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Adult Psychiatric Unit: Schizophrenia

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85 papers 1000+ followers
By Edwin Kim Resident Physician, Aspiring Addiction Psychiatrist
https://www.readbyqxmd.com/read/28541090/sixty-years-of-placebo-controlled-antipsychotic-drug-trials-in-acute-schizophrenia-systematic-review-bayesian-meta-analysis-and-meta-regression-of-efficacy-predictors
#1
REVIEW
Stefan Leucht, Claudia Leucht, Maximilian Huhn, Anna Chaimani, Dimitris Mavridis, Bartosz Helfer, Myrto Samara, Matteo Rabaioli, Susanne Bächer, Andrea Cipriani, John R Geddes, Georgia Salanti, John M Davis
OBJECTIVE: Antipsychotic drug efficacy may have decreased over recent decades. The authors present a meta-analysis of all placebo-controlled trials in patients with acute exacerbations of schizophrenia, and they investigate which trial characteristics have changed over the years and which are moderators of drug-placebo efficacy differences. METHOD: The search included multiple electronic databases. The outcomes were overall efficacy (primary outcome); responder and dropout rates; positive, negative, and depressive symptoms; quality of life; functioning; and major side effects...
October 1, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28659221/qtc-interval-in-patients-with-schizophrenia-receiving-antipsychotic-treatment-as-monotherapy-or-polypharmacy
#2
Anja Elliott, Thibault Johan Mørk, Mikkel Højlund, Thomas Christensen, Rasmus Jeppesen, Nikolaj Madsen, Anne Grethe Viuff, Peter Hjorth, Jens Cosedis Nielsen, Povl Munk-Jørgensen
OBJECTIVE: Antipsychotics are associated with a polymorphic ventricular tachycardia, torsades de pointes, which, in the worst case, can lead to sudden cardiac death. The QT interval corrected for heart rate (QTc) is used as a clinical proxy for torsades de pointes. The QTc interval can be prolonged by antipsychotic monotherapy, but it is unknown if the QTc interval is prolonged further with antipsychotic polypharmaceutical treatment. Therefore, this study investigated the associations between QTc interval and antipsychotic monotherapy and antipsychotic polypharmaceutical treatment in schizophrenia, and measured the frequency of QTc prolongation among patients...
June 29, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28590371/cocaine-abuse-traumatic-brain-injury-and-preexisting-brain-lesions-as-risk-factors-for-bupropion-associated-psychosis
#3
Rajdip Barman, Sanjeev Kumar, Bhuvaneshwar Pagadala, Mark B Detweiler
BACKGROUND AND OBJECTIVE: Bupropion is generally considered safe and is widely used both as a monotherapy and as an augmentation agent for the treatment of major depression. Concerns have been raised about bupropion's propensity to precipitate new psychosis and worsen existing psychotic symptoms, although the mechanism is poorly understood. Three cases are reported in which bupropion use was associated with psychosis. The aim of the study was to explore the risk factors and possible mechanisms of psychosis in each case...
August 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28355041/clozapine-augmentation-with-antiepileptic-drugs-for-treatment-resistant-schizophrenia-a-meta-analysis-of-randomized-controlled-trials
#4
Wei Zheng, Yu-Tao Xiang, Xin-Hu Yang, Ying-Qiang Xiang, Jose de Leon
OBJECTIVE: To meta-analyze randomized controlled trials (RCTs) for the efficacy and safety of adjunctive antiepileptic drugs (AEDs) to augment clozapine therapy for treatment-resistant schizophrenia. DATA SOURCES: The search included databases in English (PubMed, PsycINFO, Embase, and Cochrane Library databases and the Cochrane Controlled Trials Register) and in Chinese (China Journal Net [CJN], WanFang, and China Biology Medicine [CBM]) and references from retrieved articles...
May 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28255437/effects-of-a-smoking-ban-on-clozapine-plasma-concentrations-in-a-nonsecure-psychiatric-unit
#5
Siobhan H Gee, David M Taylor, Sukhwinder S Shergill, Robert Flanagan, James H MacCabe
BACKGROUND: Tobacco smoke is known to affect plasma levels of some drugs, including the antipsychotic clozapine. The effects of suddenly stopping smoking on patients who take clozapine can be severe, as plasma concentrations are expected to rapidly rise, potentially leading to toxicity. A ban on smoking at South London and the Maudsley NHS Foundation Trust (SLaM) was implemented in 2014, and this was expected to affect the plasma concentrations of clozapine for inpatients at the time...
February 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/27727006/qtc-interval-lengthening-in-first-episode-schizophrenia-fes-patients-in-the-earliest-stages-of-antipsychotic-treatment
#6
Desheng Zhai, Yan Lang, Gaopan Dong, Yijun Liu, Xin Wang, Dushuang Zhou, Taizhen Cui, Yuxin Yang, Wenxi Zhang, Ying Zhao, Ruiling Zhang
Antipsychotic use is reported to be associated with a higher risk of sudden cardiac death and new users are especially susceptible to that risk. In this study, we focused on the ability of antipsychotics to prolong the QTc interval at the earliest stages of antipsychotic use. We employed a retrospective cohort study design in a naturalistic setting where having three ECG measurements over time (at baseline and after drug exposure) in antipsychotic-naïve, first-episode schizophrenia (FES) inpatients. The results revealed, in this relatively homogeneous, drug naïve FES patient sample, that QTc intervals were statistically significantly prolongated after a relatively short term (2-4weeks) of antipsychotic treatments, compared with baseline...
January 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28202095/the-effects-of-vitamin-and-mineral-supplementation-on-symptoms-of-schizophrenia-a-systematic-review-and-meta-analysis
#7
J Firth, B Stubbs, J Sarris, S Rosenbaum, S Teasdale, M Berk, A R Yung
BACKGROUND: When used as an adjunctive with antipsychotics, certain vitamins and minerals may be effective for improving symptomatic outcomes of schizophrenia, by restoring nutritional deficits, reducing oxidative stress, or modulating neurological pathways. METHOD: We conducted a systematic review of all randomized controlled trials (RCTs) reporting effects of vitamin and/or mineral supplements on psychiatric symptoms in people with schizophrenia. Random-effects meta-analyses were used to calculate the standardized mean difference between nutrient and placebo treatments...
July 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28188887/neurobiological-underpinnings-and-modulating-factors-in-schizophrenia-spectrum-disorders-with-a-comorbid-substance-use-disorder-a-systematic-review
#8
REVIEW
Ana Adan, Arantxa Y Arredondo, Maria Del Mar Capella, Gemma Prat, Diego A Forero, José Francisco Navarro
Recently there is a growing interest in the interaction of schizophrenia spectrum disorders (SSD) and substance use disorders (SUD), a condition named dual schizophrenia spectrum disorders (SSD+). While previous research has focused on clinical and cognitive aspects, little is known about the impact of comorbidity in the brain structure and functions. Evidence suggests that dual diagnosis patients, including SSD+, show a better neurocognitive functioning during the first years of illness, followed by a serious long-term decline...
April 2017: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/21885577/substance-use-disorder-among-people-with-first-episode-psychosis-a-systematic-review-of-course-and-treatment
#9
REVIEW
Jennifer P Wisdom, Jennifer I Manuel, Robert E Drake
OBJECTIVE: People experiencing a first episode of psychosis frequently have co-occurring substance use disorders, usually involving alcohol and cannabis, which put them at risk for prolonged psychosis, psychotic relapse, and other adverse outcomes. Yet few studies of first-episode psychosis have addressed the course of substance use disorders and the response to specialized substance abuse treatments. METHODS: The authors searched MEDLINE, PsycINFO, and other medical databases for English-language articles published between 1990 and 2009...
September 2011: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27863801/long-acting-injectable-antipsychotics-for-the-prevention-of-relapse-in-patients-with-recent-onset-psychotic-disorders-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Taro Kishi, Kazuto Oya, Nakao Iwata
This meta-analysis of randomized controlled trials (RCTs) investigated the advantages of long-acting injectable antipsychotics (LAI-APs) over oral antipsychotics (OAPs) with regard to efficacy and safety for patients with recent-onset psychotic disorders. Effect sizes and 95% confidence intervals (95%CIs) were calculated. We identified five RCTs (1022 patients, mean study duration=18±7.59 months) that compared LAI-APs (paliperidone or risperidone) with OAPs. Pooled LAI-APs did not outperform OAPs in terms of the preventing of relapse (N=3, n=875)...
December 30, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/28112047/venous-thromboembolism-during-treatment-with-antipsychotics-results-of-a-drug-surveillance-programme
#11
Martin Letmaier, Renate Grohmann, Christiana Kren, Sermin Toto, Stefan Bleich, Rolf Engel, Thomas Gary, Konstantinos Papageorgiou, Anastasios Konstantinidis, Anna Katharina Holl, Annamaria Painold, Siegfried Kasper
OBJECTIVES: Venous thromboembolism (VTE) can be a life-threatening medical condition that may lead to leg swelling, respiratory distress and death. METHODS: The AMSP (Arzneimittelsicherheit in der Psychiatrie) is a continuous multicentre drug surveillance programme that assesses severe adverse drug reactions during treatment of psychiatric inpatients. We report on a total of 264,422 inpatients who were treated with antipsychotics (APs) and monitored from 1993 to 2011 in 99 psychiatric hospitals...
February 28, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/27282362/efficacy-and-safety-of-antidepressants-added-to-antipsychotics-for-schizophrenia-a-systematic-review-and-meta-analysis
#12
REVIEW
Bartosz Helfer, Myrto T Samara, Maximilian Huhn, Elisabeth Klupp, Claudia Leucht, Yikang Zhu, Rolf R Engel, Stefan Leucht
OBJECTIVE: The authors examined the safety and efficacy of antidepressants added to antipsychotic drugs in the treatment of schizophrenia. METHOD: Multiple databases and previous publications were searched through June 2015 to identify all randomized controlled trials of any add-on antidepressants compared with placebo or no-treatment in schizophrenia. Depressive and negative symptoms (primary outcomes), overall symptoms, positive symptoms, side effects, exacerbation of psychosis, and responder rates were examined...
September 1, 2016: American Journal of Psychiatry
https://www.readbyqxmd.com/read/24584988/adding-evidence-based-interventions-to-assertive-community-treatment-a-feasibility-study
#13
RANDOMIZED CONTROLLED TRIAL
Sjoerd Sytema, Frederike Jörg, Roeline Nieboer, Lex Wunderink
OBJECTIVE: This 24-month study, conducted in The Netherlands, examined the feasibility of enhancing the effectiveness of assertive community treatment (ACT) by adding evidence-based interventions. METHODS: A total of 159 patients were randomly assigned to two ACT teams, one providing standard ACT (N585) and an ACT Plus team that also provided evidence-based interventions (N574): psychoeducation, family interventions, individual placement and support, and cognitive behavioral therapy...
May 1, 2014: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27919182/treatment-resistant-schizophrenia-treatment-response-and-resistance-in-psychosis-trrip-working-group-consensus-guidelines-on-diagnosis-and-terminology
#14
REVIEW
Oliver D Howes, Rob McCutcheon, Ofer Agid, Andrea de Bartolomeis, Nico J M van Beveren, Michael L Birnbaum, Michael A P Bloomfield, Rodrigo A Bressan, Robert W Buchanan, William T Carpenter, David J Castle, Leslie Citrome, Zafiris J Daskalakis, Michael Davidson, Richard J Drake, Serdar Dursun, Bjørn H Ebdrup, Helio Elkis, Peter Falkai, W Wolfgang Fleischacker, Ary Gadelha, Fiona Gaughran, Birte Y Glenthøj, Ariel Graff-Guerrero, Jaime E C Hallak, William G Honer, James Kennedy, Bruce J Kinon, Stephen M Lawrie, Jimmy Lee, F Markus Leweke, James H MacCabe, Carolyn B McNabb, Herbert Meltzer, Hans-Jürgen Möller, Shinchiro Nakajima, Christos Pantelis, Tiago Reis Marques, Gary Remington, Susan L Rossell, Bruce R Russell, Cynthia O Siu, Takefumi Suzuki, Iris E Sommer, David Taylor, Neil Thomas, Alp Üçok, Daniel Umbricht, James T R Walters, John Kane, Christoph U Correll
OBJECTIVE: Research and clinical translation in schizophrenia is limited by inconsistent definitions of treatment resistance and response. To address this issue, the authors evaluated current approaches and then developed consensus criteria and guidelines. METHOD: A systematic review of randomized antipsychotic clinical trials in treatment-resistant schizophrenia was performed, and definitions of treatment resistance were extracted. Subsequently, consensus operationalized criteria were developed through 1) a multiphase, mixed methods approach, 2) identification of key criteria via an online survey, and 3) meetings to achieve consensus...
March 1, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/27388573/clozapine-v-first-and-second-generation-antipsychotics-in-treatment-refractory-schizophrenia-systematic-review-and-meta-analysis
#15
REVIEW
Dan Siskind, Lara McCartney, Romi Goldschlager, Steve Kisely
BACKGROUND: Although clozapine is the 'gold standard' for treatment-refractory schizophrenia, meta-analyses of clozapine for this condition are lacking. AIMS: We conducted a systematic review and meta-analysis of clozapine treatment for people with treatment-refractory schizophrenia. METHOD: We searched the Cochrane Schizophrenia Group's trial register, PubMed and EMBASE and hand-searched key papers for randomised controlled trials of clozapine for treatment-refractory schizophrenia...
November 2016: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/26455671/recommendations-for-the-monitoring-of-serum-concentrations-of-antipsychotic-drugs-in-the-treatment-of-schizophrenia
#16
Leonardo V Lopez, John M Kane
No abstract text is available yet for this article.
September 2015: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/23165366/efficacy-and-safety-of-second-generation-long-acting-injections-in-schizophrenia-a-meta-analysis-of-randomized-controlled-trials
#17
REVIEW
Paolo Fusar-Poli, Matthew J Kempton, Robert A Rosenheck
The aim of the present article is to test at a meta-analytical level the efficacy and safety of second-generation long-acting antipsychotic injections (SGLAI) in schizophrenia. Thirteen randomized-controlled trials comparing SGLAI with either placebo or oral antipsychotics were included in a quantitative meta-analysis (6313 patients). Efficacy and safety measures as well as demographic and clinical variables were extracted from each publication or obtained directly from authors. Publication bias was assessed with funnel plots and Egger's intercept...
March 2013: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/26720422/deconstructing-the-psychosis-risk-syndrome-moving-the-field-of-prevention-forward
#18
EDITORIAL
Barbara A Cornblatt, Ricardo E Carrión
No abstract text is available yet for this article.
February 2016: JAMA Psychiatry
https://www.readbyqxmd.com/read/9258854/integrating-substance-abuse-treatment-for-the-seriously-mentally-ill-into-inpatient-psychiatric-treatment
#19
REVIEW
C M Bradizza, P R Stasiewicz
This paper offers guidelines for the assessment and treatment of substance abuse problems in seriously mentally ill persons who are admitted into inpatient psychiatric treatment. This approach has been used successfully by the authors and may be most useful in settings where a specialized dual-diagnosis treatment program is not feasible. The first step consists of identifying potential substance abusers using several sources of information including the patient's record, a brief patient interview, and an interview with the patient's family and caseworker...
March 1997: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/16595355/differing-effects-of-antipsychotic-medications-on-substance-abuse-treatment-patients-with-co-occurring-psychotic-and-substance-abuse-disorders
#20
COMPARATIVE STUDY
Elizabeth B Stuyt, Terrie A Sajbel, Michael H Allen
This retrospective study of patients treated in a ninety-day, inpatient, dual-diagnosis treatment program examined antipsychotic effectiveness in this population using length of stay in treatment and successful program completion as outcome measures. All patients with co-occurring substance dependence and schizophrenia or schizoaffective disorder treated with olanzapine, risperidone, ziprasidone, and typical depot neuroleptics from January 2001 to December 2003 (N = 55) are the subjects of this study. Patients stayed longer in treatment when taking risperidone (82 +/- 19 days) or ziprasidone (74 +/- 21 days) compared with olanzapine (44 +/- 30 days) or typicals (47 +/- 36 days)...
March 2006: American Journal on Addictions
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