Achieving the Lowest Effective Antipsychotic Dose for Patients with Remitted Psychosis: A Proposed Guided Dose-Reduction Algorithm
AbstractContinuing antipsychotic treatment in patients with schizophrenia under clinical remission remains controversial. Even though the mainstream opinion declares an outweighed balance against medication discontinuation, recent reviews and critiques suggest that some patients may remain symptom free and well functioning after stopping antipsychotics, but few predictors can identify who can try medication discontinuation, whilst no guidelines exist for reducing medication to reach the lowest effective dose safely. Analyzing the findings from studies employing different methodologies, adopting evidence from pharmacodynamic research, and observing dose reduction in stable patients, as well as taking inspiration from the metaphor of the Cantor set in natural philosophy, we introduce an alternative solution and propose a guided dose-reduction algorithm that follows a set of clear precautions and instructions. The algorithm recommends only a fraction (no more than 25%) of the dosage to be reduced at a time, with at least a 6-month stabilization period required before reducing another 25% of the dose. Patients are empowered to actively participate in decision making when they are ready for further dose tapering, or should they retreat to a previous dosage if warning signs of a relapse re-emerge. An intermittent or irregular dosing schedule can be used to adapt this algorithm to real-world practice. Our preliminary findings suggest that patients with remitted psychosis can do well...
Publication date: Available online 8 October 2020Source: Journal of Pharmacological SciencesAuthor(s): Yoshifumi Inoue, Kimiko Tsuchimori, Hiroshi Nakamura
Publication date: Available online 9 October 2020Source: Progress in Neuro-Psychopharmacology and Biological PsychiatryAuthor(s): Miquel Bioque, Alexandre González-Rodríguez, Clemente Garcia-Rizo, Jesús Cobo, José Antonio Monreal, Judith Usall, Virginia Soria, PNECAT Group, Javier Labad
Publication date: March 2021Source: Schizophrenia Research: Cognition, Volume 23Author(s): Carole Leung, Ka-Shun Lei, Shu-Mei Wang, Bess Yin-Hung Lam
Publication date: March 2021Source: Schizophrenia Research: Cognition, Volume 23Author(s): Hiroki Okada, Daisuke Hirano, Takamichi Taniguchi
Alkermes hopes to introduce a new treatment for schizophrenia and bipolar disorder that minimizes weight gain.
Conclusion: Marked differences between Tunisia and Germany exist in public beliefs about the causes of mental disorders and their treatment, which correspond to differences in cultural orientations prevailing in these countries. Mental health professionals need to be sensitive to the particular cultural context in which they operate, in order to be able to reach those they intend to care for. PMID: 33029184 [PubMed]
Cochrane Corner Summary of Review Titled: "Peer Support for People with Schizophrenia or Other Serious Mental Illness". Issues Ment Health Nurs. 2020 Oct 07;:1-3 Authors: Ewens B, Barnard-Towell A, Mortimer-Jones S, Kemp V, Cole A PMID: 33027603 [PubMed - as supplied by publisher]
Contributors : Haihong Ye ; Jialu ZhaoSeries Type : Expression profiling by high throughput sequencing ; OtherOrganism : Mus musculusDifferential translation significantly contributes to gene expression regulation and FMRP is one of the upstream translation regulators in the PFC of MK-801-exposed juvenile male miceAcute exposure to the NMDA receptor antagonist MK-801 induces schizophrenia-like behavioral endophenotypes in juvenile male mice. However, the genome-wide gene expression changes that occur at the translation level in the brains of this model are unclear. Here, we performed ribosome profiling analysis on the pref...
People with serious mental illness (SMI), including schizophrenia, bipolar disorder, and major depressive disorder, have a higher mortality rate and shortened life expectancy. This is mainly attributable to physical diseases, particularly cardiovascular diseases (CVDs). Important risk factors for CVDs are obesity and other metabolic abnormalities, which are especially prevalent in people with SMI. Several factors contribute to this increased risk, including unhealthy lifestyles. Psychotropic medication independently further increases this risk. In this review we want to examine the relationship between obesity and other co...
Translational Psychiatry, Published online: 09 October 2020; doi:10.1038/s41398-020-01026-7Modulation of cognition and neuronal plasticity in gain- and loss-of-function mouse models of the schizophrenia risk gene Tcf4