Lithium toxicity at therapeutic doses as a fallout of COVID-19 infection: a case series and possible mechanisms
Lithium, a mood stabilizer used in the treatment of bipolar disorder is known for its anti-inflammatory properties with the discussion of its potential use in COVID-19 infection. The SARS-CoV-2 virus causing COVID-19 infection is known to enter the target cells through angiotensin converting enzyme-2 receptors present in abundance in the lung and renal tissue. Recent research supports the evidence for direct renal injury by viral proteins. Here we report two patients with bipolar disorder presenting with lithium toxicity in the presence of COVID-19 infection. Two patients with bipolar disorder, maintaining remission on lit...
Source: International Clinical Psychopharmacology - December 1, 2021 Category: Psychiatry Tags: Case Reports Source Type: research

Remission of functional motor symptoms following esketamine administration in a patient with treatment-resistant depression: a single-case report
We report the case of a 57-year-old woman diagnosed with treatment-resistant depression (TRD) and comorbid FMD treated with weekly intranasal administrations of esketamine over a six-month follow-up period. A comprehensive clinical and psychometric assessment was carried out at different time points. After 2 months of treatment, a complete remission of motor and axial functional disturbances (athetosis, trunk torsion and genuflections) was detectable, along with a progressive improvement in depressive symptoms during follow-up until full remission. According to novel lines of evidence, glutamatergic transmission might play...
Source: International Clinical Psychopharmacology - December 1, 2021 Category: Psychiatry Tags: Case Reports Source Type: research

Tetrahydrocannabinol fails to reduce hair pulling or skin picking: results of a double-blind, placebo-controlled study of dronabinol
This study assessed the efficacy of dronabinol, a synthetic form of tetrahydrocannabinol, in the treatment of BFRBs, and found no differences in symptom reductions between dronabinol and placebo. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - December 1, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Olanzapine intramuscular shows better efficacy than zuclopenthixol acetate intramuscular in reducing the need for restraint, but not in comparison to haloperidol intramuscular
In conclusion, in inpatients with acute agitated psychosis, olanzapine intramuscular shows better efficacy in reducing the need for restraint, at least as compared to zuclopenthixol acetate intramuscular. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - December 1, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Post-traumatic stress disorder and childhood emotional abuse are markers of subthreshold bipolarity and worse treatment outcome in major depressive disorder
Post-traumatic stress disorder (PTSD) and childhood maltreatment (CMT: parental neglect; emotional, physical and sexual abuse) have been linked to bipolar disorder but they are also common in major depressive disorder (MDD). Our objective was to investigate their association with the bipolar spectrum and antidepressant treatment outcome in 482 outpatients with DSM-IV MDD treated in the Combining Medications to Enhance Depression Outcomes trial for 28 weeks Bipolar spectrum score included age of onset (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - December 1, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Bipolar disorder and Susac syndrome: a case report
We present the case of a 41-year-old woman with a first manic episode and history of Susac-syndrome, secondary Cushing’s syndrome after receiving high doses of corticosteroids and a previous depressive episode. Differentiating between primary and secondary mania is difficult, as people with bipolar disorder are prone to multiple psychiatric and nonpsychiatric comorbidities, in this case, the differential diagnosis included secondary mania, corticoid-induced manic episode and primary bipolar disorder. Upon admission, corticosteroid treatment was suspended, and the patient was started on lithium and risperidone. Second...
Source: International Clinical Psychopharmacology - October 12, 2021 Category: Psychiatry Tags: Case Reports Source Type: research

Pharmacological and philosophical considerations for the around-the-clock use of scheduled melatonin to promote sedation and reduce aggression in individuals with serious mental illness: a case report
Melatonin, the endogenous hormone that helps maintain circadian rhythm, has been used exogenously for both primary and secondary sleep disorders. While the effects of melatonin given prior to planned sleep and to restore normal circadian sleep phases have been well studied, there is little information on the use of melatonin as a pharmacotherapeutic intervention for around-the-clock sedation to prevent agitation and aggressive patient behaviors. This is the first case report to our knowledge of melatonin used throughout the day, as a scheduled dose for prolonged treatment duration, to reduce aggression in a patient with se...
Source: International Clinical Psychopharmacology - October 12, 2021 Category: Psychiatry Tags: Case Reports Source Type: research

Clinical and demographic factors associated with early relapse in patients with schizophrenia: a naturalistic observation study
Schizophrenia is a chronic psychiatric disorder progressing in relapses. Identification of many factors that may potentially increase the risk of relapse will be an important step in preventing relapses. The aim of this study was to determine the rate of early relapse in patients with schizophrenia and possible risk factors related to early relapse. The sample of this prospective study with the naturalistic observation design consisted of 308 patients with schizophrenia. The cutoff value for early relapse was determined as 1 year. The mean age of participants was 37.38 ± 12.28 years and 66.6% of them w...
Source: International Clinical Psychopharmacology - October 12, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Vortioxetine improves cognition in mild cognitive impairment
This study investigated the effects of vortioxetine on cognitive function in adults with mild cognitive impairment (MCI). This single-arm, open-label, phase II study enrolled 111 adults with MCI without depressive symptoms to receive 5–10 mg/day vortioxetine for 6 months. Main outcomes assessed: cognitive function [Montreal Cognitive Assessment (MoCA); Digit Symbol Substitution Test (DSST)], disease severity [Clinical Dementia Rating (CDR)], clinician-assessed improvement and safety. Mean MoCA score increased from 24.2 points (baseline) to 29.7 points (month 6), placing most subjects within the cognitiv...
Source: International Clinical Psychopharmacology - October 12, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Trends of complications in patients with Parkinson’s disease in seven major cities of China from 2016 to 2019
Parkinson’s disease (PD) is a neurological disorder involving both motor and nonmotor symptoms. Multimorbidity acts synergistically to heighten the risk of adverse outcomes for patients with PD. Its complications have a major impact on the clinical management of PD. The present retrospective and multicenter study was first performed to describe the epidemiological characteristics of PD patients and assess the incidence of complications. The outpatient prescriptions for PD therapy were collected from hospitals in Beijing, Chengdu, Guangzhou, Hangzhou, Shanghai, Tianjin and Zhengzhou of China over a 40-day period per y...
Source: International Clinical Psychopharmacology - August 5, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

QT prolongation is over-estimated by Bazett compared to Friderica in Japanese child and adolescent inpatients
Recent researches suggested that the risk of drug-induced QTc prolongation is low in child and adolescent psychiatry setting. However, these cohorts enrolled mainly of Caucasian background. We aimed to assess the prevalence of QTc prolongation and its association with antipsychotic use in Japanese youth. The medical records of inpatients were reviewed. Two different definitions of QT prolongation, Bazett’s corrected QT interval (QTcB)>450 msec and Fridericia’s corrected QT interval (QTcF)>450 msec, were adopted. In 220 participants [age: 13.4 ± 2.3 years, antipsyc...
Source: International Clinical Psychopharmacology - August 5, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Infection is associated with elevated serum concentrations of antipsychotic drugs
We aimed to investigate the effects of infection on serum concentrations of different antipsychotics in inpatients with respiratory tract infections treated with psychiatric drugs, including risperidone, clozapine, quetiapine, and aripiprazole. All patients underwent therapeutic drug monitoring (TDM) and routine blood tests during infection and noninfection periods. The Wilcoxon signed-rank test was used to analyze intra-individual differences in dose-corrected serum concentrations (C/D) levels in infection and noninfection periods. To study the effects of infection intensity on drug concentrations, white blood cells (WBCs...
Source: International Clinical Psychopharmacology - August 5, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

A retrospective naturalistic study on the psychopharmacological treatment of schizoaffective disorder
Evidence on the effectiveness of psychopharmacological treatment of schizoaffective disorder is scarce and mostly comes from indirect, nonspecific sources. We carried out a large retrospective study (n = 770) of every other consecutively numbered clinical record with a recorded ICD-10 diagnosis of schizoaffective disorder in the Andalusian Health Service record system. We gathered sociodemographic, drug treatment and clinical outcomes such as improvement, relapses and change over time on DSM-5 psychotic dimensions. We analyzed data to explore associations between drug use and clinical improvement. Antipsychotics were the m...
Source: International Clinical Psychopharmacology - August 5, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Predictors of long-acting injectable antipsychotic prescription at discharge in patients with schizophrenia and other psychotic disorders
Long-acting injectable antipsychotics (LAIs) increase drug compliance and offer a reliable treatment option with stable pharmacokinetics. The aim of our study is to examine the rate and predictors of LAIs’ prescription at discharge in inpatients with schizophrenia and other psychotic disorders. This retrospective study included 400 inpatients. Sociodemographic and clinical characteristics of the patients, the treatments applied in the past and prescribed at discharge were obtained from the hospitalization files. We compared these characteristics of those who were given LAI treatment at discharge to the patients who w...
Source: International Clinical Psychopharmacology - August 5, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Safety and tolerability of lumateperone for the treatment of schizophrenia: a pooled analysis of late-phase placebo- and active-controlled clinical trials
Lumateperone, an antipsychotic that is US Food and Drug Administration-approved for the treatment of schizophrenia, has a novel mechanism of action that may confer beneficial effects with improved tolerability. This pooled analysis of three randomized, double-blind, placebo-controlled trials was conducted to evaluate the safety and tolerability of lumateperone 42 mg. The pooled population comprised 1073 patients with an acute exacerbation of schizophrenia randomized to placebo (n = 412), lumateperone 42 mg (n = 406) or risperidone 4 mg (n = 255). Treatment-emergent adverse events (...
Source: International Clinical Psychopharmacology - August 5, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Effect of sertraline on depression severity and prolactin levels in women with polycystic ovary syndrome: a placebo-controlled randomized trial
There is a paucity of data regarding the safety and efficacy of antidepressant therapy in women with polycystic ovary syndrome and depression. The effect of antidepressant medications on circulating prolactin levels is of concern in this patient population. We aimed to evaluate the effect of sertraline on depression severity and serum prolactin levels in women with polycystic ovary syndrome and mild-to-moderate depression. In a parallel-design, two-center, randomized controlled trial, we stratified participants according to their baseline prolactin level into normal ( (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - August 5, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Treatment adherence and tolerability of immediate- and prolonged-release lithium formulations in a sample of bipolar patients: a prospective naturalistic study
The aim of this study was to compare treatment adherence and tolerability of different lithium formulations in 70 bipolar patients receiving lithium therapy for the first time. During the 1-year follow-up, information was collected regarding patient’s clinical course, therapeutic adherence, side effects of the treatment and serum levels of lithium, creatinine and thyroid-stimulating hormone. At baseline, 30 patients (43%) were on prolonged-release lithium formulations and 40 (57%) on immediate-release formulations. At the final evaluation, 37 patients (53%) were considered lost to follow-up. Both prolonged- and immed...
Source: International Clinical Psychopharmacology - August 5, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Tolcapone in obsessive-compulsive disorder: a randomized double-blind placebo-controlled crossover trial
Despite the availability of evidence-based treatments for obsessive-compulsive disorder (OCD), not all patients experience sufficient benefit or are able to tolerate them. Tolcapone is a catechol-O-methyl-transferase (COMT) enzyme inhibitor that augments cortical dopaminergic transmission. Conduct a proof of concept study to examine whether a COMT inhibitor would reduce OCD symptoms to a greater extent than placebo. We conducted a randomized, placebo-controlled, double-blind crossover trial in adults with OCD (N = 20). Participants were assessed at baseline, after 2 weeks of tolcapone, and again after 2 weeks of placebo on...
Source: International Clinical Psychopharmacology - August 5, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Doxazosin improved COVID-19 associated nightmare in a patient with major depressive disorder: a case report with a positive rechallenge
This article reports on the treatment of a patient with nightmares who was treated with doxazosin of an alpha 1-adrenergic antagonists. A 71-year-old Japanese major depressive disorder (MDD) woman experienced nightmares after the coronavirus disease 2019 pandemic. She had nightmares about being chased by a coronavirus and catching the corona virus. After adding doxazosin 1 mg daily in the morning, her nightmares led to remission without side effects. We also had a rechallenge regimen with doxazosin. The nightmares ceased on the second night of the rechallenge and did not return with continued treatment. This case re...
Source: International Clinical Psychopharmacology - June 3, 2021 Category: Psychiatry Tags: Case Reports Source Type: research

Adjunctive music improves the tolerability of intravenous ketamine for bipolar depression
Intravenous ketamine is an effective treatment of bipolar depression. One of its most important side-effects is a transient altered state of consciousness commonly referred to as dissociation. These states can be anxiety-provoking, distressing and even treatment-limiting, warranting research into mitigation strategies. In this article, we present two cases that demonstrate the potential of adjunctive music to diminish the distress associated with ketamine-induced dissociation – though not necessarily its degree – in bipolar 1 disorder. Both patients suffering from severe depression underwent their first ketamin...
Source: International Clinical Psychopharmacology - June 3, 2021 Category: Psychiatry Tags: Case Reports Source Type: research

Case report: asenapine and anticholinergic toxicity
While antipsychotic medications have long been associated with anticholinergic effects, asenapine has been purported to have no capacity for muscarinic cholinergic antagonism based on in vitro studies. Research in rat brain tissue has yielded different results, with one study finding more cholinergic M1-5 binding in the medial prefrontal cortex, dorsolateral frontal cortex and hippocampal CA1 and CA3 areas than would be predicted from in vitro findings. Moreover, it is structurally similar to other anticholinergic antipsychotics such as loxapine and, to a lesser degree, quetiapine, olanzapine and clozapine. This case repor...
Source: International Clinical Psychopharmacology - June 3, 2021 Category: Psychiatry Tags: Case Reports Source Type: research

The clinical intervention choice for pediatric tic disorder patients from a tertiary children’s hospital in China: a large-scale retrospective study based on electronic medical records
Pharmacological intervention played an important role in the management of tic disorder. Large-scale prescription data for pediatric tic disorder patients in the real-world setting were scarce. The demographic and prescription data of tic disorder were extracted from the electronic medical records database of Beijing Children’s Hospital from 2018 to 2020. The intervention choice for outpatient pediatric tic disorder patients was analyzed. A total of 20 417 patients were included, 28.1% (n = 5028) of them did not receive any pharmacological treatment. Over 70% were prescribed with anti-tic medication. For children les...
Source: International Clinical Psychopharmacology - June 3, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Off-label use of second-generation antipsychotics in borderline personality disorder: a comparative real-world study among oral and long-acting injectables in Spain
In conclusion, the use of LAIs may play a role in the management of BPD. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - June 3, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Relation of medication adherence to cognitive functions in egyptian patients with bipolar I disorder
Nonadherence to medication regimens is frequently reported in bipolar I disorder (BDI) patients. However, little is known about the relationship between cognitive functions and adherence in BDI. To establish possible associations between medication adherence and cognitive function in patients with BDI. A total of 110 inpatients with BDI were subjected to the Structured Clinical Interview for DSM-IV Axis I Disorder, Morisky 8-Item Medication Adherence Scale, Young Mania Rating Scale, Wechsler Adult Intelligence Scale-Revised, Wechsler memory scale (WMS) and Wisconsin card sorting test (WCST). Patients were assessed on admis...
Source: International Clinical Psychopharmacology - June 3, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Clinical outcomes after clozapine discontinuation in responders versus nonresponders: a retrospective chart review
No studies have compared clinical outcomes after discontinuation of clozapine between patients who responded to clozapine and those who did not. Therefore, we examined 1-year clinical outcomes after clozapine discontinuation in responders and nonresponders. We reviewed data on patients who discontinued clozapine and retrospectively followed them for 1 year. Clinical information was collected from medical records starting at the initiation of clozapine administration, at discontinuation and at 1 year after discontinuation. In addition, clinical status was assessed using the Clinical Global Impression – S...
Source: International Clinical Psychopharmacology - June 3, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Predictors of long-acting injectable antipsychotic treatment discontinuation in outpatients with schizophrenia: relevance of the Drug Attitude Inventory-10
Given the importance of patients’ subjective experience and attitudes in the management of severe mental illness, the present study evaluated their potential role as predictors of future continuation of long-acting injectable antipsychotic maintenance treatment (LAI-AMT) in clinically stable outpatients with schizophrenia switching from an oral therapy. Retrospective data from 59 subjects receiving LAI-AMT for at least 6 months were collected. Patients who continued LAI treatment (n = 32) were compared to those who discontinued it (n = 27), assessing baseline socio-demographic and c...
Source: International Clinical Psychopharmacology - June 3, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Atypical antipsychotics in the treatment of psychotic symptoms in Alzheimer’s disease: a systematic review
With the advancement of Alzheimer’s disease as well as other types of dementia, in addition to the cognitive decline, psychiatric symptoms have been outlined, including psychotic symptoms. The aim of the study is to review the available results on the antipsychotic treatment of Alzheimer’s disease associated psychotic symptoms. The main objective of the study is to evaluate the efficacy of the treatment. The second objective is to assess the tolerability of this treatment. Double-blind, randomized, placebo-controlled trials, which took place over the course of at least 4 weeks, have been searched. Studie...
Source: International Clinical Psychopharmacology - June 3, 2021 Category: Psychiatry Tags: Review Article Source Type: research

Prevalence and predictors of laxatives use in clozapine-related constipation: an observational study
This study aimed to investigate the prevalence of constipation and the breakdown of laxatives, and to identify whether use of laxative may be predicted by demographics or baseline metabolic markers in 53 Japanese treatment-resistant schizophrenia inpatients switched to clozapine. Differences of present age, onset age and duration of illness, previous antipsychotic dose using the chlorpromazine equivalent, and 10-items of metabolic markers, including fasting plasma glucose and ratio of triglyceride to high-density lipoprotein cholesterol levels were compared between the laxative and nonlaxative user groups. Sequential chang...
Source: International Clinical Psychopharmacology - April 2, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

The effectiveness and safety of cariprazine in schizophrenia patients with negative symptoms and insufficient effectiveness of previous antipsychotic therapy: an observational study
The aim of the study was to examine the effectiveness and safety of cariprazine in routine psychiatric settings on schizophrenia patients with negative symptoms who have been treated with antipsychotics previously but without sufficient success. This was an open-label, flexible-dose, 16-week, observational study in Latvia. The primary outcome measure was an array of anamnesis-based clinical questions on schizophrenia symptoms rated on a seven-point scale. Other outcome measurements were the clinical global impression improvement (CGI-I) and severity (CGI-S) scales. Safety parameters included spontaneous reports of adverse ...
Source: International Clinical Psychopharmacology - April 2, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Paradoxical effect of statin medication on depressive disorder in first-ever ischemic stroke patients: possible antidepressant-like effect prestroke and the opposite in continuous medication poststroke
Poststroke depression (PSD) is the most frequent complication after stroke. Statin is a widely used prophylactic for stroke. However, some researchers reported that poststroke statin may lead to a depressive change in stroke patients. We aimed to study the effect of different statin medication timing especially prestroke timing on PSD to adopt appropriate intervention around stroke. Patients with first-ever ischemic stroke were consecutively observed from January 2012 to June 2017. They were grouped by different initiation time of statin treatment. The follow-up endpoints were set to: (1) diagnosis of PSD within 1-year and...
Source: International Clinical Psychopharmacology - April 2, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Efficacy and safety of pentoxifylline combination therapy in major depressive disorder: a randomized, double-blind, placebo-controlled clinical trial
In this randomized, double-blind, placebo-controlled clinical trial, we assessed the efficacy and safety of pentoxifylline combination therapy with sertraline in treatment of major depressive disorder (MDD). A total of 56 patients with MDD were assigned into two parallel groups to receive sertraline (100 mg/day) plus placebo or sertraline (100 mg/day) plus pentoxifylline (400 mg three times daily) for six weeks. Patients were evaluated with the Hamilton rating scale for depression (HAM-D) at baseline and weeks 2, 4 and 6. The sertraline plus pentoxifylline group demonstrated greater improvement in HAM-D scores from baselin...
Source: International Clinical Psychopharmacology - April 2, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

The efficacy of escitalopram in major depressive disorder: a multicenter randomized, placebo-controlled double-blind study
The aim of the study was to conduct a multicenter randomized double-blinded placebo-controlled clinical study to evaluate the efficacy of a generic form of escitalopram in treating major depressive disorder (MDD). A total of 390 MDD patients admitted to hospitals in six cities in China were randomized to receive the generic version of escitalopram, the proprietary form of escitalopram (Lexapro) or placebo. During the 8-week treatment, the Hamilton rating scale for depression-17 (HAM-D17), Hamilton Anxiety Rating Scale (HAMA), Montgomery-Åsberg Depression Rating Scale (MADRS), Clinical Global Impressions scale (CGI), ...
Source: International Clinical Psychopharmacology - April 2, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Effects of celecoxib augmentation of antidepressant or anxiolytic treatment on affective symptoms and inflammatory markers in patients with anxiety disorders: exploratory study
Prolonged stress has been associated with elevated levels of circulating proinflammatory cytokines. Cyclo-oxygenase-2 inhibitors such as celecoxib exert anti-inflammatory effects and may enhance the response to antidepressant drug treatment in patients with depressive disorders, but their effect on anxiety symptoms in patients with anxiety disorders is uncertain. Patients with a primary diagnosis of an anxiety disorder, with stabilised symptoms, underwent either 6 weeks of celecoxib augmentation of continued treatment (n = 18) or continued ‘treatment as usual’ (n = 9). Assessments included the Warwick–Edi...
Source: International Clinical Psychopharmacology - April 2, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Dasotraline in adults with attention deficit hyperactivity disorder: a placebo-controlled, fixed-dose trial
In a previous study, dasotraline demonstrated efficacy at a dose of 8 mg/day in adults with attention deficit hyperactivity disorder (ADHD). The aim of the current study was to evaluate the efficacy and safety of dasotraline in doses of 4 and 6 mg/day. Adults meeting Diagnostic and Statistical Manual of Mental Disorders, 5th edition criteria for ADHD were randomized to 8 weeks of double-blind, once-daily, fixed-dose treatment with dasotraline 4 mg/day, 6 mg/day, or placebo. The primary efficacy endpoint was changed in the ADHD Rating Scale, Version IV (ADHD RS-IV) total score. Secondary efficacy...
Source: International Clinical Psychopharmacology - April 2, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

The efficacy and safety in attention deficit hyperactivity disorder of second-generation antipsychotics and other medications for hyperactivity in children and adolescents with autism: a meta-analysis
This study concentrated on two widely-used medications: the second generation of antipsychotics (SGAs) and ADHD medication, aiming to conduct a meta-analysis about their effect on hyperactivity, so it would offer some evidence for clinical medication choice. The Medline, Embase, Cochrane Central Register of Controlled Trials and China National Knowledge Infrastructure databases were searched from inception to July 2019 for studies exploring the use of SGAs and ADHD medications in autistic children and adolescents. Double-blind, randomized controlled trials that reported hyperactivity as an outcome were included in the stud...
Source: International Clinical Psychopharmacology - April 2, 2021 Category: Psychiatry Tags: Review Article Source Type: research

Resurrecting the discussion on neurotoxicity of lithium at therapeutic levels
Lithium is widely used in the treatment of bipolar disorder. Here we describe the syndrome of irreversible lithium-effectuated neurotoxicity in a patient within therapeutic doses and levels, which persisted after discontinuation of Lithium. A 50-year-old gentleman with Bipolar disorder presented with symptoms of Mania following drug default. Lithium was initiated as a mood stabilizer. On day 4, the patient developed abdominal pain, itching, and sore throat. On day 5, lithium levels were 0.9 mEq/L. Subsequently, the patient was noted to have slurring of speech, dysarthria, past pointing, and dysdiadochokinesis. Lithium was ...
Source: International Clinical Psychopharmacology - February 2, 2021 Category: Psychiatry Tags: Case Reports Source Type: research

Use of subcutaneous ketamine to rapidly improve severe treatment-resistant depression in a patient with Alzheimer’s disease
No abstract available (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - February 2, 2021 Category: Psychiatry Tags: Case Reports Source Type: research

Benefit of long-acting paliperidone in Huntington’s disease: a case report
Through this brief report, we described our clinical considerations about the treatment of motor fluctuations and psychiatric comorbidities in Huntington’s disease, for example, aggressiveness and obsessive-compulsive disorders. Indeed, as classical treatment, for example, olanzapine and risperidone, were inefficient to improve motor disorders in our patient, we postulated that motor fluctuations could be influenced by the pharmacokinetic profile of oral risperidone. So, in line with recent practice in schizophrenia, we proposed empirically paliperidone 1-month long-acting injections hypothesized to improve motor flu...
Source: International Clinical Psychopharmacology - February 2, 2021 Category: Psychiatry Tags: Case Reports Source Type: research

Early administration of aripiprazole long-acting injectable in acute inpatients with schizophrenia: a clinical report
Fifty-one patients suffering an acute episode of schizophrenia and treated with aripiprazole long-acting injectable (ALAI) were chosen to elaborate an observational study in two in-patient units in Spain, in order to examine the effects of early administration during a hospital admission. When treatment with ALAI is administered in the first week of admission (in 31 patients, 60.78%), hospitalization time is significantly reduced, 12.1 days on average. It can be concluded that ALAI is an effective treatment for these patients. Analysis in economic terms and comparison with other LAI antipsychotics are interesting lines for...
Source: International Clinical Psychopharmacology - February 2, 2021 Category: Psychiatry Tags: Short Communication Source Type: research

Predictors of discontinuation and hospitalization during long-acting injectable antipsychotic treatment in patients with schizophrenia spectrum disorder
The aim of this study was to evaluate discontinuation and hospitalization rates in patients with schizophrenia spectrum disorder who were treated with long-acting injectable (LAI) antipsychotics. We recorded clinical data about the period before the LAI treatment, when LAI treatment was initiated, and during the LAI treatment. Variables related to early ( (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - February 2, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Longitudinal changes in antipsychotic dose in patients treated with long-acting injectable second-generation antipsychotics
Only a few studies have investigated changes in the dose of long-acting injectable second-generation antipsychotics (LAI-SGAs) over the long term in the maintenance treatment of schizophrenia. In this retrospective cohort study, we examined longitudinal changes in antipsychotic dose over a 3-year period in patients with schizophrenia who had been taking LAI-SGAs for at least 1 year. We compared the total daily chlorpromazine equivalent dose of antipsychotics at 12, 24 and 36 months with the baseline dose at 3 months after initiation of LAI-SGAs. We also performed multiple regression analysis to explore...
Source: International Clinical Psychopharmacology - February 2, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Efficacy of cariprazine in bipolar I depression across patient characteristics: a post hoc analysis of pooled randomized, placebo-controlled studies
Patients who experience bipolar depression have diverse demographic and clinical characteristics that have the potential to impact treatment. The efficacy of cariprazine in bipolar I depression was evaluated in patient subgroups defined by baseline demographic and clinical characteristics. Post hoc analyses of data from three randomized, double-blind, placebo-controlled trials in bipolar I depression (NCT01396447, NCT02670538 and NCT02670551) evaluated mean change from baseline in Montgomery-Åsberg Depression Rating Scale (MADRS) total scores for pooled cariprazine 1.5–3 mg/d versus placebo in subgroups defined...
Source: International Clinical Psychopharmacology - February 2, 2021 Category: Psychiatry Tags: Original Articles Source Type: research

Body dysmorphic disorder: a treatment synthesis and consensus on behalf of the International College of Obsessive-Compulsive Spectrum Disorders and the Obsessive Compulsive and Related Disorders Network of the European College of Neuropsychopharmacology
Body dysmorphic disorder (BDD) is characterized by a preoccupation with a perceived appearance flaw or flaws that are not observable to others. BDD is associated with distress and impairment of functioning. Psychiatric comorbidities, including depression, social anxiety, and obsessive-compulsive disorder are common and impact treatment. Treatment should encompass psychoeducation, particularly addressing the dangers associated with cosmetic procedures, and may require high doses of selective serotonin reuptake inhibitors* (SSRI*) and protracted periods to establish full benefit. If there is an inadequate response to SSRIs, ...
Source: International Clinical Psychopharmacology - February 2, 2021 Category: Psychiatry Tags: Review Article Source Type: research

Bilateral pedal edema associated with lurasidone: a case report
Lurasidone, an atypical antipsychotic, is currently approved for treatment of schizophrenia and bipolar depression. Little is known about whether lurasidone might also cause pedal edema. A 55-year-old female patient had been diagnosed with bipolar I disorder from the age of 26. She had been prescribed escitalopram and quetiapine 300 mg/day for her persistent depressive mood. Later, she took lurasidone plus escitalopram to treat depressive episode. Consequently, she developed mild bilateral swelling over the lower legs and ankles. After lurasidone was discontinued, the bilateral pedal edema was completely resolved, a...
Source: International Clinical Psychopharmacology - November 26, 2020 Category: Psychiatry Tags: Case Reports Source Type: research

Managing dissociative symptoms following the use of esketamine nasal spray: a case report
We present the case of a 64-year-old woman with major depressive disorder who participated in a clinical trial evaluating the efficacy and safety of esketamine nasal spray in conjunction with an oral antidepressant for TRD. The patient received flexible doses of esketamine nasal spray (56 or 84 mg) twice weekly for 4 weeks. On treatment day 1, the patient was administered 56 mg of esketamine nasal spray using two nasal spray devices (28 mg per device). Twenty minutes after the first esketamine nasal spray device was administered, the patient experienced a dissociative episode lasting 40 minutes that caused anxiety and conf...
Source: International Clinical Psychopharmacology - November 26, 2020 Category: Psychiatry Tags: Case Reports Source Type: research

Beneficial effect of quetiapine monotherapy in patients with bipolar depression and comorbid obsessive-compulsive disorder
We report the results of an open-label, short-term, prospective investigation of quetiapine monotherapy in 16 patients (three men and 13 women, aged 18–56 years) hospitalized for acute bipolar depression who in addition met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for OCD. The participants were treated with quetiapine in a dose range of 150–600 mg (mean 347 mg) for a mean duration of 4.3 ± 1.4 weeks (range 3–7 weeks). Eleven (68.8%) of the 16 study participants fulfilled the predefined criteria for response, namel...
Source: International Clinical Psychopharmacology - November 26, 2020 Category: Psychiatry Tags: Short Communication Source Type: research

Creatine kinase levels in psychotic patients who use cannabinoids
We examined whether creatine kinase levels differ in psychotic cannabinoid users and the association between creatine kinase levels and clinical measures (duration of hospitalization and need for mechanical restraint). Computerized medical records of 124 men hospitalized due to acute psychotic episodes were reviewed. Creatine kinase levels and various clinical measures at admission were documented. Cannabis users were significantly younger than nonusers. Duration of illness was longer among nonusers. Log creatine kinase among cannabinoid users (N = 32) was numerically higher compared to nonusers (N = 92) (5.6 ± 1 vs...
Source: International Clinical Psychopharmacology - November 26, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Cognitive impairment in patients diagnosed with tramadol dependence compared to healthy controls
Cognitive impairment is one of the consequences of substance use. We aimed to estimate the prevalence and correlates of cognitive impairment among patients with tramadol dependence in comparison with healthy controls. The sample consisted of 30 patients with tramadol dependence and 30 healthy controls. Cognitive functions were assessed using Benton Visual Retention Test- revised, Trail Making Test A and B and Wechsler Memory Scale. Patients were also subjected to the Structured Clinical Interview for diagnostic and statistical manual of mental disorders-fourth edition (DSM-IV) Axis I Disorder, the Structured Clinical Inter...
Source: International Clinical Psychopharmacology - November 26, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

The importance of monitoring renal function and concomitant medication to avoid toxicity in patients taking lithium
Lithium, which is used for bipolar disorder, can cause toxicity. There are two categories of lithium toxicity, namely, overdose-related and not overdose-related. However, the treatment and prognosis of each type of toxicity are not clearly understood. We, therefore, compared the clinical characteristics of patients with overdose-related and not overdose-related lithium toxicity. Relevant data were obtained from the medical records of 16 patients with lithium toxicity, and renal function and concomitant medications were retrospectively compared between the two groups. We also compared the treatment for, manifestations of, a...
Source: International Clinical Psychopharmacology - November 26, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

The effects of adding long-acting injectable antipsychotic drugs to clozapine on relapse and hospitalization in patients with treatment-resistant schizophrenia: a mirror-image retrospective study
The literature assessing the addition of long-acting injectable antipsychotics (LAIs) to clozapine is limited. The aim of this retrospective study was to determine the safety and effectiveness of adding LAIs to clozapine in patients with treatment-resistant schizophrenia (TRS). Patients aged 18–65 years with TRS, who were treated with first-generation (FGA-LAIs) and second-generation (SGA-LAIs) for at least 1 year after clozapine use, were included retrospectively by registration system scanning. Effectiveness measures included relapses and hospitalizations and days of hospitalization. Safety outcomes i...
Source: International Clinical Psychopharmacology - November 26, 2020 Category: Psychiatry Tags: Original Articles Source Type: research