Impact of Ramadan fasting on medical and psychiatric health
Ramadan is a religious month dedicated to prayer, fasting and feasting. Recently, there has been an increased interest among healthcare providers regarding possible health-related complications as a consequence of religious fasting such as that seen during Ramadan. In May 2018, a 34-year-old female patient with a diagnosis of schizoaffective disorder, depressive type, was admitted for inpatient hospitalization to an inpatient psychiatric hospital in Buffalo, New York. The earliest date of initial diagnosis is unclear; however, the patient reports an increase in symptoms during her early twenties. Upon admission, the patien...
Source: International Clinical Psychopharmacology - September 27, 2019 Category: Psychiatry Tags: Case Report Source Type: research

Trends of antidementia drugs use in outpatients with Alzheimer’s disease in six major cities of China: 2012–2017
Alzheimer’s disease is a devastating neurodegenerative disease that requires pharmacological intervention. We conducted a descriptive study using pharmacy prescription data of antidementia drugs. Prescription information of 99 541 patients was obtained from 55 hospitals. Overall the number of Alzheimer’s disease outpatients of sampling days increased from 10 239 in 2012 to 20 546 in 2017. The main age range of patients suffering Alzheimer’s disease was 75–84, while the patients aged above 85 was increasing. Nonusers of antidementia drugs, cholinesterase inhibitors (ChEIs) and memantine slowly decrea...
Source: International Clinical Psychopharmacology - September 27, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Long-term effects of paliperidone palmitate on hospital stay and treatment continuation
There is a growing need for real world data on long-term clinical and health resource utilization outcomes. The main purpose of this study was to establish the effects of 1-monthly Paliperidone Palmitate (PP1M) on treatment continuation and hospital stay in routine clinical practice. This is a naturalistic, 6-year mirror-image study examining retention and hospitalization rates 3 years pre-PP1M and 3 years post-PP1M initiation. One hundred seventy-three patients were included; 120 (70%) had a primary diagnosis of schizophrenia and 53 (30%) other diagnosis. In total, 77% of patients continued PP1M for one year, 66% for two ...
Source: International Clinical Psychopharmacology - September 27, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Compliance in schizophrenia spectrum disorders: the role of clinical pharmacist
In this study, our aim was to evaluate whether drug education provided by a clinical pharmacist during discharging period has an effect on compliance. Forty adult patients diagnosed with psychotic disorders were included. A number of scales were used to evaluate the severity of illness, medication adverse effects and compliance. At time of discharge, it was emphasized to patients by a clinical pharmacist that medication compliance was important to prevent exacerbation or hospitalization. Six to eight weeks after discharge, patients were invited to be reevaluated using the same scales as those applied during hospitalization...
Source: International Clinical Psychopharmacology - September 27, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Concomitant use of alcohol and benzodiazepine hypnotics in psychiatric outpatients: a cross-sectional survey
The objectives of this study were as follows: (1) to investigate the prevalence of concomitant use of benzodiazepine hypnotics and alcohol in psychiatric outpatients, (2) to examine the clinical characteristics and factors associated with the concomitant use, and (3) to investigate the awareness of the psychiatrists-in-charge about the concomitant use. Outpatients with schizophrenia, depression, and insomnia who were receiving benzodiazepine hypnotics were asked to fill in a sleeping diary for seven consecutive days in which use of hypnotics and alcohol was also recorded. Clinical characteristics were assessed, and logisti...
Source: International Clinical Psychopharmacology - September 27, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

A personal account of depressive illness and its antidepressant treatment
Depression crept quietly over me as a shadow lengthens towards dusk. Probable contributory factors include familial predisposition, multiple bereavement, physical illness and being abused online. The first few days of antidepressant drug treatment were unsettling, but I responded steadily, the medication side effects proved tolerable, and my depressive and anxiety symptoms had remitted within 4 weeks. Insights from literature were helpful in recovery. I hope this experience of illness and treatment will enhance my clinical practice and contribute to discussions about depression and antidepressant medicines. (Source: Intern...
Source: International Clinical Psychopharmacology - September 27, 2019 Category: Psychiatry Tags: Review Articles Source Type: research

Reintroduction of quazepam: an update on comparative hypnotic and adverse effects
Insomnia is a prevalent disorder that affects over one-third of the U.S. population to varying degrees and is highly disruptive towards quality of life. Pharmacological treatments for insomnia include benzodiazepines (BZs) and the non-BZ ‘Z-drugs’ (zolpidem, zaleplon, eszopiclone, zopiclone), which are amongst the most widely prescribed medications. Yet, these agents can produce adverse effects such as tolerance to the hypnotic effect, rebound insomnia, next-day residual drowsiness, as well as amnesia and complex behaviours such as sleep-walking, sleep-eating and sleep-driving. Quazepam, one of the five BZ appr...
Source: International Clinical Psychopharmacology - September 27, 2019 Category: Psychiatry Tags: Review Articles Source Type: research

Patient attitudes to clozapine initiation: Erratum
No abstract available (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - August 3, 2019 Category: Psychiatry Tags: Errata Source Type: research

Delayed complications after severe clozapine intoxication: a case report. The pharmacokinetic profile of clozapine and it’s important role in the course of symptoms
We present the case of a 50-year-old man showing severe complications 15 hours after intoxication with 4200 mg clozapine. Treatment consisted of strict monitoring, including vital support and regular clozapine blood levels. Clinical presentations may be delayed up to 5 days after intoxication, for which strict monitoring of clinical symptoms and vital functions during this period is of major importance. We discuss the clinical course of clozapine intoxication, the value of sampling clozapine blood levels and provide an overview of the current treatment guidelines, which we suggest to update to include the management of del...
Source: International Clinical Psychopharmacology - August 3, 2019 Category: Psychiatry Tags: Case Reports Source Type: research

Need to bleed? Clozapine haematological monitoring approaches a time for change
Regular haematological monitoring during clozapine treatment reduces the risk of complications and death from clozapine-related blood dyscrasias. However, many patients in the course of clozapine treatment develop neutropenia unrelated to drug treatment which leads to treatment discontinuation. The minimum haematological threshold allowed for the continuation of clozapine treatment was recently lowered in the US, but not in the UK. In this case series, we present four cases where lowering the haematological cut-off to that used in the US, allowed treatment continuation. Lowering the current UK threshold for clozapine cessa...
Source: International Clinical Psychopharmacology - August 3, 2019 Category: Psychiatry Tags: Case Reports Source Type: research

Clozapine-associated neutropenia in Latin America: incidence report of 5380 Chilean users
Systematic information about Latino clozapine users is still scarce. Our aim was to evaluate the risk of clozapine-associated neutropenia in a Chilean cohort using the last Food and Drug Administration’s recommendations for clozapine monitoring. Findings should improve clinical practice and promote changes in clozapine guidelines in Latin America. We conducted a retrospective observational study of 5380 Chilean clozapine users that started clozapine treatment between 2003 and 2015. The absolute risk of severe neutropenia was 0.61% (33/5380) with an incidence of 0.086 cases per 100 person-years of follow-up. 87.9% of ...
Source: International Clinical Psychopharmacology - August 3, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Addressing clozapine under-prescribing and barriers to initiation: a psychiatrist, advanced practice provider, and trainee survey
Clozapine use has declined, despite its superior antipsychotic efficacy in treatment-resistant schizophrenia. Implications for clozapine underutilization include suboptimal treatment outcomes and increased hospitalizations. Many barriers preventing the use of clozapine have been described in the literature, including suboptimal knowledge and poor perceptions. The aim of this study was to assess psychiatry prescribers’ perception and knowledge of clozapine. A survey was distributed to advanced practice providers, psychiatrists, and trainees (i.e. residents and fellows) at 10 medical centers within the US and Canada. T...
Source: International Clinical Psychopharmacology - August 3, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Cytochrome P450-mediated inhibition of venlafaxine metabolism by trimipramine
This study is to uncover the potential of pharmacokinetic interactions between venlafaxine and trimipramine in a naturalistic sample. Methods Out of a therapeutic drug monitoring database with plasma concentrations of venlafaxine (VEN) and O-desmethylvenlafaxine (ODV), we considered two groups of patients receiving venlafaxine without known cytochrome P450 confounding medications, taking solely venlafaxine: V0 (n = 905), and a group of patients co-medicated with trimipramine, VTRIM (n = 33). For VEN, ODV and active moiety (sum of VEN + ODV) plasma concentrations and dose-adjusted concentrations as well as ODV/VEN ratios...
Source: International Clinical Psychopharmacology - August 3, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Comparison of the association of risperidone and quetiapine with deteriorating performance in walking and dressing in subjects with Parkinson’s disease: a retrospective cohort study using administrative claims data
This retrospective cohort study was performed to investigate the association between risperidone and deteriorating performance in walking and dressing in subjects with Parkinson’s disease using the Japanese Diagnosis Procedure Combination data. These data include inpatient claims including information from the time of admission to discharge from 89 acute phase National Hospitals in Japan. The data were evaluated by implementing the inverse probability of treatment weighting, using propensity scores estimated from the clinical characteristics of subjects prescribed risperidone or quetiapine. The generalized estimation...
Source: International Clinical Psychopharmacology - August 3, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Comparing the efficacy of ondansetron and granisetron augmentation in treatment-resistant obsessive-compulsive disorder: a randomized double-blind placebo-controlled study
This study aimed to assess the efficacy and tolerability of ondansetron vs. granisetron in patients with treatment-resistant obsessive-compulsive disorder. A randomized clinical trial conducted on 135 patients with a Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnosis of obsessive-compulsive disorder, who were treatment-resistant and receiving stable treatment with selective serotonin reuptake inhibitors and antipsychotic, received 14 weeks (phase I, intervention period) of placebo (n = 45), ondansetron (n = 45, 4 mg), and granisetron (n = 45, 2 mg) daily augmentations. Patients were rated every 2 w...
Source: International Clinical Psychopharmacology - August 3, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Effectiveness and safety of long-term benzodiazepine use in anxiety disorders: a systematic review and meta-analysis
Long-term benzodiazepines (BZDs) use is not endorsed in the treatment guidelines for anxiety disorders, but is prevalent in the real-world clinical settings. A systematic literature review was performed by using PubMed (last search: May 2019) to identify randomized controlled trials (RCTs) or maintenance studies following RCT that examined the effectiveness of BZDs in patients with anxiety disorders for a duration of 13 weeks or more. Meta-analyses were then conducted regarding changes in the Hamilton Anxiety Rating Scale (HAM-A) scores from baseline through endpoint, all-cause discontinuation, side effects, and the number...
Source: International Clinical Psychopharmacology - August 3, 2019 Category: Psychiatry Tags: Review Source Type: research

The unmasking of hidden severe hyponatremia after long-term combination therapy in exacerbated bipolar patients: a case series
We presented three clinical cases of patients affected by a long-term psychiatric disorder and under polypharmacotherapy for several months. After excluding other potential factors, we hypothesized that pharmacological treatment with a mood stabilizer (oxcarbazepine) associated with a benzodiazepine (delorazepam), a second-generation antipsychotic (olanzapine) or an antidepressant (fluvoxamine), triggered severe hyponatremia ([Na+] ≤125 mEq/L), serum hypo-osmolarity, and elevated inappropriate urine osmolarity added to more diluted sodium concentration. When we discontinued the treatment, clinical conditions of o...
Source: International Clinical Psychopharmacology - May 31, 2019 Category: Psychiatry Tags: Case Report Source Type: research

Personalized and precision medicine as informants for treatment management of bipolar disorder
DSM-5 diagnostic categories, defined by a set of psychopathological symptoms are heterogeneous conditions that may include different biological entities, with distinct etiopathogenesis, different courses and requiring different treatment management. For bipolar disorder the major evidences for this lack of validity are the long paths before a proper diagnosis, the inconsistence of treatment guidelines, the long phases of pharmacological adjustment and the low average of long-term treatment response rates. Personalized medicine for mental disorders aims to couple established clinical–pathological indexes with new mole...
Source: International Clinical Psychopharmacology - May 31, 2019 Category: Psychiatry Tags: Review Source Type: research

Antipsychotics in the general population and the driver population: comparisons from a population-based registry study
This study is intended for updating the epidemiological knowledge of all involved in the control of use of antipsychotics and other driving-impairing medicines (healthcare providers, patients, authorities, and drug developers) in order to improve prescribing/dispensing and a well tolerated use of all driving-impairing medicines by the population. Awareness is needed to improve safety on driving, and there is a need worldwide to improve interventions in the field of medicines and driving. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - May 31, 2019 Category: Psychiatry Tags: Short Communication Source Type: research

The effectiveness of high-dose escitalopram in the treatment of patients suffering from schizophrenia with comorbid obsessive-compulsive disorder: an open-label study
Obsessive-compulsive disorder frequently co-occur with schizophrenia causing a significant impairment. There is a paucity of published data on the treatment of such complicated patients. It has been suggested that the combination of antipsychotics and antiobsessive agents is the best treatment for schizophrenia with obsessive-compulsive disorder; however, there is no published data regarding the use of high dose (up to 40 mg/day) escitalopram. This open-label, prospective study was designed to investigate the efficacy, short-term safety and tolerability of escitalopram in doses up to 40 mg in patients with sc...
Source: International Clinical Psychopharmacology - May 31, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Effects of antidepressant treatments on health service utilization and medical costs among patients with depression: a nationwide population-based retrospective cohort study in Taiwan
This study aimed to assess the associations between the use of different types of antidepressants and health service utilization and costs among depressed patients. Data used in this study were retrieved from the Taiwan National Health Insurance Research Database. We identified 447 411 new antidepressant users during the study period (2011–2015) and they were individually followed for a 1-year period. Two-part generalized estimating equation models were conducted. Results demonstrated that there was a substantial decrease in outpatient service utilized by patients undertaking serotonin antagonists and reuptake...
Source: International Clinical Psychopharmacology - May 31, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Attrition in treatment-resistant depression: predictors and clinical impact
The aim of this study was to investigate attrition (dropout) during a second antidepressant trial in treatment-resistant depression. Three hundred forty-two outpatients with major depressive disorder and lack of response to a prior antidepressant were treated with venlafaxine for 6 weeks. Sociodemographic and clinical characteristics were compared between the attrition and non-attrition groups. Attrition was reported in 65 patients (19%), of whom 30 patients (46%) dropped out within week 4. The characteristics of dropout patients included a longer duration of depressive episode (P = 0.011) and lower antidepressant doses (P...
Source: International Clinical Psychopharmacology - May 31, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Intravenous vortioxetine to accelerate onset of effect in major depressive disorder: a 2-week, randomized, double-blind, placebo-controlled study
This study supported intravenous vortioxetine as a means of rapidly reaching therapeutic vortioxetine blood levels. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - May 31, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Lithium and valproate serum level fluctuations within the menstrual cycle: a systematic review
Some women affected by mood disorders experience mood instability during the premenstrual phase. Assuming that fluctuations in drug serum levels may contribute to the worsening of mood symptoms, we carried out a systematic review of available studies that investigated changes in lithium and valproate levels in relation to menstrual phases. We selected five studies; four of which assessed menstrual fluctuations in lithium serum levels and one in valproate levels. Study samples included women in their fertile age affected by bipolar disorder, epilepsy as well as healthy ones. Preliminary results showed a close relationship b...
Source: International Clinical Psychopharmacology - March 30, 2019 Category: Psychiatry Tags: Review Source Type: research

High pretreatment cognitive impulsivity predicts response of oppositional symptoms to methylphenidate in patients with attention-deficit hyperactivity disorder/oppositional defiant disorder
The aim of this study was to compare impulsivity levels, as assessed by a continuous performance test (CPT), and the correlations between baseline CPT performance and response to methylphenidate (MPH), as assessed by the conjunctive CPT (CCPT), in children with only Diagnostic and Statistical Manual of Mental Disorders, 5th ed. attention-deficit hyperactivity disorder with no oppositional defiant disorder (ADHD/noODD) or with comorbid ODD (ADHD/ODD). Fifty-three children and adolescents were included in the study (ADHD/noODD group, n = 25, 12 women/13 men and ADHD/ODD group, n = 28, eight females/20 males). Attention was a...
Source: International Clinical Psychopharmacology - March 30, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Association between electroencephalogram changes and plasma clozapine levels in clozapine-treated patients
This retrospective observational study was performed to investigate electroencephalogram abnormalities in clozapine-treated patients with refractory schizophrenia or bipolar disorder. The electroencephalogram and plasma clozapine and norclozapine levels in 71 patients were measured on the same day. Fifty-nine patients (85.9%) had a diagnosis of schizophrenia, and 12 patients (14.1%) had a diagnosis of bipolar disorder. The mean daily clozapine dose was 242.9 ± 105.5 mg (range 25–500 mg), and the mean plasma clozapine and norclozapine levels were 429.4 ± 264.1 an...
Source: International Clinical Psychopharmacology - March 30, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Metabolism of risperidone by CYP2D6 and the presence of drug-induced dopamine supersensitivity psychosis in patients with schizophrenia
High-dose antipsychotic(s) can induce dopamine supersensitivity psychosis in schizophrenia patients. The precise relationship between a drug’s blood concentration and the occurrence of dopamine supersensitivity psychosis has not been established. We divided 36 patients with schizophrenia who had undergone treatment mainly with risperidone into two groups: one with normal metabolizing activity of CYP2D6 (n = 15), and the other with lower activity of its variant, CYP2D6*10 (n = 21). The patients’ blood concentrations of risperidone and 9-OH-risperidone were measured, and we compared th...
Source: International Clinical Psychopharmacology - March 30, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Add-on benzodiazepines for psychosis-induced aggression
We examined aggression, suicidality, and self-harm among psychotic patients treated with antipsychotic monotherapy, compared with those treated with add-on benzodiazepines, during the first 2 weeks of psychiatric hospitalization to clarify the association of add-on benzodiazepines and aggression. Electronic medical records of 400 patients consecutively admitted to Abarbanel Mental Health Center from 2012 to 2014 for psychosis, and remained hospitalized for at least 2 weeks were evaluated. Violence toward staff, patients, and property, physical restraints, seclusion, self-harm, and suicidal thoughts, were examined. Falls an...
Source: International Clinical Psychopharmacology - March 30, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Efficacy of venlafaxine extended release in major depressive disorder patients: effect of baseline anxiety symptom severity
Effects of baseline anxiety on the efficacy of venlafaxine extended release versus placebo were examined in a post hoc pooled subgroup analysis of 1573 patients enrolled in eight short-term studies of major depressive disorder. Anxiety subgroups were defined based on baseline 17-item Hamilton Rating Scale for Depression Item 10 score (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - March 30, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Depression with high levels of anxiety
No abstract available (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - March 30, 2019 Category: Psychiatry Tags: Editorial Source Type: research

Analysis of smoking behavior on the pharmacokinetics of antidepressants and antipsychotics: evidence for the role of alternative pathways apart from CYP1A2
Smoking is common among psychiatric patients and has been shown to accelerate the metabolism of different drugs. We aimed to determine the effect of smoking on the serum concentrations of psychopharmacological drugs in a naturalistic clinical setting. Dose-corrected, steady-state serum concentrations of individual patients were analyzed retrospectively by linear regression including age, sex, and smoking for amitriptyline (n=503), doxepin (n=198), mirtazapine (n=572), venlafaxine (n=534), clozapine (n=106), quetiapine (n=182), and risperidone (n=136). Serum levels of amitriptyline (P=0.038), clozapine (P=0.02), and mirtaza...
Source: International Clinical Psychopharmacology - March 1, 2019 Category: Psychiatry Tags: ORIGINAL ARTICLES Source Type: research

Proinflammatory and anti-inflammatory biomarkers in schizophrenia and influence of simvastatin on the interleukin-6
This study corroborated previous evidence for increased inflammatory biomarkers in SZ and detected a potential anti-inflammatory action of simvastatin in patients with a clinical diagnosis of SZ on clozapine therapy. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - March 1, 2019 Category: Psychiatry Tags: SHORT COMMUNICATIONS Source Type: research

Hyoscine for clozapine-induced hypersalivation: a double-blind, randomized, placebo-controlled cross-over trial
This study aims to examine the efficacy of hyoscine (scopolamine) for clozapine-induced hypersalivation. Fourteen inpatients diagnosed with treatment-resistant schizophrenia, treated with clozapine and suffering from hypersalivation were randomized to receive hyoscine 0.3 mg and placebo daily for 4 weeks each in a randomized, double-blind, placebo-controlled cross-over trial. The primary outcome was improvement in the Toronto Nocturnal Hypersalivation Scale. The secondary outcomes were change in the mass of the pillowcase, anxiety, depression and quality of life. Hypersalivation improved significantly with hyoscine ...
Source: International Clinical Psychopharmacology - February 5, 2019 Category: Psychiatry Tags: ORIGINAL ARTICLES Source Type: research

Analysis of smoking behavior on the pharmacokinetics of antidepressants and antipsychotics: evidence for the role of alternative pathways apart from CYP1A2
Smoking is common among psychiatric patients and has been shown to accelerate the metabolism of different drugs. We aimed to determine the effect of smoking on the serum concentrations of psychopharmacological drugs in a naturalistic clinical setting. Dose-corrected, steady-state serum concentrations of individual patients were analyzed retrospectively by linear regression including age, sex, and smoking for amitriptyline (n=503), doxepin (n=198), mirtazapine (n=572), venlafaxine (n=534), clozapine (n=106), quetiapine (n=182), and risperidone (n=136). Serum levels of amitriptyline (P=0.038), clozapine (P=0.02), and mirtaza...
Source: International Clinical Psychopharmacology - February 5, 2019 Category: Psychiatry Tags: ORIGINAL ARTICLES Source Type: research

Antipsychotics and pituitary tumors: an analysis of the European pharmacovigilance database (EudraVigilance)
One of the possible long-term consequences of antipsychotic-induced hyperprolactinemia is the development of pituitary tumors – prolactinomas. So far, two pharmacovigilance studies of spontaneous adverse event report databases have suggested an increased risk, whereas a longitudinal study carried out with risperidone showed no evidence of increased risk of tumors with mass effect. Besides, information on amisulpride and paliperidone is lacking. Thus, in this study, we aimed to analyze the European pharmacovigilance database (EudraVigilance) to shed light on this issue. We searched for all suspected spontaneous cases ...
Source: International Clinical Psychopharmacology - February 5, 2019 Category: Psychiatry Tags: SHORT COMMUNICATIONS Source Type: research

Proinflammatory and anti-inflammatory biomarkers in schizophrenia and influence of simvastatin on the interleukin-6
This study corroborated previous evidence for increased inflammatory biomarkers in SZ and detected a potential anti-inflammatory action of simvastatin in patients with a clinical diagnosis of SZ on clozapine therapy. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - February 5, 2019 Category: Psychiatry Tags: SHORT COMMUNICATIONS Source Type: research

Long-term safety and tolerability of cariprazine as adjunctive therapy in major depressive disorder
Lack of treatment response is a critical problem in major depressive disorder (MDD). Cariprazine is a D3-preferring dopamine D3/D2 receptor partial agonist and 5-HT1A partial agonist. This phase 3, multicenter, open-label, long-term (26-week), flexible-dose (1.5–4.5 mg/day) study assessed the long-term safety and tolerability of cariprazine used adjunctively with antidepressant therapy in adult patients with MDD who had either completed a lead-in study (n=311) or had been newly recruited (n=131). A higher percentage of continuing patients (66.2%) than new patients (35.9%) completed the study. The most common r...
Source: International Clinical Psychopharmacology - February 5, 2019 Category: Psychiatry Tags: ORIGINAL ARTICLE Source Type: research

Efficacy and acceptability of antidepressants in patients with ischemic heart disease: systematic review and meta-analysis
To assess the efficacy and acceptability of antidepressants in adults with ischemic heart disease (IHD). We gathered all available randomized-controlled trials comparing antidepressants versus placebo or other antidepressants in adults with IHD. The primary outcome was depressive symptoms at the study endpoint, as measured by validated rating scales. We pooled data in a meta-analysis using a random-effects model. The confidence in the estimates (or certainty of the evidence) was assessed using the GRADE approach. Antidepressants appeared to be more effective than placebo in reducing depressive symptoms (11 comparisons; 168...
Source: International Clinical Psychopharmacology - February 5, 2019 Category: Psychiatry Tags: REVIEW ARTICLES Source Type: research

Pharmacological treatment of attention-deficit hyperactivity disorder comorbid with an anxiety disorder: a systematic review
The purpose of this study was to conduct a systematic review of the pharmacological options available to treat patients diagnosed with attention-deficit hyperactivity disorder and anxiety disorder, for generating evidence on the safest, most-effective and tolerable pharmacotherapy. To this end, a systematic search was performed in three electronic databases (Medline, Scopus and Directory of Open Access Journals; December 2017). Randomized, double-blind, parallel-design clinical trials evaluating the efficacy, safety or tolerability of therapies for attention-deficit hyperactivity disorder and anxiety disorder in children a...
Source: International Clinical Psychopharmacology - February 5, 2019 Category: Psychiatry Tags: REVIEW ARTICLES Source Type: research

Long-acting injectable second-generation antipsychotics in first-episode psychosis: a narrative review
Long-acting injectable (LAI) antipsychotics could be a favorable option of treatment and have some advantages over oral medications. The aim of this study was to review the published data on the use of LAI formulation of second-generation antipsychotics (SGA) in first-episode psychosis (FEP). Using PubMed and Scopus databases, we performed a systematic literature search of articles published between 1 January 2000 and 30 April 2018, that reported clinical trials on the use of LAI SGAs in patients with FEP. Seventy-seven articles were considered eligible and full-text revised. Five studies fulfilled the inclusion criteria a...
Source: International Clinical Psychopharmacology - February 5, 2019 Category: Psychiatry Tags: REVIEW ARTICLES Source Type: research

Impact of mental illness on outcomes of outpatients with community-acquired pneumonia
According to the National Alliance on Mental Illness, one in five adults experience a mental health condition yearly. Community-acquired pneumonia (CAP) is often treated with QTc prolonging antibiotics. The primary outcome assessed is if psychiatric diagnosis contributed to treatment failure in CAP. Outpatients with International Statistical Classification of Diseases and Related Health Problems 9 and 10 codes for CAP from January 2008 to January 2018 were analyzed retrospectively by descriptive statistics. Bivariate analysis was used to compare baseline characteristics, treatment regimens, and outcomes between those with ...
Source: International Clinical Psychopharmacology - November 28, 2018 Category: Psychiatry Tags: ORIGINAL ARTICLES Source Type: research

The reliability and validity of a newly developed self-rating functional scale compared with Personal and Social Performance Scale and World Health Organization Disability Assessment Schedule II
A new self-rating functional scale (SRFS) was developed to assess the functionality of patients with schizophrenia, referred to the structure of Personal and Social Performance Scale (PSP). The main aim of this study was to evaluate the reliability and validity of the SRFS. A total of 210 patients with schizophrenia were recruited from outpatient clinics in six sites in China. Demographic information, SRFS, PSP, World Health Organization Disability Assessment Schedule II, and Positive and Negative Syndrome Scale were assessed. Spearman’s correlation coefficient and path analysis were used to assess the reliability an...
Source: International Clinical Psychopharmacology - November 28, 2018 Category: Psychiatry Tags: ORIGINAL ARTICLES Source Type: research

A prospective study of adverse effects of antipsychotics in adolescents with schizophrenia during a 6-month follow-up
There is a paucity of follow-up studies of neurological, endocrine, and metabolic adverse effects of antipsychotics in adolescents from low-income and middle-income countries, who have a higher prevalence of obesity and overweight, and could present increased morbidity. A Mexican sample of 86 adolescents with schizophrenia was examined during a 6-month follow-up using the Simpson–Angus, abnormal involuntary movement and Barnes Akathisia rating scales, in addition to a side effects score sheet and other laboratory measures. Binary logistic regression models were used to identify specific variables as predictors of wei...
Source: International Clinical Psychopharmacology - November 28, 2018 Category: Psychiatry Tags: ORIGINAL ARTICLES Source Type: research

The association between gabapentin and suicidality in bipolar patients
The aims of this study were to assess the association between gabapentin and suicidality in patients diagnosed with bipolar disorder (BD) and to determine whether the risk is greater relative to patients prescribed lithium. This retrospective observational study utilizes US population-based claims data assembled by PharMetrics Inc., comprising 47 918 patients diagnosed with BD. Patients were included if they were at least 18 years old and initiated a new monotherapy prescription of either gabapentin (n=2421) or lithium (n=3101). Patients were followed for up to 1 year. Gabapentin patients contributed 915.8 person-ye...
Source: International Clinical Psychopharmacology - November 28, 2018 Category: Psychiatry Tags: ORIGINAL ARTICLES Source Type: research

Markers of mineralocorticoid receptor function: changes over time and relationship to response in patients with major depression
The renin–angiotensin–aldosterone system and its hormone receptors, i.e. the angiotensin and mineralocorticoid receptor (MR), have emerged as important targets for central nervous system disorders and in particular for major depression. We have recently characterized baseline MR function as a predictor for treatment outcome with standard antidepressants. The aims of this study are (i) to characterize how strongly an early biomarker change (after 2 weeks) is related to outcome and (ii) whether these biomarker changes are related to the final outcome, that is, could serve as surrogate markers for response. Twenty...
Source: International Clinical Psychopharmacology - November 28, 2018 Category: Psychiatry Tags: ORIGINAL ARTICLES Source Type: research

The effect of selective serotonin reuptake inhibitors on major adverse cardiovascular events: a meta-analysis of randomized-controlled studies in depression
It has been reported that selective serotonin reuptake inhibitors (SSRIs) might induce major adverse cardiovascular events (MACE), but the association between the use of SSRIs and MACE has not been elucidated as yet. Therefore, the aim of this study was to evaluate the association between the use of SSRIs and MACE in depressed patients with previous cardiovascular events. Two researchers independently selected randomized-controlled studies (RCTs) according to the predefined inclusion criteria and evaluated the quality of articles. A quantitative analysis was carried out to estimate pooled risk ratios (RRs) for the associat...
Source: International Clinical Psychopharmacology - November 28, 2018 Category: Psychiatry Tags: REVIEW ARTICLES Source Type: research

The risk factors, frequency and diagnosis of atypical antipsychotic drug-induced hypothermia: practical advice for doctors
Hypothermia is unpredictable and life-threatening adverse effect of atypical antipsychotic drug (APD) treatment, which has been little described. The aim of this article is to increase the awareness that hypothermia induced by APD drugs is more common than the current published case reports may suggest, and risk factors increase its development. Moreover, valuable guidelines regarding how to detect the early stages of hypothermia in clinical practice are included. A literature search for reports on APD-induced hypothermia in PubMed, Academic Search Complete, Medline Complete and eHealthMe databases was conducted. The liter...
Source: International Clinical Psychopharmacology - November 28, 2018 Category: Psychiatry Tags: REVIEW ARTICLES Source Type: research

Pharmacological treatment of sexual offenders in German outpatient treatment centers
In Germany, depending on a sexual offender’s culpability and the severity of the offence, he/she can be placed either in the forensic-psychiatric or the correctional system. Numbers related to the pharmacological treatment of sexual offenders for the correctional system are missing so far. In sexual offenders, the pharmacological treatment of paraphilic disorders is of special importance. The present study aimed at assessing the prevalence of pharmacological sexual offender treatment in German outpatient treatment centers supervising mainly clients from the correctional sector. An online questionnaire was sent to 112...
Source: International Clinical Psychopharmacology - October 5, 2018 Category: Psychiatry Tags: Short Communication Source Type: research

Optimal treatment for obsessive compulsive disorder: a randomized controlled feasibility study of the clinical-effectiveness and cost-effectiveness of cognitive-behavioural therapy, selective serotonin reuptake inhibitors and their combination in the management of obsessive compulsive disorder
Established treatments for obsessive compulsive disorder (OCD) include cognitive behaviour therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication. Combined treatment may outperform monotherapy, but few studies have investigated this. A total of 49 community-based adults with OCD were randomly assigned to CBT, SSRI, or SSRI+CBT. Sertraline (50–200 mg/day) was given as the SSRI for 52 weeks. A 16-h-manualized individual CBT was delivered over 8 weeks with four follow-up sessions. Assessors were ‘blinded’ to treatment allocation. A preliminary health economic evaluation was conduct...
Source: International Clinical Psychopharmacology - October 5, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

The effect of methylphenidate treatment on psychopathic behavior of patients having attention-deficit hyperactivity disorder with and without oppositional defiant disorder
To evaluate the effect of 3 months of methylphenidate (MPH) treatment on psychopathic behavior in children having attention-deficit hyperactivity disorder (ADHD) with and without comorbid oppositional defiant disorder (ODD). Twenty-seven children with Diagnostic and Statistical Manual of Mental Disorders, fifth ed., ADHD (13 female/14 male; aged 13.3±2.2 years old) were compared to an age/sex matched ADHD/ODD group (N=27, eight female/19 male; aged 11.8±1.9 years). The attention-deficit hyperactivity disorder rating scale (ADHD-RS) and the California Child Q-Set (CCQ) were used in both groups before MPH treat...
Source: International Clinical Psychopharmacology - October 5, 2018 Category: Psychiatry Tags: Original Articles Source Type: research