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https://www.readbyqxmd.com/read/28816923/evaluation-of-concurrent-oral-and-long-acting-injectable-antipsychotic-prescribing-at-the-minneapolis-veterans-affairs-health-care-system
#1
Erica Dimitropoulos, Lisa Drogemuller, Kara Wong
BACKGROUND: Antipsychotic polypharmacy is defined as the concomitant prescribing of more than 1 antipsychotic medication for an individual patient. Despite clinical guideline recommendations, long-acting injectable antipsychotics (LAIAs) are often used together with oral antipsychotics (OAPs) to treat a variety of psychiatric illnesses. Little research exists to address this form of antipsychotic polypharmacy, and its role in therapy is poorly understood. The purpose of this evaluation was to determine the prevalence of this prescribing pattern at our facility, identify provider rationale for polypharmacy, and analyze trends...
August 15, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28811014/assessing-need-for-pharmacist-involvement-to-improve-care-coordination-for-patients-on-lai-antipsychotics-transitioning-from-hospital-to-home-a-work-system-approach
#2
Olufunmilola Abraham, Michelle N Myers, Amanda L Brothers, Jamie Montgomery, Bryan A Norman, Tanya Fabian
BACKGROUND: The use of Long-Acting Injectable (LAI) antipsychotic medications has increased for patients with Serious Mental Illness (SMI). Care coordination for this population is complex, and pharmacist involvement may improve and support long-term medication adherence and patient outcomes. OBJECTIVES: (1) Examine pharmacists' role in addressing care coordination and adherence challenges for patients taking Long-Acting Injectable (LAI) antipsychotics; and (2) explore patients' medication use experiences with LAI antipsychotics and educational needs...
September 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28806390/combination-antipsychotic-therapies-an-analysis-from-a-longitudinal-pragmatic-trial
#3
Adriana Foster, Peter Buckley, John Lauriello, Stephen Looney, Nina Schooler
BACKGROUND: Combination antipsychotics (CAs) are prescribed in schizophrenia despite limited evidence of efficacy. To explore the effect of switching from CA to monotherapy, we performed an exploratory analysis of the PROACTIVE (Preventing Relapse in Schizophrenia: Oral Antipsychotics Compared with Injectables: Evaluating Efficacy) study data, in which 305 patients with schizophrenia and schizoaffective disorder were followed for 30 months after randomization to long-acting injectable (LAI) risperidone or second-generation oral antipsychotic (OA)...
August 10, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28790021/deficient-striatal-adaptation-in-aminergic-and-glutamatergic-neurotransmission-is-associated-with-tardive-dyskinesia-in-non-human-primates-exposed-to-antipsychotic-drugs
#4
Catherine Lévesque, Giovanni Hernandez, Souha Mahmoudi, Frédéric Calon, Fabrizio Gasparini, Baltazar Gomez-Mancilla, Pierre J Blanchet, Daniel Lévesque
Tardive dyskinesia (TD) is a potentially disabling condition encompassing all delayed, persistent, and often irreversible abnormal involuntary movements arising in a fraction of subjects during long-term exposure to centrally acting dopamine receptor-blocking agents such as antipsychotic drugs and metoclopramide. However, the pathogenesis of TD has proved complex and remains elusive. To investigate the mechanism underlying the development of TD, we have chronically exposed 17 Cebus apella monkeys to typical (11) or atypical (6) antipsychotic drugs...
August 5, 2017: Neuroscience
https://www.readbyqxmd.com/read/28783941/five-month-persistent-extrapyramidal-symptoms-following-a-single-injection-of-paliperidone-palmitate-a-case-report
#5
Seoyoung Jang, Jungmin Woo
Long-acting injectable (LAI) antipsychotics are useful in the treatments for schizophrenic patients with poor adherence due to their maintaining feature of therapeutic plasma level without daily administrations. However, their long-lasting property can cause complicated problems such as a long-lasting side effect. We report a patient who experienced LAI-induced extrapyramidal symptoms (EPSs) for 5 months after a single injection. During that period, every trial to ameliorate this condition turned out to be a failure...
August 31, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28777027/exercise-associated-extrapyramidal-symptoms-during-treatment-with-long-acting-injectable-antipsychotic-medications-a-case-report
#6
David D Kim, Donna J Lang, Darren E R Warburton, Alasdair M Barr, Randall F White, William G Honer, Ric M Procyshyn
Antipsychotic medications can effectively treat psychotic symptoms in individuals with schizophrenia. However, side effects including cardiovascular and extrapyramidal symptoms are often inevitable. Exercise has proven effective in ameliorating cardiometabolic abnormalities in individuals with schizophrenia. In addition, exercise has consistently been an effective intervention for improving the symptoms associated with schizophrenia. We report here two cases in which individuals with schizoaffective disorder treated with a long-acting injectable antipsychotic medication displayed worsening of extrapyramidal symptoms over the course of a 12-week exercise program...
August 4, 2017: Clinical Schizophrenia & related Psychoses
https://www.readbyqxmd.com/read/28762843/cost-effectiveness-of-3-month-paliperidone-therapy-for-chronic-schizophrenia-in-the-netherlands
#7
Thomas R Einarson, Basil G Bereza, Fadi Tedouri, Kristel Van Impe, Tom R Denee, Pieter J T Dries
BACKGROUND: A new depot formulation of paliperidone has been developed that provides effective treatment for schizophrenia for three months (PP3M). It has been tested in phase-3 trials, but no data on its cost-effectiveness have been published. PURPOSE: To determine the cost-effectiveness of PP3M compared with once-monthly paliperidone (PP1M), haloperidol long-acting therapy (HAL-LAT), risperidone microspheres (RIS-LAT), and oral olanzapine (oral-OLZ) for treating chronic schizophrenia in The Netherlands...
August 1, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28758344/characterizing-the-inpatient-care-of-young-adults-experiencing-early-psychosis-a-medical-record-review
#8
Joseph H Puyat, Renata Kamieniecki, Brenda Vaughan, Tamara Mihic, Kofi Bonnie, Jeffrey Danielson, Sierra Williams
AIM: To characterize the inpatient care received by individuals experiencing early psychotic episodes in an inner city hospital. METHOD: Medical records of patients admitted between April 01, 2013, and March 31, 2015, to a psychiatric ward at an inner city hospital were retrospectively examined. Included in the study are patients who were 25 years of age or younger and were hospitalized for psychotic symptoms. Demographics and health service use were summarized using descriptive statistics...
July 31, 2017: Early Intervention in Psychiatry
https://www.readbyqxmd.com/read/28754761/directly-observed-therapy-for-clozapine-with-concomitant-methadone-prescription-a-method-for-improving-adherence-and-outcome
#9
Nicholas Tze Ping Pang, Mohd Fadzli Mohamad Isa, Vikram Suarn Singh, Ruziana Masiran
A young male presented with many years of delusions and hallucinations, with concurrent heroin use and subsequent amphetamine uses. There were no depressive or manic symptoms and psychotic symptoms prior to the amphetamine use. After the trials of two atypical antipsychotics and later clozapine due to treatment resistance, adherence and functionality were poor and there was still persistent drug use. As a result, a long acting injectable adjunct was commenced, but only minimal effects were observed. However after initiation of directly observed treatment of clozapine with methadone, there has been functional and clinical response and drug use has ceased...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28752590/comparison-of-the-g-and-v-methods-for-ventrogluteal-site-identification-muscle-and-subcutaneous-fat-thicknesses-and-considerations-for-successful-intramuscular-injection
#10
Theresa A Larkin, Asmahan Elgellaie, Elfriede Ashcroft
The ventrogluteal site is increasingly recommended for long-acting antipsychotic intramuscular injections; however, it remains infrequently utilized due to nurses' lack of confidence in site identification. The more recent G (geometric) method of ventrogluteal site identification is less subjective and likely more reliable than the V method for successful intramuscular injection outcomes. Knowledge of muscle and subcutaneous fat thicknesses, and the influence of sex and anthropometry on theoretical injection outcome, is necessary to support evidence-based use of the ventrogluteal site...
July 28, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28751663/caregiver-burden-in-schizophrenia-following-paliperidone-palmitate-long-acting-injectables-treatment-pooled-analysis-of-two-double-blind-randomized-phase-three-studies
#11
Srihari Gopal, Haiyan Xu, Kelly McQuarrie, Adam Savitz, Isaac Nuamah, Kimberly Woodruff, Maju Mathews
The pooled analysis of two double-blind, randomized, multicenter, phase-3 studies evaluated predictors of improvement or worsening of schizophrenia-related caregiver burden following paliperidone palmitate long-acting injectables (1-monthly [PP1M] and 3-monthly [PP3M]) treatment. Caregivers were offered to complete the involvement evaluation questionnaire (involvement evaluation questionnaire; 31-item scale). Total, 1498 caregivers (intent-to-treat open-label analysis set, n = 1497; mean [SD] age: 51.5 [13...
July 27, 2017: NPJ Schizophrenia
https://www.readbyqxmd.com/read/28738259/reasons-associated-with-treatment-non-adherence-in-schizophrenia-in-a-pakistan-cohort
#12
Irshad Ahmad, Muhammad Tahir Khalily, Brian Hallahan
non-adherence in patients with schizophrenia is the most common reason for a relapse of psychosis. In a cohort of participants in Pakistan who suffered a relapse of psychosis, we aimed to identify the principal factors associated with non-adherence, including any culture specific factors that might not be as significant in other jurisdictions. Semi-structured interviews were undertaken at four psychiatric hospitals in the Peshawar region in Pakistan with 55 participants (44 male and 11 female) diagnosed with schizophrenia, who had suffered a relapse of psychosis subsequent to treatment non-adherence...
July 13, 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28735640/dose-equivalents-for-second-generation-long-acting-injectable-antipsychotics-the-minimum-effective-dose-method
#13
REVIEW
Philipp H Rothe, Stephan Heres, Stefan Leucht
BACKGROUND: The concept of dose equivalence of depot medication is important for many scientific and clinical purposes. METHODS: A systematic literature search on four second-generation antipsychotics available as long-acting injectable drugs and haloperidol was conducted. We used the minimum effective dose method which is based on randomized fixed dose studies where the smallest dose which was significantly more efficacious than placebo in the primary outcome was declared as minimum effective dose...
July 21, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28734907/predicting-relapse-in-schizophrenia-is-bdnf-a-plausible-biological-marker
#14
Anilkumar Pillai, Nina R Schooler, Diya Peter, Stephen W Looney, Donald C Goff, Alexander Kopelowicz, John Lauriello, Theo Manschreck, Alan Mendelowitz, Del D Miller, Joanne B Severe, Daniel R Wilson, Donna Ames, Juan Bustillo, John M Kane, Peter F Buckley
Understanding the biological processes that underlie why patients relapse is an issue of fundamental importance to the detection and prevention of relapse in schizophrenia. Brain Derived Neurotrophic Factor (BDNF), a facilitator of brain plasticity, is reduced in patients with schizophrenia. In the present study, we examined whether decreases in plasma BDNF levels could be used as a biological predictor of relapse in schizophrenia. A total of 221 patients were prospectively evaluated for relapse over 30months in the Preventing Relapse in Schizophrenia: Oral Antipsychotics Compared to Injectables: eValuating Efficacy (PROACTIVE) study...
July 19, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28726075/effectiveness-adverse-effects-and-drug-compliance-of-long-acting-injectable-risperidone-in-children-and-adolescents
#15
Mehmet Fatih Ceylan, Betül Erdogan, Selma Tural Hesapcioglu, Esra Cop
BACKGROUND AND OBJECTIVES: Although the use of oral risperidone in children and adolescents has been well studied, there is little information on the intramuscular use of long-acting injectable risperidone (LAIR). The aims of this study were to investigate the effectiveness and adverse effects of LAIR in children and adolescents with conduct disorder, bipolar disorder, and schizophrenia. METHODS: In total, 42 patients (age range 12-17 years) who were non-adherent to oral antipsychotic drugs, received 25 mg/day of LAIR intramuscularly every 2 weeks...
July 19, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28721020/access-to-credible-information-on-schizophrenia-patients-medication-adherence-by-prescribers-can-change-their-treatment-strategies-evidence-from-an-online-survey-of-providers
#16
Jason Shafrin, Suepattra G May, Anshu Shrestha, Charles Ruetsch, Nicole Gerlanc, Felicia Forma, Ainslie Hatch, Darius N Lakdawalla, Jean-Pierre Lindenmayer
OBJECTIVE: Overestimating patients' medication adherence diminishes the ability of psychiatric care providers to prescribe the most effective treatment and to identify the root causes of treatment resistance in schizophrenia. This study was conducted to determine how credible patient drug adherence information (PDAI) might change prescribers' treatment decisions. METHODS: In an online survey containing 8 clinical case vignettes describing patients with schizophrenia, health care practitioners who prescribe antipsychotics to patients with schizophrenia were instructed to choose a preferred treatment recommendation from a set of predefined pharmacologic and non-pharmacologic options...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28712616/aripiprazole-lauroxil-compared-with-paliperidone-palmitate-in-patients-with-schizophrenia-an-indirect-treatment-comparison
#17
REVIEW
Chris Cameron, Jacqueline Zummo, Dharmik N Desai, Christine Drake, Brian Hutton, Ahmed Kotb, Peter J Weiden
BACKGROUND: Aripiprazole lauroxil (AL) is a long-acting injectable atypical antipsychotic recently approved for treatment of schizophrenia on the basis of a large-scale trial of two doses of AL versus placebo. There are no direct-comparison studies with paliperidone palmitate (PP; long-acting antipsychotic used most often in acute settings) for the acute psychotic episode. OBJECTIVES: To indirectly compare efficacy and safety of the pivotal AL study with all PP studies meeting indirect comparison criteria...
July 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28678566/cost-effectiveness-of-3-month-paliperidone-treatment-for-chronic-schizophrenia-in-spain
#18
Thomas R Einarson, Basil G Bereza, Ignacio Garcia Llinares, Beatriz González Martín Moro, Fadi Tedouri, Kristel Van Impe
BACKGROUND: A three-month long treatment of paliperidone palmitate (PP3M) has been introduced as an option for treating schizophrenia. Its cost-effectiveness in Spain has not been established. AIMS: To compare the costs and effects of PP3M compared with once-monthly paliperidone (PP1M) from the payer perspective in Spain. METHODS: We used the recently published trial by Savitz (2016) as a core model over one year. Additional data were derived from the literature...
July 5, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28673279/pharmacogenetic-evaluation-to-assess-breakthrough-psychosis-with-aripiprazole-long-acting-injection-a-case-report
#19
Seenae Eum, Mark E Schneiderhan, Jacob T Brown, Adam M Lee, Jeffrey R Bishop
BACKGROUND: Given the complex nature of symptom presentation and medication regimens, psychiatric clinics may benefit from additional tools to personalize treatments. Utilizing pharmacogenetic information may be helpful in assessing unique responses to therapy. We report herein a case of wearing-off phenomena during treatment with aripiprazole long-acting injectable (LAI) and a proof of concept strategy of how pharmacogenetic information may be used to assess possible genetic factors and also hypothesize potential mechanisms for further study...
July 3, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28672735/safety-concerns-associated-with-second-generation-antipsychotic-long-acting-injection-treatment-a-systematic-update
#20
Salvatore Gentile
Background It has been recently suggested that second-generation antipsychotic long-acting injection (SGA-LAIs) are underutilized in clinical practice, despite that their costs significantly impact on national health system budgets. Hence, an updated analysis of safety data shown by SGA-LAIs may contribute to clarify their role in clinical practice. Materials and methods English-language, peer-reviewed articles reporting updated, primary findings on the SGA-LAI safety were identified (updated through an electronic search of five databases - PubMed, EMBASE, PsycInfo, DARE and the Cochrane Library)...
June 23, 2017: Hormone Molecular Biology and Clinical Investigation
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