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Treatment-resistant Schizophrenia

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https://www.readbyqxmd.com/read/29733409/neural-correlates-of-auditory-verbal-hallucinations-in-schizophrenia-and-the-therapeutic-response-to-theta-burst-transcranial-magnetic-stimulation
#1
Xingui Chen, Gong-Jun Ji, Chunyan Zhu, Xiaomeng Bai, Lu Wang, Kongliang He, Yaxiang Gao, Longxiang Tao, Fengqiong Yu, Yanghua Tian, Kai Wang
Auditory verbal hallucinations (AVHs) are a core symptom of schizophrenia, and resistant to antipsychotic medication in a substantial proportion of patients. This study aimed to investigate the neural correlates of AVHs in schizophrenia patients and its response to a modified continuous theta-burst stimulation (cTBS) by transcranial magnetic stimulation. In a cross-sectional experiment, resting-state functional magnetic resonance images were collected from 31 AVH schizophrenia patients, 26 non-AVH schizophrenia patients, and 33 sex-/age-matched healthy controls (HCs)...
May 3, 2018: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/29732913/augmentation-strategies-for-clozapine-refractory-schizophrenia-a-systematic-review-and-meta-analysis
#2
Dan J Siskind, Michael Lee, Arul Ravindran, Qichen Zhang, Evelyn Ma, Balaji Motamarri, Steve Kisely
BACKGROUND: Although clozapine is the most effective medication for treatment refractory schizophrenia, only 40% of people will meet response criteria. We therefore undertook a systematic review and meta-analysis of global literature on clozapine augmentation strategies. METHODS: We systematically reviewed PubMed, PsycInfo, Embase, Cochrane Database, Chinese Biomedical Literature Service System and China Knowledge Resource Integrated Database for randomised control trials of augmentation strategies for clozapine resistant schizophrenia...
May 1, 2018: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/29713292/avatar-therapy-for-persistent-auditory-verbal-hallucinations-in-an-ultra-resistant-schizophrenia-patient-a-case-report
#3
Laura Dellazizzo, Stéphane Potvin, Kingsada Phraxayavong, Pierre Lalonde, Alexandre Dumais
Effective treatment strategies for schizophrenia remain very challenging and many treatment-resistant patients will suffer from persistent auditory verbal hallucinations (AVH). While clozapine is the gold-standard medication for this complex population, many will not respond to this molecule. For these ultra-resistant patients, limited options are available. Cognitive-behavioral therapy (CBT) is the most widely used psychological intervention, though it offers modest effects. With the interpersonal dimension of AVH being recognized, Avatar Therapy (AT), a novel experiential treatment enabling patients to create an avatar of their persecutor and allowing them to gain control over their symptoms, was developed and tested...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29713286/the-wnt-signaling-pathway-effector-tcf7l2-mediates-olanzapine-induced-weight-gain-and-insulin-resistance
#4
Ranran Li, Jianjun Ou, Li Li, Ye Yang, Jingping Zhao, Renrong Wu
Olanzapine is a widely used atypical antipsychotic medication for treatment of schizophrenia and is often associated with serious metabolic abnormalities including weight gain and impaired glucose tolerance. These metabolic side effects are severe clinical problems but the underpinning mechanism remains poorly understood. Recently, growing evidence suggests that Wnt signaling pathway has a critical role in the pathogenesis of schizophrenia and molecular cascades of antipsychotics action, of which Wnt signaling pathway key effector TCF7L2 is strongly associated with glucose homeostasis...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29692222/long-term-follow-up-of-clozapine-prescribing
#5
Siobhan H Gee, Sukhwinder S Shergill, David M Taylor
OBJECTIVE: Clozapine is uniquely effective for treatment-resistant schizophrenia, and so treatment continuation is essential. We aimed to identify factors associated with an increased likelihood of clozapine discontinuation in a cohort of patients in South East London. METHODS: We gathered demographic and treatment information such as duration of illness and antipsychotic treatment history. t-tests, chi-square tests and binary logistic regression were used to compare patients who continued and discontinued clozapine during the study and to identify predictor variables for discontinuation...
May 2018: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29678679/formal-thought-disorders-from-phenomenology-to-neurobiology
#6
REVIEW
Tilo Kircher, Henrike Bröhl, Felicitas Meier, Jennifer Engelen
Formal thought disorder (FTD) is present in most psychiatric disorders and in some healthy individuals. In this Review, we present a comprehensive, integrative, and multilevel account of what is known about FTD, covering genetic, cellular, and neurotransmitter effects, environmental influences, experimental psychology and neuropsychology, brain imaging, phenomenology, linguistics, and treatment. FTD is a dimensional, phenomenologically defined construct, which can be clinically subdivided into positive versus negative and objective versus subjective symptom clusters...
April 17, 2018: Lancet Psychiatry
https://www.readbyqxmd.com/read/29670504/clozapine-induced-cardiovascular-side-effects-and-autonomic-dysfunction-a-systematic-review
#7
Jessica W Y Yuen, David D Kim, Ric M Procyshyn, Randall F White, William G Honer, Alasdair M Barr
Background: Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia and has minimal risk for extrapyramidal symptoms. Therapeutic benefits, however, are accompanied by a myriad of cardiometabolic side-effects. The specific reasons for clozapine's high propensity to cause adverse cardiometabolic events remain unknown, but it is believed that autonomic dysfunction may play a role in many of these. Objective: This systematic review summarizes the literature on autonomic dysfunction and related cardiovascular side effects associated with clozapine treatment...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29669549/ethnic-minority-inequalities-in-access-to-treatments-for-schizophrenia-and-schizoaffective-disorders-findings-from-a-nationally-representative-cross-sectional-study
#8
Jayati Das-Munshi, Dinesh Bhugra, Mike J Crawford
BACKGROUND: Ethnic minority service users with schizophrenia and schizoaffective disorders may experience inequalities in care. There have been no recent studies assessing access to evidence-based treatments for psychosis amongst the main ethnic minority groups in the UK. METHODS: Data from nationally representative surveys from England and Wales, for 10,512 people with a clinical diagnosis of schizophrenia or schizoaffective disorders, were used for analyses. Multi-level multivariable logistic regression analyses were used to assess ethnic minority inequalities in access to pharmacological treatments, psychological interventions, shared decision making and care planning, taking into account a range of potential confounders...
April 18, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29650266/increased-sensorimotor-network-connectivity-associated-with-clozapine-eligibility-in-people-with-schizophrenia
#9
Carolyn Beth McNabb, Frederick Sundram, Ian Soosay, Robert R Kydd, Bruce Roy Russell
Schizophrenia is a heterogeneous disorder that exhibits variable responsiveness to treatment between individuals. Here we conducted a resting-state functional magnetic resonance imaging (rs-fMRI) study to determine whether resistance to first-line antipsychotics is reflected in resting-state connectivity. rs-fMRI data were collected from 15 people who had failed to respond to first-line antipsychotics (clozapine-eligible) and 10 first-line treatment responders (FLR). Image pre-processing and analysis were performed using FMRIB's software library (FSL)...
March 6, 2018: Psychiatry research. Neuroimaging
https://www.readbyqxmd.com/read/29626340/neuroimmune-biomarkers-in-mental-illness
#10
James W Herron, Louis Nerurkar, Jonathan Cavanagh
Exploration of neuroimmune mechanisms is vital to the understanding of the pathogenesis and pathophysiology of mental disorders. Inflammatory and immune mechanisms are increasingly understood to underpin a number of neuropsychiatric disorders, with an ever-expanding evidence base drawn from basic science to large-scale epidemiological data. Unravelling of these mechanisms should lead to biomarker discovery and potential new avenues for therapeutics that modulate immunological mechanisms. Identification of neuroimmune biomarkers is vital to improving diagnosis, stratification and treatment of mental disorders...
April 7, 2018: Current Topics in Behavioral Neurosciences
https://www.readbyqxmd.com/read/29618013/fgf21-is-associated-with-metabolic-effects-and-treatment-response-in-depressed-bipolar-ii-disorder-patients-treated-with-valproate
#11
Hui Hua Chang, Po See Chen, Yung Wen Cheng, Tzu-Yun Wang, Yen Kuang Yang, Ru-Band Lu
Background: Patients with bipolar disorder are at high risk of metabolic disturbance after mood stabilizer treatment. However, the mediators linking the two conditions remain unknown. In this study, we investigated whether fibroblast growth factor-21 (FGF21) was associated with metabolic effects and treatment response in depressed bipolar disorder patients. Methods: We recruited 78 community-dwelling controls and 137 bipolar disorder patients; the latter were interviewed using the Chinese Version of the Modified Schedule of Affective Disorder and Schizophrenia-Life Time...
April 1, 2018: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29611450/elevated-serum-vascular-endothelial-growth-factor-in-treatment-resistant-schizophrenia-treated-with-electroconvulsive-therapy-positive-association-with-therapeutic-effects
#12
Wenhuan Xiao, Qiongqiong Zhan, Fei Ye, Xiaowei Tang, Jin Li, Hui Dong, Weiwei Sha, Xiaobin Zhang
OBJECTIVES: As the name implies, vascular endothelial growth factor (VEGF) enhances angiogenesis, promotes vascular permeability, and stimulates neurogenesis in the adult brain. Furthermore, animal model studies have shown that electroconvulsive therapy (ECT), which is primarily utilized in cases of treatment-resistant schizophrenia (TRS), regulates the expression of VEGF. The current study focuses largely on the effect of ECT on VEGF serum concentration, and the relationship between VEGF and therapeutic effects in patients diagnosed with TRS...
April 3, 2018: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/29581153/aicar-prevents-acute-olanzapine-induced-disturbances-in-glucose-homeostasis
#13
Natasha D Bush, Logan K Townsend, David C Wright
Olanzapine (OLZ) is an antipsychotic drug used in the treatment of schizophrenia. While effective in reducing psychoses, OLZ causes acute increases in blood glucose. The acute effects of OLZ on hyperglycaemia are likely caused by reductions in insulin secretion, insulin resistance and increased hepatic glucose production. 5'AMP-activated protein kinase (AMPK) is an energy sensor activated during exercise that can increase insulin sensitivity and insulin-independent glucose uptake in muscle. 5-aminoimidazole-4-carboxamide ribonucleoside (AICAR) is a pharmacological agent that, among other effects, can activate AMPK in vivo...
March 26, 2018: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/29577944/downregulation-of-plasma-selenbp1-protein-in-patients-with-recent-onset-schizophrenia
#14
Edith J Chau, Md Shaki Mostaid, Vanessa Cropley, Patrick McGorry, Christos Pantelis, Chad A Bousman, Ian P Everall
Upregulation of selenium binding protein 1 (SELENBP1) mRNA expression has been reported in schizophrenia, primarily in the dorsolateral prefrontal cortex. However, peripheral blood studies are limited and results are inconsistent. In this study, we examined SELENBP1 mRNA expression in whole blood and protein expression in plasma from patients with recent-onset schizophrenia (n = 30), treatment-resistant schizophrenia (n = 71) and healthy controls (n = 57). We also examined the effects of SELENBP1 genetic variation on gene and protein expression...
March 22, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29559781/novel-treatment-options-in-depression-and-psychosis
#15
REVIEW
Eva Ceskova, Petr Silhan
In spite of tremendous development in central nervous system research, current treatment is suboptimal, especially in severe mental disorders. In medicine, there are two main methods of improving the health care provided: seeking new treatment procedures and perfecting (optimizing) the existing ones. Optimization of treatment includes not only practical tools such as therapeutic drug monitoring but also implementation of general trends in the clinical practice. New pharmacological options include new more sophisticated forms of monoaminergic drugs, old drugs rediscovered on the base of a better understanding of pathophysiology of mental illnesses, and drugs aimed at new treatment targets...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29559020/gene-polymorphisms-and-response-to-transcranial-direct-current-stimulation-for-auditory-verbal-hallucinations-in-schizophrenia
#16
Harleen Chhabra, Venkataram Shivakumar, Manjula Subbanna, Sunil V Kalmady, Anushree Bose, Sri Mahavir Agarwal, Vanteemar S Sreeraj, Damodharan Dinakaran, Janardhanan C Narayanaswamy, Monojit Debnath, Ganesan Venkatasubramanian
OBJECTIVE: Recent observations demonstrate a significant ameliorative effect of add-on transcranial direct current stimulation (tDCS) on auditory verbal hallucinations (AVHs) in schizophrenia. Of the many SNPs, NRG1 rs35753505 and catechol-o-methyl transferase (COMT) rs4680 polymorphisms have shown to have a strong association with neuroplasticity effect in schizophrenia. METHODS: Schizophrenia patients (n=32) with treatment resistant auditory hallucinations were administered with an add-on tDCS...
March 21, 2018: Acta Neuropsychiatrica
https://www.readbyqxmd.com/read/29529421/clozapine-use-in-geriatric-patients-challenges
#17
REVIEW
Shiva Shanker Reddy Mukku, P T Sivakumar, Mathew Varghese
Clozapine is the first second generation antipsychotic with different receptor profile of action. Clozapine is the most efficacious drug for the treatment of psychotic disorder and is the drug of choice in treatment resistant schizophrenia. Clozapine is used in elderly patients infrequently owing to its adverse effects profile and tolerability. There is paucity of literature with respect to clozapine use in late life. In this narrative review, we discuss clozapine use in elderly and challenges associated with its use...
March 3, 2018: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/29529289/plasma-levels-of-soluble-tumor-necrosis-factor-receptor-2-stnfr2-are-associated-with-hippocampal-volume-and-cognitive-performance-in-patients-with-schizophrenia
#18
Noriko Kudo, Hidenaga Yamamori, Tamaki Ishima, Kiyotaka Nemoto, Yuka Yasuda, Michiko Fujimoto, Hirotsugu Azechi, Tomihisa Niitsu, Shusuke Numata, Manabu Ikeda, Masaomi Iyo, Tetsuro Ohmori, Masaki Fukunaga, Yoshiyuki Watanabe, Kenji Hashimoto, Ryota Hashimoto
Background: An imbalance in the inflammatory tumor necrosis factor (TNF) system, including soluble tumor necrosis factor receptor 2 (sTNFR2), may contribute to the pathophysiology of schizophrenia. Methods: We measured the plasma levels of sTNFR2 in 256 healthy controls and 250 patients with schizophrenia including antipsychotic drug-free patients and treatment-resistant patients. We also explored the possible association between plasma sTNFR2 levels and cognitive performance in healthy controls and patients with schizophrenia using the Wechsler Adult Intelligence Scale, Third Edition (WAIS-Ⅲ), the Wechsler Memory Scale-Revised (WMS-R), and the Rey Auditory Verbal Learning Test (AVLT)...
February 24, 2018: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29528902/electroconvulsive-therapy-ect-in-schizophrenia-a-review-of-recent-literature
#19
Sohag N Sanghani, Georgios Petrides, Charles H Kellner
PURPOSE OF REVIEW: ECT remains an important, yet underutilized, treatment for schizophrenia. Recent research shows that medication-resistant patients with schizophrenia, including those resistant to clozapine, respond well to ECT augmentation. The purpose of this article is to review recent studies of the use of ECT in the treatment of schizophrenia. RECENT FINDINGS: We performed an electronic database search for articles on ECT and schizophrenia, published in 2017...
May 2018: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/29526456/early-treatment-resistance-in-a-latin-american-cohort-of-patients-with-schizophrenia
#20
Cristian Mena, Alfonso Gonzalez-Valderrama, Barbara Iruretagoyena, Juan Undurraga, Nicolas A Crossley
BACKGROUND: Failure to respond to antipsychotic medication in schizophrenia is a common clinical scenario with significant morbidity. Recent studies have highlighted that many patients present treatment-resistance from disease onset. We here present an analysis of clozapine prescription patterns, used as a real-world proxy marker for treatment-resistance, in a cohort of 1195 patients with schizophrenia from a Latin-American cohort, to explore the timing of emergence of treatment resistance and possible subgroup differences...
March 8, 2018: Schizophrenia Research
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