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https://www.readbyqxmd.com/read/27922589/does-adding-a-second-antipsychotic-to-clozapine-improve-clinical-response-in-resistant-schizophrenia
#1
Magdalena Jiménez-Cornejo, Gonzalo Munizaga, David Aceituno
Clozapine constitutes the treatment of choice in patients with schizophrenia with persisting symptoms despite antipsychotics at adequate dose and treatment duration. However, an important proportion does not respond to optimal doses of clozapine, so the addition of a second antipsychotic might increase clinical response. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified 17 systematic reviews comprising 62 studies addressing the question of this article, including 26 randomized trials...
December 2, 2016: Medwave
https://www.readbyqxmd.com/read/27917569/distinct-intrinsic-functional-brain-network-abnormalities-in-methamphetamine-dependent-patients-with-and-without-a-history-of-psychosis
#2
Jonathan C Ipser, Anne Uhlmann, Paul Taylor, Brian H Harvey, Don Wilson, Dan J Stein
Chronic methamphetamine use is associated with executive functioning deficits that suggest dysfunctional cognitive control networks (CCNs) in the brain. Likewise, abnormal connectivity between intrinsic CCNs and default mode networks (DMNs) has also been associated with poor cognitive function in clinical populations. Accordingly, we tested the extent to which methamphetamine use predicts abnormal connectivity between these networks, and whether, as predicted, these abnormalities are compounded in patients with a history of methamphetamine-associated psychosis (MAP)...
December 5, 2016: Addiction Biology
https://www.readbyqxmd.com/read/27873561/antipsychotic-drug-exposure-and-risk-of-myocardial-infarction
#3
C Barbui, C Gastaldon, D Papola, G Ostuzzi
Patients experiencing psychoses and in need of antipsychotic agents may be exposed to a higher risk of myocardial infarction (MI) than the general population. As there have been no randomised studies investigating this association, a recent systematic review and meta-analysis included all observational studies that compared the incidence of MI among patients receiving antipsychotics v. no treatment. It found nine studies and calculated that the odds (risk) for developing MI were 1.88-fold higher in antipsychotic users compared with individuals who had not taken antipsychotic drugs...
November 22, 2016: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/27866695/does-formulation-matter-a-systematic-review-and-meta-analysis-of-oral-versus-long-acting-antipsychotic-studies
#4
REVIEW
Giovanni Ostuzzi, Irene Bighelli, Ryuhei So, Toshi A Furukawa, Corrado Barbui
Recently, many authors highlighted the potential advantages of a broader prescription of long-acting injectable antipsychotics (LAIs) based on various assumptions, including favorable pharmacokinetic features. In this systematic review, data from randomized controlled trials comparing LAIs versus the oral formulation of the same antipsychotic were meta-analyzed in order to ascertain whether the route of administration may be associated with a different efficacy and tolerability profile. Of 21 included studies, 18 contributed to the meta-analysis, providing data for risperidone, olanzapine, aripiprazole, zuclopenthixol, fluphenazine and haloperidol...
November 17, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27863801/long-acting-injectable-antipsychotics-for-the-prevention-of-relapse-in-patients-with-recent-onset-psychotic-disorders-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#5
Taro Kishi, Kazuto Oya, Nakao Iwata
This meta-analysis of randomized controlled trials (RCTs) investigated the advantages of long-acting injectable antipsychotics (LAI-APs) over oral antipsychotics (OAPs) with regard to efficacy and safety for patients with recent-onset psychotic disorders. Effect sizes and 95% confidence intervals (95%CIs) were calculated. We identified five RCTs (1022 patients, mean study duration=18±7.59 months) that compared LAI-APs (paliperidone or risperidone) with OAPs. Pooled LAI-APs did not outperform OAPs in terms of the preventing of relapse (N=3, n=875)...
November 3, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/27855720/pharmacological-interventions-for-agitation-in-patients-with-traumatic-brain-injury-protocol-for-a-systematic-review-and-meta-analysis
#6
David R Williamson, Anne Julie Frenette, Lisa Burry, Marc M Perreault, Emmanuel Charbonney, François Lamontagne, Marie-Julie Potvin, Jean-François Giguère, Sangeeta Mehta, Francis Bernard
BACKGROUND: Traumatic brain injury (TBI) is a worldwide leading cause of mortality and disability. Among TBI complications, agitation is a frequent behavioural problem. Agitation causes potential harm to patients and caregivers, interferes with treatments, leads to unnecessary chemical and physical restraints, increases hospital length of stay, delays rehabilitation, and impedes functional independence. Pharmacological treatments are often considered for agitation management following TBI...
November 17, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27848269/evidence-based-pharmacotherapy-of-treatment-resistant-unipolar-depression
#7
Markus Dold, Siegfried Kasper
Treatment resistance to the antidepressive pharmacotherapy represents one of the most important clinical challenges in the pharmacological management of unipolar depression. In this review, we aimed to summarise the evidence for various pharmacological treatment options in therapy-resistant unipolar depression derived from clinical trials, systematic reviews, meta-analyses and treatment guidelines. The first measure in case of insufficient response to the initial antidepressant monotherapy contains the debarment of 'pseudo-resistance', potentially caused by inadequate dose and treatment duration of the antidepressant, insufficient plasma levels, non-compliance of the patient regarding medication intake or relevant psychiatric and/or somatic comorbidities...
November 16, 2016: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/27846195/genome-wide-association-study-of-paliperidone-efficacy
#8
Qingqin Li, Nathan E Wineinger, Dong-Jing Fu, Ondrej Libiger, Larry Alphs, Adam Savitz, Srihari Gopal, Nadine Cohen, Nicholas J Schork
OBJECTIVE: Clinical response to the atypical antipsychotic paliperidone is known to vary among schizophrenic patients. We carried out a genome-wide association study to identify common genetic variants predictive of paliperidone efficacy. METHODS: We leveraged a collection of 1390 samples from individuals of European ancestry enrolled in 12 clinical studies investigating the efficacy of the extended-release tablet paliperidone ER (n1=490) and the once-monthly injection paliperidone palmitate (n2=550 and n3=350)...
November 11, 2016: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/27828697/aripiprazole-induced-hyperlipidemia-an-update
#9
Caroline Tarraf, Wadih J Naja
OBJECTIVE: To review the literature on the metabolic side effects of aripiprazole. Three cases of aripiprazole-induced hypertriglyceridemia are also presented. DATA SOURCES: A search was conducted of English-language articles and abstracts (meta-analyses, randomized controlled trials, clinical trials, naturalistic open-label trials, reviews, and case reports) published up to August 31, 2014, in electronic databases (PubMed, MEDLINE). STUDY SELECTION: Free-text and MeSH search keywords included aripiprazole, cholesterol, triglyceride, lipid profile, hyperlipidemia, and hypercholesterolemia and their differing terminations and combinations...
August 25, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27825069/effects-of-intranasal-oxytocin-on-symptoms-of-schizophrenia-a-multivariate-bayesian-meta-analysis
#10
REVIEW
Donald R Williams, Paul-Christian Bürkner
Schizophrenia is a heterogeneous disorder in which psychiatric symptoms are classified into two general subgroups-positive and negative symptoms. Current antipsychotic drugs are effective for treating positive symptoms, whereas negative symptoms are less responsive. Since the neuropeptide oxytocin (OT) has been shown to mediate social behavior in animals and humans, it has been used as an experimental therapeutic for treating schizophrenia and in particular negative symptoms which includes social deficits. Through eight randomized controlled trials (RCTs) and three meta-analyses, evidence for an effect of intranasal OT (IN-OT) has been inconsistent...
January 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/27813505/is-electroconvulsive-therapy-effective-as-augmentation-in-clozapine-resistant-schizophrenia
#11
Lucas Kittsteiner Manubens, Diego Lobos Urbina, David Aceituno
Clozapine is considered to be the most effective antipsychotic drug for patients with treatment resistant schizophrenia, but up to a third of the patients do not respond to this treatment. Various strategies have been tried to augment the effect of clozapine in non-responders, one of these strategies being electroconvulsive therapy. However, its efficacy and safety are not yet clear. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified six systematic reviews including 55 studies, among them six randomized controlled trials addressing clozapine-resistant schizophrenia...
October 14, 2016: Medwave
https://www.readbyqxmd.com/read/27810893/solving-a-weighty-problem-systematic-review-and-meta-analysis-of-nutrition-interventions-in-severe-mental-illness
#12
REVIEW
Scott B Teasdale, Philip B Ward, Simon Rosenbaum, Katherine Samaras, Brendon Stubbs
BACKGROUND: Nutrition interventions would appear fundamental for weight management and cardiometabolic risk reduction in people experiencing severe mental illness (SMI). Comprehensive evaluation of nutrition interventions is lacking. AIMS: To subject randomised controlled trials of nutrition interventions in people with SMI to systematic review and meta-analysis, and to measure anthropometric and biochemical parameters and nutritional intake. METHOD: An electronic database search identified trials with nutrition intervention components...
November 3, 2016: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/27780320/early-nonresponse-in-the-antipsychotic-treatment-of-acute-mania-a-criterion-for-reconsidering-treatment-results-from-an-individual-patient-data-meta-analysis
#13
Carlijn C M Welten, Maarten W J Koeter, Tamar D Wohlfarth, Jitschak G Storosum, Wim van den Brink, Christine C Gispen-de Wied, Hubert G M Leufkens, Damiaan A J P Denys
OBJECTIVE: To investigate whether early nonresponse to antipsychotic treatment of acute mania predicts treatment failure and, if so, to establish the best definition or criterion of an early nonresponse. DATA SOURCES: Short-term efficacy studies assessing antipsychotics that were submitted to the Dutch Medicines Evaluation Board during an 11-year period as part of the marketing authorization application for the indication of acute manic episode of bipolar disorder...
September 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/27776571/common-pattern-of-gray-matter-abnormalities-in-drug-naive-and-medicated-first-episode-schizophrenia-a-multimodal-meta-analysis
#14
C Shah, W Zhang, Y Xiao, L Yao, Y Zhao, X Gao, L Liu, J Liu, S Li, B Tao, Z Yan, Y Fu, Q Gong, S Lui
Studies of schizophrenia at drug-naive state and on antipsychotic medication have reported a number of regions of gray-matter (GM) abnormalities but the reports have been inconsistent. The aim of this study was to conduct multimodal meta-analysis to compare the cross-sectional voxel-based morphometry studies of brain GM in antipsychotic-naive first-episode schizophrenia (AN-FES) and those with antipsychotic treatment within 1 year (AT-FES) to determine the similarities and differences in these groups. We conducted two separate meta-analyses containing 24 studies with a sample size of 801 patients and 957 healthy controls...
October 25, 2016: Psychological Medicine
https://www.readbyqxmd.com/read/27755219/efficacy-and-safety-of-adjunctive-aripiprazole-in-schizophrenia-meta-analysis-of-randomized-controlled-trials
#15
Wei Zheng, Ying-Jun Zheng, Xian-Bin Li, Yi-Lang Tang, Chuan-Yue Wang, Ying-Qiang Xiang, Jose de Leon
This meta-analysis of randomized controlled trials (RCTs) evaluated the efficacy and safety of adding aripiprazole to other antipsychotics in schizophrenia. A systematic computer search identified 55 RCTs including 4457 patients who were randomized to aripiprazole (14.0 ± 7.0 mg/d) versus placebo (18 RCTs) or open antipsychotic treatment (37 RCTs). Aripiprazole significantly outperformed the comparison interventions based on psychiatric scales: (1) total score in 43 RCTs (N = 3351) with a standardized mean difference (SMD) of -0...
December 2016: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27743650/meta-analysis-of-glucose-tolerance-insulin-and-insulin-resistance-in-antipsychotic-na%C3%A3-ve-patients-with-nonaffective-psychosis
#16
Anne Marie Greenhalgh, Leticia Gonzalez-Blanco, Clemente Garcia-Rizo, Emilio Fernandez-Egea, Brian Miller, Miguel Bernardo Arroyo, Brian Kirkpatrick
BACKGROUND: Some studies have suggested that antipsychotic-naïve patients with nonaffective psychosis (NAP) have glucose intolerance. AIMS: To conduct a systematic review and meta-analysis of fasting glucose (FG), two hour values in the oral glucose tolerance test (2HG), fasting insulin concentration (INS), and insulin resistance (IR). METHOD: We identified possibly relevant studies, then selected studies, following usual guidelines, with two authors reviewing the manuscripts...
October 13, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27720402/the-association-between-first-episode-psychosis-and-abnormal-glycaemic-control-systematic-review-and-meta-analysis
#17
Benjamin Ian Perry, Gemma McIntosh, Scott Weich, Swaran Singh, Karen Rees
BACKGROUND: Schizophrenia might share intrinsic inflammatory disease pathways with type 2 diabetes. We aimed to assess whether first-episode psychosis, which could be described as developing schizophrenia, is associated with prediabetic markers, or developing diabetes, to determine whether intrinsic disease links could cause the disorders to develop in unison. We hypothesised that biochemical measures of prediabetic states would be more common in antipsychotic naive patients with first-episode psychosis than in healthy matched controls...
October 5, 2016: Lancet Psychiatry
https://www.readbyqxmd.com/read/27717827/low-d-serine-levels-in-schizophrenia-a-systematic-review-and-meta-analysis
#18
Seo-Eun Cho, Kyoung-Sae Na, Seong-Jin Cho, Seung Gul Kang
An increasing amount of evidence indicates that d-serine, a potent and selective endogenous coagonist of the N-methyl-d-aspartate receptor (NMDAR), is efficacious in the treatment of schizophrenia. Although the therapeutic efficacy of d-serine supplementation is based on the d-serine deficit and NMDAR hypofunction hypothesis, it has not been confirmed whether d-serine levels are decreased in patients with schizophrenia compared to healthy controls. We searched the following electronic databases: Embase, Ovid Medline, and the Cochrane Library...
October 4, 2016: Neuroscience Letters
https://www.readbyqxmd.com/read/27716110/metformin-in-prevention-and-treatment-of-antipsychotic-induced-weight-gain-a-systematic-review-and-meta-analysis
#19
Varuni Asanka de Silva, Chathurie Suraweera, Suhashini S Ratnatunga, Madhubashinee Dayabandara, Nimali Wanniarachchi, Raveen Hanwella
BACKGROUND: Most antipsychotics are associated with weight gain and other metabolic complications. Several randomized trials have shown metformin to be effective, but this still hasn't been included in clinical guidelines on managing antipsychotic induced weight gain. METHODS: All double blind placebo controlled trials assessing the efficacy of metformin in the treatment of antipsychotic induced weight gain were included. Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE were searched for the period January 2000-December 2015...
October 3, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27707527/chemical-agents-for-the-sedation-of-agitated-patients-in-the-ed-a-systematic-review
#20
Viola Korczak, Adrienne Kirby, Naren Gunja
OBJECTIVE: Chemical agents commonly used to sedate agitated patients in the emergency department include benzodiazepines, antipsychotics, or a combination of the 2 classes. Our objective was to determine if a class or combination therapy is (1) more effective, as measured by the proportion sedated at 15-20 minutes and the need for repeat sedation, and (2) safer, as measured by the proportion of reported adverse events. METHODS: Systematic literature review and meta-analysis of studies comparing 2 or more chemical agents for sedation of agitated patients in the emergency department were carried out in PubMed, PsycINFO, Embase, and the Cochrane database...
September 16, 2016: American Journal of Emergency Medicine
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