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Examining prescriber perceptions of statin therapy and the potential implications these perceptions may have on guideline adherence
This study aims to determine prescribers’ perceptions of recent cholesterol treatment guidelines, and whether their prescribing may be influenced by recent, potentially oversimplified headlines in the media. (Source: International Clinical Psychopharmacology)
Source: International Clinical Psychopharmacology - July 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

Continuity of treatment with benzodiazepines in dementia patients: an analysis of German health insurance claims data
Long-term treatment with benzodiazepines (BZD) should be avoided in dementia patients because of an increased risk of adverse events. We evaluated how continuously dementia patients were prescribed BZD over 12 months. For this observational study, we used claims data from a large German public sickness fund for 2014 and 2015, including patients with an incident diagnosis of dementia in 2014. The aim was to evaluate the continuity of treatment, the frequency of BZD prescriptions and defined daily doses were evaluated. In total, 1298 (5.6%) patients received 4.7±5.2 BZD prescriptions in 2015 on average. Thereof, lorazepam (...
Source: International Clinical Psychopharmacology - July 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

A review and study of aspirin utilization for the primary prevention of cardiovascular events in a psychiatric population
This study examined how current prescribing practices of aspirin in a state psychiatric hospital align with these new guidelines and how inappropriate prescribing may jeopardize patient safety. A retrospective chart review of 93 patients was performed to evaluate whether aspirin therapy would be recommended for primary prevention of CVD based on the new USPSTF guidelines. A secondary analysis of these data was performed using the 2009 USPSTF recommendations to strengthen the assumption that practitioners were no longer using the old guidelines. Drug interactions between aspirin and concurrently prescribed pharmacotherapy w...
Source: International Clinical Psychopharmacology - July 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

A pilot, open-label, 8-week study evaluating desvenlafaxine for treatment of major depression in methadone-maintained individuals with opioid use disorder
This study sought to assess feasibility and tolerability of using DESV in depressed patients on MMT. A total of 18 depressed individuals on MMT received DESV (50–100 mg/day) for 8 weeks. Participants were assessed for the following: (a) Safety of DESV using Systematic Assessment for Treatment Emergent Events-GI, ECG [corrected Q-T (QTc) interval measurement] and methadone serum levels; (b) depressive symptoms using Montgomery–Äsberg Depression Rating Scale (MADRS); and (c) other outcomes including anxiety, suicidality, craving, substance use, quality of life, and other depression scales. Registration number on Clini...
Source: International Clinical Psychopharmacology - July 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

A systematic review of the operational definitions for antipsychotic response in delusional disorder
This review aimed to examine and analyse the definitions used for antipsychotic response in delusional disorder (DD) and to provide a discussion of the methodology used. A systematic review was performed using the PubMed, Scopus and PsycINFO databases (1990–October 2017) according to the PRISMA statement. In addition, reference searches were performed manually through identified studies to obtain other relevant articles. The search terms included ‘antipsychotic response’, ‘antipsychotics’, ‘treatment response’ and ‘delusional disorder’. After the screening and selection processes, 11 studies fulfilled our...
Source: International Clinical Psychopharmacology - July 31, 2018 Category: Psychiatry Tags: Review Article Source Type: research

The effects of brexpiprazole and aripiprazole on body weight as monotherapy in patients with schizophrenia and as adjunctive treatment in patients with major depressive disorder: an analysis of short-term and long-term studies
The aim of this analysis was to explore the effects of brexpiprazole and aripiprazole on body weight when used as monotherapy to treat schizophrenia and as adjunctive treatment to antidepressant treatment (ADT) for major depressive disorder (MDD) in short-term (4/6 weeks) and long-term (≤52 weeks) studies. Body weight data were obtained from the clinical studies of each drug (brexpiprazole and aripiprazole), in schizophrenia and adjunctive treatment of MDD. Data were pooled and analyzed to assess the mean change in body weight and to determine the incidence of a clinically relevant change in body weight from baseline (â‰...
Source: International Clinical Psychopharmacology - July 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

Effects of anxiety on suicidal ideation: exploratory analysis of a paroxetine versus bupropion randomized trial
This study explored whether anxiety predicts suicidal ideation in depressed individuals treated with paroxetine or bupropion. An 8-week double-blind trial comparing controlled-release paroxetine (N=36) versus extended-release bupropion (N=38) for effect on suicidal ideation and behavior in depressed patients with suicidal ideation, past attempt, or both found an advantage for paroxetine, but anxiety effects were not investigated. This secondary analysis explored the relationship, measured at baseline and weekly, of anxiety with suicidal ideation. Anxiety severity measured weekly correlated with suicidal ideation severity i...
Source: International Clinical Psychopharmacology - July 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

The conundrum of depression clinical trials: one size does not fit all
In this paper we review the history of antidepressant (AD) development, since the discovery of imipramine in 1957 to the present day. Through this exploration we will show that the increasing placebo response is likely a red herring and that a higher magnitude of placebo response is not an adequate explanation for AD trials’ high failure rates. As a better explanation for their lack of success, we will examine some of the fundamental flaws of AD clinical trials and their origins in historical forces. We focus on underpowering, which occurs as a consequence of unrealistic expectations for AD performance. In addition, we d...
Source: International Clinical Psychopharmacology - July 31, 2018 Category: Psychiatry Tags: Review Article Source Type: research

The effect of methylphenidate on decision making in patients with borderline personality disorder and attention-deficit/hyperactivity disorder
Impaired decision making in patients with borderline personality disorder (BPD) has been reported in several studies. Although methylphenidate (MPH) is known to ameliorate impaired decision making in patients with attention-deficit/hyperactivity disorder (ADHD), it has not yet been examined in patients with BPD. We therefore assessed the efficacy of a single dose of MPH on cognitive functions and decision making in patients with BPD. Twenty-two patients diagnosed with BPD participated in the study. The study was a randomized, double-blind placebo-controlled, random block order cross-over trial. Patients participated in two...
Source: International Clinical Psychopharmacology - May 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

Effectiveness of parental training, methylphenidate treatment, and their combination on academic achievements and behavior at school of children with attention-deficit hyperactivity disorder
This study aimed to compare the effectiveness of parental training (PT), methylphenidate treatment (MPH), and the combination of PT and MPH treatment (PT/MPH) on school achievements in children with attention-deficit hyperactivity disorder (ADHD). Twenty eight ADHD patients (age: 10.1±1.11 years) were divided into three groups: (a) PT (N=10), (b) PT/MPH (N=8), and (c) MPH alone (N=10). Their grades in academics and conduct, from their school reports before and after treatment (6 months), were coded as achievement scores. No significant differences in baseline academic and conduct scores were found between the groups (F=0....
Source: International Clinical Psychopharmacology - May 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

Mineralocorticoid receptor-related markers and outcome of major depression: focus on blood pressure and electrolytes
A close association between vegetative regulation and affect is common knowledge. Recently, the role of aldosterone and the activity of its receptor [mineralocorticoid receptor (MR)] in the clinical outcome for treatment with standard antidepressants has been shown including low systolic blood pressure and a low concentration of plasma sodium (Na+), both of which appear to be related to therapy resistance to standard antidepressants. We carried out a retrospective analysis of a double-blind placebo-controlled trial of St John’s wort extract LI160 in 247 outpatients with major depression. The study did not show a differen...
Source: International Clinical Psychopharmacology - May 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

Vilazodone efficacy in subgroups of patients with major depressive disorder: a post-hoc analysis of four randomized, double-blind, placebo-controlled trials
The efficacy of antidepressants to treat major depressive disorder (MDD) varies by patient characteristics. This post-hoc analysis evaluated the effects of vilazodone across patient subgroups in adults with MDD. Data were pooled from four trials of vilazodone (NCT00285376, NCT00683592, NCT01473394, and NCT01473381). Mean change from baseline to week 8 in Montgomery-Åsberg Depression Rating Scale (MADRS) total score, MADRS response (≥50% total score improvement), and MADRS remission (total score≤10) were analyzed in the pooled intent-to-treat population (vilazodone=1254, placebo=964) and in subgroups of patients catego...
Source: International Clinical Psychopharmacology - May 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

Methodological challenges in indirect treatment comparisons: spotlight on a recent comparison of long-acting injectable aripiprazole versus paliperidone palmitate in the treatment of schizophrenia
In a recent study, an indirect treatment comparison was performed to examine the relative efficacy and tolerability of aripiprazole once monthly and paliperidone palmitate once monthly. The authors concluded that the results may suggest relative advantages for aripiprazole once monthly over paliperidone palmitate once monthly in the short-term treatment of schizophrenia. However, the validity of the study is compromised as an indirect treatment comparison using extant data may violate important assumptions. Other methodological issues identified further highlight the challenges of performing indirect treatment comparisons....
Source: International Clinical Psychopharmacology - May 31, 2018 Category: Psychiatry Tags: Short Communication Source Type: research

Health service utilization and medical costs among patients with schizophrenia receiving long-acting injectable risperidone versus oral risperidone: a nationwide retrospective matched cohort study in Taiwan
The aim of the nationwide retrospective matched cohort study was to evaluate health service utilization and medical costs between patients with schizophrenia who received long-acting injectable (LAI) risperidone and those who took risperidone orally. Data were sourced from the 2008 to 2013 Psychiatric Inpatient Medical Claim Dataset in Taiwan. The sample selection process was performed by propensity score matching. Finally, there were 691 patients in the exposed cohort and 1382 patients in the unexposed cohort. Each patient was individually followed for a 1-year period. Two-part models and generalized estimating equations ...
Source: International Clinical Psychopharmacology - May 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research

Trends in pharmacological emergency treatment of patients suffering from schizophrenia over a 16-year observation period
Patients suffering from schizophrenia are often treated in locked psychiatric units because of psychomotor agitation, hostility and aggressive behavior, or suicidality. Because of legal conditions, investigations on these acutely ill patients are difficult, and many studies do not represent ‘real-life psychiatry’. This retrospective survey was conducted at the Department of Psychiatry, Psychotherapy and Psychosomatics of the Medical University, Innsbruck, Austria. Data were collected from the records of all adult inpatients suffering from a schizophrenia spectrum disorder according to the International Classification o...
Source: International Clinical Psychopharmacology - May 31, 2018 Category: Psychiatry Tags: Original Articles Source Type: research