Opioids/Benzos, FDA Approvals, and TMS + CBT

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Opioids and Benzodiazepines May Be Doing More Harm Than Good

Andrei Dokukin, M.D. - Medical Director at Roots Through Recovery and President of the American Society of Hirudotherapy

It is well documented and explained elsewhere, that any time there is an attempt to introduce opioid or GABA receptor agonists to the brain, the brain will modify these receptors function to counteract the excess stimulation by these psychoactive drugs. Excessive opioid receptor agonism leads to opioid induced hyperalgesia, and excessive GABA stimulation leads to counter-production of CNS stimulants. Tolerance to these exogenous substances usually leads to dose escalation.

Over 6% of Americans are addicted to opioids and various sedatives. Over 15% of the general human population is at risk of developing an addiction to psychoactive substances during lifetime. In classical medical school and residency education, physicians rarely receive any education on fundamentals of addiction physiology, psychology, and pharmacology. Most doctors who initiate treatment with these medications do not even know how to assess a patient if they are at risk of potentially developing an addiction.

It is clear, that opioids and tranquilizers only very temporarily help with symptoms, and they do not address the underlying cause of pain or anxiety. So, what kind of medicine do we continue to practice as a medical community? We advise our patients to pursue temporary symptom relief never to address the underlying causes of their complaints while destroying many lives in the process of doing so. Is this the type of care that any of us expect from our own doctor?

FDA Approves Tecentriq Hybreza

Emily VonAldenbruck - Biotech & Cancer Content Creator, Florida Atlantic University

Genentech has achieved a significant milestone with the FDA approval of Tecentriq Hybreza, the first subcutaneous formulation of an anti-PD-L1 (programmed death-ligand 1) immunotherapy. This innovative approach opens up new possibilities for improving cancer treatment, particularly for patients with non-small cell lung cancer (NSCLC) and urothelial carcinoma (bladder cancer).

Cancer cells often exploit the PD-L1/PD-1 pathway to evade detection by the immune system. PD-L1 is a protein expressed on the surface of some tumor cells that binds to the PD-1 receptor on T-cells, effectively switching off the immune response.

Tecentriq Hybreza, an anti-PD-L1 monoclonal antibody, blocks PD-L1/PD-1 pathway interaction. By inhibiting this pathway, it reactivates T-cells, empowering the immune system to recognize and destroy tumor cells.

What sets Tecentriq Hybreza apart from traditional PD-L1 inhibitors is its subcutaneous (SC) administration. With the new subcutaneous formulation, Tecentriq Hybreza can be administered in a matter of minutes—a significant improvement in convenience for both patients and healthcare providers.

Key advantages of the subcutaneous delivery method include:

• Quicker administration
• Improved patient comfort
• Potential for fewer systemic side effects

This approval of Tecentriq Hybreza represents a significant leap forward in the field of cancer immunotherapy, marking the first step in what could be a broader shift toward subcutaneous cancer treatments. As we continue to improve how therapies are delivered, the hope is that these advances will not only enhance patient outcomes but also increase the quality of life for those undergoing long-term cancer treatment.

How TMS and CBT Work Together

Nicolas Hubacz, M.S. - Business Development Manager at Magstim and Founder of NH Sponsorships

At the core of Cognitive Behavioral Therapy (CBT) is the idea that our thoughts, emotions, and behaviors are interconnected. By challenging negative thought patterns, CBT helps individuals create healthier cognitive pathways. Meanwhile, Transcranial Magnetic Stimulation (TMS) stimulates specific brain areas involved in mood regulation, such as the dorsolateral prefrontal cortex (DLPFC), which is often underactive in people with depression.

When used together, TMS boosts the brain's ability to engage in cognitive restructuring, priming neural circuits that help regulate attention, emotions, and executive functioning. Essentially, TMS helps the brain become more receptive to the cognitive changes that CBT promotes. ??

Mechanisms at Play:

?? Neuroplasticity: TMS increases neuroplasticity, or the brain’s ability to form new neural connections. This makes the brain more adaptable during CBT sessions, allowing patients to shift their negative thinking patterns more easily.

?? Targeted Brain Stimulation: By stimulating the DLPFC, TMS reduces emotional reactivity from the amygdala and improves cognitive control. This helps patients apply the strategies they learn in CBT by better managing emotional responses.

? Timing and Reinforcement: TMS can be administered before or after CBT. Pre-CBT TMS can prime the brain for cognitive therapy, while post-CBT TMS helps solidify new neural connections formed during therapy.

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