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Antipsychotic dosing

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https://www.readbyqxmd.com/read/27925164/brain-volume-change-in-first-episode-psychosis-an-effect-of-antipsychotic-medication-independent-of-bmi-change
#1
K N Jørgensen, R Nesvåg, S Nerland, L Mørch-Johnsen, L T Westlye, E H Lange, U K Haukvik, C B Hartberg, I Melle, O A Andreassen, I Agartz
OBJECTIVE: The effect of antipsychotic medication on brain structure remains unclear. Given the prevalence of weight gain as a side-effect, body mass index (BMI) change could be a confounder. METHOD: Patients with first-episode psychosis (n = 78) and healthy controls (n = 119) underwent two 1.5T MRI scans with a 1-year follow-up interval. siena (fsl 5.0) was used to measure whole-brain volume change. Weight and height were measured at both time points. Antipsychotic medication use at baseline and follow-up was converted into chlorpromazine equivalent dose and averaged...
December 7, 2016: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/27923235/association-of-the-cholinergic-muscarinic-m2-receptor-with-autonomic-nervous-system-activity-in-patients-with-schizophrenia-on-high-dose-antipsychotics
#2
Masatoshi Miyauchi, Ikuko Kishida, Akira Suda, Yohko Shiraishi, Saki Hattori, Mami Fujibayashi, Masataka Taguri, Chie Ishii, Norio Ishii, Toshio Moritani, Yoshio Hirayasu
BACKGROUND: Patients with schizophrenia have abnormal autonomic nervous system (ANS) activity compared with the general population. One reason for this difference is the muscarinic affinity for antipsychotic drugs; therefore, single nucleotide polymorphisms (SNPs) of the muscarinic receptor gene influence this ANS dysfunction. This study sought to determine the effect of SNPs of the cholinergic muscarinic receptor (CHRM) gene on ANS activity in patients with schizophrenia receiving antipsychotic drugs...
December 7, 2016: Neuropsychobiology
https://www.readbyqxmd.com/read/27922589/does-adding-a-second-antipsychotic-to-clozapine-improve-clinical-response-in-resistant-schizophrenia
#3
Magdalena Jiménez-Cornejo, Gonzalo Munizaga, David Aceituno
Clozapine constitutes the treatment of choice in patients with schizophrenia with persisting symptoms despite antipsychotics at adequate dose and treatment duration. However, an important proportion does not respond to optimal doses of clozapine, so the addition of a second antipsychotic might increase clinical response. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified 17 systematic reviews comprising 62 studies addressing the question of this article, including 26 randomized trials...
December 2, 2016: Medwave
https://www.readbyqxmd.com/read/27920120/effects-of-an-intervention-s%C3%A3-kl%C3%A3-k-on-prescription-of-potentially-inappropriate-medication-in-elderly-patients
#4
Cecilia Lenander, Åsa Bondesson, Nina Viberg, Ulf Jakobsson, Anders Beckman, Patrik Midlöv
BACKGROUND: Polypharmacy is known to increase the risk for drug-related problems, and some drugs, potentially inappropriate medications (PIMs), are especially troublesome. OBJECTIVE: To analyse the effects on prescription of PIMs of the SÄKLÄK project, an intervention model created to improve medication safety for elderly patients in primary care. METHOD: The SÄKLÄK project was a multiprofessional intervention in primary care consisting of self-assessment, peer review, feedback and written agreements for change...
December 5, 2016: Family Practice
https://www.readbyqxmd.com/read/27918778/efficacy-of-oral-risperidone-haloperidol-or-placebo-for-symptoms-of-delirium-among-patients-in-palliative-care-a-randomized-clinical-trial
#5
Meera R Agar, Peter G Lawlor, Stephen Quinn, Brian Draper, Gideon A Caplan, Debra Rowett, Christine Sanderson, Janet Hardy, Brian Le, Simon Eckermann, Nicola McCaffrey, Linda Devilee, Belinda Fazekas, Mark Hill, David C Currow
Importance: Antipsychotics are widely used for distressing symptoms of delirium, but efficacy has not been established in placebo-controlled trials in palliative care. Objective: To determine efficacy of risperidone or haloperidol relative to placebo in relieving target symptoms of delirium associated with distress among patients receiving palliative care. Design, Setting, and Participants: A double-blind, parallel-arm, dose-titrated randomized clinical trial was conducted at 11 Australian inpatient hospice or hospital palliative care services between August 13, 2008, and April 2, 2014, among participants with life-limiting illness, delirium, and a delirium symptoms score (sum of Nursing Delirium Screening Scale behavioral, communication, and perceptual items) of 1 or more...
December 5, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27917685/phosphodiesterase-10-inhibitors-in-clinical-development-for-cns-disorders
#6
Hugo Geerts, Athan Spiros, Patrick Roberts
Phosphodiesterase 10 inhibitors (PDE10-I), are conceptually attractive drugs with a potential great therapeutic window as their enriched striatal localization may likely stimulate D1R and reduce D2R downstream effects. However, so far selective PDE10-I with efficacy in animal models have not shown benefit in clinical trials and unexpectedly revealed a substantial dyskinesia motor side-effect. Areas covered: This paper reviews the underlying biological rationale of PDE10 as a target in schizophrenia, Parkinson's and Huntington's disease based on peer-reviewed published articles, the status of the different PDE10-I in clinical development for various CNS indications and explores possible reasons for the clinical trial failures and translational disconnect...
December 3, 2016: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/27914041/paliperidone-loaded-nanolipomer-system-for-sustained-delivery-and-enhanced-intestinal-permeation-superiority-to-polymeric-and-solid-lipid-nanoparticles
#7
Hala Mahmoud Helal, Sana Mohamed Mortada, Marwa Ahmed Sallam
Paliperidone (PPD) is the most recent second-generation atypical antipsychotic approved for the treatment of schizophrenia. An immediate release dose causes extrapyramidal side effects. In this work, a novel nanolipomer carrier system for PPD with enhanced intestinal permeability and sustained release properties has been developed and optimized. PPD was successfully encapsulated into a lipomer consisting of a specific combination of biocompatible materials including poly-ε-caprolactone as a polymeric core, Lipoid S75, and Gelucire® 50/13 as a lipid shell and polyvinyl alcohol as a stabilizing agent...
December 2, 2016: AAPS PharmSciTech
https://www.readbyqxmd.com/read/27906413/comparison-of-psychodrug-prescription-patterns-in-patients-diagnosed-with-bipolar-disorder-and-addiction
#8
Diego Barral, Fátima Barral, Nuria Cruz, Juan D Molina, Victoria Sánchez, Teresa Rosique
OBJECTIVE: To describe if there are differences in the prescription of psychodrug at discharge between bipolar disorder patients with or without addiction. METHODS: We review all the psychotropic drugs dispensed to inpatients of a brief hospitalization psychiatric unit diagnosed as having bipolar disorder at time of discharge. We recluted 225 patients over 18 years old on their last manic episode, between the year 2000 and 2010. We classify them according to the comorbid presence or not of a substance abuse or dependence disorder...
November 2016: Actas Españolas de Psiquiatría
https://www.readbyqxmd.com/read/27896873/identifying-fallacious-arguments-in-a-qualitative-study-of-antipsychotic-prescribing-in-dementia
#9
Parastou Donyai
BACKGROUND: Dementia can result in cognitive, noncognitive and behavioural symptoms which are difficult to manage. Formal guidelines for the care and management of dementia in the UK state that antipsychotics should only be prescribed where fully justified. This is because inappropriate use, particularly problematic in care-home settings, can produce severe side effects including death. The aim of this study was to explore the use of fallacious arguments in professionals' deliberations about antipsychotic prescribing in dementia in care-home settings...
November 29, 2016: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27891571/high-risk-medications-in-hospitalized-elderly-adults-are-we-making-it-easy-to-do-the-wrong-thing
#10
Nina L Blachman, Rosanne M Leipzig, Madhu Mazumdar, Jashvant Poeran
OBJECTIVES: To examine dosages of high-risk medications administered to elderly adults who fall in the hospital and to determine whether electronic default doses are appropriate for elderly adults. DESIGN: Retrospective. SETTING: Large urban academic hospital. PARTICIPANTS: Individuals aged 65 and older experiencing a fall. MEASUREMENTS: Prescribed daily dosages and use of high-risk medications (opiates, benzodiazepines, benzodiazepine-receptor agonists (BRAs), sleep medications, muscle relaxants, antipsychotics) administered within 24 hours before a fall were ascertained and compared with published recommended dosages for older adults and the hospital's electronic medical record (EMR) default doses for these drugs...
November 28, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27890741/perisylvian-gaba-levels-in-schizophrenia-and-bipolar-disorder
#11
Murat İlhan Atagün, Elif Muazzez Şıkoğlu, Çağlar Soykan, Can Serdar Süleyman, Semra Ulusoy-Kaymak, Ali Çayköylü, Oktay Algın, Mary Louise Phillips, Dost Öngür, Constance Mary Moore
The aim of this study is to measure GABA levels of perisylvian cortices in schizophrenia and bipolar disorder patients, using proton magnetic resonance spectroscopy ((1)H-MRS). Patients with schizophrenia (n=25), bipolar I disorder (BD-I; n=28) and bipolar II disorder (BD-II; n=20) were compared with healthy controls (n=30). (1)H-MRS data was acquired using a Siemens 3T whole body scanner to quantify right and left perisylvian structures' (including superior temporal lobes) GABA levels. Right perisylvian GABA values differed significantly between groups [χ(2)=9...
November 24, 2016: Neuroscience Letters
https://www.readbyqxmd.com/read/27888683/lifetime-antipsychotic-medication-and-cognitive-performance-in-schizophrenia-at-age-43-years-in-a-general-population-birth-cohort
#12
Anja P Husa, Jani Moilanen, Graham K Murray, Riikka Marttila, Marianne Haapea, Irina Rannikko, Jennifer H Barnett, Peter B Jones, Matti Isohanni, Anne M Remes, Hannu Koponen, Jouko Miettunen, Erika Jääskeläinen
This naturalistic study analysed the association between cumulative lifetime antipsychotic dose and cognition in schizophrenia after an average of 16.5 years of illness. Sixty participants with schizophrenia and 191 controls from the Northern Finland Birth Cohort 1966 were assessed at age 43 years with a neurocognitive test battery. Cumulative lifetime antipsychotic dose-years were collected from medical records and interviews. The association between antipsychotic dose-years and a cognitive composite score based on principal component analysis was analysed using linear regression...
November 12, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/27886063/d-lysergic-acid-diethylamide-lsd-as-a-model-of-psychosis-mechanism-of-action-and-pharmacology
#13
REVIEW
Danilo De Gregorio, Stefano Comai, Luca Posa, Gabriella Gobbi
d-Lysergic Acid Diethylamide (LSD) is known for its hallucinogenic properties and psychotic-like symptoms, especially at high doses. It is indeed used as a pharmacological model of psychosis in preclinical research. The goal of this review was to understand the mechanism of action of psychotic-like effects of LSD. We searched Pubmed, Web of Science, Scopus, Google Scholar and articles' reference lists for preclinical studies regarding the mechanism of action involved in the psychotic-like effects induced by LSD...
November 23, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27878417/neurobehavioural-evaluation-of-resveratrol-in-murine-models-of-anxiety-and-schizophrenia
#14
Mohammed Garba Magaji, Loretta Oghenekome Iniaghe, Mutiat Abolarin, Opeyemi Isa Abdullahi, Rabiu Abdusalam Magaji
Resveratrol, a caloric restriction mimetic, is a naturally occurring polyphenolic compound with antioxidant and anti-inflammatory properties. Oxidative stress has been implicated in the etiology of a number of neuropsychiatric disorders including generalized anxiety and schizophrenia. This study investigated the anxiolytic and antipsychotic potentials of resveratrol in murine models of anxiety and schizophrenia. Mice were pretreated with resveratrol (200 and 400 mg/kg) in 1% carboxymethyl cellulose for 14 days and subjected to behavioural tests on the 15th day...
November 22, 2016: Metabolic Brain Disease
https://www.readbyqxmd.com/read/27875917/campania-region-italy-spontaneous-reporting-system-and-preventability-assessment-through-a-case-by-case-approach-a-pilot-study-on-psychotropic-drugs
#15
Maurizio Sessa, Concetta Rafaniello, Liberata Sportiello, Annamaria Mascolo, Cristina Scavone, Alessandra Maccariello, Teresa Iannaccone, Michele Fabrazzo, Liberato Berrino, Francesco Rossi, Annalisa Capuano
OBJECTIVE: We conducted the first pilot Italian study to assess the preventability of adverse drug reactions involving psychotropic drugs reported through spontaneous reporting system from 01/07/2012 to 31/12/2014 in Campania Region. METHODS: Preventability was assessed, case-by-case, using an adapted version of the P-method. The evaluation was performed only for those reports that had, as suspected drug, antipsychotics, mood stabilizers, antidepressants, anxiolytic and/or sedative-hypnotic...
December 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27875318/1846g-a-polymorphism-of-cyp2d6-gene-and-extrapyramidal-side-effects-during-antipsychotic-therapy-among-russians-and-tatars-a-pilot-study
#16
Dmitriy A Sychev, Irina S Burashnikova, Ruslan E Kazakov
BACKGROUND: Сytochrome P450 CYP2D6 activity affects antipsychotic therapy safety. 1846G>A (CYP2D6*4) polymorphism frequency varies among different ethnic groups. METHODS: We studied 1846G>A polymorphism in Tatar and Russian schizophrenic patients taking different antipsychotics and association of 1846G>A polymorphism and extrapyramidal disorders (EPD) frequency in schizophrenic patients on haloperidol monotherapy in daily doses up to 20 mg. RESULTS: Heterozygous 1846GA genotype frequency among Tatars was lower (23...
December 1, 2016: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/27871720/-guidelines-for-the-prescription-of-mood-stabilizers-for-adolescents-a-literature-review
#17
G Munch, N Godart
INTRODUCTION: Adolescence is a unique phase of the human developmental process. In adolescents, psychotropic medications may have different efficacy and tolerance profiles compared to those at other stages of the lifespan. Mood stabilizers are a complex pharmacological category including lithium, some anticonvulsants, and some second generation antipsychotics. Focusing on this class of pharmacological agents, we aim to answer the following questions: in which indications and according to which modalities should mood stabilizers be prescribed during adolescence? METHODS: Information was sought from the websites of the French Haute Autorité de santé (HAS) and Agence nationale de sécurité du médicament et des produits de santé (ANSM), the American Food and Drug Administration (FDA) and the British National Institute for Health and Clinical Excellence (NICE)...
November 18, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27863522/cardiometabolic-health-prescribed-antipsychotics-and-health-related-quality-of-life-in-people-with-schizophrenia-spectrum-disorders-a-cross-sectional-study
#18
Daniel Bressington, Jolene Mui, Mei Ling Tse, Richard Gray, Eric F C Cheung, Wai Tong Chien
BACKGROUND: People with schizophrenia-spectrum disorders (SSD) often have high levels of obesity and poor cardiometabolic health. Certain types of antipsychotics have been shown to contribute towards weight gain and there is some equivocal evidence that obesity is related to poor health-related quality of life (HRQoL) in people with SSD. It is also still uncertain if antipsychotic polypharmacy/higher doses of antipsychotics are linked with HRQoL and/or increased risk of obesity/Cardiovascular Disease (CVD)...
November 18, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27862243/antidepressant-adherence-patterns-in-older-patients-use-of-a-clustering-method-on-a-prescription-database
#19
David Braunstein, Amélie Hardy, Quentin Boucherie, Elisabeth Frauger, Olivier Blin, Gaétan Gentile, Joëlle Micallef
According to the World Health Organization, depression will become the second most important cause of disability worldwide by 2020. Our objective was to identify patterns of adherence to antidepressant treatments in older patients using several indicators of adherence and to characterize these patterns in term of medication exposure. We conducted a retrospective cohort study using the French National Health Insurance reimbursement database. Incident antidepressant users aged more than 65 were included from July 1, 2010 to June 30, 2011 and followed-up for 18 months...
November 14, 2016: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/27855434/trends-in-the-outpatient-utilization-of-antipsychotic-drugs-in-the-city-of-zagreb-in-the-ten-year-period-as-a-tool-to-assess-drug-prescribing-rationality
#20
Marina Polić-Vižintin, Ingrid Tripković, Danijela Štimac, Zvonimir Šostar, Mirjana Orban
BACKGROUND: The aim was to determine distribution and trends in the outpatient utilization of antipsychotics to evaluate the rationality of antipsychotic drug prescribing during the ten year period. SUBJECTS AND METHODS: The epidemiological method of descriptive and analytical observation was used. Data on drug utilization from Zagreb Municipal Pharmacy were used to calculate the number of defined daily doses (DDD) and DDD per 1000 inhabitants per day (DDD/TID) using the World Health Organization Anatomical-Therapeutic-Chemical methodology...
December 2016: Psychiatria Danubina
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