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https://www.readbyqxmd.com/read/28645134/-arterial-hyper-and-hypotension-associated-with-psychiatric-medications-a-risk-assessment-based-on-the-summaries-of-product-characteristics-smpcs
#1
Roland W Freudenmann, Ninja Freudenmann, Bartosz Zurowski, Carlos Schönfeldt-Lecuona, Ludwig Maier, Roland E Schmieder, Christian Lange-Asschenfeldt, Maximilian Gahr
Introduction Psychiatric medications are well-known triggers of clinically relevant blood pressure changes. Therefore, we aimed at creating ranking lists for their risk of causing arterial hyper- or hypotension. Methods We analyzed 784 Summaries of Product characteristics (SmPCs, available online from "Rote Liste" or "Gelbe Liste" websites) from 105 psychiatric medications registered in adult psychiatry in Germany and extracted the standardized reported risks of increasing or decreasing arterial blood pressure...
June 23, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28643331/treatment-with-antipsychotics-in-pregnancy-changes-in-drug-disposition
#2
Andreas Austgulen Westin, Malin Brekke, Espen Molden, Eirik Skogvoll, Ingrid Castberg, Olav Spigset
Although pregnancy is known to cause changes in drug pharmacokinetics, little is known about its impact on serum levels of antipsychotics. In this study, we retrospectively assessed 201 routine serum antipsychotic therapeutic drug monitoring concentration measurements obtained from a total of 110 pregnancies in 103 women, and 512 measurements from the same women before and after pregnancy. Serum concentrations in the third trimester were significantly lower than baseline for quetiapine (-76%; CI, -83%, -66%; p<0...
June 23, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28643049/clozapine-in-reducing-aggression-and-violence-in-forensic-populations
#3
REVIEW
Kathleen Patchan, Gopal Vyas, Ann L Hackman, Marie Mackowick, Charles M Richardson, Raymond C Love, Ikwunga Wonodi, MacKenzie A Sayer, Matthew Glassman, Stephanie Feldman, Deanna L Kelly
Popular media often portray people with a mental illness as being aggressive, violent, and incarcerated as a result of their behavior. Despite exaggeration in the media, risks for some aggressive behaviors are in fact higher in individuals with schizophrenia. This is often the case with influence of comorbid substance use disorders. It is essential that mental health professionals are aware of treatments that may help with attenuating and treating behaviors that contribute to violence, aggression and incarceration...
June 22, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28642831/treatment-of-hypochondriasis-in-two-schizophrenia-patients-using-clozapine
#4
Antonio Tundo, Luca Proietti, Rocco de Filippis
Hypochondriasis (HYPO), an obsessive-compulsive spectrum disorder, is frequent in patients with schizophrenia (SCH) (20%), especially among those treated with clozapine (36.7%). Treatment options for OCS/OCD in patients under clozapine (CLZ) include combining clozapine with amisulpride/aripiprazole or a mood stabilizer, augmenting clozapine with a serotoninergic reuptake inhibitor, adding cognitive behavioural therapy, and gradually reducing dosage. No treatments have been proposed for HYPO in patients using clozapine so we examine these options in 2 cases and report the results...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28638207/effect-of-clonazepam-co-administered-with-clozapine-on-the-serum-clozapine-and-norclozapine-concentration-of-patients-with-schizophrenia-a-retrospective-survey
#5
Ping Jiang, Zhiguang Lin, Yi Jin, Juanjuan Ren, Hongmei Liu, Huiru Cui, Jijun Wang, Chunbo Li
BACKGROUND: For patients with schizophrenia clozapine (CLZ) is sometimes co-prescribed with clonazepam (CLNAZ). However, the impact of administration of CLZ along with CLNAZ on the serum concentration of CLZ and its major metabolite N-CLZ in schizophrenia is not well understood. AIM: To investigate the effects of CLNAZ co-medication, patient gender, age and CLZ dosage on serum concentration of CLZ and norclozapine (N-CLZ) in individuals with schizophrenia. METHODS: Serum CLZ and N-CLZ concentrations and demographic data were retrospectively analyzed for 341 patients with schizophrenia...
December 25, 2016: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28638195/malignant-syndrome-or-withdrawal-reaction
#6
Wenzheng Wang, Hui Wen, Jianhua Sheng
We report on a case of a female patient who had serious side effects from treatment with clozapine and chlorpromazine and the appeared to have a withdrawal reaction from cessation of clozapine. During the treatment process she was misdiagnosed as having malignant syndrome. This case highlights the importance of clinicians being able to distinguish malignant syndrome from withdrawal reactions, and to be familiar with treatment and prevention methods for both.
August 25, 2016: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28638038/-a-current-view-on-the-history-of-atypical-antipsychotics
#7
D S Danilov
Based on the analysis of the original literature, the author for the first time systemizes the data on the story of atypical antipsychotic drugs. The history of introduction of the first atypical neuroleptics - clozapine and sulpiride, which launched the dichotomic development of psychopharmacology of atypical antipsychotics, is described. Historical facts on the introduction into practice of different sulpiride- and clozapine-like neuroleptics as well as the relationship of their history with the elaboration of dopamine and serotonin hypotheses of mechanisms of action of antipsychotics are presented...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28636569/diabetic-ketoacidosis-associated-with-antipsychotic-drugs-case-reports-and-a-review-of-literature
#8
Antonia Vuk, Martina Rojnic Kuzman, Maja Baretic, Martina Matovinovic Osvatic
BACKGROUND: Second generation antipsychotics (SGAs) are associated with metabolic disturbances. Diabetic ketoacidosis (DKA) is a rare, but potentially fatal sign of acute glucose metabolism dysregulation linked to the use of SGAs. The aims of this article are to present patients with a history of psychotic disorders and of severe metabolic diabetic ketoacidosis, possibly associated with the use of antipsychotics, and to review the current literature on the topic of antipsychotic-induced DKA...
June 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28632525/clozapine-safety-and-efficacy-for-interictal-psychotic-disorder-in-pharmacoresistant-epilepsy
#9
Vincent Jetté Pomerleau, François Dubeau, Simon Ducharme
Since the middle of the 19th century, both neurologists and psychiatrists have linked psychosis and epilepsy. Clozapine, the most effective antipsychotic drug, alters electroencephalographic activity and carries a significant risk of causing seizures. Unfortunately, this risk limits the drug's potential use in treating pharmacoresistant psychosis in patients with epilepsy. We present a unique case in which we used clozapine successfully as a last resort treatment for chronic interictal psychosis in a 43-year-old woman with severe pharmacoresistant epilepsy and recurrent status epilepticus...
June 2017: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
https://www.readbyqxmd.com/read/28632422/risk-of-diabetes-and-dyslipidemia-during-clozapine-and-other-antipsychotic-drug-treatment-of-schizophrenia-in-iceland
#10
Oddur Ingimarsson, James H MacCabe, Magnús Haraldsson, Halldóra Jónsdóttir, Engilbert Sigurdsson
BACKGROUND: Type 2 diabetes (T2D) and raised blood lipids are associated with the use of antipsychotics, not least clozapine. AIMS: To describe the prevalence of high blood glucose levels, T2D, and dyslipidemia, in association with the use of clozapine or other antipsychotics in patients with schizophrenia in Iceland. METHOD: This study identified 188 patients treated with clozapine and 395 patients never treated with clozapine by searching the electronic health records of Landspitali, the National University Hospital...
June 20, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28626273/combined-antipsychotics-and-electroconvulsive-therapy-in-an-acutely-psychotic-patient-with-treatment-resistant-schizophrenia
#11
Ruth Rayikanti, Iga Lentowicz, Badari Birur, Li Li
Treatment of patients with Treatment-resistant Schizophrenia (TRS), who fail to respond to multiple antipsychotic trials, including clozapine (CLZ), is challenging. Several alternative strategies are reported in studies, one of which includes augmenting antipsychotics (AP) with Electroconvulsive therapy (ECT). We discuss a case of an acutely psychotic patient with TRS who responded effectively and sustained remission to this strategy which was ECT combined with two AP, CLZ and aripiprazole. Notable improvement in clinical and cognitive outcomes was seen with just five right unilateral ECT sessions, CLZ titrated up to 62...
May 15, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28626268/sex-differences-in-antipsychotic-related-metabolic-functioning-in-schizophrenia-spectrum-disorders
#12
A Zarina Kraal, Kristen M Ward, Vicki L Ellingrod
The adverse metabolic risks associated with second generation antipsychotics (SGAs) are well known, and likely contribute to the high rate of premature mortality due to cardiovascular disease in schizophrenia. Female schizophrenia patients appear to be diagnosed with metabolic diseases at higher rates than males, which may reflect disparate adverse responses to SGAs. However, the relationship between sex, metabolic risk, and drug use is less developed. We aimed to explore this relationship further by identifying rates of metabolic disease in community dwelling schizophrenia patients by sex and SGA risk...
May 15, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28623627/clozapine-induced-gastrointestinal-hypomotility-a-22-year-bi-national-pharmacovigilance-study-of-serious-or-fatal-slow-gut-reactions-and-comparison-with-international-drug-safety-advice
#13
Susanna Every-Palmer, Pete M Ellis
INTRODUCTION: Clozapine is the preferred antipsychotic for treatment-resistant schizophrenia, but has significant adverse effects, including gastrointestinal hypomotility or 'slow gut', which may result in severe constipation, ileus, bowel obstruction, and even death. These gastrointestinal effects remain inadequately recognized. METHODS: We reviewed all reports of serious clozapine-induced gastrointestinal hypomotility (CIGH) submitted to the Australian Therapeutic Goods Administration and New Zealand Pharmacovigilance Centre between 1992 and 2013...
June 16, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28622812/clozapine-induced-gastrointestinal-hypomotility-a-potentially-life-threatening-adverse-event-a-review-of-the-literature
#14
REVIEW
Stephen West, David Rowbotham, Glen Xiong, Chris Kenedi
OBJECTIVE: The haematological and cardiac complications of clozapine have been well documented. Recent evidence from pharmacovigilance databases suggests that gastrointestinal (GI) complications are the leading cause of clozapine related deaths. This review aims to describe clinical features along with preventative and treatment options. METHOD: A review of MEDLINE via PubMed searching for all articles published up to February of 2016. Inclusion criteria were articles that provided clinical or epidemiological information relating to the diagnosis, outcome, management or pathophysiology of clozapine related gastrointestinal disorders in humans...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28613411/outcome-in-patients-converting-to-psychosis-following-a-treated-clinical-high-risk-state
#15
Ashok Malla, Marianne de Bonneville, Jai Shah, Gerald Jordan, Marita Pruessner, Kia Faridi, Mark Rabinovitch, Srividya N Iyer, Ridha Joober
AIM: We explored 2-year outcomes in a sample of clinical high risk (CHR) patients who converted to psychosis despite receiving interventions. METHODS: Of 167 CHR patients, 18 had converted to psychosis and received treatment for their first episode of psychosis in an early intervention service over 2 years. RESULTS: Compared to patients admitted directly to the same early intervention service without having been identified as CHR prior to onset of psychosis, CHR converters were in remission for fewer months (M = 5 vs M = 10); were more likely to be prescribed more than 1 antipsychotic medication (90% vs 68%) and to receive clozapine treatment (38% vs 2%) over 2 years...
June 14, 2017: Early Intervention in Psychiatry
https://www.readbyqxmd.com/read/28613395/clozapine-dose-for-schizophrenia
#16
REVIEW
Selvizhi Subramanian, Birgit A Völlm, Nick Huband
BACKGROUND: Schizophrenia and related disorders such as schizophreniform and schizoaffective disorder are serious mental illnesses characterised by profound disruptions in thinking and speech, emotional processes, behaviour and sense of self. Clozapine is useful in the treatment of schizophrenia and related disorders, particularly when other antipsychotic medications have failed. It improves positive symptoms (such as delusions and hallucinations) and negative symptoms (such as withdrawal and poverty of speech)...
June 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28607752/enhanced-disease-reduction-using-clozapine-an-atypical-antipsychotic-agent-and-glatiramer-acetate-combination-therapy-in-experimental-autoimmune-encephalomyelitis
#17
Laura K Green, Pirooz Zareie, Nikki Templeton, Robert A Keyzers, Bronwen Connor, Anne Camille La Flamme
BACKGROUND: Atypical antipsychotic agents (AAP) alleviate the symptoms of severe mental health disorders, such as schizophrenia, by antagonizing dopamine and serotonin receptors. Recently, AAP have also been shown to exhibit immunomodulatory properties in the central nervous system (CNS). OBJECTIVE: Building on research which demonstrated the ability of the AAP risperidone and clozapine to modify the disease course of experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis (MS), we aimed to more fully investigate the potential of clozapine as a possible treatment for MS...
January 2017: Multiple Sclerosis Journal—Experimental, Translational and Clinical
https://www.readbyqxmd.com/read/28603421/effects-of-stimulus-parameters-on-motor-seizure-duration-in-electroconvulsive-therapy
#18
Sung Woo Joo, Yeon Ho Joo, Chang Yoon Kim, Jung Sun Lee
OBJECTIVE: This study examined the effect of stimulus parameters on the occurrence of adequate seizures and reconsidered the factors related to motor seizure duration. METHODS: The medical records of 187 patients who received ECT in Asan Medical Center from January 2007 to May 2014 were retrospectively reviewed. The starting stimulus dose was determined using a preselected-dose method and the cutoff value to determine the adequate motor seizure duration was 20-25 seconds...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28601891/effect-of-liraglutide-treatment-on-prediabetes-and-overweight-or-obesity-in-clozapine-or-olanzapine-treated-patients-with-schizophrenia-spectrum-disorder-a-randomized-clinical-trial
#19
Julie R Larsen, Louise Vedtofte, Mathilde S L Jakobsen, Hans R Jespersen, Michelle I Jakobsen, Camilla K Svensson, Kamuran Koyuncu, Ole Schjerning, Peter S Oturai, Andreas Kjaer, Jimmi Nielsen, Jens J Holst, Claus T Ekstrøm, Christoph U Correll, Tina Vilsbøll, Anders Fink-Jensen
Importance: Compared with the general population, patients with schizophrenia have a 2- to 3-fold higher mortality rate primarily caused by cardiovascular disease. Previous interventions designed to counteract antipsychotic-induced weight gain and cardiometabolic disturbances reported limited effects. Objectives: To determine the effects of the glucagon-like peptide-1 receptor agonist liraglutide added to clozapine or olanzapine treatment of schizophrenia spectrum disorders...
June 10, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28599751/association-between-serum-levels-of-glutamate-and-neurotrophic-factors-and-response-to-clozapine-treatment
#20
Amir Krivoy, Eldar Hochman, Kyra-Verena Sendt, Sarah Hollander, Yael Vilner, Mirjana Selakovic, Abraham Weizman, Michal Taler
Clozapine is the only available therapy for about 30% of schizophrenia patients otherwise refractory to antipsychotics. Unfortunately, the mechanism of action of the drug is still unknown and there are no biomarkers that can predict a positive response to clozapine. We aimed to examine serum neurotrophins and glutamate levels as putative biomarkers for clozapine response based on the hypothesized mode-of-action of the compound. Blood samples of 89 chronic schizophrenia patients maintained on clozapine were analyzed in a cross-sectional design...
June 7, 2017: Schizophrenia Research
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