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anticholinergics in psychosis

Jared Thomas Hinkle, Kate Perepezko, Catherine C Bakker, Martinus P G Broen, Kathleen Chin, Ted M Dawson, Vanessa Johnson, Zoltan Mari, Cherie L Marvel, Kelly A Mills, Alexander Pantelyat, Olga Pletnikova, Liana S Rosenthal, Melissa D Shepard, Daniel A Stevens, Juan C Troncoso, Jiangxia Wang, Gregory M Pontone
Background: Psychosis is among the most disabling complications of Parkinson's disease (PD). The chronicity of PD psychosis remains understudied and the relative importance of dopaminergic therapy versus the disease process itself in engendering psychosis remains unclear. Objectives: To examine pharmacologic and motoric correlates of PD psychosis onset and remission in a longitudinally monitored PD cohort. Methods: We analyzed data from 165 participants enrolled in a longitudinal PD study through the Morris K...
January 2018: Movement Disorders Clinical Practice
Alejandro Ballesteros, Ana M Sánchez-Torres, Jose M López-Ilundain, Bibiana Cabrera, Antonio Lobo, Ana M González-Pinto, Covadonga Díaz-Caneja, Iluminada Corripio, Eduard Vieta, Elena de la Serna, Julio Bobes, Judith Usall, Fernando Contreras, Ruth Lorente-Omeñaca, Gisela Mezquida, Miguel Bernardo, Manuel J Cuesta
BACKGROUND: Cognitive deficits are a core feature of early stages in schizophrenia. However, the extent to which antipsychotic (AP) have a deleterious effect on cognitive performance remains under debate. We aim to investigate whether anticholinergic loadings and dose of AP drugs in first episode of psychosis (FEP) in advanced phase of remission are associated with cognitive impairment and the differences between premorbid intellectual quotient (IQ) subgroups. METHODS: Two hundred and sixty-six patients participated...
January 14, 2018: Psychological Medicine
Hadar Zaman, Stephanie J Sampson, Alison Ls Beck, Tarang Sharma, Fiona J Clay, Styliani Spyridi, Sai Zhao, Donna Gillies
BACKGROUND: Acute psychotic illness, especially when associated with agitated or violent behaviour, can require urgent pharmacological tranquillisation or sedation. In several countries, clinicians often use benzodiazepines (either alone or in combination with antipsychotics) for this outcome. OBJECTIVES: To examine whether benzodiazepines, alone or in combination with other pharmacological agents, is an effective treatment for psychosis-induced aggression or agitation when compared with placebo, other pharmacological agents (alone or in combination) or non-pharmacological approaches...
December 8, 2017: Cochrane Database of Systematic Reviews
Jarosław Sławek, Mariusz Madaliński
The medical treatment of Parkinson's disease (PD) is symptomatic both in terms of motor and nonmotor aspects. The nonmotor symptoms therapy should be taken into account as many of them negatively influence the quality of life and are treatable. Botulinum neurotoxin (BoNT) offers effective treatment for drooling and bladder dysfunctions and alternative treatment for constipation and pain related to parkinsonism. BoNT for drooling is probably the best-documented therapy for nonmotor symptoms by clinical trials...
2017: International Review of Neurobiology
Santiago Perez-Lloret, María Cecilia Peralta, Francisco J Barrantes
Dopamine depletion is one of the most important features of Parkinson's Disease (PD). However, insufficient response to dopaminergic replacement therapy suggests the involvement of other neurotransmitter systems in the pathophysiology of PD. Cholinergic degeneration contributes to gait impairments, cognitive impairment, psychosis, and REM-sleep disturbances, among other symptoms. Areas covered: In this review, we explore the idea that enhancing cholinergic tone by pharmacological or neurosurgical procedures could be a first-line therapeutic strategy for the treatment of symptoms derived from cholinergic degeneration in PD...
December 2016: Expert Opinion on Pharmacotherapy
Savita G Bhakta, Hsun-Hua Chou, Brinda Rana, Jo A Talledo, Bryan Balvaneda, Laura Gaddis, Gregory A Light, Neal R Swerdlow
RATIONALE: Pro-cognitive agents for chronic psychotic disorders (CPDs) might be detected via experimental medicine models, in which neural targets engaged by the drug predict sensitivity to the drug's pro-cognitive effects. OBJECTIVE: This study aims to use an experimental medicine model to test the hypothesis that "target engagement" predicts pro-cognitive effects of the NMDA antagonist, memantine (MEM), in CPDs. METHODS: MATRICS Consensus Cognitive Battery (MCCB) performance was assessed in CPD (n = 41) and healthy subjects (HS; n = 41) in a double-blind, randomized cross-over design of acute (single dose) MEM (placebo vs...
June 2016: Psychopharmacology
E Peña, M Mata, L López-Manzanares, M Kurtis, M Eimil, J C Martínez-Castrillo, I Navas, I J Posada, C Prieto, C Ruíz-Huete, L Vela, B Venegas
INTRODUCTION: Although antidepressants are widely used in Parkinson's disease (PD), few well-designed studies to support their efficacy have been conducted. DEVELOPMENT: These clinical guidelines are based on a review of the literature and the results of an AMN movement disorder study group survey. CONCLUSIONS: Evidence suggests that nortriptyline, venlafaxine, paroxetine, and citalopram may be useful in treating depression in PD, although studies on paroxetine and citalopram yield conflicting results...
March 19, 2016: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Miquel Bioque, Adrián Llerena, Bibiana Cabrera, Gisela Mezquida, Antonio Lobo, Ana González-Pinto, Covadonga M Díaz-Caneja, Iluminada Corripio, Eduardo J Aguilar, Antoni Bulbena, Josefina Castro-Fornieles, Eduard Vieta, Amàlia Lafuente, Sergi Mas, Mara Parellada, Jerónimo Saiz-Ruiz, Manuel J Cuesta, Miguel Bernardo
BACKGROUND: The characterization of the first episode of psychosis and how it should be treated are principal issues in actual research. Realistic, naturalistic studies are necessary to represent the entire population of first episode of psychosis attended in daily practice. METHODS: Sixteen participating centers from the PEPs project recruited 335 first episode of psychosis patients, aged 7 to 35 years. This article describes and discusses the psychopharmacological interventions and safety profiles at baseline and during a 60-day pharmacovigilance period...
April 2016: International Journal of Neuropsychopharmacology
Tai R Kake, Nicholas Garrett, Menetta Te Aonui
OBJECTIVE: Previous research suggests that New Zealand Māori may have an elevated rate of schizophrenia. However, there is limited evidence on important clinical features of the illness in this population. This study examined cognitive neuropsychological functioning in 54 adult Māori diagnosed with schizophrenia and 56 Māori controls. This study also examined associations between cognition, medication and symptoms of psychosis in the schizophrenia group. METHOD: The groups were matched on socio-demographic variables, handedness and premorbid cognitive ability...
June 2016: Australian and New Zealand Journal of Psychiatry
Francesco Saverio Bersani, Claudio Imperatori, Mariya Prilutskaya, Ramiz Kuliev, Ornella Corazza
OBJECTIVES: The intravenous (IV) injection of tropicamide for non-clinical purposes is a new and widespread drug trend. The aim of this study is to provide the first literature review on the topic. METHODS: Relevant literature was identified through a search of MEDLINE, Psycinfo, Google Scholar, conference proceedings and select citations. RESULTS: Cases of tropicamide (IV) injection have been reported in Russia, Italy, Turkey and Kazakhstan...
July 2015: Human Psychopharmacology
Pei-Yin Pan, Meei-Shyuan Lee, Chin-Bin Yeh
BACKGROUND: Non-adherence to antipsychotic medication in schizophrenic patients is common and associated with symptom relapse and poorer long-term outcomes. The risk factors for treatment non-adherence include dosing frequency and complexity. Besides, slower dose titration in an acute schizophrenic episode may lead to attenuated efficacy. Therefore, the convenient dosage regimen and rapid initiation scheme of quetiapine extended release (XR) were expected to provide better effectiveness and promote adherence in patients with schizophrenia...
January 22, 2015: BMC Psychiatry
J D Blom, H Eker
BACKGROUND: The incubus phenomenon is a paroxysmal condition characterised by sleep paralysis coinciding with a sensed presence and the frightening sensation that something or somebody is exerting pressure on the thorax. AIM: To present an overview of the literature on the incubus phenomenon and to provide practical advice regarding diagnosis and treatment. METHOD: To obtain information for our paper we carried out a search in PubMed and the historical literature...
2015: Tijdschrift Voor Psychiatrie
Joseph H Friedman
Parkinsonism remains a common and often overlooked adverse effect of almost all neuroleptic drugs, including the "atypical," or "second generation" antipsychotics. While neuroleptic induced parkinsonism (NIP) is often thought to be well understood in terms of its clinical course, pathophysiology, and treatment, this is clearly not the case, and almost all our current beliefs are based on data published decades ago of dubious merit, and recent studies which are confounded by design conflicts. This article attempts to highlight gaps in our knowledge...
December 2014: Parkinsonism & related Disorders
Magdolna Tardy, Markus Dold, Rolf R Engel, Stefan Leucht
BACKGROUND: Antipsychotic drugs are the core treatment for schizophrenia. Treatment guidelines state that there is no difference in efficacy between antipsychotic drugs, however, low-potency antipsychotic drugs are sometimes perceived as less efficacious than high-potency compounds by clinicians, and they also seem to differ in their side effects. OBJECTIVES: To review the effects in clinical response of flupenthixol and low-potency antipsychotics for people with schizophrenia...
September 1, 2014: Cochrane Database of Systematic Reviews
Ashley Walker, Andrew Delle Donne, Elizabeth Douglas, Kristine Spicer, Thomas Pluim
INTRODUCTION: We report the case of an adolescent with anticholinergic toxidrome from diphenhydramine overdose, whose symptoms were treated with a novel application of dexmedetomidine. CASE REPORT: A 13-year-old female developed an anticholinergic toxidrome after intentionally ingesting 9.5 mg/kg of diphenhydramine. Despite routine supportive therapies, to include appropriate doses of lorazepam, she continued to have significant agitation, psychosis, and hallucinations...
December 2014: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
Barbara S Connolly, Anthony E Lang
IMPORTANCE: Parkinson disease is the second most common neurodegenerative disease worldwide. Although no available therapies alter the underlying neurodegenerative process, symptomatic therapies can improve patient quality of life. OBJECTIVE: To provide an evidence-based review of the initial pharmacological management of the classic motor symptoms of Parkinson disease; describe management of medication-related motor complications (such as motor fluctuations and dyskinesia), and other medication adverse effects (nausea, psychosis, and impulse control disorders and related behaviors); and discuss the management of selected nonmotor symptoms of Parkinson disease, including rapid eye movement sleep behavior disorder, cognitive impairment, depression, orthostatic hypotension, and sialorrhea...
April 23, 2014: JAMA: the Journal of the American Medical Association
Jennifer L Kruse, Jessica K Jeffrey, Michael C Davis, Joanna Dearlove, Waguih W IsHak, John O Brooks
BACKGROUND: Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis was formally described in 2007 and includes a range of psychiatric and neurologic symptoms. Most patients with anti-NMDAR encephalitis initially present to psychiatrists for diagnosis and treatment. However, there is limited literature summarizing treatment strategies for psychiatric symptoms. In an effort to improve identification and treatment, this review article provides an overview of anti-NMDAR encephalitis, with a focus on psychopharmacologic treatment strategies...
May 2014: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
Esther Cubo, Jacques Doumbe, Pablo Martinez-Martin, Carmen Rodriguez-Blazquez, Callixte Kuate, Natividad Mariscal, Irene Lopez, Gustave Noubissi, Yacouba Njankouo Mapoure, Jean Louis Jon, Salomon Mbahe, Benjamin Tchaleu, Maria-Jose Catalan
BACKGROUND: There are limited data in terms of the clinical profile of Parkinson's disease in sub-Saharan African patients. OBJECTIVE: To compare the clinical profile and access to standard antiparkinsonian therapies of a Cameroonian cohort of patients with an age, sex, and disease duration-matched Spanish cohort (Longitudinal Study of Parkinson's disease, ELEP). METHODS: Observational, cross-sectional design. Demographic data were collected and the following ELEP assessments were applied: Scales for Outcomes in Parkinson's disease (SCOPA) Motor, Autonomic, Cognition, Sleep and Psychosocial; Hoehn and Yahr staging; modified Parkinson Psychosis Rating Scale; Cumulative Illness Rating Scale-Geriatrics; Hospital Anxiety and Depression Scale; pain and fatigue visual analog scales; Zarit, and EuroQoL...
January 15, 2014: Journal of the Neurological Sciences
Shin Ogino, Seiya Miyamoto, Nobumi Miyake, Noboru Yamaguchi
All currently available antipsychotic drugs are the dopamine D2 receptor antagonists and are capable of producing extrapyramidal side-effects (EPS). Anticholinergic drugs are primarily used to treat EPS or prevent EPS induced by antipsychotics in the treatment of psychosis and schizophrenia. However, they can cause a variety of distressing peripheral side-effects (e.g. dry mouth, urinary disturbances, and constipation) and central adverse effects (e.g. cognitive impairment, worsening of tardive dyskinesia, and delirium)...
January 2014: Psychiatry and Clinical Neurosciences
Donna Gillies, Stephanie Sampson, Alison Beck, John Rathbone
BACKGROUND: Acute psychotic illness, especially when associated with agitated or violent behaviour, can require urgent pharmacological tranquillisation or sedation. In several countries, clinicians often use benzodiazepines (either alone or in combination with antipsychotics) for this outcome. OBJECTIVES: To estimate the effects of benzodiazepines, alone or in combination with antipsychotics, when compared with placebo or antipsychotics, alone or in combination with antihistamines, to control disturbed behaviour and reduce psychotic symptoms...
September 18, 2013: Cochrane Database of Systematic Reviews
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