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Antipsychotic augmentation

Chun-Yuan Lin, Te-Jen Lai, Yu-Hsin Wu, Ping-Kun Chen, Yuan-Fu Lin, I-Chia Chien
No abstract text is available yet for this article.
March 9, 2018: Journal of Affective Disorders
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...
March 9, 2018: Current Opinion in Psychiatry
Karin Melin, Gudmundur Skarphedinsson, Ingela Skärsäter, Bente Storm Mowatt Haugland, Tord Ivarsson
This study reports follow-up 2 and 3 years after the initial assessment of a sample of youth with a primary diagnosis of OCD. Participants were 109 children and adolescents, aged 5-17 years, recruited from a specialized, outpatient OCD clinic in Sweden. Patients were treated with cognitive behavioral therapy (CBT), augmented when indicated by selective serotonin reuptake inhibitor (SSRI). In cases where SSRIs were insufficient, augmentation with a second-generation antipsychotic (SGA) was applied. Participants were assessed with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Children's OCD Impact Scale (COIS), and Children's Depressive Inventory (CDI) at follow-ups 2 and 3 years after baseline assessment...
March 3, 2018: European Child & Adolescent Psychiatry
Andrea de Bartolomeis, Felice Iasevoli, Federica Marmo, Elisabetta Filomena Buonaguro, Livia Avvisati, Gianmarco Latte, Carmine Tomasetti
Caffeine and nicotine are widely used by schizophrenia patients and may worsen psychosis and affect antipsychotic therapies. However, they have also been accounted as augmentation strategies in treatment-resistant schizophrenia. Despite both substances are known to modulate dopamine and glutamate transmission, little is known about the molecular changes induced by these compounds in association to antipsychotics, mostly at the level of the postsynaptic density (PSD), a site of dopamine-glutamate interplay. Here we investigated whether caffeine and nicotine, alone or combined with haloperidol, elicited significant changes in the levels of both transcripts and proteins of the PSD members Homer1 and Arc, which have been implicated in synaptic plasticity, schizophrenia pathophysiology, and antipsychotics molecular action...
February 20, 2018: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
B Galling, J A Vernon, A K Pagsberg, A Wadhwa, E Grudnikoff, A J Seidman, M Tsoy-Podosenin, M Poyurovsky, J M Kane, C U Correll
OBJECTIVE: To evaluate the efficacy and safety of antidepressant augmentation of antipsychotics in schizophrenia. METHODS: Systematic literature search (PubMed/MEDLINE/PsycINFO/Cochrane Library) from database inception until 10/10/2017 for randomized, double-blind, efficacy-focused trials comparing adjunctive antidepressants vs. placebo in schizophrenia. RESULTS: In a random-effects meta-analysis (studies = 42, n = 1934, duration = 10...
March 2018: Acta Psychiatrica Scandinavica
Kazunori Suzuki, Akina Harada, Hirobumi Suzuki, Clizia Capuani, Annarosa Ugolini, Mauro Corsi, Haruhide Kimura
Activation of indirect pathway medium spiny neurons (MSNs) via promotion of cAMP production is the principal mechanism of action of current antipsychotics with dopamine D2 receptor antagonism. TAK-063 [1-[2-fluoro-4-(1H-pyrazol-1-yl)phenyl]-5-methoxy-3-(1-phenyl-1H-pyrazol-5-yl)pyridazin-4(1H)-one] is a novel phosphodiesterase 10A inhibitor that activates both direct and indirect pathway MSNs through increasing both cAMP and cGMP levels by inhibition of their degradation. The activation of indirect pathway MSNs through the distinct mechanism of action of these drugs raises the possibility of augmented pharmacological effects by combination therapy...
February 2018: Pharmacology Research & Perspectives
Dominik Strzelecki, Małgorzata Urban-Kowalczyk, Adam Wysokiński
OBJECTIVE: Augmentation of sarcosine, a natural inhibitor of the glycine transporter type I, normalizes glutamatergic neurotransmission, having beneficial impact on primary negative symptoms in schizophrenia and may also influence immune system and interleukin 6 (IL-6) levels. AIM: Finding a relationship between initial IL-6 serum concentrations or its changes and severity of symptoms as a result of sarcosine addition to stable antipsychotic treatment. METHOD: Fifity-eight individuals with schizophrenia with predominantly negative symptoms completed a 6-month randomized, double-blind placebo-controlled prospective study...
February 7, 2018: Human Psychopharmacology
Trista Askins Bailey, Sehrish Panjwani
As persons age, their risk of developing late-life depression increases. Older adults not only have an increased risk of late-life depression, but they also have an increased risk of suicidal ideation. Because of these increased risks, it is vital that clinicians be aware of the options available to assist these persons to achieve remission of their symptoms, as well as prevent relapse. Atypical antipsychotics have been considered an augmentation option in younger adults with depression. However, because of the black box warning associated with atypical antipsychotics in older adults with dementia, clinicians often exercise caution when using these agents to help treat late-life depression...
February 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Clive Ballard, Anne Corbett, Martin Orrell, Gareth Williams, Esme Moniz-Cook, Renee Romeo, Bob Woods, Lucy Garrod, Ingelin Testad, Barbara Woodward-Carlton, Jennifer Wenborn, Martin Knapp, Jane Fossey
BACKGROUND: Agitation is a common, challenging symptom affecting large numbers of people with dementia and impacting on quality of life (QoL). There is an urgent need for evidence-based, cost-effective psychosocial interventions to improve these outcomes, particularly in the absence of safe, effective pharmacological therapies. This study aimed to evaluate the efficacy of a person-centred care and psychosocial intervention incorporating an antipsychotic review, WHELD, on QoL, agitation, and antipsychotic use in people with dementia living in nursing homes, and to determine its cost...
February 2018: PLoS Medicine
Chun-Yuan Lin, Te-Jen Lai, Yu-Hsin Wu, Ping-Kun Chen, Yuan-Fu Lin, I-Chia Chien
BACKGROUND: Studies on second-generation antipsychotics (SGA) augmentation treatment for older adults with major depressive disorder (MDD) remain limited. We aimed to investigate the effectiveness of SGA augmentation for overall and older patients with MDD inpatient history by assessing the change in 1-year hospitalization before and after SGA augmentation using the latest National Health Insurance Research Database (NHIRD) in Taiwan. METHODS: The samples were MDD patients (ICD-9 CM code: 296...
January 31, 2018: Journal of Affective Disorders
Chieh-Hsin Lin, Ching-Hua Lin, Yue-Cune Chang, Yu-Jhen Huang, Po-Wei Chen, Hui-Ting Yang, Hsien-Yuan Lane
BACKGROUND: Clozapine is the last-line antipsychotic agent for refractory schizophrenia. To date, there is no convincing evidence for augmentation on clozapine. Activation of N-methyl-D-aspartate receptors, including inhibition of D-amino acid oxidase that may metabolize D-amino acids, has been reported to be beneficial for patients receiving antipsychotics other than clozapine. This study aimed to examine the efficacy and safety of a D-amino acid oxidase inhibitor, sodium benzoate, for schizophrenia patients who had poor response to clozapine...
December 26, 2017: Biological Psychiatry
Michael R Rickels, Elys M Perez, Amy J Peleckis, Erica Alshehabi, Huong-Lan Nguyen, Darko Stefanovski, Karl Rickels, Karen L Teff
Atypical antipsychotic drugs have been associated with the development of obesity and diabetes. In particular, olanzapine can induce peripheral insulin resistance and compensatory hyperinsulinemia independent of weight gain or psychiatric disease. To determine if this compensatory increase in insulin is mediated by parasympathetic muscarinic stimulation, we randomized fifteen healthy subjects 2:1 to receive double-blind olanzapine or placebo for 9 days under diet and activity controlled inpatient conditions...
December 19, 2017: American Journal of Physiology. Endocrinology and Metabolism
Shoko Kagawa, Kazuo Mihara, Takeshi Suzuki, Goyo Nagai, Akifumi Nakamura, Kenji Nemoto, Tsuyoshi Kondo
BACKGROUND/AIMS: Serum levels of brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6) were prospectively monitored in relation with therapeutic response to lamotrigine augmentation therapy in 46 (15 males and 31 females) inpatients with treatment-resistant depressive disorder during an 8-week treatment with lamotrigine using an open-study design. METHODS: The subjects were 46 depressed patients who had already shown insufficient response to at least 3 psychotropics including antidepressants, mood stabilizers, and atypical antipsychotics...
January 12, 2018: Neuropsychobiology
Zhongyong Shi, Xinchun Mei, Yingbo Zhu, Yu Shuai, Yupeng Chen, Yujie Wu, Yuan Shen
Obsessive-compulsive disorder (OCD) is a chronic, distressing and substantially impairing neuropsychiatric disorder, characterized by obsessions or compulsions. The current case describes a 44-year-old adult female diagnosed with OCD. The patient had an incomplete response to several SSRIs alone during her past treatment, and led a poor-quality life for at least three years. Current multidimensional approaches, including combined cognitive behavioral therapy (CBT) and the Selective Serotonin Reuptake Inhibitor (SSRI, Sertraline) with a small dose of antipsychotics (Aripiprazole) for augmentation, as well as familial support and resources from the internet were provided for the patient for six months...
October 25, 2017: Shanghai Archives of Psychiatry
Douglas A Drossman, Jan Tack, Alexander C Ford, Eva Szigethy, Hans Törnblom, Lukas Van Oudenhove
BACKGROUND AND AIMS: Central neuromodulators (antidepressants, antipsychotics and other CNS targeted medications) are increasingly used for treatment of functional GI disorders (FGIDs), now recognized as disorders of gut-brain interaction. However, the available evidence and guidance for the use of central neuromodulators in these conditions is scanty and incomplete. In this Rome Foundation Working Team report, a multidisciplinary team summarized available research evidence and clinical experience to provide guidance and treatment recommendations...
December 21, 2017: Gastroenterology
Logan K Townsend, Willem T Peppler, Natasha D Bush, David C Wright
Olanzapine is a second-generation antipsychotic used in the management of schizophrenia and various off-label conditions. The acute metabolic responses of olanzapine recapitulate many of the side effects associated with obesity. Obesity rates are high in the schizophrenic population, but it is unknown whether pre-existing obesity-associated metabolic dysfunction augments the acute side effects of olanzapine. To address this question, we compared the responses to olanzapine in lean and high-fat diet-induced (HFD) obese mice...
February 2018: Psychoneuroendocrinology
Wei-Hsi Chen, Yuan-Hsiang Chu, Kuo-Yen Chen
OBJECTIVES: Spontaneous orgasm is characterized by a spontaneous onset of orgasm without any preceding sexual or nonsexual trigger. It sheds insight on the mechanisms underlying orgasms and the sexual response cycle in humans. METHODS: We report a male patient of repetitive spontaneous orgasm under trazodone treatment and systematically review the literature on drug-associated spontaneous orgasm (DASO). RESULTS: A total of 25 patients (18 women and 7 men), including our reported case, experienced 27 DASO events...
January 2018: Clinical Neuropharmacology
Chittaranjan Andrade
The action of memantine on N-methyl-D-aspartate (NMDA) glutamatergic receptors and the other pharmacodynamic actions of this drug suggest that it may benefit patients with schizophrenia. Many randomized controlled trials (RCTs) have examined this possibility. These RCTs have been meta-analyzed by at least 2 groups of authors. In one meta-analysis (8 RCTs, pooled N = 448), memantine (20 mg/d for 6-12 weeks) augmentation of antipsychotic drug therapy was found to attenuate the severity of negative symptoms and improve cognitive functioning; in both regards, the effect was large...
November 2017: Journal of Clinical Psychiatry
Justin A Barterian, L Eugene Arnold, Nicole V Brown, Cristan A Farmer, Craig Williams, Robert L Findling, David J Kolko, Oscar G Bukstein, Brooke S G Molina, Lisa Townsend, Michael G Aman
OBJECTIVE: The Treatment of Severe Childhood Aggression (TOSCA) project examined augmentation of stimulant treatment and parent training (PT) with risperidone for severe physical aggression. This article summarizes the clinical implications; reanalyzes the data to examine the utility of 4 criteria for deciding to augment; and presents a treatment algorithm. METHOD: The newly analyzed 4 criteria for augmenting after 3 weeks of stimulant and PT treatment consisted of not meeting a Clinical Global Impressions-Improvement (CGI-I) score of 1 and a normal score (≤15) on the Nisonger Child Behavior Rating Form Disruptive-Total (D-Total); a CGI-I score of 1 or 2 plus 25% improvement in D-Total score; a D-Total score no higher than 15; and a CGI-Severity score of 3 (mild) or better...
December 2017: Journal of the American Academy of Child and Adolescent Psychiatry
Peter Simons, Lisa Cosgrove, Allen F Shaughnessy, Harold Bursztajn
Clinical Practice Guidelines (CPGs) are seen as the gold standard of evidence-based care. Because of their influence, these guidelines can have profound legal and economic effects. Despite their proliferation and influence, the trustworthiness and quality of guidelines have been seriously questioned and they have been implicated as drivers of overtreatment. In the U.S, augmentation with second generation antipsychotics (SGAs) is becoming an increasingly common strategy for treating major depressive disorder (MDD) when initial antidepressant treatment does not result in remission of symptoms...
November 2017: International Journal of Law and Psychiatry
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