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Rebecca Schennach, Michael Riedel, Ilja Spellmann, Richard Musil, Michael Obermeier, Markus Jäger, Roland Bottlender, Max Schmauss, Gerd Laux, Hans-Jürgen Möller
INTRODUCTION: The aim of this double-blind randomized study was to evaluate the response to antipsychotic treatment in schizophrenia patients with predicted high/low risk of nonresponse identified by applying a set of well-established scales and predictors of outcome and to compare efficacy between ziprasidone and haloperidol. METHODS: One hundred twelve schizophrenia patients (ziprasidone: n=54; haloperidol: n=58) were rated weekly on the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), the Global Assessment of Functioning Scale (GAF), the Social and Occupational Functioning Scale (SOFAS), the Simpson-Angus Scale (SAS), and Hillside Akathisia Scale (HAS)...
September 20, 2018: Pharmacopsychiatry
Ewa Kurczewska, Ewa Ferensztajn-Rochowiak, Anna Jasińska-Mikołajczyk, Maria Chłopocka-Woźniak, J K Rybakowski
INTRODUCTION: The aim was to assess the efficacy of total sleep deprivation (TSD) with sleep phase advance (SPA) in treatment-resistant depression (TRD) and associated biochemical factors. METHODS: We studied nine males and 12 females, aged 49±14 years, with treatment-resistant unipolar or bipolar depression, receiving antidepressant and mood-stabilizing drugs. The four-day schedule included single TSD and three consecutive nights with SPA. Biochemical markers were measured on the day before and on 1st, 7th and 14th day after the TSD...
September 10, 2018: Pharmacopsychiatry
Konstantinos N Fountoulakis, Vangelis Karavelas, Stefania Moysidou, Dimitris Mavridis, Konstantinos Pastiadis, Nicole Petalidou, Ioannis Nimatoudis, Siegfried Kasper
INTRODUCTION: This study tests the efficacy of pregabalin versus placebo as adjunctive treatment in patients with generalized anxiety disorder (GAD) comorbid with unipolar major depression (UMD) and with an early nonresponse to escitalopram. METHODS: This is a double-blind, placebo-controlled 8-week add-on study of pregabalin, 75-600 mg/day (n=31) versus placebo (n=29) on open-label escitalopram in outpatients meeting the DSM-IV-TR criteria for GAD and UMD. The main outcome measures were change from baseline to endpoint in total STAI-S, Trail-Making Test B (TMT-B) and the Center of Epidemiological Studies Depression Scale (CES-D)...
August 31, 2018: Pharmacopsychiatry
Pedro Oliveira, Manuel Coroa, Nuno Madeira
BACKGROUND: Insomnia is a common feature of schizophrenia. Although several studies have been published about the influence of certain drugs on schizophrenia patients' sleep, there are no well-grounded recommendations about insomnia treatment in this clinical setting. The present review aimed to identify relevant empirical evidence on available treatments of insomnia in patients with schizophrenia, assessing their safety and efficacy. METHODS: This is a systematic review of clinical trials investigating the effect of treatments for insomnia in patients with a diagnosis of schizophrenia...
July 30, 2018: Pharmacopsychiatry
Michael Bauer, A John Rush, Roland Ricken, Maximilian Pilhatsch, Mazda Adli
In spite of multiple new treatment options, chronic and treatment refractory courses still are a major challenge in the treatment of depression. Providing algorithm-guided antidepressant treatments is considered an important strategy to optimize treatment delivery and avoid or overcome treatment-resistant courses of major depressive disorder (MDD). The clinical benefits of algorithms in the treatment of inpatients with MDD have been investigated in large-scale, randomized controlled trials. Results showed that a stepwise treatment regimen (algorithm) with critical decision points at the end of each treatment step based on standardized and systematic measurements of response and an algorithm-guided decision-making process increases the chances of achieving remission and optimizes prescription behaviors for antidepressants...
July 9, 2018: Pharmacopsychiatry
Emanuel Severus, Cathrin Sauer, Michael Bauer, Michael Ostacher, Ion-George Anghelescu
INTRODUCTION: Randomized, double-blind, placebo-controlled trials were developed to draw rather unbiased conclusions regarding the efficacy of antidepressants in the treatment of a major depressive episode (internal validity), mostly with the purpose of formal approval of new compounds in this indication. However, at the same time, data suggest that the very process of randomization and blinded administrations of placebo will have a significant impact on the efficacy of the antidepressant tested and therefore may limit the external validity of results obtained from this type of studies...
July 5, 2018: Pharmacopsychiatry
Laura Kranaster, Johanna Badstübner, Suna Su Aksay, Jan Malte Bumb, Rayan Suliman, Michael Neumaier, Alexander Sartorius
Electroconvulsive therapy (ECT) is a remarkably safe procedure. However, there might exist a subgroup of patients with an increased risk for cardiovascular events. The cardiac-specific enzymes high-sensitive cardiac troponin I (hscTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured before and after ECT in 23 patients. No relevant increase of hscTnI after ECT was found. Mean NT-proBNP levels were higher after ECT and in three patients a new NT-proBNP elevation after ECT was identified...
July 2, 2018: Pharmacopsychiatry
Frank Bellivier, Cynthia Marie-Claire
Lithium (Li) is the key mood stabilizer in the prevention of mood recurrences and suicide in bipolar disorders. However, only one-third of patients become asymptomatic with Li treatment, and to date, no clinical markers can predict this response variability. Li is a multitargeting drug, complicating an understanding of its mechanisms of action. The present article reviews Li's various biological effects, including those obtained in transcriptomic and epigenetic studies, in both humans and animal models. A molecular signature of the therapeutic response to Li is urgently required, including possibly from the circulation...
September 2018: Pharmacopsychiatry
Michael Bauer
No abstract text is available yet for this article.
September 2018: Pharmacopsychiatry
Werner Felber, Michael Bauer, Ute Lewitzka, Bruno Müller-Oerlinghausen
Although lithium's serendipitous discovery as a medication for depression dates back more than 200 years, the first scientific evidence that it prevents mania and depression arose only in the 1960s. However, at that time there was a lack of knowledge about how to administer and monitor lithium therapy safely and properly. The lithium clinics in Dresden and Berlin were remarkably similar in their beginnings in the late 1960s regarding patient numbers and scientific expertise without being aware of one another due to the Iron Curtain separating Germany into a western and eastern part until 1990...
September 2018: Pharmacopsychiatry
Emanuel Severus, Michael Bauer, John Geddes
For more than 40 years, lithium has been the gold standard in the long-term treatment of bipolar disorders. In the course of the last 15 years, other drugs have been approved in this indication and are widely used in clinical practice at the expense of lithium. New research from the last few years, however, indicates that lithium is still the first-line treatment in this indication. Against this background and lithium's proven acute antimanic efficacy, we should perhaps be using lithium more regularly (in combination with an atypical antipsychotic, if necessary) right from the start for the acute treatment of a manic episode and, once remission has been achieved and euthymia maintained during continuation treatment, to regularly taper off the atypical antipsychotic, if possible, and continue with lithium as monotherapy for prophylactic treatment...
September 2018: Pharmacopsychiatry
Marylou Selo
No abstract text is available yet for this article.
September 2018: Pharmacopsychiatry
Leonardo Tondo, Ross J Baldessarini
INTRODUCTION: Suicidal behavior is strongly associated with depression in major depressive (MDD) and bipolar (BD) disorders, especially with associated behavioral activation, dysphoria, or agitation. A rare intervention with evidence of suicide risk-reducing as well as mood-stabilizing effects in mood disorder patients is lithium. METHODS: We reviewed available research evidence on associations of long-term treatment with lithium with risk of suicidal behavior. We meta-analyzed 12 randomized trials in 10 reports (with at least 1 suicide in either treatment arm) including both BD and MDD subjects, with particular attention to comparisons of lithium with placebo or other pharmacological treatments...
September 2018: Pharmacopsychiatry
Sergi Papiol, Thomas G Schulze, Martin Alda
INTRODUCTION: Lithium remains the best-established long-term treatment for bipolar disorder because of its efficacy in maintaining periods of remission and reducing the risk of suicide. Not all patients successfully respond to lithium treatment, and the individual response, including the occurrence of side effects, is highly variable and not easy to predict. The genetic basis of lithium response is supported by the fact that the response clusters in families. Likewise, recent high-throughput genomic analyses have shed light on its genetic architecture...
September 2018: Pharmacopsychiatry
Gin S Malhi
No abstract text is available yet for this article.
September 2018: Pharmacopsychiatry
Anne Duffy, Paul Grof
INTRODUCTION: There is a resurgence of interest in lithium treatment of bipolar disorders in part related to its unique anti-suicidal and neuroprotective effects. METHODS: This is a narrative review of key studies pertaining to the effectiveness and tolerability of lithium treatment in pediatric populations. RESULTS: Evidence supports that lithium is an effective and generally well-tolerated acute treatment for pediatric mania compared to placebo...
September 2018: Pharmacopsychiatry
René Ernst Nielsen, Lars Vedel Kessing, Willem A Nolen, Rasmus W Licht
INTRODUCTION: Lithium is established as an effective treatment of mania, of depression in bipolar and unipolar disorder, and in maintenance treatment of these disorders. However, due to the necessity of monitoring and concerns about irreversible adverse effects, in particular renal impairment, after long-term use, lithium might be underutilized. METHODS: This study reviewed 6 large observational studies addressing the risk of impaired renal function associated with lithium treatment and methodological issues impacting interpretation of results...
September 2018: Pharmacopsychiatry
Janusz K Rybakowski, Aleksandra Suwalska, Tomas Hajek
Evidence for a neuroprotective effect of lithium has accumulated over the last 2 decades, and this phenomenon has been regarded as an important mechanism of lithium action in mood disorders. It has been reflected by an increase in cerebral gray matter volume in lithium-treated subjects and by the favorable influence of lithium on cognitive functions. A neuroprotective effect of lithium also makes this ion a possible candidate for use as a therapeutic drug in neurology, especially in neurodegenerative disorders...
September 2018: Pharmacopsychiatry
Michael J Gitlin
No abstract text is available yet for this article.
September 2018: Pharmacopsychiatry
Adam Kroc, Marta Dębicka, Aleksandra Wierzbicka, Lidia Wołkow, Wojciech Jernajczyk, Adam Wichniak
INTRODUCTION: One of the common side effects of antipsychotic drugs is excessive sedation. The treatment with antipsychotics often manifests as an increase in slow wave activity in electroencephalography (EEG). The aim of this study was to analyze EEG recordings of patients treated with a non-sedative antipsychotic drug sertindole with regard to its adverse effects and clinical efficacy. PATIENTS AND METHODS: EEG recordings of 45 patients (27 females, mean age 30...
July 2018: Pharmacopsychiatry
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