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Treatment resistant schizophrenia

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https://www.readbyqxmd.com/read/28626273/combined-antipsychotics-and-electroconvulsive-therapy-in-an-acutely-psychotic-patient-with-treatment-resistant-schizophrenia
#1
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/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
#2
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/28620812/case-study-of-first-episode-schizophrenia-in-pregnancy-and-postpartum
#3
Kristopher A Kast, Smita Agarkar
Patients with first-episode psychosis of peripartum onset commonly prove to have a mood-disorder diathesis; however, a proportion of cases represent first-episode schizophrenia. We present such a case and discuss the clinical relevance of recognizing this small but important population of new mothers. These patients are at considerable risk of misdiagnosis, resulting in ineffective maintenance therapy, poorer recovery of function, and development of treatment resistance. Accurate diagnosis in the peripartum period will impact treatment decisions and long-term therapy...
June 15, 2017: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/28599949/quetiapine-extended-release-versus-aripiprazole-in-children-and-adolescents-with-first-episode-psychosis-the-multicentre-double-blind-randomised-tolerability-and-efficacy-of-antipsychotics-tea-trial
#4
Anne Katrine Pagsberg, Pia Jeppesen, Dea Gowers Klauber, Karsten Gjessing Jensen, Ditte Rudå, Marie Stentebjerg-Olesen, Peter Jantzen, Simone Rasmussen, Eva Ann-Sofie Saldeen, Maj-Britt Glenn Lauritsen, Niels Bilenberg, Anne Dorte Stenstrøm, Louise Nyvang, Sarah Madsen, Thomas M Werge, Theis Lange, Christian Gluud, Maria Skoog, Per Winkel, Jens Richardt M Jepsen, Birgitte Fagerlund, Christoph U Correll, Anders Fink-Jensen
BACKGROUND: Head-to-head trials to guide antipsychotic treatment choices for paediatric psychosis are urgently needed because extrapolations from adult studies might not be implementable. In this superiority trial with two-sided significance testing, we aimed to compare the efficacy and safety of quetiapine-extended release (quetiapine-ER) versus aripiprazole in children and adolescents with first-episode psychosis, to determine whether differences between the two treatments were sufficient to guide clinicians in their choice of one drug over the other...
June 6, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28597291/multiple-drug-transporters-mediate-the-placental-transport-of-sulpiride
#5
Mengru Bai, Zhiyuan Ma, Dongli Sun, Caihong Zheng, Yayun Weng, Xi Yang, Ting Jiang, Huidi Jiang
Sulpiride is a typical antipsychotic drug for the treatment of schizophrenia, depression and other psychological disorders. It has been proven that a small amount of sulpiride could cross the human placenta using an ex vivo placental perfusion model. However, the placental transfer mechanism has not been elucidated. Considering the structure of sulpiride, we speculated that the transporters expressed in placenta might be involved in sulpiride uptake across the blood-placenta barrier. The aim of our study was to determine which transporters contributed to the placental transfer of sulpiride...
June 9, 2017: Archives of Toxicology
https://www.readbyqxmd.com/read/28578741/antipsychotic-combinations-in-schizophrenia
#6
C Gastaldon, D Papola, G Ostuzzi
In the treatment of resistant schizophrenia, a number of meta-analyses attempted to quantify the efficacy and tolerability of antipsychotic (AP) polypharmacy v. monotherapy with contradictory results. Recently, a systematic review and meta-analysis of randomised controlled trials investigated the efficacy and tolerability of AP combination v. monotherapy in schizophrenia. It included 31 studies: 21 double-blind (considered high-quality studies) and 10 open-label (considered low-quality studies). The meta-analysis showed that, overall, the combination of two APs was more effective than monotherapy in terms of symptom reduction (standardised mean difference (SMD) = -0...
June 5, 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/28574288/chronotype-and-its-relationship-with-sleep-disorders-in-children-with-attention-deficit-hyperactivity-disorder
#7
Fatma Benk Durmuş, Ayşe Rodopman Arman, Ayşe Burcu Ayaz
Chronotype can be classified as morningness types, people who prefer morning hours for their physical and mental activities; eveningness types, people who prefer the afternoon or evening hours; and intermediate types, those who show characteristics of both morningness and eveningness types. Attention deficit hyperactivity disorder (ADHD) has been linked with disturbances in chronotype, particularly increased eveningness. Despite the possibility of an association between chronotypes, sleep disturbances and ADHD symptoms, there is little evidence of this association considering the child population...
June 2, 2017: Chronobiology International
https://www.readbyqxmd.com/read/28573760/oral-glucose-tolerance-test-performance-in-olanzapine-treated-schizophrenia-spectrum-patients-is-predicted-by-bmi-and-triglycerides-but-not-olanzapine-dose-or-duration
#8
Jeffrey Guina, Sayon Roy, Ankur Gupta, Daniel D Langleben, Igor Elman
OBJECTIVE: Olanzapine, an atypical antipsychotic, is associated with glucoregulatory abnormalities, but the nature of this link is not fully elucidated. This is the first olanzapine oral glucose tolerance test (oGTT) study to consider treatment dose and duration, and to compare complementary indices respectively assessing insulin sensitivity (Matsuda index) and resistance (homeostasis model assessment). METHODS: Body mass index (BMI), body composition, plasma lipids, and oGTT were measured in olanzapine-treated nondiabetic patients with DSM-IV-TR diagnosis of schizophrenia or schizoaffective disorder (n = 35)...
June 1, 2017: Human Psychopharmacology
https://www.readbyqxmd.com/read/28573688/autoantibodies-against-voltage-gated-potassium-channel-vgkc-and-glutamic-acid-decarboxylase-gad-in-psychosis-a-systematic-review-meta-analysis-and-case-series
#9
REVIEW
Rosemary Grain, John Lally, Brendon Stubbs, Steffi Malik, Anne Lemince, Timothy R Nicholson, Robin M Murray, Fiona Gaughran
Antibodies to the voltage-gated potassium channel (VGKC) complex and glutamic acid decarboxylase (GAD) have been reported in some cases of psychosis. We conducted the first systematic review and meta-analysis to investigate their prevalence in people with psychosis and report a case series of VGKC-complex antibodies in refractory psychosis. Only five studies presenting prevalence rates of VGKC seropositivity in psychosis were identified, in addition to our case series, with an overall prevalence of 1.5% (25/1720) compared to 0...
June 2, 2017: Psychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28540038/effectiveness-of-paliperidone-depot-injection-in-seriously-violent-men-with-comorbid-schizophrenia-and-dissocial-personality-disorder-in-a-uk-high-security-hospital
#10
Anna-Marie Mortlock, Fintan Larkin, Callum C Ross, Nitin Gupta, Samrat Sengupta, Mrigendra Das
BACKGROUND: High-security hospital patients are often complex in presentation and are characterized by treatment resistance, medication nonadherence and history of violence. Paliperidone is licensed both as an oral and depot antipsychotic medication in the treatment of schizophrenia. Clinical trials have shown that paliperidone depot is well tolerated with similar efficacy to risperidone depot but with additional practical advantages. Whilst data exist for the effectiveness of paliperidone palmitate (PP), there are no studies involving patients in forensic settings or those with comorbid personality disorder...
May 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28523839/algorithm-based-pharmacotherapy-for-first-episode-schizophrenia-involuntarily-hospitalized-a-retrospective-analysis-of-real-world-practice
#11
Bunta Yoshimura, Kojiro Sato, Manabu Takaki, Norihito Yamada
BACKGROUND: Little is known about the clinical outcomes of severely ill patients with first-episode schizophrenia spectrum disorders (FES) who are considered to lack the capacity to consent to clinical trials. We investigated the feasibility of an algorithm-based pharmacotherapy (ABP) and clinical outcomes of patients with FES involuntarily hospitalized and treated with ABP. METHODS: We conducted a retrospective chart review of 160 patients admitted involuntarily between October 2012 and October 2015...
May 19, 2017: Early Intervention in Psychiatry
https://www.readbyqxmd.com/read/28511206/antipsychotic-treatment-of-22q11-2-deletion-syndrome-related-psychoses
#12
Elias Angelopoulos, Christos Theleritis, Marina Economou, Korina Georgatou, Charalambos C Papageorgiou, Eleftheria Tsaltas
In the recent study by Verhoeven and Egger, 2015 and the recent letter to the editor by Boot et al. 2015 an emphasis is given to the best possible pharmacological treatment of 22q11-2 Deletion-Syndrome related psychoses. We would like to present the case of a 23-year old Cypriot patient with 22q11.2 deletion syndrome who fulfilled criteria for treatment resistant schizophrenia (TRS). He was sequentially treated with aripiprazole, risperidone, olanzapine, haloperidol and a combination treatment with olanzapine and haloperidol...
May 16, 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28508166/toxoplasma-gondii-and-schizophrenia-a-review-of-published-rcts
#13
REVIEW
Sam D Chorlton
Over the last 60 years, accumulating evidence has suggested that acute, chronic, and maternal Toxoplasma gondii infections predispose to schizophrenia. More recent evidence suggests that chronically infected patients with schizophrenia present with more severe disease. After acute infection, parasites form walled cysts in the brain, leading to lifelong chronic infection and drug resistance to commonly used antiparasitics. Chronic infection is the most studied and closely linked with development and severity of schizophrenia...
July 2017: Parasitology Research
https://www.readbyqxmd.com/read/28506706/cognitive-and-functional-deficits-in-people-with-schizophrenia-evidence-for-accelerated-or-exaggerated-aging
#14
Philip D Harvey, Jennifer B Rosenthal
Cognitive and functional deficits are commonly seen in people with schizophrenia. The profile of these impairments has a resemblance to the cognitive changes seen in healthy aging. In specific, many of the cognitive ability domains that change the most with aging in healthy people are the most salient of these deficits seen in people with schizophrenia, including prominent deficits in processing speed, working memory, and episodic memory. Functional deficits seen in schizophrenia are also similar to those seen in healthy aging...
May 12, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28484390/spatiotemporal-mapping-techniques-show-clozapine-impairs-neurogenic-and-myogenic-patterns-of-activity-in-the-colon-of-the-rabbit-in-a-dose-dependent-manner
#15
Susanna Every-Palmer, Roger G Lentle, Gordon Reynolds, Corrin Hulls, Paul Chambers, Helen Dunn, Pete M Ellis
Background: Clozapine, an antipsychotic used in treatment-resistant schizophrenia, has adverse gastrointestinal effects with significant associated morbidity and mortality. However, its effects on defined patterns of colonic contractile activity have not been assessed. Method: We used novel radial and longitudinal spatiotemporal mapping techniques, combined with and monitoring of ambient lumen pressure, in ex vivo preparations of triply and of singly haustrated portions of rabbit colon. We identified the contractile patterns of mass peristalses, fast phasic, and ripple contractions and directly qualified the effects of clozapine, at concentrations of 10 μmol/L, 20 μmol/L, and 30 μmol/L, and of norclozapine, the main metabolite of clozapine, on contractile patterns...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28453389/gwas-analysis-of-treatment-resistant-schizophrenia-interaction-effect-of-childhood-trauma
#16
Arthur Koga, Ali Bani-Fatemi, Nuwan Hettige, Carol Borlido, Clement Zai, John Strauss, Philip Gerretsen, Ariel Graff, Gary Remington, Vincenzo De Luca
AIMS: In the current study, we aimed to compare the prevalence of adverse lifetime events in treatment resistant and non-treatment resistant schizophrenia in a genome-wide association study. MATERIALS & METHODS: Our sample consisted of 84 Caucasian participants with schizophrenia spectrum disorders, assessed cross-sectionally to collect information regarding drug effectiveness and childhood trauma. Using a genome-wide association analysis, we tested single-nucleotide polymorphisms for their association with resistance to antipsychotics defined according to American Psychiatric Association criteria...
April 28, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28442424/thioredoxin-is-not-a-marker-for-treatment-resistance-depression-but-associated-with-cognitive-function-an-rtms-study
#17
Efruz Pirdogan Aydın, Abdullah Genc, Mihriban Dalkıran, Ece Türkyilmaz Uyar, Ömer Akil Özer, Kayıhan Oğuz Karamustafalıoğlu
Elevated oxidative stress is known to play an important role in development of depression and cognitive dysfunction. To date, thioredoxin (TRX), an antioxidant protein, has been investigated as a marker for psychiatric disorders such as schizophrenia, bipolar disorder and autism but its relationship with depression is yet to be unknown. The aim of this study is to detect the TRX levels in patients with treatment-resistant depression (TRD), analyse the effect of rTMS (repetitive transcranial magnetic stimulation) application on TRX levels and display the relationship of TRX with cognitive areas...
April 22, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28442422/effects-of-low-frequency-rtms-treatment-on-brain-networks-for-inner-speech-in-patients-with-schizophrenia-and-auditory-verbal-hallucinations
#18
Leonie Bais, Edith Liemburg, Ans Vercammen, Richard Bruggeman, Henderikus Knegtering, André Aleman
INTRODUCTION: Efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) targeting the temporo-parietal junction (TPJ) for the treatment of auditory verbal hallucinations (AVH) remains under debate. We assessed the influence of a 1Hz rTMS treatment on neural networks involved in a cognitive mechanism proposed to subserve AVH. METHODS: Patients with schizophrenia (N=24) experiencing medication-resistant AVH completed a 10-day 1Hz rTMS treatment. Participants were randomized to active stimulation of the left or bilateral TPJ, or sham stimulation...
April 22, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28430672/lamotrigine-uses-in-psychiatric-practice-beyond-bipolar-prophylaxis-a-hope-or-hype
#19
Ahmed Naguy, Najah Al-Enezi
BACKGROUND: Lamotrigine (LAM), an antiepileptic, with panoply of indications and uses in neurology, is FDA approved, in psychiatry, for bipolar prophylaxis. Apart from this indication, trend of its use in psychiatry is on the rise addressing a multitude of disorders. STUDY QUESTION: LAM remains one of only few psychotropic drugs with antiglutamate activity. This might render LAM a potential therapeutic option in treatment-resistant major psychiatric disorders. We reviewed LAM pharmacology and its diverse indications while examining the extant evidence...
April 19, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28418641/classics-in-chemical-neuroscience-ketamine
#20
Marshall W Tyler, Harmony B Yourish, Dawn F Ionescu, Stephen J Haggarty
Ketamine, a molecule of many faces, has contributed immeasurably to numerous realms of clinical practice and scientific inquiry. From anesthesia and analgesia to depression and schizophrenia, it continues to shed light on the molecular underpinnings of pain, consciousness, and the pathophysiology of neuropsychiatric disorders. In particular, research on ketamine's mechanism of action is providing new hope in the search for therapies for treatment-resistant depression and affords insights into disorders of glutamatergic dysfunction...
June 21, 2017: ACS Chemical Neuroscience
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