Antipsychotic-induced weight gain constitutes a major unresolved clinical problem which may ultimately be associated with reducing life expectancy by 25 years. Overweight is associated with brain deterioration, cognitive decline and poor quality of life, factors which are already compromised in normal weight patients with schizophrenia. Here we outline the current strategies against antipsychotic-induced weight gain, and we describe peripheral and cerebral effects of the gut hormone glucagon-like peptide-1 (GLP-1). Moreover, we account for similarities in brain changes between schizophrenia and overweight patients. Current interventions against antipsychotic-induced weight gain do not facilitate a substantial and lasting weight loss. GLP-1 analogs used in the treatment of type 2 diabetes are associated with significant and sustained weight loss in overweight patients. Potential effects of treating schizophrenia patients with antipsychotic-induced weight gain with GLP-1 analogs are discussed. We propose
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
Atypical antipsychotic drugs, which are distinguished from typical antipsychotic drugs by a lower incidence of extra-pyramidal side effects and less propensity to elevate serum prolactin levels (e.g., clozapine, olanzapine, risperidone, quetiapine, ziprasidone), have become the most widely used treatments for schizophrenia, although their precise mechanism of action remains controversial. It has been suggested that this group of atypical antipsychotic drugs is characterized by preferentially high affinities for 5-hydroxytryptamine (5-HT)2A serotonin receptors and relatively low affinities for D2-dopamine receptors. It has recently been proposed that these atypical antipsychotic drugs may also be distinguished from typical antipsychotic drugs (e.g., haloperidol, fluphenazine, chlorpromazine, and so on) by inverse agonist actions at the 5-HT2C-INI RNA edited isoform of the human 5-HT2C receptor transiently expressed in COS-7 cells. We have examined the relationship among 5-HT2C inverse agonist ...
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 ...
TY - JOUR. T1 - Reducing the burden of side effects during long-term antipsychotic therapy. T2 - The role of switching medications. AU - Weiden, Peter J.. AU - Buckley, Peter F.. PY - 2007/7/10. Y1 - 2007/7/10. N2 - One of the great challenges of long-term treatment of schizophrenia and related disorders is minimizing the medical or psychological burden from persistent side effects. Because of the differences in side effect profiles between the newer and older antipsychotic medications, and distinct differences among the newer agents themselves, the spectrum of side effects associated with antipsychotic therapy has changed tremendously. The authors review changing from one antipsychotic to another (switching) as a potential treatment strategy for reducing the overall side effect burden of antipsychotic therapy. This review identifies 6 steps to the evaluation of switching antipsychotics because of side effects: (1) Establish a causal attribution that the clinical problem is an adverse effect ...
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%
TY - JOUR. T1 - A randomized controlled trial undertaken to test a nurse-led weight management and exercise intervention designed for people with serious mental illness who take second generation antipsychotics. AU - Usher, Kim. AU - Park, Tanya. AU - FOSTER, Kim. AU - Buettner, Petra. PY - 2013. Y1 - 2013. N2 - To test the effect of a nurse-led intervention on weight gain in people with serious mental illness prescribed and taking second generation antipsychotic medication. Background: Weight gain and obesity has reached epidemic proportions in the general population with the prevalence of Metabolic Syndrome reaching 20-25% of the global population. People with serious mental illness are at even higher risk, particularly those taking second generation antipsychotic medication.. AB - To test the effect of a nurse-led intervention on weight gain in people with serious mental illness prescribed and taking second generation antipsychotic medication. Background: Weight gain and obesity has reached ...
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 ...
Conventional antipsychotic medication is commonly prescribed to patients with autistic spectrum disorder. However, a high incidence of severe adverse reactions highlights the need to find more favourable treatments. Atypical antipsychotics may combine efficacy in ameliorating some autistic symptoms with a lower incidence of some adverse reactions. This article reviews the use of atypical antipsychotics in autistic disorder, with particular focus on behaviour, cognition and physical well-being. Thirteen studies using risperidone, three using olanzapine, one using clozapine, one using amisulpride and one using quetiapine were identified. Few firm conclusions can be drawn due to the limitations of the studies; however, there is an indication that risperidone may be effective in reducing hyperactivity, aggression and repetitive behaviours, often without inducing severe adverse reactions. Olanzapine and clozapine may also be effective; however, there is little evidence for using amisulpride or quetiapine in
Research comparing sex differences in the effects of antipsychotic medications on acute ischemic heart disease (IHD) is limited and the findings ambiguous. This study aimed to investigate these associations within a primary care setting. Hong Kong public general outpatient electronic records of patients aged 45+ during 2007-2010 were extracted, with the last consultation date as the baseline for a 4-year follow-up period to observe acute IHD hospitalizations (2011-2014). Antipsychotic use was defined as any prescription over the previous 12 months from a list of 16 antipsychotics, while acute IHD was defined by ICD-9: 410.00-411.89. Both sex-specific and sex-combined (both sexes) mixed-effects Cox models (random intercept across 74 clinics) were implemented to examine the association and test the interaction between antipsychotics and sex. Among 1,043,236 included patients, 17,780 (1.7%) were prescribed antipsychotics, and 8342 (0.8%) developed IHD. In sex-specific analyses, antipsychotic prescription
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; ...
TY - JOUR. T1 - Treatment of schizophrenia. T2 - Preventing the progression of disease. AU - Csernansky, John G.. PY - 2003/1/1. Y1 - 2003/1/1. N2 - Atypical antipsychotic drugs offer a number of advantages compared with typical antipsychotic drugs during the acute treatment of psychotic episodes and maintenance treatment to prevent psychotic relapses in patients with schizophrenia. These advantages include superior efficacy, especially for negative symptoms and reduced extrapyramidal adverse effects. Clinicians, however, need to be vigilant regarding new adverse effects that may be more strongly associated with atypical than typical drugs, especially those related to weight gain. Despite increased pill costs for atypical antipsychotic drugs, the overall costs of providing care to patients with schizophrenia using these drugs do not appear to be substantially higher.. AB - Atypical antipsychotic drugs offer a number of advantages compared with typical antipsychotic drugs during the acute ...
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 ...
Restricted antipsychotic drug use may have caused extra deaths among schizophrenics - 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 ...
Introduction of a new group of antipsychotic drugs, called atypical because of the proprieties differing them from classical neuroleptics, gave hope for the beginning of a new era in treatment of psychoses, including schizophrenia. Different mechanisms of action not only resulted in a broader spectrum of action and high efficacy but also in a relative lack of extrapiramidal symptoms. However, atypical neuroleptics are not totally free from adverse effects. Symptoms such as sedation, metabolic changes and weight gain, often very quick and severe - present also in the case of classical drugs, but put to the background by extrapiramidal symptoms--have become prominent. Weight gain is important both from the clinical and subjective point of view--as associated with serious somatic consequences and as a source of enormous mental distress. These problems are addressed in this review, with the focus on weight gain associated with the use of specific atypical neuroleptics.
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 ...
BACKGROUND: Current neuroscience literature has related treatment with aripiprazole to improved memory performance and subcellular changes in the hippocampus.AIMS: To explore the volumetric changes in hippocampal grey matter in people with a first episode of psychosis (FEP) treated with second-generation antipsychotics.METHOD: Baseline and 1-year follow-up magnetic resonance images were obtained. Hippocampal volumes were estimated by using FreeSurfer and MAGeT-Brain. Subgroups included: aripiprazole (=13), olanzapine (=12), risperidone/paliperidone (=24), refused-antipsychotics (=13) and controls (=44).RESULTS: Aripiprazole subgroup displayed significant increases in bilateral hippocampal volume compared with all other subgroups (FreeSurfer: all s,0.012; MAGeT-Brain: all s,0.040).CONCLUSIONS: Aripiprazole is a first-line, second-generation treatment option that may provide an added benefit of pro-hippocampal growth. The biological underpinnings of these changes should be the focus of future ...
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
Do you plan on trying or maybe even switching to the new Antipsychotic - Rexulti (Brexpiprazole) anytime soon? It is very similar to Abilify, but with less Akathisia and Anxiety - It is coming out sometime in the start…
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
Pimozide is a high potency antipsychotic medication which has been used in many countries since the 1970s for the treatment of schizophrenia and other psychoses. In the US, it was licensed in the past decade as an orphan drug for the treatment of Tourettes syndrome.. Sultana and McMonagle have identified randomised controlled trials of pimozide for the treatment of schizophrenia. Not surprisingly, pimozide was found to be more effective than placebo for preventing relapse and was similar to other typical antipsychotic drugs in efficacy and side effect profile.. Several unanswered questions remain. It has been claimed that pimozide is more effective than other typical antipsychotic drugs for treating negative symptoms of schizophrenia.1 None of the studies included in the review specifically reported on negative symptoms as an outcome, so the review was unable to support or refute this claim. In addition, the efficacy of pimozide relative to the newer atypical antipsychotic drugs is unknown ...
TY - JOUR. T1 - Critical review of antipsychotic polypharmacy in the treatment of schizophrenia. AU - Fleischhacker, W. Wolfgang. AU - Uchida, Hiroyuki. PY - 2014. Y1 - 2014. N2 - Antipsychotic polypharmacy remains prevalent; it has probably increased for the treatment of schizophrenia in real-world clinical settings. The current evidence suggests some clinical benefits of antipsychotic polypharmacy, such as better symptom control with clozapine plus another antipsychotic, and a reversal of metabolic side-effects with a concomitant use of aripiprazole. On the other hand, the interpretation of findings in the literature should be made conservatively in light of the paucity of good studies and potentially serious side-effects. Also, although the available data are still limited, two smaller-scale clinical trials provide preliminary evidence that converting antipsychotic polypharmacy to monotherapy could be a valid and reasonable treatment option. Several studies have explored strategies to change ...
This study aimed to assess the neurophysiological effects of acute atypical antipsychotic treatment on cognitive functioning in subjects presenting with a first episode of psychosis. We used functional MRI to examine the modulatory effects of acute psychopharmacological intervention on brain activation during four different cognitive tasks: overt verbal fluency, random movement generation, n-back and a spatial object memory task. Treatment with atypical antipsychotics was associated with alterations in regional activation during each task and also when task demands were manipulated within paradigms. The initial treatment of psychosis with atypical antipsychotics thus appears to be associated with modifications of the neurofunctional correlates of executive and mnemonic functions. These effects need to be considered when interpreting group differences in activation between medicated patients and controls.
DESCRIPTION (provided by applicant): Clinical work on the mother-child relationship shows that the quality of maternal care from women with schizophrenia is generally inferior to that from healthy mothers. One important contributing factor recognized by both patients and their clinicians is antipsychotic medications. Both typical and atypical antipsychotics are reported to adversely affect maternal care. The PIs long-term goal is to understand the neurobiological and behavioral mechanisms of action of antipsychotic drugs. The objective of this R03 application is to determine the behavioral and neurochemical mechanisms underlying the adverse effects of both typical and atypical antipsychotics on maternal behavior using a rat model. The project hypothesis is that at the clinical relevant dose, the disruptive effect of antipsychotics on maternal behavior primarily reflects a suppressive effect on maternal motivation and is mediated via the dopamine D2 receptor system. Rat maternal behavior is ...
McIntyre RS, Mancini DA, Basile VS. Mechanisms of antipsychotic-induced weight gain. J Clin Psychiatry 2001; 62:23_29.. Ryan MCM, Flanagan S, Kinsella U, Keeling F, Thakore JH. Atypical antipsychotics and visceral fat distribution in first episode, drug-naı¨ve patients with schizophrenia. Life Sci 2004; 74:1999_2008.. Connolly M, Kelly C. Lifestyle and physical health in schizophrenia. Adv Psychiatr Treat 2005; 11:125_132.. Reist C, Mintz J, Albers L, Jamal MM, Szabo S, Ozdemir V. Second-generation antipsychotic exposure and metabolicrelated disorders in patients with schizophrenia: an observational pharmacoepidemiology study from 1988 to 2002. J Clin Psychopharmacol 2007; 27:46_51.. Newcomer JW. Second generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs 2005; 19:1_93.. Lieberman JA, Stroup TS, McEvoy JP et al. Effectiveness of antipsychotic drugs in patients with schizophrenia. N Engl J Med 2005; 353:1209_1223.. Allison DB, Mentore LJ, Heo ...
BACKGROUND: Recent literature documents a stronger association between nonfasting triglycerides (TG) and cardiovascular risk compared to fasting TG. Given concerns over antipsychotic effects on serum TG, this analysis explored changes in nonfasting TG in phase 1 of the CATIE Schizophrenia Trial.METHODS: Change in nonfasting TG, adjusted for baseline value, was compared between
Second generation antipsychotic drugs (SGAs) cause substantial body weight gain/obesity and other metabolic side-effects such as dyslipidaemia. Their antagonistic affinity to the histaminergic H1 receptor (H1R) has been identified as one of the main contributors to weight gain/obesity side-effects. The effects and mechanisms of betahistine (a histaminergic H1R agonist and H3 receptor antagonist) have been investigated for ameliorating SGA-induced weight gain/obesity in both animal models and clinical trials. It has been demonstrated that co-treatment with betahistine is effective in reducing weight gain, associated with olanzapine in drug-naïve patients with schizophrenia, as well as in the animal models of both drug-naïve rats and rats with chronic, repeated exposure to olanzapine. Betahistine co-treatment can reduce food intake and increase the effect of thermogenesis in brown adipose tissue by modulating hypothalamic H1R-NPY-AMPKα (NPY: neuropeptide Y; AMPKα: AMP-activated protein kinase α)
Antipsychotics are the most important treatment for schizophrenia. However, antipsychotics, particularly olanzapine and clozapine, are associated with severe weight gain/obesity side-effects. Although numerous studies have been carried out to identify the exact mechanisms of antipsychotic-induced weight gain, it is still important to consider other pathways. Endoplasmic reticulum (ER) stress signaling and its associated inflammation pathway is one of the most important pathways involved in regulation of energy balance. In the present study, we examined the role of hypothalamic protein kinase R like endoplasmic reticulum kinase- eukaryotic initiation factor 2α (PERK-eIF2α) signaling and the inflammatory IkappaB kinase β- nuclear factor kappa B (IKKβ-NFκB) signaling pathway in olanzapine-induced weight gain in female rats. In this study, we found that olanzapine significantly activated PERK-eIF2α and IKKβ-NFκB signaling in SH-SY5Y cells in a dose-dependent manner. Olanzapine treatment for ...
There is no standard treatment for tardive dyskinesia. Most interventions focus on adjusting the medication thought to be causing tardive dyskinesia. In many cases neuroleptic medications will be adjusted to use the lowest possible dose, or discontinued if at all possible. Stopping the medication is a gradual process, lowering the doses 10 to 25 percent every one to three months. Replacing the neuroleptic drug with other medications may help some patients. Other drugs such as tranquilizers like benzodiazepines and medicines that mimic the effect of dopamine, may also be beneficial. Symptoms of tardive dyskinesia may remain even after the medication is stopped. However, with careful management, some symptoms may improve or disappear with time.. Tardive dyskinesia symptoms may take time to develop. On some occasions symptoms do not arise until after neuroleptic drug use has been stopped. For this reason, tardive dyskinesia may be hard to diagnose. If you think you have tardive dyskinesia seek ...
OBJECTIVE: The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study examined the comparative effectiveness of antipsychotic treatments for individuals with chronic schizophrenia. Patients who had discontinued antipsychotic treatment in phases 1 and 2 were eligible for phase 3, in which they selected one of nine antipsychotic regimens with the help of their
The clinical picture and features of NMS with atypical antipsychotics seem to be different from those of typical antipsychotics. This had led to uncertainty over the diagnosis of NMS in patients on atypical antipsychotics who manifest only few of the NMS symptoms.38 Among the core symptoms of NMS, fever is often encountered less frequently in patients with atypical antipsychotic-induced NMS.38 The issue is further complicated by the various operational definitions of NMS.38 The DSM-IV-TR defines NMS as the presence of severe muscle rigidity and elevated temperature after antipsychotic initiation along with two or more of: diaphoresis, dysphagia, tremor, incontinence, changes in level of consciousness, mutism, tachycardia, elevated or labile blood pressure, leukocytosis, or laboratory evidence of muscle injury (elevated CPK level). Various other criteria for NMS have been postulated, each with varying emphasis on the individual symptoms and signs.39 Another set of criteria defines NMS in patients ...
Sarasota, FL - (PRESS RELEASE JET) - 10/20/2017 - Global Tardive Dyskinesia (TD) Treatment Market: Overview. Tardive dyskinesia (TD) is a neurological disorder that has the involvement of the involuntary movements. The terms can be described as tardive which means delayed and dyskinesia which means abnormal movement. The symptoms of tardive dyskinesia include finger movement, facial grimacing, jaw swinging, repetitive chewing, continuous blinking of the eyes, tongue thrusting, and others. The side effect of the neuroleptics medicines is tardive dyskinesia. These medicines are also known as major tranquilizers or antipsychotics. These medicines are mainly used for treating mental issues. Tardive dyskinesia occurs when you are on the medication for many months or years. As the drug that can be used for the treatment of tardive dyskinesia is not approved and method of treatment is also yet not confirmed thus the treatment of the disease is a difficult task. The tardive dyskinesia treatment affects ...
Neurocognitive impairment in schizophrenia is severe and is an important predictor of functional outcome. The relative effect of the second-generation (atypical) antipsychotic drugs and older agents on neurocognition has not been comprehensively determined. Keefe RSE, Bilder RM, Davis SM, Harvey PD, Palmer BW, Gold JM, Meltzer HY, Green MF, Capuano G, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Davis CE, Hsiao JK, and Lieberman JA for the CATIE Investigators and the Neurocognitive Working Group. Neurocognitive effects of antipsychotic medications in patients with chronic schizophrenia in the CATIE trial. Archives of General Psychiatry, 2007; 64 (6): 633-647.
The use of antipsychotic agents can be limited by side effects, particularly extrapyramidal symptoms (EPS) and tardive dyskinesia (TD). These neurologic movement disorders can occur early in the course of treatment (often as EPS) or as a more latent effect (TD). TD can be debilitating, and several patient-related and treatment-related factors have been associated with an increased risk for its development. Of these, older age has been strongly linked to TD. The advent of novel antipsychotics for the treatment of schizophrenia and severe behavioral disorders permits the use of such agents with reduced risk of EPS and TD. Most clinical trials of the novel antipsychotics have enrolled younger patients, but some data on their efficacy and safety in the elderly are now available. This article reviews the relationship between TD and aging and its treatment in elderly patients. ...
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Extrapyramidal Side Effects Antipsychotic-induced EPS may occur acutely or after long-term treatment. First-generation antipsychotics, in particular high-potency neuroleptics, are more likely than second-generation antipsychotics to cause EPS when the drugs are used at usual therapeutic doses. However, as can be noted in Table Selected side effects of commonly used antipsychotic medications, considerable variation in the… Read More ». ...
Define tardive dyskinesia. tardive dyskinesia synonyms, tardive dyskinesia pronunciation, tardive dyskinesia translation, English dictionary definition of tardive dyskinesia. n. A chronic disorder of the nervous system characterized by involuntary jerky movements of the face, tongue, jaws, trunk, and limbs, usually caused by...
The serotonin (5-HT) 1A receptor has been found to be dysregulated in prefrontal cortex and other brain regions in schizophrenia, and 5-HT1A receptor levels in the amygdala have been related to negative schizophrenia symptoms. We have assessed the impact of the functional C-1019G variant of the 5-HT1A receptor on the response to risperidone or haloperidol in a prospective, randomized, double-blind study. Patients were treated for 4 weeks and negative symptoms assessed weekly. The variant influenced the response to risperidone: improvement of negative symptoms by 4.38 points for carriers of the C allele, compared with the GG genotype (1.22 points, P=0.046). In a second independent study of 130 schizophrenia patients treated with atypical antipsychotics, this effect was confirmed (P=0.003). The functional variant of the 5-HT1A receptor thus influences the response of schizophrenia patients to atypical antipsychotics and may be useful in the future to predict the pharmacogenetics of negative ...
The NICE guideline issued in 2002 recommended that the second-generation, so-called atypical antipsychotics, should be used as first-line treatments mainly due to a reduced incidence of extrapyramidal side-effects.[4] The revised guidance, however, does not recommend a particular medicine, or class of medication, but highlights the role of patient choice; it recommends that the choice of medicine should be a joint decision between the service user and healthcare professional.[3]. The decision should consider the adverse event profile, particularly in respect to extrapyramidal and metabolic adverse events, and if appropriate involve the carer.[3]. The new guidelines have been heavily influenced by two major new studies; CATIE and CUTLASS.[5],[6] In CATIE 1,493 people with chronic schizophrenia from 57 sites in the USA, were randomised to the typical anti-psychotic, perphenazine, or one out of four atypicals (olanzapine, quetiapine, risperidone or ziprasidone, which is not available in the ...
While the recent publication of Phase I results of the landmark Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study enabled pharmaceutical companies and stock pundits to declare winners and losers among the marketed antipsychotics, the big winners may be clinicians who treat the 3.2 million Americans suffering from schizophrenia. The results of the CATIE study provide the most comprehensive set of data on the pharmacologic treatment of schizophrenia ever assembled, Jeffrey A. Lieberman, M.D., a Columbia University psychiatrist and lead author of the study, said at a press conference. These [results] will guide doctors in their selection of treatments and clinical management of individual patients. This is because no study has ever examined all marketed drugs in a controlled fashion for such a long time period using such extensive measures of safety and efficacy, much less the cost data.. Thomas Insel, M.D., director of the National Institute of Mental Health, which ...
JL13 [5-(4-methylpiperazin-1-yl)-8-chloro-pyrido[2,3-b][1,5] benzoxazepine fumarate] is a substance with a close structural resemblance to clozapine. However, it is less sensitive to oxidation and may therefore have less hematological side effects. In the present study, JL13 was compared with clozapine and haloperidol in several animal models for schizophrenia. The paw test represents a screening model for antipsychotic drugs that can discriminate between drugs with extrapyramidal side effects and drugs without. Haloperidol increased both forelimb retraction time and hindlimb retraction time (HRT), whereas both clozapine and JL13 increased only HRT. In the prepulse inhibition paradigm, all three drugs reversed the apomorphine- and the amphetamine-induced disruption of prepulse inhibition. However, whereas haloperidol was equally effective against both dopaminergic drugs, JL13 and clozapine were more effective against amphetamine. Finally, only JL13 was able to increase prepulse inhibition in ...
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Atypical antipsychotics are highly effective antischizophrenic medications but their clinical utility is limited by adverse metabolic sequelae. We investigated whether upregulation of macrophage migration inhibitory factor (MIF) underlies the insulin resistance that develops during treatment with the most commonly prescribed atypical antipsychotic, olanzapine. Olanzapine monotherapy increased BMI and circulating insulin, triglyceride, and MIF concentrations in drug-naive schizophrenic patients with normal MIF expression, but not in genotypic low MIF expressers. Olanzapine administration to mice increased their food intake and hypothalamic MIF expression, which led to activation of the appetite-related AMP-activated protein kinase and Agouti-related protein pathway. Olanzapine also upregulated MIF expression in adipose tissue, which reduced lipolysis and increased lipogenic pathways. Increased plasma lipid concentrations were associated with abnormal fat deposition in liver and skeletal muscle, ...
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Extrapyramidal side effects are symptoms that can occur if you're taking antipsychotic medications. Here's what they include and how they're treated.
Previous studies have reported that context can powerfully modulate the inhibitory effect of an antipsychotic drug on phencyclidine (PCP)-induced hyperlocomotion (a behavioral test used to evaluate putative antipsychotic drugs). The present study investigated the experimental conditions under which environmental stimuli exert their influence through associative conditioning processes. Experiment 1 examined the extent to which prior antipsychotic treatment in the home cages affected a drugs ability to inhibit PCP-induced hyperlocomotion in a novel motor activity test apparatus. Five days of repeated haloperidol (0.05 mg/kg, sc) and olanzapine (2.0 mg/kg, sc) treatment in the home cages still potentiated their inhibition of PCP-induced hyperlocomotion (i.e. sensitization) assessed in a new environment, whereas the clozapine (10.0 mg/kg, sc) treatment enhanced the development of clozapine tolerance, indicating a lack of environmental modulation of antipsychotic efficacy. Experiment 2 assessed the impact
Increased activity within known reward-processing neurocircuitry (eg, ventral striatum, VS) has been reported among medicated individuals with bipolar disorder (BD) I and II. However, such findings are confounded by the potential ameliorative effects of mood-stabilizing and antipsychotic medications on neural activations. This study tests the hypothesis that a pathophysiological locus of alterations in reward processing is present within the striatum in antipsychotic and lithium-naive individuals with BD. Twenty antipsychotic and lithium-naive individuals with BD II or BD not-otherwise specified (NOS) and 20 matched healthy comparison individuals participated in functional magnetic resonance imaging during the performance of a monetary incentive delay task. Between-group comparisons were conducted using small-volume correction focusing on orthogonal a priori regions of interest centered in the VS and dorsal striatum (DS), respectively. During reward anticipation, unmedicated individuals with BD II/NOS
OBJECTIVE: The efficacy and safety of olanzapine were compared with those of ziprasidone.. METHOD: This was a multicenter randomized, double-blind, parallel-group, 28-week study of patients with schizophrenia. Patients were randomly assigned to treatment with 10-20 mg/day of olanzapine or 80-160 mg/day of ziprasidone. The primary efficacy measure was the Positive and Negative Syndrome Scale total score. Secondary efficacy and safety measures included Positive and Negative Syndrome Scale subscales as well as mood, quality of life, and extrapyramidal symptom scales. Safety was evaluated by recording treatment-emergent adverse events and measuring vital signs and weight.. RESULTS: The study was completed by significantly more olanzapine-treated patients (165 of 277, 59.6%) than ziprasidone-treated patients (115 of 271, 42.4%). At 28 weeks, the olanzapine-treated patients showed significantly more improvement than the ziprasidone-treated patients on the Positive and Negative Syndrome Scale overall ...
Description of disease Tardive dyskinesia. Treatment Tardive dyskinesia. Symptoms and causes Tardive dyskinesia Prophylaxis Tardive dyskinesia
Schizophrenia Antipsychotic Drugs: Prominent psychiatrist Loren Mosher argues for treatment of schizophrenia without antipsychotics. Describes Soteria Project.
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Abstract: Metabolic Syndrome is a cluster of risk factors that raise an individuals risk for developing diabetes, heart disease, stroke, and other health problems. These risk factors include: low HDL cholesterol, high blood pressure, high fasting blood glucose, high triglycerides, high BMI, and a large waistline. Metabolic Syndrome has become a more prominent topic in child and adolescent psychiatry with the increase in the prescription of antipsychotic drugs. Numerous studies have found the differential prevalence of metabolic syndrome associated with atypical antipsychotic drugs. In fact, atypical antipsychotics carry an FDA warning about metabolic risk. Specifically, there have been higher effects noted for antipsychotic medication on triglycerides, glucose, weight, and waist circumference. Many insurance companies now require monitoring for Metabolic Syndrome by psychiatric prescribers be performed and documented in the medical record. Additionally, it has been estimated that 80% of ...
The study of brain networks, including those derived from functional neuroimaging data, attracts a broad interest and represents a rapidly growing interdisciplinary field. Comparing networks of healthy volunteers with those of patients can potentially offer new, quantitative diagnostic methods and a framework for better understanding brain and mind disorders. We explore resting state functional Magnetic Resonance Imaging (fMRI) data through network measures. We construct networks representing 15 healthy individuals and 12 schizophrenia patients (males and females), all of whom are administered three drug treatments: i) a placebo; and two antipsychotic medications ii) aripiprazole and iii) sulpiride. We compare these resting state networks to a performance at an
TY - JOUR. T1 - Asenapine sensitization from adolescence to adulthood and its potential molecular basis. AU - Shu, Qing. AU - Qin, Rongyin. AU - Chen, Yingzhu. AU - Hu, Gang. AU - Li, Ming. PY - 2014/10/15. Y1 - 2014/10/15. N2 - Asenapine is a new antipsychotic drug that induces a long-lasting behavioral sensitization in adult rats. The present study investigated the developmental impacts of adolescent asenapine treatment on drug sensitivity and on 3 proteins implicated in the action of antipsychotic drugs (i.e. brain-derived neurotrophic factor (BDNF), dopamine D2 receptor, and δFosB) in adulthood. Male adolescent Sprague-Dawley rats (postnatal days, P 43-48) were first treated with asenapine (0.05, 0.10 or 0.20mg/kg, sc) and tested in the conditioned avoidance or PCP (2.0mg/kg, sc)-induced hyperlocomotion tasks for 5 days. After they became adults (~P 76), asenapine sensitization was assessed in a single avoidance or PCP-induced hyperlocomotion challenge test with all rats being injected with ...
Psychology Definition of NEUROLEPTIC MALIGNANT SYNDROME: results after complications with conventional therapies such as the use of antipsychotics which can give rise to a wide range of symptoms such as- fever,
Doctors give unbiased, trusted information on the benefits and side effects of Sertraline to treat Schizophrenia: Dr. Steiner on zoloft for schizophrenia: Antidepressants, mood stabilizers, and antipsychotic medications are often combined to treat schizophrenia. The decision is best made by the treating psychiatrist and the patient.
The drug: Although the exact mechanism of action of risperidone is unknown, the drug blocks receptors in the dopaminergic, adrenergic and histaminergic neurotransmitter systems as well as those in the serotonin system that may play a role in agression.7,8,9 Like other atypical antipsychotic agents, risperidone is a popular first-line agent for psychotic disorders because it is effective (especially for negative symptoms) and is associated with fewer extrapyramidal adverse effects than are traditional antipsychotic drugs.7 Risperidone, at doses higher than those used in dementia, appears to cause diabetes, worsened lipid profiles and obesity in some patients,10 but any relation between these adverse effects and risperidone-associated cerebrovascular adverse events is unclear. Risperidone should be used with caution in patients with seizure disorders and avoided in states of dehydration and hypotension.. What to do: Dementia is a difficult burden for patients and caregivers,11 but the degree to ...
Objectives Although there have been important advances in the treatment of posttraumatic stress disorder (PTSD), many patients fail to respond to first-line pharmacotherapy. Limited evidence suggests that second generation antipsychotics may have a role to play as monotherapy in PTSD. Methods We undertook a randomized, placebo-controlled study using flexible-dose olanzapine monotherapy for 8 weeks in 28 adult male and female participants (mean age: 40.75 ± 11.59 years) with non-combat related chronic PTSD. Data were analysed with repeated measures analysis of variance, using an intention to treat, last observation carried forward approach. Results The olanzapine group (n = 14) demonstrated significantly greater improvement on the Clinician Administered PTSD Scale from baseline to endpoint than the placebo group (n = 14) (F = 5.71, p = 0.018). Olanzapine was generally well tolerated, with no serious adverse events recorded. Substantial weight gain (6-10 kg) was, however, reported in 6/14 ...
In 2017 the US Food and Drug Administration approved a monthly injectable form of the atypical antipsychotic drug aripiprazole, Abilify Maintena, for the prevention of manic and mixed episodes in bipolar I disorder. The intramuscular injections are available for monotherapy in preparations of 300 mg or 400 mg. Maintena did not prevent depressive episodes.. Maintena is already FDA-approved for the treatment of schizophrenia and Tourettes syndrome in adults.. The approval for bipolar I disorder follows a 52-week phase 3, double-blind, placebo-controlled randomized trial. Participants were experiencing a manic episode during screening for the study, met the criteria for bipolar I disorder, and had had at least one prior manic or mixed episode severe enough to require treatment.. Compared to placebo, Maintena in once-a-month injections delayed the recurrence of any mood episode following the initial manic episode at screening. When the researchers separated their analysis based on type of episode, ...
Patients infected by the human immunodeficiency virus are predisposed to many infectious and noninfectious complications and often receive a variety of drugs. Furthermore, they seem to have a particular susceptibility to idiosyncratic adverse drug reactions. It is therefore surprising that only a few cases of the neuroleptic malignant syndrome have been described in patients with the acquired immunodeficiency syndrome. A high index of suspicion is required to diagnose the neuroleptic malignant syndrome in these patients, as its usual manifestations, including fever and altered consciousness, are frequently attributed to an underlying infection.. ...