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Extrapyramidal symptoms (EPS)

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https://www.readbyqxmd.com/read/30515916/baseline-imbalances-and-clinical-outcomes-of-atypical-antipsychotics-in-dementia-a-meta-epidemiological-study-of-randomized-trials
#1
Tessa A Hulshof, Sytse U Zuidema, Peter J K van Meer, Christine C Gispen-de Wied, Hendrika J Luijendijk
OBJECTIVES: To assess baseline imbalances in placebo-controlled trials of atypical antipsychotics in dementia, and their association with neuropsychiatric symptoms (NPS), extrapyramidal symptoms (EPS), and mortality. METHOD: We searched for trials in multiple sources. Two reviewers extracted baseline characteristics and outcomes per treatment group. We calculated direction, range, pooled mean, and heterogeneity in the baseline differences, and used meta-regression for the relationship with the outcomes...
December 4, 2018: International Journal of Methods in Psychiatric Research
https://www.readbyqxmd.com/read/30498351/time-to-onset-and-time-to-resolution-of-extrapyramidal-symptoms-in-patients-with-exacerbated-schizophrenia-treated-with-3-monthly-vs-once-monthly-paliperidone-palmitate
#2
Maju Mathews, Isaac Nuamah, Adam J Savitz, David W Hough, Dean Najarian, Edward Kim, Srihari Gopal
Objective: The aim of this study was to evaluate the safety of 3-monthly paliperidone palmitate (PP3M) vs once-monthly paliperidone palmitate (PP1M) treatment with regard to extrapyramidal symptom (EPS)-related treatment-emergent adverse events (TEAEs) in patients with schizophrenia, previously stabilized on PP1M treatment. Patients and methods: Data on overall incidence, time to onset (TTO), and time to resolution (TTR) of EPS-related TEAEs (overall, subclasses such as dyskinesia, dystonia, hyperkinesia, parkinsonism, and tremor) from a randomized double-blind (DB) non-inferiority study were compared between PP3M and PP1M...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/30410159/extrapyramidal-symptoms-resulting-from-risperidone-use-in-a-four-year-old-child-a-case-report
#3
Ehsan Elahi, Umar Zia, Omar Akhlaq Bhutta, Sidrah Andleeb
Extrapyramidal symptoms (EPS) are the major constraint in the use of antipsychotic agents. It is usually forewarned whenever therapy with these agents is considered. In this case, we present a child diagnosed with relapsed Wilm's tumour, who developed EPS just after a short duration of initiation of risperidone prescribed as an appetite stimulant. The patient became symptom free after management and risperidone was discontinued. Although risperidone has been approved to treat different indications in adolescents and children, scarce scientific evidence and our case report, are suggestive of further studies to establish safety of risperidone use in preschool children...
November 2018: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/30234886/characterization-of-neurological-soft-signs-in-a-brazilian-sample-of-stable-patients-with-schizophrenia
#4
Vinicius Sousa Pietra Pedroso, Antônio Lúcio Teixeira, João Vinícius Salgado
INTRODUCTION: Neurological soft signs (NSS) have been considered one of the target features and a potential endophenotype for schizophrenia. The present study aimed to characterize NSS in a sample of patients with chronic schizophrenia and to compare them with healthy control individuals. METHODS: In this study, we evaluated the presence of NSS in a sample of stable patients (n = 24) diagnosed with schizophrenia according to DSM-IV criteria, recruited at the Schizophrenia Outpatient Clinic of Instituto Raul Soares, Belo Horizonte, state of Minas Gerais, southeastern Brazil...
July 2018: Trends in Psychiatry and Psychotherapy
https://www.readbyqxmd.com/read/30185173/comparative-efficacy-and-safety-between-amisulpride-and-olanzapine-in-schizophrenia-treatment-and-a-cost-analysis-in-china-a-systematic-review-meta-analysis-and-cost-minimization-analysis
#5
Peng Men, Zhanmiao Yi, Chaoyun Li, Shuli Qu, Tengbin Xiong, Xin Yu, Suodi Zhai
BACKGROUND: Amisulpride was introduced into China in 2010 as a second-generation atypical antipsychotic, while olanzapine has been on the market since 1999 as one of the leading treatments for schizophrenia in China. Since more Chinese patients are gaining access to amisulpride, the study aims to compare the efficacy, safety, and costs between amisulpride and olanzapine for schizophrenia treatment in China. METHODS: PubMed, Embase, the Cochrane library, China National Knowledge Infrastructure (CNKI) and WanFang database were systematically searched for randomized controlled trials (RCTs) up to July 2018...
September 5, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/30109845/long-term-safety-and-tolerability-of-aripiprazole-lauroxil-in-patients-with-schizophrenia
#6
Henry A Nasrallah, Ralph Aquila, Yangchun Du, Arielle D Stanford, Amy Claxton, Peter J Weiden
OBJECTIVE: Safety and tolerability of long-term treatment with the long-acting antipsychotic aripiprazole lauroxil (AL) were evaluated in patients with schizophrenia. METHODS: This was an international, multicenter, phase 3, 52-week safety study of 2 fixed doses of AL (441 mg or 882 mg intramuscular every 4 weeks). Safety endpoints included adverse events (AEs) and extrapyramidal symptoms (EPS) including akathisia, injection-site reactions (ISRs), and clinically relevant changes in metabolic and endocrine values...
August 15, 2018: CNS Spectrums
https://www.readbyqxmd.com/read/29924506/clinical-predictors-of-extrapyramidal-symptoms-associated-with-aripiprazole-augmentation-for-the-treatment-of-late-life-depression-in-a-randomized-controlled-trial
#7
Jonathan H Hsu, Benoit H Mulsant, Eric J Lenze, Marcos Sanches, Jordan F Karp, Charles F Reynolds, Daniel M Blumberger
OBJECTIVE: Augmentation with aripiprazole is an effective pharmacotherapy for treatment-resistant late-life depression (LLD). However, aripiprazole can cause extrapyramidal symptoms (EPS) such as akathisia and parkinsonism; these symptoms are distressing and can contribute to treatment discontinuation. We investigated the clinical trajectories and predictors of akathisia and parkinsonism in older patients receiving aripiprazole augmentation for treatment-resistant LLD. METHODS: Between 2009 and 2013, depressed older adults who did not remit with venlafaxine were randomized to aripiprazole or placebo in a 12-week trial...
June 19, 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29920656/antipsychotics-for-treatment-of-delirium-in-hospitalised-non-icu-patients
#8
REVIEW
Lisa Burry, Sangeeta Mehta, Marc M Perreault, Jay S Luxenberg, Najma Siddiqi, Brian Hutton, Dean A Fergusson, Chaim Bell, Louise Rose
BACKGROUND: Guidelines suggest limited and cautious use of antipsychotics for treatment of delirium where nonpharmacological interventions have failed and symptoms remain distressing or dangerous, or both. It is unclear how well these recommendations are supported by current evidence. OBJECTIVES: Our primary objective was to assess the efficacy of antipsychotics versus nonantipsychotics or placebo on the duration of delirium in hospitalised adults. Our secondary objectives were to compare the efficacy of: 1) antipsychotics versus nonantipsychotics or placebo on delirium severity and resolution, mortality, hospital length of stay, discharge disposition, health-related quality of life, and adverse effects; and 2) atypical vs...
June 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29802039/efficacy-acceptability-and-tolerability-of-antipsychotics-in-children-and-adolescents-with-schizophrenia-a-network-meta-analysis
#9
REVIEW
Marc Krause, Yikang Zhu, Maximilian Huhn, Johannes Schneider-Thoma, Irene Bighelli, Anna Chaimani, Stefan Leucht
Children and adolescents with schizophrenia are a particularly vulnerable group. Thus, we integrated all the randomized evidence from the available antipsychotics used for this subgroup by performing a network-meta-analysis and pairwise meta-analysis using a random-effects model. We searched multiple databases up to Nov 17, 2016 (final update search in PubMed: Dec 12, 2017). The primary outcome was efficacy as measured by overall change/endpoint in symptoms of schizophrenia. Secondary outcomes included positive and negative symptoms, response, dropouts, quality of life, social functioning, weight gain, sedation, prolactin, extrapyramidal side effects (EPS) and antiparkinsonian medication...
June 2018: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29780333/neurological-soft-signs-spontaneous-and-treatment-emergent-extrapyramidal-syndromes-in-black-africans-with-first-episode-schizophrenia
#10
Akin Ojagbemi, Bonga Chiliza, Toyin Bello, Laila Asmal, Oluyomi Esan, Robin Emsley, Oye Gureje
Background: Very little is known about the relationship between spontaneous and treatment-induced motor syndromes in Africans with first episode schizophrenia. Objective: We investigated the association between spontaneous NSS and EPS, with treatment-induced EPS in a homogenous sample of Black Africans with first episode schizophrenia. Methods: We examined Xhosa (South Africa) and Yoruba (Nigeria) patients, using the Neurological Evaluation Scale and extrapyramidal symptoms scale before and at 3 months after exposure to low dose flupenthixol decanoate...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29686794/risperidone-induced-angioedema-with-concurrent-eps-symptoms-a-case-report-and-review-of-literature
#11
Gursharan Singh Samra, Saumitra Kant, Robert Chow
Angioedema has recently been reported as a side effect associated with the antipsychotic risperidone. We report a case of dystonia with concurrent angioedema due to risperidone. A 40-year-old male with a history of schizophrenia was started on 3 mg of risperidone BID and developed perioral and periorbital edema along with increased muscle rigidity and hand tremor within 24 h of initial administration. His symptoms abated after cessation of risperidone and intravenous administration of corticosteroids and antihistamine...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29516413/interplay-between-adenosine-receptor-antagonist-and-cyclooxygenase-inhibitor-in-haloperidol-induced-extrapyramidal-effects-in-mice
#12
Devinder Arora, Jayesh Mudgal, Madhavan Nampoothiri, Sanchari Basu Mallik, Manas Kinra, Susan Hall, Shailendra Anoopkumar-Dukie, Gary D Grant, Chamallamudi Mallikarjuna Rao
Antipsychotic drugs are the mainstay of psychotic disorders. The 'typical' antipsychotic agents are commonly employed for the positive symptoms of schizophrenia, though at an expense of extrapyramidal side effects (EPS). In the present study, we employed haloperidol (HP)-induced catalepsy model in mice to evaluate the role of adenosine receptor antagonist and cyclooxygenase (COX) enzyme inhibitor in the amelioration of EPS. HP produced a full blown catalepsy, akinesia and a significant impairment in locomotion and antioxidant status...
August 2018: Metabolic Brain Disease
https://www.readbyqxmd.com/read/29433934/evidence-based-review-of-pharmacotherapy-for-acute-agitation-part-2-safety
#13
Leslie S Zun
BACKGROUND: The management of acute agitation in the emergency department often requires the administration of rapid-acting antipsychotic agents. However, there are few comparative studies and little guidance regarding the risks associated with use of such drugs in the acute setting. OBJECTIVE: This structured evidence-based review compared the safety of antipsychotic pharmacotherapies for acute agitation using data from randomized controlled trials identified by a literature search of the PubMed database...
April 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29092658/an-unexpected-circumstance-acute-dystonic-reaction-in-the-setting-of-clozapine-administration
#14
Alexander Morris Kaplan, William Bradly Pitts, Iqbal Ahmed
Clozapine is a second-generation antipsychotic typically reserved for refractory psychotic disorders due to its high-risk side effect profile to include agranulocytosis, with its attendant need for regular blood draws. While reports of extrapyramidal symptoms (EPS), including acute dystonic reactions, are exceedingly rare, we present the case of a 44-year-old male with a long-standing history of treatment-resistant schizoaffective disorder and no history of EPS who experienced an acute buccal dystonic reaction in the setting of clozapine initiation and discontinuation of depot and oral risperidone...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28867897/extrapyramidal-symptoms-probably-related-to-risperidone-treatment-a-case-series
#15
Sereen Rose Thomson, Bharti Chogtu, Dipanjan Bhattacharjee, Saurabh Agarwal
BACKGROUND: Atypical antipsychotics, like risperidone purportedly, score over their typical counterparts in terms of their lower propensity toward producing extrapyramidal symptoms (EPS). However, recent studies have furnished evidence to the contrary. Hereby, we present a case series implicating risperidone as the causative agent for EPS. METHODS: As a part of the pharmacovigilance programme of India, the authors have assessed 10 physician-reported cases of EPS among the 1,830 patients who were prescribed risperidone within the time period of January 2012-December 2014 in a tertiary care hospital in South India...
July 2017: Annals of Neurosciences
https://www.readbyqxmd.com/read/28858444/a-population-approach-to-guide-amisulpride-dose-adjustments-in-older-patients-with-alzheimer-s-disease
#16
Suzanne Reeves, Julie Bertrand, Emma McLachlan, Fabrizia D'Antonio, Stuart Brownings, Akshay Nair, Suki Greaves, Alan Smith, Joel T Dunn, Paul Marsden, Robert Kessler, Hiroyuki Uchida, David Taylor, Robert Howard
OBJECTIVE: We have previously reported high dopamine D2/3 receptor occupancies at low amisulpride concentrations in older people with Alzheimer's disease (AD), during off-label treatment of AD-related psychosis. This post hoc analysis explored pharmacokinetic (concentration) and pharmacodynamic (prolactin, D2/3 occupancy) contributions to symptom reduction and extrapyramidal side effects (EPS) to inform AD-specific dose adjustments. METHODS: Population pharmacokinetic-pharmacodynamic models were developed by combining pharmacokinetic data from a phase 1 study in 20 healthy older people with pharmacokinetic prolactin, [¹⁸F]fallypride D2/3 receptor imaging, and clinical outcome data from 28 older patients prescribed open amisulpride (25-75 mg/d) to treat AD-related psychosis...
July 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28844639/rapid-vs-slow-antipsychotic-initiation-in-schizophrenia-a-systematic-review-and-meta-analysis
#17
REVIEW
Hiroyoshi Takeuchi, Sadhana Thiyanavadivel, Ofer Agid, Gary Remington
BACKGROUND: How antipsychotics should be initiated/titrated in patients with acute schizophrenia as well as patients undergoing an antipsychotic switch remains a question. METHODS: MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were systematically searched. Randomized controlled trials examining rapid vs. slow antipsychotic initiation in patients with schizophrenia were selected. Data on study discontinuation, psychopathology, extrapyramidal symptoms (EPS), and treatment-emergent adverse events (TEAEs) were extracted and synthesized in studies including clinically different populations of acute patients and stable patients undergoing an antipsychotic switch...
March 2018: Schizophrenia Research
https://www.readbyqxmd.com/read/28843918/the-safety-and-tolerability-of-cariprazine-in-patients-with-manic-or-mixed-episodes-associated-with-bipolar-i-disorder-a-16-week-open-label-study
#18
MULTICENTER STUDY
Terence A Ketter, Gary S Sachs, Suresh Durgam, Kaifeng Lu, Anju Starace, István Laszlovszky, György Németh
BACKGROUND: We evaluated the safety/tolerability of longer-term open-label treatment with cariprazine in patients who had responded to cariprazine for acute bipolar mania. METHODS: In this multinational, multicenter study, open-label, flexible-dose, cariprazine 3-12mg/d was administered for up to 16 weeks to patients (18-65 years) with bipolar mania. Safety evaluations included adverse events (AEs), laboratory values, vital signs, and extrapyramidal symptom (EPS) scales...
January 1, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28839341/long-term-safety-and-tolerability-of-valbenazine-nbi-98854-in-subjects-with-tardive-dyskinesia-and-a-diagnosis-of-schizophrenia-or-mood-disorder
#19
Richard C Josiassen, John M Kane, Grace S Liang, Joshua Burke, Christopher F O'Brien
BACKGROUND: The short-term safety profile of once-daily valbenazine (NBI-98854) has been evaluated in several double-blind, placebo-controlled (DBPC) trials in adults with tardive dyskinesia (TD) who had a diagnosis of schizophrenia/schizoaffective (SCHZ) disorder or mood disorder. Studies with longer treatment duration (up to 48 weeks) were conducted to evaluate the long-term safety of this novel drug in subjects with TD. METHODS: The pooled long-term exposure (LTE) population included valbenazine-treated subjects from 3 studies: KINECT (NCT01688037: 6-week DBPC, 6-week open-label); KINECT 3 (NCT02274558: 6-week DBPC, 42-week blinded extension, 4-week drug-free follow-up); KINECT 4 (NCT02405091: 48-week open-label, 4-week drug-free follow-up)...
August 1, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28783940/aripiprazole-induced-tardive-dyskinesia-in-13-years-old-girl-successfully-treated-with-biperiden-a-case-report
#20
Marco Lamberti, Gabriella Di Rosa, Francesca Cucinotta, Erica Pironti, Cecilia Galati, Antonella Gagliano
In the last years second-generation antipsychotics are increasingly prescribed in the pediatric population for the treatment of several psychiatric disorders. Among the long term adverse effects, extrapyramidal symptoms (EPS) are less reported compared to first-generation antipsychotics. Tardive dyskinesia (TD) is a iatrogenic rare syndrome characterized by persistent slow writhing and sudden involuntary movements mainly involving the oral-buccal-lingual area with masticatory movements. We report a young girl with mood disorders accompanied by mild intellectual disability and behavioral problems who had TD after treatment with Aripiprazole, which responded to Biperiden therapy...
August 31, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
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