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prolactin antipsychotic

Christoph U Correll, Leslie Citrome, Peter M Haddad, John Lauriello, Mark Olfson, Stephen M Calloway, John M Kane
Long-acting injectable antipsychotics (LAIs) are among the most effective treatments in psychiatry, yet they remain underutilized in clinical practice. Although LAIs are typically used to maintain treatment adherence in patients with chronic schizophrenia, recent research has suggested that they may also provide an effective treatment strategy for patients with early-phase or first-episode disease. In October 2015, a group of 8 experts on the management of schizophrenia and LAIs met to evaluate the evidence surrounding the efficacy, safety, and cost-effectiveness of LAIs and to develop practical recommendations regarding the clinical use, education, and unmet needs related to LAIs...
2016: Journal of Clinical Psychiatry
Jonathan R Scarff
Schizophrenia occurs in approximately 0.3 to 0.7 percent of the world's population and is associated with significant morbidity and mortality. Although atypical antipsychotics reduce positive and negative symptoms, they are associated with varying degrees of metabolic adverse effects. This necessitates continued development of efficacious yet metabolically favorable treatments. This article reviews brexpiprazole, a medication recently approved to treat patients with schizophrenia. Brexpiprazole was well-tolerated, and adverse reactions were statistically insignificant...
July 2016: Innovations in Clinical Neuroscience
Süheyla Doğan Bulut, Serdar Bulut, Dicle Görkem Atalan, Rıza Gökçer Tulaci, Türker Türker, Eda Gürçay, Çiğdem Aydemir
BACKGROUND: The aim of this study was to compare the bone mineral density (BMD) of male schizophrenia patients with those of healthy controls in order to determine the relationship between BMD and hormonal changes. SUBJECTS AND METHODS: The study sample included male outpatients between 18 and 55 years old, diagnosed with schizophrenia who had used prolactin-raising antipsychotics (n=23) and prolactin-sparing antipsychotics (n=19) for at least twelve months, along with an age - matched healthy control group...
September 2016: Psychiatria Danubina
Marc De Hert, Davy Vancampfort, Brendon Stubbs, Tine Sabbe, Hans Wildiers, Johan Detraux
BACKGROUND: Over the last decades prolactin (PRL) has gained attention for its possible role in breast tumorigenesis. As all antipsychotics (although differences with respect to PRL elevation are large) have the propensity to induce hyperprolactinemia (HPRL), questions have arisen concerning the influence of PRL-elevating antipsychotic medications on breast cancer risk. SUBJECTS AND METHODS: A literature search (until January 2016), using the MEDLINE database, was conducted for English-language published clinical studies to identify and synthesize data of the current state of knowledge concerning the relationship between HPRL, breast cancer risk (factors) and antipsychotic medication...
September 2016: Psychiatria Danubina
T Sabbe, J Detraux, M De Hert
BACKGROUND: The use of antipsychotics can result in elevated prolactin levels or hyperprolactinemia. An increasing number of studies suggests that prolactin plays a role in mammary carcinogenesis, leading to concerns about a possible relationship between antipsychotics and breast cancer.<br/> AIM: To provide an overview of recent literature regarding the relationship between prolactin, antipsychotics and breast cancer and an association between schizophrenia and breast cancer...
2016: Tijdschrift Voor Psychiatrie
Edward Kim, Christoph U Correll, Lian Mao, H Lynn Starr, Larry Alphs
OBJECTIVE: This analysis of the Paliperidone Palmitate Research in Demonstrating Effectiveness (PRIDE) study (NCT01157351) compared outcomes after administration of once-monthly paliperidone palmitate (PP) vs conventional oral antipsychotics (COAs) or atypical oral antipsychotics (AOAs). METHODS: PRIDE was a 15-month study of 444 individuals with schizophrenia and a history of incarceration. They were randomly assigned to PP or to 1 of 7 commonly prescribed OAs...
September 15, 2016: CNS Spectrums
Henry A Nasrallah, John W Newcomer, Robert Risinger, Yangchun Du, Jacqueline Zummo, Anjana Bose, Srdjan Stankovic, Bernard L Silverman, Elliot W Ehrich
OBJECTIVE: Aripiprazole lauroxil, a long-acting injectable antipsychotic, demonstrated safety and efficacy in treating symptoms of schizophrenia in a double-blind, placebo-controlled trial. Because the metabolic profile of antipsychotics is an important safety feature, the effects of aripiprazole lauroxil on body weight, endocrine and metabolic profiles, and safety were examined in a secondary analysis. METHODS: Patients with schizophrenia (DSM-IV-TR criteria) were randomly assigned to aripiprazole lauroxil 441 mg, aripiprazole lauroxil 882 mg, or placebo intramuscularly once monthly between December 2011 and March 2014...
August 30, 2016: Journal of Clinical Psychiatry
Benedicto Crespo-Facorro, Jose Maria Pelayo-Teran, Jacqueline Mayoral-van Son
Implementing the most suitable treatment strategies and making appropriate clinical decisions about individuals with a first episode of psychosis (FEP) is a complex and crucial task, with relevant impact in illness outcome. Treatment approaches in the early stages should go beyond choosing the right antipsychotic drug and should also address tractable factors influencing the risk of relapse. Effectiveness and likely metabolic and endocrine disturbances differ among second-generation antipsychotics (SGAs) and should guide the choice of the first-line treatment...
August 23, 2016: Neurology and Therapy
Kim S J Lao, Ying He, Ian C K Wong, Frank M C Besag, Esther W Chan
BACKGROUND: Cariprazine is a novel antipsychotic agent recently approved for treating schizophrenia and bipolar mania in the USA. The sample sizes of published randomized controlled trials (RCTs) of the drug are small; previous meta-analyses included few RCTs and did not specifically investigate the tolerability/safety profile of cariprazine. OBJECTIVE: Our objective was to conduct a meta-analysis of published RCTs to systematically review the tolerability and safety of cariprazine versus placebo...
August 22, 2016: CNS Drugs
Fuminari Misawa, Taishiro Kishimoto, Katsuhiko Hagi, John M Kane, Christoph U Correll
OBJECTIVE: We aimed to assess whether long-acting injectable antipsychotics (LAIs), which are initiated in a loading strategy or overlapping with oral antipsychotics (OAPs) and which cannot be stopped immediately, are associated with greater safety/tolerability issues than OAPs. METHOD: Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing LAIs and OAPs, including only LAI-OAP pairs of the same OAP (allowing oral risperidone and paliperidone as comparators for either risperidone or paliperidone LAI)...
October 2016: Schizophrenia Research
Chien-Yu Chen, Hsien-Yuan Lane, Chieh-Hsin Lin
Low bone mineral density (BMD) and osteoporosis are common in patients with schizophrenia and detrimental to illness prognosis and life quality. Although the pathogenesis is not fully clear, series of studies have revealed factors related to low BMD such as life style, psychotic symptoms, medication use and the activity of bone absorption markers. It has been known that antipsychotic-induced hyperprolactinemia plays a critical role on decreased BMD. However, it remains uncertain whether the risk factors differ between men and women...
August 31, 2016: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
Young Sup Woo, Won-Myong Bahk, Young-Min Park, Sangkeun Chung, Bo-Hyun Yoon, Seunghee Won, Jeong Goo Lee, Hwang-Bin Lee, Won Kim, Jong-Hyun Jeong, Kwanghun Lee, Moon-Doo Kim
We evaluated the effectiveness of aripiprazole among bipolar patients who had switched to this medication as a result of difficulty maintaining on their prestudy atypical antipsychotics (AAPs) because of subsyndromal mood symptoms or intolerance. This study included 77 bipolar patients who were in syndromal remission with an AAP as monotherapy or with an AAP combined with a mood stabilizer(s) who needed to switch from their present AAP because of subsyndromal symptoms or intolerance. At 24 weeks after switching to aripiprazole, the remission rates on the Montgomery-Åsberg Depression Rating Scale (MADRS) and on both the MADRS and the Young Mania Rating Scale were increased significantly in the full sample and in the inefficacy subgroup...
September 2016: International Clinical Psychopharmacology
Leslie Citrome
Cariprazine is an antipsychotic medication and received approval by the U.S. Food and Drug Administration for the treatment of schizophrenia in September 2015. Cariprazine is a dopamine D3 and D2 receptor partial agonist, with a preference for the D3 receptor. Cariprazine is also a partial agonist at the serotonin 5-HT1A receptor and acts as an antagonist at 5-HT2B and 5-HT2A receptors. The recommended dose range of cariprazine for the treatment of schizophrenia is 1.5-6 mg/d; the starting dose of 1.5 mg/d is potentially therapeutic...
2016: Clinical Schizophrenia & related Psychoses
Subramoniam Madhusoodanan, Leah R Steinberg, Alisa Coleman, Samuel Bavli
BACKGROUND: Hyperprolactinemia can be caused by medications, primarily antipsychotics, or by anterior pituitary tumors. The consequences of hyperprolactinemia including gynecomastia, galactorrhea, and sexual dysfunction are very disturbing for males and females. It is sometimes difficult to differentiate the etiology of hyperprolactinemia from a clinical perspective. OBJECTIVE: Identification of the etiology of hyperprolactinemia requires a careful review of the causes and appropriate work-up...
July 19, 2016: Current Drug Safety
Hui Woo Yoon, Jung Suk Lee, Sang Jin Park, Seon-Koo Lee, Won-Jung Choi, Tae Yong Kim, Chang Hyung Hong, Jeong-Ho Seok, Il-Ho Park, Sang Joon Son, Daeyoung Roh, Bo-Ra Kim, Byung Ook Lee
OBJECTIVES: Hyperprolactinemia is an important but often overlooked adverse effect of antipsychotics. Several studies have shown that switching to or adding aripiprazole normalizes antipsychotic-induced hyperprolactinemia. However, no study has directly compared the effectiveness and safety of the 2 strategies. METHODS: A total of 52 patients with antipsychotic-induced hyperprolactinemia were recruited. Aripiprazole was administered to patients with mild hyperprolactinemia (serum prolactin level < 50 ng/mL)...
July 19, 2016: Clinical Neuropharmacology
Elena Rubio-Abadal, Núria Del Cacho, Gerard Saenz-Navarrete, Belen Arranz, Rosa-Maria Cambra, Daniel Cuadras, Demián Rodante, Csaba Fehér, Mercedes Roca, Vanessa Barneda, Judith Usall
OBJECTIVE: We aimed to study the relationship between hyperprolactinemia (HPRL) and sexual dysfunction (SED) in a sample of patients being prescribed a dose-stable antipsychotic medication, and to evaluate sex differences in the prevalence of HPRL and SED and their relationship. METHOD: A cross-sectional study was carried out including patients between 18 and 55 years of age with a psychotic spectrum diagnosis who were attending community mental health services or hospitalized in medium and long stay units...
October 2016: Journal of Clinical Psychopharmacology
Beibei Zhang, Lu Deng, Haishan Wu, Xiaozi Lu, Lihong Peng, Renrong Wu, Wenbin Guo, Jindong Chen, Lehua Li, Jingping Zhao
BACKGROUND: Increasing evidence shows that schizophrenia patients with long-term exposure to antipsychotic medications have decreased bone mass, which suggests that they are at a high risk of osteoporosis. However, the mechanism underlying this remains unclear. In this study, we selected two bone turnover markers to explore whether atypical antipsychotics can affect bone metabolism and identified possible influencing factors. METHODS: A total of 116 schizophrenia patients (18-40years old) participated in the study...
October 2016: Schizophrenia Research
Rabia Nazik Yüksel, Zeynep Elyas Kaya, Nesrin Dilbaz, Merve Cingi Yirün
Cabergoline is an orally administered synthetic dopamine agonist that is used for the treatment of hyperprolactinemia, Parkinson's disease and antipsychotic-induced prolactin elevation. One of the main characteristics of cabergoline is its long duration of effect. It is highly effective in suppressing prolactin levels up to 21 days after a single 1 mg oral dose. The prolonged elimination half-life offers an advantage of once-daily dosing, but it might be a handicap in terms of washout of adverse effects such as psychosis...
June 2016: Therapeutic Advances in Psychopharmacology
Natchaya Vanwong, Santirat Prommas, Apichaya Puangpetch, Yaowaluck Hongkaew, Nopadol Nuntamool, Chalitpol Na Nakorn, Nattawat Ngamsamut, Penkhae Limsila, Chonlaphat Sukasem
BACKGROUND: Risperidone (RIS) is a widely used atypical antipsychotic drug. We developed and validated a sensitive and accurate LC-MS/MS method, which requires a small-volume of plasma and small-volume injection for measurement of RIS levels in ASD pediatric patients. We also investigated the relationship between RIS levels and RIS dosages, including prolactin levels. METHOD: Blood samples were processed by protein precipitation extraction. Only 1 μl of sample was injected...
June 26, 2016: Journal of Clinical Laboratory Analysis
Sam Padamadan Joseph
Hyperprolactinemia is a common adverse effect of antipsychotic medication. Switching over to aripiprazole or adjunctive aripiprazole has been advocated for optimal management of antipsychotic-induced hyperprolactinemia. Adjunctive treatment with aripiprazole has been shown to normalize prolactin levels without affecting already achieved improvements in psychotic symptoms. However, here, we present the case of a 36 year old female with delusional disorder who developed symptomatic hyperprolactinemia while on aripiprazole treatment...
May 2016: Indian Journal of Psychological Medicine
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