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Treatment resistant schizophrenia

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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
#1
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
#2
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
#3
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
#4
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...
May 15, 2017: Parasitology Research
https://www.readbyqxmd.com/read/28506706/cognitive-and-functional-deficits-in-people-with-schizophrenia-evidence-for-accelerated-or-exaggerated-aging
#5
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
#6
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
#7
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
#8
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
#9
Leonie Bais, Edith Liemburg, Ans Vercammen, Richard Bruggeman, Rikus 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
#10
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
#11
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...
April 21, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28418011/more-than-25-years-of-genetic-studies-of-clozapine-induced-agranulocytosis
#12
REVIEW
S A J de With, S L Pulit, W G Staal, R S Kahn, R A Ophoff
Clozapine is one of the most effective atypical antipsychotic drugs prescribed to patients with treatment-resistant schizophrenia. Approximately 1% of patients experience potential life-threatening adverse effects in the form of agranulocytosis, greatly hindering its applicability in clinical practice. The etiology of clozapine-induced agranulocytosis (CIA) remains unclear, but is thought to be a heritable trait. We reviewed the genetic studies of CIA published thus far. One recurrent finding from early candidate gene study to more recent genome-wide analysis is that of the involvement of human leukocyte antigen locus...
April 18, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28407747/antipsychotic-prescribing-for-vulnerable-populations-a-clinical-audit-at-an-acute-australian-mental-health-unit-at-two-time-points
#13
Sara S McMillan, Sara Jacobs, Louise Wilson, Theo Theodoros, Gail Robinson, Claire Anderson, Gabor Mihala, Amanda J Wheeler
BACKGROUND: Antipsychotics are recognised as a critical intervention for schizophrenia and bipolar disorder. Guidelines globally endorse the routine practice of antipsychotic monotherapy, at the minimum effective dose. Even in treatment-resistant schizophrenia, clozapine use is endorsed before combining antipsychotics. This aim of this study was to review antipsychotic polytherapy alone, high-dose therapy alone, polytherapy and high-dose prescribing patterns in adults discharged from an inpatient mental health unit at two time-points, and the alignment of this prescribing with clinical guideline recommendations...
April 13, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28406327/key-updates-in-the-clinical-application-of-electroconvulsive-therapy
#14
Richard D Weiner, Irving M Reti
ECT is the oldest and most effective therapy available for the treatment of severe major depression. It is highly effective in individuals with treatment resistance and when a rapid response is required. However, ECT is associated with memory impairment that is the most concerning side-effect of the treatment, substantially contributing to the controversy and stigmatization surrounding this highly effective treatment. There is overwhelming evidence for the efficacy and safety of an acute course of ECT for the treatment of a severe major depressive episode, as reflected by the recent FDA advisory panel recommendation to reclassify ECT devices from Class III to the lower risk category Class II...
April 13, 2017: International Review of Psychiatry
https://www.readbyqxmd.com/read/28395674/antipsychotic-treatment-resistance-in-first-episode-psychosis-prevalence-subtypes-and-predictors
#15
A Demjaha, J M Lappin, D Stahl, M X Patel, J H MacCabe, O D Howes, M Heslin, U A Reininghaus, K Donoghue, B Lomas, M Charalambides, A Onyejiaka, P Fearon, P Jones, G Doody, C Morgan, P Dazzan, R M Murray
BACKGROUND: We examined longitudinally the course and predictors of treatment resistance in a large cohort of first-episode psychosis (FEP) patients from initiation of antipsychotic treatment. We hypothesized that antipsychotic treatment resistance is: (a) present at illness onset; and (b) differentially associated with clinical and demographic factors. METHOD: The study sample comprised 323 FEP patients who were studied at first contact and at 10-year follow-up...
April 11, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28373848/the-current-status-of-the-ketogenic-diet-in-psychiatry
#16
REVIEW
Emmanuelle C S Bostock, Kenneth C Kirkby, Bruce V M Taylor
BACKGROUND: The ketogenic diet (KD) has been used in treatment-resistant epilepsy since the 1920s. It has been researched in a variety of neurological conditions in both animal models and human trials. The aim of this review is to clarify the potential role of KD in psychiatry. METHODS: Narrative review of electronic databases PubMED, PsychINFO, and Scopus. RESULTS: The search yielded 15 studies that related the use of KD in mental disorders including anxiety, depression, bipolar disorder, schizophrenia, autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD)...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28355041/clozapine-augmentation-with-antiepileptic-drugs-for-treatment-resistant-schizophrenia-a-meta-analysis-of-randomized-controlled-trials
#17
Wei Zheng, Yu-Tao Xiang, Xin-Hu Yang, Ying-Qiang Xiang, Jose de Leon
OBJECTIVE: To meta-analyze randomized controlled trials (RCTs) for the efficacy and safety of adjunctive antiepileptic drugs (AEDs) to augment clozapine therapy for treatment-resistant schizophrenia. DATA SOURCES: The search included databases in English (PubMed, PsycINFO, Embase, and Cochrane Library databases and the Cochrane Controlled Trials Register) and in Chinese (China Journal Net [CJN], WanFang, and China Biology Medicine [CBM]) and references from retrieved articles...
March 28, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28348731/clonazepam-improves-dopamine-supersensitivity-in-a-schizophrenia-patient-a-case-report
#18
REVIEW
Mina Fukai, Tetsu Hirosawa, Tetsuya Takahashi, Reizo Kaneda, Mitsuru Kikuchi, Yoshio Minabe
Dopamine supersensitivity is an important consideration for assessing treatment-resistant schizophrenia. The emergence of dopamine supersensitivity might be related to upregulation of dopamine D2 receptor, which engenders tolerance to antipsychotics, rebound psychosis, and tardive dyskinesia (TD). A 24-year-old man with a history of treatment-resistant schizophrenia was hospitalized for treatment of bone fracture sustained during a suicide attempt. After the operation, his clinical symptoms implied malignant catatonia...
March 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28344764/atypical-antipsychotics-recent-research-findings-and-applications-to-clinical-practice-proceedings-of-a-symposium-presented-at-the-29th-annual-european-college-of-neuropsychopharmacology-congress-19-september-2016-vienna-austria
#19
REVIEW
Robin Murray, Christoph U Correll, Gavin P Reynolds, David Taylor
Available evidence suggests that second-generation atypical antipsychotics are broadly similar to first-generation agents in terms of their efficacy, but may have a more favourable tolerability profile, primarily by being less likely to cause extrapyramidal symptoms. However, atypical antipsychotics are variably associated with disturbances in the cardiometabolic arena, including increased body weight and the development of metabolic syndrome, which may reflect differences in their receptor binding profiles...
March 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28343762/clozapine-and-incidence-of-myocarditis-and-sudden-death-long-term-australian-experience
#20
Arshad A Khan, Asma Ashraf, David Baker, Mohammed S Al-Omary, Lindsay Savage, Avedis Ekmejian, Rajinder Singh Harjit Singh, Stephen Brienesse, Tazeen Majeed, Tracy Gordon, Vincent Drinkwater, Nicholas J Collins
BACKGROUND: Clozapine is the cornerstone of therapy for refractory schizophrenia; however, the potential for cardiotoxicity is an important limitation in its use. In the current analysis we sought to evaluate the long term cardiac outcomes of clozapine therapy. METHODS: All-cause mortality, incidence of sudden death and time to myocarditis were assessed in a cohort of patients maintained on clozapine between January 2009 and December 2015. All patients had regular electrocardiograms, complete blood count, clozapine levels and echocardiography as part of a formal protocol...
March 6, 2017: International Journal of Cardiology
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