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Treatment resistant schizophrenia

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https://www.readbyqxmd.com/read/29117910/increased-resting-state-global-functional-connectivity-density-of-default-mode-network-in-schizophrenia-subjects-treated-with-electroconvulsive-therapy
#1
Huan Huang, Yuchao Jiang, Mengqing Xia, Yingying Tang, Tianhong Zhang, Huiru Cui, Junjie Wang, Yu Li, Lihua Xu, Adrian Curtin, Jianhua Sheng, Yuping Jia, Dezhong Yao, Chunbo Li, Cheng Luo, Jijun Wang
Modified electroconvulsive therapy (MECT) has been widely applied to help treat schizophrenia patients who are treatment-resistant to pharmaceutical therapy. Although the technique is increasingly prevalent, the underlying neural mechanisms have not been well clarified. We conducted a longitudinal study to investigate the alteration of global functional connectivity density (gFCD) in schizophrenia patients undergoing MECT using resting state fMRI (functional magnetic resonance imaging). Two groups of schizophrenia inpatients were recruited...
November 6, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/29116126/development-of-multivariable-models-to-predict-change-in-body-mass-index-within-a-clinical-trial-population-of-psychotic-individuals
#2
Rebecca N S Harrison, Fiona Gaughran, Robin M Murray, Sang Hyuck Lee, Jose Paya Cano, David Dempster, Charles J Curtis, Danai Dima, Hamel Patel, Simone de Jong, Gerome Breen
Many antipsychotics promote weight gain, which can lead to non-compliance and relapse of psychosis. By developing models that accurately identify individuals at greater risk of weight gain, clinicians can make informed treatment decisions and target intervention measures. We examined clinical, genetic and expression data for 284 individuals with psychosis derived from a previously published randomised controlled trial (IMPACT). These data were used to develop regression and classification models predicting change in Body Mass Index (BMI) over one year...
November 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29083297/in-male-rats-the-ability-of-central-insulin-to-suppress-glucose-production-is-impaired-by-olanzapine-whereas-glucose-uptake-is-left-intact
#3
Chantel Kowalchuk, Celine Teo, Virginia Wilson, Araba Chintoh, Loretta Lam, Sri Mahavir Agarwal, Adria Giacca, Gary J Remington, Margaret K Hahn
BACKGROUND: Insulin receptors are widely expressed in the brain and may represent a crossroad between metabolic and cognitive disorders. Although antipsychotics, such as olanzapine, are the cornerstone treatment for schizophrenia, they are associated with high rates of type 2 diabetes and lack efficacy for illness-related cognitive deficits. Historically, this risk of diabetes was attributed to the weight gain propensity of antipsychotics, but recent work suggests antipsychotics can have weight-independent diabetogenic effects involving unknown brain-mediated mechanisms...
November 2017: Journal of Psychiatry & Neuroscience: JPN
https://www.readbyqxmd.com/read/29077650/safety-and-efficacy-of-theta-burst-stimulation-in-the-treatment-of-psychiatric-disorders-a-review-of-the-literature
#4
REVIEW
Fady Rachid
Theta-burst stimulation (TBS) is a form of repetitive transcranial magnetic stimulation and is thought to induce more rapid and longer-lasting effects on synaptic plasticity than conventional repetitive transcranial magnetic stimulation protocols. TBS is being used as an investigational and more recently as a therapeutic tool. The purpose of this review is to describe and discuss the studies that have evaluated the safety and efficacy of this technique in the treatment of various psychiatric disorders such as depression, schizophrenia, obsessive-compulsive disorder, Tourette's disorder, nicotine and cocaine addiction, and pathological gambling...
November 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/29072776/antipsychotic-plasma-levels-in-the-assessment-of-poor-treatment-response-in%C3%A2-schizophrenia
#5
R McCutcheon, K Beck, E D'Ambrosio, J Donocik, C Gobjila, S Jauhar, S Kaar, T Pillinger, T Reis Marques, M Rogdaki, O D Howes
OBJECTIVE: Treatment resistance is a challenge for the management of schizophrenia. It is not always clear whether inadequate response is secondary to medication ineffectiveness, as opposed to medication underexposure due to non-adherence or pharmacokinetic factors. We investigated the prevalence of subtherapeutic antipsychotic plasma levels in patients identified as treatment-resistant by their treating clinician. METHOD: Between January 2012 and April 2017, antipsychotic plasma levels were measured in 99 individuals provisionally diagnosed with treatment-resistant schizophrenia by their treating clinicians, but not prescribed clozapine...
October 26, 2017: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/29057817/unresolved-issues-for-utilization-of-atypical-antipsychotics-in-schizophrenia-antipsychotic-polypharmacy-and-metabolic-syndrome
#6
REVIEW
Sang Won Jeon, Yong-Ku Kim
Atypical antipsychotics (AAP) are the prevailing form of schizophrenia treatment today due to their low side effects and superior efficacy. Nevertheless, some issues still need to be addressed. First, there are still a large number of patients with treatment-resistant schizophrenia (TRS), which has led to a growing trend to resort to AAP polypharmacy with few side effects. Most clinical treatment guidelines recommend clozapine monotherapy in TRS, but around one third of schizophrenic patients fail to respond to clozapine...
October 18, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29053485/the-effects-of-electroconvulsive-therapy-augmentation-of-antipsychotic-treatment-on-cognitive-functions-in-patients-with-treatment-resistant-schizophrenia
#7
Bjanka Vuksan Ćusa, Nataša Klepac, Nenad Jakšić, Zoran Bradaš, Marija Božičević, Natalia Palac, Marina Šagud
OBJECTIVES: Treatment-resistant schizophrenia (TRS) continues to be a challenge in modern psychiatry. Most of these patients have severe neurocognitive deficits. Electroconvulsive therapy (ECT) has proved effective and safe in the treatment of TRS, but because of potential neurocognitive adverse effects, it is associated with many controversies. The aim of this prospective, open study was to evaluate the effects of ECT augmentation of antipsychotics on cognitive functions in patients with TRS...
October 19, 2017: Journal of ECT
https://www.readbyqxmd.com/read/29050493/serum-bdnf-is-positively-associated-with-negative-symptoms-in-older-adults-with-schizophrenia
#8
Sasha S Binford, Erin M Hubbard, Elena Flowers, Bruce L Miller, Heather Leutwyler
OBJECTIVES: Older adults with chronic schizophrenia are at greater risk for functional disability and poorer health outcomes than those without serious mental illness. These individuals comprise 1-2% of the elderly population in the United States and are projected to number approximately 15 million by 2030. The symptoms of schizophrenia can be disabling for individuals, significantly reducing quality of life. Often, the negative symptoms (NS) are the most resistant to treatment and are considered a marker of illness severity, though they are challenging to measure objectively...
January 1, 2017: Biological Research for Nursing
https://www.readbyqxmd.com/read/29049083/ketamine-and-pharmacological-imaging-use-of-functional-magnetic-resonance-imaging-to-evaluate-mechanisms-of-action
#9
Eric A Maltbie, Gopinath S Kaundinya, Leonard L Howell
Ketamine has been used as a pharmacological model for schizophrenia as subanesthetic infusions have been shown to produce temporary schizophrenia-like symptoms in healthy humans. More recently, ketamine has emerged as a potential treatment for multiple psychiatric disorders, including treatment-resistant depression and suicidal ideation. However, the mechanisms underlying both the psychotomimetic and the therapeutic effects of ketamine remain poorly understood. This review provides an overview of what is known of the neural mechanisms underlying the effects of ketamine and details what functional MRI studies have yielded at a systems level focused on brain circuitry...
December 2017: Behavioural Pharmacology
https://www.readbyqxmd.com/read/29046626/curcumin-activates-ampk-pathway-and-regulates-lipid-metabolism-in-rats-following-prolonged-clozapine-exposure
#10
Zhen Liu, Changmeng Cui, Pengfei Xu, Ruili Dang, Hualin Cai, Dehua Liao, Mengqi Yang, Qingyan Feng, Xin Yan, Pei Jiang
Clozapine (CLO) remains an ultimate option for patients with treatment resistant schizophrenia. However, the atypical antipsychotic is often associated with serious metabolic side effects, such as dyslipidemia. Hepatic sterol regulatory element-binding proteins (SREBPs) are central in the allosteric control of a variety of lipid biosynthetic pathways. There is emerging evidence that CLO can activate SREBP pathway and enhance downstream lipogenesis, whereas curcumin (CUR), a major active compound of Curcuma longa, contains hypolipidemic properties...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29045304/effect-of-clozapine-vs-other-second-generation-antipsychotics-on-hospitalization-and-seclusion-a-retrospective-mirror-image-study-in-a-japanese-public-psychiatric-hospital
#11
Fuminari Misawa, Takefumi Suzuki, Yasuo Fujii
BACKGROUND: Clozapine has been regarded as the gold standard for patients with treatment-resistant schizophrenia, but a recent network meta-analysis has questioned its relative superiority over other second-generation antipsychotics (SGAs) such as olanzapine and risperidone. PURPOSE: We conducted a retrospective mirror-image study of clozapine vs other SGAs to evaluate real-world effectiveness of clozapine in terms of the duration of hospitalization and seclusion, both of which represent a critical outcome...
October 17, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29042073/functional-network-dysconnectivity-as-a-biomarker-of-treatment-resistance-in-schizophrenia
#12
Carolyn B McNabb, Roger J Tait, Meghan E McIlwain, Valerie M Anderson, John Suckling, Robert R Kydd, Bruce R Russell
Schizophrenia may develop from disruptions in functional connectivity regulated by neurotransmitters such as dopamine and acetylcholine. The modulatory effects of these neurotransmitters might explain how antipsychotics attenuate symptoms of schizophrenia and account for the variable response to antipsychotics observed in clinical practice. Based on the putative mechanisms of antipsychotics and evidence of disrupted connectivity in schizophrenia, we hypothesised that functional network connectivity, as assessed using network-based statistics, would exhibit differences between treatment response subtypes of schizophrenia and healthy controls...
October 14, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/29035174/in-male-rats-the-ability-of-central-insulin-to-suppress-glucose-production-is-impaired-by-olanzapine-whereas-glucose-uptake-is-left-intact
#13
Chantel Kowalchuk, Celine Teo, Virginia Wilson, Araba Chintoh, Loretta Lam, Sri Mahavir Agarwal, Adria Giacca, Gary J Remington, Margaret K Hahn
BACKGROUND: Insulin receptors are widely expressed in the brain and may represent a crossroad between metabolic and cognitive disorders. Although antipsychotics, such as olanzapine, are the cornerstone treatment for schizophrenia, they are associated with high rates of type 2 diabetes and lack efficacy for illness-related cognitive deficits. Historically, this risk of diabetes was attributed to the weight gain propensity of antipsychotics, but recent work suggests antipsychotics can have weight-independent diabetogenic effects involving unknown brain-mediated mechanisms...
October 16, 2017: Journal of Psychiatry & Neuroscience: JPN
https://www.readbyqxmd.com/read/29028689/effective-switch-from-clozapine-to-aripiprazole-in-treatment-resistant-schizophrenia-and-comorbid-alcohol-use-disorder
#14
Robert J Feeley, Bachaar Arnaout, Gihyun Yoon
No abstract text is available yet for this article.
October 12, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29026311/artesunate-prevents-rats-from-the-clozapine-induced-hepatic-steatosis-and-elevation-in-plasma-triglycerides
#15
Yanmei Li, Ruibing Su, Shuqin Xu, Qingjun Huang, Haiyun Xu
Clozapine is an atypical antipsychotic with therapeutic efficacy in treatment-resistant schizophrenia patients and low incidence of extrapyramidal side effects. However, the use of clozapine has been limited by its adverse effects on metabolism. Artesunate is a semisynthetic derivative of artemisinin and was shown to decrease the plasma cholesterol and triglyceride in rabbits and rats in recent studies. The aim of this study was to examine possible effects of artesunate on the clozapine-induced metabolic alterations in rats given saline, clozapine, artesunate, or clozapine plus artesunate for 6 weeks...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29024893/plasma-ratio-of-clozapine-to-n-desmethylclozapine-can-predict-cognitive-performance-in-treatment-resistant-psychotic-patients
#16
Conrad Molins, Mar Carceller-Sindreu, Helena Navarro, Cristina Carmona, Marina Piñeiro, Estrella Martínez, Enric Álvarez, Maria J Portella
Cognitive symptoms play a central role in schizophrenia and are strongly associated with social functioning. Treatment with clozapine presents controversial results regarding its effects on cognition. The opposite effects of clozapine and n-desmethylclozapine (NDMC) on cholinergic system have been suggested to underlie these inconclusive findings. The aim of this study is to determine whether clozapine/NDMC ratio can predict cognitive performance in patients with treatment-resistant psychosis. Nineteen clinically stable patients with schizophrenia or schizoaffective disorder treated with clozapine monotherapy completed demographic and clinical interviews...
December 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29017334/brexpiprazole-a-new-leaf-on-the-partial-dopamine-agonist-branch
#17
Judy Hope, David Castle, Nicholas A Keks
OBJECTIVES: Brexpiprazole is a new dopamine partial agonist antipsychotic in the same class as aripiprazole. This paper will briefly review brexpiprazole and compare it with aripiprazole. CONCLUSIONS: Brexpiprazole and aripiprazole are both partial agonists at dopamine D2, and serotonin 5-HT1A and antagonists at serotonin 5-HT2A and noradrenergic α1B receptors. However, the two drugs are significantly different in potencies at various receptors; neurochemical profiles predict that brexpiprazole may be comparable with aripiprazole in its antipsychotic efficacy but may cause less akathisia, extrapyramidal side effects (EPS) and activation...
October 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28983259/remission-of-psychosis-in-treatment-resistant-schizophrenia-following-bone-marrow-transplantation-a-case-report
#18
Tsuyoshi Miyaoka, Rei Wake, Sadayuki Hashioka, Maiko Hayashida, Arata Oh-Nishi, Ilhamuddin Abdul Azis, Muneto Izuhara, Keiko Tsuchie, Tomoko Araki, Ryosuke Arauchi, Rostia Arianna Abdullah, Jun Horiguchi
The authors present the case of a 24-year-old male with treatment-resistant schizophrenia, with predominant severe delusion and hallucination, who received bone marrow transplantation (BMT) for acute myeloid leukemia. After BMT, he showed a remarkable reduction in psychotic symptoms without administration of neuroleptics. He also showed drastic improvement in social functioning. Follow-up evaluations 2 and 4 years after BMT showed persistent significant improvement of the psychotic state and social functioning...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28976410/early-onset-schizophrenia-associated-with-obsessive-compulsive-disorder-clinical-features-and-correlates
#19
Burak Baytunca, Tuğba Kalyoncu, Ismail Ozel, Serpil Erermiş, Bülent Kayahan, Dost Öngur
OBJECTIVES: Obsessive-compulsive disorder (OCD) is notably a comorbid disorder in patients with schizophrenia. This study aimed to evaluate clinical features and correlates of early onset patients with schizophrenia with OCD. METHODS: In the present study, we included 10 patients with both schizophrenia and OCD and 19 patients with schizophrenia without OCD. The mean antipsychotic doses the patients needed for treatment are standardized as chlorpromazine equivalent dose...
November 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28953788/benzodiazepines-in-combination-with-antipsychotic-drugs-for-schizophrenia-gaba-ergic-targeted-therapy
#20
Adam Włodarczyk, Joanna Szarmach, Wiesław Jerzy Cubała, Mariusz Stanisław Wiglusz
Antipsychotics are a key intervention strategy in pharmacotherapy of schizophrenia. However, benzodiazepines are often prescribed to control sleep disturbances, anxiety or behavioural disinhibition. There is clinical evidence for the beneficial effect of the combined treatment of antipsychotics and benzodiazepines resulting in more favorable treatment outcome in schizophrenia with regard to positive and negative symptoms. This clinical phenomenon seems to be associated with the GABA-ergic activit ythat is believed to be disrupted in the schizophrenia and direct benzodiazepines effect on GABA-A receptors...
September 2017: Psychiatria Danubina
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