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Antipsychotic augmentation

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https://www.readbyqxmd.com/read/29351487/contribution-of-parasympathetic-muscarinic-augmentation-of-insulin-secretion-to-olanzapine-induced-hyperinsulinemia
#1
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
https://www.readbyqxmd.com/read/29332095/both-serum-brain-derived-neurotrophic-factor-and-interleukin-6-levels-are-not-associated-with-therapeutic-response-to-lamotrigine-augmentation-therapy-in-treatment-resistant-depressive-disorder
#2
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
https://www.readbyqxmd.com/read/29276354/multidimensional-approaches-for-a-case-of-severe-adult-obsessive-compulsive-disorder
#3
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
https://www.readbyqxmd.com/read/29274869/neuromodulators-for-functional-gi-disorders-disorders-of-gut-brain-interaction-a-rome-foundation-working-team-report
#4
REVIEW
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
https://www.readbyqxmd.com/read/29241148/obesity-exacerbates-the-acute-metabolic-side-effects-of-olanzapine
#5
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...
December 8, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29194112/drug-associated-spontaneous-orgasm-a-case-report-and-systematic-review-of-literature
#6
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...
December 1, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/29178686/memantine-as-an-augmentation-treatment-for-schizophrenia-limitations-of-meta-analysis-for-evidence-based-evaluation-of-research
#7
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 21, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29173736/clinical-implications-from-the-treatment-of-severe-childhood-aggression-tosca-study-a-re-analysis-and-integration-of-findings
#8
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
https://www.readbyqxmd.com/read/29157513/antipsychotic-augmentation-for-major-depressive-disorder-a-review-of-clinical-practice-guidelines
#9
REVIEW
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
https://www.readbyqxmd.com/read/29110139/the-place-of-antipsychotics-in-the-therapy-of-anxiety-disorders-and-obsessive-compulsive-disorders
#10
REVIEW
Baptiste Pignon, Chloé Tezenas du Montcel, Louise Carton, Antoine Pelissolo
PURPOSE OF REVIEW: The purpose of this review was to assess and present the findings up to this date on the efficacy of antipsychotics in the treatment of generalized anxiety disorders (GAD), social anxiety disorders (SAD), panic disorders (PD), and obsessive-compulsive disorders (OCD), mostly based on published randomized controlled trials (RCTs) or on open-label studies when RCT were lacking. RECENT FINDINGS: Quetiapine could be recommended in patients with GAD...
November 7, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/29107818/low-comorbid-obsessive-compulsive-disorder-in-patients-with-major-depressive-disorder-findings-from-a-european-multicenter-study
#11
Markus Dold, Lucie Bartova, Daniel Souery, Julien Mendlewicz, Stefano Porcelli, Alessandro Serretti, Joseph Zohar, Stuart Montgomery, Siegfried Kasper
BACKGROUND: This cross-sectional European multicenter study examined the association between major depressive disorder (MDD) and comorbid obsessive-compulsive disorder (OCD). METHODS: Socio-demographic, clinical, and treatment features of 1346 adult MDD patients were compared between MDD subjects with and without concurrent OCD using descriptive statistics, analyses of covariance (ANCOVA), and binary logistic regression analyses. RESULTS: We determined a point prevalence of comorbid OCD in MDD of 1...
October 28, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29102368/-body-dysmorphic-disorder-future-prospects-of-medical-care
#12
E Siegfried, A Ayrolles, H Rahioui
Body dysmorphic disorder (BDD) is characterized by excessive preoccupation with a slight or imagined defect in one's physical appearance, believing they look ugly, abnormal or deformed. While the most common preoccupations focus on the skin, hair and nose, any part of the body may be involved. Preoccupations are intrusive, time-consuming and hard to control. Repetitive behaviors are performed in response to the preoccupations. BDD is associated with marked impairment in socio-professional functioning, poor quality of life and high suicide rates...
November 1, 2017: L'Encéphale
https://www.readbyqxmd.com/read/29053485/the-effects-of-electroconvulsive-therapy-augmentation-of-antipsychotic-treatment-on-cognitive-functions-in-patients-with-treatment-resistant-schizophrenia
#13
Bjanka Vuksan Ćusa, Nataša Klepac, Nenad Jakšić, Zoran Bradaš, Marija Božičević, Natalia Palac, Marina Šagud
OBJECTIVES: Treatment-resistant schizophrenia (TRS) continues to be a challenge in modern psychiatry. Most of these patients have severe neurocognitive deficits. Electroconvulsive therapy (ECT) has proved effective and safe in the treatment of TRS, but because of potential neurocognitive adverse effects, it is associated with many controversies. The aim of this prospective, open study was to evaluate the effects of ECT augmentation of antipsychotics on cognitive functions in patients with TRS...
October 19, 2017: Journal of ECT
https://www.readbyqxmd.com/read/29036711/impacts-of-electroconvulsive-therapy-on-1-year-outcomes-in-patients-with-schizophrenia-a-controlled-population-based-mirror-image-study
#14
Hai-Ti Lin, Shi-Kai Liu, Ming H Hsieh, Yi-Ling Chien, I-Ming Chen, Shih-Cheng Liao, Hui-Ju Tsai, Chi-Shin Wu
Objectives: Despite the decline in the use of electroconvulsive therapy (ECT) in patients with schizophrenia, ECT augmentation is still recommended for those with poor response to standard pharmacological intervention. However, the effectiveness of augmentation of antipsychotics with ECT on long-term clinical outcomes needs to be verified in an expanded sample. Methods: Patients who were hospitalized for schizophrenia and received ECT for the first time during that hospitalization were identified from the total population health insurance database in Taiwan between 2002 and 2011...
September 23, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/28911850/activation-of-indoleamine-2-3-dioxygenase-pathway-by-olanzapine-augments-antidepressant-effects-of-venlafaxine-in-mice
#15
Jaya Thomas, Razia Khanam, Divya Vohora
Recent clinical studies report antipsychotics as a better option to augment the action of antidepressants in treatment resistant cases. However, the proper mechanisms underlying the antidepressant effect of antipsychotics is still not clear. Indolamine 2, 3 dioxygenase (IDO) pathway is considered to be an important pathway in pro-inflammatory cytokine associated stress-induced depression. The present study investigated the antidepressant effect of venlafaxine, olanzapine and their combinations in chronic forced-swim stress-induced depression in mice...
December 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28906325/antidepressant-combination-versus-antidepressants-plus-second-generation-antipsychotic-augmentation-in-treatment-resistant-unipolar-depression
#16
Gabriella Gobbi, Maykel F Ghabrash, Nicolas Nuñez, John Tabaka, Jessica Di Sante, Marie Saint-Laurent, Stephen Vida, Theodore Kolivakis, Nancy Low, Pablo Cervantes, Linda Booij, Stefano Comai
Patients with treatment-resistant unipolar depression (TRD) are treated with antidepressant combinations (ADs) or with second-generation antipsychotics plus AD (SGA+AD) augmentation; however, the clinical characteristics, the factors associated independently with response to SGA+AD, and the outcome trajectories have not yet been characterized. We performed a naturalistic study on the latest stable trial (medication unchanged for about 3 months) in 86 TRD patients with resistance to at least two ADs trials, who received ADs (n=36) or SGA+AD (n=50) treatments...
January 2018: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28892416/roman-high-and-low-avoidance-rats-differ-in-their-response-to-chronic-olanzapine-treatment-at-the-level-of-body-weight-regulation-glucose-homeostasis-and-cortico-mesolimbic-gene-expression
#17
Simon S Evers, Gretha J Boersma, Kellie Lk Tamashiro, Anton Jw Scheurink, Gertjan van Dijk
Olanzapine, an antipsychotic agent mainly used for treating schizophrenia, is frequently associated with body weight gain and diabetes mellitus. Nonetheless, studies have shown that not every individual is equally susceptible to olanzapine's weight-gaining effect. Therefore, Roman high and low avoidance rat strains were examined on their responsiveness to olanzapine treatment. The Roman high avoidance rat shares many behavioral and physiological characteristics with human schizophrenia, such as increased central dopaminergic sensitivity, whereas the Roman low avoidance rat has been shown to be prone to diet-induced obesity and insulin resistance...
August 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28869006/amisulpride-augmentation-in-clozapine-unresponsive-schizophrenia-amicus-a-double-blind-placebo-controlled-randomised-trial-of-clinical-effectiveness-and-cost-effectiveness
#18
Thomas Re Barnes, Verity C Leeson, Carol Paton, Louise Marston, Linda Davies, William Whittaker, David Osborn, Raj Kumar, Patrick Keown, Rameez Zafar, Khalid Iqbal, Vineet Singh, Pavel Fridrich, Zachary Fitzgerald, Hemant Bagalkote, Peter M Haddad, Mariwan Husni, Tim Amos
BACKGROUND: When treatment-refractory schizophrenia shows an insufficient response to a trial of clozapine, clinicians commonly add a second antipsychotic, despite the lack of robust evidence to justify this practice. OBJECTIVES: The main objectives of the study were to establish the clinical effectiveness and cost-effectiveness of augmentation of clozapine medication with a second antipsychotic, amisulpride, for the management of treatment-resistant schizophrenia...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28855875/therapeutic-potential-of-selectively-targeting-the-%C3%AE-2c-adrenoceptor-in-cognition-depression-and-schizophrenia-new-developments-and-future-perspective
#19
REVIEW
Madeleine Monique Uys, Mohammed Shahid, Brian Herbert Harvey
α2A- and α2C-adrenoceptors (ARs) are the primary α2-AR subtypes involved in central nervous system (CNS) function. These receptors are implicated in the pathophysiology of psychiatric illness, particularly those associated with affective, psychotic, and cognitive symptoms. Indeed, non-selective α2-AR blockade is proposed to contribute toward antidepressant (e.g., mirtazapine) and atypical antipsychotic (e.g., clozapine) drug action. Both α2C- and α2A-AR share autoreceptor functions to exert negative feedback control on noradrenaline (NA) release, with α2C-AR heteroreceptors regulating non-noradrenergic transmission (e...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28838328/backing-into-the-future-pharmacological-approaches-to-the-management-of-resistant-depression
#20
P J Cowen
Pragmatic studies indicate that a substantial number of depressed patients do not remit with current first-line antidepressant treatments and after two failed treatment steps the chance of remission with subsequent therapies is around 15%. This paper focuses on current evidence for pharmacological treatments in resistant depression as well as possible future developments. For patients who have failed to respond to two antidepressant trials, augmentation with atypical antipsychotic drugs, specifically quetiapine and aripiprazole, has the best evidence for efficacy, though older treatments such as lithium and triiodothyronine still have utility...
November 2017: Psychological Medicine
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