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antipsychotic switching

Takafumi Watanabe, Atsurou Yamada
BACKGROUND: Risperidone long-acting injection (RLAI) is increasingly being switched to paliperidone palmitate (PP) because of several benefits. However, this switching is not always successful. METHODS: We examined patient profiles following discontinuation of PP after switching from RLAI. We collected the electronic records of 24 patients with schizophrenia who had switched from RLAI to PP treatment at our hospital between November 2013 and March 2014. Twelve patients continued PP injection for over 1 year (PP-continuers), the other 12 patients discontinued within 1 year (PP-discontinuers), and both groups were followed up until December 31, 2014...
August 15, 2016: Psychopharmacology Bulletin
Xiaowei Zhang, Kyeong-Man Kim
The amino acid sequences and signaling pathways of D2-like dopamine receptors (D2R, D3R, and D4R) are highly conserved. D4R has been suggested to be associated with novelty seeking, and binds with high affinity to an atypical antipsychotic drug with fewer motor function-related side effects than typical neuroleptics. A study comparing D2R and D3R reported that palmitoylation is important for the proper functioning of D3R. Although D4R is a member of the D2-like receptor family, its palmitoylation status and the functional significance of any such posttranslational modification are unknown...
October 14, 2016: Biochemical and Biophysical Research Communications
Monika Szkultecka-Dębek, Katarzyna Miernik, Jarosław Stelmachowski, Miro Jakovljević, Vlado Jukić, Kaire Aadamsoo, Sven Janno, István Bitter, Judit Tolna, Marek Jarema, Slobodan Jankovic, Jan Pecenak, Livia Vavrusova, Rok Tavčar, Jacek Walczak, Darren Talbot, Joanna Augustyńska
OBJECTIVE: The aim is to analyze how schizophrenia is pharmacologically treated in seven CEE countries: Croatia, Estonia, Hungary, Poland, Serbia, Slovakia and Slovenia. METHODS: Psychiatrists from selected centers in each of participating countries were asked to complete a pre-defined questionnaire on their current clinical practice. Information on protocols and resource utilization in schizophrenia treatment was included and derived from randomly selected patient medical records...
September 2016: Psychiatria Danubina
Reiji Yoshimura, Hikaru Hori, Asuka Katsuki, Kiyokazu Atake
Meige syndrome is a relatively rare type of oral facial dystonia. The dominant symptoms involve involuntary eye blinking and chin thrusting. Some patients may experience excessive tongue protrusion, squinting, muddled speech, or uncontrollable contraction of the platysma muscle. A 44-year-old Japanese male was suffering from schizophrenia. The initial presentation of his psychosis consisted of auditory hallucinations, delusions of persecution, psychomotor excitement, loosening association, and restlessness...
September 2016: Journal of UOEH
W Wolfgang Fleischhacker, Alex Hofer, Christian Jagsch, Walter Pirker, Georg Psota, Hans Rittmannsberger, Klaus Seppi
Tardive dyskinesia (TD) remains a relevant clinical problem despite the increasing use of new-generation antipsychotics. Antipsychotic-induced tardive syndromes are difficult to treat and have a low tendency of remission. Therefore, prophylaxis is of utmost importance, with the responsible use of antipsychotics as a prime desideratum. With respect to managing tardive dyskinesia, discontinuing the antipsychotic, if possible, albeit not backed up by unequivocal evidence, is still the main recommendation. If this is not possible, the switch to an antipsychotic with a lower TD risk is the next-preferred option...
September 2016: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
Eve S Fields, Raymond A Lorenz, Joel G Winner
This report describes two cases in which pharmacogenomic testing was utilized to guide medication selection for difficult to treat patients. The first patient is a 29-year old male with bipolar disorder who had severe akathisia due to his long acting injectable antipsychotic. The second patient is a 59-year old female with major depressive disorder who was not responding to her medication. In both cases, a proprietary combinatorial pharmacogenomic test was used to inform medication changes and improve patient outcomes...
2016: Pharmacogenomics and Personalized Medicine
Timothy Peters-Strickland, Cathy Zhao, Pamela P Perry, Anna Eramo, Phyllis M Salzman, Robert D McQuade, Brian R Johnson, Raymond Sanchez
OBJECTIVE: To assess the effects of aripiprazole once-monthly 400 mg (AOM 400) on clinical symptoms and global improvement in schizophrenia after switching from an oral antipsychotic. METHODS: In a multicenter, open-label, mirror-image, naturalistic study in patients with schizophrenia (>1 year, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision [DSM-IV-TR] criteria), changes in efficacy measures were assessed during prospective treatment (6 months) with AOM 400 after switching from standard-of-care oral antipsychotics...
August 17, 2016: CNS Spectrums
Mihai Mutică, Ileana Marinescu, Felicia Militaru, Mihail Cristian Pîrlog, Ion Udriştoiu
Paranoid schizophrenia with long-term course is a challenge for the clinical and therapeutic research, particularly because chronic course is difficult to identify due to the high rate of mortality in this category of patients. The therapeutic stability on an antipsychotic molecule (haloperidol) is indeed an exception, since the current trend in the case of unfavorable course is based on therapeutic versatility and polypharmacy. Haloperidol is the first-generation antipsychotic that is referred in the therapeutic guidelines as the "golden standard" regarding its efficacy on positive symptoms...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Anita H Clayton, Andrew R Alkis, Nishant B Parikh, Jennifer G Votta
Sexual functioning is important to assess in patients with psychiatric illness as both the condition and associated treatment may contribute to sexual dysfunction (SD). Antidepressant medications, mood stabilizers, antipsychotics, and antianxiety agents may be associated with SD related to drug mechanism of action. Sexual adverse effects may be related to genetic risk factors, impact on neurotransmitters and hormones, and psychological elements. Effective strategies to manage medication-induced sexual dysfunction are initial choice of a drug unlikely to cause SD, switching to a different medication, and adding an antidote to reverse SD...
September 2016: Psychiatric Clinics of North America
Young Sup Woo, Won-Myong Bahk, Young-Min Park, Sangkeun Chung, Bo-Hyun Yoon, Seunghee Won, Jeong Goo Lee, Hwang-Bin Lee, Won Kim, Jong-Hyun Jeong, Kwanghun Lee, Moon-Doo Kim
We evaluated the effectiveness of aripiprazole among bipolar patients who had switched to this medication as a result of difficulty maintaining on their prestudy atypical antipsychotics (AAPs) because of subsyndromal mood symptoms or intolerance. This study included 77 bipolar patients who were in syndromal remission with an AAP as monotherapy or with an AAP combined with a mood stabilizer(s) who needed to switch from their present AAP because of subsyndromal symptoms or intolerance. At 24 weeks after switching to aripiprazole, the remission rates on the Montgomery-Åsberg Depression Rating Scale (MADRS) and on both the MADRS and the Young Mania Rating Scale were increased significantly in the full sample and in the inefficacy subgroup...
September 2016: International Clinical Psychopharmacology
F Pietrini, M Spadafora, L Tatini, G A Talamba, C Andrisano, G Boncompagni, M Manetti, V Ricca, A Ballerini
BACKGROUND: To present real-world evidence on the differences between long-acting injectable (LAI) and oral antipsychotic maintenance treatment (AMT) in terms of subjective well-being, attitudes towards drug and quality of life in a sample of remitted schizophrenic subjects. METHODS: Twenty outpatients with remitted schizophrenia treated with either olanzapine or paliperidone and switching from the oral to the LAI formulation of their maintenance treatment were recruited before the switch (LAI-AMT group)...
September 2016: European Psychiatry: the Journal of the Association of European Psychiatrists
Hui Woo Yoon, Jung Suk Lee, Sang Jin Park, Seon-Koo Lee, Won-Jung Choi, Tae Yong Kim, Chang Hyung Hong, Jeong-Ho Seok, Il-Ho Park, Sang Joon Son, Daeyoung Roh, Bo-Ra Kim, Byung Ook Lee
OBJECTIVES: Hyperprolactinemia is an important but often overlooked adverse effect of antipsychotics. Several studies have shown that switching to or adding aripiprazole normalizes antipsychotic-induced hyperprolactinemia. However, no study has directly compared the effectiveness and safety of the 2 strategies. METHODS: A total of 52 patients with antipsychotic-induced hyperprolactinemia were recruited. Aripiprazole was administered to patients with mild hyperprolactinemia (serum prolactin level < 50 ng/mL)...
July 19, 2016: Clinical Neuropharmacology
Hiroshi Kimura, Nobuhisa Kanahara, Tsuyoshi Sasaki, Naoya Komatsu, Minoru Ishige, Katsumasa Muneoka, Hidetoshi Ino, Kazuyuki Yoshimura, Hiroshi Yamanaka, Tomotaka Suzuki, Hideki Komatsu, Hiroyuki Watanabe, Eiji Shimizu, Masaomi Iyo
UNLABELLED: Dopamine supersensitivity psychosis (DSP) resulting from antipsychotic treatment is related to treatment-resistant schizophrenia (TRS), and its treatment has not been established to date. Maintaining thoroughly stable occupancy of the dopamine D2 receptor by risperidone long-acting injectable (RLAI) is one strategy for treatment. In this study, RLAI was given as an adjunctive medication to oral antipsychotic(s), which were switched partially and gradually to RLAI in 108 treatment-resistant patients for an additional 1-year follow-up in a 2-year study, and to compare the effects in 72 patients with a DSP history (DSP group) and 36 patients without this history (NonDSP group)...
August 2016: Journal of Psychopharmacology
Sam Padamadan Joseph
Hyperprolactinemia is a common adverse effect of antipsychotic medication. Switching over to aripiprazole or adjunctive aripiprazole has been advocated for optimal management of antipsychotic-induced hyperprolactinemia. Adjunctive treatment with aripiprazole has been shown to normalize prolactin levels without affecting already achieved improvements in psychotic symptoms. However, here, we present the case of a 36 year old female with delusional disorder who developed symptomatic hyperprolactinemia while on aripiprazole treatment...
May 2016: Indian Journal of Psychological Medicine
John Lally, Mary J Docherty, James H MacCabe
BACKGROUND: Clozapine is an efficacious treatment for treatment-resistant schizophrenia; however its use can be limited by side effect intolerability. Sinus tachycardia is a common adverse event associated with clozapine treatment. Various pharmacological treatments are used to control heart rate increase due to clozapine use and can include a decreased rate of clozapine titration, a switch to a different antipsychotic, or treatment with negative chronotropic drugs. OBJECTIVES: To assess the clinical effects and efficacy of pharmacological interventions for clozapine-induced sinus tachycardia...
June 9, 2016: Cochrane Database of Systematic Reviews
Kingwai Lui, Gagandeep Randhawa, Vicken Totten, Adam E Smith, Joachim Raese
OBJECTIVE: Metabolic syndrome is a common underdiagnosed condition among psychiatric patients exacerbated by second-generation antipsychotics, with the exception of aripiprazole and ziprasidone. This study evaluated the prescribing and treating behavior with regard to antipsychotics and metabolic syndrome of psychiatrists before and after implementation of a mandatory admission order set and electronic notification of results. METHOD: Baseline data from 9,100 consecutive psychiatric admissions to a mental health hospital (July 2013-July 2014) were compared to postintervention data (July 2014-January 2015), which included 1,499 consecutive patient records...
2016: Primary Care Companion to CNS Disorders
George Awad, Daisy Ng-Mak, Krithika Rajagopalan, Jay Hsu, Andrei Pikalov, Antony Loebel
BACKGROUND: Long-term improvement of health-related quality of life (HRQoL) in schizophrenia may improve adherence and reduce relapse and rehospitalization. This analysis examines long-term changes in HRQoL among patients with schizophrenia switched to lurasidone from other antipsychotics. METHODS: Patients who completed an open-label 6-week switch study continued on lurasidone for an additional 24-weeks. HRQoL was measured using the self-reported Personal Evaluation of Transitions in Treatment (PETiT) scale and Short-Form 12 (SF-12) questionnaire...
2016: BMC Psychiatry
Tuanthon Boonlue, Suphat Subongkot, Piyameth Dilokthornsakul, Ronnachai Kongsakon, Oraluck Pattanaprateep, Orabhorn Suanchang, Nathorn Chaiyakunapruk
BACKGROUND: Several clinical practice guidelines suggest using atypical over typical antipsychotics in patients diagnosed with schizophrenia. Nevertheless, cost-containment policy urged restricting usage of atypical antipsychotics and switching from atypical to typical antipsychotics. OBJECTIVE: This study aimed to evaluate clinical and economic impacts of switching from atypical to typical antipsychotics in schizophrenia patients in Thailand. METHODS: From October 2010 through September 2013, a retrospective cohort study was performed utilizing electronic database of two tertiary hospitals...
2016: ClinicoEconomics and Outcomes Research: CEOR
Andrea de Bartolomeis, Federica Marmo, Elisabetta F Buonaguro, Gianmarco Latte, Carmine Tomasetti, Felice Iasevoli
The postsynaptic density (PSD) has been regarded as a functional switchboard at the crossroads of a dopamine-glutamate interaction, and it is putatively involved in the pathophysiology of psychosis. Indeed, it has been demonstrated that antipsychotics may modulate several PSD transcripts, such as PSD-95, Shank, and Homer. Despite switching antipsychotics is a frequent strategy to counteract lack of efficacy and/or side effect onset in clinical practice, no information is available on the effects of sequential treatments with different antipsychotics on PSD molecules...
October 3, 2016: Progress in Neuro-psychopharmacology & Biological Psychiatry
Sean A Rasmussen, Patricia I Rosebush, Rebecca E Anglin, Michael F Mazurek
Early antipsychotic response predicts outcomes for psychotic patients, but recent evidence suggests that this may not be true for patients treated with olanzapine. In this study, we assessed the predictive value of early response to olanzapine or haloperidol in 75 antipsychotic-naive, first-episode psychosis inpatients. Patients were assessed weekly using the Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and Young Mania Rating Scale (YMRS)...
July 30, 2016: Psychiatry Research
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