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International Clinical Psychopharmacology

Naomi A Fineberg, David S Baldwin, Lynne M Drummond, Solange Wyatt, Jasmine Hanson, Srinivas Gopi, Sukhwinder Kaur, Jemma Reid, Virender Marwah, Ricky A Sachdev, Ilenia Pampaloni, Sonia Shahper, Yana Varlakova, Davis Mpavaenda, Christopher Manson, Cliodhna O'Leary, Karen Irvine, Deela Monji-Patel, Ayotunde Shodunke, Tony Dyer, Amy Dymond, Garry Barton, David Wellsted
Established treatments for obsessive compulsive disorder (OCD) include cognitive behaviour therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication. Combined treatment may outperform monotherapy, but few studies have investigated this. A total of 49 community-based adults with OCD were randomly assigned to CBT, SSRI, or SSRI+CBT. Sertraline (50-200 mg/day) was given as the SSRI for 52 weeks. A 16-h-manualized individual CBT was delivered over 8 weeks with four follow-up sessions. Assessors were 'blinded' to treatment allocation...
August 15, 2018: International Clinical Psychopharmacology
YongHwan Kim, Young Sook Lee, Myeong Gyu Kim, Yun-Kyoung Song, Youngwon Kim, Hayoung Jang, Jae Hyun Kim, Nayoung Han, Eunhee Ji, In-Wha Kim, Jung Mi Oh
It has been reported that selective serotonin reuptake inhibitors (SSRIs) might induce major adverse cardiovascular events (MACE), but the association between the use of SSRIs and MACE has not been elucidated as yet. Therefore, the aim of this study was to evaluate the association between the use of SSRIs and MACE in depressed patients with previous cardiovascular events. Two researchers independently selected randomized-controlled studies (RCTs) according to the predefined inclusion criteria and evaluated the quality of articles...
August 9, 2018: International Clinical Psychopharmacology
Julia Dehning, Heinz Grunze, Michaela Walpoth-Niederwanger, Georg Kemmler, Armand Hausmann
Antipsychotics (AP) are commonly used in the treatment of bipolar disorder. They cover a broad spectrum of indications including acute psychotic, manic and depressive symptoms, and maintenance treatment. This study evaluates the changes in prescribing patterns of first-generation antipsychotics (FGA) and second-generation AP at Innsbruck University Hospital for the treatment of bipolar inpatients between 1999 and 2016. In this retrospective chart review, we included adult patients with a diagnosis of bipolar affective disorder (ICD 9: F296; ICD 10: F31) who were admitted as inpatients at the Department for Psychiatry and Psychotherapy between 1999 and 2016 for more than 7 days...
August 8, 2018: International Clinical Psychopharmacology
Maurizio Fava, Suresh Durgam, Willie Earley, Kaifeng Lu, Robert Hayes, István Laszlovszky, György Németh
This 19-week, double-blind, placebo-controlled, randomized phase 2 study evaluated the efficacy, safety, and tolerability of adjunctive cariprazine (0.1-0.3 and 1.0-2.0 mg/day) as an antidepressant treatment for adults with treatment-resistant major depressive disorder (MDD) (NCT00854100). The primary endpoint was change in the Montgomery-Åsberg Depression Rating Scale (MADRS) total score and the secondary was change in the Clinical Global Impression-Intensity score. Additional efficacy parameters were also assessed...
July 24, 2018: International Clinical Psychopharmacology
Suresh Durgam, Carl Gommoll, Raffaele Migliore, Changzheng Chen, Cheng-Tao Chang, Michelle Aguirre, Michael E Thase
This randomized withdrawal study assessed relapse prevention with vilazodone in adults with major depressive disorder. After 20 weeks of open-label treatment with vilazodone 40 mg/day, responders were randomized (1 : 1 : 1) to 28 weeks of double-blind, fixed-dose treatment with vilazodone 20 mg/day, vilazodone 40 mg/day, or placebo. The primary efficacy endpoint was time to first relapse, defined as Montgomery-Åsberg Depression Rating Scale total score of at least 18 and meeting major depressive episode criteria, Montgomery-Åsberg Depression Rating Scale total score of at least 18 at two consecutive visits, or discontinuation for an insufficient therapeutic response...
July 23, 2018: International Clinical Psychopharmacology
Georgios Schoretsanitis, Ekkehard Haen, Christoph Hiemke, Bianca Fay, Sandra Unholzer, Christoph U Correll, Gerhard Gründer, Michael Paulzen
We assessed the effect of body weight and BMI on plasma concentrations of venlafaxine (VEN), O-desmethylvenlafaxine (ODVEN), active moiety (AM=VEN+ODVEN), and dose-corrected plasma concentrations (C/D). A database containing concentrations of VEN and ODVEN including 737 of 1594 eligible patients was analyzed. Analyses included sex, body weight, and BMI as well as concentrations of VEN, ODVEN, AM, and C/D. A positive correlation was detected between body weight and daily dosage (rs=0.168, P<0.001). A negative correlation was found between body weight and AM (rs=-0...
July 18, 2018: International Clinical Psychopharmacology
Philipp Hessmann, Jan Zeidler, Sarah Neubauer, Mona Abdel-Hamid, Jona Stahmeyer, Sveja Eberhard, Claus Wolff-Menzler, Jens Wiltfang, Bernhard Kis
Long-term treatment with benzodiazepines (BZD) should be avoided in dementia patients because of an increased risk of adverse events. We evaluated how continuously dementia patients were prescribed BZD over 12 months. For this observational study, we used claims data from a large German public sickness fund for 2014 and 2015, including patients with an incident diagnosis of dementia in 2014. The aim was to evaluate the continuity of treatment, the frequency of BZD prescriptions and defined daily doses were evaluated...
September 2018: International Clinical Psychopharmacology
Arif Khan, Kaysee Fahl Mar, Walter A Brown
In this paper we review the history of antidepressant (AD) development, since the discovery of imipramine in 1957 to the present day. Through this exploration we will show that the increasing placebo response is likely a red herring and that a higher magnitude of placebo response is not an adequate explanation for AD trials' high failure rates. As a better explanation for their lack of success, we will examine some of the fundamental flaws of AD clinical trials and their origins in historical forces. We focus on underpowering, which occurs as a consequence of unrealistic expectations for AD performance...
September 2018: International Clinical Psychopharmacology
Kaitlyn Victor, Megan Skelly, Kimberly Mulcahy, Tammie Lee Demler, Eileen Trigoboff
In April 2016, the US Preventive Service Task Force (USPSTF) updated the aspirin guidelines for the primary prevention of cardiovascular disease (CVD) and colorectal cancer. This review assesses the importance of appropriate use of aspirin for the primary prevention of CVD and, specifically, how individuals with psychiatric disorders may benefit from such use. This study examined how current prescribing practices of aspirin in a state psychiatric hospital align with these new guidelines and how inappropriate prescribing may jeopardize patient safety...
September 2018: International Clinical Psychopharmacology
Alexandre González-Rodríguez, Francesc Estrada, José A Monreal, Diego Palao, Javier Labad
This review aimed to examine and analyse the definitions used for antipsychotic response in delusional disorder (DD) and to provide a discussion of the methodology used. A systematic review was performed using the PubMed, Scopus and PsycINFO databases (1990-October 2017) according to the PRISMA statement. In addition, reference searches were performed manually through identified studies to obtain other relevant articles. The search terms included 'antipsychotic response', 'antipsychotics', 'treatment response' and 'delusional disorder'...
September 2018: International Clinical Psychopharmacology
Catherine Weiss, Emmanuelle Weiller, Ross A Baker, Ruth A Duffy, Keva K Gwin, Peter Zhang, Robert D McQuade
The aim of this analysis was to explore the effects of brexpiprazole and aripiprazole on body weight when used as monotherapy to treat schizophrenia and as adjunctive treatment to antidepressant treatment (ADT) for major depressive disorder (MDD) in short-term (4/6 weeks) and long-term (≤52 weeks) studies. Body weight data were obtained from the clinical studies of each drug (brexpiprazole and aripiprazole), in schizophrenia and adjunctive treatment of MDD. Data were pooled and analyzed to assess the mean change in body weight and to determine the incidence of a clinically relevant change in body weight from baseline (≥7% increase or decrease, at any time) in each treatment group...
September 2018: International Clinical Psychopharmacology
Michelle S Parris, Julia E Marver, Sadia R Chaudhury, Steven P Ellis, Allison V Metts, John G Keilp, Ainsley K Burke, Maria A Oquendo, Joseph J Mann, Michael F Grunebaum
It is unclear whether anxiety increases or decreases suicidal risk. This may contribute to the lack of guidance on which antidepressant medications are best for suicidal depressed patients who present with high anxiety. This study explored whether anxiety predicts suicidal ideation in depressed individuals treated with paroxetine or bupropion. An 8-week double-blind trial comparing controlled-release paroxetine (N=36) versus extended-release bupropion (N=38) for effect on suicidal ideation and behavior in depressed patients with suicidal ideation, past attempt, or both found an advantage for paroxetine, but anxiety effects were not investigated...
September 2018: International Clinical Psychopharmacology
Emily Leppien, Tammie Lee Demler
Not all psychiatric inpatients who are candidates for statin therapy are prescribed statin medication. It is unclear whether this is because of prescriber guideline uncertainty or purposeful avoidance because of other reasons. This study aims to determine prescribers' perceptions of recent cholesterol treatment guidelines, and whether their prescribing may be influenced by recent, potentially oversimplified headlines in the media.
September 2018: International Clinical Psychopharmacology
Cynthia El Hage, Maykel F Ghabrash, Simon Dubreucq, Suzanne Brissette, François Lespérance, Paul Lespérance, Clairélaine Ouellet-Plamondon, Julie Bruneau, Didier Jutras-Aswad
Depression is one of the most prevalent psychiatric disorders among opioid-dependent individuals. Clinical trials testing selective serotonin reuptake inhibitors among depressed patients on methadone maintenance therapy (MMT) failed to show efficacy, whereas those on tricyclic antidepressants produced mixed results with potential for cardiotoxicity. Desvenlafaxine (DESV) is a SNRI with minimal cardiotoxicity and drug interactions. This study sought to assess feasibility and tolerability of using DESV in depressed patients on MMT...
September 2018: International Clinical Psychopharmacology
Hila Z Gvirts, Yael D Lewis, Shira Dvora, Kfir Feffer, Uriel Nitzan, Ziv Carmel, Yechiel Levkovitz, Hagai Maoz
Impaired decision making in patients with borderline personality disorder (BPD) has been reported in several studies. Although methylphenidate (MPH) is known to ameliorate impaired decision making in patients with attention-deficit/hyperactivity disorder (ADHD), it has not yet been examined in patients with BPD. We therefore assessed the efficacy of a single dose of MPH on cognitive functions and decision making in patients with BPD. Twenty-two patients diagnosed with BPD participated in the study. The study was a randomized, double-blind placebo-controlled, random block order cross-over trial...
July 2018: International Clinical Psychopharmacology
Davide Papola, Giovanni Ostuzzi, Lehana Thabane, Gordon Guyatt, Corrado Barbui
To investigate the extent to which exposure to first-generation and second-generation antipsychotics (APs) is associated with an increased risk of fractures, with a particular focus on hip fractures, and to ascertain the risk associated with exposure to individual drugs. We included observational studies that reported data on fractures in individuals exposed to APs compared with unexposed individuals or individuals with previous exposure. We extracted information on study design, source of data, population characteristics, outcomes of interest, matching and confounding factors, and used a modified version of the Newcastle-Ottawa Scale to judge study risk of bias...
July 2018: International Clinical Psychopharmacology
Monika Edlinger, Anna-Sophia Welte, Nursen Yalcin-Siedentopf, Georg Kemmler, Felix Neymeyer, W Wolfgang Fleischhacker, Alex Hofer
Patients suffering from schizophrenia are often treated in locked psychiatric units because of psychomotor agitation, hostility and aggressive behavior, or suicidality. Because of legal conditions, investigations on these acutely ill patients are difficult, and many studies do not represent 'real-life psychiatry'. This retrospective survey was conducted at the Department of Psychiatry, Psychotherapy and Psychosomatics of the Medical University, Innsbruck, Austria. Data were collected from the records of all adult inpatients suffering from a schizophrenia spectrum disorder according to the International Classification of Diseases, 10th ed...
July 2018: International Clinical Psychopharmacology
Susan Kornstein, Cheng-Tao Chang, Carl P Gommoll, John Edwards
The efficacy of antidepressants to treat major depressive disorder (MDD) varies by patient characteristics. This post-hoc analysis evaluated the effects of vilazodone across patient subgroups in adults with MDD. Data were pooled from four trials of vilazodone (NCT00285376, NCT00683592, NCT01473394, and NCT01473381). Mean change from baseline to week 8 in Montgomery-Åsberg Depression Rating Scale (MADRS) total score, MADRS response (≥50% total score improvement), and MADRS remission (total score≤10) were analyzed in the pooled intent-to-treat population (vilazodone=1254, placebo=964) and in subgroups of patients categorized by sex, age, MDD duration, recurrent episodes, baseline MADRS total score, and current episode duration...
July 2018: International Clinical Psychopharmacology
Pavel Golubchik, Hagar Hamerman, Iris Manor, Miriam Peskin, Abraham Weizman
This study aimed to compare the effectiveness of parental training (PT), methylphenidate treatment (MPH), and the combination of PT and MPH treatment (PT/MPH) on school achievements in children with attention-deficit hyperactivity disorder (ADHD). Twenty eight ADHD patients (age: 10.1±1.11 years) were divided into three groups: (a) PT (N=10), (b) PT/MPH (N=8), and (c) MPH alone (N=10). Their grades in academics and conduct, from their school reports before and after treatment (6 months), were coded as achievement scores...
July 2018: International Clinical Psychopharmacology
Arun Singh, Srihari Gopal, Edward Kim, Maju Mathews, Jennifer Kern-Sliwa, Ibrahim Turkoz, Annette Wooller, Jesse Berlin
In a recent study, an indirect treatment comparison was performed to examine the relative efficacy and tolerability of aripiprazole once monthly and paliperidone palmitate once monthly. The authors concluded that the results may suggest relative advantages for aripiprazole once monthly over paliperidone palmitate once monthly in the short-term treatment of schizophrenia. However, the validity of the study is compromised as an indirect treatment comparison using extant data may violate important assumptions...
July 2018: International Clinical Psychopharmacology
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