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Antipsychotic augmentation

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
Sevcan Karakoç 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
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
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
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...
September 21, 2016: Psychiatry Research
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
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
Agnieszka Bratek, Krzysztof Krysta, Karolina Drzyzga, Justyna Barańska, Krzysztof Kucia
BACKGROUND: Gender differences in schizophrenia have been recognized for a long time and it has been widely accepted that sex steroid hormones, especially estradiol, are strongly attributed to this fact. Two hypotheses regarding estradiol action in psychoses gained special research attention - the estrogen protection hypothesis and hypoestrogenism hypothesis. A growing number of studies have shown benefits in augmenting antipsychotic treatment with estrogens or selective estrogen receptor modulators (SERM)...
September 2016: Psychiatria Danubina
Francesco Franza
BD-II has been consistently associated with cognitive dysfunction across a broad range of cognitive domains. Atypical antipsychotic drugs, or SGAs are effective antipsychotics in these diseases, often in combination with antidepressants and mood stabilizers. Data on the possible effect of antipsychotics on neuro-cognition are rare and conflicting. The main objective of our study was to assess the effectiveness and possible risks to cognitive function in a group of inpatients affected by BD-II. Forty-five inpatients with Bipolar II Disorder (DSM-5) were included in a two-year observational study...
September 2016: Psychiatria Danubina
Christine Gottschling, Maren Geissler, Gianna Springer, Rainer Wolf, Georg Juckel, Andreas Faissner
The therapy of patients suffering the psychiatric disorder schizophrenia requires the usage of antipsychotic drugs that are classified into two different groups, the first-generation (FGAs) and the second-generation antipsychotics (SGAs). This study compares the effects of the two FGAs haloperidol and flupentixol with those of the SGA olanzapine on synapse formation and synaptic activity of embryonic rat hippocampal neurons. To this end, the development of perineuronal nets (PNNs), the formation of synapses and the resulting spontaneous network activity under control and treatment conditions were studied using an indirect co-culture system of neurons and astrocytes in completely defined media...
September 8, 2016: Neuroscience
W Zheng, Y-T Xiang, Y-Q Xiang, X-B Li, G S Ungvari, H F K Chiu, C U Correll
OBJECTIVE: To systematically examine the randomized controlled trial (RCT) evidence regarding efficacy and tolerability of topiramate cotreatment with antipsychotics in schizophrenia-spectrum disorders. METHODS: Random-effects meta-analysis of RCTs of topiramate cotreatment with antipsychotics vs. placebo/ongoing antipsychotic treatment in schizophrenia-spectrum disorders. Standardized or weighted mean difference (SMD/WMD), risk ratio (RR) ±95% confidence intervals (CIs), and number needed to harm (NNH) were calculated...
November 2016: Acta Psychiatrica Scandinavica
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
Alexander T Chen, John T Chibnall, Henry A Nasrallah
BACKGROUND: Several studies have reported that schizophrenia is associated with mitochondrial abnormalities, glutathione deficit, and increased brain oxidative stress (free radicals). N-acetylcysteine (NAC) is a strong antioxidant with potential therapeutic benefit in schizophrenia, according to some reports. We conducted a review of the published controlled studies, with the goal of determining the efficacy profile of NAC as an adjunctive treatment for schizophrenia. METHODS: An online search was conducted for all placebo-controlled, double-blind, randomized clinical trials of NAC in schizophrenia, and a review was conducted...
August 2016: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
Robert Christian Wolf, Henrike Maria Nolte, Dusan Hirjak, Stefan Hofer, Ulrich Seidl, Malte Sebastian Depping, Bram Stieltjes, Klaus Maier-Hein, Fabio Sambataro, Philipp Arthur Thomann
Electroconvulsive therapy (ECT) is one of the most effective treatments in severe and treatment-resistant major depressive disorder (MDD). In schizophrenia (SZ), ECT is frequently considered in drug-resistant cases, as an augmentation of antipsychotic treatment or in cases when rapid symptom relief is indicated. Accumulating neuroimaging evidence suggests modulation of medial temporal lobe and prefrontal cortical regions in MDD by ECT. In SZ, ECT-effects on brain structure have not been systematically investigated so far...
September 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Dominik Strzelecki, Olga Kałużyńska, Justyna Szyburska, Adam Wysokiński
AIM: Find changes in matrix metallopeptidase-9 (MMP-9) levels during augmentation of antipsychotic treatment with sarcosine and a relationship between schizophrenia symptoms severity and initial level of MMP-9. METHOD: Fifty-eight patients with diagnosis of schizophrenia with predominant negative symptoms participated in a six-month prospective RCT (randomized controlled trial). The patients received two grams of sarcosine (n = 28) or placebo (n = 30) daily. At the beginning, after six weeks and after six months MMP-9 levels were measured...
2016: International Journal of Molecular Sciences
Madeleine Uys, Mohammed Shahid, Jukka Sallinen, Walter Dreyer, Marike Cockeran, Brian H Harvey
Early studies suggest that selective α2C-adrenoceptor (AR)-antagonism has anti-psychotic-like and pro-cognitive properties. However, this has not been demonstrated in an animal model of schizophrenia with a neurodevelopmental construct. The beneficial effects of clozapine in refractory schizophrenia and associated cognitive deficits have, among others, been associated with its α2C-AR modulating activity. Altered brain-derived neurotrophic factor (BDNF) has been linked to schizophrenia and cognitive deficits...
November 3, 2016: Progress in Neuro-psychopharmacology & Biological Psychiatry
Aysun Kalenderoğlu, Mustafa Çelik
Clozapine is the only antipsychotic which has definitely shown to be effective in refractory schizophrenia. Clozapine treatment is usually preferred in schizophrenia patients with a partial response to treatment and augmentation strategies are tried when clozapine also fails to provide full treatment response. In treatment resistant schizophrenia patients addition of a second antipsychotic is a frequently preferred augmentation method. With previous augmentation strategies consistent positive results could not be obtained...
2016: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
Jaime M Monti, Pablo Torterolo, Seithikurippu R Pandi Perumal
Insomnia is a common feature in schizophrenia, and is characterized by an increase of sleep latency (SL), as well as reductions in total sleep time (TST) and sleep efficiency (SE). Regarding sleep architecture, non-rapid-eye-movement (NREM) sleep, slow wave sleep (SWS) and rapid-eye-movement (REM) sleep latency are decreased, whereas REM sleep tends to remain unchanged. According to polysomnographic studies, clozapine, olanzapine, quetiapine and ziprasidone administration increased TST and/or SE in healthy subjects...
May 15, 2016: Sleep Medicine Reviews
Alexander M Ponizovsky, Eli Marom, Michal Ben-Laish, Igor Barash, Abraham Weizman, Eyal Schwartzberg
BACKGROUND: Although serious mental illneses are treated with both typical and atypical antipsychotic grugs, trends in their use in psychiatric inpatient population in Israel are unrecognized. The aim of this study was to detect trends in the use of typical and atypical antipsychotic drugs in the Israeli inpatient psychiatric population throughout the last decade. METHODS: Data regarding allocation of typical and atypical antipsychotics, over the period 2004 to 2013, were extracted from the electronic records of SAREL, Israel's largest private supplier of drugs to healthcare and medical facilities...
2016: Israel Journal of Health Policy Research
Wei Zheng, Ying-Qiang Xiang, Xian-Bin Li, Gabor S Ungvari, Helen F K Chiu, Feng Sun, Carl D'Arcy, Xiangfei Meng, Yu-Tao Xiang
OBJECTIVE: The aim of this study was to examine the efficacy of huperzine A (HupA), an isolate of Huperzine serrata, in the treatment of cognitive deficits in schizophrenia spectrum disorders. METHODS: PubMed, PsycINFO, Embase, Cochrane Library, Cochrane Controlled Trials Register, WanFang, Chinese Biomedical, and China Journal Net databases were searched from inception to 15 July 2015 for randomized controlled trials (RCTs) in English or Chinese of HupA augmentation of antipsychotic drug therapy versus placebo or ongoing antipsychotic treatment...
July 2016: Human Psychopharmacology
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