TY - JOUR. T1 - Second-generation antipsychotic medications in the treatment of mood disorders. T2 - Focus on aripiprazole. AU - Buckley, Peter F.. PY - 2005/1/1. Y1 - 2005/1/1. N2 - Second-generation antipsychotic medications offer a broader range of therapeutic efficacies than first-generation agents. Consequently, our field has witnessed a rapid expansion of the use of second-generation antipsychotic drugs for several conditions beyond psychosis. The use of second-generation antipsychotic medications has been most pronounced in mood disorders, especially in bipolar disorders. Information about the agents clozapine, risperidone, olanzapine, quetiapine, ziprasidone and aripiprazole in terms of their efficacy and tolerability in bipolar disorder is now available. Aripiprazole, a new agent whose proposed mechanism(s) of action differs from that of other agents, has been shown in placebo-controlled comparative trials in bipolar patients to be an effective and well tolerated treatment option for ...
In psychotic disorders, early intervention with antipsychotic medications increases the likelihood of favourable long-term course. However, the pharmacologic management especially with conventional antipsychotic medications is complicated by a high rate of adverse effects including sexual dysfunction. This study aims to determine the demographic and clinical factors associated with sexual dysfunction among male psychiatric outpatients on conventional antipsychotic medications in South-western Nigeria. Two hundred and seventy five consecutive male outpatients with psychotic disorders on conventional antipsychotic medications were interviewed. Data was collected on demographic characteristics, illness-related and medication-related variables. Illness severity was assessed with the Brief psychiatric rating scale. The International Index of Erectile Function questionnaire was used to assess for sexual dysfunctions. A total of 111 (40.4%) respondents had one or more forms of sexual dysfunction. Sexual desire
Title:Antipsychotic Drugs: From Receptor-binding Profiles to Metabolic Side Effects. VOLUME: 16 ISSUE: 8. Author(s):Spyridon Siafis, Dimitrios Tzachanis, Myrto Samara and Georgios Papazisis*. Affiliation:Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 3rd Department of Psychiatry, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki. Keywords:Receptor-binding profiles, antipsychotics, metabolic side effects, neurotransmitters, obesity, diabetes, metabolic regulation, feeding behavior.. Abstract:Background: Antipsychotic-induced metabolic side effects are major concerns in psychopharmacology and clinical psychiatry. Their pathogenetic mechanisms are still not elucidated. Methods: Herein, we review the ...
The major finding of this study is that inverse agonism at the h5-HT2C-INI receptor is not a reliable predictor of atypical antipsychotic activity. Additionally, several potent 5-HT2-family antagonists with equivocal (e.g., M100907, ritanserin) or no (isoclozapine, mianserin, amitriptyline) antipsychotic activity were found to be potent and effective inverse agonists at the h5-HT2C-INI receptor. These results indicate that inverse agonist activity at the h5-HT2C-INI receptor does not, by itself, reliably distinguish between typical and atypical antipsychotic drugs.. Several prior studies have described inverse agonist actions of typical and atypical antipsychotic drugs at 5-HT2C and 5-HT2A receptors (Barker et al., 1994; Westphal and Sanders-Bush, 1994; Labrecque et al., 1995; Egan et al., 1998;Herrick-Davis et al., 2000). Thus, Egan et al. (1998) were the first to systematically evaluate a large series of typical and atypical antipsychotic drugs for their inverse agonist actions at h5-HT2A ...
Objective: A recent meta-analysis has indicated that, in patients with dementia, the use of atypical antipsychotics is associated with an excess mortality. Later observational studies have suggested that conventional antipsychotics may pose an even greater risk of death. None of these studies could evaluate the risk associated with single antipsychotics nor could they provide any conclusive evidence concerning the risk among nursing home residents. We conducted a retrospective cohort study to compare the risk of death associated with atypical and conventional antipsychotics in a large population of nursing home residents with dementia.. Method: We identified 6,524 new users of atypical antipsychotics and 3,205 new users of conventional antipsychotics living in 1,581 Medicare- or Medicaid-certified nursing homes in 5 US states during the years 1998-2000. The outcome measure was all-cause mortality, which was determined during 6-months of follow-up.. Results: After adjusting for potential ...
Two main conclusions can be drawn from this review. Firstly, taking the trial results at face value, atypical antipsychotics are slightly more effective and better tolerated in patients with schizophrenia. Atypical antipsychotics also have a significantly lower risk of causing extrapyramidal side effects. We found no reliable evidence of differential effects between atypical antipsychotics and we have therefore grouped them together in this discussion. Secondly, when we controlled for the higher than recommended dose of conventional antipsychotics used in some trials, a modest advantage in favour of atypical antipsychotics in terms of extrapyramidal side effects remains, but the differences in efficacy and overall tolerability disappear, suggesting that many of the perceived benefits of atypical antipsychotics are really due to excessive doses of the comparator drug used in the trials. Taking these points into account, we think it inappropriate to advocate the first line use of a new drug ...
Data are limited on the benefits and risks of dose reduction in managing side effects associated with antipsychotic treatment. As an example, antipsychotic dose reduction has been recommended in the management of tardive dyskinesia (TD), yet the benefits of lowering doses are not well studied. However, stable maintenance treatment is essential to prevent deterioration and relapse in schizophrenia. A retrospective cohort study was conducted to analyze the healthcare burden of antipsychotic dose reduction in patients with schizophrenia. Medical claims from six US states spanning a six-year period were analyzed for ≥10% or ≥ 30% antipsychotic dose reductions compared with those from patients receiving a stable dose. Outcomes measured were inpatient admissions and emergency room (ER) visits for schizophrenia, all psychiatric disorders, and all causes, and TD claims. A total of 19,556 patients were identified with ≥10% dose reduction and 15,239 patients with ≥30% dose reduction. Following a ≥ 10%
The incidence of sudden cardiac death in users of atypical anti-psychotics like clozapine, risperidone, quetiapine and olanzapine is almost twice that of individuals who do not take these drugs. Sudden cardiac death is a sudden pulseless condition that is fatal, precipitated by ventricular tachyarrhythmia in the absence of known non-cardiac cause. This risk of sudden cardiac death increases with increased dose of the anti-psychotic medications.. Of late atypical anti-psychotics are being increasingly prescribed and are replacing the older anti-psychotic drugs. The results were obtained from a retrospective cohort trail that involved 93,300 users of anti-psychotic medications and 18300 matched controls. It is useful to note that typical anti-psychotics like haloperidol and thioridazine can also cause increased incidence of sudden cardiac death. One of the explanations provided is that anti-psychotics through blockade of potassium channels increase the prolongation of the cardiac repolarization, ...
As violence against self and others is an important outcome in the treatment of patients with psychosis-spectrum disorders and hostility is an important indicator for violence, we set out to evaluate the effects of different types of antipsychotic agents in reducing hostility. We performed a systematic literature search, which provided 18 suitable randomized studies comparing typical to atypical antipsychotics for at least 4 weeks in patients with psychotic disorders. Results showed a small (0.26) but significant effect for atypical as compared to typical antipsychotics, with high heterogeneity, even though the mean dose of typical antipsychotics was higher. This effect size remained similar when separately analyzing sponsored and non-sponsored studies. When differentiating between high and low-dose studies, the high-dose group showed a significant difference between typical and atypical antipsychotics whereas the low-dose group did not. An analysis comparing clozapine to typical antipsychotics ...
The atypical antipsychotics risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole have become first-line treatment for schizophrenia because they reduce the positive symptoms of psychosis but do not have a high incidence of extrapyramidal symptoms. However, these agents, like other antipsychotics, may take as long as 16 or more weeks to produce a response, and even with prolonged treatment are unlikely to evoke responses greater than 50% improvement in symptoms. This has led to the experimental use of high atypical antipsychotic doses, antipsychotic polypharmacy, and augmentation with other psychotropic drugs, all of which occur commonly in clinical practice. This article reviews the current evidence for these increasingly common means of treating schizophrenia and psychosis, with particular emphasis on polypharmacy and augmentation. To date, there are only two controlled studies of antipsychotic polypharmacy involving an atypical antipsychotic; the rest of the data are uncontrolled ...
The new Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) HEDIS measure calculates the percentage of children ages 1-17 who have had two or more antipsychotic prescriptions filled and at least one metabolic test for blood glucose HbA1c, and at least one test for low-density lipoprotein cholesterol (LCL-C) or total cholesterol each year. Examples of first and second-generation antipsychotic medications included in this measure are chlorpromazine, aripiprazole, clozapine, olanzapine, risperidone, haloperidol, and trifluoperazine. As you know, while antipsychotic medications are effective in treating certain mental illnesses in children, their side effects can lead to or exacerbate other health problems. Children taking antipsychotics are prone to significant weight gain and obesity-related complications such as cardiovascular issues, hypertension, hypercholesterolemia, and insulin-resistant type 2 diabetes. Consequently, it is important that patients on antipsychotic ...
Preface ix Acknowledgements x. Notes on using The Maudsley Prescribing Guidelines xi. Notes on inclusion of drugs xi. List of abbreviations xii. Chapter 1 Plasma level monitoring of psychotropic drugs and anticonvulsants 1. Interpreting sample results 2. Chapter 2 Schizophrenia 11. Antipsychotic drugs 11. Antipsychotic drugs: equivalent doses 13. Antipsychotic drugs: minimum effective doses 14. Antipsychotic drugs: licensed maximum doses 16. New antipsychotic drugs 17. Antipsychotic drugs: general principles of prescribing 21. National Institute for Health and Clinical Excellence guidelines for the treatment of schizophrenia 22. Treatment algorithms for schizophrenia 24. Antipsychotic drugs: monitoring of metabolic effects 26. Switching antipsychotic drugs because of poor tolerability 31. Antipsychotic response: to increase the dose, to switch, to add or just wait - what is the right move? 33. Speed and onset of antipsychotic drug action 36. First-generation antipsychotic drugs: place in therapy ...
This proposal aims to use a well-characterized procedure, the modified Frequently Sampled Intravenous Glucose Tolerance Test (FSIGTT), to characterize the glucoregulatory effects of the two most commonly prescribed atypical antipsychotic medications, ziprasidone and olanzapine, in comparison to the conventional antipsychotic haloperidol. Abnormalities in peripheral glucose regulation and type 2 diabetes can occur more commonly in individuals with schizophrenia than in healthy subjects or in other psychiatric conditions. While abnormalities in glucose regulation were first reported in schizophrenia prior to the introduction of antipsychotic medications, antipsychotic treatment may contribute significantly to abnormalities in glucose regulation.. Recently, the adverse effect of antipsychotic medications on systemic glucose regulation has received increased attention as investigators noted prominent adverse glucoregulatory effects associated with certain newer antipsychotic medications. Abnormal ...
Evid Based Mental Health doi:10.1136/ebmental-2012-100740 Aetiology Atypical antipsychotics are associated with incident diabetes in older adults without schizophrenia or bipolar disorder Question Question Is atypical antipsychotic use associated with incident diabetes or hyperlipidaemia in older people without schizophrenia or bipolar disorder? People Medicare advantage or commercial managed healthcare plan enrolees aged 65 and above with no…
Objectives: Given the concern that mortality rates may be increased in geriatric patients exposed to atypical antipsychotic agents, we assessed mortality rates for adult patients with schizophrenia assigned to an investigational antipsychotic (olanzapine, quetiapine, risperidone, or ziprasidone), a control antipsychotic (haloperidol or chlorpromazine), or placebo in preapproval clinical development programs to assess relative risk with atypical antipsychotics as compared to typical antipsychotics or placebo.. Method: We reviewed safety data (from clinical trials conducted from approximately 1982 to 2002) for 16,791 adult patients with schizophrenia (DSM-III or DSM-IV criteria) in U.S. Food and Drug Administration (FDA) Summary Basis of Approval (SBA) reports for 6 antipsychotic drugs. Mortality rates were calculated for each treatment group (investigational agent, active control, orplacebo) on the basis of patient exposure years (PEY) and gross mortality. We compared the differences in mortality ...
A group of nine neuroleptic drug free schizophrenic patients (seven men, two women; ages 30-45 years) were compared with a group of nine schizophrenic patients (seven men, two women; ages 29-42 years) established on antipsychotic medication. All the patients met DSM-IV criteria for schizophrenia.12 Seven of the neuroleptic drug free patients were antipsychotic naïve and the remaining two had not received antipsychotic medication for at least six months. Andreasans rating scales were used to assess the predominance of positive (SAPS) and negative (SANS) symptoms in drug naïve and medicated patients. The mean (SD) SAPS score was 35.2 (15.9) in the medicated patients and 41.0 (22.2) in the drug naïve patients. The mean SANS (SD) score was 15.0 (16.9) in the medicated patients and 17.6 (15.7) in the drug naïve patients. There was no significant difference (independent t test; P,0.05) for either score between the two groups of patients. There was no difference (Mann-Whitney rank sum test; ...
This proposal aims to use a well-characterized procedure, the modified Frequently Sampled Intravenous Glucose Tolerance Test (FSIGTT), to characterize the glucoregulatory effects of the two most commonly prescribed atypical antipsychotic medications, risperidone and olanzapine, in comparison to the conventional antipsychotic haloperidol. Abnormalities in peripheral glucose regulation and type 2 diabetes can occur more commonly in individuals with schizophrenia than in healthy subjects or in other psychiatric conditions. While abnormalities in glucose regulation were first reported in schizophrenia prior to the introduction of antipsychotic medications, antipsychotic treatment may contribute significantly to abnormalities in glucose regulation.. Recently, the adverse effect of antipsychotic medications on systemic glucose regulation has received increased attention as investigators noted prominent adverse glucoregulatory effects associated with certain newer antipsychotic medications. Abnormal ...
The review currently includes nine randomised controlled trials (RCTs) with 3361 participants. The overall rate of premature study discontinuation was very high (59.1%). Data for the comparisons of ziprasidone with amisulpride, clozapine, olanzapine, quetiapine and risperidone were available. Ziprasidone was a less acceptable treatment than olanzapine (leaving the studies early for any reason: 5 RCTs, n=1937, RR 1.26 CI 1.18 to 1.35, NNH 7 CI 5 to 10) and risperidone (3 RCTs, n=1029, RR 1.11 CI 1.02 to 1.20, NNH 14 CI 8 to 50), but not than the other second generation antipsychotic drugs. Ziprasidone was less efficacious than amisulpride (leaving the study early due to inefficacy: 1 RCT, n=123, RR 4.72 CI 1.06 to 20.98, NNH 8 CI 5 to 50) olanzapine (PANSS total score: 4 RCTs, n=1291, MD 8.32 CI 5.64 to 10.99) and risperidone (PANSS total score: 3 RCTs, n=1016, MD 3.91 CI 0.27 to 7.55). Based on limited data there were no significant differences in tolerability between ziprasidone and amisulpride ...
... - Thousands of extra deaths among schizophrenia patients worldwide may have resulted because of the restrictions imposed by authorities on the use of antipsychotic drug clozapine over safety concerns, suggests a new piece of research. - AndhraNews.net
Anti-psychotic drugs are widely used within psychiatric services as a first-line treatment of schizophrenia. A review is presented of the short-term and long-term effectiveness of anti-psychotics in reducing the distress associated with hallucinations and delusions, together with a discussion about the means by which they achieve their outcomes. The wide range of negative side-effects is also listed. It is concluded that anti-psychotic drugs achieve their impact by means of a general slowing of
Risperidone is a benzisoxazole derivative with antagonistic activity, primarily at dopamine D2 and serotonin 5-HT2A receptors. The higher binding affinity of risperidone for 5-HT2A than for D2 receptors, along with the mesolimbic specificity of action, is thought to account for the reduced incidence of EPS relative to conventional antipsychotic drugs. It also has affinity for α1-adenergic receptors and lower affinity for α2-adrenergic and H1-histaminergic receptors. Unlike clozapine, it has no affinity for cholinergic receptors. The first two large, placebo-controlled, double-blind trials examining the efficacy and tolerability of an atypical antipsychotic drug for patients with BPSD was using risperidone (De Deyn et al, 1999; Katz et al, 1999).. Katz et al (1999) randomised 625 nursing home patients to receive risperidone at 3 possible doses (0.5, 1 or 2 mg daily) or placebo in 2 divided doses for 12 weeks. Treatment response at end-point was defined as a greater than 50% reduction in total ...
BACKGROUND: The concept of dose equivalence is important for many purposes. The classical approach published by Davis in 1974 subsequently dominated textbooks for several decades. It was based on the assumption that the mean doses found in flexible-dose trials reflect the average optimum dose which can be used for the calculation of dose equivalence. We are the first to apply the method to second-generation antipsychotics. METHODS: We searched for randomized, double-blind, flexible-dose trials in acutely ill patients with schizophrenia that examined 13 oral second-generation antipsychotics, haloperidol, and chlorpromazine (last search June 2014). We calculated the mean doses of each drug weighted by sample size and divided them by the weighted mean olanzapine dose to obtain olanzapine equivalents. RESULTS: We included 75 studies with 16 555 participants. The doses equivalent to 1 mg/d olanzapine were: amisulpride 38.3 mg/d, aripiprazole 1.4 mg/d, asenapine 0.9 mg/d, chlorpromazine 38.9 mg/d, clozapine
Chicago Soaring numbers of American children are being prescribed anti-psychotic drugs. And in many cases, theyre being prescribed for attention deficit disorder or other behavioral problems for which these medications have not been proven to work, a study found.. The annual number of children prescribed anti-psychotic drugs jumped fivefold between 1995 and 2002, to an estimated 2.5 million, the study said. That is an increase from 8.6 out of every 1,000 children in the mid-1990s to nearly 40 out of 1,000.. But more than half of the prescriptions were for attention deficit and other nonpsychotic conditions, the researchers said.. The findings are worrisome "because it looks like these medications are being used for large numbers of children in a setting where we dont know if they work," said lead author Dr. William Cooper, a pediatrician at Vanderbilt Childrens Hospital.. The increasing use of anti-psychotics since the mid-1990s corresponds with the introduction of costly and heavily marketed ...
Clinical obervations indicate that antipsychotic action starts early and increases in magnitude with repeated treatment. Animal models that faithfully capture this time course of action are few. Inhibition of hyperlocomotion induced by amphetamine or phencyclidine has been widely used as a screening tool for the antipsychotic activity of a drug. We thus investigated whether repeated antipsychotic treatment could produce an early-onset and progressively increased antagonistic effect on amphetamine or phencyclidine-induced hyperlocomotion as a way of assessing the validity of such models in capturing time course of antipsychotic action. One each of the five consecutive test days, different groups of rats (n = 6-7/group) received an initial injection of either haloperidol (0.01-0.10 mg/kg, sc), clozapine (5-20.0 mg/kg, sc), olanzapine (1.0 mg/kg, sc), chlordiazepoxide (10.0 mg/kg, ip) or vehicle (sterile water, sc) 30 min prior to a second injection of either amphetamine (1.5 mg/kg, sc) or phencyclidine (3
By applying genetic analysis to the NIMH-funded Clinical Antipsychotic Trials of Intervention Effectiveness, we show that variants in a specific gene, RGS4, predict the effectiveness of different antipsychotic treatments. Our results also indicate that the predictive power of the RGS4 genetic variants differed between patients of self-reported African and European ancestry, and thus emphasize the importance of including multiple ethnic groups in a study." The authors importantly note that their results will require replication, but the findings indicate that RGS4 contributes to both the severity of schizophrenia symptoms and the response to antipsychotic treatment. Dr. Krystal adds, "While this type of information is not yet ready to guide clinical practice, since the RGS4 variants explain only a small component of overall patterns of treatment response, these data provide an example of "pharmacogenomics", the approach that will very likely ultimately guide treatment.". ...
Title: Partial Dopamine Receptor Agonists as Newer Atypical Antipsychotics:Intrinsic Activity Appropriate for Treatment of Schizophrenic Patients. VOLUME: 7 ISSUE: 3. Author(s):Yuji Odagaki. Affiliation:Department of Psychiatry,Faculty of Medicine, Saitama Medical University, 38 Morohongo,Moroyama-achi, Iruma-gun, Saitama 350-0495, Japan.. Keywords:Atypical antipsychotics, aripiprazole, dopamine receptor, partial agonist, intrinsic activity, presynaptic autoreceptor, schizophrenia, dopamine system stabilizer. Abstract: Conventional antipsychotic drugs, which have been used for a half century to treat a range of major psychiatric disorders like schizophrenia, are being replaced by modern "atypical antipsychotics". Although the term "atypical" has been applied broadly to antipsychotic drugs marketed in the past decade, these newer drugs are strikingly heterogeneous in chemical, pharmacological, and clinical points of view. Recently, much attention has been directed to partial dopamine receptor ...
Available evidence suggests that second-generation atypical antipsychotics are broadly similar to first-generation agents in terms of their efficacy, but may have a more favourable tolerability profile, primarily by being less likely to cause extrapyramidal symptoms. However, atypical antipsychotics are variably associated with disturbances in the cardiometabolic arena, including increased body weight and the development of metabolic syndrome, which may reflect differences in their receptor binding profiles. Effective management of schizophrenia must ensure that the physical health of patients is addressed together with their mental health. This should therefore involve consideration of the specific tolerability profiles of available agents and individualization of treatment to minimize the likelihood of adverse metabolic sequelae, thereby improving long-term adherence and optimizing overall treatment outcomes. Alongside this, modifiable risk factors (such as exercise, diet, obesity/body weight ...
By Dr. Mercola Thanks to aggressive marketing techniques, pharmaceutical companies are raking in profits from atypical antipsychotic medications -
Antipsychotic medications are effective drugs for schizophrenia, and have in recent years also been used for bipolar disorder. The medications are not equally effective for all patients, and have a limited effect on the core symptoms for approximately 20 % of those treated. Side effects are problematic and in some cases serious, such as for instance cardiovascular risk factors (blodlipids, diabetes, weight gain etc).. Research at NORMENT has a particular focus on immune and lipid systems. We use animal models to enhance our knowledge about the mechanisms of action of antipsychotic medication. We aim to optimize antipsychotic treatment by contributing to increasing the desired effect of medication and reducing side effects.. ...
The findings, which are published in the February issue of the Archives of General Psychiatry, suggest that physicians should consider using the lowest effective dose of antipsychotics when treating patients with schizophrenia. However, lead study author Beng-Choon Ho, M.D., associate professor of psychiatry in the UI Carver College of Medicine, notes that the study does not mean that patients with schizophrenia should not be treated with antipsychotic medications.. "Antipsychotic medications are still the most important and effective form of treatment for schizophrenia patients," Ho said. "These medications reduce psychiatric symptoms and prevent relapse in patients. What our study suggests is that careful review of risks and benefits of dosage and duration is very important.". Schizophrenia affects 1 percent of the worlds population and is a leading cause of chronic disability among young adults. On average, progressive loss of brain tissue occurs at a faster rate in patients with ...
Previous work has shown that withdrawal from chronic antipsychotic treatment leads to a supersensitive psychomotor response to dopamine agonists (Gianutsos et al., 1974; Sayers et al., 1975; Smith and Davis, 1975, 1976; Clow et al., 1979; Montanaro et al., 1982; Rebec et al., 1982; Meng et al., 1998). We show here that behavioral dopamine supersensitivity is not just evident on withdrawal, but develops early during antipsychotic exposure and significantly undermines the efficacy of ongoing treatment. The loss of efficacy was seen with typical or atypical antipsychotics in two widely used tests of antipsychotic-like effects in animals and occurred despite ongoing, clinically relevant, levels of striatal D2-receptor blockade. Thus, the effects were not likely caused by pharmacokinetic or peripheral factors, but by compensatory neurobiological changes in response to ongoing treatment.. One possible explanation for the progressive loss in the ability of antipsychotics to suppress amphetamine-induced ...
Health,...Among patients with schizophrenia whose medication is changed because ...For almost 50 years antipsychotic medications have been the primary m...Peter B. Jones M.D. Ph.D. University of Cambridge and Cambridgeshir...,Second-generation,antipsychotic,medications,appear,to,offer,little,advantage,over,older,drugs,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
Youth with serious mental illness may experience improved psychiatric stability with second generation antipsychotic (SGA) medication treatment, but unfortunately may also experience unhealthy weight gain adverse events. Research on weight loss strategies for youth who require ongoing antipsychotic treatment is quite limited. The purpose of this paper is to present the design, methods, and rationale of the Improving Metabolic Parameters in Antipsychotic Child Treatment (IMPACT) study, a federally funded, randomized trial comparing two pharmacologic strategies against a control condition to manage SGA-related weight gain. The design and methodology considerations of the IMPACT trial are described and embedded in a description of health risks associated with antipsychotic-related weight gain and the limitations of currently available research. The IMPACT study is a 4-site, six month, randomized, open-label, clinical trial of overweight/obese youth ages 8-19 years with pediatric schizophrenia-spectrum and
Define first-generation antipsychotic. first-generation antipsychotic synonyms, first-generation antipsychotic pronunciation, first-generation antipsychotic translation, English dictionary definition of first-generation antipsychotic. adj. Counteracting or diminishing the symptoms of psychotic disorders, such as schizophrenia. n. An antipsychotic drug. adj preventing or treating psychosis...
During the four decades that research has been carried out on antipsychotic drugs, a variety of methods have been used to study the effects of these compounds on dopamine neurotransmission. An important issue in this research was to find an explanation for the difference between "typical" and "atypical" antipsychotic drugs. The hypothesis that the beneficial properties and the motor side effects of antipsychotic drugs result from their effects on different groups of dopamine neurons has received considerable attention. Numerous researchers have tried to discover regiospecific actions of antipsychotic drugs in mesolimbic and in mesocortical dopamine neurons. An overview of these research attempts is presented here. Electrophysiological studies showed a selective action of atypical antipsychotic drugs on A10 dopamine neurons. It was found that chronic treatment with these compounds induced a preferential depolarisation block of the A10 neurons that project to the mesolimbic areas. The model ...
Iloperidone, also known as Fanapt, Fanapta, and previously known as Zomaril, is an atypical antipsychotic for the treatment of schizophrenia. Iloperidone is used for the treatment of schizophrenia. In a 2013 study in a comparison of 15 antipsychotic drugs in effectivity in treating schizophrenic symptoms, iloperidone was found to be almost as effective as ziprasidone, chlorpromazine, and asenapine, and as effective as lurasidone. It was approved by the U.S. Food and Drug Administration (FDA) for use in the United States on May 6, 2009. Iloperidone is a monoamine directed towards acting upon and antagonizing specific neurotransmitters, particularly multiple dopamine and serotonin receptor subtypes. It is considered an atypical antipsychotic because it displays serotonin receptor antagonism, similar to other atypical antipsychotics. The older typical antipsychotics are primarily dopamine antagonists. Iloperidone has been shown to act as an antagonist at all tested receptors. It exhibits high ...
Introduction: In spite of recent pharmacologic advances, psychopharmacological treatment of patients with severe mental illness has remained a challenging task. Despite limited supporting evidence, the use of polypharmacy (prescription of more than one antipsychotic drug for an individual patient) has become a frequent approach. Polypharmacy has been associated with an increased incidence of adverse effects. Objective: To explore patterns of prescribing antipsychotic agents in a long-term inpatient facility. To examine the prevalence of polypharmacy and its association with age, sex, ethnicity and legal status in a sample of individuals with diverse psychiatric diagnoses. To determine the association of antipsychotic agents (single agent and polypharmacy use) and increased body mass index (BMI). Method: We examined the prescribing of antipsychotic drugs in a sample of 234 in-patients, during a 2-month period in a long term in-patient facility in Central Massachusetts during 2013. We performed a
Amisulpride warrants particular attention because its pharmacological profile is clearly distinct from other currently available atypicals. Other atypicals have greater serotonin 5-HT2 versus dopamine D2 antagonism,1 whereas amisulpride has no effects on the serotonin 5-HT2 system.. Amisulpride, like risperidone, has a risk of EPS that is dose dependent and evident at high therapeutic doses. Another similarity to risperidone is the risk of elevated prolactin. Amisulprides superiority in acute psychosis for global and negative symptoms when compared with conventional antipsychotics must be qualified. These studies have routinely used conventional antipsychotic doses equivalent to ≥12 mg/day of haloperidol. Another meta-analysis showed that differences can be eliminated when comparisons with more appropriate doses are made.2 This caution in interpreting differences is relevant not only for negative symptoms but also for total scores. Again, this critique is not just levelled at amisulpride but ...
TY - JOUR. T1 - Length of psychiatric hospitalization and prediction of antipsychotic response. AU - Zemian, Frank P.. AU - Thienhaus, Ole J.. AU - Garver, David L.. PY - 1990. Y1 - 1990. N2 - 1. 1. Clinical variables determining length of psychiatric hospitalization for psychotic inpatients were explored. Forty psychotic inpatients received a 14 day fixed dose neuroleptic trial. 2. 2. Neuroleptic responders ( 25 40) were discharged 15 ± 2 days after initiation of phannacotherapy. For neuroleptic non-responders ( 15 40) antipsychotic medication was then altered as clinically indicated. Patients requiring one change in medication (N = 8) were discharged after 27 ± 5 days; those requiring two medication adjustments (N = 4) were discharged after 33 ± 3 days and those requiring three alterations in phannacotherapy (N = 3) were discharged after 42 ± 12 days. 3. 3. Statistical analysis of clinical and diagnostic variables indicated that 84% of the variation in length of hospitalization was ...
Instead of using mood stabilizers, people suffering from acute mania could be treated more effectively by using anti-psychotic drugs
Data about treatment of schizoaffective and bipolar disorders are summarised. In both disorders the frequent first choice is the combination of mood stabilizers and antipsychotics, respective antidepressants. In th 70s lithium was very popular, in the 80s anticonvulsants appeared and in the 90s atypical antipsychotics started to bi in the focus of attention. It is not clear whether atypical antipsychotics are mood stabilizers, because there is a lack of adequate studies. The authors data about the treatment of schizoffective disorders are presented. The authors, using retrospective chart analysis, found taht in this indication antipsychotics were preferred. On admission mood stabilizers were used in 20/64 (31%), only in 3/20 (15%) as monotherapy and in combination, in 46/64 (72%) antipsychotics were used. Atypical antipsychotics were preferre(33/46, 72%)to conventional antipsychotics (21/46, 46%). This ratio persisted on discharge. On discharge a higher number of patients were treated with ...
Using data from the MAX data from pregnant women who delivered infants born 2001-2010, researchers looked at patterns of antipsychotic use during pregnancy.
Clinical potential of lurasidone in the management of schizophrenia Ludovic Samalin, Marion Garnier, Pierre-Michel LlorcaCentre Hospitalier Universitaire, Clermont-Ferrand, FranceAbstract: Lurasidone is a new second-generation antipsychotic approved in October 2010 by the Food and Drug Administration for the treatment of schizophrenia. Like other second-generation antipsychotics, lurasidone is a powerful antagonist of D2 dopamine and 5HT2A serotonin receptors, but differs from the other second-generation antipsychotics in its action profile for certain receptors. Lurasidone is the second-generation antipsychotic with the greatest affinity for 5HT7 receptors and has a high affinity for 5HT1A serotonin receptors, compatible with favorable effects on cognitive function and an antidepressant action. By contrast, lurasidone has a low affinity for α1 and α2C-adrenergic and 5HT2C serotonin receptors, and no affinity for histaminergic H1 or muscarinic M1 receptors, suggesting a better tolerability profile
As Santayana says, those who do not learn from history are doomed to repeat it, and once again it will be the patients who are harmed. The benefit of second generation antipsychotic drugs in depression is underwhelming, while the risks of tardive dyskinesia, though less than with the early antipsychotic drugs, are nevertheless very real. That is why I chastised a lazy and compromised KOL like Charles Nemeroff so strictly last week, especially for his disease mongering (expanding the market for antipsychotic drug use to augment antidepressants) and for his reckless promotiion of the early and broad use of these drugs in NONPSYCHOTIC depressed patients. In doing so he serves his corporate handlers, whose marketing goal is the widest possible use of these problematic agents. ...
Clozapine has been reported to be effective in open studies in mania, including treatment-resistant patients (McElroy et al, 1991; Tohen & Zarate, 1998), and in a randomised trial (Suppes et al, 1999). Some patients had rapid cycling disorders so that spontaneous improvement would have contributed to the findings. In a comparative trial, clozapine appeared as effective as chlorpromazine in mania over 3 weeks (Barbini et al, 1997).. Many of the new atypical antipsychotic drugs developed in the wake of clozapine have potent activity for blocking 5-HT2 receptors. This is thought to protect against Parkinsonian side-effects by an interaction on dopamine neurons to enhance dopamine release, while the drugs also block subtypes of D2 receptors post-synaptically. Since dopamine agonists are able to trigger mania in predisposed individuals (Gerner et al, 1976; Turner et al, 1984), these atypical antipsychotic drugs carry a theoretical risk of triggering mania. Therefore, controlled trials are essential ...
Altered heart rate dynamics associated with antipsychotic-induced subjective restlessness in patients with schizophrenia Jong-Hoon Kim,1,2 Jun-Hyung Ann,2 Jinyoung Lee,1 Mee-Hee Kim,1 Ah-Young Han1 1Department of Psychiatry, Gil Medical Center, 2Graduate School of Medicine, Gachon University, Incheon, South Korea Background: Antipsychotic-induced subjective inner restlessness is one of the common and distressing adverse effects associated with antipsychotics; however, its underlying neurobiological basis is not well understood. We examined the relationship between antipsychotic-induced subjective inner restlessness and autonomic neurocardiac function. Methods: Twenty-two schizophrenia patients with antipsychotic-induced subjective restlessness, 28 schizophrenia patients without antipsychotic-induced subjective restlessness, and 28 matched healthy control subjects were evaluated. Assessments of the linear and nonlinear complexity measures of heart rate dynamics were performed. Multivariate analysis of
Although anti-psychotic medications are available, they are often associated with various adverse effects that lead to poor treatment adherence. Physicians are facing multiple challenges when designing a treatment plan for their schizophrenic patient.
In a footnote, the study also found that patients in the study whose blood tests showed signs of exposure to the parasite toxoplasmosis had a poor response to treatment. Toxoplasmosis is a parasite borne by cats and some other domestic animals. Lieberman speculated on this result: "Theres a theory that an infectious agent, a parasite or some other microorganism, can cause schizophrenia - and toxoplasmosis has an affinity for the nervous system, where it can lie dormant for a long time in its migration to the brain." Lieberman suggested that schizophrenic patients in a population with a high risk for toxoplasmosis should be given standard anti-psychotic medication along with one of the drugs typically used against the parasite. ...
An apparent suicidal feline attraction and risk behavioural profile among untreated infected individuals was clearly evident here. Under natural conditions, these are all behavioural traits likely to increase predation rate by the definitive host and hence completion of the parasites life cycle (Webster 2001), either through increased risk behaviours (presence in areas with evidence of cat presence), conspicuousness (increased activity or still and exposed), or through decreased attention on predator avoidance (grooming in exposed areas) relative to their untreated uninfected counterparts (figure 2, table 2). Treatment of infected rats with, in order of decreasing efficacy: HAL, PD and VAL, reduced these predator-risk behavioural traits. Therefore, our results lend support to the hypothesis that the anti-psychotic and mood stabilizing activity of some medications used in the treatment of schizophrenia and human affective disorder may be augmented through their inhibitory impact upon T. gondii in ...
Health,...Drugs such as olanzapine quetiapine may also lower good cholesterol...WEDNESDAY April 15 (HealthDay News) Newer antipsychotic drugs promot...The drugs olanzapine and quetiapine were both associated with signif...The longer patients took the drugs the more likely they were to exper...,Newer,Antipsychotics,May,Boost,Weight,in,Alzheimers,Patients,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
Loxitane (Loxapine) is a tricyclic antipsychotic medication used to treat schizophrenia as well as demntia in elderly adults. Loxitane is a new second generation antipsychotic medication from Watso...
Hilary Shepherd on the impact of person-centred care on quality of life, agitation, and antipsychotic use in people with dementia living in nursing homes.
Antipsychotic medications for bipolar treatment. Covers types, including atypical antipsychotics, and side effects of antipsychotic medications. Read more.
Saphris (asenapine) is used for the treatment of schizophrenia and bipolar I disorder. Saphris information includes news, clinical trial results and side effects.
Schizophrenia is associated with substantial disability and excess morbidity/mortality; life expectancy is curtailed by over 16 years1 with over a third of excess deaths attributable to cardiovascular disease and type 2 diabetes mellitus (T2DM).1 Increased risk of cardiometabolic disease in this population is multifactorial with possible contributing components including genetic predisposition to developing T2DM,2 reduced physical activity,3 suboptimal nutrition4 and glucose dysregulation associated with antipsychotic medications.5 Although other antipsychotic medications are effective treatments for schizophrenia,6 approximately 20%-33% of patients remain treatment refractory.7 Treatment refractory schizophrenia is defined as non-response with ongoing psychotic symptoms and functional deficits despite adequate trials of at least two different antipsychotic medications.8 For people with treatment refractory schizophrenia, clozapine is the most effective medication for reducing the positive ...
Long-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia (TD). TD causes muscle movements a person cant control. The movements commonly happen around the mouth. TD can range from mild to severe, and in some people the problem cannot be cured. Sometimes people with TD recover partially or fully after they stop taking the medication.. Every year, an estimated 5 percent of people taking typical antipsychotics get TD. The condition happens to fewer people who take the new, atypical antipsychotics, but some people may still get TD. People who think that they might have TD should check with their doctor before stopping their medication.. How are antipsychotics taken and how do people respond to them?. Antipsychotics are usually pills that people swallow, or liquid they can drink. Some antipsychotics are shots that are given once or twice a month.. Symptoms of schizophrenia, such as feeling agitated and having hallucinations, usually go away within days. ...
Updated 5/2/2006 10:09 AM ET Rex Evans, a student at Watson Junior High in Colorado Springs, suffers from involuntary jerking, which his parents believe was caused by atypical anti-psychotic...
BACKGROUND: The clearest advantage of new generation, atypical antipsychotics is a reduced risk of extrapyramidal side-effects (EPS), compared with conventional compounds. These findings might have been biased by the use of the high-potency antipsychotic haloperidol as a comparator in most of the trials. We aimed to establish whether the new drugs induce fewer EPS than low-potency conventional antipsychotics. METHODS: We did a meta-analysis of all randomised controlled trials in which new generation antipsychotics had been compared with low-potency (equivalent or less potent than chlorpromazine) conventional drugs. We included studies that met quality criteria A or B in the Cochrane Collaboration Handbook, and assessed quality with the Jadad scale. The primary outcome of interest was the number of patients who had at least one EPS. We used risk differences and 95% CIs as measures of effect size. FINDINGS: We identified 31 studies with a total of 2320 participants. Of the new generation drugs, ...
Oliver D. Howes, Ph.D., of the Imperial College London and colleagues conducted a systematic review of case-control studies reporting on fasting plasma glucose levels, fasting insulin levels, insulin resistance, and hemoglobin A1c (HbA1c) levels in individuals with first-episode schizophrenia who had minimal (≤2 weeks of antipsychotic treatment) or no exposure to antipsychotics. A total of 16 case-control studies were included in the analysis, including 731 patients and 614 controls. Fasting plasma glucose levels, plasma glucose levels after an oral glucose tolerance test, fasting plasma insulin levels, and insulin resistance were all significantly elevated in patients compared with controls, but HbA1c levels were not altered in patients compared with controls. ...
People with schizophrenia and bipolar disorder have a greater risk of developing diabetes than the general population.. Lifestyle issues associated with severe mental illness and antipsychotics are probably both contributing factors. Clozapine and olanzapine are associated with the greatest increase in blood glucose and the risk of diabetes with risperidone and quetiapine appears to be relatively low. Hyperglycemia due to clozapine or olanzapine is not usually dose dependent. It occurs between 10 days to 18 months after starting the drug and is reversible on stopping.. Monitoring recommendations. ...
Tytuł projektu: Rozbudowa i przekształcenie bibliograficznej bazy danych AGRO w bazę bibliograficzno-abstraktową z wykorzystaniem oprogramowania YADDA. Nr umowy: POIG 02.03.02-00-031/09 (okres realizacji 2009-2013 ...
New York, New York (PRWEB) August 19, 2014 -- As Risperdal lawsuits (www.risperdallawsuitcenter.com) mount in U.S. courts, Bernstein Liebhard LLP notes the
Initially developed for the exclusive treatment of psychosis and schizophrenia, antipsychotic medications are now sometimes used to stabilize mood and as preventative medications against bipolar disorder relapses.
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In this literature search 16 reports were located with comparisons of SGAs in clinical settings, and performed with the basic methodological demands such as randomization fulfilled. With regards to global outcomes the most consistent finding was a superior drug adherence or time to treatment discontinuation (drug survival) for olanzapine in patients suffering from chronic schizophrenia. Drug adherence and survival were considered global effectiveness outcome measures, as they were thought to reflect both efficacy and tolerability of the drugs as judged by both the patient and treating psychiatrist. The outcome measure is clinically important, as antipsychotic drug adherence has major influences on risks of relapse, rehospitalisation and suicide in patients with schizophrenia [40]. Three of the five studies using this outcome measure were from the CATIE trial. A critical question is whether the comparator drugs were used in equivalent doses in the CATIE studies [41]. To permit blinding combined ...
Medications used to treat schizophrenia and related disorders. Also called neuroleptics. Includes both conventional antipsychotics such as chlorpromazine (Thorazine) and haloperidol (Haldol), and atypical antipsychotics such as risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), and ziprasidone (Geodon).
Title Perceptions of support staff with respect to discontinuation of long-term used antipsychotics for residential individuals with intellectual disability; a mixed method study Background Antipsychotics are the most used psychotropic drugs by residential intellectually disabled individuals and have harmful side effects. There is limited evidence on the efficacy ... read more of antipsychotics on challenging behaviour. Discontinuation is possible for a part of residential individuals with intellectual disability and decreases some harmful side effects. In order to discontinue antipsychotics the cooperation of support staff is important. There is no knowledge on perceptions of support staff with respect to discontinuation of antipsychotic medication in persons with intellectual disability. Aim This study wants to gain insights in the perceptions of support staff about discontinuation of antipsychotics in residential individuals with intellectual disability. Method Four focus groups were ...
Prospective study to quantify the prevalence of possible tardive dyskinesia (TD) in outpatient psychiatry practices in the United States (US), as well as to
But a team of scientists, led by Brown virologist Walter Atwood, has found that a handful of antipsychotic drugs can prevent brain cells from becoming infected by the JC virus. The drugs may prove to be an effective, ready-made therapy for PML prevention or treatment. Their results are published in the current issue of Science. "This is very promising," Atwood said. "These are generic drugs we can take off the shelf that may help a lot of people." "It is likely that there are many other drugs with none of the potential side effects of antipsychotic drugs that will also block infection," said co-author Bryan Roth, professor of biochemistry at the Case School of Medicine and director of the National Institute of Mental Health s Psychoactive Drug Screening Program ...
Janssen Pharmaceutica, Inc. recently sent a letter out to physicians which advised physicians of important labeling changes regarding its antipsychotic drug, Risperdal ® (risperidone).. Risperdal was FDA approved for the treatment of schizophrenia. Janssen Pharmaceutica, Inc.advised the physicians that the FDA has asked all manufacturers of atypical antipsychotic medications, including Janssen Pharmaceutica, Inc. to add a Warnings statement describing the increased risk of hyperglycemia and diabetes in patients taking these medications, including Risperdal.. Accordingly, the Warning section of the Risperdal Prescribing Information was updated to warn that hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported in patients treated with atypical antipsychotics, including Risperdal.. It also advised that patients with an established diagnosis of diabetes mellitus who are started on atypical antipsychotics should be monitored regularly ...
People with severe mental illness (SMI-e.g., schizophrenia, bipolar disorder) die on average 25 years earlier than the general population, most often from cardiovascular disease (CVD) [1, 2]. Although CVD mortality in this population is multifactorial, some risk is attributed to treatment with antipsychotic medications [3]. In 2004, the American Diabetes Association and American Psychiatric Association published metabolic screening guidelines for people taking antipsychotic medications [4]. Although adherence to screening guidelines improves care in the general population [5], a review of 48 studies on metabolic monitoring of people taking antipsychotic medications found screening to be consistently low [6]. Leading experts agree that the geographic, electronic, cultural, and fiscal separation of primary care and mental health within most US healthcare systems contributes to poor quality of medical care in general for this vulnerable population [3, 7]. Notably, people with SMI are receptive to ...
Involuntary hyperkinetic dyskinesias, which can result from exposure to DRBAs, are a serious limiting factor for chronic antipsychotic drug therapy (Youssef and Waddington, 1987; Browne et al., 1996; Ballesteros et al., 2000). Chronic neuroleptic exposure has long been known to produce EPS and TD (Casey, 1991), and it was hoped that the development of a new class of second-generation (or atypical) antipsychotics would dramatically decrease the risk of EPS and TD. Although initial studies provided some evidence that this was indeed the case, a relatively recent prospective cohort study reported that in 352 initially TD-free psychiatric patients, the prevalence and incidence of TD were comparable despite the increased use of atypical antipsychotics (Woods et al., 2010). Several hypotheses for the pathophysiological mechanisms of TD have been proposed (e.g., dopamine hypersensitivity and neurotoxicity), but suitable treatment options targeting the underlying etiology of TD remain largely ...
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 ...
Clotiapine (Entumine) is an atypical antipsychotic of the dibenzothiazepine chemical class. It was first introduced in a few European countries (namely, Belgium, Italy, Spain and Switzerland), Argentina, Taiwan and Israel in 1970. Some sources regard clotiapine as a typical antipsychotic rather than atypical due to its high incidence of extrapyramidal side effects compared to the atypicals like clozapine and quetiapine, to which it is structurally related.Despite its profile of a relatively high incidence of extrapyramidal side effects it has demonstrated efficacy in treatment-resistant schizophrenic patients according to a number of psychiatrists with clinical experience with it, some weak clinical evidence supports this view too. ...
Long-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia (TD). TD causes muscle movements a person cant control. The movements commonly happen around the mouth. TD can range from mild to severe, and in some people the problem cannot be cured. Sometimes people with TD recover partially or fully after they stop taking the medication.. TD happens to fewer people who take the atypical antipsychotics, but some people may still get TD. People who think that they might have TD should check with their doctor before stopping their medication.. How are antipsychotics taken and how do people respond to them?. Antipsychotics are usually in pill or liquid form. Some anti-psychotics are shots that are given once or twice a month.. Symptoms of schizophrenia, such as feeling agitated and having hallucinations, usually go away within days. Symptoms like delusions usually go away within a few weeks. After about six weeks, many people will see a lot of ...
Although fewer young people with ADHD are treated with antipsychotic drugs than suspected, many prescriptions for the drugs do not appear to be clinically warranted, according to a new study from psychiatry researchers at Columbia University Vagelos College of Physicians and Surgeons.
An EEG test to study and treat schizophrenia has been validated by University of California, San Diego School of Medicine scientists.
Aripiprazole lauroxil is a long-acting injectable atypical antipsychotic drug used in the treatment of schizophrenia in adult patients. It is a prodrug of aripiprazole, which acts as a partial agonist at the D2 and 5-HT1A receptors, and as an antagonist at the 5-HT2A receptors . Affecting about 1% of the adult population in the United States and approximately 26 million people worldwide, schizophrenia is a chronic neurological disorder that may result in impairments in cognition and executive functions . The quality of life in patients is greatly reduced due to negative health outcomes, and oftentimes the patients are faced with social stigma and discriminations. Schizophrenia is characterized by positive symptoms such as delusions, hallucinations, thought disorders, and catanoia, and negative symptoms that include social withdrawal, anhedonia, and flattening of emotional responses . D2 receptors have been the most common target for antipsychotic agents used in the treatment of schizophrenia: the
The Food and Drug Administration (FDA) is warning that ziprasidone, an atypical antipsychotic agent, has been linked to a rare but serious skin reaction called Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), which can progress to other parts of the body.
Objective: Several second generation antipsychotic (SGA) drugs have been associated with weight gain, hyperglycemia, and dyslipidemia. We evaluated whether glucose and lipid testing increased after the ADA Consensus Statement recommending metabolic monitoring for SGA-treated patients.. Research Design and Methods: Laboratory claims for serum glucose and lipid testing were identified for an incident cohort of 18,876 adults initiating SGA drugs in a US commercial health plan (2001-2006) and a control group of 56,522 adults with diabetes not receiving antipsychotics. Interrupted time series models were used to estimate the effect of ADA recommendations on baseline and annual testing trends after adjusting for differences in age, sex, mental health diagnoses and cardiovascular risk using propensity score matching.. Results: Mean baseline testing rates for SGA-treated patients during the study period were 23% (glucose) and 8% (lipids). Among persistent users of SGA medication, annual testing rates ...
In randomized clinical trials,51-57 haloperidol Studies have suggested that antiglutamatergic and the atypical antipsychotic agents risperidone therapy may be useful for treating Alzheimers dis- and olanzapine, when compared with placebo, re-ease and vascular dementia by limiting the neuro- duced the rates of agitation, delusions, and hallu-nal damage that may result from excessive release cinations by about 20 to 30 percent. Atypical anti-of glutamate.41,42 In one recent study,41 patients psychotic agents may be better tolerated than thewith Alzheimers disease who had moderate-to- older, traditional antipsychotic drugs, such as halo-severe dementia (MMSE score, ,8) and were treat- peridol. Side-effect profiles should guide the choiceed with memantine, a noncompetitive N-methyl- of agents (Table 3).44 Similarly, antidepressant d-aspartate-receptor antagonist, for a seven-month agents (including sertraline, citalopram, and flu- period had improvements in ratings of severe im- oxetine) have ...
University of California, Irvine scientists led by Emiliana Borrelli and colleagues have discovered the key cellular mechanism that underlies the antipsychotic-induced parkinsonism -- which includes involuntary movements, tremors and other severe physical conditions. These studies present evidence that will stimulate a targeted approach for the design of novel antipsychotics without side-effects.
See Caravaggio and Graff-Guerrero (doi:10.1093/awx023) for a scientific commentary on this article.Antipsychotic drugs, originally developed to treat schizophrenia, are used to treat psychosis, agitation and aggression in Alzheimers disease. In the absence of dopamine D2/3 receptor occupancy data to inform antipsychotic prescribing for psychosis in Alzheimers disease, the mechanisms underpinning antipsychotic efficacy and side effects are poorly understood. This study used a population approach to investigate the relationship between amisulpride blood concentration and central D2/3 occupancy in older people with Alzheimers disease by combining: (i) pharmacokinetic data (280 venous samples) from a phase I single (50 mg) dose study in healthy older people (n = 20, 65-79 years); (ii) pharmacokinetic, 18F-fallypride D2/3 receptor imaging and clinical outcome data on patients with Alzheimers disease who were prescribed amisulpride (25-75 mg daily) to treat psychosis as part of an open study (n = ...
Purpose: Antipsychotics are versatile drugs. Intranasal route could provide efficient delivery for certain therapeutic agents; however, studies on intranasal antipsychotics are limited. Moreover, the systemic and central nervous system (CNS) dispositions of active metabolites after intranasal drug administration are seldom investigated. The current project aims to 1) identify the antipsychotics that are more suitable to be developed into intranasal medications; and 2) characterize the CNS pharmacokinetic (PK) and pharmacodynamic (PD) profiles of the selected antipsychotic delivered by intranasal route, with a special attention to the role of drug metabolism in PK and PD outcomes.. Methods: To select an antipsychotic with greater potential for intranasal delivery, a systematic approach was adopted to screen antipsychotic candidates with in silico evaluations and then in vitro permeability assays. The systemic and CNS PK and PD profiles of the selected antipsychotic would be investigated in ...
The present invention relates to the delivery of antipsychotics through an inhalation route. Specifically, it relates to aerosols containing antipsychotics that are used in inhalation therapy. In a method aspect of the present invention, an antipsychotic is delivered to a patient through an inhalation route. The method comprises: a) heating a composition, wherein the composition comprises an antipsychotic, to form a vapor; and, b) allowing the vapor to cool, thereby forming a condensation aerosol comprising particles with less than 5% antipsychotic drug degradation products. In a kit aspect of the present invention, a kit for delivering an antipsychotic through an inhalation route is provided which comprises: a) a thin coating of an antipsychotic composition and b) a device for dispensing said thin coating as a condensation aerosol.
Researchers from Kings College London and the University of Nottingham have identified neuroimaging markers in the brain which could help predict whether people with psychosis respond to antipsychotic medications or not.. In approximately half of young people experiencing their first episode of a psychosis (FEP), the symptoms do not improve considerably with the initial medication prescribed, increasing the risk of subsequent episodes and worse outcome. Identifying individuals at greatest risk of not responding to existing medications could help in the search for improved medications, and may eventually help clinicians personalize treatment plans.. In a study published today in JAMA Psychiatry, researchers used structural Magnetic Resonance Imaging (MRI) to scan the brains of 126 individuals - 80 presenting with FEP, and 46 healthy controls. Participants had an MRI scan shortly after their FEP, and another assessment 12 weeks later, to establish whether symptoms had improved following the first ...
The use of atypical antipsychotic drugs in kids (up to 18 years old) tipples the chances of getting type 2 diabetes later in life.
A generic form of paliperidone extended-release tablets is now available. Indications: Paliperidone is an atypical antipsychotic agent indicated for treatment of schizophrenia in adults and adolescents. Dosage and administration: For adults, initial dose is 6 mg/day, and the recommended dose is 3 to 12 mg/day. For adolescents, the initial dose is 3 mg/day, and the recommended dose is 3 to 12 mg/day depending on weight.
What next? A few years ago, there was a study from China on how to treat weight gain induced by medications. The Chinese study involved use of the drug, Metformin, to help reduce weight gain.
Aripiprazole lauroxil long-acting injectable (LAI) [Aristada®] is an intramuscularly administered, extended-release prodrug of aripiprazole, an established atypical antipsychotic agent that, in terms
Individuals with chronic mental illnesses are more likely to have poor dental hygiene and nutrition; antipsychotic drugs that decrease salivary flow can increase problems with oral health.
Komossa K, Rummel-Kluge C, Hunger H, Schwarz S, Schmid F, Lewis R, Kissling W, Leucht S. Sertindole versus other atypical antipsychotics for schizophrenia. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD006752. DOI: 10.1002/14651858.CD006752.pub2. ...
OBJECTIVE: The authors examined the refusal of antipsychotic medications and associated outcomes prospectively in a group of 348 psychiatric patients admitted to three acute inpatient units in a state-operated mental health ...
The aim of this review was to determine the spectrum and severity of effects of unintentional antipsychotic poisoning in children. A computerised literature search of MEDLINE (1966 to February 2005) and EMBASE (1980 to February 2005) was undertaken. The Internet was searched using URL: www.google.com. The proceedings of the North American Congress of Clinical Toxicology (NACCT) and the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) were hand searched. All cases of unintentional antipsychotic (all classes) poisoning in children aged 0-6 years were included. The data extracted included the age, weight, antipsychotic, dose, clinical effects, treatment and outcomes. The toxic dose was estimated as the lowest dose causing objective adverse effects. Sixty-eight reports were identified. Few contained all of the required information. Most of the case series included multiple antipsychotics with limited information on individual drugs or all ages with limited paediatric ...
In replyGurwitzs concerns regarding an appropriate starting dose for antipsychotic therapy in elderly patients with behavioral symptoms of dementia is well fou
Results Among 39 244 individuals eligible for this study, 6924 (17.6%) initiated an antipsychotic over the accrual window, of whom 1863 (26.9%) had no psychiatric diagnosis in the prior 2 years. A number of factors were significantly associated with antipsychotic initiation, including male gender, residence in a group home, prior use of benzodiazepines, antidepressants or cognitive enhancers, a recent emergency department visit or mental health hospitalisation and a visit to a psychiatrist or family physician in the prior 90 days. In a secondary analysis, the association between antipsychotic initiation and age, prior diagnosis of diabetes or myocardial infarction and polypharmacy differed slightly on the basis of whether an individual had a previously diagnosed psychiatric disorder. ...
TORONTO - Abilify (aripiprazole), an atypical antipsychotic, proved effective and well tolerated at adult doses for children and adolescents with a primary diagnosis of schizophrenia and bipolar disor
The array of studies reporting the negative implications of added sugar led to WHO making a proposal to revise their added sugar recommendations in 2014. The organization issued a draft guideline stating they would like to halve their recommended daily free sugar intake from 10% to 5%.. «The objective of this guideline is to provide recommendations on the consumption of free sugars to reduce the risk of noncommunicable diseases in adults and children,» WHO explained, «with a particular focus on the prevention and control of weight gain and dental caries.». In addition, it seems many health experts, nutritionists and even celebrities like Gwyneth have jumped on a «no sugar» bandwagon.. But is it even possible to completely eliminate sugar from a diet? And is it safe? Biochemist Leah Fitzsimmons, of the University of Birmingham in the UK, told The Daily Mail:. «Cutting all sugar from your diet would be very difficult to achieve. Fruits, vegetables, dairy products and dairy replacements, ...
NEW ORLEANS -- The atypical antipsychotic aripiprazole (Abilify) appears to be safe for longer-term treatment of irritability associated with autism, but patients are at an increased risk of weight ga
Buy generic abilify - over the internet no rx. Aripiprazole tablets, an atypical antipsychotic medication, are approved for the treatment of schizophrenia and for the acute treatment of manic and mixed episodes associated with bipolar I disorder