Current Medicinal Chemistry - Volume 29, Issue 35, 2022

Background: Obsessive-compulsive disorder is a highly debilitating psychiatric disorder with a high rate of treatment resistance. Biomarkers for obsessive-compulsive disorder may assist clinicians by predicting response to treatments and prognosis. Objective: The aim of the study was to review the literature with regards to two of the more easily ascertainable and relatively inexpensive physiological biomarkers, i.e., heart rate variability and electroencephalography. Methods: A narrative review of the literature was conducted. Results: Decreased heart rate variability has been associated with increased symptom severity of obsessive-compulsive disorder. Findings from electroencephalography have also predicted response to pharmacotherapy and it is likely that biomarkers for OCD will have their greatest utility in predicting response to different pharmacological agents. However, the number of studies is small and results are inconsistent. Conclusion: More research is required to determine whether heart rate variability and electrophysiological studies play a clinical role as biomarkers for obsessive-compulsive disorder.

Introduction: Since insomnia and disturbed sleep may affect neuroplasticity, we aimed at reviewing their potential role as markers of disrupted neuroplasticity involved in mood disorders. Methods: We performed a systematic review, according to PRIMA, on PubMed, PsycINFO and Embase electronic databases for literature regarding mood disorders, insomnia, sleep loss/deprivation in relation to different pathways involved in the impairment of neuroplasticity in mood disorders such as (1) alterations in neurodevelopment (2) activation of the stress system (3) neuroinflammation (4) neurodegeneration/neuroprogression, (5) deficit in neuroprotection. Results: Sixty-five articles were analyzed and a narrative/ theoretical review was conducted. Studies showed that insomnia, sleep loss and sleep deprivation might impair brain plasticity of those areas involved in mood regulation throughout different pathways. Insomnia and disrupted sleep may act as neurobiological stressors by over-activating the stress and inflammatory systems, which may affect neural plasticity causing neuronal damage. In addition, disturbed sleep may favor a deficit in neuroprotection hence contributing to impaired neuroplasticity. Conclusion: Insomnia and disturbed sleep may play a role as markers of alteration in brain plasticity in mood disorders. Assessing and targeting insomnia in the clinical practice may potentially play a neuroprotective role, contributing to “repairing” alterations in neuroplasticity or to the functional recovery of those areas involved in mood and emotion regulation.

With what has become increasingly common among nearly all medical specialties, the number of patients who have various comorbid diseases both psychiatrically and mentally challenges the field of psychiatry. As a result, it is not uncommon for physicians to be imposed with treatment decisions regarding polypharmacy, the use of multiple medications to treat different diseases, or even the same illness several times. In recent years, the concept of polypharmacy has been known to have a negative undertone, implying that its use is inappropriate or causes more harm than the potential benefit. Although the use of any medication should involve risk versus benefit discussion, when used with good clinical judgment and pharmacologically sound knowledge, this practice can be potentially life-altering for patients.

Background: Oxytocin is a nonapeptide synthesized in the paraventricular and supraoptic nuclei of the hypothalamus. Historically, this molecule has been involved as a key factor in the formation of infant attachment, maternal behavior and pair bonding and, more generally, in linking social signals with cognition, behaviors and reward. In the last decades, the whole oxytocin system has gained a growing interest as it was proposed to be implicated in etiopathogenesis of several neurodevelopmental and neuropsychiatric disorders. Methods: With the main goal of an in-depth understanding of the oxytocin role in the regulation of different functions and complex behaviors as well as its intriguing implications in different neuropsychiatric disorders, we performed a critical review of the current state of the art. We carried out this work through the PubMed database up to June 2021 with the search terms: 1) “oxytocin and neuropsychiatric disorders”; 2) “oxytocin and neurodevelopmental disorders”; 3) “oxytocin and anorexia”; 4) “oxytocin and eating disorders”; 5) “oxytocin and obsessive- compulsive disorder”; 6) “oxytocin and schizophrenia”; 7) “oxytocin and depression”; 8) “oxytocin and bipolar disorder”; 9) “oxytocin and psychosis”; 10) “oxytocin and anxiety”; 11) “oxytocin and personality disorder”; 12) “oxytocin and PTSD”. Results: Biological, genetic, and epigenetic studies highlighted quality and quantity modifications in the expression of oxytocin peptide or in oxytocin receptor isoforms. These alterations would seem to be correlated with a higher risk of presenting several neuropsychiatric disorders belonging to different psychopathological spectra. Collaterally, the exogenous oxytocin administration has shown to ameliorate many neuropsychiatric clinical conditions. Conclusion: Finally, we briefly analyzed the potential pharmacological use of oxytocin in a patient with severe symptomatic SARS-CoV-2 infection due to its anti-inflammatory, antioxidative and immunoregulatory properties.