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Antipsychotic dosing

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https://www.readbyqxmd.com/read/28078208/influence-of-different-second-generation-antipsychotics-on-the-qtc-interval-a-pragmatic-study
#1
Roy E Olsen, Rune A Kroken, Sigmund Bjørhovde, Kristina Aanesen, Hugo A Jørgensen, Else-Marie Løberg, Erik Johnsen
AIM: To investigate whether differential influence on the QTc interval exists among four second generation antipsychotics (SGAs) in psychosis. METHODS: Data were drawn from a pragmatic, randomized head-to-head trial of the SGAs risperidone, olanzapine, quetiapine, and ziprasidone in acute admissions patients with psychosis, and with follow-up visits at discharge or maximally 6-9 wk, 3, 6, 12 and 24 mo. Electrocardiograms were recorded on all visits. To mimic clinical shared decision-making, the patients were randomized not to a single drug, but to a sequence of the SGAs under investigation...
December 22, 2016: World Journal of Psychiatry
https://www.readbyqxmd.com/read/28076676/use-of-metformin-for-cardiometabolic-risks-in-psychiatric-practice-need-to-know-safety-issues
#2
Chittaranjan Andrade
Metformin, a biguanide drug, is emerging as an important treatment option for the prevention or treatment of weight gain, type 2 diabetes mellitus, and the metabolic syndrome in psychiatric patients, especially those who require or receive antipsychotic drugs. Metformin treatment is commonly associated with gastrointestinal adverse effects; the risk of these is reduced by gradual dose uptitration, administration of the drug with meals, and use of a time-release formulation. Lactic acidosis, a potentially fatal complication of biguanide therapy, is very rare with metformin; the risk can be reduced by avoidance of its prescription in patients with impaired renal function, impaired liver function, cardiac failure, and certain other conditions...
November 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28074349/second-generation-antipsychotic-utilization-and-metabolic-parameter-monitoring-in-an-inpatient-pediatric-population-a-retrospective-analysis
#3
Valerie D Nolt, Alexandra Victoria Kibler, G Lucy Wilkening, Tanya J Fabian
BACKGROUND: Second-generation antipsychotics (SGAs) are prescribed for a variety of indications and are strongly associated with adverse metabolic effects. Studies of pediatric outpatients have revealed several deficiencies in monitoring practices for adverse effects associated with SGAs. OBJECTIVE: Our objective was to characterize SGA prescribing and metabolic parameter monitoring (MPM) in an inpatient pediatric population. METHODS: Patients aged <18 years and discharged on SGA treatment between 1 November 2013 and 30 April 2014 from an inpatient psychiatric institution in Pittsburgh, PA, USA were included...
January 10, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28065403/medication-errors-in-parkinson-s-disease-inpatients-in-the-basque-country
#4
Unax Lertxundi, Arantxa Isla, María Ángeles Solinís, Saioa Domingo- Echaburu, Rafael Hernandez, Javier Peral-Aguirregoitia, Juan Medrano, Juan Carlos García-Moncó
INTRODUCTION: Parkinson's disease (PD) medication errors, including both missing dopaminergic drug doses and antidopaminergic usage, have been suggested as risk factors for prolonged hospital stays. The objective of this study was to evaluate the prevalence of such errors in PD patients admitted to public acute-care hospitals in the Basque Country over a two year period and their association with clinically relevant adverse health outcomes, such as length of hospital stay and mortality...
December 31, 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28063918/simultaneous-in-vivo-receptor-occupancy-assays-for-serotonin-1a-2a-and-dopamine-2-receptors-with-the-use-of-non-radiolabelled-tracers-proposed-method-in-screening-antipsychotics
#5
Jagadeesh Babu Thentu, Ramakrishna Nirogi, Gopinadh Bhyrapuneni, Devender Reddy Ajjala, Raghupathi Reddy Aleti, Veera Raghava Choudary Palacharla
INTRODUCTION: Conventionally, receptor occupancy assays employ radiolabelled tracer.However, recent advances with non-radiolabelled tracers brought a revolution in target engagement assays.Non-radiolabelled tracer based receptor occupancy uses LC-MS/MS based quantification.It offers simultaneous quantification of more than one tracer; thus, provides the feasibility of evaluating multiple targets in a single animal.In the present study, we demonstrated simultaneous measurement of serotonin 1A, serotonin 2A, and dopamine 2 receptor occupancy using non-radiolabelled tracers in rats...
January 4, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/28062232/interactions-between-estradiol-and-haloperidol-on-perseveration-and-reversal-learning-in-amphetamine-sensitized-female-rats
#6
Anne Almey, Lauren Arena, Joshua Oliel, Nada Hafez, Cynthia Mancinelli, Lukas Henning, Aleks Tsanev, Wayne G Brake
There are sex differences associated with schizophrenia, as women exhibit later onset of the disorder, less severe symptomatology, and better response to antipsychotic medications. Estrogens are thought to play a role in these sex differences; estrogens facilitate the effects of antipsychotic medications to reduce the positive symptoms of schizophrenia, but it remains unclear whether estrogens protect against the cognitive symptoms of this disorder. Amphetamine sensitization is used to model some symptoms of schizophrenia in rats, including cognitive deficits like excessive perseveration and slower reversal learning...
January 3, 2017: Hormones and Behavior
https://www.readbyqxmd.com/read/28062214/in-utero-exposure-to-atypical-antipsychotic-drug-risperidone-effects-on-fetal-neurotoxicity-in-hippocampal-region-and-cognitive-impairment-in-rat-offspring
#7
K P Singh, Manoj Kr Singh
Clinical studies indicate that about one-third of pregnant women with psychotic symptoms are exposed to either typical or atypical antipsychotic drugs (APDs). Reports on prenatal subject/model are lacking hence, the present study was undertaken to investigate the effect of prenatal exposure to risperidone (RIS) on the fetal hippocampus, and their related functional changes in young rat offspring. In this study, pregnant Wistar rats were exposed to equivalent therapeutic doses of RIS at 0.8mg/kg, 1.0mg/kg, and 2...
January 3, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
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
#8
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...
January 3, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28057524/involvement-of-presynaptic-5-ht1a-receptors-in-the-low-propensity-of-brexpiprazole-to-induce-extrapyramidal-side-effects-in-rats
#9
Cedric Mombereau, Jørn Arnt, Arne Mørk
Previous studies have shown that partial and full 5-HT1A receptor agonists reduce antipsychotic-induced catalepsy. Consequently, some antipsychotics combining balanced efficacy between dopamine (DA) D2 antagonism or partial agonism and 5-HT1A receptor agonism have a low propensity to induce extrapyramidal side effects (EPS), as reflected by low cataleptogenic activity in rodents. In the present experiments, we attempted to explore the importance of pre- and postsynaptic 5-HT1A agonistic properties of brexpiprazole and aripiprazole in the context of neurological side-effect liabilities...
January 3, 2017: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/28055066/association-between-antipsychotic-agents-and-risk-of-acute-respiratory-failure-in-patients-with-chronic-obstructive-pulmonary-disease
#10
Meng-Ting Wang, Chen-Liang Tsai, Chen Wei Lin, Chin-Bin Yeh, Yun-Han Wang, Hui-Lan Lin
Importance: Acute respiratory failure (ARF) is a life-threatening event that has been linked in case reports to antipsychotic use, but this association lacks population-based evidence. Particular attention should be focused on patients with chronic obstructive pulmonary disease (COPD) regarding this drug safety concern because these patients are prone to ARF and are commonly treated with antipsychotics. Objective: To determine whether the use of antipsychotics is associated with an increased risk of ARF in patients with COPD...
January 4, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28053591/potentially-inappropriate-medications-prescribed-for-elderly-patients-through-family-physicians
#11
Abdulaziz Al Odhayani, Ayla Tourkmani, Mohammed Alshehri, Hala Alqahtani, Adel Mishriky
The elderly population is increasing throughout the globe, resulting in higher healthcare costs. Potential inappropriate medication (PIM) prescriptions are a major health problem affecting the elderly persons. Due to limited studies in PIM use in primary care and home healthcare in Saudi Arabia, we aim to examine the extent of PIM prescription for and use by elderly patients. This study was carried out with 798 elderly patients, arbitrarily selected from Prince Sultan Medical Military City through the patient register...
January 2017: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/28027109/the-relationship-between-early-haloperidol-response-and-associated-extrapyramidal-side-effects
#12
Sean A Rasmussen, Patricia I Rosebush, Michael F Mazurek
BACKGROUND: Early response to antipsychotic medication within 2 weeks of initiating treatment can predict psychiatric outcomes. However, it is unclear whether early response is also predictive of extrapyramidal side effects (EPSs) associated with antipsychotic medications. METHODS: In this study, we investigated 136 consecutive antipsychotic-naive, first-episode psychosis patients naturalistically treated with haloperidol. Patients were assessed at baseline and weekly after treatment initiation using the Brief Psychiatric Rating Scale, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale...
February 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28012825/detection-of-the-antipsychotic-drug-quetiapine-in-the-blood-urine-and-hair-samples-of-the-victim-of-a-drug-facilitated-sexual-assault
#13
Sys Stybe Johansen
A drug rape facilitated with the sedative antipsychotic drug quetiapine is presented here. A teenage girl and her girlfriend went to the home of an adult couple they had met at a bar. Here, the teenage girl (victim) felt tired after consuming some alcoholic drinks and fell asleep. While she was asleep, the others left her at the house alone and returned to the bar. Later, the girl woke up to witness the adult male having intercourse with her, but she was not able to resist the attack. She fell asleep again and slept through the next day and a half, after which she left the house...
December 15, 2016: Forensic Science International
https://www.readbyqxmd.com/read/28009769/movement-disorders-induced-by-the-atypical-antipsychotic-aripiprazole
#14
Karim Selfani, Valérie L Soland, Sylvain Chouinard, Philippe Huot
OBJECTIVES: Aripiprazole is an antipsychotic that acts as a partial agonist at dopamine D2 receptors. Because of its partial agonist activity, it was believed that aripiprazole would be less susceptible than typical antipsychotics to induce extrapyramidal side effects. However, a few case-reports and case-series detailing aripiprazole-induced movement disorders have been published, suggesting that aripiprazole-induced movement disorders may arise. Here, we seek to report further cases of aripiprazole-induced movement disorders to raise the awareness of clinicians on this adverse effect...
January 2017: Neurologist
https://www.readbyqxmd.com/read/28008349/dosing-patterns-and-medication-adherence-in-bipolar-disorder-patients-treated-with-lurasidone-a-us-retrospective-claims-database-analysis
#15
Martha Sajatovic, Daisy Ng-Mak, Caitlyn T Solem, Fang-Ju Lin, Krithika Rajagopalan, Antony Loebel
BACKGROUND: The aim of this study was to describe dosing patterns and medication adherence among bipolar patients who initiated lurasidone in a real-world setting. METHODS: Adult bipolar patients who initiated lurasidone between 1 November 2010 and 31 December 2012 (index period) with 6-month pre- and post-index continuous enrollment were identified from the IMS RWD Adjudicated Claims US database. Patients were grouped by starting lurasidone daily dose: 20 mg (7...
December 2016: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28008348/do-doctors-agree-on-doses-of-antipsychotic-medications
#16
Johan Schill, Hans Olsson
BACKGROUND: The objective of this study was to investigate the concordance in attitudes of psychiatrists towards the doses of antipsychotics given to stable outpatients with schizophrenia and to examine the psychiatrists' estimates of equally potent doses of haloperidol and olanzapine. METHODS: We asked all 22 doctors serving at the psychiatry department of Jönköping County Hospital if they considered the combined dose of antipsychotics for 20 individual patients to be 'low', 'medium' or 'high'...
December 2016: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28008260/association-between-the-high-dose-use-of-benzodiazepines-and-rehospitalization-in-patients-with-schizophrenia-a-2-year-naturalistic-study
#17
Yukika Takita, Yoshikazu Takaesu, Kotaro Ono, Kunihiro Futenma, Akiyoshi Shimura, Akiko Murakoshi, Yoko Komada, Yuichi Inoue, Takeshi Inoue
BACKGROUND: High-dose use of benzodiazepines (BZPs) reportedly causes adverse effects on cognitive function and quality of life in patients with schizophrenia. However, effects of BZPs on the clinical course of schizophrenia have not been clarified. This study was set out to investigate the association between BZPs and rehospitalization of patients with schizophrenia. METHODS: In this retrospective study, patients with schizophrenia who were discharged from Tokyo Medical University Hospital between January 2009 and February 2012 were eligible as subjects...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28004623/new-ema-report-on-paliperidone-3-month-injections-taking-clinical-and-policy-decisions-without-an-adequate-evidence-base
#18
G Ostuzzi, D Papola, C Gastaldon, C Barbui
Three-month long-acting paliperidone is a new, recently marketed, formulation of paliperidone, characterised by the longest available dosing interval among long-acting antipsychotics. The clinical profile of 3-month long-acting paliperidone was recently summarised by the European Medicines Agency (EMA) in a public assessment report, released in April 2016. In this commentary, the main strengths and limitations of the EMA assessment report were appraised and discussed, in order to highlight possible implications for clinical practice, future research and regulatory practices for drug approval...
December 22, 2016: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/28002167/haloperidol-versus-ondansetron-for-treatment-of-established-nausea-and-vomiting-following-general-anesthesia-a-randomized-clinical-trial
#19
Vanda G Yazbeck-Karam, Sahar M Siddik-Sayyid, Hanane B Barakat, Serge Korjian, Marie T Aouad
BACKGROUND: Haloperidol is an antipsychotic. At low doses, it is a useful agent for the prophylaxis of postoperative nausea and vomiting (PONV). However, its use for treating established PONV has not been well studied. METHODS: This randomized double-blinded trial tested whether haloperidol is noninferior to ondansetron for the early treatment of established PONV in adult patients undergoing general anesthesia. The primary outcome is whether patients were PONV free during the first 4 hours...
December 19, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27999544/mitragyna-speciosa-leaf-extract-exhibits-antipsychotic-like-effect-with-the-potential-to-alleviate-positive-and-negative-symptoms-of-psychosis-in-mice
#20
Kamini Vijeepallam, Vijayapandi Pandy, Thubasni Kunasegaran, Dharmani D Murugan, Murali Naidu
In this study, we investigated the antipsychotic-like effect of methanolic extract of Mitragyna speciosa leaf (MMS) using in vivo and ex vivo studies. In vivo studies comprised of apomorphine-induced climbing behavior, haloperidol-induced catalepsy, and ketamine-induced social withdrawal tests in mice whereas the ex vivo study was conducted utilizing isolated rat vas deferens preparation. Acute oral administration of MMS (50-500 mg/kg) showed an inverted bell-shaped dose-response in apomorphine-induced cage climbing behavior in mice...
2016: Frontiers in Pharmacology
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