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Antipsychotic augmentation

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https://www.readbyqxmd.com/read/28062203/semi-mechanistic-computer-simulation-of-psychotic-symptoms-in-schizophrenia-with-a-model-of-a-humanized-cortico-striatal-thalamocortical-loop
#1
Athan Spiros, Patrick Roberts, Hugo Geerts
Despite new insights into the pathophysiology of schizophrenia and clinical trials with highly selective drugs, no new therapeutic breakthroughs have been identified. We present a semi-mechanistic Quantitative Systems Pharmacology (QSP) computer model of a biophysically realistic cortical-striatal-thalamo-cortical loop. The model incorporates the direct, indirect and hyperdirect pathway of the basal ganglia and CNS drug targets that modulate neuronal firing, based on preclinical data about their localization and coupling to voltage-gated ion channels...
January 3, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28008259/efficacy-and-tolerability-of-topiramate-augmentation-therapy-for-schizophrenia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
Yuji Okuyama, Kazuto Oya, Shinji Matsunaga, Taro Kishi, Nakao Iwata
This study aimed to perform a comprehensive meta-analysis of topiramate-augmentation therapy in patients with schizophrenia receiving antipsychotic agents. Data published up to June 20, 2016 were obtained from the PubMed, PsycINFO, and Cochrane Library databases. Twelve randomized controlled trials comparing topiramate to placebo or antipsychotic only were included (n=676 patients). The primary outcome was change in overall symptoms. Relative risk (RR) and standardized mean difference (SMD), along with 95% confidence intervals, were calculated using random effects model for each outcome...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28004621/augmentation-of-phenelzine-with-aripiprazole-and-quetiapine-in-a-treatment-resistant-patient-with-psychotic-unipolar-depression-case-report-and-literature-review
#3
Jonathan M Meyer, Michael A Cummings, George Proctor
Irreversible monoamine oxidase inhibitor (MAOI) antidepressants have significant efficacy in treatment-resistant unipolar depression, but in some instances patients may not achieve remission. Among the adjunctive and augmentation strategies, certain second-generation antipsychotics (SGAs) have approval for inadequate responders to antidepressant therapy, including aripiprazole, brexpiprazole, and quetiapine, with lurasidone and the olanzapine/fluoxetine combination indicated for bipolar depression. Clinicians may eschew SGA options in part due to the limited literature on SGA-MAOI combinations, with only one published case involving aripiprazole, and none for olanzapine, lurasidone, or brexpiprazole...
December 22, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27977041/risperidone-versus-placebo-for-schizophrenia
#4
REVIEW
Ranganath D Rattehalli, Sai Zhao, Bao Guo Li, Mahesh B Jayaram, Jun Xia, Stephanie Sampson
BACKGROUND: Risperidone is the first new-generation antipsychotic drug made available in the market in its generic form. OBJECTIVES: To determine the clinical effects, safety and cost-effectiveness of risperidone compared with placebo for treating schizophrenia. SEARCH METHODS: On 19th October 2015, we searched the Cochrane Schizophrenia Group Trials Register, which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO, and registries of clinical trials...
December 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27919104/dual-health-care-system-use-and-high-risk-prescribing-in-patients-with-dementia-a-national-cohort-study
#5
Joshua M Thorpe, Carolyn T Thorpe, Walid F Gellad, Chester B Good, Joseph T Hanlon, Maria K Mor, John R Pleis, Loren J Schleiden, Courtney Harold Van Houtven
Background: Recent federal policy changes attempt to expand veterans' access to providers outside the Department of Veterans Affairs (VA). Receipt of prescription medications across unconnected systems of care may increase the risk for unsafe prescribing, particularly in persons with dementia. Objective: To investigate the association between dual health care system use and potentially unsafe medication (PUM) prescribing. Design: Retrospective cohort study...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27884042/valproate-for-schizophrenia
#6
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/27852961/effect-of-antipsychotic-pharmacotherapy-on-clinical-outcomes-of-intermittent-theta-burst-stimulation-for-refractory-depression
#7
Laura Schulze, Gary Remington, Peter Giacobbe, Sidney H Kennedy, Daniel M Blumberger, Zafiris J Daskalakis, Jonathan Downar
Theta-burst stimulation is an emerging protocol for repetitive transcranial magnetic stimulation that takes 1-3 min to administer, yet offers equal/superior potency to conventional protocols lasting 30-60 min. However, preclinical evidence suggests that D2 receptor blockade may abolish the acute effects of theta-burst stimulation on synaptic facilitation or inhibition. As many patients presenting for repetitive transcranial magnetic stimulation are taking antipsychotic medications as augmentation for treatment-resistant depression, this finding is potentially concerning for the implementation of theta-burst stimulation in clinical settings...
November 9, 2016: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/27848269/evidence-based-pharmacotherapy-of-treatment-resistant-unipolar-depression
#8
Markus Dold, Siegfried Kasper
Treatment resistance to the antidepressive pharmacotherapy represents one of the most important clinical challenges in the pharmacological management of unipolar depression. In this review, we aimed to summarise the evidence for various pharmacological treatment options in therapy-resistant unipolar depression derived from clinical trials, systematic reviews, meta-analyses and treatment guidelines. The first measure in case of insufficient response to the initial antidepressant monotherapy contains the debarment of 'pseudo-resistance', potentially caused by inadequate dose and treatment duration of the antidepressant, insufficient plasma levels, non-compliance of the patient regarding medication intake or relevant psychiatric and/or somatic comorbidities...
November 16, 2016: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/27844095/antidepressant-effects-of-combination-of-brexpiprazole-and-fluoxetine-on-depression-like-behavior-and-dendritic-changes-in-mice-after-inflammation
#9
Min Ma, Qian Ren, Chun Yang, Ji-Chun Zhang, Wei Yao, Chao Dong, Yuta Ohgi, Takashi Futamura, Kenji Hashimoto
RATIONALE: Addition of low doses of atypical antipsychotic drugs with selective serotonin reuptake inhibitors (SSRIs) could promote a rapid antidepressant effect in treatment-resistant patients with major depression. Brexpiprazole, a new atypical antipsychotic drug, has been used as adjunctive therapy for the treatment of major depression. OBJECTIVES: The present study was undertaken to examine whether brexpiprazole could augment antidepressant effects of the SSRI fluoxetine in an inflammation model of depression...
November 15, 2016: Psychopharmacology
https://www.readbyqxmd.com/read/27826741/the-porirua-protocol-in-the-treatment-of-clozapine-induced-gastrointestinal-hypomotility-and-constipation-a-pre-and-post-treatment-study
#10
Susanna Every-Palmer, Pete M Ellis, Mike Nowitz, James Stanley, Eve Grant, Mark Huthwaite, Helen Dunn
BACKGROUND: Clozapine, an antipsychotic used in treatment-resistant schizophrenia, causes slow gastrointestinal transit in 50-80% of patients. Clozapine-induced gastrointestinal hypomotility is both common and serious, and potential complications include severe constipation, ileus, bowel obstruction and related complications, with a higher mortality rate than clozapine-related agranulocytosis. Little evidence exists on its prevention and management. METHOD: Using a well-validated radiopaque marker ('Metcalf') method, we compared colonic transit times (CTTs) of clozapine-treated inpatients not receiving laxatives with their transit times when receiving laxatives, with treatment prescribed according to the Porirua Protocol for clozapine-related constipation (docusate and senna augmented by macrogol 3350 in treatment-resistant cases)...
November 8, 2016: CNS Drugs
https://www.readbyqxmd.com/read/27813505/is-electroconvulsive-therapy-effective-as-augmentation-in-clozapine-resistant-schizophrenia
#11
Lucas Kittsteiner Manubens, Diego Lobos Urbina, David Aceituno
Clozapine is considered to be the most effective antipsychotic drug for patients with treatment resistant schizophrenia, but up to a third of the patients do not respond to this treatment. Various strategies have been tried to augment the effect of clozapine in non-responders, one of these strategies being electroconvulsive therapy. However, its efficacy and safety are not yet clear. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified six systematic reviews including 55 studies, among them six randomized controlled trials addressing clozapine-resistant schizophrenia...
October 14, 2016: Medwave
https://www.readbyqxmd.com/read/27788337/adjunctive-brexpiprazole-for-the-treatment-of-major-depressive-disorder
#12
John L Beyer, Richard H Weisler
The lifetime prevalence of major depressive episodes in the United States is nearly 17%. Clinical trials and clinical effectiveness studies have demonstrated that many patients will fail to achieve remission using traditional monotherapy, contributing to significant morbidity and suffering. Because of this, augmentation strategies have been proposed to improve both treatment response and remission. Areas covered: Brexpiprazole is a second generation antipsychotic (SGA) approved by the US FDA in 2015 as an add-on treatment to an antidepressant medication for the treatment of adults with MDD, based on the results of two large-scale, randomized, placebo-controlled trials...
October 27, 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27783545/estimating-the-value-of-new-technologies-that-provide-more-accurate-drug-adherence-information-to-providers-for-their-patients-with-schizophrenia
#13
Jason Shafrin, Taylor T Schwartz, Darius N Lakdawalla, Felicia M Forma
BACKGROUND: Nonadherence to antipsychotic medication among patients with schizophrenia results in poor symptom management and increased health care and other costs. Despite its health impact, medication adherence remains difficult to accurately assess. New technologies offer the possibility of real-time patient monitoring data on adherence, which may in turn improve clinical decision making. However, the economic benefit of accurate patient drug adherence information (PDAI) has yet to be evaluated...
November 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27745541/patient-preferences-and-acceptability-of-evidence-based-and-novel-treatments-for-obsessive-compulsive-disorder
#14
Sapana R Patel, Hanga Galfavy, Marcia B Kimeldorf, Lisa B Dixon, Helen Blair Simpson
OBJECTIVE: This study examined preferences for and acceptability of treatments for obsessive-compulsive disorder (OCD). METHODS: Through an online survey, adults who self-reported OCD chose their preferred evidence-based treatments, rated acceptability of novel treatments, and answered open-ended questions about their preferences. Analyses examined associations between demographic, clinical, and treatment variables and first-line and augmentation treatment preferences...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27738375/ziprasidone-augmentation-in-an-adolescent-with-obsessive-compulsive-disorder-a-case-report
#15
Sevcan KarakoƧ Demirkaya, Behiye Alyanak
Obsessive compulsive disorder (OCD) is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Although selective serotonin reuptake inhibitors are widely used to treat OCD, only half of the patients respond well. Several potentiation strategies including off-label use of antipsychotics (mostly risperidone, quetiapine) have been tried. Ziprasidone is an atypical antipsychotic with the best affinity ratio of 5 HT 2A/D2 and 5HT2C/D2 receptors. There is a limited data on ziprasidone in pediatric groups...
March 1, 2016: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/27703781/inflammatory-response-to-clozapine-in-the-absence-of-myocarditis-case-report
#16
Patrick Davey, Siobhan Gee, Sukhi S Shergill
SUMMARY: A case is presented of a 25-year-old man with treatment-resistant paranoid schizophrenia whose only previous trial of clozapine had been stopped following a suspected clozapine-induced myocarditis. Due to the failure of his psychosis to respond to a number of antipsychotic treatments and augmentation strategies, clozapine was restarted on admission. His rechallenge was marked by intermittent pyrexia, tachycardia and elevated C-reactive protein (CRP), but eosinophilia was absent...
May 2016: BJPsych Open
https://www.readbyqxmd.com/read/27692282/the-effect-of-second-generation-antipsychotic-drugs-on-sleep-parameters-in-patients-with-unipolar-or-bipolar-disorder
#17
Jaime M Monti
Sleep disturbances predominantly take the form of insomnia in patients with unipolar disorder, while patients with bipolar disorder show a decreased need for sleep. Sleep impairment in these patients is a risk factor for the development of a major depressive episode and suicidal behavior. Administration of second-generation antipsychotics (SGAs) olanzapine, quetiapine, and ziprasidone as augmentation therapy or monotherapy to unipolar and bipolar disorder patients, respectively, has been shown to improve sleep continuity and sleep architecture...
July 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27690134/induced-obsessive-compulsive-symptoms-ocs-in-schizophrenia-patients-under-atypical-2-antipsychotics-aaps-review-and-hypotheses
#18
REVIEW
Diane Grillault Laroche, Adeline Gaillard
The prevalence of OCS and OCD is higher in schizophrenic patients than in the general population. These disorders are sometimes induced by AAPs. There is higher frequency of OCS and greater severity in patients treated with antipsychotics with predominant anti-serotoninergic profiles opposed to those with predominant dopaminergic blockade. Induced OCS may be due to complex neuromodulation involving many serotonin, dopamine and glutamate receptors and several subtypes. Concerning connectivity, AAPs differentially influence the BOLD signal, depending on the intensity of D2 receptor blockade...
December 30, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/27689026/second-generation-antipsychotics-in-the-treatment-of-major-depressive-disorder-an-update
#19
REVIEW
Sheng-Min Wang, Changsu Han, Soo-Jung Lee, Tae-Youn Jun, Ashwin A Patkar, Prakash S Masand, Chi-Un Pae
Less than one third of patients who suffer from major depressive disorder (MDD) report remission following antidepressant treatments requiring more diverse treatment approaches. Augmentation of second generation antipsychotics (SGAs) has been increasingly recognized as an important treatment option. The authors have previously provided a comprehensive review of SGAs for the treatment of MDD in 2013. Since then, numerous additional clinical trials have been conducted to investigate diverse issues regarding the utility of SGAs in MDD...
September 2016: Chonnam Medical Journal
https://www.readbyqxmd.com/read/27672315/atypical-antipsychotics-as-add-on-treatment-in-late-life-depression
#20
Sibel Cakir, Zeynep Senkal
BACKGROUND: Second-generation antipsychotics (SGAs) have been used in the augmentation of treatment-resistant depression. However, little is known about their effectiveness, tolerability, and adverse events in the treatment of late-life depression, which were the aim of this study. METHODS: The retrospective data of patients aged >65 years who had a major depressive episode with inadequate response to antidepressant treatment and had adjuvant SGA treatment were analyzed...
2016: Clinical Interventions in Aging
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