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Antipsychotic augmentation

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https://www.readbyqxmd.com/read/28514486/efficacy-of-42-pharmacologic-cotreatment-strategies-added-to-antipsychotic-monotherapy-in-schizophrenia-systematic-overview-and-quality-appraisal-of-the-meta-analytic-evidence
#1
Christoph U Correll, Jose M Rubio, Gabriella Inczedy-Farkas, Michael L Birnbaum, John M Kane, Stefan Leucht
Importance: Limited treatment responses in schizophrenia prompted the testing of combining an antipsychotic drug treatment with a second psychotropic medication. A comprehensive evaluation of the efficacy of multiple medication combinations is missing. Objective: To summarize and compare the meta-analytically determined efficacy of pharmacologic combination strategies of antipsychotic drugs in adults with schizophrenia. Data Sources: Systematic search of PubMed and PsycInfo until May 13, 2016...
May 17, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28484390/spatiotemporal-mapping-techniques-show-clozapine-impairs-neurogenic-and-myogenic-patterns-of-activity-in-the-colon-of-the-rabbit-in-a-dose-dependent-manner
#2
Susanna Every-Palmer, Roger G Lentle, Gordon Reynolds, Corrin Hulls, Paul Chambers, Helen Dunn, Pete M Ellis
Background: Clozapine, an antipsychotic used in treatment-resistant schizophrenia, has adverse gastrointestinal effects with significant associated morbidity and mortality. However, its effects on defined patterns of colonic contractile activity have not been assessed. Method: We used novel radial and longitudinal spatiotemporal mapping techniques, combined with and monitoring of ambient lumen pressure, in ex vivo preparations of triply and of singly haustrated portions of rabbit colon. We identified the contractile patterns of mass peristalses, fast phasic, and ripple contractions and directly qualified the effects of clozapine, at concentrations of 10 μmol/L, 20 μmol/L, and 30 μmol/L, and of norclozapine, the main metabolite of clozapine, on contractile patterns...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28474552/new-directions-in-the-use-of-brain-stimulation-interventions-in-patients-with-obsessive-compulsive-disorder
#3
Bernardo Dell'Osso, Laura Cremaschi, Lucio Oldani, Altamura Alfredo Carlo
Obsessive-Compulsive Disorder (OCD) is a highly disabling condition with early onset and chronic course in most of the affected patients. In addition, OCD may show high comorbidity and suicide attempt rates, which worsen the overall burden of the disease for patients and their caregivers. First-line treatments for OCD consist of pro-serotonergic compounds and cognitive-behavioral therapy. Nonetheless, many patients show only limited benefit from such interventions and require additional "next-step" interventions, including augmentative antipsychotics and glutamate-modulating agents...
May 4, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28455126/neurochemical-arguments-for-the-use-of-dopamine-d4-receptor-stimulation-to-improve-cognitive-impairment-associated-with-schizophrenia
#4
Mei Huang, Sunoh Kwon, Wenqi He, Herbert Y Meltzer
BACKGROUND: Dopamine (DA) D4 receptors have been implicated in schizophrenia and the ability of some atypical antipsychotic drugs (APDs) to improve the cognitive impairment associated with schizophrenia (CIAS). Systemic administration of a D4 agonist, PD168077, at a sub-effective dose, together with a sub-effective dose of lurasidone, an atypical APD which is a weak D4 receptor antagonist, reversed the deficit in novel object recognition (NOR) in rats treated subchronically with phencyclidine (PCP), a rodent model of CIAS...
April 25, 2017: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/28410959/the-involvement-of-bdnf-creb-signaling-pathways-in-the-pharmacological-mechanism-of-combined-ssri-antipsychotic-treatment-in-schizophrenia
#5
Reef Einoch, Orly Weinreb, Nina Mandiuk, Moussa B H Youdim, Warren Bilker, Henry Silver
Previous studies into the mechanism of SSRI-antipsychotic synergism in our laboratory identified unique changes in the brain, particularly in the γ-aminobutyric acid (GABA)-A receptor and its modulators. This study examined the role of brain derived neurotrophic factor (BDNF)-cAMP response element binding (CREB) protein signaling pathways, including protein kinase B (AKT), glycogen synthase kinase (GSK)-3β and related molecules in the molecular response to haloperidol, fluvoxamine, combined haloperidol+fluvoxamine and clozapine treatments in rat frontal cortex, hippocampus and primary cortical neuronal cultures...
April 11, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28403623/lithium-a-classic-drug-frequently-discussed-but-sadly-seldom-prescribed
#6
Olga Zivanovic
OBJECTIVE: Distinguished authors in the field have repeatedly alerted psychiatrists of the alarming trends in the treatment of bipolar disorders: decline of lithium use, paralleled by the increase of prescribing anticonvulsants and second-generation antipsychotic drugs. Research has been conducted in order to explore the factors that led to this development and to provide arguments for the need to reverse this trend. METHOD: This paper represents a narrative review of the literature containing retrieved research articles focusing on the efficacy of lithium...
April 1, 2017: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/28349992/central-neuromodulators-for-treating-functional-gi-disorders-a-primer
#7
REVIEW
W Harley Sobin, Thomas W Heinrich, Douglas A Drossman
Patients with functional GI disorders (FGIDs) are commonplace in the gastroenterologist's practice. A number of these patients may be refractory to peripherally acting agents, yet respond to central neuromodulators. There are benefits and potential adverse effects to using TCAs, SSRIs, SNRIs, atypical antipsychotics, and miscellaneous central neuromodulators in these patients. These agents can benefit mood, pain, diarrhea, constipation, nausea, sleep, and depression. The mechanisms by which they work, the differences between classes and individual agents, and the various adverse effects are outlined...
May 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28347261/dopamine-d4-receptor-stimulation-contributes-to-novel-object-recognition-relevance-to-cognitive-impairment-in-schizophrenia
#8
Masanori Miyauchi, Nichole M Neugebauer, Herbert Y Meltzer
Several atypical antipsychotic drugs (APDs) have high affinity for the dopamine (DA) D4 receptor, but the relevance to the efficacy for the treatment of cognitive impairment associated with schizophrenia (CIAS) is poorly understood. The aim of this study was to investigate the effects of D4 receptor stimulation or blockade on novel object recognition (NOR) in normal rats and on the sub-chronic phencyclidine (PCP)-induced novel object recognition deficit. The effect of the D4 agonist, PD168077, and the D4 antagonist, L-745,870, were studied alone, and in combination with clozapine and lurasidone...
April 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28344764/atypical-antipsychotics-recent-research-findings-and-applications-to-clinical-practice-proceedings-of-a-symposium-presented-at-the-29th-annual-european-college-of-neuropsychopharmacology-congress-19-september-2016-vienna-austria
#9
REVIEW
Robin Murray, Christoph U Correll, Gavin P Reynolds, David Taylor
Available evidence suggests that second-generation atypical antipsychotics are broadly similar to first-generation agents in terms of their efficacy, but may have a more favourable tolerability profile, primarily by being less likely to cause extrapyramidal symptoms. However, atypical antipsychotics are variably associated with disturbances in the cardiometabolic arena, including increased body weight and the development of metabolic syndrome, which may reflect differences in their receptor binding profiles...
March 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28338544/associations-between-medication-class-and-subsequent-augmentation-of-depression-treatment-in-privately-insured-us-adults
#10
Omid Ameli, Rene Soria-Saucedo, Eric G Smith, Howard J Cabral, Marina Soley-Bori, Lewis E Kazis
IMPORTANCE: Treatment augmentation is an important clinical decision in the pharmacotherapy for depression, yet few studies have examined the rates of treatment augmentation by medication class. OBJECTIVE: The aim of this study was to examine which initial pharmacotherapies for depression are more likely than others to result in subsequent treatment augmentation. METHODS: This study is a retrospective cohort analysis of administrative data of 214,705 privately insured US adults between the age of 18 and 64 years who were diagnosed with a new episode of depression in 2009...
June 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28331329/successful-treatment-for-psychomotor-agitation-in-neuromyelitis-optica-spectrum-disorder-with-trazodone-risperidone-combination-a-case-report
#11
Zui Narita, Harumasa Takano, Tomiki Sumiyoshi
Neuromyelitis optica (NMO) is a relapsing disease that typically affects the spinal cord and optic nerves. So far, a few studies have reported pharmacologic treatment for psychiatric symptoms in patients with NMO spectrum disorder (NMOSD). However, no literature has described psychomotor agitation associated with the disease and its treatment. We report an 84-year-old woman with NMOSD whose psychomotor agitation was effectively treated with a combination of trazodone and risperidone. Our observation suggests the ability of augmentation of antipsychotic drugs with antidepressants to ameliorate psychotic symptoms associated with NMOSD...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28318897/efficacy-of-off-label-augmentation-in-unipolar-depression-a-systematic-review-of-the-evidence
#12
REVIEW
Julia Kleeblatt, Felix Betzler, Laura L Kilarski, Tom Bschor, Stephan Köhler
Treatment of unipolar depression with currently available antidepressants is still unsatisfactory. Augmentation with lithium or second generation antipsychotics is an established practice in non-responders to antidepressant monotherapy, but is also associated with a substantial non-response rate and with non-tolerance. Based on a systematic review of the literature, including meta-analyses, randomized controlled trials (RCTs), non-randomized comparative studies and case studies, off-label augmentation agents (administered in addition to an antidepressant, without FDA approval for treatment of MDD) were identified and evaluated regarding their efficacy using levels of evidence...
March 16, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28302501/pharmacokinetic-considerations-in-antipsychotic-augmentation-strategies-how-to-combine-risperidone-with-low-potency-antipsychotics
#13
Michael Paulzen, Georgios Schoretsanitis, Benedikt Stegmann, Christoph Hiemke, Gerhard Gründer, Koen R J Schruers, Sebastian Walther, Sarah E Lammertz, Ekkehard Haen
OBJECTIVES: To investigate in vivo the effect of low-potency antipsychotics on metabolism of risperidone (RIS). METHODS: A therapeutic drug monitoring database containing plasma concentrations of RIS and its metabolite 9-OH-RIS of 1584 patients was analyzed. Five groups were compared; a risperidone group (n=842) and four co- medication groups; a group co-medicated with chlorprothixene (n=67), a group with levomepromazine (n=32), a group with melperone (n=46), a group with pipamperone (n=63) and a group with prothipendyl (n=24)...
March 14, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28294084/continuous-circular-cycling-as-a-predictor-of-treatment-response-in-bipolar-disorders-a-comprehensive-review-of-the-current-literature
#14
Antonio Tundo, Paola Cavalieri
Evidence from the literature suggests that, on average, 27% of patients with a bipolar disorder (BD) experience a continuous cycling course (CCC) and that this subgroup differs significantly from patients with a noncontinuous cycling course (N-CCC) with respect to sociodemographic characteristics and clinical presentation. The aim of the present paper is to review the studies that evaluated short- and long-term treatment responses in BD patients with CCC. The retrieved studies indicate that CCC is a significant predictor of poor response to long-term treatment with lithium (the odds of a response in the CCC group were 57% less than in the N-CCC group; p<0...
March 15, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28288438/epidemiology-of-pharmaceutically-treated-depression-and-treatment-resistant-depression-in-taiwan
#15
Daniel Fife, Yu Feng, Michael Yao-Hsien Wang, Chee-Jen Chang, Chia-Yih Liu, Hsiao-Ting Juang, Wesley Furnback, Jaskaran Singh, Bruce Wang
Epidemiologic data on treatment resistant depression (TRD) in Asia-Pacific countries are limited. We estimated the incidence of TRD in Taiwan using a cohort of 704,265 adults randomly sampled from Taiwan's National Health Insurance Research database for 2005. TRD was defined as a patient having pharmaceutically treated depression (PTD) not adequately responding to 2 antidepressant (AD) regimens, i.e., AD regimens that were followed by other AD regimens. Among 2751 PTD subjects, 576 (20.94%, 95% CI: 19.46, 22...
June 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28280892/antidepressant-pharmacotherapy-in-old-age-depression-a-review-and-clinical-approach
#16
REVIEW
Nathalie Pruckner, Vjera Holthoff-Detto
PURPOSE: Depression in old age is a disabling disease associated with functional and cognitive decline severely affecting quality of life. Studies specifically investigating antidepressant treatment for this special cohort of patients remain scarce and results are often conflicting. A narrative literature review was undertaken, synthesizing findings from published studies, systematic reviews, and treatment guidelines specifically conducted in elderly depressed patients to summarize implications and current recommendations as well as gaps in evidence for old-age pharmacologic treatment...
March 10, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28182008/thioridazine-enhances-sensitivity-to-carboplatin-in-human-head-and-neck-cancer-cells-through-downregulation-of-c-flip-and-mcl-1-expression
#17
Seung Un Seo, Hyuk Ki Cho, Kyoung-Jin Min, Seon Min Woo, Shin Kim, Jong-Wook Park, Sang Hyun Kim, Yung Hyun Choi, Young Sam Keum, Jin Won Hyun, Hyun Ho Park, Sang-Han Lee, Dong Eun Kim, Taeg Kyu Kwon
Carboplatin is a less toxic analog of cisplatin, but carboplatin also has side effects, including bone marrow suppression. Therefore, to improve the capacity of the anticancer activity of carboplatin, we investigated whether combined treatment with carboplatin and thioridazine, which has antipsychotic and anticancer activities, has a synergistic effect on apoptosis. Combined treatment with carboplatin and thioridazine markedly induced caspase-mediated apoptosis in head and neck squamous cell carcinoma (AMC-HN4) cells...
February 9, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28127934/antipsychotic-augmentation-vs-monotherapy-in-schizophrenia-systematic-review-meta-analysis-and-meta-regression-analysis
#18
Britta Galling, Alexandra Roldán, Katsuhiko Hagi, Liz Rietschel, Frozan Walyzada, Wei Zheng, Xiao-Lan Cao, Yu-Tao Xiang, Mathias Zink, John M Kane, Jimmi Nielsen, Stefan Leucht, Christoph U Correll
Antipsychotic polypharmacy in schizophrenia is much debated, since it is common and costly with unclear evidence for its efficacy and safety. We conducted a systematic literature search and a random effects meta-analysis of randomized trials comparing augmentation with a second antipsychotic vs. continued antipsychotic monotherapy in schizophrenia. Co-primary outcomes were total symptom reduction and study-defined response. Antipsychotic augmentation was superior to monotherapy regarding total symptom reduction (16 studies, N=694, standardized mean difference, SMD=-0...
February 2017: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
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
#19
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...
February 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
#20
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
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