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Antipsychotic medications

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25 papers 100 to 500 followers
By Abraham Nunes Psychiatry resident interested in computational neuroscience, forensic psychiatry, and neuropsychiatry.
Donald C Goff, Peter Falkai, W Wolfgang Fleischhacker, Ragy R Girgis, Rene M Kahn, Hiroyuki Uchida, Jingping Zhao, Jeffrey A Lieberman
Concerns have been raised that treatment with antipsychotic medication might adversely affect long-term outcomes for people with schizophrenia. The evidence cited for these concerns includes the association of antipsychotic treatment with brain volume reduction and with dopamine receptor sensitization, which might make patients vulnerable to relapse and illness progression. An international group of experts was convened to examine findings from clinical and basic research relevant to these concerns. Little evidence was found to support a negative long-term effect of initial or maintenance antipsychotic treatment on outcomes, compared with withholding treatment...
September 1, 2017: American Journal of Psychiatry
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
Martina Curto, Nicoletta Girardi, Luana Lionetto, Giuseppino M Ciavarella, Stefano Ferracuti, Ross J Baldessarini
Clozapine is exceptionally effective in psychotic disorders and can reduce suicidal risk. Nevertheless, its use is limited due to potentially life-threatening adverse effects, including myocarditis and cardiomyopathy. Given their clinical importance, we systematically reviewed research on adverse cardiac effects of clozapine, aiming to improve estimates of their incidence, summarize features supporting their diagnosis, and evaluate proposed monitoring procedures. Incidence of early (≤2 months) myocarditis ranges from <0...
July 2016: Current Psychiatry Reports
T Scott Stroup, Tobias Gerhard, Stephen Crystal, Cecilia Huang, Mark Olfson
OBJECTIVE: The authors compared the effectiveness of initiating treatment with either clozapine or a standard antipsychotic among adults with evidence of treatment-resistant schizophrenia in routine clinical practice. METHOD: U.S. national Medicaid data from 2001 to 2009 were used to examine treatment outcomes in a cohort of patients with schizophrenia and evidence of treatment resistance that initiated clozapine (N=3,123) and in a propensity score-matched cohort that initiated a standard antipsychotic (N=3,123)...
February 1, 2016: American Journal of Psychiatry
Lee S Cohen, Adele C Viguera, Kathryn A McInerney, Marlene P Freeman, Alexandra Z Sosinsky, Danna Moustafa, Samantha P Marfurt, Molly A Kwiatkowski, Shannon K Murphy, Adriann M Farrell, David Chitayat, Sonia Hernández-Díaz
OBJECTIVE: Second-generation antipsychotics are used to treat a spectrum of psychiatric illnesses in reproductive-age women. The National Pregnancy Registry for Atypical Antipsychotics was established to determine the risk of major malformations among infants exposed to second-generation antipsychotics during pregnancy relative to a comparison group of unexposed infants of mothers with histories of psychiatric morbidity. METHOD: Women were prospectively followed during pregnancy and the postpartum period; obstetric, labor, delivery, and pediatric medical records were obtained...
March 1, 2016: American Journal of Psychiatry
Angel L Montejo, Laura Montejo, Felipe Navarro-Cremades
PURPOSE OF REVIEW: Psychotropic-related sexual dysfunction is a quite frequent issue in clinical practice, mainly in chronic treatments affecting both quality of life and compliance. RECENT FINDINGS: In the last decade fortunately antidepressants and antipsychotic compounds have been deeply screened in order to identify sexual adverse events that were commonly underdiagnosed and previously underestimated by clinicians and perhaps by pharmaceutical companies as well...
November 2015: Current Opinion in Psychiatry
Deepak K Sarpal, Miklos Argyelan, Delbert G Robinson, Philip R Szeszko, Katherine H Karlsgodt, Majnu John, Noah Weissman, Juan A Gallego, John M Kane, Todd Lencz, Anil K Malhotra
OBJECTIVE: Clinical response to antipsychotic drug treatment is highly variable, yet prognostic biomarkers are lacking. The authors recently demonstrated that successful antipsychotic drug treatment alters resting-state functional connectivity of the striatum. The goal of the present study was to test whether intrinsic striatal connectivity patterns provide prognostic information and can serve as a potential biomarker of treatment response to antipsychotic drugs. METHOD: The authors used resting-state functional MRI (fMRI) to develop a prognostic index in a discovery cohort of 41 first-episode schizophrenia patients, then tested this index in an independent cohort of 40 newly hospitalized chronic patients with acute psychosis...
January 2016: American Journal of Psychiatry
Herbert Y Meltzer
Antipsychotic drugs (APDs) are best classified as typical or atypical. The distinction is based solely on their ability to cause extrapyramidal side effects (EPS), including tardive dyskinesia (TD). The two classes differ in mechanism of action, with atypical APDs providing important modulation of serotonergic neurotransmission. TD increases the death rate and can be minimized by limiting use of typical APDs. Clozapine is unique among the atypical APDs in its efficacy for ameliorating psychosis in patients with treatment-resistant schizophrenia (TRS), for reduction of suicide, and for improving longevity...
2013: Annual Review of Medicine
Naoki Hashimoto, Atsuhito Toyomaki, Minoru Honda, Satoru Miyano, Nobuyuki Nitta, Hiroyuki Sawayama, Yasufumi Sugawara, Keiichi Uemura, Noriko Tsukamoto, Tsukasa Koyama, Ichiro Kusumi
BACKGROUND: While the frequency and importance of antipsychotic switching in patients with schizophrenia, there is insufficient evidence with regard to switching strategy. Quetiapine is one of the drugs of choice for switch because of its unique receptor profile. However, there were no data on the long-term clinical and neurocognitive effect of quetiapine in patients who had responded inadequately to prior antipsychotics. The purpose of this study is to examine the long-term efficacy and tolerability of quetiapine in patients with schizophrenia who switched from other antipsychotics because of inadequate therapeutic response...
2015: Annals of General Psychiatry
Dina Popovic, Philippe Nuss, Eduard Vieta
Loxapine is an antipsychotic used in psychiatry for over 40 years with a well-established profile. Loxapine is a dibenzoxazepine tricyclic antipsychotic agent, available for oral, intramuscular and inhalatory administration. In the light of the recent approval by the regulatory agencies of inhaled loxapine for use in the acute treatment of mild-to-moderate agitation in adults affected with schizophrenia or bipolar disorder, this article aims to critically review the available literature on loxapine, irrespective of its formulation...
2015: Annals of General Psychiatry
Joris Berwaerts, Yanning Liu, Srihari Gopal, Isaac Nuamah, Haiyan Xu, Adam Savitz, Danielle Coppola, Alain Schotte, Bart Remmerie, Nataliya Maruta, David W Hough
IMPORTANCE: Treatment nonadherence and relapse are common problems in patients with schizophrenia. The long-acting 3-month formulation of paliperidone palmitate, owing to its extended elimination half-life, may offer a valuable therapeutic option for these patients. OBJECTIVE: To evaluate the efficacy and safety of the 3-month formulation of paliperidone palmitate vs placebo in delaying time to relapse of schizophrenia symptoms. DESIGN, SETTING, AND PARTICIPANTS: This randomized, multicenter trial conducted from April 26, 2012, through April 9, 2014, in 8 countries consisted of 4 phases: 3-week screening phase, flexible-dose 17-week open-label transition phase, 12-week open-label maintenance phase, and open-ended double-blind (DB) phase...
August 2015: JAMA Psychiatry
K J Ronaldson, P B Fitzgerald, J J McNeil
OBJECTIVE: We review the published cases of clozapine-induced myocarditis and describe reasons for the higher incidence in Australia (>1%) than elsewhere (<0.1%). METHOD: Medline was searched to September 2014 using 'clozapine' as the sole term. RESULTS: A total of around 250 cases of clozapine-induced myocarditis have been published. Fever among patients commencing clozapine has been reported internationally, and very few of these cases were investigated for myocarditis...
October 2015: Acta Psychiatrica Scandinavica
Antonio Vita, Luca De Peri, Giacomo Deste, Stefano Barlati, Emilio Sacchetti
BACKGROUND: Deficits in cortical gray matter (GM) have been found in patients with schizophrenia, with evidence of progression over time. The aim of this study was to determine the role of potential moderators of such changes, in particular of the amount and type of antipsychotic medication intake. METHODS: Longitudinal magnetic resonance imaging studies comparing changes in the volume of cortical GM over time between patients with schizophrenia and healthy control subjects published between January 1, 1983, and March 31, 2014, were analyzed...
September 15, 2015: Biological Psychiatry
Trino Baptista, Yamily ElFakih, Euderruh Uzcátegui, Ignacio Sandia, Eduardo Tálamo, Enma Araujo de Baptista, Serge Beaulieu
Excessive bodyweight gain was reported during the 1950s as an adverse effect of typical antipsychotic drug treatment, but the magnitude of bodyweight gain was found to be higher with the atypical antipsychotic drugs that were introduced after 1990. Clozapine and olanzapine produce the greatest bodyweight gain, ziprasidone and aripiprazole have a neutral influence, and quetiapine and risperidone cause an intermediate effect. In the CATIE study, the percentage of patients with bodyweight gain of >7% compared with baseline differed significantly between the antipsychotic drugs, i...
2008: CNS Drugs
Donovan T Maust, Hyungjin Myra Kim, Lisa S Seyfried, Claire Chiang, Janet Kavanagh, Lon S Schneider, Helen C Kales
IMPORTANCE: Antipsychotic medications are associated with increased mortality in older adults with dementia, yet their absolute effect on risk relative to no treatment or an alternative psychotropic is unclear. OBJECTIVE: To determine the absolute mortality risk increase and number needed to harm (NNH) (ie, number of patients who receive treatment that would be associated with 1 death) of antipsychotic, valproic acid and its derivatives, and antidepressant use in patients with dementia relative to either no treatment or antidepressant treatment...
May 2015: JAMA Psychiatry
Y Joseph Hwang, Stephanie N Dixon, Jeffrey P Reiss, Ron Wald, Chirag R Parikh, Sonja Gandhi, Salimah Z Shariff, Neesh Pannu, Danielle M Nash, Faisal Rehman, Amit X Garg
BACKGROUND: Several adverse outcomes attributed to atypical antipsychotic drugs, specifically quetiapine, risperidone, and olanzapine, are known to cause acute kidney injury (AKI). Such outcomes include hypotension, acute urinary retention, and the neuroleptic malignant syndrome or rhabdomyolysis. OBJECTIVE: To investigate the risk for AKI and other adverse outcomes associated with use of atypical antipsychotic drugs versus nonuse. DESIGN: Population-based cohort study...
August 19, 2014: Annals of Internal Medicine
Christoph U Correll
Many patients with schizophrenia have problems adhering to their medication regimen. Numerous factors affect patients' adherence, such as patient and illness characteristics; medication efficacy, tolerability and formulations; provider and system characteristics; and patients' support networks. To compound this problem, accurately measuring adherence is challenging. Data suggest that clinicians should use multiple methods to assess patients' adherence, including supplementing their own clinical judgment and patient reports with more objective measures...
November 2014: Journal of Clinical Psychiatry
Sofia Brissos, Miguel Ruiz Veguilla, David Taylor, Vicent Balanzá-Martinez
Despite their widespread use, long-acting injectable (LAI) antipsychotics (APs) are often regarded with some negativity because of the assumption of punishment, control and insufficient evolution towards psychosocial development of patients. However, LAI APs have proved effective in schizophrenia and other severe psychotic disorders because they assure stable blood levels, leading to a reduction of the risk of relapse. Therapeutic opportunities have also arisen after introduction of newer, second-generation LAI APs in recent years...
October 2014: Therapeutic Advances in Psychopharmacology
J Peuskens, L Pani, J Detraux, M De Hert
Since the 1970s, clinicians have increasingly become more familiar with hyperprolactinemia (HPRL) as a common adverse effect of antipsychotic medication, which remains the cornerstone of pharmacological treatment for patients with schizophrenia. Although treatment with second-generation antipsychotics (SGAs) as a group is, compared with use of the first-generation antipsychotics, associated with lower prolactin (PRL) plasma levels, the detailed effects on plasma PRL levels for each of these compounds in reports often remain incomplete or inaccurate...
May 2014: CNS Drugs
Salvatore Gentile
As second-generation antipsychotic long-acting injections (SGA-LAIs) are rapidly replacing depot first-generation antipsychotics as first-line agents in treating schizophrenia spectrum disorders, a systematic assessment of their adverse effects is timely. English-language, peer-reviewed articles reporting original data on the safety and tolerability of SGA-LAIs were identified electronically by searching the MEDLINE, EMBASE, PsycINFO, and DARE databases and the Cochrane Library (January 2001-April 2013). In addition to second-generation (atypical) antipsychotics and long-acting injection (depot) antipsychotics, a separate search was performed for each available drug: aripiprazole LAI, olanzapine pamoate, paliperidone palmitate, and risperidone LAI...
October 2013: Pharmacotherapy
2015-02-13 19:31:58
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