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Antipsychotic dosing

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https://www.readbyqxmd.com/read/29223744/effect-of-various-antipsychotic-regimens-on-incidence-of-delirium-in-critically-ill-adults
#1
W Anthony Hawkins, Stephanie V Phan, Stacey L Campbell
PURPOSE: Delirium is common during critical illness but it is unknown whether the choice of antipsychotic or dosing strategy impacts delirium outcomes. We evaluated the incidence of delirium in critically ill adults receiving different antipsychotic regimens. MATERIALS AND METHODS: Single center retrospective cohort study of adult patients admitted to the intensive care unit (ICU). Patients who received haloperidol or quetiapine and scored negative on the Confusion Assessment Method for the ICU (CAM-ICU) prior to initiation were included...
November 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29219628/penetration-enhancer-containing-spanlastics-pecss-for-transdermal-delivery-of-haloperidol-in-vitro-characterization-ex-vivo-permeation-and-in-vivo-biodistribution-studies
#2
Abdurrahman M Fahmy, Doaa Ahmed El-Setouhy, Ahmed B Ibrahim, Basant A Habib, Saadia A Tayel, Noha A Bayoumi
Haloperidol (Hal) is one of the widely used antipsychotic drugs. When orally administered, it suffers from low bioavailability due to hepatic first pass metabolism. This study aimed at developing Hal-loaded penetration enhancer-containing spanlastics (PECSs) to increase transdermal permeation of Hal with sustained release. PECSs were successfully prepared using ethanol injection method showing reasonable values of percentage entrapment efficiency, particle size, polydispersity index and zeta potential. The statistical analysis of the ex vivo permeation parameters led to the choice of F1L - made of Span® 60 and Tween® 80 at the weight ratio of 4:1 along with 1% w/v Labrasol® - as the selected formula (SF)...
November 2018: Drug Delivery
https://www.readbyqxmd.com/read/29214869/the-relationship-between-the-personality-inventory-for-the-dsm-5-pid-5-and-the-psychotic-disorder-in-a-clinical-sample
#3
Tim Bastiaens, Dirk Smits, Marc De Hert, Erik Thys, Hendrik Bryon, Kim Sweers, Teresa Teugels, Joeri Van Looy, Tim Verwerft, Dominique Vanwalleghem, Ludi Van Bouwel, Laurence Claes
Recent studies have successfully investigated the validity of the DSM-5 Alternative Model for Personality Disorders. In a final sample of 174 psychiatric patients, the present study examined the relationship between the Personality Inventory for the DSM-5 (PID-5) and syndromal psychosis. Results showed that patients diagnosed with versus without a psychotic disorder significantly differed on all PID-5 domains except Antagonism. Discriminant function analysis indicated that lower Detachment, lower Negative Affect, lower Disinhibition, and higher Psychoticism best discriminated patients with a psychotic disorder from patients with other psychiatric conditions...
February 1, 2017: Assessment
https://www.readbyqxmd.com/read/29210867/antipsychotic-polypharmacy-and-its-relation-to-metabolic-syndrome-in-patients-with-schizophrenia-an-egyptian-study
#4
Dina M Aly El-Gabry, Karim Abdel Aziz, Tarek Okasha, Hanan Azzam, Ahmed Okasha
PURPOSE/BACKGROUND: Few studies have examined the relationship between antipsychotic polypharmacy and metabolic syndrome in schizophrenia. Some studies suggest that antipsychotic polypharmacy may be associated with greater metabolic risk, whereas other studies suggest that this is uncertain. To date, there have been no studies in Egypt or the Arab world that have investigated this relationship. We sought to compare subjects with schizophrenia receiving antipsychotic polypharmacy and monotherapy as regards metabolic outcomes and to investigate medication-related factors associated with metabolic syndrome...
November 28, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29210808/prophylactic-use-of-haloperidol-and-changes-in-glucose-levels-in-hospitalized-older-patients
#5
Kris van Keulen, Wilma Knol, Edmée J M Schrijver, Rob J van Marum, Astrid M van Strien, Prabath W B Nanayakkara
BACKGROUND: Treatment with antipsychotic drugs has been associated with glucose dysregulation in older outpatients, especially in the early stage of therapy. The underlying mechanism is, however, unclear. The aim of this study was to investigate changes in glucose levels during haloperidol use compared with the use of placebo among older hospitalized patients. METHODS: This substudy was part of a larger multicenter, randomized, double blind, placebo-controlled clinical trial among hospitalized patients aged 70 years and older who had an increased risk of in-hospital delirium...
November 27, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29203336/spontaneous-recovery-of-traumatic-brain-injury-induced-functional-deficits-is-not-hindered-by-daily-administration-of-lorazepam
#6
Jeffrey P Cheng, Jacob B Leary, Darik A O'Neil, Elizabeth A Meyer, Kristin E Free, Corina O Bondi, Anthony E Kline
Agitation and aggression are common sequelae of traumatic brain injury (TBI) and pose a challenge to physicians and other health providers during acute patient care and subsequent neurorehabilitation. Antipsychotic drugs (APDs) are routinely administered to manage TBI patients displaying such maladaptive behaviors despite several clinical and preclinical studies demonstrating that they hinder recovery. A potentially viable alternative to APDs may be the benzodiazepines, which have differing mechanisms of action...
December 1, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/29201642/the-effect-of-duration-of-illness-and-antipsychotics-on-subcortical-volumes-in-schizophrenia-analysis-of-778-subjects
#7
Naoki Hashimoto, Yoichi M Ito, Naohiro Okada, Hidenaga Yamamori, Yuka Yasuda, Michiko Fujimoto, Noriko Kudo, Ariyoshi Takemura, Shuraku Son, Hisashi Narita, Maeri Yamamoto, Khin Khin Tha, Asuka Katsuki, Kazutaka Ohi, Fumio Yamashita, Shinsuke Koike, Tsutomu Takahashi, Kiyotaka Nemoto, Masaki Fukunaga, Toshiaki Onitsuka, Yoshiyuki Watanabe, Hidenori Yamasue, Michio Suzuki, Kiyoto Kasai, Ichiro Kusumi, Ryota Hashimoto
Background: The effect of duration of illness and antipsychotic medication on the volumes of subcortical structures in schizophrenia is inconsistent among previous reports. We implemented a large sample analysis utilizing clinical data from 11 institutions in a previous meta-analysis. Methods: Imaging and clinical data of 778 schizophrenia subjects were taken from a prospective meta-analysis conducted by the COCORO consortium in Japan. The effect of duration of illness and daily dose and type of antipsychotics were assessed using the linear mixed effect model where the volumes of subcortical structures computed by FreeSurfer were used as a dependent variable and age, sex, duration of illness, daily dose of antipsychotics and intracranial volume were used as independent variables, and the type of protocol was incorporated as a random effect for intercept...
2018: NeuroImage: Clinical
https://www.readbyqxmd.com/read/29198287/a-cross-sectional-examination-of-the-prevalence-of-psychotropic-medications-for-people-living-with-dementia-in-australian-long-term-care-facilities-issues-of-concern
#8
Mitchell McMaster, Elaine Fielding, David Lim, Wendy Moyle, Elizabeth Beattie
BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) are a common problem in long-term care facilities (LTC). Clinical guidelines dictate that first-line treatments for BPSD are psychosocial and behavioral interventions; if these are unsuccessful, psychotropic medications may be trialed at low doses and their effects can be monitored. METHODS: There have previously been no studies with nationally representative samples to investigate psychotropic administration in LTCs in Australia...
December 4, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/29195684/mice-lacking-interleukin-18-gene-display-behavioral-changes-in-animal-models-of-psychiatric-disorders-possible-involvement-of-immunological-mechanisms
#9
S F Lisboa, A C Issy, C Biojone, K Montezuma, V Fattori, E A Del-Bel, F S Guimarães, F Q Cunha, W A Verri, S R L Joca
Preclinical and clinical evidence suggests pro-inflammatory cytokines might play an important role in the neurobiology of schizophrenia and stress-related psychiatric disorders. Interleukin-18 (IL-18) is a member of the IL-1 family of cytokines and it is widely expressed in brain regions involved in emotional regulation. Since IL-18 involvement in the neurobiology of mental illnesses, including schizophrenia, remains unknown, this work aimed at investigating the behavior of IL-18 null mice (KO) in different preclinical models: 1...
November 10, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/29195167/effects-of-short-and-long-term-aripiprazole-treatment-on-group-i-mglurs-in-the-nucleus-accumbens-comparison-with-haloperidol
#10
Jeremy S Lum, Bo Pan, Chao Deng, Xu-Feng Huang, Lezanne Ooi, Kelly A Newell
The D2 receptor partial agonist, aripiprazole, has shown increased therapeutic efficacy for schizophrenia, autism and Tourette's syndrome compared to traditional antipsychotics such as the D2 receptor antagonist, haloperidol. Recent evidence suggests this superior profile may be associated with downstream effects on glutamatergic synapses. Group 1 metabotropic glutamate receptors (mGluRs) and their endogenous modulators, Norbin and Homer1, are regulated by D2 receptor activity, particularly within the nucleus accumbens (NAc), a target region of aripiprazole and haloperidol...
November 21, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29194112/drug-associated-spontaneous-orgasm-a-case-report-and-systematic-review-of-literature
#11
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/29189421/asenapine-in-the-management-of-impulsivity-and-aggressiveness-in-bipolar-disorder-and-comorbid-borderline-personality-disorder-an-open-label-uncontrolled-study
#12
Andrea Aguglia, Ludovico Mineo, Alessandro Rodolico, Maria S Signorelli, Eugenio Aguglia
Borderline personality disorder (BPD) often co-occurres with bipolar disorder (BD). Impulsivity and aggressiveness represent core shared features and their pharmacological management is mainly based on mood stabilizers and antipsychotics, although scarce evidence is available for this context of comorbidity. The aim of the present study was to evaluate the role of Asenapine as an adjunctive drug for reducing aggressiveness and impulsivity in a sample of Italian BD type I outpatients with or without a comorbid BPD...
November 17, 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29187462/control-of-nausea-based-on-risk-analysis-in-patients-with-esophageal-and-gastric-cancer-who-received-cisplatin-based-chemotherapy
#13
Hironori Fujii, Hirotoshi Iihara, Noriko Kajikawa, Ryo Kobayashi, Akio Suzuki, Yoshihiro Tanaka, Kazuya Yamaguchi, Kazuhiro Yoshida, Yoshinori Itoh
BACKGROUND: Cisplatin is commonly used for esophageal and gastric cancer, but has a high emetic risk. Although the control of vomiting is favorable, nausea is still poorly controlled in patients receiving cisplatin-based regimens. The present study was designed to determine the risks for cisplatin-induced nausea. The effect of olanzapine, an antipsychotic drug, as an antiemetic for patients with risk of poor control of nausea was subsequently examined. PATIENTS AND METHODS: The prevalence of antiemetic medication and the control of nausea and vomiting were retrospectively examined in patients with esophageal or gastric cancer receiving the first cycle of cisplatin-based chemotherapy...
December 2017: Anticancer Research
https://www.readbyqxmd.com/read/29183893/brief-psychotic-episode-in-a-patient-with-chromosome-2q37-microdeletion-syndrome
#14
Kevin Lally, Nuraini Ibrahim, Mary Kelly, Gautam Gulati
A 21-year-old woman with moderate learning disability secondary to chromosome 2 microdeletion at q37 was admitted to a general adult psychiatric ward following a period of agitation with incessant pressure of speech, nihilistic delusions and worsening of sleep and eating patterns. Her presentation was preceded for a number of weeks by social stressors of an ill family member and another family member moving away. She had also been diagnosed and treated for a respiratory infection several weeks prior to presentation...
November 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29180868/the-efficacy-of-antipsychotics-for-prolonged-delirium-with-renal-dysfunction
#15
Satoko Asano, Yasuto Kunii, Hiroshi Hoshino, Yusuke Osakabe, Tetsuya Shiga, Shuntaro Itagaki, Itaru Miura, Hirooki Yabe
Aim: Delirium is commonly encountered in daily clinical practice. To identify predictors influencing outcomes, we retrospectively examined the characteristics of inpatients with delirium who required psychiatric medication during hospitalization. Methods: We extracted all new inpatients (n=523) consulted for psychiatric symptoms at Fukushima Medical University Hospital between October 2011 and September 2013. We selected 203 inpatients with delirium diagnosed by psychiatrists...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29179595/efficacy-and-safety-of-aripiprazole-lauroxil-once-monthly-versus-aripiprazole-once-monthly-long-acting-injectable-formulations-in-patients-with-acute-symptoms-of-schizophrenia-an-indirect-comparison-of-two-double-blind-placebo-controlled-studies
#16
Chris Cameron, Jacqueline Zummo, Dharmik Desai, Christine Drake, Brian Hutton, Ahmed Kotb, Peter J Weiden
BACKGROUND: Aripiprazole lauroxil (AL) is a long-acting injectable atypical antipsychotic recently approved for the treatment of schizophrenia. OBJECTIVE: To indirectly compare the safety and efficacy of AL and aripiprazole once-monthly (AOM). METHODS: We performed a systematic search to identify randomized, controlled trials of AOM and AL that met criteria for indirect comparison according to Bayesian network meta-analysis. The analysis indirectly compared AL and AOM treatment groups for efficacy by mean change in Positive and Negative Syndrome Scale (PANSS) total score and ≥30% reduction in PANSS total score, as well as tolerability including adverse events, akathisia, and weight gain...
November 27, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29178683/reducing-anticholinergic-medication-burden-in-patients-with-psychotic-or-bipolar-disorders
#17
Ana M Lupu, Kimberly Clinebell, Jessica M Gannon, Justin C Ellison, K N Roy Chengappa
OBJECTIVE: Anticholinergic medications are prescribed to treat extrapyramidal side effects (EPS) associated with antipsychotics. Anticholinergic medications cause several side effects and can often be withdrawn during the maintenance phase of antipsychotic treatment without EPS reemergence. The purpose of this quality improvement (QI) project was to reduce anticholinergic medication burden and improve quality of life in patients with severe mental illness. METHODS: Patients with DSM-IV-TR-diagnosed schizophrenia, schizoaffective disorder, and bipolar disorders in an outpatient psychiatric clinic who were prescribed benztropine were identified, screened for anticholinergic side effects by the treating psychiatrist, and referred to an on-site clinical pharmacist for a comprehensive medication review...
November 21, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29177572/aripiprazole-lauroxil-a-review-in-schizophrenia
#18
James E Frampton
Aripiprazole lauroxil long-acting injectable (LAI) [Aristada®] is an intramuscularly administered, extended-release prodrug of aripiprazole, an established atypical antipsychotic agent that, in terms of its relative position within the class, is at the low end of the risk spectrum for metabolic side effects. In the USA, aripiprazole lauroxil LAI is indicated for the treatment of schizophrenia; approved doses of the drug can be injected once-monthly (q4w), every 6 weeks (q6w) or every 2 months (q8w). The efficacy of the 441 and 882 mg q4w dosages in the treatment of acute exacerbations of schizophrenia and as long-term maintenance therapy in stable schizophrenia has been directly demonstrated in a phase III clinical trial and extension, while the efficacy of the 662 mg q4w, 882 mg q6w and 1064 mg q8w dosing regimens has been established on the basis of pharmacokinetic bridging studies...
November 25, 2017: Drugs
https://www.readbyqxmd.com/read/29175562/utilisation-and-polypharmacy-aspects-of-antiepileptic-drugs-in-elderly-versus-younger-patients-with-epilepsy-a-pharmacoepidemiological-study-of-cns-active-drugs-in-norway-2004-2015
#19
Arton Baftiu, Silje Andrea Feet, Pål Gunnar Larsson, Margrete Larsen Burns, Oliver Henning, Erik Sætre, Espen Molden, Anne Gerd Granas, Svein I Johannessen, Cecilie Johannessen Landmark
BACKGROUND AND PURPOSE: Many patients with epilepsy use antiepileptic drugs (AEDs) in combination. The elderly is a vulnerable group regarding polypharmacy. The purpose of this study was to investigate changes in utilisation of AEDs, and the extent of polypharmacy with other CNS-active drugs in elderly versus younger patients in Norway. METHODS: This pharmacoepidemiological study included all prescriptions of antiepileptic, antidepressant and antipsychotic drugs from Norwegian pharmacies in the Norwegian Prescription Database (NorPD) (2004-2015)...
November 11, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29173736/clinical-implications-from-the-treatment-of-severe-childhood-aggression-tosca-study-a-re-analysis-and-integration-of-findings
#20
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
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