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Antipsychotic dosing

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https://www.readbyqxmd.com/read/28816923/evaluation-of-concurrent-oral-and-long-acting-injectable-antipsychotic-prescribing-at-the-minneapolis-veterans-affairs-health-care-system
#1
Erica Dimitropoulos, Lisa Drogemuller, Kara Wong
BACKGROUND: Antipsychotic polypharmacy is defined as the concomitant prescribing of more than 1 antipsychotic medication for an individual patient. Despite clinical guideline recommendations, long-acting injectable antipsychotics (LAIAs) are often used together with oral antipsychotics (OAPs) to treat a variety of psychiatric illnesses. Little research exists to address this form of antipsychotic polypharmacy, and its role in therapy is poorly understood. The purpose of this evaluation was to determine the prevalence of this prescribing pattern at our facility, identify provider rationale for polypharmacy, and analyze trends...
August 15, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28812541/systematic-review-of-interventions-for-treating-or-preventing-antipsychotic-induced-tardive-dyskinesia
#2
Hanna Bergman, Dawn-Marie Walker, Adriani Nikolakopoulou, Karla Soares-Weiser, Clive E Adams
BACKGROUND: Antipsychotic medication can cause tardive dyskinesia (TD) - late-onset, involuntary, repetitive movements, often involving the face and tongue. TD occurs in > 20% of adults taking antipsychotic medication (first-generation antipsychotics for > 3 months), with this proportion increasing by 5% per year among those who continue to use these drugs. The incidence of TD among those taking newer antipsychotics is not different from the rate in people who have used older-generation drugs in moderate doses...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28812124/clozapine-chlorpromazine-and-risperidone-dose-dependently-reduce-emotional-hyperthermia-a-biological-marker-of-salience
#3
William W Blessing, Esther M Blessing, Mazher Mohammed, Youichirou Ootsuka
RATIONALE: We recently introduced a new rat model of emotional hyperthermia in which a salient stimulus activates brown adipose tissue (BAT) thermogenesis and tail artery constriction. Antipsychotic drugs, both classical and second generation, act to reduce excessive assignment of salience to objects and events in the external environment. The close association between salient occurrences and increases in body temperature suggests that antipsychotic drugs may also reduce emotional hyperthermia...
August 15, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28802513/nonconvulsive-status-epilepticus-after-electroconvulsive-therapy-a-review-of-literature
#4
Awais Aftab, Ashley VanDercar, Ayham Alkhachroum, Christine LaGrotta, Keming Gao
BACKGROUND: The clinical presentation and risk factors of nonconvulsive status epilepticus (NCSE) in the context of electroconvulsive therapy (ECT) are poorly understood, and guidance regarding diagnosis and management remains scarce. In this article, we identify case reports of ECT-induced NCSE from literature, and discuss the presentation, diagnosis, and management of these cases in the context of what is known about NCSE from the neurology literature. METHODS: A literature search on PubMed for case reports of NCSE after ECT...
July 15, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28800801/behavioral-emergencies-special-considerations-in-the-geriatric-psychiatric-patient
#5
REVIEW
Awais Aftab, Asim A Shah
This article reviews psychiatric considerations and common psychiatric emergencies in the elderly. The elderly are vulnerable to medication side-effects because of pharmacokinetic changes from aging, and require lower doses and slower titration. They are a high-risk group for suicide, with more serious intent, fewer warning signs, and more lethality. Prompt diagnosis and treatment of delirium in emergency settings is essential, given association with worse outcomes when undiagnosed. Pharmacologic options with demonstrable efficacy for agitation in dementia are limited to antipsychotics, which are, however, associated with an increased risk of mortality; behavioral interventions are universally recommended as first-line measures...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28796022/a-pilot-study-of-the-usefulness-of-a-single-olanzapine-plasma-concentration-as-an-indicator-of-early-drug-effect-in-a-small-sample-of-first-episode-psychosis-patients
#6
Arantzazu Zabala, Mariana Bustillo, Imanol Querejeta, Marta Alonso, Oiane Mentxaka, Ana González-Pinto, Amaia Ugarte, J Javier Meana, Miguel Gutiérrez, Rafael Segarra
PURPOSE/BACKGROUND: Studies analyzing concentration-effect relationships in second-generation antipsychotics have reported contradictory results in chronic schizophrenia. No data are available for the early stages of the disease. The present study aims to evaluate the association between a single olanzapine plasma concentration, clinical response, and severity of adverse effects in first-episode psychosis (FEP); to test the utility of various plasma breakpoints as markers of early response to treatment; and to identify variables affecting olanzapine concentrations...
August 8, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28790826/convulsive-syncope-related-to-a-small-dose-of-quetiapine-in-an-adolescent-with-bipolar-disorder
#7
Jianbo Lai, Qiaoqiao Lu, Tingting Huang, Shaohua Hu, Yi Xu
Quetiapine, an atypical antipsychotic, has been extensively used in patients with bipolar disorder. Overdose of quetiapine can result in severe complications, such as coma, seizure, respiratory depression, arrhythmia, and even death. However, the paucity of toxicological evaluation in adolescence causes more potential risks in this population. Herein, we present a case of hypotension and convulsive syncope after exposure to a small dose of quetiapine in a 16-year-old who was diagnosed with bipolar disorder...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28783939/galactorrhea-probably-related-with-switching-from-osmotic-release-oral-system-methylphenidate-mph-to-modified-release-mph-an-adolescent-case
#8
Ozalp Ekinci, Serkan Gunes, Nuran Ekinci
Galactorrhea, as an adverse effect of psychotropic medications, usually develops due to high dose of antipsychotics. Selective serotonin reuptake inhibitors (SSRIs) have also been reported to be related to galactorrhea. To the best of our knowledge, no previous study reported galactorrhea with methylphenidate (MPH) use. Hereby, we report a case of an adolescent girl who developed galactorrhea after increasing his modifed-release oral MPH to 50 mg/day while under treatment of sertraline and very low dose haloperidol...
August 31, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28758432/psychotropic-medication-use-in-australia-2007-to-2015-changes-in-annual-incidence-prevalence-and-treatment-exposure
#9
Jonathan Brett, Emily A Karanges, Benjamin Daniels, Nicholas A Buckley, Carl Schneider, Atheer Nassir, Helga Zoega, Andrew J McLachlan, Sallie-Anne Pearson
OBJECTIVE: To examine changes in annual patterns of psychotropic medication use in Australia from 2007 to 2015. METHODS: We used a 10% sample of individual-level nationwide dispensing claims for concessional beneficiaries dispensed psychotropic medications (stratified by class, subclass) to investigate annual trends and changes in the incidence and prevalence of use, median annual duration of exposure, proportion of people with single psychotropic dispensing and median defined daily doses per person dispensed each medicine per year...
July 1, 2017: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/28758123/peripheral-antinociception-induced-by-aripiprazole-is-mediated-by-the-opioid-system
#10
Renata Cristina Mendes Ferreira, Ana Flávia Almeida-Santos, Igor Dimitri Gama Duarte, Daniele C Aguiar, Fabricio A Moreira, Thiago Roberto Lima Romero
BACKGROUND: Aripiprazole is an antipsychotic drug used to treat schizophrenia and related disorders. Our previous study showed that this compound also induces antinociceptive effects. The present study aimed to assess the participation of the opioid system in this effect. METHODS: Male Swiss mice were submitted to paw pressure test and hyperalgesia was induced by intraplantar injection of prostaglandin E2 (PGE2, 2 μg). Aripiprazole was injected 10 min before the measurement...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28755603/anticholinergic-use-trends-in-14-013-patients-with-schizophrenia-from-three-national-surveys-on-the-use-of-psychotropic-medications-in-china-2002-2012
#11
Yun-Ai Su, Feng Yan, Qian Li, Yu-Tao Xiang, Liang Shu, Xin Yu, Yu-Ping Ning, Ke-Rang Zhang, Tao Li, Qi-Yi Mei, Ke-Qing Li, Tian-Mei Si
Our previous study demonstrated that there have been changes in the patterns of prescription antipsychotic use in China over the period from 2002 to 2012. The aim of this study was to evaluate whether time trends were present for the prescription of anticholinergic medications (ACMs) during the observation period. A total of 14,013 patients with schizophrenia treated in 45 psychiatric hospitals/centers nationwide were surveyed in 2002, 2006 and 2012. Basic socio-demographic and clinical characteristics and the prescription of psychotropic drugs were recorded using a standardized protocol and data collection procedure...
July 21, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28754408/antipsychotics-for-aggression-in-adults-a-meta-analysis
#12
REVIEW
Gerrit I van Schalkwyk, Chad Beyer, Jessica Johnson, Morgan Deal, Michael H Bloch
Aggressive behavior complicates the presentation of many psychiatric illnesses, and is associated with significant morbidity. Antipsychotic medications are used to treat this symptom dimension across multiple diagnoses. In this meta-analysis we sought to identify the effect size of antipsychotic medications for the treatment of reactive-impulsive aggression in adults, and identify differences across underlying diagnosis and specific agent. A search was conducted of four databases, MEDLINE, PsychINFO, Embase and the Cochrane Library to end date of August 10, 2016...
July 25, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28751663/caregiver-burden-in-schizophrenia-following-paliperidone-palmitate-long-acting-injectables-treatment-pooled-analysis-of-two-double-blind-randomized-phase-three-studies
#13
Srihari Gopal, Haiyan Xu, Kelly McQuarrie, Adam Savitz, Isaac Nuamah, Kimberly Woodruff, Maju Mathews
The pooled analysis of two double-blind, randomized, multicenter, phase-3 studies evaluated predictors of improvement or worsening of schizophrenia-related caregiver burden following paliperidone palmitate long-acting injectables (1-monthly [PP1M] and 3-monthly [PP3M]) treatment. Caregivers were offered to complete the involvement evaluation questionnaire (involvement evaluation questionnaire; 31-item scale). Total, 1498 caregivers (intent-to-treat open-label analysis set, n = 1497; mean [SD] age: 51.5 [13...
July 27, 2017: NPJ Schizophrenia
https://www.readbyqxmd.com/read/28750419/pipamperone-and-delirium-a-preliminary-evaluation-of-its-effectiveness-in-the-management-of-delirium-and-its-subtypes
#14
Soenke Boettger, Silvana Knöpfel, Maria Schubert, David Garcia Nuñez, Michael Martin Plichta, Richard Klaghofer, Josef Jenewein
INTRODUCTION: Delirium has been recognised as an underdiagnosed and undermanaged syndrome with substantial prevalence rates and potentially deleterious consequences in the medically ill population. Despite its frequent administration in the management of delirium, the effectiveness of pipamperone has not yet been evaluated. METHODS: In this retrospective, descriptive cohort study of 192 patients, pipamperone as monotherapy and as an adjunct to haloperidol, haloperidol alone, or atypical antipsychotics were compared with respect to their effectiveness in the management of delirium and its subtypes over the course of 20 days...
July 27, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28749091/efficacy-of-ziprasidone-augmentation-of-escitalopram-for-cognitive-symptoms-of-major-depressive-disorder
#15
Nadia Iovieno, Richard C Shelton, Samuel R Petrie, Cristina Cusin, Maurizio Fava, George I Papakostas
OBJECTIVE: To examine the efficacy of adjunctive ziprasidone for cognitive symptoms in adult patients with major depressive disorder (MDD) experiencing persistent symptoms after 8 weeks of open-label escitalopram. METHODS: This post hoc analysis was conducted on a database derived from a previously published study. The parent study was a multicenter, parallel, randomized, double-blind, placebo-controlled trial conducted at 3 academic medical centers in the United States from July 2008 to October 2013...
July 25, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28742396/valbenazine-for-tardive-dyskinesia
#16
Oliver Freudenreich, Gary Remington
Tardive dyskinesia (TD) remains a clinical concern for any patient who receives an antipsychotic. While the overall risk of developing TD is lower with newer antipsychotics compared to older agents, a significant number of patients who require long-term treatment will develop TD. Recently, valbenazine (brand name Ingrezza) became the first drug to be approved by the FDA specifically for the treatment of TD. In this New Drug Review, we summarize the basic pharmacology and clinical trial results for valbenazine...
2017: Clinical Schizophrenia & related Psychoses
https://www.readbyqxmd.com/read/28742260/incorporating-patient-preferences-into-estimation-of-optimal-individualized-treatment-rules
#17
Emily L Butler, Eric B Laber, Sonia M Davis, Michael R Kosorok
Precision medicine seeks to provide treatment only if, when, to whom, and at the dose it is needed. Thus, precision medicine is a vehicle by which healthcare can be made both more effective and efficient. Individualized treatment rules operationalize precision medicine as a map from current patient information to a recommended treatment. An optimal individualized treatment rule is defined as maximizing the mean of a pre-specified scalar outcome. However, in settings with multiple outcomes, choosing a scalar composite outcome by which to define optimality is difficult...
July 25, 2017: Biometrics
https://www.readbyqxmd.com/read/28741387/baseline-characteristics-and-treatment-patterns-of-patients-with-schizophrenia-initiated-on-once-every-three-month-paliperidone-palmitate-in-the-real-world-setting
#18
Kruti Joshi, Marie-Hélène Lafeuille, Brianne Brown, Willy Wynant, Bruno Emond, Patrick Lefebvre, Neeta Tandon
OBJECTIVES: Since May 2015, adult patients with schizophrenia adequately treated with once-monthly paliperidone palmitate (PP1M) may be transitioned to once-every-three-month paliperidone palmitate (PP3M). This study aims to describe baseline characteristics and treatment patterns of patients with schizophrenia initiated on PP3M in the real-world setting. METHODS: Pharmacy and medical claims from 05/2014-09/2016 for adult patients with schizophrenia initiated on PP3M (index date) in the Symphony Health Solutions database were analyzed...
July 25, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28740828/omega-3-fatty-acids-related-to-cognitive-impairment-in-patients-with-schizophrenia
#19
Kazumi Satogami, Shun Takahashi, Shinichi Yamada, Satoshi Ukai, Kazuhiro Shinosaki
Cognitive impairment is strongly associated with functional outcome in patients with schizophrenia but its pathophysiology remains largely unclear. Involvement of omega-3 fatty acids in the cognitive function of healthy individuals and patients with neuropsychiatric disease has received increasing attention. The aim of this study was to examine the relationship between omega-3 fatty acids with cognitive function, social function, and psychiatric symptoms in patients with schizophrenia. The subjects included 30 patients with schizophrenia or schizoaffective disorder...
September 2017: Schizophrenia Research. Cognition
https://www.readbyqxmd.com/read/28740637/antipsychotic-induced-hyperprolactinemia-in-tourette-syndrome
#20
REVIEW
Judith J G Rath, Marlies E J Deen, Hessel van Houten, Sebastiaan F T M de Bruijn, Joop van Gerven, Dick Mul
For many years, Tourette syndrome (TS) was considered to be a rare disorder, but tics and TS are now recognized as fairly common childhood-onset conditions. Children and adolescents with TS are frequently treated with antipsychotics, either as monotherapy or in combination with psychostimulants, melatonin and selective serotonin reuptake inhibitors (SSRIs). Antipsychotics are most often used in schizophrenia and related psychotic disorders, and in these conditions hyperprolactinemia is one of the most common adverse effects associated with antipsychotics, occurring in 40-50% of patients...
July 2017: Therapeutic Advances in Psychopharmacology
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