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https://www.readbyqxmd.com/read/28196698/-when-and-how-prescribe-antipsychotics
#1
S Tebeka, G Airagnes, F Limosin
Antipsychotics are commonly prescribed in the general population since they have many indications. They can be used in acute care such as agitation or behavior disorders, or to treat more characterized psychiatric disorders like psychotic or mood disorders. Consequently, any practitioner will have to prescribe or renew a prescription of antipsychotics. These treatments require a benefit/risk balance assessment taking into account the specific context of each patient. Indeed, antipsychotics have many side effects, mainly neurological (extrapyramidal syndrome, dyskinesia, akathisia), metabolic and cardiac...
February 10, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28193195/assessing-the-burden-of-treatment-emergent-adverse-events-associated-with-atypical-antipsychotic-medications
#2
Pierre-Michel Llorca, Christophe Lançon, Ann Hartry, T Michelle Brown, Dana B DiBenedetti, Siddhesh A Kamat, Clément François
BACKGROUND: Treatment of schizophrenia and major depressive disorder (MDD) with atypical antipsychotics (AAPs) show improved efficacy and reduced side effect burden compared with older antipsychotic medications. However, a risk of treatment-emergent adverse events (TEAEs) remains. TEAEs are hard to quantify and perspectives on the importance of TEAEs differ across patients and between patients and physicians. The current study is a qualitative assessment that investigates TEAEs of AAPs from both patient and physician perspectives to provide better understanding of the occurrence and burden of TEAEs associated with these medications...
February 13, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28185672/cariprazine-versus-risperidone-monotherapy-for-treatment-of-predominant-negative-symptoms-in-patients-with-schizophrenia-a-randomised-double-blind-controlled-trial
#3
György Németh, István Laszlovszky, Pál Czobor, Erzsébet Szalai, Balázs Szatmári, Judit Harsányi, Ágota Barabássy, Marc Debelle, Suresh Durgam, István Bitter, Stephen Marder, W Wolfgang Fleischhacker
BACKGROUND: Although predominant negative symptoms of schizophrenia can be severe enough to cause persistent impairment, effective treatment options are lacking. We aimed to assess the new generation antipsychotic cariprazine in adult patients with predominant negative symptoms. METHODS: In this randomised, double-blind, phase 3b trial, we enrolled adults aged 18-65 years with long-term (>2 year), stable schizophrenia and predominant negative symptoms (>6 months) at 66 study centres (mainly hospitals and university clinics, with a small number of private practices) in 11 European countries...
February 6, 2017: Lancet
https://www.readbyqxmd.com/read/28150091/reliability-and-validity-of-the-short-version-of-udvalg-for-kliniske-undersogelser-in-antipsychotic-treatment
#4
Kun-Po Chen, For-Wey Lung
The aim of this study was to develop a reliable and valid short version of the Udvalg for Kliniske Undersogelser (UKU) to efficiently evaluate the side effects of antipsychotics in patients with schizophrenia. This multi-site study included 10 hospitals, which included 331 inpatients and outpatients diagnosed with schizophrenia. UKU, Clinical Global Impression-Severity (CGI-S), Personal and Social Performance (PSP) and dosage of paliperidone were collected. The predictive validity of the UKU-short version, as well as that of the CGI-S, PSP and paliperidone dosages, was analyzed using structural equation modeling (SEM), latent growth models (LGM), and confirmatory factor analysis to test its content and construct validity...
February 1, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28146613/efficacy-and-safety-of-aripiprazole-once-monthly-in-the-maintenance-treatment-of-bipolar-i-disorder-a-double-blind-placebo-controlled-52-week-randomized-withdrawal-study
#5
Joseph R Calabrese, Raymond Sanchez, Na Jin, Joan Amatniek, Kevin Cox, Brian Johnson, Pamela Perry, Peter Hertel, Pedro Such, Phyllis M Salzman, Robert D McQuade, Margaretta Nyilas, William H Carson
OBJECTIVE: To evaluate efficacy, safety, and tolerability of long-acting injectable antipsychotic aripiprazole once-monthly 400 mg (AOM 400) as maintenance treatment for bipolar I disorder (BP-I). METHODS: In a double-blind, placebo-controlled, 52-week randomized withdrawal study conducted from August 2012 to April 2016, patients with a DSM-IV-TR diagnosis of BP-I currently experiencing a manic episode were stabilized sequentially on oral aripiprazole and AOM 400 and then randomized to AOM 400 or placebo...
January 31, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28141623/activating-and-sedating-adverse-effects-of-second-generation-antipsychotics-in-the-treatment-of-schizophrenia-and-major-depressive-disorder-absolute-risk-increase-and-number-needed-to-harm
#6
Leslie Citrome
PURPOSE/BACKGROUND: Activating and sedating adverse effects of antipsychotics can be obstacles to their use. METHODS/PROCEDURES: This study quantified the activating and sedating properties of first-line oral second-generation antipsychotics by examining the rates of adverse reactions as reported in product labeling for the indications of schizophrenia and adjunctive treatment of major depressive disorder. Additional data sources included regulatory documents, study synopses, and published study reports...
January 30, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28141621/high-incidence-and-prevalence-of-drug-related-movement-disorders-in-young-patients-with-psychotic-disorders
#7
Thierry Q Mentzel, Ritsaert Lieverse, Oswald Bloemen, Wolfgang Viechtbauer, Peter N van Harten
BACKGROUND: Drug-related movement disorders (DRMDs) reduce quality of life and contribute to medication noncompliance of patients with psychotic disorders. Little is known about the epidemiology of DRMDs in relatively young patients a few years after onset of psychosis. This is an important period to study, as the impact of the antipsychotic treatment on the long-term potentiation of the neural pathways associated with psychotic disorders and DRMDs is still minimal. This study investigated the prevalence, incidence, persistence, and clinical correlates of DRMDs in patients during their first years after disease onset...
January 30, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28129308/comparison-of-the-efficacy-and-safety-of-aripiprazole-versus-bupropion-augmentation-in-patients-with-major-depressive-disorder-unresponsive-to-selective-serotonin-reuptake-inhibitors-a-randomized-prospective-open-label-study
#8
Eun-Jin Cheon, Kwang-Hun Lee, Young-Woo Park, Jong-Hun Lee, Bon-Hoon Koo, Seung-Jae Lee, Hyung-Mo Sung
PURPOSE: The purpose of this study was to compare the efficacy and safety of aripiprazole versus bupropion augmentation in patients with major depressive disorder (MDD) unresponsive to selective serotonin reuptake inhibitors (SSRIs). METHODS: This is the first randomized, prospective, open-label, direct comparison study between aripiprazole and bupropion augmentation. Participants had at least moderately severe depressive symptoms after 4 weeks or more of SSRI treatment...
January 26, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28115240/lower-limb-flexor-reflex-comparisons-between-drug-induced-akathisia-and-restless-legs-syndrome
#9
Aysegul Gunduz, Baris Metin, Sinem Zeynep Metin, Burc Cagri Poyraz, Derya Karadeniz, Gunes Kiziltan, Meral E Kiziltan
BACKGROUND AND OBJECTIVE: Akathisia is characterized by restlessness and crawling sensations similar to restless legs syndrome (RLS). Long latency flexor reflex (LLFR) which has helped to advance RLS pathophysiology has never been investigated in akathisia. Due to the clinical commonalities of akathisia and RLS, we investigated the behavior of LLFR in patients with akathisia aiming to understand pathophysiology of akathisia. PATIENTS AND METHODS: Seven patients with neuroleptic-induced akathisia, 12 drug-naïve patients with primary RLS and 17 healthy subjects were prospectively enrolled in the study...
January 20, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28079463/influence-of-abcb1-polymorphisms-and-serum-concentrations-on-venlafaxine-response-in-patients-with-major-depressive-disorder
#10
Gul Ozbey, Feryal Cam Celikel, Birgul Elbozan Cumurcu, Derya Kan, Berna Yucel, Ekrem Hasbek, Ferda Percin, Ismail Cüneyt Guzey, Canan Uluoglu
BACKGROUND: The pharmacokinetics and the pharmacodynamics of antidepressants show large inter-individual variations which result in unpredictable clinical responses. AIM: The aim of the study was to examine the effect of ABCB1 polymorphisms and the serum concentrations on the efficacy and tolerability of venlafaxine in patients with major depressive disorder (MDD). METHODS: Fifty-two outpatients who met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria for MDD were recruited for the study...
January 12, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28063397/clinical-and-treatment-related-determinants-of-subjective-quality-of-life-in-patients-with-first-episode-psychosis
#11
Vivian Wing Yan Kwong, Wing Chung Chang, Gloria Hoi Kei Chan, Olivia Tsz Ting Jim, Emily Sin Kei Lau, Christy Lai Ming Hui, Sherry Kit Wa Chan, Edwin Ho Ming Lee, Eric Yu Hai Chen
Subjective quality of life (SQoL) has been increasingly studied in first-episode psychosis (FEP). Prior research primarily examined the impact of psychiatric symptoms on SQoL. Relationship between treatment-related factors and SQoL is under-studied. In this study, 159 Chinese patients who had completed 2-year treatment from early intervention service in Hong Kong were recruited. Assessments on premorbid adjustment, clinical profiles including social anxiety measure, functioning, antipsychotic-induced extrapyramidal side-effects and attitude toward medication treatment were conducted...
December 27, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/28027109/the-relationship-between-early-haloperidol-response-and-associated-extrapyramidal-side-effects
#12
Sean A Rasmussen, Patricia I Rosebush, Michael F Mazurek
BACKGROUND: Early response to antipsychotic medication within 2 weeks of initiating treatment can predict psychiatric outcomes. However, it is unclear whether early response is also predictive of extrapyramidal side effects (EPSs) associated with antipsychotic medications. METHODS: In this study, we investigated 136 consecutive antipsychotic-naive, first-episode psychosis patients naturalistically treated with haloperidol. Patients were assessed at baseline and weekly after treatment initiation using the Brief Psychiatric Rating Scale, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale...
February 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28009769/movement-disorders-induced-by-the-atypical-antipsychotic-aripiprazole
#13
Karim Selfani, Valérie L Soland, Sylvain Chouinard, Philippe Huot
OBJECTIVES: Aripiprazole is an antipsychotic that acts as a partial agonist at dopamine D2 receptors. Because of its partial agonist activity, it was believed that aripiprazole would be less susceptible than typical antipsychotics to induce extrapyramidal side effects. However, a few case-reports and case-series detailing aripiprazole-induced movement disorders have been published, suggesting that aripiprazole-induced movement disorders may arise. Here, we seek to report further cases of aripiprazole-induced movement disorders to raise the awareness of clinicians on this adverse effect...
January 2017: Neurologist
https://www.readbyqxmd.com/read/28008301/iloperidone-in-the-treatment-of-schizophrenia-an-evidence-based-review-of-its-place-in-therapy
#14
REVIEW
Fernanda S Tonin, Astrid Wiens, Fernando Fernandez-Llimos, Roberto Pontarolo
INTRODUCTION: Schizophrenia is a chronic and debilitating mental disorder that affects the patient's and their family's quality of life, as well as financial costs and health care settings. Despite the variety of available antipsychotics, optimal treatment outcomes are not always achieved. Novel drugs, such as iloperidone, can provide more effective, tolerable and safer strategies. AIM: To review the evidence for the clinical impact of iloperidone on the treatment of patients with schizophrenia...
2016: Core Evidence
https://www.readbyqxmd.com/read/27997809/brexpiprazole-for-the-treatment-of-schizophrenia
#15
Wen-Yu Hsu, Hsien-Yuan Lane, Chieh-Hsin Lin
Limited efficacy on negative and cognitive symptoms and adverse effects of current antipsychotics raise the need of developing new antipsychotics. Brexpiprazole, a new antipsychotic drug approved by the U.S. Food and Drug Administration in July 2015 for the treatment of schizophrenia, is a novel serotonin-dopamine receptor modulator with partial agonist activity at serotonin 1A (5-HT1A) and D2/3 receptors. Areas covered: We reviewed brexpiprazole related in vitro and in vivo studies, including phase II and phase III clinical trials in this article...
February 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27978821/metabolic-syndrome-and-adverse-clinical-outcomes-in-patients-with-bipolar-disorder
#16
Ya-Mei Bai, Cheng-Ta Li, Shih-Jen Tsai, Pei-Chi Tu, Mu-Hong Chen, Tung-Ping Su
BACKGROUND: Metabolic syndrome (MetS) is highly prevalent among patients with bipolar disorder. MetS may cause complications in the brain, but studies investigating MetS-associated clinical psychiatric outcomes remain scant. METHODS: We enrolled clinically stable outpatients with bipolar disorder aged 18-65 years and performed anthropometric and fasting biochemical assessments to investigate MetS prevalence. We then performed clinical assessments by using the Young Mania Rating Scale for manic symptoms, the Montgomery-Åsberg Depression Rating Scale for depressive symptoms, the Positive and Negative Symptom Scale for psychotic symptoms, the Involuntary Movement Scale for tardive dyskinesia, the Barnes Akathisia Rating Scale for akathisia, the Udvalg for Kliniske Undersogelser for general side effects, the Schedule for Assessment of Insight for insight, the Global Assessment of Functioning scale for global functioning, and the Wisconsin Card Sorting Test (WCST) for cognitive executive function...
December 15, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27975000/cariprazine-for-schizophrenia-and-bipolar-disorder
#17
REVIEW
Jonathan R Scarff
Schizophrenia and bipolar disorder are associated with significant morbidity and mortality. Although atypical antipsychotics reduce positive and negative symptoms of schizophrenia as well as manic or mixed episodes of bipolar disorder, they are associated with varying degrees of metabolic adverse effects. This necessitates continued development of efficacious yet metabolically favorable treatments. Cariprazine was recently approved to treat adult patients with schizophrenia and manic or mixed episodes. It was well-tolerated and adverse reactions included akathisia, extrapyramidal symptoms, nausea, or constipation...
September 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/27941419/adjunctive-brexpiprazole-as-a-novel-effective-strategy-for-treating-major-depressive-disorder-a-systematic-review-and-meta-analysis
#18
Seoyoung Yoon, Sang Won Jeon, Young-Hoon Ko, Ashwin A Patkar, Prakash S Masand, Chi-Un Pae, Changsu Han
PURPOSE/BACKGROUND: Brexpiprazole was approved for adjunctive treatment of major depressive disorder (MDD) in 2015. Because only a small number of randomized controlled trials have investigated the use of brexpiprazole in MDD, we performed a meta-analysis. METHODS/PROCEDURES: We systematically searched literatures in PubMed, Cochrane Library database, EMBASE, Google Scholar, and clinicaltrials.gov up to January 2016. The primary efficacy measure was the mean change in total Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline...
February 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27928948/revisiting-antipsychotic-induced-akathisia-current-issues-and-prospective-challenges
#19
Haitham Salem, Caesa Nagpal, Teresa Pigott, Antonio Lucio Teixeira
Akathisia continues to be a significant challenge in current neurological and psychiatric practice. Prompt and accurate detection is often difficult and there is a lack of consensus concerning the neurobiological basis of akathisia. No definitive treatment has been established for akathisia despite numerous preclinical and clinical studies. With these issues in mind, we reviewed antipsychotic-induced akathisia including its clinical presentation, proposed underlying pathophysiology, and an update of potential treatment strategies...
December 8, 2016: Current Neuropharmacology
https://www.readbyqxmd.com/read/27927708/clarithromycin-induced-akathisia-a-class-effect-of-macrolides
#20
Ivie Imasuen Gbinigie, Daniel Lasserson
Clarithromycin is an antibiotic of the macrolide family, which is commonly used in the treatment of respiratory tract infections. We report a woman aged 77 years with bronchiectasis who was prescribed oral clarithromycin for lower respiratory tract infection. She developed akathisia after 2 doses. On withdrawing the antibiotic, her symptoms resolved rapidly after 7 days.
December 7, 2016: BMJ Case Reports
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