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Antipsychotic Weight Gain

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https://www.readbyqxmd.com/read/28209485/effects-of-clozapine-on-adipokine-secretions-productions-and-lipid-droplets-in-3t3-l1-adipocytes
#1
Tomomi Tsubai, Akira Yoshimi, Yoji Hamada, Makoto Nakao, Hiroshi Arima, Yutaka Oiso, Yukihiro Noda
Clozapine, a second-generation antipsychotic (SGA), is a cause of side effects related to metabolic syndrome. The participation of serotonin 5-HT2C and histamine H1 receptors in the central nervous system has been reported as a mechanism of the weight gain caused by clozapine. In the present study, we investigated the direct pharmacological action of clozapine on the 3T3-L1 adipocytes and compared it to that of blonanserin, an SGA with low affinity for both receptors. Short-term exposure to clozapine decreased secretion and mRNA expression of leptin...
January 28, 2017: Journal of Pharmacological Sciences
https://www.readbyqxmd.com/read/28195931/should-antipsychotic-medications-for-schizophrenia-be-given-for-a-lifetime-a-naturalistic-long-term-follow-up-study
#2
Ira D Glick, John M Davis, Daisy Zamora, Jacob Ballon, Meena Nuthi
BACKGROUND: Schizophrenia remains a major health problem despite antipsychotic medications that, for most patients, can decrease acute symptoms, decrease relapses, and contribute to partial and sometimes strong positive response in patients with chronic symptoms. What has not been clear-because a double-blind, randomized, placebo-controlled trial is not feasible or ethical-is how many years after the initial episode, or onset of antipsychotic treatment, should medication be continued to achieve the best global outcome...
February 13, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28193195/assessing-the-burden-of-treatment-emergent-adverse-events-associated-with-atypical-antipsychotic-medications
#3
Pierre-Michel Llorca, Christophe Lançon, Ann Hartry, T Michelle Brown, Dana B DiBenedetti, Siddhesh A Kamat, Clément François
BACKGROUND: Treatment of schizophrenia and major depressive disorder (MDD) with atypical antipsychotics (AAPs) show improved efficacy and reduced side effect burden compared with older antipsychotic medications. However, a risk of treatment-emergent adverse events (TEAEs) remains. TEAEs are hard to quantify and perspectives on the importance of TEAEs differ across patients and between patients and physicians. The current study is a qualitative assessment that investigates TEAEs of AAPs from both patient and physician perspectives to provide better understanding of the occurrence and burden of TEAEs associated with these medications...
February 13, 2017: BMC Psychiatry
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
#4
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
https://www.readbyqxmd.com/read/28112539/long-acting-injectable-antipsychotics-in-children-and-adolescents
#5
Sarah Lytle, Molly McVoy, Martha Sajatovic
OBJECTIVE: While a number of articles have reviewed the use of long-acting injectable antipsychotics (LAIs) in first-episode psychosis, there has been extremely limited focus on LAIs in children and adolescents. This review of the literature evaluated use of LAIs in children and youth under the age of 18. METHODS: We conducted a comprehensive search of the PubMed, PsychINFO, CINAHL, and EMBASE databases using keywords related to LAIs, children, and psychiatric conditions, including schizophrenia, bipolar disorder, and schizoaffective disorder...
February 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28109665/a-randomized-double-blind-comparison-of-the-efficacy-and-safety-of-low-dose-olanzapine-plus-low-dose-trifluoperazine-versus-full-dose-olanzapine-in-the-acute-treatment-of-schizophrenia
#6
Ching-Hua Lin, Fu-Chiang Wang, Shih-Chi Lin, Yu-Hui Huang, Cheng-Chung Chen
OBJECTIVE: Antipsychotic polypharmacy is common in clinical practice, but not recommended in guidelines for treating schizophrenia patients. This study aimed to compare the efficacy and safety of low-dose olanzapine plus low-dose trifluoperazine (a first-generation antipsychotic [FGA]) to full-dose olanzapine (a second-generation antipsychotic [SGA]) in the treatment of acute schizophrenia. METHOD: In this 6-week, double-blind, fixed-dose study, patients were randomized to receive 5mg/day of olanzapine plus 5mg/day of trifluoperazine or 10mg/day of olanzapine for 6weeks...
January 18, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28108226/efficacy-acceptability-and-tolerability-of-8-atypical-antipsychotics-in-chinese-patients-with-acute-schizophrenia-a-network-meta-analysis
#7
REVIEW
Zhihua Bai, Guoqiang Wang, Shangli Cai, Xindi Ding, Weiwei Liu, Depei Huang, Weidi Shen, Juncheng Zhang, Kui Chen, Yuqing Yang, Lili Zhang, Xiaochen Zhao, Qiong Ouyang, Jingping Zhao, Huafei Lu, Wei Hao
OBJECTIVE: We aimed to create hierarchies of the efficacy, acceptability and tolerability of eight atypical antipsychotics in the treatment of Chinese patients with acute schizophrenia. METHOD: We systematically searched for RCT articles published between January 1st 2005 and December 31st 2014 in electronic databases (Medline, Pubmed, Embase, the Cochrane Library and ClinicalTrial.gov for studies in English and the China National Knowledge Infrastructure, Wan Fang, and VIP Information/Chinese Scientific Journals Database for studies in Chinese)...
January 17, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28076676/use-of-metformin-for-cardiometabolic-risks-in-psychiatric-practice-need-to-know-safety-issues
#8
Chittaranjan Andrade
Metformin, a biguanide drug, is emerging as an important treatment option for the prevention or treatment of weight gain, type 2 diabetes mellitus, and the metabolic syndrome in psychiatric patients, especially those who require or receive antipsychotic drugs. Metformin treatment is commonly associated with gastrointestinal adverse effects; the risk of these is reduced by gradual dose uptitration, administration of the drug with meals, and use of a time-release formulation. Lactic acidosis, a potentially fatal complication of biguanide therapy, is very rare with metformin; the risk can be reduced by avoidance of its prescription in patients with impaired renal function, impaired liver function, cardiac failure, and certain other conditions...
November 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28073046/olanzapine-and-aripiprazole-differentially-affect-glucose-uptake-and-energy-metabolism-in-human-mononuclear-blood-cells
#9
Britta Stapel, Alexandra Kotsiari, Michaela Scherr, Denise Hilfiker-Kleiner, Stefan Bleich, Helge Frieling, Kai G Kahl
The use of antipsychotics carries the risk of metabolic side effects, such as weight gain and new onset type-2 diabetes mellitus. The mechanisms of the observed metabolic alterations are not fully understood. We compared the effects of two atypical antipsychotics, one known to favor weight gain (olanzapine), the other not (aripiprazole), on glucose metabolism. Primary human peripheral blood mononuclear cells (PBMC) were isolated and stimulated with olanzapine or aripiprazole for 72 h. Cellular glucose uptake was analyzed in vitro by 18F-FDG uptake...
December 22, 2016: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28008301/iloperidone-in-the-treatment-of-schizophrenia-an-evidence-based-review-of-its-place-in-therapy
#10
REVIEW
Fernanda S Tonin, Astrid Wiens, Fernando Fernandez-Llimos, Roberto Pontarolo
INTRODUCTION: Schizophrenia is a chronic and debilitating mental disorder that affects the patient's and their family's quality of life, as well as financial costs and health care settings. Despite the variety of available antipsychotics, optimal treatment outcomes are not always achieved. Novel drugs, such as iloperidone, can provide more effective, tolerable and safer strategies. AIM: To review the evidence for the clinical impact of iloperidone on the treatment of patients with schizophrenia...
2016: Core Evidence
https://www.readbyqxmd.com/read/28005435/is-there-a-weight-neutral-second-generation-antipsychotic-for-bipolar-disorder
#11
Fang Fang, Zuowei Wang, Renrong Wu, Joseph R Calabrese, Keming Gao
Antipsychotic-induced weight gain (WG) and metabolic abnormalities are major concerns. This review was untaken to answer if there is a weight-neutral second-generation antipsychotic for bipolar disorder (BPD). Areas covered: English-language literature in MEDLINE was searched with the keywords of antipsychotic/second-generation antipsychotic or generic/brand name of second-generation antipsychotic, and BPD/mania/depression or bipolar maintenance, and safety/tolerability or WG/weight increase, and randomized, placebo-controlled trial...
January 2, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/27990038/morbid-obesity-and-use-of-second-generation-antipsychotics-among-adolescents-in-foster-care-evidence-from-medicaid
#12
Benjamin T Allaire, Ramesh Raghavan, Derek S Brown
BACKGROUND: Many adolescents enter foster care with high body mass index (BMI), and patterns of treatment further exacerbate the risk of morbid obesity. A principal risk factor for such exacerbation is the use of second generation antipsychotics (SGAs). We examine the association between receiving a morbid obesity diagnosis and SGA prescriptions among adolescents in foster care. METHODS: We analyzed claims from 36 states' Medicaid Analytic Extract (MAX) files for 2000 through 2003...
August 2016: Children and Youth Services Review
https://www.readbyqxmd.com/read/27983772/metabolic-response-to-olanzapine-in-healthy-chinese-subjects-with-rs7093146-polymorphism-in-transcription-factor-7-like-2-gene-tcf7l2-a-prospective-study
#13
Qing Li, Dong Guo, Hong Yang, Zhi Ye, Jin Huang, Yan Shu
Olanzapine is a widely used atypical antipsychotic with significant weight gain and other metabolic side effects. The locus of the transcription factor 7-like 2 (TCF7L2) gene is strongly associated with type 2 diabetes (T2D). The goal of this study was to determine whether polymorphic TCF7L2 is involved in the susceptibility to the metabolic changes associated with the atypical antipsychotic agents (AAPs). In this study, a parallel clinical study with 3-day consecutive administration of olanzapine (10 mg/day) was conducted in 17 healthy subjects with a genotype of TCF7L2 rs7903146 CC (N=10) or CT (N=7)...
December 16, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27932499/genetic-variation-in-one-carbon-metabolism-and-changes-in-metabolic-parameters-in-first-episode-schizophrenia-patients
#14
Błażej Misiak, Łukasz Łaczmański, Natalia Kinga Słoka, Elżbieta Szmida, Ryszard Ślęzak, Patryk Piotrowski, Andrzej Kiejna, Dorota Frydecka
BACKGROUND: In this study, we aimed to investigate the effects of polymorphisms in genes encoding 1-carbon metabolism enzymes on differential development of metabolic parameters during 12 weeks of treatment with second-generation antipsychotics in first-episode schizophrenia patients. METHODS: The following polymorphisms in 1-carbon metabolism genes were genotyped: MTHFR (C677T and A1298C), MTHFD1 (G1958A), MTRR (A66G), and BHMT (G742A). A broad panel of metabolic parameters including body mass index, waist circumference, total cholesterol low and high density lipoproteins, triglycerides, homocysteine, folate, and vitamin B12 was determined...
December 8, 2016: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27931900/dimensions-of-schizophrenia-and-their-time-course-of-response-to-a-second-generation-antipsychotic-olanzapine-a-clinical-study
#15
Badari Birur, Jagadisha Thirthalli, N Janakiramaiah, Richard C Shelton, Bangalore N Gangadhar
BACKGROUND: The pattern of symptom response to second generation antipsychotics (SGAs) has not been studied extensively. Understanding the time course of symptom response would help to rationally monitor patient progress. OBJECTIVE: To determine the short-term differential time course of response of symptom dimensions of first episode schizophrenia viz., negative, positive symptoms and 5 factors of anergia, thought disturbance, activation, paranoid-belligerence and depression to treatment with SGA olanzapine...
December 2016: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/27925164/brain-volume-change-in-first-episode-psychosis-an-effect-of-antipsychotic-medication-independent-of-bmi-change
#16
K N Jørgensen, R Nesvåg, S Nerland, L Mørch-Johnsen, L T Westlye, E H Lange, U K Haukvik, C B Hartberg, I Melle, O A Andreassen, I Agartz
OBJECTIVE: The effect of antipsychotic medication on brain structure remains unclear. Given the prevalence of weight gain as a side-effect, body mass index (BMI) change could be a confounder. METHOD: Patients with first-episode psychosis (n = 78) and healthy controls (n = 119) underwent two 1.5T MRI scans with a 1-year follow-up interval. siena (fsl 5.0) was used to measure whole-brain volume change. Weight and height were measured at both time points. Antipsychotic medication use at baseline and follow-up was converted into chlorpromazine equivalent dose and averaged...
February 2017: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/27898069/clozapine-modifies-the-differentiation-program-of-human-adipocytes-inducing-browning
#17
E Kristóf, Q-M Doan-Xuan, A K Sárvári, Á Klusóczki, P Fischer-Posovszky, M Wabitsch, Z Bacso, P Bai, Z Balajthy, L Fésüs
Administration of second-generation antipsychotic drugs (SGAs) often leads to weight gain and consequent cardio-metabolic side effects. We observed that clozapine but not six other antipsychotic drugs reprogrammed the gene expression pattern of differentiating human adipocytes ex vivo, leading to an elevated expression of the browning marker gene UCP1, more and smaller lipid droplets and more mitochondrial DNA than in the untreated white adipocytes. Laser scanning cytometry showed that up to 40% of the differentiating single primary and Simpson-Golabi-Behmel syndrome (SGBS) adipocytes had the characteristic morphological features of browning cells...
November 29, 2016: Translational Psychiatry
https://www.readbyqxmd.com/read/27897267/increasing-bmi-is-associated-with-reduced-expression-of-p-glycoprotein-abcb1-gene-in-the-human-brain-with-a-stronger-association-in-african-americans-than-caucasians
#18
J Vendelbo, R H Olesen, J K Lauridsen, J Rungby, J E Kleinman, T M Hyde, A Larsen
The efflux pump, p-glycoprotein, controls bioavailability and excretion of pharmaceutical compounds. In the blood-brain barrier, p-glycoprotein regulates the delivery of pharmaceutical substances to the brain, influencing efficacy and side effects for some drugs notably antipsychotics. Common side effects to antipsychotics include obesity and metabolic disease. Polymorphisms in the ABCB1 gene coding for p-glycoprotein are associated with more severe side effects to neuro-pharmaceuticals as well as weight gain, indicating a potential link between p-glycoprotein function and metabolic regulation...
November 29, 2016: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/27884042/valproate-for-schizophrenia
#19
REVIEW
Yijun Wang, Jun Xia, Bartosz Helfer, Chunbo Li, Stefan Leucht
BACKGROUND: Many people with schizophrenia do not achieve a satisfactory treatment response with ordinary antipsychotic drug treatment. In these cases, various add-on medications are used, and valproate is one of these. OBJECTIVES: To examine whether:1. valproate alone is an effective treatment for schizophrenia and schizoaffective psychoses; and2. valproate augmentation of antipsychotic medication is an effective treatment for the same illnesses. SEARCH METHODS: We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (July 2002; February 2007; July 2012; March 04, 2016)...
24, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27871720/-guidelines-for-the-prescription-of-mood-stabilizers-for-adolescents-a-literature-review
#20
G Munch, N Godart
INTRODUCTION: Adolescence is a unique phase of the human developmental process. In adolescents, psychotropic medications may have different efficacy and tolerance profiles compared to those at other stages of the lifespan. Mood stabilizers are a complex pharmacological category including lithium, some anticonvulsants, and some second generation antipsychotics. Focusing on this class of pharmacological agents, we aim to answer the following questions: in which indications and according to which modalities should mood stabilizers be prescribed during adolescence? METHODS: Information was sought from the websites of the French Haute Autorité de santé (HAS) and Agence nationale de sécurité du médicament et des produits de santé (ANSM), the American Food and Drug Administration (FDA) and the British National Institute for Health and Clinical Excellence (NICE)...
November 18, 2016: L'Encéphale
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