Eosinophilic pneumonia during treatment with clozapine: reports from a retrospective case series
Clozapine is an atypical antipsychotic known to cause multiple hematologic abnormalities, most seriously agranulocytosis, but also notably eosinophilia. It is considered as an allergic reaction with a spontaneous remission, however, sometimes, it may predict subsequent major inflammatory complications. The aim of this study was to investigate the relationship between clozapine usage and drug-induced pneumonia based on characteristic respiratory symptoms and radiological findings, retrospectively in 69 Japanese treatment-resistant schizophrenia patients. Comparisons of the 26 weeks consecutive levels: white blood cell count...
Source: International Clinical Psychopharmacology - July 31, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Patterns of pharmacological treatment of patients with migraine, tension-type headache, and cluster headache in a large group of patients in Colombia, 2019
The objective was to determine the pharmacological treatment patterns of headache disorders in a Colombian population. Cross-sectional study. The dispensations of drugs for the management of tension-type headache, migraine, and cluster headache in the first trimester of 2019 were reviewed from a national medication dispensing database. Sociodemographic, diagnostic, and treatment variables (acute or prophylactic; concomitant drugs) were analyzed. During the study period, 7450 patients were identified: 68.5% with migraine, 25.1% with tension-type headache, and 6.4% with cluster headache. A total of 79.7% (n = 5...
Source: International Clinical Psychopharmacology - July 31, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Benzodiazepine exposure in subjects with incident Alzheimer’s disease and related syndromes in France: a longitudinal study 2011–2017
Benzodiazepines are commonly used for behavioral and psychiatric symptoms of dementia, despite their numerous adverse effects and the lack of evidence regarding their efficacy in this context. We studied longitudinal benzodiazepines exposure in incident cases of Alzheimer’s disease and related syndromes (ADRS) in France. We used a cohort of incident ADRS patients identified in 2012 within the national health data system. Benzodiazepines exposure was measured 1 year before, to 5 years after ADRS identification. Quarterly benzodiazepines prevalence and incidence were computed. We identified factors associ...
Source: International Clinical Psychopharmacology - July 31, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Predictors of 1-year rehospitalization in inpatients with bipolar I disorder treated with atypical antipsychotics
The objective of study is to explore predictors of 1-year rehospitalization in patients with bipolar I disorder treated with AAP. A retrospective chart review on inpatients with bipolar I disorder was conducted. All participants were followed up for 1 year, and they were subdivided into three AAP treatment groups (olanzapine, risperidone, and quetiapine group). Kaplan–Meier survival analysis was implemented to detect time to rehospitalization due to any mood episodes within 1 year after discharge. Cox proportional regression model was adopted to find predictors of 1-year hospitalization in patients who ...
Source: International Clinical Psychopharmacology - July 31, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

5-Hydroxytryptophan as adjuvant therapy in treatment of moderate to severe obsessive-compulsive disorder: a double-blind randomized trial with placebo control
On the basis of numerous previous studies, the serotonergic system plays a role in the pathogenesis of obsessive-compulsive disorder (OCD) and effective agents in this pathway, such as 5-hydroxytryptophan, can potentially contribute to treatment of patients with this disorder. Evaluating the efficacy of 5-hydroxytryptophan in treating OCD was the aim of the present randomized, double-blind, placebo-controlled 12-week trial. In a 12-week, randomized double-blind study, 60 patients with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of moderate to severe OCD and a Yale–Brown Obsessive ...
Source: International Clinical Psychopharmacology - July 31, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Understanding the effects of chronic benzodiazepine use in depression: a focus on neuropharmacology
Benzodiazepines are frequently prescribed on an ongoing basis to individuals with depression, mainly to alleviate anxiety or insomnia, despite current guideline recommendations that continuous use should not exceed 4 weeks. Currently, there are no efficacy trials published beyond 8 weeks. Several antidepressant trials demonstrate that the concomitant use of a benzodiazepine is associated with poorer depressive outcomes and functional status; however, it is unclear why this is the case. Patients with depression receiving a benzodiazepine may reflect a more ill or high anxiety group, although even within anxiet...
Source: International Clinical Psychopharmacology - July 31, 2020 Category: Psychiatry Tags: Review Articles Source Type: research

Genetics and major depressive disorder: clinical implications for disease risk, prognosis and treatment
In the post-genomic era, genetics has led to limited clinical applications in the diagnosis and treatment of major depressive disorder (MDD). Variants in genes coding for cytochrome enzymes are included in guidelines for assisting in antidepressant choice and dosing, but there are no recommendations involving genes responsible for antidepressant pharmacodynamics and no consensus applications for guiding diagnosis or prognosis. However, genetics has contributed to a better understanding of MDD pathogenesis and the mechanisms of antidepressant action, also thanks to recent methodological innovations that overcome the challen...
Source: International Clinical Psychopharmacology - July 31, 2020 Category: Psychiatry Tags: Review Articles Source Type: research

Effect of N-acetylcysteine on clozapine-induced sialorrhea in schizophrenic patients: a case series
Clozapine is an atypical antipsychotic demonstrated to be superior in the treatment of refractory schizophrenia. Despite all this effectiveness, it has side effects that can be serious and bothersome. Sialorrhea is the most common adverse drug reaction that occurs during clozapine treatment. It is usually persistent, may impair the patient’s quality of life and reduce treatment compliance. However, there is limited evidence to guide possible treatment strategies for sialorrhea. N-Acetylcysteine (NAC) is a powerful antioxidant. It acts directly as a scavenger of free radicals, in particular oxygen radicals. The antiox...
Source: International Clinical Psychopharmacology - June 1, 2020 Category: Psychiatry Tags: Case Report Source Type: research

Impact of early use of long-acting injectable antipsychotics on psychotic relapses and hospitalizations in first-episode psychosis
This study describes the impact of early LAI-AP utilization on relapse and rehospitalization rates in FEP. A three-year, longitudinal, prospective, naturalistic study of all admissions of psychosis patients for early intervention services was conducted. Four hundred sixteen patients were subdivided into four groups according to the route of antipsychotic administration. Patients who received LAI-AP as their first treatment modality were more likely to exhibit poor prognostic factors at baseline. However, their relapse rate over time was similar to those with good prognostic factors at baseline who only received oral antips...
Source: International Clinical Psychopharmacology - June 1, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Clinical correlates of paliperidone palmitate and aripiprazole monohydrate prescription for subjects with schizophrenia-spectrum disorders: findings from the STAR Network Depot Study
This study, based on the ‘Servizi Territoriali Associati per la Ricerca’ (STAR) Network Depot Study nationwide baseline data, explored whether individual symptoms severity and clusters might influence the prescription of paliperidone palmitate 1-month (PP1M) vs. aripiprazole monohydrate. The Brief Psychiatric Rating Scale (BPRS) was used to assess psychopathology and relevant symptoms clusters. Drug Attitude Inventory, 10 items, was used to test attitude towards medications. Adherence to treatments was rated according to the Kemp seven-point scale. We assessed for eligibility 451 individuals and, among them, we...
Source: International Clinical Psychopharmacology - June 1, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Low levels of serum vitamin D in clozapine-treated schizophrenia patients are associated with high levels of the proinflammatory cytokine IL-6
Low levels of vitamin D are prevalent among patients with schizophrenia and have been linked to the risk and outcome of the disorder. Vitamin D has a regulatory effect on the inflammatory system, which is dysfunctional in schizophrenia. We investigated the association between serum vitamin D levels, inflammatory status, and severity of schizophrenia symptoms. A total of 39 clozapine-treated schizophrenia patients were recruited to the study. Blood samples for biochemical analysis were collected from all participants. Serum levels of vitamin D and cytokines (IL-4, IL-6, IL-10, and TNF-α) were analyzed and the associat...
Source: International Clinical Psychopharmacology - June 1, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

The association of antidepressant monotherapy and weight change in a Middle Eastern psychiatric population
Genetic and lifestyle factors influence weight changes secondary to antidepressants. However, the association between antidepressants and weight changes is seldom studied in Middle Eastern populations who have a unique genetic, lifestyle and dietary profile. This is a chart-based retrospective longitudinal study that describes the 6-month evolution of weight in outpatient Lebanese adults initiated on serotonin reuptake inhibitor (SRI) antidepressant monotherapy, with the exclusion of confounders with metabolic implications. A linear mixed model was used to estimate the association of weight with time. Demographic factors w...
Source: International Clinical Psychopharmacology - June 1, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

A personal account of reducing and stopping antidepressant treatment
Having responded well to an antidepressant I was determined to continue treatment for 6 months, to increase the probability of a full and lasting recovery. My productivity at work and confidence in social situations increased and it seemed easier to talk about emotional matters. Side effects became gradually less bothersome, though at times I was somewhat apathetic. Escitalopram may have helped to reduce long-standing back pain and niggly acoustic problems. Some symptoms appeared whilst I reduced the antidepressant dosage steadily: these were mild and resolved swiftly, but a few were quite puzzling. I hope this experience ...
Source: International Clinical Psychopharmacology - June 1, 2020 Category: Psychiatry Tags: Review Articles Source Type: research

Clinical advances in obsessive-compulsive disorder: a position statement by the International College of Obsessive-Compulsive Spectrum Disorders
In this position statement, developed by The International College of Obsessive-Compulsive Spectrum Disorders, a group of international experts responds to recent developments in the evidence-based management of obsessive-compulsive disorder (OCD). The article presents those selected therapeutic advances judged to be of utmost relevance to the treatment of OCD, based on new and emerging evidence from clinical and translational science. Areas covered include refinement in the methods of clinical assessment, the importance of early intervention based on new staging models and the need to provide sustained well-being involvin...
Source: International Clinical Psychopharmacology - June 1, 2020 Category: Psychiatry Tags: Review Articles Source Type: research

Clozapine induced neutropenia, onset after 6 years of treatment: a case report
No abstract available (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - March 28, 2020 Category: Psychiatry Tags: Case Report Source Type: research

Switching from clozapine to paliperidone palmitate-3-monthly improved obesity, hyperglycemia and dyslipidemia lowering antipsychotic dose equivalents in a treatment-resistant schizophrenia cohort
Clozapine, an antipsychotic developed in 1958, is considered the gold standard and the treatment of choice in treatment-resistant schizophrenia despite its side effects and despite 40–70% of these patients not responding to clozapine. In the last decade, new antipsychotics, such as paliperidone palmitate (PP), have emerged as well as its long acting-injectable (LAI) formulations, available as PP-1-monthly (PP1M) and the newest PP-3-montlhy (PP3M). Despite paliperidone having shown a similar efficacy as others antipsychotics for the treatment of schizophrenia, and that PP3M has been shown to reduce relapses compared t...
Source: International Clinical Psychopharmacology - March 28, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Estimation of lithium clearance in patients with bipolar disorder
Lithium is an effective agent approved for the treatment of bipolar disorder. It has narrow therapeutic window and significant variability in its pharmacokinetic. The aim of this study is to determine the population pharmacokinetics of lithium in patients with bipolar disorder in Saudi Arabia and to identify the factors that explain variability. A retrospective chart review was performed on patients with bipolar disorder who received oral lithium. The population pharmacokinetic models were developed using Monolix 4.4. After the appropriate base model was established, five covariates were tested, namely age, sex, weight, se...
Source: International Clinical Psychopharmacology - March 28, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Evaluation of cariprazine in the treatment of bipolar I and II depression: a randomized, double-blind, placebo-controlled, phase 2 trial
This double-blind placebo-controlled, fixed/flexible-dose phase 2 trial assessed the efficacy, safety, and tolerability of cariprazine vs. placebo for depressive episodes associated with bipolar I or II disorder. Primary endpoint was change in Montgomery–Åsberg Depression Rating Scale (MADRS) total scores (baseline to week 8), and secondary endpoint was mean Clinical Global Impressions-Improvement score (week 8). Patients were randomized (N = 233) 1:1:1 to placebo, ‘low-dose’ 0.25–0.5 mg/day or ‘high-dose’ 1.5–3.0 mg/day cariprazine. Adverse events...
Source: International Clinical Psychopharmacology - March 28, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

A randomized, double-blind study comparing the efficacy and safety of trazodone once-a-day and venlafaxine extended-release for the treatment of patients with major depressive disorder
This study confirmed that both venlafaxine XR and trazodone OAD may represent a valid treatment option for patients with MDD. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - March 28, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

A systematic review of studies with clinician-rated scales on the pharmacological treatment of delusional disorder
To collect the best available evidence and to compare the first-generation antipsychotics (FGAs) vs. the second-generation antipsychotics (SGAs) in the treatment of delusional disorder (DD). Systematic review including studies evaluating treatment response in DD using clinician-rated scales appearing in PubMed and Web of Science databases from inception till September 2019. Those studies meeting inclusion criteria were selected. Outcomes were summarized into two response categories: (1) response to treatment equal to or greater than 50% and (2) response less than 50%. Biases and quality of the studies were evaluated, and r...
Source: International Clinical Psychopharmacology - March 28, 2020 Category: Psychiatry Tags: Review Articles Source Type: research

Efficacy and safety of brexpiprazole in acute management of psychiatric disorders: a meta-analysis of randomized controlled trials
Brexpiprazole is a new atypical antipsychotic for schizophrenia management and as adjunct in major depressive disorder (MDD). We searched randomized controlled trials (RCT) to review brexpiprazole efficacy and tolerability in acute management of schizophrenia and MDD using PubMed, EUDRACT, ClinicalTrials.gov and Cochrane Central Register of Controlled Trials. A meta-analysis was conducted using the identified 14 RCT to assess its efficacy using positive and negative syndrome scale (PANSS), clinical global impressions – severity of illness (CGI-S), personal and social performance scale (PSP), Montgomery–Ås...
Source: International Clinical Psychopharmacology - March 28, 2020 Category: Psychiatry Tags: Review Articles Source Type: research

Rapid improvement of obsessive-compulsive disorder associated with schizophrenia with cariprazine add-on in a subject under paliperidone long-acting injection: a case report
Obsessive-compulsive disorder is often associated with schizophrenia and may represent a significant challenge in the treatment as this comorbidity may not respond properly to antipsychotic medication and usually require a pharmacological and psychotherapeutic add-on. In the present case report, we present the case of a 26-year-old male blue-collar subject who developed obsessive-compulsive disorder after a year of complete remission of schizophrenia symptoms under paliperidone long-acting injection that rapidly resolved after low-dosage cariprazine add-on. No adverse effects were reported due to cariprazine- paliperidone ...
Source: International Clinical Psychopharmacology - January 31, 2020 Category: Psychiatry Tags: Case Report Source Type: research

Effects of medications on ventricular repolarization in children with attention deficit hyperactivity disorder
Attention deficit hyperactivity disorder (ADHD) is a multifactorial neurodevelopmental disorder that manifests during childhood. Methylphenidate (MPH), which is a psychostimulant drug, has been often prescribed for the treatment of ADHD in patients. It may increase the risk of fatal arrhythmias by impairing ventricular repolarization. Indicators of ventricular repolarization in ECG are intervals of QT, corrected QT (QTc), QT dispersion (QTd), T-peak to T-end (Tp-e), and Tp-Te/QTc ratio. We aimed to determine ventricular repolarization findings before and after MPH drug therapy in children with ADHD. The study retrospective...
Source: International Clinical Psychopharmacology - January 31, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Poor performance of the ‘child Reading the Mind in the Eyes Test’ correlates with poorer social-emotional functioning in children with attention-deficit/hyperactivity disorder
The performance of the ‘child Reading the Mind in the Eyes Test’ (cRMET), a measure of Theory of Mind (ToM), was assessed in children with attention-deficit/hyperactivity disorder (ADHD) with relation to social-emotional functioning and ADHD severity. The impact of a single dose of methylphenidate on cRMET performance was evaluated. A group of 25 children aged 7–17 years diagnosed with ADHD were assessed at baseline by cRMET, the Strengths and Difficulties Questionnaire (SDQ) and the ADHD-rating scale. cRMET assessment was repeated after administration of a single dose of methylphenidate. Significant corr...
Source: International Clinical Psychopharmacology - January 31, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Association between previous high-dose antipsychotic therapy and brexpiprazole discontinuation after the initiation of brexpiprazole in patients with schizophrenia or schizoaffective disorder
The objective of this study was to identify the factors associated with brexpiprazole discontinuation after initiating brexpiprazole in patients with schizophrenia or schizoaffective disorder. All patients with schizophrenia or schizoaffective disorder who were started on brexpiprazole in our institution between May 2018 and April 2019 were retrospectively screened. The continuation rate of brexpiprazole during a follow-up period of 16 weeks was examined. Multivariate Cox regression analysis was conducted to identify predictors of brexpiprazole discontinuation. During the follow-up period, 52 out of 120 patients (43.4%) di...
Source: International Clinical Psychopharmacology - January 31, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Plasma levels of 3-methoxy-4-hydroxyphenylglycol levels, number of hospitalization and cognitive function predicts the cognitive effect of atypical antipsychotic monotherapy in patients with acute schizophrenia
Although the effects of atypical antipsychotics with regard to improving neurocognitive function are not sufficiently high. The present study applied an atypical antipsychotic monotherapy for patients with acute schizophrenia to (1) examine the percentage of patients who respond well to this treatment, (2) explore the factors that predict response (e.g. the improvement of neurocognition), and (3) identify the factors associated with improved neurocognitive function. We studied 40 patients with acute schizophrenia who had received atypical antipsychotic monotherapy for 24 weeks. The following parameters were evaluated at ba...
Source: International Clinical Psychopharmacology - January 31, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Efficacy of melatonin as an adjunct in the treatment of acute mania: a double-blind and placebo-controlled trial
This is a double-blind, placebo-controlled, parallel-grouped clinical trial, which was designed to investigate the potential effects of melatonin add-on treatment with lithium and risperidone on acute manic episodes in patients with bipolar disorder (BD). A total of 54 patients were included and randomly assigned into two groups of melatonin and placebo. The trial group received 3 mg/day risperidone, 900 mg/day lithium, and 6 mg/day melatonin. The placebo group received the same dose of risperidone and lithium plus placebo. The participants were evaluated at four sessions, consisting of baseline, weeks 1, 4, and 6. The man...
Source: International Clinical Psychopharmacology - January 31, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Comorbid personality disorders in manic bipolar I disorder patients is associated with increased use of long-acting injectable antipsychotic treatment and higher rates of rehospitalization
In conclusion, comorbid personality disorder in manic bipolar disorder-I patients is associated with increased use of long-acting injectable antipsychotics and higher rates of rehospitalization. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - January 31, 2020 Category: Psychiatry Tags: Original Articles Source Type: research

Ophthalmic adverse effects of lithium
Lithium is the current mainstay treatment for both acute and maintenance management of bipolar disorders. However, its narrow therapeutic index and array of side effects, although well-documented, can be challenging to manage. Comparatively, the side effects of lithium that involve the ophthalmic structures are not as well established in the literature and only partially appreciated, which can potentially lead to noncompliance. In this article, an extensive literature review of lithium and its ophthalmic adverse effects were performed and comprehensively summarized. Based on the search, documented ophthalmic adverse effect...
Source: International Clinical Psychopharmacology - January 31, 2020 Category: Psychiatry Tags: Review Articles Source Type: research

mHealth in affective disorders: hype or hope? A focused narrative review
The constant growth and widespread availability of mobile technologies (i.e. smartphones and wearables) over the last decades have been a subject of intense interest and research in the affective disorders (AD) field. The potential of mHealth for collecting a new kind of passive and active information while providing cost-effective and tailored interventions have raised many hopes. However, until now, despite some encouraging results, research in the field has not been translated to reach real-world clinical settings or to develop additional evidence-based mHealth tools for people suffering from AD. Meanwhile, commercial u...
Source: International Clinical Psychopharmacology - January 31, 2020 Category: Psychiatry Tags: Review Articles Source Type: research

Cytochrome P450-mediated inhibition of venlafaxine metabolism by trimipramine: Erratum
No abstract available (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - December 3, 2019 Category: Psychiatry Tags: Erratum Source Type: research

Antipsychotic use in Northern Italian inter-episode bipolar disorder patients: considering both second- and first-generation agents
Evidence supports increasing antipsychotic use in bipolar disorder, especially second-generation antipsychotics. However, data regarding first-generation antipsychotic contemporary use are limited. We studied 380 Northern Italian bipolar disorder inter-episode patients, grouped according to current antipsychotic use, stratified by bipolar subtype (BDI vs. BDII). Furthermore, we compared first-generation antipsychotic users vs. non-users. In our sample (n = 357), 81.8% were taking antipsychotics (74% second-generation antipsychotics, 24.1% first-generation antipsychotics), with antipsychotic use in BDI significantly more pr...
Source: International Clinical Psychopharmacology - December 3, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Sexual dysfunction in tramadol hydrochloride use disorder male patients: a case-control study
Evidence suggests that opioids can modulate gonadal function, with consequent decreased release of sex hormones. We attempted to investigate the sexual function of males using tramadol hydrochloride (HCL) and its relationship to levels of free testosterone, luteinizing hormone, and follicle stimulating hormone, and to compare them with heroin use disorder patients and healthy controls. Our sample consisted of 60 opiate use disorder patients (assessed by Structured Clinical Interview for DSM-IV Axis I) (30 heroin and 30 tramadol) and 30 healthy controls. Sexual dysfunction was assessed using the International Index of Erect...
Source: International Clinical Psychopharmacology - December 3, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Use of cardiovascular and antidiabetic drugs before and after starting with clozapine versus other antipsychotic drugs: a Dutch database study
Reports of decreased mortality among patients with schizophrenia who use clozapine may be biased if clozapine is prescribed to relatively healthy patients and if intensive monitoring during its use prevents (under-treatment of) somatic disorder. We aimed to assess whether there is a difference in: (1) somatic comorbidity between patients who start with clozapine and those who start with other antipsychotics and (2) prescribed somatic medication, between patients using clozapine and those using olanzapine. Cohort study based on insurance claims (2010–2015). After selecting new users of antipsychotics and those who sub...
Source: International Clinical Psychopharmacology - December 3, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Effects of Passiflora incarnata Linnaeus on polysomnographic sleep parameters in subjects with insomnia disorder: a double-blind randomized placebo-controlled study
The purpose of the present double-blind randomized placebo-controlled clinical study was to investigate the effects of Passionflower on polysomnographic sleep parameters in subjects with insomnia disorder. A total number 110 adult participants (mean age = 40.47 ± 11.68, Female = 53.6%) met the inclusion criteria of insomnia disorder according to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). After randomization, patients received either the Passionflower extract or the placebo for 2 weeks. Patients underwent an overnight polysomnography and complet...
Source: International Clinical Psychopharmacology - December 3, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

OnabotulinumtoxinA for the treatment of major depressive disorder: a phase 2 randomized, double-blind, placebo-controlled trial in adult females
This 24-week double-blind placebo-controlled multicenter randomized phase 2 trial evaluated efficacy and safety of onabotulinumtoxinA (onabotA; BOTOX) vs. placebo for major depressive disorder (MDD) [NCT02116361]. Primary endpoint was the change in Montgomery-Åsberg Depression Rating Scale (MADRS); secondary endpoints were Clinical Global Impressions-Severity and 17-item Hamilton Depression Rating Scale at week 6. A total of 255 adult females were treated. OnabotA 30 U approached significance compared to placebo on MADRS (mixed-effect model repeated measures least-squares mean difference: −3.7; P = 0.053) and r...
Source: International Clinical Psychopharmacology - December 3, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Differential core pharmacotherapy in bipolar I versus bipolar II disorder and European versus American patients not in a syndromal episode
Assess bipolar disorder subtype and treatment location effects on bipolar disorder core pharmacotherapy. Outpatients not in a syndromal episode referred to the University of Milan and Stanford University Bipolar Disorder Clinics were assessed with SCID for the fourth Edition of the Diagnostic and Statistical Manual of Mood Disorders, and the Systematic Treatment Enhancement Program for Bipolar Disorder Affective Disorders Evaluation, respectively. Prevalence and clinical correlates of antidepressant, antipsychotic, and mood stabilizer use, in aggregate and individually, were compared in bipolar I (BDI) versus II (BDII) pat...
Source: International Clinical Psychopharmacology - December 3, 2019 Category: Psychiatry Tags: Original Articles Source Type: research

Safety of traditional medicine and natural product supplements in psychiatry
Traditional medicines in the form of health food and supplements are highly popular nowadays. They are often aggressively promoted with unsubstantiated health benefit claims. Patients suffering from chronic illness, such as psychiatric disorders may be attracted to these products and use them concurrently with their prescribed drugs. The potential danger of these health supplements and traditional medicines containing products have prompted repeated warnings by the US Food and Drug Administration in recent years. A new initiative by the Food and Drug Administration in 2019 was also implemented to strengthen the oversight o...
Source: International Clinical Psychopharmacology - December 3, 2019 Category: Psychiatry Tags: Review Article Source Type: research

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