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https://www.readbyqxmd.com/read/28222513/clinical-effectiveness-and-tolerability-of-electroconvulsive-therapy-in-patients-with-neuropsychiatric-symptoms-of-dementia
#1
Moshe Isserles, Zafiris J Daskalakis, Sanjeev Kumar, Tarek K Rajji, Daniel M Blumberger
BACKGROUND: Dementia frequently presents with aggression, agitation, and disorganized behavior for which current treatment is partially effective and is associated with significant adverse effects. OBJECTIVE: The aim of this study was to retrospectively assess the clinical effectiveness and tolerability of electroconvulsive therapy (ECT) in a sample of patients with neuropsychiatric symptoms of dementia (NPS) and to explore factors associated with response and with cognitive adverse effects...
February 7, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28215471/dopamine-serotonin-stabilizer-rp5063-a-randomized-double-blind-placebo-controlled-multicenter-trial-of-safety-and-efficacy-in-exacerbation-of-schizophrenia-or-schizoaffective-disorder
#2
Marc Cantillon, Arul Prakash, Ajay Alexander, Robert Ings, Dennis Sweitzer, Laxminarayan Bhat
The study objectives were to evaluate the efficacy, safety, tolerability, and pharmacokinetics of RP5063 versus placebo. The study was conducted in adults with acute exacerbation of schizophrenia or schizoaffective disorder. This 28-day, multicenter, placebo-controlled, double-blind study randomized 234 subjects to RP5063 15, 30, or 50mg; aripiprazole; or placebo (3:3:3:1:2) once daily. The aripiprazole arm was included solely to show assay sensitivity and was not powered to show efficacy. The primary endpoint was change from baseline to Day 28/EOT (End-of-Treatment) in Positive and Negative Syndrome Scale (PANSS) total score; secondary endpoints included PANSS subscales, improvement ≥1 point on the Clinical Global Impressions-Severity (CGI-S), depression and cognition scales...
February 16, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28208695/the-role-of-inhaled-loxapine-in-the-treatment-of-acute-agitation-in-patients-with-psychiatric-disorders-a-clinical-review
#3
REVIEW
Domenico de Berardis, Michele Fornaro, Laura Orsolini, Felice Iasevoli, Carmine Tomasetti, Andrea de Bartolomeis, Nicola Serroni, Alessandro Valchera, Alessandro Carano, Federica Vellante, Stefano Marini, Monica Piersanti, Giampaolo Perna, Giovanni Martinotti, Massimo Di Giannantonio
Loxapine is a first generation antipsychotic, belonging to the dibenzoxazepine class. Recently, loxapine has been reformulated at a lower dose, producing an inhaled powder that can be directly administered to the lungs to treat the agitation associated with psychiatric disorders, such as schizophrenia and bipolar disorder. Thus, the aim of this narrative and clinical mini-review was to evaluate the efficacy and tolerability of inhaled loxapine in the treatment of acute agitation in patients with psychiatric disorders...
February 8, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28205446/intramuscular-ziprasidone-dosing-for-acute-agitation-in-the-pediatric-emergency-department
#4
Tammy Nguyen, Jillian Stanton, Robin Foster
BACKGROUND: Intramuscular (IM) ziprasidone is often used to manage acute agitation. Limited data exist on the pediatric dosing of ziprasidone in the emergency department (ED). OBJECTIVE: To characterize the mg/kg dosing differences between pediatric ED patients who respond to an initial dose of ziprasidone versus patients who do not. METHODS: This was a retrospective, observational study of 5- to 18-year-old patients who were treated with IM ziprasidone in the pediatric ED from 2007 to 2015...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28205038/clinical-trial-simulations-and-pharmacometric-analysis-in-pediatrics-application-to-inhaled-loxapine-in-children-and-adolescents
#5
Min Dong, Tsuyoshi Fukuda, Sally Selim, Mark A Smith, Laura Rabinovich-Guilatt, James V Cassella, Alexander A Vinks
BACKGROUND AND OBJECTIVES: Loxapine for inhalation is a drug-device combination product approved in adults for the acute treatment of agitation associated with schizophrenia or bipolar I disorder. The primary objective of this study was to develop a clinical trial protocol to support a phase I pharmacokinetic study in children aged 10 years and older. In addition, this report details the results of the clinical study in relation to the predicted likelihood of achieving the target exposure associated with therapeutic effect in adults...
February 15, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28196698/-when-and-how-prescribe-antipsychotics
#6
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/28178037/benefits-of-dexmedetomidine-in-management-of-post-ect-agitation
#7
Puneet Narang, Francesca Ianovich, Simrat Kaur Sarai, Steven Lippmann
Electroconvulsive therapy (ECT) is an intervention for patients with a variety of psychiatric conditions. Occasionally, people exhibit dangerous degrees of agitation after this treatment, and some do not respond well to conventional pharmacotherapies. Dexmedetomidine is a central α-2 agonist that can induce significantly calmative effects in persons with post-ECT agitation. The indication for it is in calming individuals with acute and/or recurrent posttreatment agitation. Dexmedetomidine is safe and effective when infused just before, or postictally, at ECT sessions...
February 8, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28173768/-bowel-prep-hyponatremia-a-state-of-acute-water-intoxication-facilitated-by-low-dietary-solute-intake-case-report-and-literature-review
#8
Martin Windpessl, Christoph Schwarz, Manfred Wallner
BACKGROUND: Symptomatic hyponatremia is considered a rare complication of oral bowel preparation for colonoscopy. The pathophysiology underlying this phenomenon has been widely regarded as a mere sequela of excessive arginine vasopressin (AVP) release. CASE PRESENTATION: This case describes a 61-year old woman who developed acute hyponatremic encephalopathy when preparing for elective outpatient lower endoscopy. She had had negligible oral solute intake for two days and ingested four liters of clear fluid within two hours...
February 7, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28160494/intravenous-midazolam-droperidol-combination-droperidol-or-olanzapine-monotherapy-for-methamphetamine-related-acute-agitation-subgroup-analysis-of-a-randomised-controlled-trial
#9
Celene Y L Yap, David Mc D Taylor, Jonathan C Knott, Simone E Taylor, Georgina A Phillips, Jonathan Karro, Esther W Chan, David C M Kong, David J Castle
AIM: To examine the efficacy and safety of (1) midazolam-droperidol vs droperidol and (2) midazolam-droperidol vs olanzapine for methamphetamine-related acute agitation. DESIGN AND SETTING: A multi-centre, randomised, double-blind, controlled, clinical trial was conducted in two Australian emergency departments, between October 2014 and September 2015. PARTICIPANTS: Three hundred and sixty-one patients, aged 18-65 years, requiring intravenous medication sedation for acute agitation were enrolled...
February 4, 2017: Addiction
https://www.readbyqxmd.com/read/28156305/clinical-characteristics-of-synthetic-cannabinoid-use-in-a-large-urban-psychiatric-emergency-setting
#10
Marc W Manseau, Amit Rajparia, Adriana Joseph, Sarah Azarchi, Donald Goff, Ritvij Satodiya, Crystal Fuller Lewis
BACKGROUND: Increasing reports of synthetic cannabinoid (SC)-related adverse events have largely comprised case reports and analyses of calls to poison control centers. Existing studies have also mostly involved white male populations. OBJECTIVES: The purpose of this study is to systematically describe clinical characteristics of SC use in a relatively large, diverse, urban sample presenting to a psychiatric emergency setting. METHODS: SC users (n = 110) were identified by reviewing charts (n = 948) from the psychiatric emergency service of a large, urban public hospital in the United States for November 2014, which was randomly selected from the 12 months of that year...
February 3, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28152160/new-or-worsening-symptoms-and-signs-in-community-dwelling-persons-with-dementia-incidence-and-relation-to-use-of-acute-medical-services
#11
Philip D Sloane, Christopher H Schifeling, Anna S Beeber, Kimberly T Ward, David Reed, Lisa P Gwyther, Bobbi Matchar, Sheryl Zimmerman
OBJECTIVES: To understand the range of symptoms that present to family caregivers of community-dwelling persons with Alzheimer's disease and related dementias (ADRD). DESIGN: Six-month longitudinal prospective study to identify the incidence of new or worsening symptoms and their association with acute care medical service use. SETTING: Community-based sample of volunteers from multiple states. PARTICIPANTS: A total of 136 patient-caregiver dyads with a range of dementia severity...
February 2, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28149316/effect-of-intravenous-midazolam-on-cardiac-parameters-in-acute-tricyclic-antidepressants-poisoning
#12
Nastaran Eizadi-Mood, Elham Aboofazeli, Valiollah Hajhashemi, Farzad Gheshlaghi, Shirinsadat Badri, Ali Mohammad Sabzghabaee
BACKGROUND: Midazolam is commonly and safely used in poisoning management and intensive care for the control of agitated poisoned patients. Despite the introduction of newer and safer antidepressants, tricyclic antidepressants (TCAs) are still prescribed and used in many countries due to their cost-effectiveness. Severe morbidity and mortality associated with these drugs arises largely from their well-documented cardiovascular toxicity. In this study we aimed to investigate the probable effect of midazolam on some hemodynamic indices in TCAs-poisoned patients...
July 2016: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/28148613/delirium-in-trauma-patients-prevalence-and-predictors
#13
Kathryn T Von Rueden, Breighanna Wallizer, Paul Thurman, Karen McQuillan, Tiffany Andrews, Jennifer Merenda, Heesook Son
BACKGROUND: Delirium is associated with increased mortality, morbidity, hospital costs, and postdischarge cognitive dysfunction. Most research focuses on nontrauma patients receiving mechanical ventilation in the intensive care unit. OBJECTIVES: To determine the prevalence and predictors of delirium in trauma patients residing in intensive and intermediate care units of an academic medical center. METHODS: Trauma patients were screened for delirium by using the Confusion Assessment Method for the Intensive Care Unit...
February 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28141725/acute-agitation-and-self-injury-in-a-5-year-old-with-autism
#14
Jason Schweitzer, Christine James, Willough Jenkins, Michael I Reiff, Martin T Stein
A 5-year-old nonverbal child with autism spectrum disorder (ASD) was admitted to inpatient pediatrics with new onset agitation and self-injurious behavior. His parents described him as a pleasant child without previous episodes of self-injury. Four days before admission, the parents noted new irritability followed by 2 days of self-injury to the face without clear precipitant. His hitting intensified with closed fist to face, and he required parental physical restraint to prevent further injury. Car rides and ibuprofen provided only temporary relief...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28138201/asenapine-for-the-control-of-physical-aggression-a-prospective-naturalist-pilot-study
#15
Jin Shi Amon, Sarah B Johnson, Rif S El-Mallakh
It has been previously purported that higher relative affinity to the dopamine D4 receptor compared to D2 (i.e., D4/D2 affinity ratio > 1) may underlie unique antiaggression potency. Asenapine is a newer antipsychotic that also has D4/D2 affinity ratio > 1. It has demonstrated efficacy in reducing acute agitation in a placebo-controlled study. We performed a prospective naturalistic, pilot, proof of concept study on an inpatient psychiatric unit. Among patients with aggression at time of admission (≥ 12 on Refined Aggression Questionnaire [RAQ], or ≥ 2 on Modified Overt Aggression Scale [MOAS]), asenapine treatment was associated with a significant reduction in total aggression as measured by the MOAS (-14...
January 26, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28137731/clinical-presentation-autopsy-results-and-toxicology-findings-in-an-acute-n-ethylpentylone-fatality
#16
Phoutthasone Thirakul, Laura S Hair, Kirstin L Bergen, Julia M Pearson
The clinical presentation, autopsy findings and toxicology results in an acute fatality involving N-ethylpentylone, a new cathinone derivative, are described. Law enforcement transported a male who was agitated and exhibiting unusual behavior to a local hospital. Upon arrival at the hospital, his body temperature was 105.5 degrees Fahrenheit and his blood pH was 6.7. Clinical laboratory analysis revealed elevated troponins, rhabdomyolysis, hypoglycemia, hepatic and renal injury, respiratory failure and disseminated intravascular coagulation...
January 30, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28123618/comparison-of-neurological-clinical-manifestation-in-patients-with-hemorrhagic-and-ischemic-stroke
#17
Seyedhossein Ojaghihaghighi, Samad Shams Vahdati, Akram Mikaeilpour, Ali Ramouz
BACKGROUND: Cerebrovascular accident (CVA) is the third leading cause of death and disability in developed countries. Anyone suspected of having a stroke should be taken immediately to a medical facility for diagnosis and treatment. The symptoms that follow a stroke aren't significant and depend on the area of the brain that has been affected and the amount of tissue damaged. Parameters for predicting long-term outcome in such patients have not been clearly delineated, therefore the aim of this study was to investigate this possibility and to test a system that might practicably be used routinely to aid management and predict outcomes of individual stroke patients...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28111239/benefits-and-harms-of-atypical-antipsychotics-for-agitation-in-adults-with-dementia
#18
REVIEW
Martin R Farlow, Tatyana A Shamliyan
We evaluated the most current evidence regarding the benefits and harms of atypical antipsychotics in adults with dementia. In June 2016, following a protocol developed a priori, we systematically searched several databases for published and unpublished data from randomized controlled trials (RCT), observational studies, and meta-analyses; conducted direct meta-analyses using a random effects model; and graded the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group...
January 19, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28101036/anti-n-methyl-d-aspartate-receptor-encephalitis-in-hiv-infection
#19
Eunice Patarata, Vera Bernardino, Ana Martins, Rui Pereira, Conceição Loureiro, Maria Francisca Moraes-Fontes
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare condition characterized by emotional and behavioral disturbances, dyskinesias, and extrapyramidal signs. It occurs in young women of reproductive age and is classically described as a paraneoplastic phenomenon. We present a 36-year-old, HIV-positive female who was admitted to the hospital in an acute confusional state, with a stiff posture, periods of motor agitation, and myoclonic jerks of the hands. Her mental state progressively deteriorated...
September 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/28095806/predictors-of-mental-health-review-tribunal-mhrt-outcome-in-a-forensic-inpatient-population-a-prospective-cohort-study
#20
Amelia Jewell, Kimberlie Dean, Tom Fahy, Alexis E Cullen
BACKGROUND: Previous studies have investigated factors associated with outcome at Mental Health Review Tribunals (MHRTs) in forensic psychiatric patients; however, dynamic variables such as treatment compliance and substance misuse have scarcely been examined, particularly in UK samples. We aimed to determine whether dynamic factors related to behaviour, cooperation with treatment, and activities on the ward were prospectively associated with outcome at MHRT. METHODS: At baseline, demographic, clinical, behavioural, and treatment-related factors were ascertained via electronic medical records and census forms completed by the patient's clinical team...
January 17, 2017: BMC Psychiatry
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