsby. "Neuromodulatory Approaches to the Management of Medically Refractory Cluster Headache". US Neurology 06, n.º 02 (2010): 125. http://dx.doi.org/10.17925/usn.2010.06.02.125.

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The trigeminal autonomic cephalalgias are a group of primary headache disorders characterized by unilateral trigeminal distribution of pain that occurs in association with ipsilateral cranial autonomic features. The most prominent one is cluster headache, a dreadful disease with excrutiating pain attacks. These attacks last no longer than two hours but may occur several times per day. It is mandatory to find an efficient therapy for these patients, but some are unresponsive to all treatments. In these intractable cases invasive procedures are introduced, but the available evidence (while conflicting) illustrates that trigeminal denervation may not be effective in preventing the headache attacks or autonomic symptoms of chronic cluster headache. Modern neurostimulating approaches, such as stimulation of the greater occipital nerve and hypothalamic deep brain stimulation, supersede neurodestructive procedures. Both stimulation methods are exquisite and potentially life-saving treatment options in otherwise intractable patients, but they need to be better characterized and further long-term data are needed.

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Tesis sobre el tema "Neuromodulatory treatments"

Conti, Emilia. "In vivo optical imaging of cortical plasticity induced by rehabilitation after stroke". Doctoral thesis, 2019. http://hdl.handle.net/2158/1152568.

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In my PhD thesis I have studied the changes in functional and structural plasticity induced by a photothrombotic stroke in mouse primary motor cortex. In order to dissect the multiple aspects consequent to the damage we exploit fluorescent imaging techniques that allow to investigate the functional and structural rearrangement of the cortex at different scale, from the entire hemisphere, with wide-field calcium imaging, up to the single synapse with two-photon microscopy. To promote a functional recovery of the mouse forelimb we applied different rehabilitative strategies in order to both foster the stabilization of regions of the cortex linked to the stroke core, and stimulate the remodelling of peri-infarct areas. We took advantage of a robotic platform (M-Platform), developed by our collaborator in Pisa, to perform the rehabilitation of mouse forelimb through a repetitive motor training. Together with this approach we applied different strategies to mould cortical activity. We temporary inhibited the healthy primary motor cortex, with an intracortical injection of Botulin Neuro Toxin E, in order to counterbalance the iper-excitability of the healthy hemisphere and to promote the structural and functional remodelling of the peri-infarct cortex. This combined rehabilitative protocol promotes the recovery of cortical maps of activation during motor training and the rewiring of interhemispheric connectivity, both from functional and structural level. Then we applied an optogenetic approach as a pro-plasticizing treatment by stimulating with light the region of the cortex surrounding the damage. By coupling this treatment with an intense motor training on the M-Platform we observed a generalized recovery of forelimb functionality in terms of manual dexterity and cortical profiles of activation. In this study, we have shown that different rehabilitative protocols that combines repetitive motor training and neuronal modulation of specific cortical regions induce a synergic effect on neuronal plasticity that promotes the recovery of structural features of healthy neuronal networks.

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Libros sobre el tema "Neuromodulatory treatments"

Interventional and neuromodulatory techniques for pain management. Philadelphia: Elsevier/Saunders, 2012.

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Frye, Mark A., Paul E. Croarkin, Marin Veldic, Malik M. Nassan, Katherine M. Moore, Simon Kung, Susannah J. Tye, William V. Bobo y Jennifer L. Vande Voort. Evidence-based treatment of bipolar depression. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0007.

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Despite the predominant illness burden, evidence-based treatment, and by extension regulatory approved, for acute bipolar depression is significantly less than evidence bases in acute mania and maintenance treatment. Complicating this deficit has been persistent use of unimodal antidepressant therapy without clear and convincing benefit. Successful regulatory-approved drug development has focused on atypical antipsychotic therapy. Evidence-based treatments also include lamotrigine and divalproex by meta-analyses and a number of manual-based psychotherapies. In contrast, unimodal antidepressants as a class for bipolar depressed patients as a group appear to provide substantial benefit and may pose risk for mood destabilization. Promising novel and neuromodulatory treatments while encouraging require further systematic investigation. Understanding unimodal antidepressant response and risk patterns in bipolar disorder has immediate clinical implications. Moreover, evidence-based guidelines will need to bridge more individualized or precision-based treatment interventions.

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Raymer, Anastasia M. y Leslie J. Gonzalez Rothi. Principles of Aphasia Rehabilitation. Editado por Anastasia M. Raymer y Leslie J. Gonzalez Rothi. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780199772391.013.18.

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This chapter reviews the broad literature on approaches to treatment of aphasia. Behavioral interventions for aphasia are influenced by perspectives from neuroscience that emphasize that neuroplasticity in rehabilitation is experience-dependent and potent. Several principles of neuroplasticity are reviewed, and examples are described from the aphasia treatment literature. Additional principles are considered regarding influences of error production and feedback in aphasia rehabilitation outcomes. Adjuvant treatments then are described that are meant to enhance behavioral treatment outcomes through pharmacologic and neuromodulatory interventions. Finally, life participation approaches are highlighted that encourage use of multi-modality communication for daily life activities along with training of communication partners. An interdisciplinary process is emphasized in which many professionals work together to provide individuals with aphasia the maximum benefits in language recovery, communication skills, and meaningful social engagement and quality of life.

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Lanctot, Krista y André Aleman. Apathy. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198841807.001.0001.

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Apathy is characterized by loss of motivation, decreased initiative, and emotional blunting. It is highly prevalent in neurological and psychiatric disorders such as Alzheimer’s disease, traumatic brain injury, schizophrenia, Parkinson’s disease, Huntington’s disease, cerebrovascular disorders, and mild behavioural impairment. It has negative outcomes including impairments in activities of daily living, caregiver burden, and higher rates of institutionalization and mortality. The definition of apathy has changed over the years alongside the development of diagnostic criteria and apathy scales and measurements. Apathy is emerging as a treatment target with interest in pharmacological, non-pharmacological, and neuromodulatory treatments for apathy. There is also an increased understanding of the neurobiology of apathy with functional and structural neuroimaging research studies. This book is a comprehensive, in-depth review from experts in neurology and psychiatry. It examines the current state of apathy in these various disorders while also summarizing apathy diagnostic criteria, scales and measurements, neuropathology, and treatments.

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Brennan, Brian P. y Scott L. Rauch. Functional Neuroimaging Studies in Obsessive-Compulsive Disorder: Overview and Synthesis. Editado por Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0021.

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Studies using functional neuroimaging have played a critical role in the current understanding of the neurobiology of obsessive-compulsive disorder (OCD). Early studies using positron emission tomography (PET) identified a core cortico-striatal-thalamo-cortical circuit that is dysfunctional in OCD. Subsequent studies using behavioral paradigms in conjunction with functional magnetic resonance imaging (fMRI) have provided additional information about the neural substrates underlying specific psychological processes relevant to OCD. More recently, studies utilizing resting state fMRI have identified abnormal functional connectivity within intrinsic brain networks including the default mode and frontoparietal networks in OCD patients. Although these studies, as a whole, clearly substantiate the model of cortico-striatal-thalamo-cortical circuit dysfunction in OCD and support the continued investigation of neuromodulatory treatments targeting these brain regions, there is also growing evidence that brain regions outside this core circuit, particularly frontoparietal regions involved in cognitive control processes, may also play a significant role in the pathophysiology of OCD.

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Brunoni, Andre Russowsky, Bernardo de Sampaio Pereira Júnior y Izio Klein. Neuromodulatory approaches for bipolar disorder: current evidences and future perspectives. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0028.

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Bipolar disorder is a prevalent condition, with few therapeutic options and a high degree of refractoriness. This justifies the development of novel non-pharmacological treatment strategies, such as the non-invasive techniques of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), as well as the invasive techniques of deep brain stimulation (DBS) and vagus nerve stimulation (VNS). In this chapter, we provide a summary of the development of the techniques as well as the studies carried out with patients with bipolar disorder. Although many promising results regarding the efficacy of theses techniques were described, the total number of studies is still low, highlighting the need of further studies in larger samples as to provide a definite picture regarding the use of clinical neuromodulation in bipolar disorder.

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Carvalho, André F. y Eduard Vieta, eds. The Treatment of Bipolar Disorder. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.001.0001.

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Bipolar disorder is a chronic and debilitating mental illness affecting a significant proportion of the world’s population. It is associated with significant impairments in health-related quality of life and psychosocial functioning, and has significant illness-related morbidity and heightened mortality rates due to medical co-morbidities and suicide. The management of this disorder requires a complex combination of pharmacological and psychosocial interventions which can be challenging for clinicians. This book provides readers with a concise and comprehensive guide to the integrative management of bipolar disorder. This resource contains 31 chapters on the various management choices available, from both established and novel treatment areas, such as psychoeducation, psychotherapeutic interventions, neuromodulatory approaches, and novel therapeutic targets. The complexity and diversity of the management choices available makes this a continually evolving field and necessitates forward thinking. By discussing both the current management of bipolar disorder and the future developments available, this book provides all clinicians working with patients with bipolar disorder an up-to-date and reflective guide to its management and what the future holds.

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Beauchaine, Theodore P., Aimee R. Zisner y Elizabeth P. Hayden. Neurobiological Mechanisms of Psychopathology and Treatment Action. Editado por Thomas H. Ollendick, Susan W. White y Bradley A. White. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780190634841.013.54.

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In recent years, it has become increasingly clear that common forms of psychopathology derive from complex interactions among neurobiological vulnerabilities and environmental adversities. These interactions can alter neurobehavioral development to yield progressively intractable forms of psychopathology across childhood and adolescence. This chapter focuses on neurobiological mechanisms of trait impulsivity, trait anxiety, stress reactivity, and emotion regulation/executive function. How these traits confer vulnerability to externalizing disorders, internalizing disorders, heterotypic comorbidity, and heterotypic continuity is described. Next, neurobiological mechanisms of treatment response are considered. Trait impulsivity and trait anxiety are highly heritable and derive initially from subcortical structures that mature early in life. In contrast, emotion regulation and executive function, which modulate trait impulsivity and trait anxiety, are more sensitive to environmental influence and derive from cortical structures that mature into young adulthood. Neurobiological mechanisms of psychosocial treatment response are represented largely in the cortex and its neuromodulatory connections with the subcortex.

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Charlson, Robert W. y Matthew S. Robbins. Migraine and Other Headache Disorders. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0047.

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In recent years, the characterization of the neurobiology of migraine and other headache disorders has been driven by the search to better understand several key factors: genetics, the role of neuromodulators such as calcitonin gene-related peptide (CGRP), processes including central and peripheral sensitization, neurogenic inflammation, central pain networks, and areas of activation demonstrated by advancing functional neuroimaging techniques. Yet the ultimate causes of migraine remain unknown. Nonetheless, recent work has advanced our understanding of this complex disorder, and pointed toward a future where these modalities may provide an integrated understanding of its pathophysiology and provide specific treatment targets.

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Kim, Philip, Leonardo Kapural y Timothy Deer. Diagnosis, Management, and Treatment of Discogenic Pain E-Book : Volume 3: A Volume in the Interventional and Neuromodulatory Techniques for Pain Management Series; Expert Consult Premium Edition -- Enhanced Online Features. Elsevier - Health Sciences Division, 2011.

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Capítulos de libros sobre el tema "Neuromodulatory treatments"

Moellhoff, Nicholas y Sebastian Cotofana. "Anatomical Considerations to Improve Aesthetic Treatments Using Neuromodulators". En Optimizing Aesthetic Toxin Results, 81–92. London: CRC Press, 2022. http://dx.doi.org/10.1201/9781003008132-11.

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Goadsby, P. J. "Neuromodulatory Approaches to the Treatment of Trigeminal Autonomic Cephalalgias (TACs)". En Proceedings of the Medtronic Forum for Neuroscience and Neuro-Technology 2005, 45–47. Berlin, Heidelberg: Springer Berlin Heidelberg, 2007. http://dx.doi.org/10.1007/978-3-540-32746-2_11.

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"74. Nonresective and Neuromodulatory Treatments of Refractory Epilepsy". En Principle and Practice of Pediatric Neurosurgery, editado por Leland Albright, Ian Pollack y David Adelson. Stuttgart: Georg Thieme Verlag, 2015. http://dx.doi.org/10.1055/b-0034-98114.

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Coetzee, John P. y Nolan Williams. "Neuromodulation for Depression". En Depression, editado por Steven D. Hollon, 318–42. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190929565.003.0019.

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Neuromodulation (also known as neurostimulation) is a growing and important category of treatments for depression. First-line treatments such as pharmacotherapy and counseling often fail to achieve remission, and neuromodulation can help many such patients. Neuromodulatory techniques can be broadly divided into invasive approaches, which include deep brain stimulation, epidural cortical stimulation, and vagal nerve stimulation, and noninvasive approaches, which include electroconvulsive therapy, transcranial magnetic stimulation, theta burst stimulation, and transcranial direct-current stimulation, among others. While efficacy varies among techniques, those with the most efficacy tend to be those that target nodes of a proposed tripartate functional connected circuit that includes left dorsolateral prefrontal cortex, subgenual anterior cingulate cortex, and vagus nerve. Treatments currently being developed that hold promise include accelerated intermittent theta burst stimulation and low-intensity focused ultrasound pulsation.

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Witcher, Mark y Thomas L. "Neuromodulatory Treatment of Medically Refractory Epilepsy". En Novel Treatment of Epilepsy. InTech, 2011. http://dx.doi.org/10.5772/18856.

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Hunt, Patrick J., Patrick J. Karas, Ashwin Viswanathan y Sameer A. Sheth. "Cingulotomy for Intractable Pain". En Pain Neurosurgery, 141–48. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190887674.003.0018.

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Chronic pain is a common and often debilitating condition. This pain can be intractable to pharmacologic treatment, thereby necessitating non-pharmacologic approaches. Here we review anterior cingulotomy as a surgical solution to intractable chronic pain, from assessment and planning through the procedure and aftercare. Ablating tissue within the anterior cingulate cortex may allow for the amelioration of the affective aspect of chronic pain. This is especially beneficial to patients with significant psychiatric components to their pain, patients who are unfit for neuromodulatory implants, and patients with terminal diagnoses. Anterior cingulotomy is irreversible and is less commonly used than reversible neuromodulatory approaches. However, anterior cingulotomy remains an important option for patients suffering from intractable chronic pain.

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Angelo-Khattar, Maria. "The Non-Cosmetic Dermatological Use of Botulinum Neurotoxin". En Botulinum Toxin - Recent Topics and Applications [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.102543.

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Botulinum neurotoxin injections are currently the most popular non-surgical cosmetic therapy for treating hyperdynamic lines and rebalancing face muscles all over the world. However, there is emerging interest in the use of the neuromodulator for the treatment of non-cosmetic clinical conditions. The present evidence supporting the use of Botulinum toxin in the treatment of acne and oily skin, rosacea, alopecia areata and androgenic alopecia, scar prevention and therapy, postherpetic neuralgia, hyperhidrosis, and disorders exacerbated by sweating is discussed in this chapter. Case reports and a few randomized controlled trials are used to support the use of Botulinum toxin in several of these illnesses. Nonetheless, the therapeutic application of Botulinum toxin in various skin conditions linked with discomfort, inflammation, and hyperhidrosis has a lot of promise.

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Reuber, Markus, Gregg H. Rawlings y Steven C. Schachter. "Neurologist, Psychiatrist, 20 years’ experience, USA". En Non-Epileptic Seizures in Our Experience, editado por Markus Reuber, Gregg H. Rawlings y Steven C. Schachter, 137–38. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190927752.003.0048.

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This chapter examines the case of a patient with psychogenic non-epileptic seizures (PNES) and moral injury (MI). Identified in some civilian and military personnel, MI occurs in people who commit, witness or fail to prevent acts that transgress deeply held moral beliefs. Since returning from military service, every time he picked up his little boy at home, the patient saw the child who unknowingly stepped out in front of his target, just before he pulled the trigger. He has been seen in the posttraumatic stress disorder clinic and the substance abuse treatment program, as well as groups for veterans who saw combat overseas. None of them have taken away the pain of the core issue: MI. The patient cannot get over the guilt and shame of what he did while deployed. Knowing that no pharmacological or neuromodulatory intervention or treatment manual can provide a cure for this scar makes one question what neurologists, psychiatrists, and therapists really have to offer.

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Devarajan, Jagan y Beth H. Minzter. "Phantom Pain". En Neuropathic Pain, editado por Justin F. Averna, Alexander Bautista, George C. Chang Chien y Michael Saulino, 217–28. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190298357.003.0025.

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This chapter discusses phantom pain, defined as an unpleasant or painful sensation in the distribution of the lost or deafferentiated body part. It is more commonly reported in the limbs but also has been reported in other body parts such as the tongue, teeth, nose, breast, part of the gastrointestinal tract, and the penis. The incidence varies from 42.2% to 78.8%. Perception of non-painful sensations from the amputated body part is known as phantom sensation. The severity and frequency of attacks slowly decrease with time during the first 6 months, after which they remain constant. Patients with significant preoperative pain, stump pain, and infection are at increased risk of developing phantom pain. The mechanism of origin is not known; it is thought to be due to peripheral nerve damage, which contributes to neural sensitization at peripheral, spinal, and supraspinal levels. Both chemical mediators and psychological factors are involved. Phantom pain improves with time and responds to conservative medical management, mirror therapy, and psychological counseling. A small percentage of cases are resistant to treatment and may require invasive neuromodulatory treatment options such as spinal cord stimulation and peripheral nerve stimulation.

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Liu, Bowen, Jun Zhang, Xiaojian Zhou, Shuduan Deng y Guanben Du. "Research Progress on the Health Benefits of Scented Tea". En Health Benefits of Tea - Recent Advances [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.106605.

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Scented tea, also known as fragrant tea, mainly comprises green tea as the tea base and the dried and processed flowers of various plants. It is a unique reprocessed tea in China. There are many types of scented tea, including jasmine, lily, osmanthus, rose and honeysuckle. The scenting process greatly influences the quality of the scented tea. Humidifying continuous scenting processes, frying flower processes and innovative drying methods have been developed to resolve the issues of cumbersome, time-consuming and low utilisation rates of flowers in the process of making scented tea. The main chemical components of scented tea are polyphenols as well as exogenous plant glycosides, flavonoids, lactones, coumarins, quercetin, steroids, terpenoids and other compounds. Scented tea plays an active role in the prevention and treatment of various diseases and has as anti-oxidant, anti-cancer, hypoglycaemic, hypolipidemic, immunomodulatory and neuromodulatory effects. This chapter mainly reviews and summarises the types of scented teas and their related health functions.

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Actas de conferencias sobre el tema "Neuromodulatory treatments"

"METHADONE WITHDRAWAL PSYCHOSIS: A CLINICAL CASE". En 23° Congreso de la Sociedad Española de Patología Dual (SEPD) 2021. SEPD, 2021. http://dx.doi.org/10.17579/sepd2021p132v.

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The purpose of this article is, through a clinical case, to review the literature on psychosis secondary to methadone withdrawal. Observation of the patient and consultation of the clinical file. Non-systematic literature review on methadone use, methadone discontinuation and dual pathology. A 47-year-old male, history of opioid and cannabinoid use disorder, currently in abstinence and under opioid substitution therapy with methadone. After abrupt discontinuation of methadone, he began presenting delusional ideas of jealousy and persecution with multiple delusional interpretations. A diagnosis of persistent delusional disorder was made, and he was medicated with long-term injectable aripiprazole. Methadone is a synthetic opioid agonist used to treat addictions to opioids, such as heroin. Methadone maintenance treatment (MMT) contributes to cessation or reduction of heroin use, reduced risk of HIV and hepatitis virus infections, decreased mortality, improved family and social relationships and employment status. Side effects include dizziness, drowsiness, vomiting, sweating, respiratory depression and prolongation of the QT interval. Other important consequences are precipitation of withdrawal symptoms with consequent relapse to heroin use and withdrawal from MMT. Methadone withdrawal leads to the classic symptoms of opiate withdrawal - abnormalities in vital signs, dilated pupils, agitation, irritability, insomnia, sneezing, nausea and vomiting. In a minority of cases, it can lead to the sudden onset of affective disorders and psychotic disorders. Although scarce, psychotic symptoms after opioid withdrawal have already been described in the literature. Opioids function not only as neurotransmitters, but also as neuromodulators that may be involved in the regulation of the dopaminergic system. An altered neuromodulation of the central opioid-dopamine systems due to long-term MTM may be related to psychotic pathogenesis. Considering the high prevalence of psychiatric comorbidity in patients with substance use disorder, it's important to pay attention and monitor any change in opioid medication, with close observation for possible psychotic symptoms.

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