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Treatment resistant schizophrenia

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https://www.readbyqxmd.com/read/28335437/effect-of-clozapine-on-dna-methylation-in-peripheral-leukocytes-from-patients-with-treatment-resistant-schizophrenia
#1
Makoto Kinoshita, Shusuke Numata, Atsushi Tajima, Hidenaga Yamamori, Yuka Yasuda, Michiko Fujimoto, Shinya Watanabe, Hidehiro Umehara, Shinji Shimodera, Takanobu Nakazawa, Masataka Kikuchi, Akihiro Nakaya, Hitoshi Hashimoto, Issei Imoto, Ryota Hashimoto, Tetsuro Ohmori
Clozapine is an atypical antipsychotic, that is established as the treatment of choice for treatment-resistant schizophrenia (SCZ). To date, no study investigating comprehensive DNA methylation changes in SCZ patients treated with chronic clozapine has been reported. The purpose of the present study is to reveal the effects of clozapine on DNA methylation in treatment-resistant SCZ. We conducted a genome-wide DNA methylation profiling in peripheral leukocytes (485,764 CpG dinucleotides) from treatment-resistant SCZ patients treated with clozapine (n = 21) in a longitudinal study...
March 14, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28333365/clozapine-combined-with-different-antipsychotic-drugs-for-treatment-resistant-schizophrenia
#2
REVIEW
Sarah Barber, Uwaila Olotu, Martina Corsi, Andrea Cipriani
BACKGROUND: Between 40% and 70% of people with treatment-resistant schizophrenia do not respond to clozapine, despite adequate blood levels. For these people, a number of treatment strategies have emerged, including the prescription of a second anti-psychotic drug in combination with clozapine. OBJECTIVES: To determine the clinical effects of various clozapine combination strategies with antipsychotic drugs in people with treatment-resistant schizophrenia both in terms of efficacy and tolerability...
March 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28323458/clozapine-related-tachycardia-in-an-adolescent-with-treatment-resistant-early-onset-schizophrenia
#3
Venkata Kolli, Dalton Bourke, Jeannie Ngo, Maxwell J Luber, Barbara J Coffey
No abstract text is available yet for this article.
March 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28293046/efficacy-of-risperidone-augmentation-with-ondansetron-in-the-treatment-of-negative-and-depressive-symptoms-in-schizophrenia-a-randomized-clinical-trial
#4
Roya Samadi, Susan Soluti, Reza Daneshmand, Shervin Assari, Ali Akhoundpour Manteghi
BACKGROUND: Given the potential role of the 5-hydroxytryptamine-3 receptor in the pathogenesis of schizophrenia, this study was performed to determine whether ondansetron plus risperidone could reduce the negative and depressive symptoms in patients with treatment-resistant schizophrenia. METHODS: In a double-blinded, placebo-controlled, randomized trial (IRCT registration # 201112125280N7), in 2012-2013 in Mashhad, Iran, 38 patients with treatment-resistant schizophrenia received risperidone either combined with a fixed dose (4-8 mg/d) of ondansetron (n=18) or with a placebo (n=20) for 12 weeks...
January 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28277565/pharmacogenetic-analysis-of-functional-glutamate-system-gene-variants-and-clinical-response-to-clozapine
#5
Danielle L Taylor, Arun K Tiwari, Jeffrey A Lieberman, Steven G Potkin, Herbert Y Meltzer, Joanne Knight, Gary Remington, Daniel J Müller, James L Kennedy
Altered glutamate neurotransmission is implicated in the etiology of schizophrenia (SCZ) and the pharmacogenetics of response to clozapine (CLZ), which is the drug of choice for treatment-resistant SCZ. Response to antipsychotic therapy is highly variable, although twin studies suggest a genetic component. We investigated the association of 10 glutamate system gene variants with CLZ response using standard genotyping procedures. GRM2 (rs4067 and rs2518461), SLC1A2 (rs4354668, rs4534557, and rs2901534), SLC6A9 (rs12037805, rs1978195, and rs16831558), GRIA1 (rs2195450), and GAD1 (rs3749034) were typed in 163 European SCZ/schizoaffective disorder patients deemed resistant or intolerant to previous pharmacotherapy...
February 2017: Molecular Neuropsychiatry
https://www.readbyqxmd.com/read/28277309/differential-gene-expression-profiles-in-neurons-generated-from-lymphoblastoid-b-cell-line-derived-ips-cells-from-monozygotic-twin-cases-with-treatment-resistant-schizophrenia-and-discordant-responses-to-clozapine
#6
Takanobu Nakazawa, Masataka Kikuchi, Mitsuru Ishikawa, Hidenaga Yamamori, Kazuki Nagayasu, Takuya Matsumoto, Michiko Fujimoto, Yuka Yasuda, Mikiya Fujiwara, Shota Okada, Kensuke Matsumura, Atsushi Kasai, Atsuko Hayata-Takano, Norihito Shintani, Shusuke Numata, Kazuhiro Takuma, Wado Akamatsu, Hideyuki Okano, Akihiro Nakaya, Hitoshi Hashimoto, Ryota Hashimoto
Schizophrenia is a chronic psychiatric disorder with complex genetic and environmental origins. While many antipsychotics have been demonstrated as effective in the treatment of schizophrenia, a substantial number of schizophrenia patients are partially or fully unresponsive to the treatment. Clozapine is the most effective antipsychotic drug for treatment-resistant schizophrenia; however, clozapine has rare but serious side-effects. Furthermore, there is inter-individual variability in the drug response to clozapine treatment...
October 27, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/28264565/dual-modulation-of-human-p-glycoprotein-and-abcg2-with-prodrug-dimers-of-the-atypical-antipsychotic-agent-paliperidone-in-a-model-of-the-blood-brain-barrier
#7
Kelsey Bohn, Allison Lange, Jean Chmielewski, Christine A Hrycyna
Many atypical antipsychotic drugs currently prescribed for the treatment of schizophrenia have limited brain penetration due to the efflux activity of ATP-binding cassette (ABC) transporters at the blood-brain barrier (BBB), including P-glycoprotein (P-gp) and ABCG2. Herein, we describe the design and synthesis of the first class of homodimeric prodrug dual inhibitors of P-gp and ABCG2. These inhibitors are based on the structure of the atypical antipsychotic drug paliperidone (Pal), a transport substrate for both transporters...
March 6, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28259863/-review-of-the-psychiatric-aspects-of-anti-nmda-n-methyl-d-aspartic-acid-receptor-encephalitis-case-report-and-our-plans-for-a-future-study
#8
Levente Herman, Ildiko Reka Zsigmond, Laszlo Peter, Janos M Rethelyi
Anti-NMDAR (N-methyl-D-aspartic acid receptor) encephalitis, first described in 2007, is a rare, autoimmune limbic encephalitis. In half of the cases anti-NMDAR antibodies are paraneoplastic manifestations of an underlying tumor (mostly ovarian teratoma). In the early stage of the disease psychiatric symptoms are prominent, therefore 60-70% of the patients are first treated in a psychiatric department. In most of the cases, typical neurological symptoms appear later. Besides the clinical picture and typical symptoms, verifying presence of IgG antibodies in the serum or CSF is necessary to set up the diagnosis...
December 2016: Neuropsychopharmacologia Hungarica
https://www.readbyqxmd.com/read/28258419/clozapine-for-treatment-resistant-schizophrenia-still-the-gold-standard
#9
EDITORIAL
David M Taylor
No abstract text is available yet for this article.
March 2017: CNS Drugs
https://www.readbyqxmd.com/read/28250565/multimodal-hallucinations-in-schizophrenia-and-its-management
#10
Vijaya Kumar, Virupakshappa Bagewadi, Dayanand Sagar, Shivarama Varambally
A cluster of symptoms including hallucinations characterizes schizophrenia. Hallucinations that occur in more than one modality simultaneously and emanate from a single source are called multimodal hallucinations (MMHs). The occurrence of simultaneous hallucinations as the major manifestations of a psychiatric disorder often was dismissed as factitious disorder or malingering. Conversely, MMHs have been reported in severe mental disorders including schizophrenia. Here, we report MMH in two patients of treatment-resistant schizophrenia and its successful management with clozapine...
January 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28225745/predictors-of-nonhospitalization-and-functional-response-in-clozapine-treatment-a-nationwide-population-based-cohort-study
#11
Ole Köhler-Forsberg, Henriette T Horsdal, Sophie E Legge, James H MacCabe, Christiane Gasse
BACKGROUND: Clozapine remains the only evidence-based treatment for treatment-resistant schizophrenia, and prediction of clozapine response is important in developing stratified treatment. We studied potential predictors of clozapine response, applying functional assessments as well as service use. PROCEDURES: We performed a nationwide cohort study among all individuals diagnosed with schizophrenia in Denmark after 1995 (age, ≥18 years) who initiated clozapine treatment between 2004 and 2011 with a Global Assessment of Functioning (GAF-F) score registered at clozapine initiation...
April 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28184875/polygenic-risk-score-for-schizophrenia-and-treatment-resistant-schizophrenia
#12
Theresa Wimberley, Christiane Gasse, Sandra Melanie Meier, Esben Agerbo, James H MacCabe, Henriette Thisted Horsdal
No abstract text is available yet for this article.
February 10, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/28163559/new-schizophrenia-treatments-address-unmet-clinical-needs
#13
Chris Fellner
We present several novel drugs in development for enhancing cognition, treating negative symptoms, and providing improved options for treatment-resistant patients. Drug makers aim to enhance safety profiles and increase patient compliance to therapy.
February 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28162976/neuromodulation-in-response-to-electroconvulsive-therapy-in-schizophrenia-and-major-depression
#14
Philipp Arthur Thomann, Robert Christian Wolf, Henrike Maria Nolte, Dusan Hirjak, Stefan Hofer, Ulrich Seidl, Malte Sebastian Depping, Bram Stieltjes, Klaus Maier-Hein, Fabio Sambataro, Torsten Wüstenberg
BACKGROUND: Electroconvulsive therapy (ECT) is one of the most effective treatments in severe and treatment-resistant major depressive disorder (MDD). ECT has been also shown to be effective in schizophrenia (SZ), particularly when rapid symptom reduction is needed or in cases of resistance to drug-treatment. However, its precise mechanisms of action remain largely unknown. OBJECTIVE/HYPOTHESIS: This study examined whether ECT exerts disorder-specific or unspecific modulation of brain structure and function in SZ and MDD...
January 16, 2017: Brain Stimulation
https://www.readbyqxmd.com/read/28153339/characterization-of-admission-types-in-medically-hospitalized-patients-prescribed-clozapine
#15
Jonathan G Leung, M Earth Hasassri, Jason N Barreto, Sarah Nelson, Robert J Morgan
BACKGROUND: Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia; however, rigorous monitoring is required to prevent or detect adverse drug events that contribute to morbidity and mortality. In addition to the Food and Drug Administration (FDA) boxed safety warnings specific to clozapine (agranulocytosis, hypotension, seizures, and cardiomyopathy/myocarditis), other adverse events such as pneumonia and gastrointestinal hypomotility have been reported in the literature to result in hospitalization...
November 18, 2016: Psychosomatics
https://www.readbyqxmd.com/read/28152470/effectiveness-of-electroconvulsive-therapy-in-patients-with-treatment-resistant-schizophrenia-a-retrospective-study
#16
Sandeep Grover, Subho Chakrabarti, Nandita Hazari, Ajit Avasthi
This study aimed to evaluate the effectiveness of electroconvulsive therapy (ECT) among patients with treatment resistant schizophrenia (TRS). Records of patients who had received ECT were reviewed to identify patients with TRS who were administered ECT in combination with clozapine. Socio-demographic, clinical data and ECT details were extracted. The most common diagnosis was of paranoid schizophrenia (49%) followed by undifferentiated schizophrenia (36%). A-fifth (22%) of the patients were judged to have poor response to clozapine...
March 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28142068/the-critical-treatment-window-of-clozapine-in-treatment-resistant-schizophrenia-secondary-analysis-of-an-observational-study
#17
Bunta Yoshimura, Yuji Yada, Ryuhei So, Manabu Takaki, Norihito Yamada
Previous studies have suggested that a delay in initiating clozapine is one of the predictors of outcomes in treatment-resistant schizophrenia (TRS). However, whether there is a critical treatment window of clozapine in TRS and the duration of that window remain unclear. We conducted a secondary analysis of a previously published observational study using a retrospective chart review of 105 patients with TRS who were treated with clozapine. We included 90 patients who remained on clozapine for at least 3 months...
January 24, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28141630/neuroprotective-effect-of-modified-electroconvulsive-therapy-for-schizophrenia-a-proton-magnetic-resonance-spectroscopy-study
#18
Jing-Li Gan, Hui-Feng Duan, Zheng-Xiang Cheng, Jia-Ming Yang, Xi-Quan Zhu, Cun-You Gao, Lan-Min Zhao, Xue-Jun Liang
The underlying mechanism of modified electroconvulsive therapy (MECT) treatment for drug-resistant and catatonic schizophrenia remains unclear. Here, we aim to investigate whether MECT exerts its antipsychotic effects through elevating N-acetylaspartate (NAA) concentration measured by proton magnetic resonance spectroscopy (H-MRS). Multiple-voxel H-MRS was acquired in the bilateral prefrontal cortex (PFC) and thalamus to obtain measures of neurochemistry in 32 MECT, 34 atypical antipsychotic-treated schizophrenic patients, and 34 healthy controls...
January 30, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28138403/clozapine-in-a-patient-with-treatment-resistant-schizophrenia-and-hypertrophic-cardiomyopathy-a-case-report
#19
Asiel Yair Adan Sanchez, Jessica J Foster, Carla M Plymen, Sukhi Shergill
BACKGROUND: There is currently limited experience in the initiation and maintenance of clozapine for treatment-resistant psychosis in adults with established structural heart disease. These complex patients require close supervision and liaison between colleagues. Here we present the successful experience of treating one such patient within our service and describe a monitoring plan to ensure that these treatments can be provided both safely and effectively. CASE PRESENTATION: A 36-year-old man with treatment-resistant schizophrenia and known hypertrophic cardiomyopathy (HCM) was admitted to a specialist unit for a trial of clozapine...
November 2016: BJPsych Open
https://www.readbyqxmd.com/read/28128334/protein-kinase-c-%C3%AE-a-new-target-therapy-to-prevent-the-long-term-atypical-antipsychotics-induced-weight-gain
#20
Alessandro Rimessi, Chiara Pavan, Elli Ioannidi, Federica Nigro, Claudia Morganti, Alberto Brugnoli, Francesco Longo, Chiara Gardin, Letizia Ferroni, Michele Morari, Vincenzo Vindigni, Barbara Zavan, Paolo Pinton
Antipsychotic drugs are currently used in clinical practice for a variety of mental disorders. Among them, clozapine is the most effective medication for treatment-resistant schizophrenia and is most helpful in controlling aggression and the suicidal behavior in schizophrenia and schizoaffective disorder. Although clozapine is associated with a low likelihood of extrapyramidal symptoms and other neurological side effects, it is well-known for the weight gain and metabolic side effects, which expose the patient to a greater risk of cardiovascular disorders, premature death, as well as psychosocial issues leading to non-adherence to therapy...
January 27, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
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