Comparative Tolerability of Dopamine D2/3 Receptor Partial Agonists for Schizophrenia

AbstractAripiprazole, brexpiprazole and cariprazine differ from all other second-generation antipsychotics due to partial agonism at the dopamine D2 and D3 receptors. In contrast to aripiprazole, brexpiprazole has lower intrinsic dopamine D2 activity and higher affinity for the serotonin 5-HT1A and 5-HT2A receptors, while cariprazine has the highest affinity for the dopamine D3 receptor, and the longest half-life. The main adverse effect of dopamine receptor partial agonists (DRPAs) is akathisia of low-to-moderate severity, which occurs in a small proportion of patients, usually in the first few weeks of treatment. While definitive conclusions concerning differences between the DRPAs require head-to-head comparison studies, on the available evidence, akathisia is probably least likely to occur with brexpiprazole and most likely with cariprazine; the risk of akathisia with aripiprazole lies in between. Weight-gain risk is low with aripiprazole and cariprazine, but moderate with brexpiprazole. Risk of sedation is low with DRPAs, as is risk of insomnia and nausea. Partial dopamine agonism leads to a low risk for hyperprolactinaemia (and probably a low risk of sexual dysfunction). Prolactin concentrations fall in some patients (particularly those with elevated levels prior to initiating the drugs). Rates of discontinuation due to adverse effects in pivotal studies were low, and on the whole, DRPAs are well tolerated. Aripiprazole has been implicated in pathological gambling and o...
Source: CNS Drugs - Category: Neurology Source Type: research

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Authors: Kleinaki Z, Kapnisi S, Theodorelou-Charitou SA, Nikas IP, Paschou SA Abstract Diabetes mellitus (DM) is a chronic multisystem disease. Diabetic nephropathy (DN) is one of its significant microvascular complications, associated with increased morbidity and mortality. The aim of this article is to review the literature regarding the latest advances in the management of type 2 DM (T2DM) in patients with chronic kidney disease (CKD). We initially refer to the screening guidelines, the diagnostic tests used, the need for novel biomarkers in DN, the recent advances in high-risk patient identification, the recomm...
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research
Background: Brachial plexus birth injury (BPBI) is a condition in which the brachial plexus is thought to be damaged during the birth process. Studies have cited a varying incidence rate ranging from 0.5 to 4.0 per 1000 live births. The purpose of this study is to evaluate birth claims data over a 15-year period to identify risk and protective factors for BPBI in the state of Colorado. Methods: A data request was made to the state hospital association for birth claims data. We requested all birth claims from the years 2000 to 2014. ICD9 codes for variables of interest included: BPBI, shoulder dystocia, heavy-for-dates...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Upper Extremity Source Type: research
Conclusion. The spontaneous incidence rate of vertebral body infection among OVF patients was 0.7%; however, the occurrence of this complication led to serious events. Clinicians should pay attention to the possibility of bacillemia in elderly or immunocompromised OVF patients. Level of Evidence: 4
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Conclusion. Although intent-to-treat analysis failed to show significant differences in patients treated surgically, results of the as-treated analysis determined statically greater improvements in those patients with spondylolisthesis who were treated surgically as compared to those treated nonoperatively. Level of Evidence: 2
Source: Spine - Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research
Purpose of review To give an updated review on the underlying mechanisms and clinical effects of improved glucose control after bariatric surgery. Recent findings The basic principles of the mechanism for the metabolic effects of bariatric surgery can be categorized into calorie restriction, deviation of nutrients, and reduced amounts of adipose tissue. Recent findings suggest the importance of early changes following deviation of nutrients to more distal parts of the small bowel resulting in altered release of gastrointestinal hormones, altered gut microbiota, and weight-reduction. In the long-term, loss of adipose t...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - Category: Nutrition Tags: CARBOHYDRATES: Edited by Bettina Mittendorfer and Olle Ljungqvist Source Type: research
Background: Treatment with a duodenal-jejunal bypass sleeve (DJBS) induces clinically significant weight loss, but little is known about the mechanisms of action of this device. Aim: The aim of this study was to characterize the mechanisms of action of the DJBS and determine the durability of weight loss and metabolic improvements. Materials and Methods: We studied a cohort of 19 subjects with severe obesity and type 2 diabetes (baseline body mass index: 43.7±5.3 kg/m2). Anthropometry, body composition, blood pressure, biochemical measures, and dietary intake were monitored for 48 weeks after DJBS imp...
Source: Journal of Clinical Gastroenterology - Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research
Publication date: Available online 6 June 2020Source: Canadian Journal of DiabetesAuthor(s): Jessie Benson, Cameron Severn, Julia Hudnut-Beumler, Stacey L. Simon, Natalie Abramson, Lauren B. Shomaker, Lauren D. Gulley, Anya Taylor, Megan M. Kelsey, Kristen J. Nadeau, Philip Zeitler, Laura Pyle, Melanie Cree-Green
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
Publication date: 5 October 2020Source: Journal of Ethnopharmacology, Volume 260Author(s): Geisla Teles Vieira, Tânia Toledo de Oliveira, Marco Antonio Alves Carneiro, Silvia Dantas Cangussu, Gabriel Almeida Paes Humberto, Jason Guy Taylor, Jorge Luiz Humberto
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
This article will summarize the effects of more intensive blood pressure (BP) control on cardiovascular, cognitive, and renal outcomes among elderly (age ≥75 years) individuals at high risk for cardiovascular events. Subsets of patients who may not benefit and obstacles to implementation will be addressed. The authors’ insights will conclude the review. Recent findings A burst of new research regarding the effects of lower BP targets on cardiovascular, cognitive, and renal endpoints among the elderly has been published. Achieved values of 123 mmHg systolic in those without diabetes or prior stroke revealed st...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research
This article aims to review the most current literature and update readers on the epidemiology, pathophysiology and management of HTN in heart transplant patients. Recent findings In contrast to the general nontransplant hypertensive patient population, traditional risk factors, including family history of HTN, obesity and diabetes, play a minor role in the genesis of posttransplant HTN. Dysregulation in sodium and water balance, vascular stiffness, endothelial dysfunction, abnormal cardiorenal neural reflexes resulting from immunosuppression and cardiac denervation seem to be the predominant factors leading to posthear...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research
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