Chemicals and Drugs Commons^™

Cobenfy(Xanomeline/Trospium) Vs. Clozapine For Treatment-Resistant Schizophrenia, Harmann Singh, Akash M. Patel, Abdullah Noory, Kush C. Patel, Simran Gandhi

Rowan-Virtua Research Day

Background: Treatment-resistant schizophrenia (TRS) poses significant therapeutic challenges. Although clozapine remains the gold-standard pharmacologic treatment for TRS, its clinical utility is hampered by severe side effects and intensive monitoring requirements. KarXT (Cobenfy), a combination of xanomeline and trospium chloride, represents a novel antipsychotic approach by targeting muscarinic M1/M4 receptors instead of dopamine D2 pathways.

Hypothesis: KarXT offers comparable efficacy to clozapine with a more favorable safety and tolerability profile, making it a viable alternative for patients with TRS.

Methods: A systematic review was conducted to identify studies from 2015–2025 evaluating KarXT in schizophrenia. Sources included PubMed, ClinicalTrials.gov, FDA databases, ICER …

Kratom As A Therapeutic Option For Opioid Use Disorder​: A Comprehensive Review​, Harmann Singh, Abdullah Noory, Akash M. Patel, Kush C. Patel, Simran Gandhi

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Kratom (Mitragyna speciosa) has gained significant attention for its potential role in managing opioid use disorder (OUD). This review examines kratom’s pharmacology, safety profile, addiction potential, and ethical considerations in research, while exploring its future as a therapeutic option. Kratom’s primary alkaloids, mitragynine and 7-hydroxymitragynine, act as partial mu-opioid receptor agonists, producing analgesic and sedative effects at higher doses and stimulant-like effects at lower doses. Preclinical and observational studies suggest kratom may alleviate opioid withdrawal symptoms and cravings, but concerns remain regarding its dependency potential and adverse effects, including gastrointestinal distress, hepatotoxicity, and withdrawal symptoms upon cessation. While kratom carries …

Hydralazine-Induced Vasculitis Resulting In Large Pleural Effusion And Progressive Renal Dysfunction, Michael A. Acevedo, Hammad Choudhry

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Hydralazine is a vasodilator commonly used to treat high blood pressure. Even with the safety profile of Hydralazine, it is necessary to know that it may lead to Hydralazine-Induced Vasculitis. Here, we discuss how this rare side effect can present in an 80-year-old female with a past medical history of hypertension who presented to the emergency department with complaints of progressive shortness of breath on exertion and while lying supine. Further evaluation revealed a large right-sided pleural effusion with consolidation at the right lower lobe. The patient’s dyspnea worsened, and the surgical team placed a chest tube. The patient also …

Symptomatic Treatment Of Cannabis Withdrawal Syndrome: A Review Of The Existing Literature, Aria Sen, Dale Shober

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Despite its public reputation as a recreational substance that does not cause physical withdrawal symptoms, cannabis withdrawal syndrome (CWS) was added to the DSM-5 in 2013. Existing research would suggest that almost half of regular cannabis users will experience symptoms such as mood symptoms, insomnia, and gastrointestinal distress. For more than 20 years, the rates of cannabis use have continued to trend upward due to expanding legislation on the recreational use of marijuana. Currently, there are no FDA approved treatments for CWS. Considering this trend, the lack of a well-formed treatment protocol for CWS will have a growing impact on …

Is The Vaping Epidemic Linked To Neurologic Changes And Mental Health Diagnoses Amongst Us Adolescents?, Tracy Lin, Victoria Shwe

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Vaping has significantly increased among U.S. adolescents, driven by the rise of e-cigarettes and flavored pods. Nicotine exposure during brain development is linked to changes in the limbic-dopaminergic system, white matter integrity, and increased risk of emotional and behavioral dysregulation. Higher rates of depression, anxiety, and suicidality are reported among adolescent users, with greater symptom severity seen in those with high vaping dependence. Though studies show correlation rather than causation, findings suggest vaping may contribute to rising mental health diagnoses. Addressing vaping’s neurological and psychological impact is critical to guiding prevention efforts, regulatory policies, and support for at-risk youth.

Transient Small Bowel Intussusception In An Adult Patient: A Rare Complication Of Glp-1 Receptor Agonist Therapy, Shmilah Choudhary, Alisha Vincent, Majid Michael, Sagar Acharya, Christopher Bader

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Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are widely used to treat type 2 diabetes (T2DM) and obesity due to their benefits in glycemic control, weight loss, and cardioprotection. However, their effects on gastrointestinal (GI) motility raise concerns about potential complications, including bowel obstruction and, in rare cases, intussusception. We present a case of a 34-year-old male on semaglutide for weight loss who developed transient small bowel intussusception. The patient has no prior gastrointestinal surgeries or structural abnormalities, but he had a history of baseline slow bowel motility and was also diagnosed with influenza A during his hospitalization. His condition improved …

Identifying Early Presentation Of Serotonin Syndrome In A 20-Year-Old Male Prescribed Clomipramine And Quetiapine: A Case Report, Veronica Alday, Justin Scarano, Jonathan Yuh, Christie Richardson

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Serotonin syndrome, a potentially life-threatening condition, can be challenging to diagnose due to its diverse etiology and varied symptomatology. Despite its severity, serotonin syndrome may present from mild to fatal, with symptoms such as autonomic instability, altered mental status, and neuromuscular excitation (e.g. muscle rigidity, hyperreflexia). Here, we present a 20-year-old male with an extensive psychiatric history who was prescribed clomipramine and developed serotonin syndrome. Few cases of serotonin syndrome have been reported to date, exacerbating the difficulty in recognizing and quickly treating such cases. Cases of serotonin syndrome should continue to be reported, in order to familiarize clinicians with …

Dabigatran Reduced Acute Microgliosis In A Mouse Model With Tbi, Nicholas R. Eltman, Rashmeena Abbasi, Mary C. Kosciuk, Syed Ahmed, Jose L. Pascual, Randel L. Swanson, Nimish K. Acharya

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Objective:

The study objective was to investigate the acute anti-inflammatory effects of dabigatran in a preclinical mouse controlled cortical impact (CCI) model of severe traumatic brain injury (TBI).

Design

Mice were separated into three groups: controlled cortical impact (CCI) with dabigatran (drug treatment, n=5), CCI with saline (positive control, n=5), and sham CCI without saline or dabigatran (negative control, n=3). Dabigatran (80mg/kg) or saline was administered orally at 2, 10, 18, 26, 34, and 42 hours following experimental CCI in the drug treatment or positive control groups, respectively. Animals in the negative control group received sham CCI only. 48h following …

The Anxiolytic Effects Of Ashwagandha Supplementation In Adults With Autism Spectrum Disorder And Anxiety, Jessica Mitchell, Andrea Iannuzzelli, Wendy Aita

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BACKGROUND: The neuroendocrine system activates the hypothalamus-pituitary-adrenal (HPA) axis during stress,1 and individuals with autism spectrum disorder (ASD) may have atypical stress responses linked to HPA axis dysregulation.2 Prolonged activation of this system increases cortisol secretion, the body’s primary stress hormone.3 Withania somnifera (Ashwagandha) is a traditional herbal remedy believed to reduce stress by modulating the HPA axis and lowering cortisol levels.5

HYPOTHESIS: Following four weeks of Ashwagandha supplementation, the treatment group is expected to exhibit reduced cortisol levels, improved Aberrant Behavior Checklist (ABC) scores, and decreased stress-related behaviors, reflecting its anxiolytic effects.

METHODS: Forty-two adult participants with ASD and …

The Use Of Glp-1 Agonists In Alcohol Use Disorder And Reducing Alcohol Consumption: A Scoping Review, Alec Birnbaum, Yashas Sattur, Akash Patel

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Alcohol use disorder (AUD) reigns as one of the most pressing issues in the United States with high rates of complications, morbidity, and mortality. Recent studies have exhibited the potential for Glucagon-Like Peptide-1 (GLP-1) agonists to decrease alcohol cravings or alcohol-related adverse events through human and animal studies via reward and satiety signaling pathways. To investigate the ability of GLP-1 agonists to decrease alcohol use, alcohol cravings, and alcohol-related adverse events, this study conducted a scoping review of the current literature to uncover the potential benefit of GLP-1 agonists in patients with AUD. A systematic search across 6 databases was …

Case Report: A Case Of Transient Dress Syndrome (Drug Rash With Eosinophilia And Systemic Symptoms), Dip Patel, James Espinosa, Alan Lucerna

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We report a case of a 41-year-old female with a history of hypertension who presented with fever and a diffuse erythematous rash after taking trimethoprim-sulfamethoxazole (TMP-SMX) for an ear infection. Due to her symptoms, mild eosinophilia, and elevated liver function tests, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) was suspected. Although the patient’s rash had resolved by the time of initial evaluation, it recurred overnight, reinforcing suspicion for DRESS syndrome. TMP-SMX was discontinued, and acetylcysteine was administered due to the patient’s high-dose use of acetaminophen in the days prior to her hospital presentation. Infectious and autoimmune workups were negative. …

The Impact Of Obesity On The Risk Of Venous Thromboembolism In Users Of Combined Oral Contraceptives: A Comprehensive Literature Review, Adeena Javed

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Background: Combined oral contraceptives (COCs) are a widely used method of birth control in the U.S., particularly among women aged 15–44. COCs are known to increase the risk of venous thromboembolism (VTE). Obesity, which affects over 40% of adult women in the U.S., is also a recognized independent risk factor for VTE. However, the compounded risk posed by the simultaneous presence of obesity and COC use has not been thoroughly explored.

Hypothesis: Obesity significantly elevates the risk of VTE in women using COCs, demonstrating a synergistic interaction between these two factors.

Methods: A systematic literature review was conducted using PubMed, …

Exploring Anticoagulant Prescription Disparities: A Focus On Hispanic Patient Care, Michael Acevedo, Vanessa Veltre

Rowan-Virtua Research Day

Anticoagulants play a critical role in preventing thromboembolic events, yet disparities persist in their prescription among minority populations. This presentation explores inequities in anticoagulant prescribing patterns, with a specific focus on Hispanic patient care. Using retrospective electronic health record data, we analyzed the prescription rates of warfarin versus direct oral anticoagulants (DOACs) among adults with clinical indications for anticoagulation. Our findings reveal that Hispanic patients are significantly less likely to receive DOACs compared to non-Hispanic White patients, even after adjusting for demographics, comorbidities, and insurance status. Contributing factors include language barriers, lack of insurance, and potential implicit bias in provider …

Literature Review: Prazosin Used For Ptsd In Pregnancy, Afshan Khan, Natali Sharma, Rebekah M. Dietrich, Martin Forsberg

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Posttraumatic Stress Disorder (PTSD) affects 3–4% of pregnant and postpartum individuals and is associated with complications such as preterm birth, low birth weight, and postpartum depression. Pharmacologic treatment options during pregnancy are limited by concerns about fetal safety.

Methods: A literature review was conducted focusing on studies reporting maternal or neonatal outcomes following prazosin exposure in pregnancy.

Results: One observational study of 11 pregnancies found 54.5% had uneventful outcomes, with rates of preterm birth, miscarriage, and preeclampsia similar to the general population. Hypotension and limited lactation data remain concerns.

Conclusion: Early evidence suggests prazosin may be a relatively safe and …

Pain Management In Pregnant Women With Opioid Use Disorder: A Systematic Review, Adeena Javed

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Background: The prevalence of opioid use disorder (OUD) among pregnant individuals has risen significantly, posing challenges in managing labor and postpartum pain. Factors such as opioid tolerance, opioid-induced hyperalgesia, and concerns about relapse complicate analgesic strategies. Despite these complexities, evidence-based guidelines for pain management in this population remain limited.

Hypothesis: Pregnant women with OUD experience disparities in pain management during labor and postpartum periods, leading to suboptimal outcomes.

Methods: A systematic review was conducted, analyzing peer-reviewed studies from databases including PubMed and Embase. Inclusion criteria encompassed studies focusing on pain management in pregnant women with OUD. Data extraction focused on …

Radiofrequency Ablation Versus Naproxen For The Management Of Ankylosing Spondylitis: A Comparative Analysis, Akash Manish Patel, Alec Birnbaum, Yashas Sattur

Rowan-Virtua Research Day

Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by inflammation primarily affecting the spinal vertebrae and sacroiliac joints, leading to pain, stiffness, and progressive loss of spinal mobility.

Management typically focuses on alleviating symptoms and controlling inflammation to improve patient quality of life. In this study, we compared the efficacy of two common treatment modalities: radiofrequency ablation (RFA) and naproxen. RFA is a minimally invasive procedure that targets specific nerve endings to interrupt pain signals, whereas naproxen is a non-steroidal anti-inflammatory drug (NSAID) used to reduce inflammation and provide symptomatic relief. Our systematic review involved a cohort of AS …

Effects Of The Non-Stimulant Norepinephrine Reuptake Inhibitor, Atomoxetine, On Cognitive Flexibility In Healthy Adult Long-Evans Rats, Noah A. Ivak, Samantha Walkow, Christopher Knapp, Eleni Papadopoulos, Barry D Waterhouse, Rachel L Navarra

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Executive function is the control of multiple higher order cognitive processes that include attention, working memory, and cognitive flexibility. Cognitive flexibility is the ability to shift behavioral strategies

in response to changing environmental demands and task complexity. This cognitive modality is often impaired in many neuropsychiatric disorders like attention deficit hyperactivity disorder (ADHD). Deficits in cognitive flexibility are associated with dysregulation of the catecholamines, norepinephrine (NE) and dopamine (DA) within the prefrontal cortex (PFC). Atomoxetine (ATX), a non-stimulant NE reuptake inhibitor, elevates levels of NE and DA in the PFC by inhibiting the norepinephrine transporter (NET). ATX is used to …

Polypharmacy As A Treatment Barrier In Autism Spectrum Disorder, Ahmed Aly

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The purpose of the study is to assess the prevalence of polypharmacy in current literature in the Autism Spectrum Disorder (ASD) population. It is hypothesized to find patients with ASD over prescribed compared to the neurotypical counterparts.

Examining The Relationship Between Sleep Habits And Caffeine Consumption, Daniel Calaff, Rachel Pruchno

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Sleep is essential for cognitive function, mood regulation, immune defense, and metabolic health. Despite widespread caffeine use, its impact on sleep remains debated. It was initially hypothesized that higher caffeine consumption would correlate with greater sleep disturbances. This study explored the relationship between caffeine consumption and sleep habits in a general adult population using a Qualtrics-based self-report survey. Participants (n=93) reported average hours slept per night, time to fall asleep, and number of nighttime awakenings. Caffeine consumption was calculated based on reported intake and categorized into four dosage groups. Sleep outcomes were statistically compared using ANOVA, t-tests, and Pearson correlation. …

The Correlation Between A Methylenetetrahydrofolate Reductase Deficiency In Autism Spectrum Disorder Patients And The Presence Of Mental Health Disorders, Hinal Joshi, Andrea Iannuzzelli

Rowan-Virtua Research Day

• Currently little literature exists on connection between Methylenetetrahydrofolate reductase (MTHFR) deficiency and mental health disorders

• Reduced enzyme activity associated with certain MTHFR variants contributes to altered folate metabolism, elevated homocysteine levels, and disrupted DNA methylation, all of which are implicated in mental health disorders

• Identifying genetic risk factors could facilitate earlier diagnosis and intervention, leading to improved outcomes

• Relevant results could help reduce stigma and promote greater understanding of challenges faced by patients on the spectrum